Clinical Training

 

professional psychology students Celeste Kelly

 

Students in the Professional Psychology Program receive clinical training throughout their time in the program, with responsibilities and opportunities for leadership increasing each year. The Center Clinic offers a hands-on learning environment, where students practice intake procedures, conduct interviews, build caseloads and more. Coursework also provides foundational knowledge in clinical training, and students have the ability to work with affiliate sites to diversify their clinical experiences. 

 


Orientation

Students attend orientation each year that they are in the program. Orientation is held every fall within the first two weeks of classes. During the orientation program, students meet faculty and fellow students, initiate contact with their advisor to plan a course of studies and anticipate and discuss issues particular to that year. Information and schedules for orientation week are provided early in the summer to incoming students.


Clinical Practicum

Students are required to complete a practicum during each year of study in the program. The practicum component, the core experiential learning element of the PsyD program, provides doctoral candidates with the opportunity to integrate theory and practice. Students participate in a practicum during every term of enrollment.

All students train in the program’s in-house clinic for their first two years in the program and may either continue in the clinic for their third year or choose an external site at which to fulfill the practicum requirement. If a student wishes to take on additional work outside of the required clinical work for the program, they should review this with their advisor to ensure work is properly structured.

 


Practicum Guidelines

First Year

The first-year practicum immerses students in the basics of psychological assessment and introduces students to the psychodynamic approaches to psychotherapy. First-year doctoral students receive hands-on experience administering, scoring, interpreting and writing reports involving both cognitive and personality assessments.

Towards the end of the first year and after the first course in psychodynamic psychotherapy, students begin their supervised experience in conducting psychotherapy in the Center Clinic.

Incoming first-year students are paired with more advanced students within the program to ease their transition into the community and provide a foundation for increased social and psychological support. Peer mentors are assigned during the summer, and mentors contact their mentee before classes begin in order to answer any questions.

Current students are available to incoming students to answer questions, improve their transition into the program and be a friendly face.

In the spring, first-year students observe an intake conducted by a clinic extern and then join the extern during the presentation of the case in a team meeting. Beginning in the summer, first-year students become second-year students who conduct intakes under observation of third-year consultants, present the cases in team meetings and write the intake reports.

Practicum labs are integrated into all assessment courses in the first year to promote the development of assessment interviewing, testing and interpretive skills. A variety of cognitive instruments are covered, and a variety of objective and projective personality instruments. Students are required to demonstrate basic assessment skills before being approved to conduct psychological examinations in the clinic. Students develop these assessment and interviewing skills during the Practicum in Clinical Skills (PSYD 8203) in the summer of the first year.

In the early fall of the first year, students begin training on how to conduct telephone screenings of prospective patients.

All students participate in a Group Relations Conference during their first year. The goal of this conference is to further understanding of the influence of group and organizational unconscious processes. The conference is experiential; students explore their thoughts, feelings and behavior while participating in small groups and a conference-wide group.


Second Year

In the second year of training, students serve as student clinical externs at the Center Clinic.

In their second and third years in the program, students are placed in clinical externships in the Center Clinic. Rising second-year students are matched to an affiliate site. Through these externships, students gain in-depth experience conducting closely supervised psychotherapy and advanced assessment.

Each second-year extern is expected to build a caseload of four to six hours of patient contact each week. The optimal disbursement of these hours would be to divide them evenly between the clinic and the affiliate site in order to provide different clinical experiences. These numbers, however, vary by site. In general, externs should have two to three psychotherapy hours and two to three hours for administrative requirements and/or team meetings at the affiliate site.

 

 

Each second-year clinical extern is expected to administer, score and write four comprehensive clinical assessment tests, known as psychological assessment batteries, by the end of the clinic year. Testing cases are assigned within the treatment team or by supervisors, and material covers cognitive and emotional functioning. Failure to complete four batteries may result in an extern being ineligible to sit for comprehensive exams.

All second-year students must complete a one-credit assessment practicum to demonstrate their knowledge of psychological assessment report writing based on synthetic understanding, conceptualization and interpretation of assessment interview and testing data. Emphasis will be placed on development of reports that answer referral questions.

The primary task of the intake coordinator is to identify a circumscribed presenting problem, detail the history of the presenting problem and gather other pertinent information that allows them to evaluate danger to self or others, impulsivity, drug/alcohol use and forensic history. The coordinator should gather enough information to make a preliminary, descriptive diagnosis as well as convey the patient’s mental status and day-to-day functioning.

After an intake, the coordinator presents the case during their team meeting. If the team determines that the clinic is a suitable place for the patient to receive some type of treatment, the postdoctoral fellow assigns the case for diagnostic study based on extern availability and patient needs. The extern assigned to the case contacts the intake coordinator to receive a copy of the intake report and discuss the case.

If the team determines the patient needs a higher or different level of care than the clinic can provide, the coordinator is responsible for providing a referral to an external treatment provider.

The intake coordinator is responsible for the clinical care and management of the patient until an effective transfer has been made to the assigned clinician or until a referral out has been made. The intake coordinator writes a report and submits the first draft to his or her postdoctoral fellow team shortly after the intake appointment.

The beginning of treatment at the clinic is best viewed as an extended evaluation; the extern helps to elaborate upon information gathered during the intake by assessing the patient in greater depth. The initial treatment can help the extern arrive at a richer understanding of the patient’s presenting problem by:

  • tracing salient issues from the present problem through his or her personal history,
  • assessing in greater depth the patient’s compromise formations, ego functioning, object relations, attachment style and/or sense of self, and
  • making inferences about aspects of the unfolding relationship, including the patient’s transference(s), countertransference reactions by the therapist and the therapeutic alliance.

Externs also provide additional, more specific or tailored treatment recommendations. This might include psychiatric consultation, group therapy, psychological assessment or referral out of the clinic. The extern then presents his or her understanding of the patient in a concise summary with an explanation of the patient’s problem and provides recommendations for treatment.

Clinic externs are divided into multiple treatment teams. Each team is typically co-led by a licensed psychologist and a postdoctoral fellow. Teams meet weekly and attendance is mandatory, as participation prepares students for presenting clinical material in professional settings. Treatment teams discuss intakes and assess the clinic’s suitability for treatment of a prospective patient. They also provide a forum to address administrative or organizational issues and concerns.

Early in the second year, a training seminar is held to prepare externs for responding to crisis phone calls. All second-year clinic externs are responsible for being “on call” at some point in their training. Being on call requires the assigned extern to carry a cell phone at all times. Second-year externs rotate responsibility for the emergency pager on a weekly basis. A faculty member is always on call for supervision in an emergency situation.

Second-year students meet with a third-year peer consultant at a frequency and duration to be determined by the consultant.

Third Year

Rising third-year students have the option of either continuing their training in the clinic or pursuing an extramural externship outside the clinic.

Third-year externs may build a weekly caseload of six to eight hours. Generally, rising third-year externs are given preference on their affiliate site placement. The optimal disbursement of these hours would be to divide them evenly between the clinic and the affiliate site in order to provide different clinical experiences. Third-year students who remain in the clinic also hold leadership positions as peer consultants.

The third-year extramural externship option is completed alongside the third-year curriculum requirements and is separate from the full-time internship requirement for all students in the fourth year of study.

Students who choose this option leave the clinic and receive all training and supervision at the new externship site. The application process is not under the purview of the clinic, though some resources may be provided to externs.

The Professional Psychology Program office keeps an updated externship book, in which you will find information on the approved sites and their individual application requirements, and application due dates. To assist in continuity of care in the Center Clinic, you are required to inform the associate clinic director of your plans to obtain a third-year extramural internship. This notice should reach the clinic director at least three months prior to your departure from the clinic.

Most externship sites require two to three letters of recommendation. Careful consideration should be given to this piece of your application, and equally careful consideration should be given to the people you ask for these letters. Give your recommenders enough time to respond to your request.

Most sites in the area offer externships that adhere to the APPIC guidelines. In particular, most externships are offered on a specific day and at a specific time. It is your responsibility to inform yourselves about this information. Also, there are local rules developed by area-wide clinical programs. Externships should not exceed 16 hours per week and there must be one hour of supervision for every three clinical contact hours.

Our program and university require that we enter into a formal externship Affiliation Agreement with each extramural externship and affiliate site. So that this procedure occurs in a timely fashion, please inform the program as soon as you have accepted an externship so that the process can be initiated well in advance of the beginning of your externship.

Once you have accepted an externship, you are no longer eligible to see patients in the clinic. However, you will be required to attend a third-year practicum. You will not be required to attend clinic team meetings. The externship you accept will provide you with the remainder of your clinical training other than that of your regular academic requirements. If you have questions or concerns about this, please direct your inquiries and comments to the clinic director.

Fourth Year

Having completed the academic curriculum, students complete a year at a full-time internship.