Counseling & Assessment Services Doctoral Internship in PSYCHOLOGY 2007-2008

Back to Table of Contents

CONTENT IN MORE DETAIL

• Intake Interview for Therapy/Counseling Clients
• Clinical Training Meeting
• Therapy/Counseling Caseload
• Client Population
• Psychiatric Consultation
• Psychological Assessment
• Report Writing
• Individual Supervision of Therapy/Counseling Caseload
• Family Systems Supervision of Therapy/Counseling Caseload
• Group Supervision of Assessment Caseload
• Flex Hour

Intake Interview for Therapy/Counseling Clients

The intake interview is the primary means by which prospective clients access services and interns develop their counseling/therapy caseload. A student may make an intake appointment either in person or by telephone. These appointments are scheduled by the receptionist who assigns clients the first available intake hour that fits their schedules. Interns and professional staff are responsible for regularly informing the secretary of their available hours. Unless contraindicated, the therapist who does the intake continues with the client, providing counseling, therapy, consultation, and/ or referral as needed.

Back to Table of Contents

To Top of Page

Clinical Training Meeting

All new cases are presented and discussed during the weekly clinical meeting. In this setting, the intake therapist reviews the presenting information and provides a brief history and initial formulation. The staff and interns then discuss the case from a variety of theoretical, clinical, and pragmatic perspectives. The second half of the clinical intake meeting is devoted to refining interns' understanding and use of diagnostic criteria for the range of disorders in the DSM-IV. Interns prepare and give presentations on pertinent topics of interest to clinical and counseling psychologists, as well as present psychotherapy cases for peer review and discussion.

Back to Table of Contents

To Top of Page

Therapy/Counseling Caseload

Interns are expected to schedule four hours per week for intake appointments. From their intakes, interns will generate a client caseload of 8-10 clients per week. While the counseling/therapy hours are designated to be between 8-10 clients per week, interns may carry more than ten clients at any given time, as some clients are seen less frequently than on a weekly basis. Although most clients are seen in the context of a short-term therapy model, interns are encouraged to carry a few long-term clients (about 20% of their caseload) for a broader training experience.

Back to Table of Contents

To Top of Page

Client Population

While most of the clients who request our therapeutic and assessment services are 18-22 year old Caucasian undergraduates, we also serve numerous students of color, graduate students, adult learners, and international students. Although most of our clients function reasonably well in their daily lives, a significant proportion present profiles which indicate high levels of distress and dysfunction. Consequently, interns have the opportunity to work with a variety of client concerns. While most of our work is with individuals, we also see couples and occasionally the children, parents, and siblings of clients as well. Some of the issues with which clients present include low self-esteem, separation difficulties, eating disorders, sexual abuse, substance abuse, family dysfunction, stress, depression, anxiety, and career indecision.

“The world breaks everyone  /  and afterward  /  some are strong  /  at the broken places.” Ernest Hemingway

Back to Table of Contents

To Top of Page

Psychiatric Consultation

Psychiatric consultation is available from Mental Health Services on campus. In most instances when psychotropic medication is prescribed, our staff and interns continue to provide psychotherapeutic services to the client while the medication regimen is monitored by the prescribing psychiatrist.

Back to Table of Contents

To Top of Page

Psychological Assessment

Approximately 50% of the predoctoral internship at CAS is dedicated to psychological assessments. Interns administer, score, and interpret various cognitive, psychological, personality, and educational measures in the service of Learning Disability and Attention-Deficit/Hyperactivity Disorder evaluations. Students present to CAS for assessments on their own accord or after being referred by a number of sources, including mental health practicioners, physicians, faculty, parents, and friends. Any student at the University of Massachusetts Amherst may be tested, including undergraduates and graduates, and clients range vastly in age, ethnicity, culture, and socioeconomic status. The evaluations are conducted by means of specialized assessment batteries, which may consist of measures such as the Wechsler Adult Intelligence Scale-III (WAIS-III), Woodcock Johnson-III (WJ-III) Tests of Achievement, Wechsler Memory Scale-III (WMS-III), Mini International Neuropsychiatric Interview (MINI-PLUS), Nelson-Denny Reading Test, Test of Language Competence (TLC), Comprehensive Test of Phonological Processing (CTOPP), Boston Naming Test, Rey-Osterrieth Complex Figure, Wisconsin Card Sorting Test, Test of Variables of Attention (TOVA), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), behavior rating scales, and a family interview.

Back to Table of Contents

To Top of Page

The brain is wider than the sky,  /   For put them side by side, The one the other will include  /   With ease, and you beside. Emily Dickinson

Back to Table of Contents

To Top of Page

Report Writing

As part of the assessment component of the internship training, interns assume primary responsibility for writing comprehensive psychological assessment reports. Within these reports, interns integrate test findings, historical information, psychological and personality findings, and other relevant information to support the diagnostic conclusions and recommendatons. Interns present this report and the findings of the evaluation to the student in a final consultation.

In addition to assessment reports, interns are expected to prepare therapy client intake reports, diagnostic reports, up-to-date treatment progress reports, and case summaries. Given the centrality of these activities to the quality of their professional work in both aspects of our program, report writing receives major emphasis in our training activities and is carefully monitored in both individual and group supervision.

Back to Table of Contents

To Top of Page

Individual Supervision of Therapy/Counseling Caseload

Supervision of each intern's therapy/counseling caseload is conducted on a regularly scheduled individual basis by licensed psychologists who are also credentialed as health service providers. Generally, each intern has one primary supervisor for the entire year but is actively encouraged to consult with other senior staff members as particular client needs arise. In addition, the individual supervisor is available throughout the week for informal consultation and support. Supervisory activities may include the use of audio and video tapes and case conferences.

“Staff provided a supportive and protected environment for learning counseling / short term psychotherapy skills. Also the training in assessment of learning disabilities was extensive, informative, and really helped me develop my skills in that area.” Former Intern

Back to Table of Contents

To Top of Page

Family Systems Supervision of Therapy/Counseling Caseload

This two-hour group supervision is provided weekly by a licensed family therapist. It is structured as a peer consultation and builds on the family and narrative theory presented during orientation. The format includes readings, live consultation, case presentations, and opportunities for self-reflection.

Case consultations are done as reflecting conversations. On a rotating schedule, interns present a case for which they want additional ideas. They can sit back (as if behind a one-way mirror) and listen as colleagues and supervisor have a conversation in which they reflect on what they heard in the presentation. After the team conversation, the presenting therapist is "invited back into the room" to reflect on the reflections. This is followed by a free flowing discussion. Reflections gathered early in the work often serve to expand the way in which the therapist conceptualizes or formulates the case. Those gathered later in the work tend to help the therapist through a place that feels "stuck."

These presentations, reflections, and reflections on the reflections are often video-taped and reviewed at a subsequent meeting in which the particular case is being updated. This re-viewing offers an opportunity not only to mark therapeutic progress, but to see what new ideas about the conversations emerge from this different perspective in time and space. In addition, the therapist can bring selected segments of the tape into subsequent sessions with the client (who has previously given permission for this possibility).

During the second semester, each intern is encouraged to participate in at least one live supervision experience with the team. In these sessions, the supervisor "interviews" the therapist about his or her work with the client - in the presence of the client who subsequently joins the conversation. After about twenty minutes, the therapist and client exchange places with the team members who have been listening to this conversation and who now have an opportunity to reflect with the supervisor on what they have heard. The final round of discussion occurs as the team returns to its listening position and the therapist and client return to continue their conversation with the supervisor. Here they have an opportunity to comment on any parts of the multiple conversations that have been "useful." (In reflecting conversation, we are looking to uncover threads of resourcefulness and possiblities, which can then be woven into ever thickening stories/ideas that are more hopeful and more liberating than the ones with which the client came.) The session ends with the acknowledgment that the conversation developed in this meeting will continue in subsequent conversations between the therapist and client.

“Therapy is, at heart, an intimate conversation, a participatory dialogic process consisting of nothing more and nothing less than talk” Virginia Goldner

Back to Table of Contents

To Top of Page

Group Supervision of Assessment Caseload

Group supervision of each intern’s assessment caseload is provided two hours per week. This supervisory group gives interns the opportunity to present case material (e.g., interview information, test findings, behavioral observations) which has not yet been formalized into a written report. Interns use this supervisory time to ask questions pertaining to test administration and scoring, to receive guidance with regard to the interpretation of particular test results, to receive feedback from other interns, to discuss qualitative aspects of the assessment process, and to react to their own experiences related to each case. This manner of interaction between the supervisor and the interns assists the interns in establishing the overall framework from which the psychological assessment report is to be written and also gives the interns an opportunity to reflect on the process of providing psychological assessments.

"Those who teach us inevitably teach themselves, since all learning flows through the medium of relationship. Our teachers bind us to them with their stories." Rachel Adler

" The staff treated me with the dignity and respect that they would afford a colleague, yet I was treated with the care and concern that was appropriate to my role as an intern. " Former intern

Back to Table of Contents

To Top of Page

Flex Hour

Interns meet with the training director for one hour each week. This time is used for multiple purposes. At least once per month (more if needed), this hour is used to talk about any issues, needs, or problems facing the interns that require the attention of the training director. At other times, this hour is used for presentation and discussion of relevant articles from the professional research literature. The interns, as well as the training director, take turns in leading the discussion. Each semester we try to keep the research theme-centered. For example, one semester the theme might be multicultural issues in psychotherapy. The next semester, the theme might be diversity and life-style issues. This hour is also used for individual case presentation. Again, the interns take turns in presenting their psychotherapy work to the group.

Back to Table of Contents

To Top of Page

Last updated July 24, 2006