apa standard for internship site

[ikibah]

I'm an MSW Intern at a site that happens to be APA accredited so I work together with psych interns who are completing their internship as well. My question is what does it take for a site to get APA accreditation. It can't be too hard because I see first hand that this placement is a joke - the interns spend copious amounts of time on facebook and rarely work/see clients. Why don't more places have APA accreditation? I can't imagine it's too hard to get.

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[erg923]

I'm an MSW Intern at a site that happens to be APA accredited so I work together with psych interns who are completing their internship as well. My question is what does it take for a site to get APA accreditation. It can't be too hard because I see first hand that this placement is a joke - the interns spend copious amounts of time on facebook and rarely work/see clients. Why don't more places have APA accreditation? I can't imagine it's too hard to get.

It takes money. And it takes a lot of paperwork/documentation.

That' said, for a site to become accredited, they have to show more than suffiencient amounts of evidence that it is a functioning training program which includes the development of program training goals/competencies, didactics, meeting the 4 hour/week supervision requirement, and of course providing interns with sufficient clinical/patient contact (usually no less than 15 hours/week).

 

[WisNeuro]

http://www.apa.org/ed/accreditation/

Yeah, it's way too easy to get, as long as you go through a good amount of up front documentation. Many of us would love to see standards tightened up considerably, but I'm pessimistic that it will happen anytime soon due to financial and political reasons.

The problem these people could come up to, when license time comes around, is that they may have to lie on their applications to get licensed. For example, some states require that during that full year internship, you had approximately 25% of your hours constituted by face to face patient care, with an associated amount of indirect contact.

 

[WisNeuro]

It takes money. And it takes a lot of paperwork/documentation.

Exactly, somewhat difficult to obtain up front. Not that difficult to maintain, though.

 

[Justanothergrad]

As they said above. It reminds me of the old saying "What do you call a doctor who graduates at the bottom of his class?" Quality is not promised merely because of a title, but you still get the name. There are plenty of instances of poor training being provided because of an ability to pay money and do paperwork (*cough* Argosy *Cough*).

I also suspect that you do not see the full amount of work that they are doing.

 

[Therapist4Chnge]

There may be quite a bit of variance in setting/training/etc….though I'd agree with justanothergrad about the limited sample. I did the vast majority of my work behind closed doors of in-pt rooms, exam/testing rooms, and my office. The "public" computers were more about answering a page, checking an e-mail, and yes…maybe even checking on my fantasy teams.

 

[WisNeuro]

and yes…maybe even checking on my fantasy teams.

Shh. We're not supposed to tell people about that. How else would I find time to manage my 4 teams?

 

[Ollie123]

Pretty much just going to second the above. Just as there are some pretty awful accredited graduate schools, there are some pretty awful accredited internships.

It is also likely you are missing a lot of what is going on. Depending on how often you overlap with them, they may have days that are more focused on supervision/didactics with other days being more case-heavy, the last few weeks are unusually slow for pretty much any outpatient clinic since everyone tends to disappear around the holidays, etc. Of course, its also possible they don't have that much to do...

 

[Ms. Freud]

Posting my question here, since I am have posted in the wrong forum:
Hello everyone,
Curious to hear about people's internship or professional experiences. I interviewed with an APA accredited outpatient community mental health agency site and was told by an intern that the caseload consists of about 60 clients. While many of them are seen monthly or biweekly, I find it difficult to comprehend how effective care (and valuable training) is possible. Is this typical of public agency sites? Has anyone had such an experience? What is the typical caseload in this type of setting? If this is not typical, how is this permitted by apa? Would really appreciate any input. Thank you so much.

 

[erg923]

Posting my question here, since I am have posted in the wrong forum:
Hello everyone,
Curious to hear about people's internship or professional experiences. I interviewed with an APA accredited outpatient community mental health agency site and was told by an intern that the caseload consists of about 60 clients. While many of them are seen monthly or biweekly, I find it difficult to comprehend how effective care (and valuable training) is possible. Is this typical of public agency sites? Has anyone had such an experience? What is the typical caseload in this type of setting? If this is not typical, how is this permitted by apa? Would really appreciate any input. Thank you so much.

I'm in the VA- an outpatient medical clinic. My current case load is about 80 active patients. Some are only seen monthly. Session are 30 minutes. And not an intern anymore.

Interns should ideally have about 15-25 hours of patient contact per week.

 

[Ms. Freud]

I'm in the VA-outpatient medical clinic. My current case load is about 80 active patients. Some are only seen monthly. Session are 30 minutes. And not an intern anymore.

Interns should ideally have about 15-25 hours of patient contact per week.

Thank you for your response. It seems that the intern has about 13-15 individual client hours per week, so the numbers don't quite add up to me, unless she is seeing the clients for a very limited amount of time. In that case, I wonder if it is more of "check in" contact as opposed to actual therapy.

 

[bmedclinic]

the paperwork isnt the barrier; those sites that are appic are already doing most of the same paperwork. It's the money.

 

[smalltownpsych]

I'm an MSW Intern at a site that happens to be APA accredited so I work together with psych interns who are completing their internship as well. My question is what does it take for a site to get APA accreditation. It can't be too hard because I see first hand that this placement is a joke - the interns spend copious amounts of time on facebook and rarely work/see clients. Why don't more places have APA accreditation? I can't imagine it's too hard to get.

That is just sad. I loved my internship and was busy most of the time and worked extremely hard while there. Facilitated two groups a week, met with anywhere from 4 to 8 patients each day, four hours of clinical supervision, about one assessment a month, taught a college course, collaborative treatment team meetings, attended weekly didactics, gave a presentation to all staff at hospital, conducted a bi-monthly experiential training for new staff about psychosis, and supervised a practicum student the second half of the year. The other interns were just as busy. I find it hard to conceive of an internship program that doesn't provide that level of experience.

 

[CheetahGirl]

I interviewed with an APA accredited outpatient community mental health agency site and was told by an intern that the caseload consists of about 60 clients

Is this intern counting group therapy patients and hours? On my VA internship, my caseload could vary from 12-18 individual cases, but I also had intakes (about 2-3 per week, but not consistently each week) who I followed until they were scheduled with their provider, and I ran 3 groups per 2 rotations (each group had from 5-15 patients). So even if I counted all the cases that I was privy to and individuals who were 'treated' or assessed, it still wouldn't be 60 clients....maybe 40 max.

I agree with smalltownpsych, we had weekly didactics, multidisciplinary meetings, weekly clinical case presentations, and group + individual supervision. I can't imagine internship being what equates to 'free labor,' with minimal benefit to the trainee. Sure, building stamina is part of the deal, too. But, something is suspect with this intern's account of "60 clients," and seems like an egregious outlier.

Edit: OP, are you referencing what a clinical psych intern does compared to what an MSW intern does? Because perhaps, the MSW intern has more clients on their caseload, as some of it is 'checking in' and case management. Psych interns do the same, but we're also delivering a service - such as whatever appropriate clinical intervention. I have heard that social workers have huge caseloads. Perhaps someone out there who is a Social Worker can shine some light on this point.

 

[Ms. Freud]

Is this intern counting group therapy patients and hours? On my VA internship, my caseload could vary from 12-18 individual cases, but I also had intakes (about 2-3 per week, but not consistently each week) who I followed until they were scheduled with their provider, and I ran 3 groups per 2 rotations (each group had from 5-15 patients). So even if I counted all the cases that I was privy to and individuals who were 'treated' or assessed, it still wouldn't be 60 clients....maybe 40 max.

I agree with smalltownpsych, we had weekly didactics, multidisciplinary meetings, weekly clinical case presentations, and group + individual supervision. I can't imagine internship being what equates to 'free labor,' with minimal benefit to the trainee. Sure, building stamina is part of the deal, too. But, something is suspect with this intern's account of "60 clients," and seems like an egregious outlier.

Edit: OP, are you referencing what a clinical psych intern does compared to what an MSW intern does? Because perhaps, the MSW intern has more clients on their caseload, as some of it is 'checking in' and case management. Psych interns do the same, but we're also delivering a service - such as whatever appropriate clinical intervention. I have heard that social workers have huge caseloads. Perhaps someone out there who is a Social Worker can shine some light on this point.

Thanks for your input! I don't believe she is counting intakes, maybe counting groups but she only runs 2 of them. I just wonder if it is possible to provide quality care when having so many cases, particularly when one is in training.

 

[bmedclinic]

I just wonder if it is possible to provide quality care when having so many cases, particularly when one is in training.

spoiler: no, its not.

 

[Ms. Freud]

spoiler: no, its not.

 

[futurepsydoc]

There is a great deal of variance across internship programs and those students who are selected for a given internship program, especially when considering the number of APA Accredited Internships, number of doctoral psychology students applying for internships, and the imbalance of students to the number of available accredited sites/positions. Recently, there has been a push to increase the number of accredited internship programs due this matter, with the imbalance decreasing slowly over time. That said, I am curious about how long the program has been accredited.