The internship provides extensive training in each of the areas of competency required of the interns.
Intern Activities and Program Requirements
Intern Activities and Program Requirements:
Requirements of the training program and the associated training experiences are designed to support the interns’ learning by providing the experience necessary to achieve learning, with clear messages about expectations for trainee performance.
Assessment and Psychotherapy
Philosophical understanding of assessment. The assessment component of our training program is influenced by Steven Finn’s model of Therapeutic Assessment, which emphasizes the use of testing to create a positive and therapeutic experience for the client. Assessment is seen as the broad method by which psychologists determine the nature of the problems afflicting clients and arrive at a sound treatment plan. Interns receive experience in assessment through three basic components: clinical interviews (walk-in and intake), integration of testing with the intern’s own clients, and the administration of multitest batteries.
At the USDCC, quick, accurate and thorough assessment and referral/disposition of all new clients in need is a priority, reflecting our value of service to the university community. Consequently, all clinical staff members participate on a regular basis in some form of assessment.
Initial assessment and clinical interviewing skills are obtained through two activities: participating in the USDCC Walk-In system, and providing intake interviews. Interns are expected to allocate two to three hours per week for walk-in. They are provided didactic training for this activity during orientation. Consistent with the developmental nature of our training, interns begin assuming walk in duties with a designated back-up supervisor available at all times. Typically, interns will begin by observing one or more walk in sessions, then by performing one under observation, then will do walk-ins with the designated supervisor available.
Intake skills are also an important aspect of interns’ training, and are supervised by primary supervisors. The number of intakes per week varies depending how many clinical openings the intern has.
In addition to clinical interviewing, depending on the needs of any given client, different methods may be used in collecting the data needed for a sound evaluation. While for the majority of our clients, intake interviewing supplemented by client information forms, the AUDIT and the OQ-45 is adequate, some clients benefit from additional testing efforts. Consistent with the practitioner-scholar model, psychological testing supported by research may be incorporated into clinical work. Some clients benefit from occasional integration of testing data into ongoing clinical work. The occasional use of such data is role modeled by many staff psychologists.
Finally, when appropriate, clients may be referred for more comprehensive testing including multitest batteries. With the university population, these batteries generally take the form of either personality testing, learning disability screening, or some combination of both.
Testing requirements. Our program aims to expose interns to the use of psychological testing as one method of assessing clients. To ensure that a basic level of exposure is achieved, a minimum amount of testing is required. This standard is designed to be flexible, allowing for interns with different training goals to meet the standard in different ways while still covering the broad range of client concerns typically seen at a Counseling Center. Throughout the course of the year, interns are required to incorporate psychological testing into their work with at least six of their own clinical cases and at least three multitest batteries, typically referred by other staff. Interns are strongly encouraged to develop a broad assessment experience that may include a variety of different instruments over the course of the year.
To prepare them for this training experience, interns participate in assessment seminar, which has biweekly meetings throughout the academic year. The assumption is made that graduate students who have progressed to internship have received basic instruction on cognitive and personality assessment. Therefore, the focus of the seminar is a review of testing principles, integration of results, and report writing, rather than on exhaustive teaching of each instrument. More time is devoted to instruments interns are less likely to have learned comprehensively in their graduate programs. For interns with little exposure to assessment, additional readings will be required, and extra consultation is available; such interns will often be counseled to utilize at least part of their professional development time to learning assessment skills and techniques.
Individual, couple and family counseling and psychotherapy. Interns spend the bulk of their time in direct contact with clients. Depending on what training experiences they have selected on their service contract, they have between 12-18 client contact hours per week. If some of these cases are seen on a biweekly basis, their caseload may reach twenty active clients. Most client work will be short-term in nature. Interns may elect to take on one or two long-term clients and are encouraged to keep in mind their training goals as well as the USDCC’s policies regarding length of treatment. Predoctoral interns use webcams to record sessions, with permission of clients, for the purposes of clinical supervision.
Crisis coverage and training. Formal crisis training is achieved with approximately 8 hours of didactic training per year coupled with mentoring in after hours crisis coverage. During the middle to the end of the first semester, interns are paired with a psychologist, typically their primary supervisor. The intern will carry the after hours emergency telephone, with the designated staff available by telephone for immediate consultation and backup. Interns will carry the after hours emergency telephone at least four weeks during the year.
While the Counseling Center does not provide mandated psychotherapy, we do provide mandated assessments. These assessments are required by the university in situations involving the potential of threat to harm of self or others and other mental health emergencies. As a component of the interns’ crisis training, they are trained to provide these assessments, and participate in them as required. Intern involvement in mandatory assessments takes place during the second semester of internship.
Group counseling and psychotherapy. Interns are required to co-facilitate a therapy group each semester. Groups will often be co-facilitated and supervised by a senior staff member. In some cases, groups are co-led by interns under supervision. One hour of supervision will be provided per week for this activity, often provided in half hour increments (half hour pre-group preparation, and half hour debriefing).
Academic probation clients. All staff members at the USDCC see clients referred to the Counseling Center because of having been placed on academic probation. In addition, at the beginning of the academic year before intern caseloads are busy, interns may have the opportunity to see a limited number of first and second year academic probation cases referred to the Center for Student Success (CSS).
Outreach and Prevention
Outreach and prevention are viewed as an integral part of a psychologist’s efforts in the university counseling center setting. Philosophically, we see outreach as meeting several needs for our population: providing prevention efforts and identifying students who would benefit from services in critical topical areas (e.g., eating disorders, substance abuse), recruiting and providing nontraditional services to underrepresented client populations, reaching beyond the Center’s walls to introduce students to the Counseling Center staff and destigmatize counseling services, and providing creative services in an efficient way to a larger body of students.
Interns’ training in outreach, similar to other areas, is sequential. An Outreach Seminar is offered during orientation to prepare interns for their outreach training experience. As part of this, interns will assess their current level of outreach skill, as well as any individualized training needs they might have in this area. During orientation, interns observe senior staff members conducting training programs for resident assistants. This gives interns exposure to varying presentation styles. Interns’ training in outreach will be individualized depending on amount of skill and experience they have in this area; some interns may be encouraged to present several times with more experienced staff, while others may be encouraged to present on their own earlier. In either case, interns’ outreach work will be attended at least twice, ideally once by the outreach supervisor and once by another staff member, to provide interns with support and feedback as they continue to develop their outreach skills. Ongoing consultation with the supervisor is also given on both a formal and informal basis to allow interns to develop outreach skills and to solidify confidence in their ability to provide psychological services within this modality.
Interns may also experience the opportunity to gain consultation experience by participating in university committees and/or consulting with campus agencies. These opportunities vary each year depending on interns’ interests and campus needs. Supervision of such activities is provided by the outreach supervisor or primary supervisor.
Interns are required to present a minimum of eight outreach programs each year in addition to participating in university committees; most interns present more frequently than this. Interns are encouraged to develop a well-rounded experience which may include participating in a variety of different forms of outreach including psychoeducational workshops, committee work, introductions to counseling center services, screening days, or other activities. Although many (though certainly not all) interns experience some anxiety about the outreach training component, we have also found that skill and confidence quickly improve when interns volunteer early and actively in the year. To reach an optimal audience, many of our outreach workshops occur after-hours.
Cultural and Individual Differences and Diversity
An understanding of the impact of culture is integrated into every aspect of the work we do in direct services, training, scholarly activity and research. We define culture and diversity broadly, allowing our definition to encompass racial and ethnic differences, gender, sexual orientation, socioeconomic status, nationality, acculturation, religious affiliation, and ability status. Comprehensive understanding of the impact of culture is seen by our staff as an integral ingredient of competent psychological practice. Such factors are fully integrated into each aspect of our clinical work, as well as each aspect of the training program.
Our training in this area addresses knowledge, skills, and self awareness. Topics relevant to diversity are regular features of the didactic component of our trainings, in-services, and intern seminars. In addition, cultural factors are discussed in individual and group supervision formats, and assessment seminar. Outreach presentations and consultations are frequently provided to the campus community on diversity issues. Interns interested in targeting diversity issues in their outreach efforts should contact the CHWP supervisor. Skills are addressed through practice and individual and group supervision with diverse clientele, which may include individual or group work. Self awareness and skills are addressed in the biweekly Diversity Consultation experience.
In the past year, to enhance our interns’ experiences with diverse populations, we have recently added two external experiences. One of these involved providing outreach at a local agency that provides mentoring and tutoring to high school students from a culturally rich, low income San Diego neighborhood, to support their efforts to attend college. In our pilot experience last year, the intern group provided a stress management and burnout prevention workshop to their staff. In addition to this experience, two interns piloted a new optional summer rotation at a residential home for children (see description under optional rotations.)
Professional Identity
Because internship is the last formal aspect of an intern’s predoctoral training, we view the development of sound ethical knowledge and practice, professionalism, and the development of professional identity as a psychologist as integral to the training experience. In our view, this encompasses several components: ethics, deportment, self-awareness, professional judgment, responsible and timely record keeping, maintaining appropriate professional relationships, and emotional stability. These components are addressed through mentoring, supervision, modeling, and didactic training. When possible, we take interns to a Board of Psychology meeting to expose them to the decision making process and rules of the licensing board. Activity in professional organizations is encouraged by the agency, and is modeled by staff. Staff members strive to model self-care and to encourage interns to be aware of their limitations.
During the summer, when intern caseloads are low, interns are asked to take on at least one “summer project”, which typically involves assisting one or more USD Wellness Area staff members with a project. Past projects have included assistance with developing a template for interns and staff to use in screening for ADHD, providing supervision for an undergraduate student to use in creating passive programming in the residence halls, working with the Practicum Coordinator to create a practicum policies and procedures manual for the Counseling, the update of the center referral database, assistance to the Coordinator of Training in improving the Training Manual and designing the orientation schedule, developing an Excel spreadsheet future interns may use to track their hours, and assisting with the development of large-scale outreach projects. These projects may involve administrative, outreach, or clinical planning tasks, and vary each year.
Supervision
Supervision experiences are provided in two formats: the first, individual supervision with a practicum student from an APA-accredited program in clinical psychology, and the second in group supervision of undergraduate peer advisors.
Supervision of practicum. Interns have the opportunity to provide supervision to a masters level graduate student. To prepare interns for this experience, they are provided with a four hour supervision seminar, and with weekly supervision of supervision that includes review of session recordings of supervision. While the great majority of interns will leave our site having had this experience, there are times when it is not possible. Reasons for this could include staff judgment that the intern is not ready to provide supervision; the intern is on a remediation plan and other activities take priority; or the practicum student leaves the program early.
Supervision of peer advisors. Interns have the opportunity to provide training and supervision to peer advisors. Supervision is conducted in small groups of no more than four peer advisors. Interns are encouraged to provide supplemental didactic training to the peer advisors as needed.
Optional Training:
In addition to the training requirements described previously, interns have the option of completing one or more rotations in designated areas of interest. Interns may complete one rotation per semester. Please note that each rotation is not necessarily available each semester. Rotations are typically about two to four hours per week and include both experiential activities and supervision; they may also include didactic training. Current rotations that have been formally developed include:
Career Counseling. This rotation takes place at USD’s Career Services office. This rotation is developmental in nature; interns move from observing seasoned career professionals intervene, to cofacilitating, to providing career counseling on their own. This rotation is three – four hours per week for a semester, including 2 – 3 hours per week of client contact and one hour per week of supervision.
Mindfulness. This is an internal rotation taking place at the Counseling Center. Its goal is to provide specialized training to interns with an interest in integrating mindfulness approaches within psychotherapy. This rotation is three – four hours per week for a semester, usually including a mindfulness group, at least one client, and one hour per week of supervision.
Alcohol and Other Drug Assessment and Education. Interns selecting this rotation will co-facilitate psycho-educational groups for students who are mandated to seek services, due to an alcohol violation. Additional opportunities may include individual AOD assessments, working with peer educators, and providing outreach to the USD community. This rotation is expected to be four hours per week. This rotation will be supervised by a psychologist from the Center for Health and Wellness Promotion. We are planning to pilot this rotation Spring 2012.
Disability Services. During this rotation interns are exposed to the workings of a disability services department, gain experience coordinating services for, working with, and advocating for students with disabilities and their families. There are also opportunities for administering and interpreting learning disability screening measures.
External rotations. During the summer, when clinical loads at the USDCC are lower, we have begun working with a community agency to offer a 4-6 hour per week, approximately 8 week rotation at a local residential home for children and adolescents. During the first year, interns provided group therapy to adolescents.
Supervision Experiences:
Individual Supervision is provided to enhance interns' clinical skills. Given that individual psychotherapy is interns' primary clinical duty at the USDCC, supervision is viewed as an integral part of the training experience. In order to provide exposure to varying theoretical styles and approaches of supervisor, supervision rotates midyear.
Consultation Group is designed to allow interns to receive and provide case consultation in a setting that includes about three staff members, one to two interns and a practicum student. In this setting, new intakes are presented and staffed, and ongoing cases are discussed. Interns receive exposure to the clinical work of different staff and have the opportunity to receive feedback from staff not currently supervising them. Interns are also encouraged to give feedback to staff presenting cases; this is a primary setting in which interns begin to view themselves as colleagues as well as trainees.
Supervision of Group Therapy is provided for each group the intern facilitates. This experience facilitates the intern's development of effective group therapy skills. One hour of supervision per group is typically provided, often in the form of one half hour of group preparation and one half hour of post-group discussion.
Consultation with Coordinator of Training occurs weekly. This group supervision session is held with the Coordinator of Training and the three interns. Within this group, emerging issues in the internship are processed, professional development issues discussed, and clinical consultation provided.
Diversity Consultation. These meetings provide interns with an opportunity to develop a greater sense of self and cultural awareness, and how this impacts their capacity to integrate issues of diversity into their work and their professional identities as psychologists.
Assessment Consultation is scheduled biweekly. The focus of this experience is clinical consultation regarding the interns’ use of testing with their clients. Additional consultation is available as needed, and interns are also encouraged to discuss their testing experiences in primary supervision and consultation group.
Supervision of Supervision occurs weekly for interns supervising practicum students, and allows interns to process their supervision experiences.
Outreach provides ongoing consultation and mentoring in outreach for intern activities. This begins weekly; frequency is adjusted as interns develop more skill and competence.
Rotation Supervision is provided for interns completing a rotation.
Additional supervision and consultation is available from all staff as needed.
Didactic Training:
