Counseling Services

Doctoral Internship Training Activities and Completion Requirements

• Initial Consultations and Testing
  Initial Consultations and Testing services provide interns with the opportunity to develop the profession-wide competencies related to assessment, communication and interpersonal skills, and individual and cultural differences.

  Initial Consultations. Interns regularly conduct initial consultation interviews in order to develop and refine skills in assessment, problem-formulation and diagnosis. These are 30 minute appointments that serve as the starting point for students seeking services.

  Testing. A portion of Counseling Services time is dedicated to the assessment of Attention Deficit/ Hyperactivity Disorder (AD/HD) in adult learners. Interns are expected to assist in this activity. Interns begin training on AD/HD assessment with didactic seminars during orientation and then participate in group assessment supervision throughout the academic year. Interns also complete formal psychological assessments utilizing personality assessments. Interns are required to complete 4 testing batteries are part of the internship exit requirements.

• Crisis Intervention

  Interns are scheduled with a weekly “Counselor-on-Duty” shift throughout the academic year and may take additional crisis appointments on an as-needed-basis. Interns may also participate in the "Counselor-on-Call" afterhours coverage rotation. Interns receive training in suicide assessment and crisis intervention during fall orientation. Interns are expected to demonstrate the ability to assess and respond appropriately to these crisis situations, as well as follow Counseling Services documented policies. Occasionally, interns assist in providing crisis intervention outside the clinic, for example in consultations with faculty or staff.

• Therapeutic Intervention

  Individual Therapy. The agency operates as the primary mental health care facility for students, for whom therapy services are free of charge. Clientele present with a full spectrum of problems, from relationship or developmental issues to major affective, anxiety, psychotic, or personality disorders.

  An approach to treatment that integrates the psychological, social, and physical needs of clients is emphasized. Interns are asked to videotape their counseling sessions in order to enrich the training experience. Videotaped sessions are reviewed during supervision, after which it is the intern’s responsibility to ensure they are erased. In the beginning of the training year, interns are required to videotape every client at every session.

  Supervisors assume the liability and professional responsibility for the clients with whom the intern works. Thus, acceptance of a particular client onto an intern’s caseload is up to the discretion of the intern’s primary supervisor. Agency demands and availability of particular client characteristics also influence disposition of clients to an intern’s caseload.

  Relationship Therapy. Over the course of internship, interns might also engage in couples therapy. The number of couples seeking services from our agency is small overall and varies from year to year. When couples do present for therapy, we attempt to funnel these clients to interns so that interns can obtain experience in this area. Given the low frequency of couples, couple’s work is not considered a core activity of the training and program and not separately evaluated as a distinct skill set.

  Group Therapy. Student Counseling Services has a strong group program and routinely refer clients to therapy and support groups. Interpersonal process groups, psychoeducational groups, and support groups are typically available to clients throughout the academic year. Topics for problem-focused structured psychoeducational groups include anxiety management, stress management, depression management, and body image concerns. Structured workshops in time or anger management, grief issues or other topics are offered when the need arises or an adequate number of interested students for a specific topic are available. Support groups are organized around shared identities (e.g., BIPOC support group) or shared experiences (e.g., grief support group)
  
  In addition to these groups, the initial service provided for the majority of students requesting services is a series of 3 “seminars”/psychoeducational workshops introducing the basics self-awareness and coping skills. All staff members including interns are involved in presenting and facilitating these seminars on a regular basis.

  Development of group counseling skills is designed to be sequential. During fall quarter, an intern is expected to work with a senior staff member in the preparation and implementation of a group as well as a Pathways series. Once approved, the intern has the option of conducting that group on their own, may supervise a master’s student as a group co-leader (in a psychoeducational group), may facilitate a group with another intern, or may choose to become involved in the facilitation of a different group with a senior staff member.

  Interns are expected to accrue 500 hours of direct service over the course of the internship.

• Outreach

  Outreach. Outreach demands fluctuate greatly, typically being greatest in the Fall Quarter. We believe that the ability to communicate psychological information effectively and in an engaging way is an important skill for a developing psychologist. Interns will participate in outreach opportunities as they arise. Outreach presentations are often delivered outside of normal operating hours and may involve evening or weekend work and interns may take comp time for after-hours work. If an intern is interested in developing this area as part of their individual training goals, the program will work with the intern to create additional outreach opportunities.

  Outreaches that are psychoeducational in nature count toward the 500 direct service requirement.

• Provision of Supervision

  Student Counseling Services typically employs two Graduate Assistants who are second year students in the Master's of Mental Health Counseling program at CWU. Doctoral interns provide clinical supervision to the Graduate Assistants. The program strives to ensure that each doctoral intern has an opportunity to provide clinical supervision as part of the internship experience. Doctoral intern supervisors typically provide one hour a week of clinical supervision, review and provide feedback on recordings of supervisee's work, review and sign-off on clinical charting, and provide support and consultation to their supervisee. Doctoral interns may also co-lead groups with a Graduate Assistant later in the internship year, thereby having the opportunity to provide supervision of group skills as well. Doctoral interns also complete evaluations for the Graduate Assistant's program. If a doctoral intern is not providing direct clinical supervision during a portion of the internship year, they still participate in supervision of supervision and are expected to act as a peer supervisor to their colleagues who are providing direct clinical supervision.

  Provision of supervision counts toward the 500 hour direct service requirement.

• Ethical and Professional Behavior

  During the internship year, interns are expected to exhibit the self-knowledge, attitudes, professional knowledge, and skills for effective and ethical practice. Didactic seminars, supervision, and staff-wide case consultation are forums to learn the ethical, legal, and practice guidelines governing clinical work. Interns are also encouraged to work on their professional development. For example, interns may be encouraged and financially assisted to attend trainings through regional psychological associations. Interns are supported in making the transition from the role of student/intern to that of an entry-level psychologist.

• Individual and Cultural Differences and Social Justice

  The Counseling Services staff value diversity, cultural humility, and a social justice orientation among professional staff, trainees, and students. In our work, we are aware of cultural, individual, and role differences, including those of age, gender identity, race, ethnicity, national origin, citizenship status, religion, sexual orientation, disability, language, and socioeconomic status. We strive to reduce the impact of biases on our work. We work to challenge systemic discriminatory practices. Issues pertinent to social justice, identities, and cultural backgrounds are embedded in all elements of training activities as well as service delivery. Focused training takes place during a series of intern seminars held throughout the internship year.

  Interns also participate in the center-wide social justice initiative each year. Our social justice initiative focuses both on our own growth within the area of social justice awareness and work as clinicians and humans as well as how we are enacting our commitment to social justice across the wider university.

• Consultation and Interprofessional/Interdisciplinary Skills

  There are many opportunities for interns to gather consultation skills. These include:

  (a) Consultation with university Case Managers both individually and in a bi-weekly meeting to discuss students who are in service with both Case Management and Counseling Services.

  (b) Consultation with Student Health Services medical providers who are working with shared clients/patients. This is typically a client for whom Student Health Services is providing psychotropic medications, but it could also be related to a chronic health condition that has psychological impacts.

  (c) Counselor-on-Call duties. Student Counseling Services staff, including doctoral interns, provide afterhours consultations in emergency situations, usually when a student is being evaluated by a Designated Crisis Responder (see below) for suicidal risk. Counselor-on-Call assists the DCR in gathering background information for the risk investigation and aids in planning for follow-up care if the student is not hospitalized. Consistent with our developmental model, interns have back-up and mentoring whenever they are on call.

  (d) Consultation with Designated Crisis Responder (DCR). In Washington State, only DCRs are given the authority to authorize involuntary hospitalizations. When a client is at significant risk and is either unwilling to safety plan or an adequate safety plan cannot be developed, interns consult with a DCR to determine appropriate next steps, which often includes formal evaluation for hospitalization. During these evaluations, the intern serves as consultant to the DCR, providing information regarding the client’s risks and other historical data that is important in determining appropriate level of intervention for the client. Interns can also consult informally with DCRs if a student’s risk does not rise to the level of hospitalization but they are needing an additional perspective on risk issues and how to address them. Consultations with DCRs are also initiated after consultation with a supervisor or senior staff member. Keeping with our developmental framework, a supervisor/senior staff person is often closely involved with a first consultation, modeling contact or walking interns through step by step. Later, interns are coached, as needed, from a distance, and encouraged to take on the primary role in working with DCR.

  (e) Consultation with faculty, staff, parents, or other students concerned about a student or client also occurs on an occasional basis. The Counseling Clinic Director often fields these contacts, but interns may be asked to serve this role, particularly later in the year. Such consultation involves active listening to concerns, provision of basic advice regarding how to refer the student of concern to the clinic or other resources or access emergency intervention if needed, and coaching on how to approach difficult conversations such as concern for a student.

  (f) Consultation with off-site providers. Interns are encouraged to consult with past providers, either medical or counseling, when students transfer care to our clinic. This is particularly encouraged when a student will continue a relationship with this provider when they return home for breaks.