How to Pick a Practicum and Internship

by | Oct 3, 2023 | Blog, Internships | 0 comments

Internship/Practicum decisions for your final semesters of your clinical mental health counseling education.

Getting Ready

Welcome to your final semesters as a master’s level student in clinical mental health counseling (CMHC)! So you are starting to research and look for the setting and population you want to work in, and you may be feeling overwhelmed. That’s normal and understandable. It’s a big moment and a process. We’re going to break down and slow the process, and work through this together.

Deciding Your Environment

Before applying to practicum/internship sites, it is important to think about your career, what setting you want to gain experience in, and think about where you want to be hired after your internship. We are allowed to change paths or goals, but it is important to consider your future and the options that you have. Let’s look at some different settings, and what you may experience and learn. 

  1. Setting Types
    1. Hospital – Fast-paced setting, emergency situations, stabilization, inpatient, intensive outpatient, private or state insurance (Medicaid) clients.
      1. Many legal, ethical, multicultural factors to consider when working with patients.
      2.  Documentation, referrals to community resources, individual and group sessions. 
      3. Types of disorders you may see: neurodevelopmental and neurocognitive disorders, mood disorders, schizophrenia, bipolar, feeding and eating disorders, substance use disorders, etc. 
    2. Behavioral/Community Mental Health Centers – Outpatient clinic setting, individual, couples, and group sessions.
      1. Using referrals to community resources and psychiatrists and dealing with private or state insurance (Medicaid) clients. 
      2. Many legal, ethical, and multicultural factors in counseling. 
      3. Types of disorders you may see: neurodevelopmental and neurocognitive disorders, mood disorders, schizophrenia, bipolar, feeding and eating disorders, substance use disorders, personality disorders, etc. 
    3. Private Practice – Outpatient office setting, individual, couples, and group sessions
      1. There is lower risk of crisis or emergencies and more flexibility in hours
      2.  Working with clients who have private insurance or self-pay, still using documentation, legal, ethical, and multicultural considerations in counseling
      3. Typical types of disorders or issues you may see depending on the area: Depression, anxiety, feeding or eating disorders, grief, interpersonal issues (couples), etc. 
    4. School Partnered Agencies – Behavioral health centers, community mental health centers, and large private practices may all have the potential to partner up with local school districts to offer services to students. I wanted to highlight this type of agency if you’re planning on being a social worker or licensed professional counselor, this is a great way to work with students, within a school, yet still have flexibility of working with an agency (practice).
      1. Please see sections B and C for what to expect
  2. Environment Dynamics
    1. Structured – Hospitals are typically more structured with intern programs, including supervision, hours or availability, documentation, treatment planning, trainings, dress code, etc. 
    2. Semi-Structured – When I say semi-structured, I am thinking of behavioral health centers or larger private practices (chains or group practices). There maybe structured internship programs or standardizations of how you’re trained, the type and amount of cases you see, requirements of documentation, treatment planning, and sometimes even hours depending on supervision. However, semi-structured still has some flexibility about initiative, what you want to learn, populations, dress code, etc. 
    3. Independent – An independent structure is most likely a small private practice. You have one maybe supervisor, you can create your own schedule with clients, you should be a self-starter, with a lot more flexibility of how you’re trained or what you want to learn, less standardization of documentation because of private insurance or self pay clients, more specific clientele and experience, flexible hours, flexible dress code, etc. 

Let’s Figure Out Population

The practicum and internship stages of your counseling career should be your opportunity of growth. It may be daunting to think about your first internship. What kind of disorders or population do you feel you’re most competent working with? As a student, the answer is you’ll never truly know unless you’re willing to experience multiple populations and a wide range of disorders. The point of practicum and internship is to have supervision, attend trainings, learn more about different interventions, and modalities of therapy. You may feel like you really want to work with only adult women. That is great, work with a few, but broaden your competency to women of diverse backgrounds and cultures, LGBTQIA+ women, elderly women, branch off to couples, and eventually teenagers. Don’t limit yourself… you may find your niche somewhere you weren’t expecting.

  1. Preferred Population

A preferred population is who you think is within your skill set, theoretical orientation, age range, diagnosis, etc. You feel like you’ll be most comfortable with this population – maybe you’ve experienced something similar within this population, so you feel equipped to support and use your preferred theoretical orientation. Things to be aware of countertransference – is this case too close to home? Transference – is it hindering or helping the therapeutic relationship and process?

  1. Population for Experience

As I’ve said, remember not to limit yourself. Expand your internship populations to a wide range of people/clients. This time is an experiential, hands-on learning process to find out your niche.

Interviewing Process

Interviewing for a practicum/internship is just like interviewing for a job. You may choose your perfect fit because the site is a preferred population or environment, but always have a backup plan and apply to multiple places. Finding a site can be competitive at times because there are only so many spots are open for interns.

However, when you get to the interview stage, don’t fret, the first one is always the most intimidating. Let them ask some get to know you questions, talk about your go to theoretical orientation and interventions you like to use. Hype up your grades and experiences you’ve had that will help you in your internship. Overall, show up as your authentic self. 

Moreover, just as any other interview, ask questions during the interview process: what does supervision look like, will they be willing to hire you on? Talk to more than the interviewers, talk to other interns or staff. Ask questions about what kind of cases you will see, what does support look like, the training process, the culture of the office, what kind of hours do they expect or is it more flexible?

Listen To Your Intuition

You are the expert of you. To find your best fit, listen to your intuition. Create pros and cons of each site or talk it with someone you trust that has your best interest at heart. If you’re extended multiple offers, listen to your gut which one feels right and ask yourself, what makes it the right place, what did you experience during the interview process? You got this! Happy searching!

Disclaimer from author: The premise of this narrative is based on personal experience and research. Every hospital and practice are different – this is a generalization of what one may experience. Ultimately use resources, research, and the interview process to understand specifics of each internship to find what is best for you.

If you are seeking internship opportunities please reach out to netali@bridgeviewcounseling.com. Bridgeview Clinical Services offers a variety of clinical and non-clinical internships at the Bachelors, Master’s, Ph.D levels. 

Sources:

NYC Health and Hospitals

APA

The Center for Growth