Overview Of The Internship Program

Training Philosophy, Program Aims, Competencies and Elements

The American Psychological Association accredited program at the University of San Francisco-CAPS provides doctoral internship training in Health Service Psychology (HSP) within a university counseling center context. Best described as a practitioner model, an emphasis is placed upon grounding clinical practice in theory and research and the development of mentoring relationships with supervising psychologists.

The USF Counseling and Psychological Services (CAPS) has a strong commitment to training that includes participation of all clinical staff. The training program is cumulative and sequential, supporting and enhancing knowledge and skills that interns possess while also providing didactic and experiential opportunities that facilitate development as a generalist in health service psychology. CAPS is consistent with USF’s Core value of having a commitment to the “full, integral development of each person,” by providing a training program that facilitates the development of ethical, competent, psychologists who can function independently and make positive contributions to the profession.

CAPS is committed to a brief, time-limitedtherapy approach to clinical practice that is grounded in evidence-based treatment. We believe that the important aspects of training in brief therapy include: 1) an attitudinal shift on the part of the therapist, to see brief therapy as efficacious and oftentimes considered as the treatment of choice; 2) an exposure to a multiplicity of therapeutic frames and methods, with a focus on adapting them to brief work; 3) an insistence, to the extent possible, that therapeutic frame and method be fitted to the client rather than the reverse; 4) an integration of a multicultural perspective into both case formulation and an interactive approach to the client; and 5) an emphasis on continual practice in defining a focus with the client, and in orienting the therapy to that focus and its associated therapeutic goals.

Also in line with our sponsor institution’s “belief in and commitment to adiversity of perspectives,” our training in brief therapy is based on an integrationist approach. Our approach incorporates various theoretical models and interventions, while keeping in mind individual, cultural, and societal considerations. These ideal characteristics of a multicultural, integrationist approach to brief therapy are not simply actualized in some absolute fashion, even by experienced staff members. Rather, they represent orienting considerations that inform our work and training in an ongoing fashion. We see training as a process where we share our struggles and questions, our successes and failures, as a group. In the end, we are committed to assisting interns in developing their own perspectives toward brief therapy and moving closer to the integration of evidence-based frameworks and methods.

Clinical and training activities are structured in a sequential, graded, and cumulative format consistent with the Revised Competency Benchmarks in Professional Psychology (APA, 2012).   Through achievement of Profession Wide Competencies, the overarching aims of the training program are to:    (1) Develop core clinical and counseling skills for entry level practice in health service psychology, and (2) Foster attitudes and behaviors which promote a professional identity as a psychologist.

By the end of the training year, interns will develop a level of competence, consistent with the following required Profession Wide Competencies (PWC), for entry-level practice in health service psychology:

  1. Ethical and Legal Standards
  2. Individual and Cultural Diversity
  3. Professional Values, Attitudes, and Behaviors
  4. Communication and Interpersonal Skills
  5. Assessment
  6. Intervention
  7. Supervision
  8. Consultation and Interprofessional/Interdisciplinary Skills
  9. Research

By the end of the training year, interns will also have developed specific competence in the following Program-Specific Areas:  Crisis Response and Outreach.

Intern Roles

Before considering specific activities, it is important to place these activities in some context, which can be defined in terms of three characteristics of our system and three associated roles.

First, our training program is guided by APPIC and APA standards: "A psychology internship is an organized program which, in contrast to supervised experience or on-the-job-training, is designed to provide the Intern with a planned, programmed sequence of training experiences." Thus, while Interns may hold professional positions outside the CAPS, they will be considered trainees within CAPS.

Second, in many respects, CAPS operates as a typical agency. We expect that Interns will participate in our policies and procedures as agency members. For example, Interns will be asked to establish a work schedule at the beginning of each semester, and then follow that schedule.

Finally, in some respects, CAPS differs both from other types of mental health agencies and from private practice.  CAPS psychologists define their responsibilities quite broadly, beyond that of providing direct service for one’s individual caseload.  We function in a variety of roles, including providing outreach, consultation, and education to the University community.  We function as a team in terms of responding to crisis situations or other student needs which may arise and we also work together to ensure that the Center always has adequate coverage.  Thus, we expect Interns to function as team members.

Many Interns come to CAPS with extensive prior experience and may be accustomed to functioning quite autonomously.  We recruit Interns who have relevant prior experience and who can function independently in many situations, however, it is important to acknowledge that there are always limits to autonomy in training situations. Licensed staff members are responsible for signing-off on the Intern’s cases, and providing evaluation of the intern’s progress.  Of course, we endeavor to work collaboratively with interns in the training process.  If a conflict should arise between the Intern and a staff member, we encourage an open discussion of the perceptions of both parties and have established Due Process and Grievance procedures for more serious issues.  We also invite informal feedback from Interns at any time and solicit formal feedback twice a year, in order to ensure that our training program and policies are responsive to an Intern’s needs.

Overview of Training Year

Interns participate in several weekly structured training activities that support the CAPS training aims. Interns receive specialized training in:  intake evaluation and disposition planning, individual psychotherapy, group counseling, crisis intervention, outreach, consultation, supervision, program development/evaluation, and utilization of University and community resources and referrals. In addition to individual supervision of direct service, the program provides a series of weekly group training experiences, which infuse relevant literature including Group Supervision, Case Conference, Didactic In-service Seminar, Intercultural Seminar, and the Supervision, Program Evaluation, and Professional Development Seminar.  Additional training includes participation in University of San Francisco departmental professional development workshops and attendance at the Bay Area University Counseling Center conferences, which offer additional networking and mentoring opportunities.

ORIENTATION

Our training begins with a comprehensive Orientation that introduces Interns to CAPS policies and procedures, University and departmental collaborators, and foundational clinical and outreach skills.  Opportunities are created to facilitate cohort team-building and establish professional working relationships with licensed and administrative staff.  Additionally, logistical matters central to CAPS and the larger institution are accomplished.

FALL SEMESTER

Interns participate in the Fall Didactic seminar series, which focuses on exposure to a variety of evidenced-based models (e.g., CBT, Time Limited Dynamic Psychotherapy, etc.), orienting Interns toward technical integration of interventions supported by theory and research, and increasing their knowledge of developmental and clinical issues relevant to a college population.  Seminars include Psychotherapy Integration Overview, Cognitive Behavioral Therapy, Time-Limited Dynamic Psychotherapy, and Acceptance and Commitment Therapy. Intercultural Seminar topics include Social Class, Sexual Fluidity,and Multicultural Assessment and Case Conceptualization.

SPRING SEMESTER

Interns are expected to integrate different evidenced-based models of psychotherapy into their clinical work with more complexity as the training year progresses.  In addition to acquiring advanced understanding of clinical and developmental issues, Interns develop and provide scholarly presentations to the clinical staff incorporating theory and evidenced-based practice,relevant to their work at CAPS.  Didactic In-service Seminars include Humor and Healing, Positive Psychology, and DBT Interventions in Brief Therapy, and Applying Self-Compassion in Clinical Work.  Intercultural Seminar topics include Psychotherapy and Spirituality, Cultural Considerations in Working with Chinese International Students, and Working with First Generation Students.

SUMMER SEMESTER

Acquisition of supervisory skills and knowledge of best practice supervision models are a focus of the Summer Supervision, Program Evaluation, and Professional Development Seminar. Interns will also acquire knowledge of program evaluation models and complete a summer project. The final two sessions are dedicated to topics related to establishing a professional presence as a psychologist. Components include discussions with psychologists who are working in various capacities in the field of psychology, involvement in professional organizations, and understanding of the licensing process.

Training Program Activities

Supervision

Interns receive two hours of individual supervision on a weekly basis. One hour of weekly face-to-face supervision is provided by the Primary Supervisor, who monitors the overall clinical and professional development and individual caseload throughout the training year. Specific goals are developed collaboratively by the Primary Supervisor and Intern to supplement the general goals of the internship and provide an individualized learning experience. An additional hour of weekly supervision is provided by another licensed Staff Psychologist, who functions as the Individual Delegated Supervisor. Interns submit video recordings to Primary and Delegated Supervisors for direct observation each semester.  In addition, supervision may include review of case notes or direct observation in the therapy room, depending on the needs and skill level of the Intern. There are opportunities to change Delegated Supervisors during the summer semester to broaden the training experience.Interns participate in two and one half hours of weekly Group Supervision.  During group supervision with the Training Director, interns present cases and video recordings of their work on a rotating basis for consultation and discussion.  Opportunities for discussion of issues related to the internship experience and professional development are also provided during this time.  An additional hour of group supervision is provided with a focus on case formulation and clinical intervention skills from an Evidence Based Perspective. Drawing from their caseload, interns present case formulations and video recordings of their work, on a rotating weekly basis, from a variety of evidence based treatment models.The intern also has the opportunity to receive additional supervision from the licensed staff psychologist functioning as their co-therapist for any group psychotherapy.

Case Conference

Interns participate with licensed staff members in a one hour Case Conference, where all clinical staff members present cases for group feedback and discussion. During the first month, interns observe licensed staff and Post Doctoral fellows presenting cases and have the opportunity to witness the case conference format and provide feedback. For the remainder of the training year, interns present on a rotating basis with the entire clinical staff.  Please see the Case Conference Presentation Outline.

Educational Staff Meeting

A weekly one-hour meeting with the entire clinical staff to address clinical issues, CAPS procedures and policies, and increase effective response to needs of clients and the University at large.

Peer Consultation

Clinical material, interventions, and professional development are discussed in monthly peer consultation meetings facilitated by the Post Doctoral fellows.  

Intercultural Seminar

A weekly 60-minute seminar with a licensed staff member, during which Interns are provided with a forum to explore a variety of intercultural issues relevant to the practice of psychology.  This seminar utilizes a variety of training modalities including: staff/guest speaker presentations, readings, films, and group discussion of case material.  The purpose of this seminar is to integrate intercultural issues in an ongoing manner, while continuously striving for competence in assessment, case formulation, and the delivery of psychotherapy services to a diverse college campus. Interns examine how their own cultural beliefs and values may impact interactions with one another and their clients. The experience culminates with an Intern’s Capstone Intercultural Case Presentation to the CAPS clinical staff at the end of the Spring Semester.

Didactic In-Service Seminar

A weekly two-hour seminar where CAPS licensed staff psychologists and guest speakers from the community present topics relevant to the acquisition of assessment and psychotherapy skills, grounded in evidenced-based practices and legal and ethical guidelines.  

Supervision, Program Evaluation, and Professional Development Seminar

An eight-session series with three components:  (1) knowledge of best practice models of supervision and acquisition of basic supervision skills; (2) knowledge of models of program evaluation and completion of summer project; and (3) an exposure to career options in psychology (through interactions with psychologists in the greater professional community), an understanding of the licensing process, and an emphasis on networking within the professional community and involvement in professional organizations.

Direct Service

CAPS provides assistance to students seeking counseling/psychotherapy for a wide range of presenting concerns—from typical, developmental, and situational issues to significant clinical concerns. We work within a session-limited approach (12-session maximum), and make an assessment at intake regarding the appropriateness of brief individual or group therapy, or referral for longer-term or more specialized work.

  • Individual Counseling/Psychotherapy–Focus on brief, time-limited integrative therapy with a maximum of 12 sessions per academic year (over the course of the Fall and Spring semesters) per client. Individual clients are not regularly seen on a weekly basis.
  • Group Counseling/Psychotherapy–Both structured-thematic and process-oriented groups are offered each semester.  Interns are encouraged to serve as co-therapists in ongoing CAPS groups, or to initiate a new group relevant to the needs of the USF student population.  There are no client session limits on the number of groups attended. Anticipated groups include Thriving in Relationships, Re-Claiming Self:  ACOA support, and Gender and Sexual Diversity.
  • Intake Assessment and Disposition Planning–Intake assessment interviewing; interview-based evaluation of presenting problem and differential diagnosis; evaluation of motivation for treatment and disposition planning.
  • Single Session Therapy (SST)-Clients are seen for one planned session focused on a goal of their choosing with implementation of specific strategies and provision of resources.
  • Crisis Assessment and Intervention–Crisis evaluation, intervention, and management including assessment of safety and risk factors, effective response to crisis situations, and facilitation of hospitalization.  Summer after-hours on-call duties including staff consultation with Public Safety, Student Housing and Residential Education (SHaRE) and other University representatives; and provision of referrals.  Interns consult with a licensed staff supervisor in crisis situations involving potential harm to self or others.
  • Psychological Testing–Routine administration of the Counseling Center Assessment of Psychological Symptoms (CCAPS-62) to clients at intake, termination, and the CCAPS-34 at specific intervals during the course of therapy.  The CCAPS is supplemented by other assessment instruments (e.g., Beck Depression and Anxiety Inventories, Alcohol Use Disorders Identification Test (AUDIT), and the Eating Attitudes Test (EAT-26), as relevant to the evaluation and treatment of the client.
  • Consultation and Collaboration Activities–Provide consultations to staff, faculty, and other University representatives; parents and family members; and students regarding mental health issues and CAPS services.  Provision of appropriate on and off-campus referrals, discussion of rationale, and follow-up; establish professional and collaborative relationships with University and community colleagues for appropriate wrap-around care for recipients of CAPS services; liaison to Residence Director in Student Housing and Residential Education (SHaRE).  
  • Outreach Activities-Provide preventive/educational services and/or developmental programs to serve the needs of the larger USF community, promote social justice, and celebrate diversities in all its forms. Services have traditionally included training student, staff, and faculty on mental health related topics; conducting educational programs; developing and implementing passive programming; serving as an affiliate of a student organization such as a culturally-focused student club, or other academic and/or service-oriented organizations. Interns are expected to deliver various types of outreach activities. 

Sample Weekly Schedule

I. Direct Service
A. Individual Psychotherapy 14-15
B. Group Counseling(includes 1/2hour supervision) 0-2*
C. Intake Assessment   3
D. Crisis Intake/Crisis Consultation 1
E. Single Session Therapy (SST)   2
F. Outreach 0-1
Subtotal 22
II. Training Activities**

A. Supervision
     Individual:  2 hours (Primary-1; Delegated-1)
     Group:        2.5 hours

4.5
B. Supervision, Program Evaluation, Professional Development Seminar/In-Service Didactic Training Seminar      2
C. Intercultural Seminar (Fall and Spring semesters) 1
D. Case Conference/Peer Consultation 1
E. Educational Staff meeting 1
Subtotal 9.5
III. Professional Development
A.Weekly Professional Development   4
IV. Administrative/Planning
A. Records /Case Management/Planning 8.5***

Evaluations

Interns receive and are encouraged to provide ongoing verbal and written feedback to CAPS licensed staff throughout the training year.

Evaluation of Interns

 

Required Levels of Minimum Achievement

Interns are formally evaluated on a Likert scale from one to seven for each element on the CAPS Psychology Intern Evaluation Form.  It is expected that an Intern will receive a minimum rating of 3 (Emerging Competence) on all elements in all Competency areas at mid-year.

If an Intern receives a rating of two at mid-year on any element, the primary supervisor provides specialized attention to increase the Intern’s functioning to the expected level of competency which may include remedial work. If an Intern receives a rating of one on any element at mid-year, the Primary Supervisor, in collaboration with the Training Director, develops and institutes a specific remediation plan. For successful completion of the internship, it is expected that the Intern will receive an a rating of 4 (Competence Level) at end of year on all elements in the Profession Wide and Program Specific Competency areas; this is the expected level at completion of an internship required by APA accredited internships indicating appropriate for “entry-level practice in health service psychology”. If a rating of 1-“Remedial”, 2-Significant Growth Area”, or 3-“Emerging Competence” is given on any element of a Competency area on the final evaluation, the intern does not successfully complete their internship.  

Evaluation of Supervisors

Interns are given the opportunity to evaluate their supervisors on a biannual basis.  The Evaluation of Individual Supervisor Form should be completed for each individual supervisor during the mid-year and end-of-training year evaluation periods and given to each at the Intern evaluation meeting.  Additionally, Interns complete a Training Director Evaluation Format the end-of-training year.

Interns are given ongoing feedback regarding their areas of strength and weakness in the course of supervision and a formal written evaluation is provided at mid-year and at end-of-training year.  The Primary and Delegated Supervisors collaborate in the evaluation process, and the Primary Supervisor completes a single evaluation form, comprised of feedback from supervisors.  The format for this evaluation consists of the CAPS Psychology Intern Evaluation Form which follows the APA Standards of Accreditation in Health Service Psychology.  Both the Primary and Individual Delegated Supervisors meet with the Intern together to discuss and review the evaluation.  Interns are provided with a completed and signed copy of both mid-year and end-of-year Psychology Intern Evaluation forms.

Interns are evaluated on the following Profession Wide Competencies (PWC) and related elements:

Competency I:  Research
Competency Elements:

  • Critically evaluates and disseminates research or other scholarly activities (e.g., case conference presentations, in-service presentations, publications) at the local, regional, or national level.
  • Participates in seminars that involve reading, discussion, and application of research findings to clinical work.
  • Develops a program and/or implements a program evaluation informed by scholarly research and relevant to a University setting.

Competency II:  Ethical and Legal Standards
Competency Elements:

  • Demonstrates knowledge of and acts in accordance with APA Ethical Principles of Psychologists and Code of Conduct.
  • Demonstrates knowledge of relevant CA laws and regulations, and relevant professional standards, guidelines, rules and policies governing health service psychology.
  • Recognizes ethical dilemmas and applies ethical decision-making processes.
  • Conducts self in an ethical manner in all professional activities.
  • Seeks guidance and consultation from supervisors in addressing ethical and legal issues.

Competency III:  Individual and Cultural Diversity
Competency Elements:

  • Demonstrates an understanding of how own personal and cultural history may impact interactions with those who are different from themselves.
  • Demonstrates knowledge of current theoretical and empirical knowledge bases as it relates to diversity in all professional activities.
  • Integrates awareness and knowledge of individual and cultural differences in the conduct of professional roles.
  • Integrates knowledge and understanding of diversity and culture into assessment, case formulation, treatment planning, and interventions.
  • Independently applies knowledge in working effectively with a range of diverse individuals and groups.
  • Pursues on-going learning about individual and cultural diversity.

Competency IV:  Professional Values, Attitudes, and Behaviors
Competency Elements:

  • Conducts self in ways that reflect the values and attitudes of psychology, including integrity, deportment, professional identity, professional development, accountability, and concern for the welfare of others.
  • Demonstrates the ability to engage in reflective practice.
  • Demonstrate openness and responsiveness to feedback and supervision.
  • Responds professionally in increasingly complex situations with a greater degree of independence.
  • Regularly attends and actively participates in trainings as an engaged participant; comes prepared to discuss case material and/or readings.
  • Demonstrates understanding and adherence to CAPS clinical and administrative policies and procedures.
  • Recognizes areas of strength and areas of growth in all professional roles.
  • Self-monitors own reactions, behaviors, and needs for self-care and takes initiative in addressing concerns.
  • Demonstrates competence in time management skills including punctuality, meeting project deadlines, and CAPS commitments.
  • Effectively manages clinical demands of the expected client caseload.

Competency V:  Communication and Interpersonal Skills
Competency Elements:

  • Develops and maintains good working relationships with a range of individuals including the training cohort, professional and administrative staff, the University and the wider community.
  • Effectively produces and comprehends oral, nonverbal, and written communications, displaying a thorough grasp of professional language.
  • Demonstrates effective interpersonal skills and the ability to manage challenging interactions.
  • Maintains appropriate and timely record keeping in accordance with professional standards and CAPS policies.
  • Collaborates and provides constructive feedback to supervisor(s), training staff, and training cohort.

Competency VI: Assessment
Competency Elements:

  • Selects and applies assessment methods that draw from empirical literature.
  • Gathers accurate and relevant data during an intake assessment, utilizing multiple sources and methods.
  • Demonstrates current knowledge of diagnostic classification systems, functional and dysfunctional behaviors, including client strengths and psychopathology.
  • Demonstrates understanding of human behavior within its context (e.g., family, social, societal and cultural).
  • Applies knowledge of functional and dysfunctional behaviors including context to the assessment and/or diagnostic process.
  • Interprets assessment results to inform case conceptualization, diagnostic impressions (that are culturally contextualized and developmentally appropriate), and disposition planning.
  • Articulates appropriate brief therapy case formulations.
  • Communicates findings in an accurate and effective manner to clients, supervisors, and appropriate 3rd parties.

Competency VII:  Intervention
Competency Elements:

  • Establishes and maintains effective working relationships with clients reporting a range of presenting problems and developmental concerns.
  • Develops evidence-based intervention plans in accordance with service delivery model and therapeutic goals of client.
  • Applies relevant research literature to clinical decision making.
  • Implements interventions informed by current scientific literature, diversity characteristics, and contextual variables.
  • Integrates a range of evidence-based therapeutic modalities and interventions as appropriate for clients and in accordance with service delivery model.
  • Modifies and adapts evidence-based approaches.
  • Evaluates intervention effectiveness, and modifies intervention goals as necessary in collaboration with the client.
  • Refers clients to appropriate university resources and/or community referrals, including psychiatric evaluation, longer-term therapy, and intensive outpatient therapy.

Competency VIII:  Supervision (only evaluated for the end-of-year evaluation)
Competency Elements:

  • Demonstrates knowledge of supervision models and practices.
  • Applies supervisory models and practice in peer supervision with psychology interns.


Competency IX:  Consultation and Inter professional/Interdisciplinary Skills
Competency Elements:

  • Consults in a respectful and competent manner with faculty, administrators, student support staff, and other university professionals.
  • Consults in a respectful and competent manner and with mental health professionals, family members, and agencies outside of the university.   
  • Responds sensitively and appropriately to ethical issues, confidentiality, and professional boundaries during consultation.
  • Provides accurate and relevant information, appropriate referrals, and effective follow-up, as necessary.

Interns are evaluated on the following Program Specific Competencies and related elements:
Program Specific Competency:  Crisis Response
Competency Elements:

  • Identifies urgent/emergency situations and conducts risk assessments pertaining to danger to self/others and grave disability.
  • Implements appropriate crisis interventions.
  • Appropriately seeks consultation in crisis response.
  • Determines and facilitates appropriate dispositions related to urgency, and conducts appropriate follow-up with client and/or provider.
  • Utilizes family, social, academic, medical, or other environmental support systems to assist students in crisis.
  • Manages internal responses and maintains sound judgment during crisis situations.
  • Completes appropriate documentation of crisis assessment and response, including safety and risk factors, in a timely manner according to CAPS policies and professional standards.

Program Specific Competency:  Outreach
Competency Elements:

  • Designs effective outreach programming based on demonstrated need in the University community. Integrates knowledge and understanding of diversity and culture into outreach programming.
  • Provides accurate and relevant information in outreach activities.
  • Effectively represents CAPS and the range of services provided to the University community.
  • Utilizes evaluation measures to improve outreach activities.

Training Program Evaluation

Interns are also requested to complete a formal evaluation of the program at the end-of-training year evaluation period (see Training Program Evaluation Form).  This information allows CAPS to continue to adapt and refine the program, based on Interns’ perceptions and needs.  Additionally, the Intern cohort has the opportunity to reflect upon and provide feedback about the training program at the mid-training year Staff Retreat and to provide feedback following each training seminar (see CAPS Seminar Evaluation Form).

The final evaluation consists of an individual exit interview with the Training Director.  In addition to providing feedback on various aspects of the program, we would like your general comments (i.e., strengths/weaknesses, likes/dislikes) about the training experience as a whole.  We welcome your comments and suggestions about any or all aspects of the program, including Orientation, training seminars, case conferences, supervision and clinical training, clinical caseload, groups, and outreach/consultation opportunities.