ACA Blog

Apr 08, 2013

Graduate Counseling Internships: A Primer on Experience, Clinical Setting, and Priorities

A recent email from a would-be-graduate counseling intern:

“I am currently completing my counseling graduate coursework at a university in pursuit of licensure.  I have been searching for an internship position beginning in the Fall 2013.  I have been looking for 6 months now.  I interviewed, but did not get an internship from an agency who had only 14 applicants for 10 open positions.  Their response to me was that they thought I could obtain something elsewhere due to my extensive background (I already have an M.A. in Human Services and Education) and others could not.  I wish they'd tell me the real reason as I thought the interview went very well.  I am frustrated, so I was avidly searching for other places to apply and found your site… Since I have plenty of experience, I am baffled as to why I cannot find an internship.”

(Note: All identifying information has been changed to protect identity, and some points have been amended for clarity.)

I agreed with this student’s conclusion that the agency had probably not been entirely straightforward about the reason for turning him down.  In an effort to help, I reviewed his resume, and here are all of the job titles I found, which he was claiming as mental health experience (clarifications in parentheses):

  • Trainer/Consultant (for a company which serves adults with disabilities)
  • Quality Assurance Coordinator (for the same organization)
  • Trainer/Consultant (for what appeared to be a self-employment consulting business that worked with providers of an array of mental health services, primarily related to intellectual disabilities)
  • Interviewer (for a university, apparently for a project that sought to understand a variety of factors about individuals in institutionalized settings)
  • Division/Director Designee for Senate Bill (helping determine whether people met the criteria for an exception to state mental health hospital rules)
  • Senior Practitioner/Case Manager MR/MI/Essential Lifestyle Plan (ELP) Trainer (this position was the longest standing – and was apparently mostly community case management for persons with intellectual disabilities)

Do you see the immediate problem?  He was assuming he had something he did not – the kind of experience that really qualifies as experience. 

Consider the following titles that were on my resume when I went to apply for an internship:

  • Intensive In-Home Therapist
  • Mental Health Therapist
  • Education Support Mental Health Clinician
  • Residential Mental Health Counselor

I’ve blogged about all of this before – the notion that many interns assume degrees, or “counseling-ish” experience will net them advanced standing, and that it usually does not.   So this is nothing super new, but this student’s approach is worth discussing at length.

He conceded readily in further email dialogue that he didn’t have “clinical experience”, but stated vehemently that he did in fact have “mental health experience”.   This is true.   

But it’s a bit like a medical student applying for a residency and citing his experience as an x-ray tech.  Or like applying for an executive director position and citing your experience in the mailroom.  He’s working in the same building, and the same industry, sort of, but one set of experiences isn’t likely to be seen as leading to the other in direction fashion.

Perhaps these are overstated metaphors for this student; his years of consulting with agencies and case management experience were certainly worth something.  Just not what he thought.   This wasn’t about his personal skills, or about his person at all.  He (and you) shouldn’t take this personally.  It’s just how the industry is likely to see your experience.

The great irony was that even though he made a distinction between the two kinds of experiences, his approach acted as if there was none - he would not consider positions that were entry level, that only required a college degree, that only required a high school education, that included ancillary support services (i.e., doing direct care work in addition to counseling), etc.

Here’s the job description for one of the positions I suggested to this student:

“We are seeking Residential Counselors who have a passion for providing support to marginalized, disabled residents of our area. The prospective employee will work independently, providing mental health services to a caseload of an average of 7-8 mentally ill adults in a home that would include: Housekeeping skills, cooking/meal preparation, nutrition, medication management, interpersonal skills, setting boundaries skills, crisis intervention, etc."

 The student’s response:

 “I looked over the [internship] suggestions you had, 2 of them were for HS graduates with 1 or 2 years experience in mental health.  I used to provide supervision to those people.  They provide daily situational counseling and support the person to have the best life they can.  I've been there and done that.  However, they do not provide clinical experience…” 

The only kind of supervision this student could’ve provided previously was managerial and/or experiential.  And his belief that “clinical experience” holds such a limited connotation is a tragic misunderstanding a great majority of the time. Whether I’m meeting with you in your home, on the street, in the school, or in the office, if I’m providing counseling related to your mental health functioning, that is, in a word, “clinical”. 

At the 2013 ACA Conference, I had the privilege of picking the brain of Associate Professor of Counseling at Niagara University, Dr. Shannon Hodges.  He is the author of the best-selling book I highly recommend, “The Counseling Practicum and Internship Manual: A Resource for Graduate Counseling Students”.  It is the single best all-in-one resource I’ve read for all things practicum and internship.  The only requirement for a clinical setting for practicum and internship mentioned in his book is “a clinical placement in a particular field setting”.  Dr. Hodges is citing from the 2009 CACREP standards themselves.

But to be sure, I talked with Dr. Hodges a bit about this particular situation, and about his views on whether entry-level mental health work that involves direct care in addition to counseling experiences is generally considered appropriate.   At the Clinical Mental Health Counseling program at Niagara University, it’s just fine, “provided they had enough actual counseling (individual mini sessions and regular group counseling), and were supervised by a licensed clinician (e.g., counselor, social worker, etc.).”  He’s quick to add that student should “always check with your faculty to make sure you are interviewing at an approved site that will make you license-eligible when you graduate from your counseling program.”  I heartily agree.

In other (my) words, when performed under the supervision of a state-approved supervisor, clinical experience is exactly what entry-level settings provide, so long as you are in fact doing “counseling”.  Some counseling programs may have specific requirements, but not in his case, and my experience is, not in most cases.  Likewise, some state boards may have specific requirements, but the Commonwealth of Virginia (arguably one of the pickiest states in the union) granted me a license, the 4000 hours of supervised counseling for which I performed having contained some 20-30% in these entry-level kinds of settings.  In about 2 months I’ll also be licensed in Missouri and Illinois, so it seems they won’t be too picky either.  And neither will your state, most likely.

So, if you find yourself in a similar position, I have 2 suggestions. 

Firstly, recognize that unlike the medical field, and unlike our sister discipline of psychology, the real tragedy is that there are few “in-between” positions designed specifically and exactly for graduate counseling student interns.  The great majority of persons passing through graduate internships into licensure do so through the kinds of entry-level mental health work I’ve described here and advocated for consistently.  Orient yourself to this reality and quit beating down doors looking for “internships” – they are few and far between.  Instead, look for entry-level “jobs”.  And unlike this student, don’t insist on applying for positions for which you aren’t qualified, and ignore all the ones you for which you are overqualified, even if they require additional, less than glamorous tasks.

Secondly, start off with 1 priority: to find placement - any placement - to which your school might give the "ok".  Don’t make the mistake of believing that if you don’t get the exact kind of internship you want (or think you deserve), it won’t be worthwhile, or that it won’t be “clinical”.  And remember that it is much easier to steer a moving car than a parked one.   I.e., Land a spot that has all the important factors (free supervision and an opportunity to do counseling being chief among them), and then get choosey later.  You can always have your internship comprised of opportunities from more than one site (what most or many do), and it’s much easier to find a second site once you’ve found the first, if for no other reasons than the pressure is off, and the second employer is likely to recognize that someone else found your skills worthwhile enough to hire you.

Let me know if I can help you along your journey!
________________________________________________________________________
Ryan Thomas Neace is a counselor, professor, and entrepreneur. He is the founder of CounselingInternships.com, and helps counselors-in-training and student counselors find internships and direction in clinical practice. Find a counseling internship now at http://counselinginternships.com

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3 Comments

  1. 3 Natasha 19 Apr
    This has been very informative. I think I was making the mistake of looking for an internship that would put me in an office and I would assist with counseling whoever walked through the door. As you stated, don't just look for an internship look for an entry level job and nevermind the glamour. We have to start somewhere. Thank you. 
  2. 2 Lee Roberts 19 Jul
    Wow.  Thanks for the great information.  I have been "beating my head"  looking for that "internship".  I will be getting a copy of the book you suggested.  Would you have a list or suggestion of some entry level mental health job.  Again, thank you.

    Lee Roberts
  3. 1 Lee Roberts 19 Jul
    Ryan,  This is some great information.  I do have a concern.  My wife Tammy Roberts, (leetammyroberts@comcast.net).  My wife joined your online site on July 2nd and after a number of emails she has yet to be contacted or helped in any way.  Can you help us.

    Lee Roberts,  360-389-6629

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