Cognitive Behavioral Institute of Albuquerque

Clinical and Postdoctoral Fellowship Performance Evaluation Form

PRIVATE AND CONFIDENTIAL – FOR SUPERVISOR AND TRAINEE ONLY

Assessment, evaluation, and diagnosis:

Trainee makes optimal use of scientifically rigorous psychological and personality theory to structure and organize observations of patients’ self-reports, historical data, and current behavior.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee formulates and tests hypotheses both systematically and opportunistically.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee is aware of his or her own limitations in training and experience, and seeks supervision or referral as indicated.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Diagnoses are adequately supported by criteria and are carefully selected to minimize harm while maximizing therapeutic utility.

Needs remediation (specify) Could use attention Adequate Better than Adequate

 

Case conceptualization:

Trainee continually refines hypotheses about patients’ most important learning needs within a developmentally, culturally, and interpersonally appropriate context.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Patients are understood to be theorists of their own environments and internal resources.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee seeks to understand as clearly as possible both the functionality and dysfunctionality of patients’ theories.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee routinely invites patients to formulate and discuss their own strategies for increasing their comfort and function.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Using expert judgment on behalf of patients’ long-term best interests, trainee independently formulates optimal emotional learning goals, philosophical learning goals, and skill learning goals for the patient, and Trainee remains able to articulate these goals, seeking the patient’s agreement, at all times.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee uses case conceptualization transparently and collaboratively as a therapeutic learning task.

Needs remediation (specify) Could use attention Adequate Better than Adequate

 

Selection of evidence-based treatments:

Trainee selects treatment tasks based on the individualized case conceptualization, with careful consideration of the empirical status of the treatments selected and not selected.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee shows adequate understanding of the mechanisms underlying empirically-supported treatments, and is able to effectively customize these treatments to the specific needs of each patient.

Needs remediation (specify) Could use attention Adequate Better than Adequate

 

Utilization of the therapeutic alliance:

Trainee continually reviews agreements with patients about the goals of therapy and the tasks used to pursue those goals.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee is able to articulate his or her case conceptualization in ways that encourage the patient to provide feedback and functional refinement of the shared conceptualization.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee encourages and reinforces each patient’s ability and willingness to become his or her own best therapist.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee prioritizes safety and handles patient crises effectively while continuing to pursue patients’ central therapeutic learning goals.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee is able to make optimal use of ruptures in the therapeutic alliance as therapeutic learning opportunities, in explicit accordance with the shared case conceptualization.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee is able to disagree with patients about the goals and tasks of therapy, and is able to explicitly refuse to pursue non-therapeutic goals.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee custom-designs cognitive-behavioral interventions using patients’ own language, constructs, and memorable learning experiences.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee is able to identify and remediate his or her own counter-therapeutic emotional reactions, including counter-therapeutic processing of irritation, anxiety, or affiliation.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee is increasingly able to use his or her emotional reactions in furtherance of the goals and tasks of therapy.

Needs remediation (specify) Could use attention Adequate Better than Adequate

 

Adequacy of documentation:

Progress notes and other documentation is adequate to establish the diagnosis, the treatments selected, the patient’s response, and meets state and federal requirements.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Documentation shows sensitivity to privacy concerns, and only necessary information is documented.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Documentation is as brief and concise as possible under legal and ethical requirements.

Needs remediation (specify) Could use attention Adequate Better than Adequate

 

Collaboration and consultation:

Trainee makes optimal use of other Institute staff in assessment, case conceptualization, treatment, and utilization of the therapeutic alliance.

Needs remediation (specify) Could use attention Adequate Better than Adequate

Trainee participates as a reliable resource on a highly collaborative, mutually supportive team.

Needs remediation (specify) Could use attention Adequate Better than Adequate