Psychology Internship

Supervision

We view supervision as the cornerstone of clinical skill development. Supportive and empathic supervision allows the intern to consolidate academic and clinical experiences and helps to form a professional identity based on the values of competence, ethics, and service to others. Consequently, extensive clinical supervision is offered in the areas of psychological and diagnostic evaluation; individual therapy; family therapy; group therapy; consultation; and research.

Supervision takes many forms, from watching an interview or being watched at the bedside, to meeting in the office with the supervisor, to presenting a case to a group during the assessment seminar. By far, the most frequent modality on rotations is side-by-side supervision during the delivery of psychological services.  Traditional “sit-down” supervision will also occur during the rotation and as part of managing an outpatient caseload.  Each intern is assigned two psychotherapy supervisor at the beginning of the year that will help cover their outpatient adult and pediatric caseload. It is expected that, when needed or desired, the intern will obtain additional individual supervision from members of the faculty (psychologists and psychiatrists) for outpatient psychotherapy cases.

INTERN DEVELOPMENT AND FEEDBACK

THE INTERN TRAINING PLAN AND ASSESSMENT OF PROGRESS

Early in the internship year, the Director of Training meets with each intern to review the intern's prior training and to mutually agree upon experiences that are necessary for the intern’s transition from a graduate student to an independent clinician. A written training plan is generated for each intern that addresses the following areas:

• Competence in assessment and consultation (e.g., interviewing, testing, case conceptualization, report writing, feedback to referral sources via oral and written modalities, etc.);
• Competence in intervention (e.g., individual, marital/couples, family, and/or group psychotherapy, etc.);
• Competence across various populations (e.g., children, adolescents, adults, older individuals; medical surgical, psychiatric, neurological patients, etc.);
• Competence in one or (preferably) more theoretical orientations (e.g., behavioral, cognitive, systems, interpersonal, dynamic, etc.);
• Basic research competence; and
• Other skills (e.g., supervisory experience, presentations, etc.).
  

This training plan is reviewed every two months with the intern with feedback based on input from the intern's training supervisors. This training plan is also a contract between intern and the internship faculty stating that the internship will provide the opportunities and supervision necessary to gain such skills and that the intern will show progress towards and ultimate attainment of these goals.  As such, the intern has a responsibility to the internship faculty to let it be known when they do not feel that the quality and/or quantity of experiences and/or supervision is satisfactory enough for the intern to achieve his/her training goals.  It becomes the responsibility of the internship to satisfactorily address these concerns.  We believe that this mutual dedication towards training goals enhances both the intern’s education and the overall quality of the internship.

While some skills are “rotation specific”, it is expected that the intern will show growth both within the 4 months of each rotation and over the course of the training year.  By the end of the training year, it is expected that the intern will display entry-level competence in interviewing (i.e., efficiently gathering necessary background and observational information, performing a mental status examination, etc.) and assessment (i.e., being able to design, administer, and interpret a battery of tests that will aid in the conceptualization, diagnosis, and treatment of the patient), case conceptualization, communication (via both oral and written means and in a timely fashion), treatment (appreciating and being able to apply various therapeutic modalities), ethical and cultural awareness of issues in relation to the practice of psychology in a health sciences center, and research methods.

ASSESSMENT AND FEEDBACK OF INTERN'S PROGRESS

A variety of means are utilized to assess an intern’s progress.  Given the internship’s mentoring model, the most frequent method of assessment is the direct observation of interns performing their duties.  In addition, supervisors will review case notes and/or video or audio tapings of interviews, testing, and therapy sessions.  Interns will be observed during case presentations to judge the quality and clarity of their case conceptualization.  Also, as the intern often functions as part of a multidisciplinary team, feedback from other team members will be solicited. 

Feedback to the intern is provided through various means.  The most common form comes from direct feedback from the clinical supervisor after he/she has observed an intern/patient encounter.  Besides being the most frequent, the faculty believes that this is the most important feedback that the intern will receive.  More formal feedback occurs every two months during the mid-point and at the end of each rotation (concurrent with the review of the intern training plan).  Evaluation forms are provided, along with a wealth of didactic and administrative readings, in the Intern Handbook that is issued to the interns on Day 1 of the internship.  Given the frequency of observational feedback and supervision, it is the faculties’ goal that the formal feedback sessions will not contain any “surprises” for the intern.  At the end of each rotation, recommendations will be made by the faculty based on the individual training plan for growth during the subsequent four months and conveyed to the intern during the review process at the end of each rotation and by the Director of Clinical Training (DCT).  In addition, the intern is expected to complete both written and oral feedback regarding their experience on each rotation and the quality of supervision provided.  Such feedback will be reviewed with each rotation supervisor and with the DCT.  Written feedback is sent to each intern’s training program at the mid-point and at the conclusion of the internship.  Each written evaluation will be reviewed by the intern and the DCT.  The intern is encouraged to indicate points of agreement or disagreement in a separate letter to their home program’s Director of Clinical Training.

The purpose of these frequent evaluations allows for ongoing intern and program evaluation that serves to aid the interns’ overall training.  If minor intern training deficiencies are identified, they are usually corrected through the traditional channels of observation, experience, supervision, didactics and/or mentoring.  Usually, such minor deficiencies do not get communicated with the intern’s home program except in the context of the mid-year progress report, most often in the context of successful intern growth and development.  These frequent evaluations also serve to detect any major training deficiencies early in the training year and allow for more intensive remediation.  If a major deficiency is detected, several steps are taken.  First, after discussion with the DCT and representative faculty, the intern is placed on “probationary” status and the nature of the deficiency is communicated in written and oral fashion to both the intern and the intern’s home program.  Second, a remediation plan is developed by the faculty and DCT that aims to identify specific skill deficiencies and offers concrete solutions to improve such skill areas.  Again, techniques such as increased supervised experience, reading, observation, and mentoring are frequently used as the basis for remediation.  Given that “probationary” status has been invoked, the frequency of supervision is obviously increased until the deficiency is resolved.  As part of probationary status, a realistic timetable is offered for remediating each skill deficiency.  At the end of the specified time period, the faculty and DCT again meet and decide to 1) lift the “probationary” status upon successful completion of the remediation plan; 2) continue “probationary” status for another specified amount of time (which usually occurs when more than one major skill area is defined as deficient); or 3) consider dismissal from the program as the intern, based on reviews of multiple supervisory evaluations, has not demonstrated sufficient progress.  Over the course of the 30+ years of the Temple Internship, only one student has ever been dismissed due to major skill deficiencies and less than a handful of interns have needed “probationary” status.  Formal policies regarding intern expectations, evaluations, and due process, along with an explanation of the role of the internship ombudsperson, are provided to incoming interns as part of their orientation in the form of the “Intern Handbook”. 

Given our commitment to optimal training experiences, the intern plays an integral part in providing feedback regarding rotations and supervision.  Each time interns are provided feedback regarding their progress, they will also be asked to give opinions regarding the adequacy of patient experiences, supervision, etc. Through the years, the constructive comments offered by interns have helped to shape the training, educational, research, and didactic experiences for themselves and future interns.  For example, the Shriner’s Hospital minor rotation was restructured from one full day to two half-days based on intern feedback.  Thus, the program is constantly evolving and being shaped as a result of feedback provided by trainees over the year.   

Requirements to complete internship 

• A minimum of 2000 training hours
• Satisfactory evaluations completed by rotation and outpatient therapy and assessment supervisors.  No ratings on the final evaluations of each rotation and each quarterly outpatient evaluations shall be below “satisfactory”.
• Satisfactory attendance and participation in all required didactics.
• Satisfactory progress in the Research requirement as measured by presentations to the internship faculty and at the CHP research day and by satisfactory progress towards submission of a manuscript for publication by the end of the internship year.