Internship: Training Program

Nestled on a 524-acre wildlife and nature preserve, University of Houston-Clear Lake (UHCL) has become a cornerstone of higher education along the upper Gulf Coast of Texas. A historically upper-level (junior and senior) undergraduate and graduate university, UHCL accepted its first freshman and sophomores in fall 2014. UHCL has an adult student population of approximately 6,700 undergraduate students and 2,400 graduate students with average ages of 27 and 32 years, respectively. Most students are Texas residents, and 62 percent of the student population is female. UHCL's student population reflects a diverse mix of ethnicities with 63 percent identifying as other than white and nearly 5 percent as international students from around the world. In 2010, UHCL was designated as a Hispanic-Serving Institution by the Hispanic Association of Colleges & Universities.

The Counseling and Mental Health Center is part of the division of UHCL Student Affairs. The mission of UHCL Counseling and Mental Health Center is to help students fulfill their goals by fostering connections with and among members of the university community, facilitating the discovery and realization of power in their strengths and developing the ability to address emotional and psychological challenges. We accomplish this mission by helping students resolve personal and psychological concerns and difficulties with high quality therapeutic services, helping students overcome barriers to academic success, promoting the personal development and psychological wellness of students, helping students make appropriate educational and vocational choices, and helping maintain a university environment which responds to student needs and problems.

Our center takes a fundamentally client-centered approach to therapy, drawing upon a variety of theoretical models. We adhere to a short-term goal-oriented therapy model, although we do not have strict session limits.  When fully staffed the Counseling and Mental Health Center staff is a small, cohesive team of four psychologists, two therapists and two social workers of varied orientations and backgrounds whose collective professional experience is extensive. Training is a core component of our center, which is reflected in our philosophy below. Our center is accredited by the International Association of Counseling Services, Inc. (IACS). For more about our center and services, please visit the Counseling and Mental Health Center.

The UHCL Counseling and Mental Health Center Psychology Internship Training Program is integrated into the overall goal of providing high quality, effective services to our clientèle.  Therefore, our philosophy of training is to provide trainees with the experiences, training, and supervision necessary to develop and grow as psychologists in a flexible and supportive professional environment, while providing excellent direct and outreach services to UHCL students.

The training approach is based on the premise that development of both professional identity and professional skills are essential outcomes of a successful internship experience.  The attainment of a sufficient level of skill proficiency is required by the conclusion of the internship, but professional skill development remains a lifelong career quest long after internship.  It is the acquisition of a solid professional identity, including deep commitment to ethical behavior and the desire for ongoing learning, which enables that continued skill growth to take place.  The training approach assumes that the development of a strong professional identity occurs in tandem with a strong personal identity, which requires, among other things, deep appreciation of one’s own cultural identities. The integration of personal and professional identities is how trainees come to embody the values, ethics, and practices that allow them to function independently in their identity as a psychologist. The following principles elaborate this approach.

Our internship is guided by five core principles that we promote as a staff and integrate into all areas of the training program. These five principles form the foundation of the program’s commitment to upholding the profession-wide core competencies as outlined by the American Psychological Association’s Standards of Accreditation for Health Service Psychology.

Developmental Approach to Training

We are committed to developmentally appropriate training experiences designed to facilitate maximum growth of trainees.  Interns usually enter the internship year with a central identity of a “student.”  From the initial period of orientation through to a graduation ceremony, interns are coached and encouraged to adopt and internalize the values, attitudes, and behaviors of a professional psychologist.  Learning occurs through modeling, repetition, approximation, and feedback, moving from superficial adoption of behaviors to deep internalization of a professional identity.  Likewise, interns usually enter internship with an uneven array of clinical skills.  Skill proficiency in all areas is assessed early in the internship year, and clients are assigned to the interns that are within their capability; more challenging cases are slowly added to the caseload to offer the opportunity to expand and refine clinical skills until the intern reaches exit level skill development.  While attainment of minimum proficiency standards is required of all interns, individualized supervision goals are established jointly with the supervisor that are developmentally appropriate.

Multicultural Focus

Our staff places a high value on multicultural competence, and facilitating trainee growth towards that competence is central to our training philosophy. It is one of our core values as a staff, and therefore, it is one of our main goals for intern professional development. We try to include a multicultural dimension in every training activity in which we engage. It is explicitly addressed in the multicultural seminar, although multicultural aspects of any topic are regularly discussed. In addition, multicultural issues are regularly discussed in supervision, in terms of the client work, the relationship between the trainee and the supervisor, and in terms of the development of the intern in this area.

Several dimensions of multicultural competence are addressed in the internship program. Foremost is the cultural self-awareness of the intern, including awareness of personal identity and history, attitudes toward other cultures that are embedded in one’s own culture, and the intersectionality of one’s own various identities. Second is the openness to and acceptance of diverse cultural norms and experiences of individuals from different cultures. Third is cultural knowledge relevant to the specific groups represented in the UHCL student population. And fourth is culturally sensitive and appropriate therapeutic assessment and intervention. All UHCL Counseling and Mental Health Center trainees are expected to develop competencies to effectively serve a diverse public, including clients whose identity, beliefs, worldview, or cultural background may create personal conflict with that of the intern.  Therefore, we subscribe to APA’s position “Preparing Professional Psychologists to Serve a Diverse Public: A Core Requirement in Doctoral Education and Training” which can be found at http://www.apa.org/pi/lgbt/resources/policy/diversity-preparation.aspx. 

Essential to the realization of this multicultural focus is the opportunity to apply these skills with a highly diverse clientèle. The diversity of the UHCL student population and the Counseling and Mental Health Center clientèle is sufficient to support this aspect of our training program. We are a Hispanic-serving institution and serve a very diverse clientèle. The range of diversity in the areas of ethnicity, socioeconomic status, and age are especially notable. We also have a significant percentage of international students from many areas. It is typical for a trainee to have at least 50% of their caseload be students of color. Therefore, interns have an excellent opportunity for working with individuals of many backgrounds and expanding their knowledge of many different multicultural issues.

Safe and Experiential Learning Environment

As part of the foundation of our training philosophy and rooted in our developmental approach, it is important to create a safe learning environment for all trainees. We recognize that, as early career professionals, interns are still in an intensive learning stage of development, and that training is the process of learning and making mistakes in order to enhance effectiveness as a therapist. It is essential that trainees feel safe to challenge themselves and discuss difficult issues with their supervisors. Supervisors are often willing to share their own work through discussion or recordings, so trainees can learn from them as well. We also do group, couples, and supervision work as co-leaders with trainees so that they can challenge themselves in session while still having the safety of a supervisor present. We also adopt an experiential learning environment where trainees learn by becoming fully involved in the life of the center.

Professional Identity Development

Another major focus of the training program is to help trainees develop their professional identity.  Professional identity, referred to in the first principle, includes values, attitudes, and behaviors held in common with other individual psychologists and embodied in ethical and competence standards of professional organizations.  The intern’s role from the beginning of the internship year is defined as a staff member within an organization, with the expectations of deportment and performance to meet professional standards.  We work in supervision to help trainees more fully develop and conceptualize clients within their chosen theoretical framework and provide exposure to other frameworks. Trainees move progressively from dependence toward independence, and from external supervision toward peer supervision and self-supervision.  We also help them gain experience in the many roles that counseling center psychologists engage in.  By being part of all aspects of the counseling center and discussing professional issues in supervision, the trainee learns about and receives feedback on their professional functioning. Across the internship year, trainees are encouraged to reflect on the crossover between their professional and personal identities and to develop an appreciation of the interplay which necessarily exists between the two.

Practitioner-Scholar

The staff of the Counseling and Mental Health Center recognizes the importance of practice that is informed by scholarly inquiry, and promotes a practitioner-scholar approach to the work we do.  Theoretical and research literature are integrated into training through the inclusion of professional literature in supervision and training seminars. There is the recognition of the importance of the scientific method in clinical practice, especially through critical thinking, evaluation/clinical assessment data, awareness of biases, integration of data into thorough case conceptualization, testing hypotheses, and assessing the impact of interventions though outcome data. Administrative clinical service decisions are informed by scholarly review of literature as well as ongoing examination of service utilization data, client demographics, client satisfaction, and client outcome data.

The overarching aim of the training program is to prepare doctoral interns, through a year-long university counseling center internship, for entry-level practice as culturally-competent health service psychologists embodying a solid integration of professional and personal identities and committed to the values and ethics of the profession.  Consistent with the profession-wide core competencies, the internship program provides an array of supervised educational activities which will enable the exiting intern to possess the skills commonly expected of entry-level staff psychologists.  These skills encompass areas of competency in both clinical practice and professional functioning.

Competency 1:  Research - Application of Scientific Methods / Scholarly Inquiry

• Element 1: Disseminate research or other scholarly activities (e.g., case conference, presentation, publication) at the local, regional, or national level

Competency 2: Ethical and Legal Standards

• Element 1: Be knowledgeable of and act in accordance with: (1) APA Ethical Principles & Code of Conduct; (2) relevant laws, regulations, rules and policies governing Health Service Psychology at the organizational, local, state, regional, and federal levels; and (3) relevant professional standards and guidelines
• Element 2: Recognize ethical dilemmas as they arise, and apply ethical decision-making processes in order to resolve the dilemmas
• Element 3: Conduct self in an ethical manner in all professional activities

Competency 3: Individual and Cultural Diversity

• Element 1: Demonstrate awareness/understanding of how own personal/cultural history, attitudes, and biases may affect how one understands and interacts with people different from themselves
• Element 2: Demonstrate knowledge of the current theoretical and empirical knowledge base as it relates to addressing diversity in all professional activities including research, training, supervision/consultation, and service
• Element 3: Demonstrate ability to independently apply knowledge and approach to work effectively with range of diverse individuals and groups across professional roles (e.g., research, services, and other professional activities). 
• Element 4: Demonstrate effective working with areas of individual and cultural diversity not previously encountered, as well as ability to work effectively with individuals whose group membership, demographic characteristics, or worldviews are different or conflict with own. 

Competency 4: Professional Values and Attitudes

• Element 1: Behave in ways that reflect values and attitudes of psychology, including integrity, deportment, professional identity, accountability, lifelong learning, and concern for welfare of others
• Element 2: Engage in self-reflection regarding one’s personal and professional functioning; engage in activities to maintain and improve performance, well-being, and professional effectiveness
• Element 3: Actively seek and demonstrate openness and responsiveness to feedback and supervision
• Element 4: Respond professionally in increasingly complex situations with a greater degree of independence as progress across levels of training
• Element 5: Meet responsibilities in a reliable and timely manner; prioritizes effectively; communicates about delays.

Competency 5: Communication and Interpersonal Skills

• Element 1: Develop and maintain effective relationships with a wide range of individuals, including colleagues, communities, organizations, supervisors, supervisees, and those receiving professional services
• Element 2: Produce and comprehend verbal, nonverbal, and written communication that is informative and well-integrated; demonstrate a thorough grasp of professional language and concepts
• Element 3: Demonstrate effective interpersonal skills and the ability to manage difficult communication well.

Competency 6: Assessment

• Element 1: Select and apply assessment methods that draw from the best available empirical literature, and that reflect the science of measurement and psychometrics; Individualize assessment/collect relevant data using multiple sources and methods appropriate to the context, professional role, and identified goals and questions of the assessment as well as relevant developmental and diversity characteristics of the service recipient. 
• Element 2: Interpret assessment results to inform case conceptualization, classification and recommendations following current research, professional standards, and guidelines; Guard against decision-making biases, distinguishing aspects of assessment that are subjective from those that are more objective
• Element 3: Accurately and effectively communicate (verbally and in written documents) the findings and implications of the assessment in a manner that is adapted/sensitive to the needs of a range of audiences

Competency 7: Intervention

• Element 1: Establish and maintain effective relationships with the recipients of psychological services (e.g., effectively builds rapport/partnership with family, attuned to patient/family, foresees possible threats to productive working alliance; able to manage/respond thoughtfully and effectively)
• Element 2: Develop evidence-based intervention plans specific to the service delivery goals; Modify and adapt evidence-based approaches effectively when a clear evidence-base is lacking
• Element 3: Provide clinical services that integrate relevant research literature, evaluation/assessment findings, diversity characteristics, developmental, and contextual variables
• Element 4: Evaluate intervention effectiveness, and adapt intervention goals and methods consistent with ongoing evaluation

Competency 8: Supervision

• Element 1: Apply knowledge of supervision models and practices in direct practice

Competency 9: Consultation and Interprofessional/Interdisciplinary Skills

• Element 1: Demonstrate knowledge and respect for the roles and perspectives of other professions
• Element 2: Apply knowledge of consultation models and practices with individuals/families, other healthcare professionals, interprofessional groups, or systems related to health and behavior

All of our training has a strong developmental and multicultural focus, although individual supervisors have their own theoretical orientations. We offer direct and indirect training experiences which focus on the development of the intern’s clinical and professional development. Below are descriptions of these elements.

Service Components

The Counseling and Mental Health Center offers a variety of experiential training activities in the different service areas essential to the college counseling center setting. Depending on the level of student interest in particular areas and professional goals, the amount of exposure to and involvement in some areas may vary.

• Individual Therapy - Individual therapy is the primary focus for the internship year.  Interns typically see 14-16 individual psychotherapy clients per week. This includes hours doing initial consultations and intakes. The majority of clients are seen within our brief therapy model, but a few clients may be seen long-term. Each intern’s caseload varies depending upon other clinical activities such as participation in groups and supervision of a practicum student, demand for services, and other factors. 
• Couples Therapy - Interns have an option to work with couples, either under supervision or doing co-therapy with a senior staff member.
• Group Therapy - Interns participate in group therapy experiences and supervision, through co-leadership of groups and through supervision of group work. Groups are generally process oriented therapy groups, although occasionally more structured or topical groups are offered. 
• Outreach - Interns are actively involved in outreach to the UHCL community.  They participate in the design and provision of psychoeducational and preventive workshops and awareness events.  They also co-lead or provide outreach workshops to the university community. Interns are required to design one outreach display each semester and conduct at least two presentations over the year, although typically do many more than that. They also participate in Counseling and Mental Health Center marketing activities, such as new student orientation.
• Co-Supervision of Practicum Therapist - We have a model of co-supervision in which a senior staff member and intern provide joint supervision to a practicum therapist. The specifics of this arrangement are negotiated between the senior staff member and the intern at the beginning of that semester. This offers the practicum therapist a fuller experience of experiencing two different supervisory styles and therapeutic orientations, and provides for a much richer supervision of supervision experience for the intern.
• Consultation and Liaison Experiences - Interns have exposure to working in a collaborative student services environment, including consultation with other offices and collaborative program planning. For example, interns may consult with faculty/staff about students of concern or collaborate with another office to provide programs for that office or its student audience.
• Crisis Intervention - The Counseling and Mental Health Center is not on call after hours or over weekends, but does respond to students in crisis during business hours. Interns have an opportunity to see students who present in distress for crisis intervention.
• Assessment - Client assessment is based primarily on use of the clinical interview and interpretation of the Counseling Center Assessment of Psychological Symptoms (CCAPS), supplemented by other forms of formal testing, as deemed clinically appropriate. In accord with an evidence-based practice approach, interns are required to formulate cases based on appropriate evidence with reference to normative standards.

Training Components

Orientation

Interns begin their internship with a two to three-week orientation. The orientation provides an opportunity for interns to learn about the specifics of UHCL and the Counseling and Mental Health Center, as well as the required internship activities and optional experiences. Interns will have the opportunity to interact with all of the staff and learn about the theoretical orientations and supervisory styles of potential supervisors. Interns will also participate in didactic and experiential seminars on key topics. All senior staff members participate in orientation. By the end of orientation, interns formulate their goals for supervision for the semester, in consultation with their supervisors and the Training Director. Interns will also have an opportunity to connect with their fellow intern cohort and practicum trainees.

 Supervision

• Individual Supervision: Supervision is a highly valued experience in our center for both trainees and senior staff. We are developmentally oriented and “trainee-centered.” Part of the supervision experience includes not only case review, but structured self-reflection elements designed to help the intern develop greater self-awareness. In addition, there are opportunities during supervision to discuss application of theoretical perspectives into clinical work. Interns are assigned a primary supervisor with whom they meet weekly for two hours.  That supervisor generally changes each semester.  In addition, interns are actively encouraged to seek regular consultation with their supervisors throughout the week, as the need arises. Our staff have an open door policy and a strong commitment to training and consulting with each other.
• Supervision of Group Work: Interns are provided supervision by the senior staff member they co-lead group with. They meet for 45 minutes each week to plan the group, discuss group process, and receive feedback about group therapy competencies from the supervisor. Interns also receive one hour weekly of group supervision of groups led by the Center’s group coordinator and attended by trainees involved in group work.
• Group Supervision in Case Conference: Counseling and Mental Health Services weekly, one hour Case Conference meeting involves all clinical staff and interns, under leadership of the Associate Director. The joint case conference enables trainees to discuss and obtain feedback about their own cases as well as learn from the case discussions of the Counseling Services staff. Interns provide one formal case presentation that incorporates relevant empirical and theoretical literature during the case conference each semester. Case Conference emphasizes intern clinical growth and development and provides important group supervision of their clinical work as well as opportunities for interns to provide consultation to fellow interns and senior staff.
• Supervision of Couples Therapy: If interns are seeing a couple with a senior staff co-therapist, they receive supervision on that couples work from that staff member. If they are not participating in co-therapy with a senior staff member, the supervision is provided by the intern’s primary supervisor.
• Supervision of Supervision: When interns are providing co-supervision of a practicum student with a licensed psychologist, they meet with that supervisor for an hour a week for supervision of supervision.
• Supervision of Outreach, Projects, etc.:  Interns have staff supervisors for their outreach displays, presentations, special projects, etc.  There is no specified amount of time allotted for specific activities; supervision is based on the activity and the need.

Seminars

• Clinical Issues Seminar:  This seminar consists of didactic presentations about applied topics of interest in the practice of psychology. These seminars are two hours per week and alternate at the same time slot with our multicultural seminar, which is described below. Possible topics include: couples therapy, shame, anxiety, personality disorders, suicide assessment, crisis intervention training, sex therapy, religion and psychotherapy, boundaries and countertransference, academic issues, vocational counseling, assessing and utilizing client strengths, Acceptance and Commitment Therapy, motivational interviewing, and substance misuse.
• Multicultural Seminar: Every other week, we have a training seminar that focuses on a multicultural topic. These are either presentations by outside experts or professional staff. Seminars can be didactic in nature, or an open discussion or experiential exercise around multicultural topics. Such topics might include the Safe Zone Program, working with international students, working with first generation college students, intercultural dating, spirituality, working with transgender students, working with LGBTQ students, ability status, class/SES, cultural identity and competence, and issues concerning therapy with specific ethnic groups.
• Supervision Seminar: This seminar meets weekly during the spring semester and combines supervision training with group supervision of interns’ practicum supervision experiences.  It focuses on developing supervisory skills. Topics for the didactic portion include supervision models, supervision roles and responsibilities, process in supervision, ethics, and multicultural supervision. It also provides a forum for discussing and sharing experiences as a supervisor.
• Outreach Seminar: This seminar led by our Outreach Coordinator. Seminar readings and discussions can include marketing outreach on a college campus, consultation, and community connections. The seminar also focuses on outreach projects the interns are involved in, which may include presentations, on-line programs, educational/awareness displays, and brochures. Additionally, this meeting provides a forum for discussing experiences with outreach activities in order to promote interns’ growth and development in the area of outreach.
• Assessment Seminar:  The purpose of the seminar is to provide interns with opportunities to learn about the assessment of various psychological issues that commonly impact university students. The seminar focuses on assessment through both formalized testing and clinical interview and observation.
• Intern Meeting with Training Director: This occurs twice per month and provides a forum for examining the interns’ training and professional work as well as a time to explore their own growth as emerging professionals. The meeting helps prepare interns for the expanding world of psychology that includes the multiple facets in this dynamic, contemporary field. Time is spent exploring career goals and career opportunities. Interns are encouraged to bring up issues and interests to explore. Interns will also have the opportunity to discuss their doctoral research and any other ongoing research projects.
• Intern Only Meeting: This occurs once per month and provides an opportunity for interns to meet and discuss ongoing clinical issues, professional development issues, and to provide one another with support. Interns may use this time as they collectively see fit. A secondary goal of this meeting is to facilitate intern cohort bonding and connection.

Professional Development

Interns’ professional development is encouraged and fostered with supervisor and staff support, financial support, and time for professional development activities. Interns can count 2 hours per week of outside time as professional development towards their internship hours.  UHCL participates in both CHATS (Consortium of Houston Area Training Sites) which provides monthly trainings to Houston area doctoral interns in a variety of sites and in the Texas Intern Conference which is a two-day statewide professional development conference gathering for all counseling center interns. When funding is available, interns are financially supported to attend other conferences or trainings as well. Finally, interns are also eligible for professional development leave time, which can be used for attending conferences or professional development workshops, dissertation research or defense, or job interviewing.  Interns can use up to 36 hours of professional development time, scheduled with the prior approval of the training director.

Interns participate in weekly staff meetings and general case conference meetings with senior staff. Staff meetings offer interns the opportunity to stay abreast of the functions of the Counseling and Mental Health Center, to model the professional behavior of staff, and to engage in the ongoing self-evaluation and growth of the center as a whole. Once a week, the psychiatric provider has a case conference focused on clients under psychiatric care at the Counseling and Mental Health Center and on related psychiatric topics.

Case Conferences

Interns participate in weekly case conference meetings with senior staff. The joint training case conference enables the trainee to learn from the case discussions of the Counseling and Mental Health Center staff as well as discuss and obtain feedback about their own cases, as needed. Interns are expected to provide one formal case presentation that incorporates relevant empirical and theoretical literature during the case conference each semester.  These case conferences are largely for the benefit of trainees and provide important group supervision. Once a week, the psychiatric provider has a case conference focused on clients under psychiatric care at the Counseling and Mental Health Center and on related psychiatric topics. 

Intern Project

Interns are required to produce an intern project during the year. The project emphasizes the development of skills involved in program development, marketing, administration, or evaluation. There is an expectation that the project yield a permanent product such as a publication/presentation, a manual for program implementation, or a set of audio/visual materials - something that can be used after the intern leaves. The Training Director supervises the development and completion of the project. Interns have time to work on their project within their regularly scheduled 40-hour week and are encouraged to make use of periods when clinical loads are lighter (i.e., between semesters).

Interns are expected to work a regular 40 hours per week with additional extra hours periodically; the modal number of hours spent in the office or engaged in formal training and outreach experiences is 40 hours per week. The Counseling and Mental Health Center regular office hours are Monday - Friday, 8 a.m. - 5 p.m.. In addition to the weekly 40 hours of responsibility, interns are required to be available to work on some evenings and Saturdays for professional development activities and outreach commitments.  Any lunches taken in the office and up to two hours per week of additional time spent on professional reading can be also logged in order to fulfill a 2000 hour internship requirement.

Generally, interns devote about 22 hours per week to direct service activities. These include individual therapy, initial consultation, intake, couples, group therapy, and provision of outreach services on campus. If the intern is supervising a practicum therapist, this falls under direct service as well, and result in the intern seeing fewer individual clients.

Because parts of the training agreement are individualized depending on the needs/interests of the intern and the service needs of the Center, the amount of time spent in each category may vary slightly from the sample below.

Sample Weekly Schedule

The Counseling and Mental Health Center office is warm and inviting. UHCL Counseling and Mental Health Center interns each have their own office furnished with comfortable seating, desk, a computer, printer, webcam, phone, internet, and connection to our electronic records system. The overall office also houses a group room, two small-group rooms/practicum offices a relaxation/biofeedback room, a conference/seminar room, and a kitchenette/break room. Counseling and Mental Health Center support staff provide administrative secretarial support to staff and interns, and the university office of computing and telecommunications provides support with technology.