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Mark Nicolas

Educational and supervisory decision aid

Supervised Helping Observation Record

Use observed behavior, reflection, and supervisory judgment. This tool has no numerical score and has not been validated as a psychometric measure.

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Record context

Observed behavior

Follows instructions

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Maintains assigned role

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Protects confidentiality

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Recognizes changes

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Communicates concerns promptly

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Does not independently expand scope

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Tolerates periods of inactivity

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Does not make themselves central

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Uses appropriate language with participants

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Respects participant autonomy

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Maintains boundaries

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Asks appropriate questions

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Receives feedback

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Recognizes when they do not know something

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Demonstrates reliability

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Remains regulated around participant distress

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed
Uses supervision

Current observation or determination

○ Consistently observed ○ Usually observed ○ Developing ○ Concern requiring intervention ○ Not yet observed

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