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INDIVIDUAL PROCESS RECORDING
This is an educational tool used in field instruction and not in agency
records. It is the property of the student and should
be handled confidentially. All identifying information of clients should
be disguised (For example: use the client’s initials
instead of their name).
Your Name: ___________________ Agency: _____________________
Date of Contact: _______________ Length of Contact (in minutes):____
Type of Contact: Individual Nature of Contact: In Person
Family Telephone
Collateral Telehealth
Initial Other _______ Other
On-going
Location of contact (home visit, agency, , etc.): ________________
Language(s) of interview: ___________________ Was an interpre
ter used? _______
Brief Description of
Client(s) (age, gender, identity, race, religion, and other relevant
information):
What are the
short-term goals with this client?
What are the
long-term goals with this client?
Purpose of this
particular contact (What did you want to achieve in this contact?):
Pre-engagement How
did you prepare for this meeting with the client. What do you know about the
client and their
situation? What is
your empathic understanding of the client?
Verbatim:
Write up a verbatim
account with dialogue of an interview/session with a client as soon as possible
after the meeting. Any
use of note-taking
in your session should be discussed in advance with our field instructor, who
can provide further
guidance. Write
about an interaction that was problematic, difficult, or anxiety-provoking
since these will provide an
excellent learning
experience for you.
Account of
Interview/Session (after meeting)
**Add pages as
needed to continue dialogue**
Interview Content
Verbatim
Student ‘s Feelings
Student’s Thoughts
and Analysis
Practice skills and
rationale (or
applied theory)
Field Instructor’s
Comment
1.
ASSESSMENT OF INTERVIEW
Reflecting on this
interview did you think it well or were there challenges you encountered?
Please describe:
2. EVALUATION:
Evaluate your
interactions with the client and explain the interventions used (refer to
theories learned, e.g., crisis
intervention,
solution-focused, cognitive-behavioral, etc.):
3. FUTURE PLANS:
What will you do
next?
4 Include 2-3 questions for Field Instructor below
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