Practicum Experience Time Log and Journal Template

Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

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Time Log


· Develop diagnoses for clients receiving psychotherapy

· Evaluate the efficacy of existential-humanistic therapy for clients

· Analyze legal and ethical implications of counseling clients with psychiatric disorders

· Analyze clinical supervision experiences

· Analyze how nursing and counseling theories guided personal practice in psychotherapy

· Analyze goals and objectives for personal practicum experiences

· Analyze the impact of psychotherapy on social change

List the objective(s) met and briefly describe the activities you completed during each time period.

You are encouraged to complete your practicum hours on a regular schedule, so you will complete the required hours by the END of WEEK 11.

Time Log


Dates Times


Total Hours for This Time Frame Activities/Comments

Learning Objective(s) Addressed
Total Hours Completed:

Journal Entries

· Include references immediately following the content.

· Use APA style for your journal entry and references.

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