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Recently I spoke with a graduate student in counseling who needed to interview someone in the field for a paper he was writing for class. He told me he had called numerous therapists but was told that they were too busy to talk. I have gotten to talk to many students, both graduate and undergraduate, over the years and it has always been a very enjoyable experience. I encourage therapists to make time for students and to give back to them. Many have helped us along our path.

What follows is a result of several conversations with students looking for internships. It was originally published in the newsletter of the Virginia Counselors Association.

Even though it is spring, it is not too early to begin planning for a fall practicum or internship for your graduate program. Slots at agencies and programs can fill up early, especially with the number of graduate programs these days. You are not only competing for spaces with others in your program, but with students from programs at nearby schools, from online degree programs, and sometimes from students who may go to a school from a distance away but who live close by you and look for placements near home.

The first step is to check with your school for a list of agencies and programs with which the school already has a valid affiliation agreement. Affiliation agreements involve the school and the program exchanging agreements signed by the directors of both entities with each program having an original of the agreement. The agreement states the responsibilities of both parties and the liability insurance information. Students can get liability insurance for free with their ACA membership, or at a tremendous discount (approximately $35) with their membership in VCA. It is a good idea to have your own insurance even after you are licensed and working for an agency that has insurance that covers you. The insurance that the agency has looks out for you, but the primary responsibility is to the agency. If the agency can prove you failed to follow policies or procedures, you may be left on our own. Your own insurance’s responsibility is to advocate for you. If you find a place that you would really like to intern and there is no agreement, most likely you will need to find a person at the agency who is willing to follow through on getting an agreement. This can take time, and if the process is not started early, it may not be done in time for the start of the placement, if it occurs at all.

Larger agencies and schools may use the same process for taking on an intern as they would for hiring a new employee (except without the pay). This includes going through an interview process, having references, providing a transcript, resume, and completing a job application. Make sure your references are easily reachable. I remember instances when a reference had a full voicemail box and did not respond to several messages left with the receptionist nor to multiple emails. I had to ask the student for an alternate reference. Also make sure that you provide documentation as requested. If a sealed transcript is required, providing a personal copy will not work. Your placement may be delayed or may not occur at all. If a job application is required in addition to a resume, repeatedly writing “see resume” for questions on the application may not be acceptable either. Sometimes bureaucracies put their needs over user friendliness to applicants.

Once you begin at the placement, you may go through an orientation in which you learn about the organization and its structure, policies and procedures. There may also be criminal background checks, DMV and social services checks, finger printing, and drug screens. And then there is training to be done. If you are at a facility that is licensed by the Dept of Behavioral Health, that will include things like CPR and First Aid (if you have these already and the certifications are valid through the time you will be at the agency, you may be able to present your card and not have to take the training again), behavior management, client rights, cultural competency, ethics, confidentiality and privacy of health records, developing treatment plans, health record documentation, and infection control among others. You would also have to learn the ins and outs of whatever health record system the agency uses and more and more that means an electronic health record. Being comfortable with computers has become a pretty essential part of the behavioral health workplace. You may also learn about whatever other forms the agency uses, such as incident report forms.

You will probably have an easier time finding a placement at larger agencies, or at least places that provide for fee services. Since you are not licensed yet, services that you provide cannot be billed to insurance companies. If you are at a stage where you could meet the Medicaid criteria for qualified mental health provider, the agency might be able to bill for services such as case management or intensive in-home services, but not for psychotherapy at the office, unless the client pays out of pocket. The for fee services would be things like services contracted by entities like courts, Community Corrections, probation and parole, Alcohol Safety Action Program, jail programs, or social services. This may involve intake evaluations, individual counseling, group counseling and psychoeducation. The focus may be mostly on groups. Groups can be for drunk driving offenders, possession of marijuana, underage possession of alcohol, family violence, and anger management. Groups may also be part of programs like intensive outpatient programs and partial hospital programs. You may also be asked to do breathalyzers and drug screens, including observing urine drug screens. You may also have to make reports to referring agencies like probation or social services.

You will also learn the ins and outs of the culture of the workplace. Some are very nurturing and mentor very well. At the other end are toxic places with lots of office politics rife with turf and ego wars. And many have a various mix of the two. Like most things, office cultures seem to follow a bell curve from very healthy to very unhealthy with most somewhere in between. You may run across hierarchies based on credentials and clashing philosophies. The practitioner as expert pathology-based medical model versus client centered strength-based recovery model are two examples of competing philosophies that cause friction in the workplace and a difference in ideas of how best to work with clients. How would you cope with that?

It is imperative that you research the places you are applying to as much as possible and make yourself a list of questions to ask when you talk to them. They are interviewing you to see if they want to work with you and for fit, but you are also interviewing them to see if it is a place you would want to be and if it would be a good fit for you. You may feel you need to positively impress them, but they also need to positively impress you for you to consider them. This research is crucial, particularly trying to talk to folks who work there to get an idea of what it is like. Management isn’t always straightforward on what the real conditions and expectations are like, so sometimes interviews have about as much predictive value as say an SAT or GRE for academic performance – none. Write out the questions you want to ask during the interview and take them with you so you are sure to remember them. It is useful, too, if you know someone who has gotten services at a place to talk with them and see how they were treated – more than one person if possible. Also people who make referrals to a place can be a help, though less so for various reasons. But I think those who get counseling from a place can give you a pretty good idea of the treatment philosophy of the program. Also talk to students and graduates who have been placed there before if you can. Find what kind of situations they were put in and what kind of guidance and mentoring they received or did not receive. Find out if there are individuals there who will advocate for you, and who can do so effectively. And always advocate for yourself, and that especially includes after you begin the placement. If things are not going well, do not wait to the end of the semester to bring up what has not been going well.

So if you are planning on starting a practicum or internship in the fall, the time to start working on it is now. You can find out more about the Virginia Counselors Association at http://www.vcacounselors.org/.

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