102.1 Educational Objectives
- Students advance their clinical skills
- Reflect upon the integration of theory and practice
- Systematically study clinical processes in depth
- Think critically about their knowledge, values, and skills
- Gain advanced competence as scholars in research and teaching
The Clinical Internship is intended as a 2-year laboratory. Most students develop work-study internships within their places of employment. Others develop internships at training centers or agencies around the country. Students must complete arrangements for clinical internships, including supervision, before beginning their first summer of classes. Arrangements are to be made in consultation with the Field Director and the clinical training center. Final approval for the clinical internship, including supervision, must be obtained from the Field Director in conjunction with the Program Director.
The Clinical Internship is graded on a Pass (P) / Marginal Pass (MP) / Fail (F) basis. A grade of MP for the first clinical internship session initiates a review of the student’s learning. A plan for the student to successfully meet first year learning goals will be explored. The student may be permitted to participate in session 3 (second academic session). The student must receive a Pass in their first year clinical internship to advance to the second summer. A student receiving a grade of F in either of the two clinical internship sessions will not be permitted to continue on to the next academic session, but would be given an opportunity to repeat the failed clinical internship session. A second grade of MP or F in clinical internship would be grounds for dismissal from the Program.
For the 1st year clinical internship, the final grade is made up of three components:
- the grade for clinical internship;
- the grade for the Written Clinical Qualifying Exam; and
- the grade for the Oral Clinical Qualifying Exam.
The written clinical qualifying exam is given at the end of the 1st year clinical internship session. The oral clinical qualifying exam is given at the end of the 1st year clinical internship session or in December of the 2nd year. Both exams, as well as the clinical internship component, must be passed before a student's transcript will show a grade of Pass for the 1st year clinical internship. In the interim, the student’s transcript will show a grade of I (Incomplete). More specific information on the Clinical Qualifying Exams may be found later in this section.
102.2 The Training Center
The training center supports advanced clinical education for social workers and accords priority to students' learning needs during the clinical internship by providing the following:
- Opportunities for intensive treatment, including treatment over a two-year period, with a patient population varied as to age and diagnosis.
- An emphasis on individual treatment with adults, as well as opportunities in a range of treatment modalities (i.e., couple, family, and group treatment, short-term treatment, etc.).
- Supervision by a Ph.D. level clinical social worker who meets the School's criteria is preferred. If not available, an advanced, dynamically oriented practitioner from another discipline may be proposed. - Regular consultation with senior staff involved in specialized areas of practice. (i.e., couple, family, and group treatment, child treatment, adult treatment, etc.)
- Supplemental educational resources, such as staff conferences where clinical data are examined from theoretical and dispositional points of view. Whenever training sites offer educationally relevant seminars, it is expected that students will have access to these learning opportunities.
- During the 2nd-year internship, opportunities for pertinent professional experiences in consultation, clinical teaching and training opportunities, and supervision.
Smith Ph.D. students are required to complete 24 hours weekly at their clinical internships between September and the end of April. This may include, among other duties, seeing 8-10 clients weekly, staff meetings, training provided by the agency, grand rounds, and documentation requirements. Students may be paid or unpaid as clinical interns, as the agency structure allows. Our students are most often social workers who have been working in the field. Some placements offer in kind supervision and training opportunities. Most agencies pay students either as salaried staff or as per diem employees since students are able to bill third parties.
- Administrative Supervisor
The clinical internship at the training center is supported by an Administrative Supervisor, the person at the agency who is responsible for:
- Ensuring that the student is provided with the caseload and learning opportunities outlined here.
- Ensuring that there is adequate time for clinical supervision
- Ensuring that time is allotted for qualifying exams
- Where appropriate, helping the student gain experience in providing training and supervision, as well as ensuring access to training and other learning opportunities at the agency
Students are expected to spend a minimum of 3 days a week in clinical practice at the training center. Those in private practice may do 2 days at the training center and the third day in private practice. Cases should represent diversity in race, ethnicity, gender, sexual orientation, age, and physical ability and students should be practicing in ways that allow for the use and integration of psychodynamic psychotherapy.
- Students are expected to have 8-12 clinical hours a week of direct client contact, mostly with adult individuals during the 1st yr. They may include couple, family, or group treatment, during the 2nd year.
- It is expected that students will carry 3 or 4 clients over both years of clinical internship. Those students expecting to return to a training center for a second year should arrange to maintain contact with continuing cases.
- Students should carry at least 2 planned short-term cases.
- The agency should locate for the 1st year student at least 3 clients who will be ready to start treatment at the point of the student's entry into the training site.
- Extra Clinical Learning
Students should seek out additional learning opportunities (e.g., in-service training, consultation seminars, etc.) within the training center and the community, including any learning opportunities that are within a reasonable commuting distance. The School permits students 3 days during each field session for attending conferences. Students should obtain information about conferences that would be reasonable for them to attend during clinical internship periods and should make plans well in advance so that time may be taken at the convenience of the training center.
- Technology & Telehealth
The introduction of technology into social work practice has presented the opportunity for social workers and therefore, students, to practice using special apps, social media, portals for communication, and digital telehealth platforms like Zoom and Doxy to provide face to face services. This in turn has created challenges in jurisdictional regulation regarding confidentiality, risk, responsibility, and liability. Liability, ethics, and risk are the same when using telehealth as they are for in-person work. Just as in in-person clinical work, students are expected to abide by NASW standards including the protection of client private health information, respect for clients, client confidentiality, and professional practice ethics.
Students who will be practicing telehealth at their agencies are expected to participate in any required training in technology and telehealth practice and to follow protocols and regulations set forth in their placement agencies. In addition, students may be provided the use of agency owned technology, digital platforms, and equipment and must adhere to agency policies.
- Permitted Holidays during the Clinical Internship
Clinical Internship runs from September through April. The School prepares a yearly calendar indicating beginning and ending dates for clinical internship as well as dates for School-permitted holidays occurring during this period. Training centers may observe additional holidays; students are permitted these times off as well. Students who wish to take additional time in accordance with personal beliefs should coordinate with the training site.
102.3 Clinical Supervision
Ideally, the student will use a Primary Clinical Supervisor who is a senior clinician (social worker, psychologist, psychiatrist), and in most cases, a Secondary Clinical Supervisor. While clinical supervision by a senior social work clinician is considered important, not all clinical supervision needs to be with a social worker.
- Supervisory Guidelines
- Students are to have 2 hours a week of clinical supervision by a psychodynamically oriented supervisor (or 1 hour per week by each of 2 different psychodynamically oriented supervisors).
- Supervision should focus largely on individual treatment but should also cover other modalities the student may be using.
- Supervisors should be able and willing to teach from process recordings.
- Primary Clinical Supervisor has responsibility for coordinating student's overall learning in the field and for submitting 4 performance evaluations of the student's clinical work over the course of the clinical internship session.
- Supervisors must be available to meet 2 times a year with the student's Faculty Field Adviser when the FFA makes the field visit to the student's clinical internship.
- 1st year supervision. Supervisors help the student prepare for the clinical qualifying exams. Students are expected to know, apply, integrate, and critique advanced psychodynamic theories (drive, ego psychology, object relations, self psychology). Not every supervisor is expected to be well versed in all four theories; however, they should have expertise in at least two of them.
- Supervisory Evaluations
Supervisors are asked to comment 4 times a year on various aspects of the student's performance in the internship. Evaluations are completed by supervisors via Sonia, the system program utilized by the School. Students are expected to participate with their supervisors in the evaluation process and to acknowledge each report through Sonia.
102.4 – PhD Faculty Field Adviser (FFA)
The Faculty Field Adviser (FFA) is responsible for overseeing the student's 1st and 2nd year clinical internships. FFAs typically support the student both years. FFAs are members of the School's resident and adjunct faculty, and also may be appointed by the School. FFAs serve as teaching, mentoring, evaluative, and administrative liaisons between the student, the School and the placement. They monitor caseloads and supervision, grade and provide comprehensive feedback on students’ field assignments, and serve as consultants on problems that may arise in the field. Entering students are assigned FFAs during the summer. The FFA will contact the student's supervisor/s at the start of the internship to introduce themselves and to orient the supervisor/s to the learning goals. In the 1st year clinical internship, FFAs support students in organizing a study plan to prepare for the clinical qualifying exams and coach them toward readiness. The FFA sits on the oral exam panel for their student. Three Panelists that include the FFA, the Clinical Coordinator/Field Director, and one other faculty panelist evaluate the student and the grade comprises those three perspectives.
- FFA Field Visits
FFAs make field visits once in the Fall and once in the Spring to evaluate students in their clinical internship settings. They meet with students for a minimum of 2 hours to discuss written assignments, process recordings, and other case materials; to frame areas for further learning; and to help organize and prepare for exams. FFAs meet with the student's supervisor/s to review progress, troubleshoot issues or dilemmas and maintain orientation to the Smith SSW PhD program. Field visits may require up to half a day, depending on the agency and student. It is the student's responsibility to make all meeting arrangements. Visits may be virtual. At least one visit will be in person.
- FFA Field Visit Reports
Following their Fall and Spring field visits, FFAs complete a Field Visit Report via the Sonia field database, the platform utilized by the Smith SSW. Students receive reports, and are expected to acknowledge each report, via Sonia.
102.5 Student Field Assignments
Students are required to complete assignments during the field year. Assignments are maintained in the Sonia field database for review and grading by the FFA and the Clinical Coordinator/Field Director. FFAs will retrieve and upload assignments using the Sonia field database. Students are expected to complete all assignments by the final day of field as noted in the SSW and Ph.D. calendars. Exceptions are to be discussed with the Clinical Coordinator/Field Director or designee.
- First-Year Clinical Internship Field Assignments
The list of monthly field assignments for the first year clinical internship is shown in Appendix A, with case study guidelines shown in Appendix B;
- Second-Year Clinical Internship Field Assignments
The list of monthly field assignments for the second year clinical internship is shown in Appendix C.
102.6 – Standards of Performance for the First- & Second-Year Clinical Internships
- First-Year Clinical Internship Standards of Performance
While each class is made up of students with a range of experience and knowledge, it is expected that students will expand their knowledge and skill beyond their individualized beginning points. Progress in clinical learning is measured, therefore, in terms of the following criteria and individualized beginning points. During the internship, the first-year student should gain the knowledge, values, and skills to demonstrate:
- The use of social theories in understanding, analyzing, and intervening in the client’s social contextual conditions
- The capacity to take a critical, reflective, "meta" theoretical stance, appreciating the contextual nature of theories and the ways in which each theory assigns different meanings to the same material
- The capacity to make informed biopsychosocial assessments and to develop treatment plans with specific clinical interventions that follow from those assessments
- The ability to reflect upon those social structures that maintain discrimination and inequity and to selectively identify strategies for change
- The capacity to establish and maintain clinical relationships with a range of diverse clients
- The capacity to set long- and short-term goals including clinical case management
- The capacity for self-awareness and for the differential use of self
- The capacity to understand and evaluate the working alliance, transference, and countertransference
- The capacity to show evidence of the effectiveness of practice using process recordings
- The capacity to evaluate clinical processes using data as clinical evidence
- The capacity to make effective use of clinical supervision
- The capacity for ethical practice based on the NASW Code of Ethics
- Second Year Clinical Internship Standards of Performance
The goal for the second year is to prepare students for a range of leadership roles in clinical social work. In addition to increasing their clinical knowledge and skill, students are now expected to gain teaching experience, whether as classroom teachers, supervisors, and/or consultants, and expected to demonstrate:
- Deepen the capacity to critically examine and apply a variety of practice modalities as strategies for change, including individual, group, and family therapy
- The capacity to critique advanced theories and practice based on research findings for their fit with clients' needs and contexts
- The capacity for differential uses of self, including transference/countertransference and intersubjectivity
- A more advanced ability to reflect upon those social structures that maintain discrimination and inequity, and to selectively identify strategies for change
- An advanced capacity to synthesize social and psychological theories and their application to biopsychosocial assessments and treatment processes
- An advancing capacity to select from among biopsychosocial theories and treatment modalities, using time limits and other parameters with a clearly articulated understanding of the gains and losses inherent in any clinical decision
- An understanding of the specific and differing meanings of treatment interruptions to clients, especially those whose long-term therapy was interrupted during the summer academic session
- The ability to critique social policies that contribute to inequities, conflicts, and barriers to delivery in mental health service models, including the effects on the clinical process
- A more advanced capacity to evaluate process and outcomes in practice
- Leadership in teaching writing, program development, consultation, or administration
102.7 – Extensions of the Clinical Internship (added 2011)
When a student has not completed all internship requirements before completing all summer courses, they will incur additional costs for an extended field period. Such extensions may also impact on student loan availability and repayment.
102.8 – Clinical Advanced Standing
Applicants who have been accepted in the Ph.D. Program may petition to enter with Clinical Advanced Standing status. The option is available to meet the needs of the rare applicant for whom our standard two years of supervised advanced clinical practice would be truly superfluous. Clinical Advanced Standing status is achieved by taking and passing the clinical qualifying exams before commencing the first summer of coursework, rather than taking them at the end of the 1st year clinical internship, as is usual. A fee is charged for the exam. Note that for Clinical Advanced Standing candidates, each of the clinical qualifying exams is graded on a Pass/Fail basis only. There is no grade option of Marginal Pass for Clinical Advanced Standing candidates, and therefore, no opportunity to rewrite any part of either exam. If the status of Clinical Advanced Standing is not achieved, the accepted applicant may still enter the Program as a regular degree candidate. Clinical Advanced Standing students must meet all Program requirements, except that they may choose one of the following clinical internship options.
Option A: One year of clinical internship with the standard three days a week of seeing clients and two hours a week of clinical supervision. This one-year internship conforms to the 2nd year clinical internship, except that clinical advanced standing students choosing this option take the internship during their first year in the Program. These students are required to meet the performance standards and to complete the field assignments for the 2nd year rather than the 1st year clinical internship.
Option B: Two years of clinical internship with one-and-a-half days a week of seeing clients and one hour a week of supervision. (Option B adopted 2001-02.) The Clinical Advanced Standing student consults with the Program Director on how to integrate into her/his schedule the 2nd year teaching requirement.