Cognitive Behavioral Institute of Albuquerque
Clinical and Postdoctoral Fellowship Written Performance Evaluation Form
PRIVATE AND CONFIDENTIAL – FOR SUPERVISOR AND TRAINEE ONLY
This written evaluation form is provided to all Fellows during their orientation, and is administered in writing semiannually, with the Fellow completing it for self-evaluation, and the Supervisor completing it for Fellow evaluation. Fellow and Supervisor meet to compare their respective evaluations, and the Fellow is given a copy of the Supervisor's evaluation in written form to keep for their records. If the number or severity of "Needs Remediation" or "Could Use Attention" scores warrant it, in the judgement of the Supervisor, the Supervisor may recommend a formal Remediation Plan as described in our Due Process procedure. This is a clinical and training judgement by the Supervisor, as there is no set score than can automatically trigger this recommendation.
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