What to expect in your first clinical counseling internship . . .
“Oh my goodness, congratulations!!!”
“I KNEW YOU’D GET IT! WOO-HOOO”
“I’m so proud of you, you’re going to kill it!”
Your phone buzzes, alerting you to each incoming message from your friends or family. You’re grinning from ear to ear and your heart feels like it may burst through your chest. You reread the email from your soon-to-be practicum or internship supervisor, lingering on the words excited to offer you a position. You’re one step closer to becoming a therapist.
So…now what? What should you expect as you enter your first clinical counseling internship?
Whether you started your graduate studies straight after completing your undergraduate degree, or you’re changing careers after years in working in another field, beginning your clinical counseling internship is daunting. Every internship site and every internship supervisor will be different. Some sites require hours of specialized training before you begin and require months of silent shadowing before you’re allowed to engage in direct client contact. Other clinical counseling sites have you seeing clients in your first week. Sites may be in-person, fully virtual, or a hybrid. Your clinical counseling supervisor may want to approve every clinical counseling therapeutic intervention that you want to use in session, while others may be difficult to get an email back from.
In a perfect world, you will find, interview for, and get accepted at the clinical counseling site of your dreams. In all reality, that may not be what happens. If you’d like some guidance on finding the right internship for you, check out the Center for Growth’s earlier article on Maximizing Your Counseling Internship Experience. Hopefully, you are beginning your clinical counseling experience at a site you are interested in and which serves clients you are excited to work with, and you are under the supervision of a licensed professional counselor, social worker, marriage and family therapist, or psychologist that you trust and are comfortable asking for help. Whether you’re beginning the clinical counseling internship of your dreams or you are starting at a site that feels a little further from perfect, below is some of what you can expect as you begin the next stage of your training.
Reading, Writing, Typing, and Also More Reading
There is a lot of paperwork involved in your clinical counseling internship, so get your typing fingers ready! Every site will operate somewhat differently, but you will be typing regardless. You should expect to be writing out intake notes, treatment plans, progress notes, contact notes, cancelation notes, termination notes, and more. If you are scheduled for an 8-hour shift at your internship site, it is likely not feasible to plan on seeing eight clients. You will need to dedicate a portion of your time to your note writing (which will get easier as you get accustomed to it), and be prepared to spend some time agonizing over your notes when you first start. Is this too much detail? Too little? Is my voice coming across as professional and clinical or does this sound too casual?
For many new clinicians, there will be a learning curve. You will likely have notes returned to you or rejected by your supervisor, although they will also hopefully have feedback for you to incorporate into your note writing. Keep a list for yourself with feedback that you receive more than once and refer back to it until the correction comes naturally. Additionally, consider investing in one of those squishy mouse pads for your desk. Your wrists and elbows will thank you.
If your favorite graduate school activity wasn’t already reading, congratulations - your new favorite internship activity is going to be reading! In addition to writing all of your notes, you will also be reading and re-reading them.
You are most likely not an expert on every DSM disorder that you will encounter in session, so plan on spending a significant chunk of your time researching the best treatment options for each of your clients. Connect with your supervisor, other clinicians, and other interns at your clinical counseling internship to see if they have recommendations for books to read, workshops and lectures to attend, or additional trainings that may be useful. Other clinicians at your internship site will also have access to great resources for worksheets that you can give your clients during your sessions.
The Wonderful World of Supervision
Welcome to the next phase of your professional life: supervision. Supervision is not only limited to your time in internship, as you will continue to seek supervision as you work toward your license and furthering your career. So, what exactly is it? Typically, you will have a direct supervisor who reviews your cases and guides your clinical growth. You will meet with your supervisor once a week or more for individual supervision, and you may also attend group supervision with other interns and clinicians.
Supervision is a wonderful tool where everything is about you – your experience, your questions, your concerns, your learning. Some days, you may feel on top of the world when your supervisor suggests an intervention you were already planning for your next session (or already implemented in your last session) or compliments a particular skill, and that’s great.
However, your supervision will also be challenging. This is a space where you can and should bring your mistakes and your failures. Your supervisor may highlight a phrase that you used in a session over which you are brimming with pride, and tell you that it was bad - your client actually failed to come back because you said X, Y, and Z to them. You missed an important detail while you were conceptualizing a case and now need to rethink your treatment plan. You didn’t introduce an intervention properly, or the intervention you chose wasn’t the best fit for a client’s needs. These moments will, naturally, be uncomfortable - but they are also the moments in which you will grow and become better.
Your Emotional Landscape
Whenever you begin to see your own clients (either individually or in group), the transition from student to student-clinician can be difficult. After spending your day with your clients, you may feel drained and struggle to stay present with your own loved ones when they try to vent about their lives. This is normal – you are flexing your emotional muscles in a new and different way compared to before. You will not have the same emotional energy for your personal relationships after being present with client experiences and trauma all day. Your friends and family may struggle to understand this change at first, so consider talking to them beforehand so you can prepare together.
Set aside time to process your own emotions after your internship. Some of what is shared with you in session may be particularly heavy – treat yourself the same way that you would a client and give yourself space to feel whatever is coming up for you. You may be especially impacted by a client’s story or find yourself struggling with countertransference. Schedule time, preferably right after your internship, to check in with your emotional state and be present with it. Remember, you cannot share the details of this experience with the people in your life. You are bound both ethically and legally to protect your clients’ confidentiality, so your processing will need to be done SOLO. Bring strong reactions to your supervisor, and consider seeking out your own personal therapy during this time to address possible countertransference.
In addition to setting aside time for your own emotions, you will want to etch out time for self-care. While it is a wonderful learning experience, your clinical counseling internship will be exhausting.You may inadvertently find yourself psychoanalyzing yourself or your loved ones, questioning your own behaviors and motives, or recognize concerns that your clients bring into treatment in yourself. Monitor yourself for signs of burnout, such as a loss of motivation and energy, a sense of detachment or of self-doubt, and increased negativity. Other common symptoms of burnout include finding yourself being increasingly impatient, finding it difficult to stay present in session, or noticing that your stress levels are interfering with your daily functioning, either in or out of the counseling room. Burnout doesn’t go away on its own, and it builds up progressively over time. Connect with your supervisor and discuss any concerns you may have about burnout as soon as you notice them; your supervisor will help you access your caseload and brainstorm ways for you to lighten it, if needed. There is no weakness in knowing when you need help and being comfortable asking for it, and both you and your clients will be better off if you address potential burnout issues early on.
Make sure you are getting enough sleep, eating well, and doing things that make you happy. Your clinical counseling internship is going to be exciting, rewarding, and joyful in so many ways. While much of your growth will come from your mistakes, don’t discount your achievements throughout your internship. Celebrate your development as a counselor just as you would celebrate your clients’ accomplishments - be proud of yourself!
Your first clinical counseling internship is an experience in which you will be rapidly growing. There will be times when you will be uncomfortable, overwhelmed, or even lost. You may feel as clumsy as a puppy whose legs are too long for its body. Those feelings are real, and they are valid. The day will come where an intake feels like second nature and your notes are easy to write. Give yourself time and be patient. You are just beginning your journey. Enjoy it.
The Center for Growth offers a First and/or Second Year Graduate Student Counseling Internship as well as a Post-Masters/Doctoral Degree Training program. If you’re interested in applying for either position, please fill out the application and call Alex Caroline Robboy at (267) 324-9564 to schedule an interview.
You can self schedule an in-person or virtual couples therapy session at the Center for Growth by calling (215) 922-5683 x 100.
For your convenience we have 5 physical therapy and counseling offices and provide virtual therapy and counseling services in Florida, Georgia, Pennsylvania, New Jersey, New Mexico, and Virginia.
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· Telemedicine: We have therapists who are licensed to work in Florida, Georgia, New Jersey, Virginia New Mexico and Pennsylvania
Therapy Services Offered in Philadelphia, Ocean City, Mechanicsville, Santa Fe:
Individual Counseling and therapy
Couples Counseling and marriage counseling
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Breaking the cycle of Codependency and being your own person
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Personality disorder treatments Narcissist, Borderline, Histrionic
We decided to run a mini experiment. . . . . how do human therapists compare to computer generated responses. In this case we asked the computer to respond to the prompt:
What to expect in your first clinical counseling internship
A clinical counseling internship is a supervised learning experience that provides students with the opportunity to apply their theoretical knowledge in a real-world setting. During an internship, students will typically have the opportunity to observe and participate in therapy sessions, conduct assessments, and work on case studies under the supervision of a licensed therapist.
During the first internship, students can expect to:
- Learn about the different types of therapy and the theories behind them
- Observe experienced therapists in action and gain insight into the therapy process
- Learn about the ethical and legal considerations involved in counseling
- Develop their therapeutic skills, such as active listening, empathy, and providing feedback
- Understand the role of a therapist and the responsibilities of the profession
- Learn how to work with diverse populations and in different settings (schools, community centers, hospitals, etc.)
- Understand the administrative and technical aspects of running a private practice
It's important to note that the internship will be a supervised experience and the student will be closely monitored by the supervisor to ensure that the student is applying their knowledge and skills appropriately. The student may be asked to submit case notes, attend supervision sessions, and complete other assignments to demonstrate their understanding of the material.
As with any learning experience, it is important for the student to take an active role in their own learning, ask questions, and seek out feedback from the supervisor. It is also important to find a supervisor that is a good fit and that aligns with the student's learning objectives and career goals.