Second Year

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

Clinical Practicum

Upper-level (i.e., second- and third-year) practicum placements, called "clinical externships," provide our students with in-depth experience conducting closely supervised psychotherapy and, as indicated, advanced assessment.

The PsyD program also operates its own in-house Clinic, The Center Clinic. Through the Clinic, our students serve the local community, including the George Washington University community, by providing adjusted fee psychotherapy and assessment services to children, adults, couples and families. Rising second-year students are also matched to an Affiliate Site. Affiliate Sites are schools or community agencies with which the Clinic enters into a partnership. There are three types of settings: child, adult, and testing.

By taking advantage of the alliances that exist between the PsyD program and several dozen public and private agencies in the greater Washington area, PsyD students have the opportunity to work with a diverse patient population in a variety of practicum settings throughout their three years in the program.

Each second-year Center Clinic extern is expected to build a caseload of 4-6 hours of patient contact weekly. It is generally expected that externs will spend 4-6 hours at their Affiliate Site. These numbers, however, vary by site. In general, externs should have 2-3 psychotherapy hours and 2-3 hours for administrative requirements and/or team meetings at the site. 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.

Assessment Practicum

Each second-year clinic extern is expected to administer, score, and write an integrative report for four comprehensive (cognitive and emotional functioning) batteries by the end of the clinic year. Testing cases are assigned in team or by supervisors. Failure to complete four batteries may result in an extern being ineligible to sit for comprehensive exams. 

A one-credit assessment practicum will be required of second year students to ensure learning 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.  

Intake Interviews

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 the Coordinator 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 his or her 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 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.  

Initial Treatment Notes

The beginning of treatment at the Clinic is best viewed as an extended evaluation. That is, it is a period of time during which the extern elaborates upon information gathered during the intake in order to: 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; assess in greater depth the patient’s compromise formations, ego functioning, object relations, attachment style, and/or sense of self; make inferences about aspects of the unfolding relationship, including: the patient’s transference(s), countertransference reactions by the therapist, and the therapeutic alliance.

Provide additional, more specific, or tailored treatment recommendations. This might include psychiatric consultation, group therapy, psychological assessment, or referral out of the Clinic.

The diagnostic study is the format in which the extern presents his or her understanding of the patient though supervision, course work, and session material. It offers a concise summary and explanation of the patient’s problem as well as provides recommendations for treatment.  

Treatment Team

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.   

The purpose of the treatment team is to discuss intakes and assess the Clinic’s suitability for treatment of a prospective patient.   Risk factors are evaluated and a risk-management plan developed, if necessary. Diagnostic questions are raised and/or clarified and specific areas identified in which further study may be necessary. Indications and contra-indications for psychiatric evaluation, psychological testing, group therapy, or other treatment modalities are discussed.  

The treatment team also provides a forum to address administrative or organizational issues and concerns. All questions regarding the Clinic, Affiliate Site, supervisors, or paperwork should be addressed in a team meeting.

The treatment team is also designed to prepare students for presenting clinical material in professional settings.  

Crisis Intervention

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. Pager duty is one week long. A faculty member is always “on-call” for supervision in an emergency situation.  

Peer Consultation

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