Potential Agencies. Sincerely, Traci Lilley, LCSW Associate Director and Director of Field Education

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To: Potential Agencies Thank you for your interest in exploring the possibility of becoming an affiliated agency for internship placement of graduate students in the LSU Master s of Social Work Program. New and enthusiastic supervisors and agencies are always welcome! Once we receive your Affiliation Application, we will contact your agency to schedule a site visit. We look forward to meeting with your agency. Enclosed you will find an agency application form and the course objectives for the first year and second year placements. In order for an agency to become an internship placement, a few basic requirements should be noted for both the agency and the supervisor: The Supervisor: 1) Assignments given by the supervisor to the intern must coincide with the objectives of the field course in which the student is enrolled. 2) A LCSW must be available, either on-site or off-site, to provide a minimum of one hour per week of direct supervision. 3) New supervisors must attend an orientation workshop held at the end of the summer. 4) A current resume of any person(s) providing supervision to the intern. The Agency: 1) The agency must complete the application for affiliation form. 2) Agencies are required to be non-discriminatory in personnel practices and services delivery. 3) The agency administrator or director must be willing to release the supervisor to attend at least one supervision workshop per year. 4) The educational opportunities available at the agency must be broad enough to meet the objectives of the field course in which the student is enrolled. 5) The agency must allow the supervisor adequate time (minimum of one hour per week) to devote to the supervision and education of the intern. Once we receive your completed application, we will be contacting your agency within a few weeks to arrange a site visit and initiate the University-Agency contract. If you have any questions, please feel free to call our office. We look forward to learning more about your agency, and to the rich learning opportunities your agency will offer our students. Sincerely, Traci Lilley, LCSW Associate Director and Director of Field Education

I. IDENTIFYING INFORMATION: Date: LSU SCHOOL OF SOCIAL WORK AGENCY APPLICATION FOR AFFILIATION Agency Name: Official Agency Name (if different than applying agency): Physical Address: Preferred Mailing Address (if different than physical): City: State: Zip: Phone #: Fax#: E-mail: Website Address: Director of Agency: Director of Social Work: Contact Person: Has you agency been affiliated with the MSW program at LSU in the past? Yes No If yes, please list dates and reason for inactive status? Number of available student placements: Semesters you are able to accept students (check all that apply): Fall Spring Summer Single(2 days/16 hours week) Double Block (12weeks/40 hours a week) II. AGENCY DESCRIPTION: Describe the purpose and philosophy of your agency (attach brochure if applicable).

III. SERVICES AND PROGRAMS: What services does your agency provide? What is its mission? What intervention modalities are used? Describe any outreach the agency does in targeting particular populations (attach brochure if applicable). IV STAFF: Please describe the agency's staff and administrative personnel in terms of discipline, size, ethnicity, race, gender, educational background, etc. How are disciplines organized in relation to each other? Are there particular functions served by social workers? Or by other disciplines? V. STUDENT INVOLVEMENT: After reviewing the Internship Objectives (enclosed in packet), Describe how you envision students fitting into your agency. What needs would they meet in your agency? What are the possible training opportunities for LSU Work Students? Give a brief outline of how you would expect to train LSU students (including the required 1 hour per week of supervision), and any possible educational opportunities, such as seminars, consultations, etc. If you have already identified potential supervisors, please include names and attach current resume on each. Indicate how your agency supports the student supervisory function (i.e., are supervisors given adequate time for supervisory responsibilities per student?)

VI. Directions to Agency Please include a map or detailed instructions to your agency from LSU in Baton Rouge. VII. STIPENDS: The School welcomes stipends that affiliated training centers can offer students during the placement period. Please describe any existing or potential sources for student stipends. VII. CONTACT INFORMATION If your agency or contact person is unavailable during the summer months, please list alternative contact information or instructions: Address: Phone#: Special Instructions: Signature Date

FIELD EDUCATION COMPETENCIES DEVELOPMENTAL CONTINUUM The field education competencies for all four required field courses are developed on a skill continuum, and represent a range of skills from foundation knowledge to advance competency to prepare students for master level direct social work practice. The progression is based on a competency developmental model beginning with Pre-Competence (SW7007) then Emerging Competence (SW7008) to Competence (SW7502) and finally Advanced Competence (SW7503). Although the goal is to master each competency, the progression is highlighted in learning activities starting in the foundation field courses and continuing through the advanced field courses. Below are the nine major competency areas outlined by CSWE Educational Policy and Accreditation Standards (2015): I. Demonstrate Ethical and Professional Behavior Competency II. Engage Diversity and Difference in Practice Competency III. Advance Human Rights and Social, Economic, and Environmental Justice Competency IV. Engage In Practice-informed Research and Research-informed Practice Competency V. Engage in Policy Practice Competency VI. Engage with Individuals, Families, Groups, Organizations, and Communities Competency VII. Assess Individuals, Families, Groups, Organizations, and Communities Competency VIII. Intervene with Individuals, Families, Groups, Organizations, and Communities Competency IX. Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities Note: Client may be defined as individual, family, group, or community. Learning samples to distinguish foundation and advanced activities included in sample. FOUNDATION SW7007/7008 The field internship sequence exposes students to a wide variety of social work experiences and allows them to integrate and apply academic coursework in a field setting under the guidance and direction of a field supervisor. The Foundation Internship I and Foundation Internship II courses establish a beginning practice frame of reference for a range of practice fields and settings. They provide practical field experience in developing beginning competence to work with various size systems, individual, family, group, organizations, and communities as well as reinforce the student s self-identification with the profession. SWSW7007 affords the opportunity for students to develop skills and knowledge to support the programs foundation generalist focus. Beginning Knowledge Student will demonstrate beginning understanding Emerging Competence Student will develop beginning competency ADVANCED SW7502/SW7503 The advanced internship sequence expands and deepens the students knowledge and professional abilities with respect to the theoretical perspectives, empirical evidence, and practice methods and skills necessary to provide direct social work services to diverse client populations within a range of human service agencies. Building upon the overall framework for direct practice developed in the first year Foundation courses, advanced students will be oriented to a broad range of fields of practice for students to develop mastery of the skills, knowledge and values for advanced competency in agency settings. Advanced Internship I and Advanced Internship II afford the opportunity to prepare graduates to deliver highly professionalized, culturally competent social work services to diverse client populations within a range of practice fields and settings. Competence Student demonstrates competency Advanced Competence Student consistently demonstrates advanced competency I. Demonstrate Ethical and Professional Behavior Competency Social workers understand the value base of the profession and its ethical standards, as well as relevant laws and regulations that may impact practice at the micro, mezzo, and macro levels. Social workers understand frameworks of ethical decision-making and how to apply principles of critical thinking to those frameworks in practice, research, and policy arenas. Social workers recognize personal values and the distinction between personal and professional values. They also understand how their personal experiences and affective reactions influence their professional judgment and behavior. Social workers understand the profession s history, its mission, and the roles and responsibilities of the profession. Social Workers also understand the

role of other professions when engaged in inter-professional teams. Social workers recognize the importance of life-long learning and are committed to continually updating their skills to ensure they are relevant and effective. Social workers also understand emerging forms of technology and the ethical use of technology in social work practice Ability to make ethical decisions by applying the standards of the NASW Code of Ethics, relevant laws and regulations, models for ethical decision-making, ethical conduct of research, and additional codes of ethics as appropriate to context Ability to use reflection and self-regulation to manage personal values and maintain professionalism in practice situations Ability to demonstrate professional demeanor in behavior; appearance; and oral, written, and electronic communication Develop skills is using technology ethically and appropriately to facilitate practice outcomes Uses supervision and consultation to guide professional judgment and behavior II. Engage Diversity and Difference in Practice Competency Social workers understand how diversity and difference characterize and shape the human experience and are critical to the formation of identity. The dimensions of diversity are understood as the intersectionality of multiple factors including but not limited to age, class, color, culture, disability and ability, ethnicity, gender, gender identity and expression, immigration status, marital status, political ideology, race, religion/spirituality, sex, sexual orientation, and tribal sovereign status. Social workers understand that, as a consequence of difference, a person s life experiences may include oppression, poverty, marginalization, and alienation as well as privilege, power, and acclaim. Social workers also understand the forms and mechanisms of oppression and discrimination and recognize the extent to which a culture s structures and values, including social, economic, political, and cultural exclusions, may oppress, marginalize, alienate, or create privilege and power Ability apply and communicate understanding of the importance of diversity and difference in shaping life experiences in practice at the micro, mezzo, and macro levels Student presents themselves as learners and engage clients and constituencies as experts of their own experiences Ability to apply self-awareness and self-regulation to manage the influence of personal biases and values in working with diverse clients and constituencies III. Advance Human Rights and Social, Economic, and Environmental Justice Competency Social workers understand that every person regardless of position in society has fundamental human rights such as freedom, safety, privacy, an adequate standard of living, health care, and education. Social workers understand the global interconnections of oppression and human rights violations, and are knowledgeable about theories of human need and social justice and strategies to promote social and economic justice and human rights. Social workers understand strategies designed to eliminate oppressive structural barriers to ensure that social goods, rights, and responsibilities are distributed equitably and that civil, political, environmental, economic, social, and cultural human rights are protected. Ability to apply their understanding of social, economic, and environmental justice to advocate for human rights at the individual and system levels Student engages in practices that advance social, economic, and environmental justice IV. Engage In Practice-informed Research and Research-informed Practice Competency Social workers understand quantitative and qualitative research methods and their respective roles in advancing a science of social work and in evaluating their practice. Social workers know the principles of logic, scientific inquiry, and culturally informed and ethical approaches to building knowledge. Social workers understand that evidence that informs practice derives from multi-disciplinary sources and multiple ways of knowing. They also understand the processes for translating research findings into effective practice

Student uses practice experience and theory to inform scientific inquiry and research Ability to apply critical thinking to engage in analysis of quantitative and qualitative research methods and research findings Student uses and translates research evidence to inform and improve practice, policy, and service delivery V. Engage in Policy Practice Competency Social workers understand that human rights and social justice, as well as social welfare and services, are mediated by policy and its implementation at the federal, state, and local levels. Social workers understand the history and current structures of social policies and services, the role of policy in service delivery, and the role of practice in policy development. Social workers understand their role in policy development and implementation within their practice settings at the micro, mezzo, and macro levels and they actively engage in policy practice to effect change within those settings. Social workers recognize and understand the historical, social, cultural, economic, organizational, environmental, and global influences that affect social policy. They are also knowledgeable about policy formulation, analysis, implementation, and evaluation. Ability to Identify social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services Ability to assess how social welfare and economic policies impact the delivery of and access to social services Ability to apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice VI. Engage with Individuals, Families, Groups, Organizations, and Communities Competency Social workers understand that engagement is an ongoing component of the dynamic and interactive process of social work practice with, and on behalf of, diverse individuals, families, groups, organizations, and communities. Social workers value the importance of human relationships. Social workers understand theories of human behavior and the social environment, and critically evaluate and apply this knowledge to facilitate engagement with clients and constituencies, including individuals, families, groups, organizations, and communities. Student can apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks to engage with clients and constituencies Ability to use empathy, reflection, and interpersonal skills to effectively engage diverse clients and constituencies VII. Assess Individuals, Families, Groups, Organizations, and Communities Competency Social workers understand that assessment is an ongoing component of the dynamic and interactive process of social work practice with, and on behalf of, diverse individuals, families, groups, organizations, and communities. Social workers understand theories of human behavior and the social environment, and critically evaluate and apply this knowledge in the assessment of diverse clients and constituencies, including individuals, families, groups, organizations, and communities. Social workers understand methods of assessment with diverse clients and constituencies to advance practice effectiveness. Social workers recognize the implications of the larger practice context in the assessment process and value the importance of inter-professional collaboration in this process. Social workers understand how their personal experiences and affective reactions may affect their assessment and decision-making Ability to collect and organize data, and apply critical thinking to interpret information from clients and constituencies Student applies knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in the analysis of assessment data from clients and constituencies Ability to develop mutually agreed-on intervention goals and objectives based on the critical assessment of strengths, needs, and challenges within clients and constituencies Ability to select appropriate intervention strategies based on the assessment, research knowledge, and values and preferences of clients and constituencies

VIII. Intervene with Individuals, Families, Groups, Organizations, and Communities Competency Social workers understand that intervention is an ongoing component of the dynamic and interactive process of social work practice with, and on behalf of, diverse individuals, families, groups, organizations, and communities. Social workers are knowledgeable about evidence-informed interventions to achieve the goals of clients and constituencies, including individuals, families, groups, organizations, and communities. Social workers understand theories of human behavior and the social environment, and critically evaluate and apply this knowledge to effectively intervene with clients and constituencies. Social workers understand methods of identifying, analyzing and implementing evidence-informed interventions to achieve client and constituency goals. Social workers value the importance of interprofessional teamwork and communication in interventions, recognizing that beneficial outcomes may require interdisciplinary, interprofessional, and inter-organizational collaboration. Ability to critically choose and implement interventions to achieve practice goals and enhance capacities of clients and constituencies Ability to apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in interventions with clients and constituencies Ability to use inter-professional collaboration as appropriate to achieve beneficial practice outcomes Ability to negotiate, mediate, and advocate with and on behalf of diverse clients and constituencies Ability to facilitate effective transitions and endings that advance mutually agreed-on goals IX. Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities Social workers understand that evaluation is an ongoing component of the dynamic and interactive process of social work practice with, and on behalf of, diverse individuals, families, groups, organizations and communities. Social workers recognize the importance of evaluating processes and outcomes to advance practice, policy, and service delivery effectiveness. Social workers understand theories of human behavior and the social environment, and critically evaluate and apply this knowledge in evaluating outcomes. Social workers understand qualitative and quantitative methods for evaluating outcomes and practice effectiveness Ability to select and use appropriate methods for evaluation of outcomes Ability to apply knowledge of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks in the evaluation of outcomes Ability to critically analyze, monitor, and evaluate intervention and program processes and outcomes Ability to apply evaluation findings to improve practice effectiveness at the micro, mezzo, and macro levels