2000 Doctoral Program: Clinical Internship

The policies found in section 2000 are specific to the doctoral program and do not apply to master’s students.

2000.1 Educational Objectives and Components

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

Students will complete two 8 month clinical internships over the course of their residency; one in the first year, and one in the second year. Most students develop work-study internships within their places of employment.

Others develop internships at sites 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 Director of Practicum Learning and the site. Final approval for the clinical internship, including supervision, must be obtained from the Director of Practicum Learning in conjunction with the Program Director.
Students will also participate in a mentored seminar during the first year internship. The seminar helps prepare students for the written and oral exams. The cohort meets online 6 times during the internship year. Post-Resident students are selected to facilitate the seminar.

The written and oral clinical qualifying exams are given at the end of the 1st year clinical internship session. The second year clinical internship includes a learning plan and the internship.

2000.2 Grading of the Clinical Internship

The Clinical Internship is graded on a Pass (P) / Fail (F) basis. For the 1st year clinical internship, the ﬁnal grade is made up of three components:

the grade for clinical internship, including passing all assignments as listed on the course syllabus for each practicum year;
the grade for the Written Clinical Qualifying Exam; and
the grade for the Oral Clinical Qualifying Exam.

The written and oral clinical qualifying exams are given at the end of the 1st year clinical internship session. 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.

The student must receive a final grade of 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 and would be grounds for dismissal from the Program.

2000.3 Internship Site

The internship site 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 varied patient population.
An emphasis on individual treatment with adults 17 and up, 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 is desired. (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 internship 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 the beginning of 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 profession. Some placements offer in kind supervision and training opportunities.

Many social workers and clinicians are working in private practice settings, whether their own or someone else’s private group practice. Students may elect to use private practice as the practicum when certain criteria are met.

The student in private practice must have a broad range of clients who are diverse in diagnosis and presenting concerns, age, cultural, racial, and identity factors, and gender and gender expression among other differences. The practice may be a specialized practice that is serving a historically marginalized group or groups. The private practice must have the capacity to take insurance including medicaid/medicare and/or would have pro bono options for clients who otherwise might not be able to access psychotherapy. All of the criteria for caseload and extra clinical training opportunities must be met. If possible the student should connect with opportunities for advocacy, teaching, supervision, and may participate in an outside clinical consultation group or community coalition. The Director of Practicum Learning must approve the private practice site.

1. 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

Administrative Supervisors are not considered Primary Supervisors unless specifically assigned this responsibility from the Clinical Director.

2. Caseloads

Students are expected to spend a minimum of 3 days a week in clinical practice at the internship site. Cases should be practiced in ways that allow for the 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.
It is expected that students will carry 3 or 4 clients over both years of clinical internship. Those students expecting to return to an internship site for a second year should arrange to maintain contact with continuing cases.
The agency or student for the 1st year should be prepared with at least 3 clients who will be ready to start treatment at the point of entry into the internship site.

3. Extra Clinical Learning

Students should seek out additional learning opportunities (e.g., in-service training, consultation, seminars, etc.) within the training site and the community, including any learning opportunities that are within a reasonable commuting distance.

4. 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, 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.

5. Permitted Holidays during the Clinical Internship

Clinical Internship runs from early 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. Internship sites 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 internship site.

2000.4 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.

1. 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 practicum learning 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 Practicum Faculty Adviser when the PFA makes their 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 be versed in at least two of them.

2. Supervisory Evaluations

Primary Supervisors are asked to comment twice a year on various aspects of the student's performance in the internship. Narratives 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.

2000.5 Ph.D. Practicum Faculty Adviser (PFA)

The Practicum Faculty Adviser (PFA) is responsible for overseeing the student's 1st and 2nd year clinical internships. PFAs typically support the student both years. PFAs are members of the School's resident and adjunct faculty, and also may be appointed by the School. PFAs 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’ practicum learning assignments, and serve as consultants on problems that may arise in the internship. Entering students are assigned PFAs during the summer. The PFA 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, PFAs support students in organizing a study plan to prepare for the clinical qualifying exams and coach them toward readiness. The PFA sits on the oral exam panel for their student. Three Panelists that include the PFA, the Clinical Coordinator/Practicum Learning Director, and one other faculty panelist evaluate the student and the grade comprises those three perspectives.

1. PFA Internship Visits

PFAs schedule internship visits, via Zoom, 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. PFAs also meet with the student's supervisor/s to review progress, troubleshoot issues or dilemmas and maintain orientation to the Smith SSW Ph.D. program. Internship 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. All visits are virtual.

2. PFA Internship Visit Reports

Following their Fall and Spring internship visits, PFAs complete an Internship Visit Report via the Sonia practicum learning database, the platform utilized by the Smith SSW. Students receive reports, and are expected to acknowledge each report, via Sonia.

2000.6 Student Practicum Learning Assignments

Students are required to complete assignments during the practicum learning year. Assignments are maintained in the Sonia practicum learning database for review and grading by the PFA and the Clinical Coordinator/Practicum Learning Director. PFAs will retrieve and upload assignments using the Sonia practicum learning database. Students are expected to complete all assignments by the ﬁnal day of internship as noted in the SSW and Ph.D. calendars. Exceptions are to be discussed with the Clinical Coordinator/Practicum Learning Director or designee.

Students will receive syllabi for each practicum year at the end of first and second summer session respectively.

2000.7 Standards of Performance for the First- & Second-Year Clinical Internships

1. 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

2. 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

2000.8 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. Note that for Clinical Advanced Standing candidates, each of the clinical qualifying exams is graded on a final Pass/Fail basis only and there is 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 only complete 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 take the internship during their ﬁrst year in the Program. These students are required to meet the performance standards and to complete the practicum assignments for the 2nd year rather than the 1st year clinical internship.