Date of Evaluation (today)(Required)

Student Name(Required)

Agency Name(Required)

Site Supervisor(Required)

Site Supervisor Email(Required)

Additional Supervisor (optional)

The student's direct Art Therapy Supervisor at the practicum site.

Additional Supervisor Email

Practicum Start Date(Required)

(Anticipated) Finish Date

1. The student’s process of becoming acclimatized to the agency, clinic, or organization.(Required)

2. The student’s general aptitude for providing client services within the agency, clinic, or organization.(Required)

3. The student’s ability to establish rapport with clients.(Required)

4. The student’s ability to create and maintain a therapeutic environment.(Required)

5. Does the student demonstrate the necessary flexibility in the application of goals?(Required)

The student’s ability to establish goals and to follow through on these goals.

6. The student’s ability to maintain the therapeutic process over time.(Required)

7. The student’s handling of relevant agency paperwork.(Required)

8. The student’s ability to receive and integrate feedback.(Required)

9. From your perspective, does this student utilize art therapy activities effectively?(Required)

10. What changes would improve this practicum placement experience for another student

11. Further comments about this student.

Apply now for the Art Psychotherapy Diploma program