Assessment and intervention hours needed for a neuro track internship

[BrainStormer]

I will be applying to internships in a couple of years, and I am wondering how many hours of both intervention and neuropsychological assessment I need to be competitive for a reputable neuro track AMC or VA. My practicum experiences offer little to no intervention hours because they are full neuro. I am worried I will not be considered without a decent amount of intervention hours given a good chunk of internship is intervention based. Can any training directors or matched students speak into the minimum amount of hours needed as well as a competitive amount of hours for each category?

---

Members don't see this ad.

 

[PsyNeuro37]

Get at least a little bit over the minimum hour requirements for the site. After that, quality and diversity of experiences matter much more than the quantity of hours. Papers like this I think do a much better job of capturing what makes an applicant competitive for neuropsych internships.

A Survey of Doctoral Internships Offering Clinical Neuropsychology Training: Updated Expectations for Competitive Applicants - PubMed

This study updated expectations for competitive applicants from a diverse sample of neuropsychology training programs, underscored the importance of fit between trainee and program, and demonstrated consistency over time for trainees seeking neuropsychology training during internship.

pubmed.ncbi.nlm.nih.gov

 

[summerbabe]

My practicum experiences offer little to no intervention hours because they are full neuro.

I assume you'll be completing therapy only/focused pracs in the future, no?

Even if you're 1000000% committed to neuro, you're currently training to be a clinical psychologist, which means getting exposure in all core clincial competencies during grad school and internship (individual therapy, group therapy, cognitive assessment, personality assessment).

It's not like somebody who is 100000% focused on running Yalom style groups for their career can just decide to ignore assessment during grad school. I guess they can try but as somebody who reviews VA internship apps, it will be a struggle for them to match at my site.

In my program, our DCT basically solely determined everybody's practicum placement (with our preferences & match needs in mind) because we were in a rural area with limited total placements.

But I know students in other programs who were essentially 99% responsible for finding and negotiating their placements each term.

Regardless, it might be helpful to have a sit-down with your DCT soon to discuss how your future pracs will/could be spent so you'll be able to hit all the core competencies and benchmarks, while focusing as much as you can on neuro.

Lastly, refer to sites that you're interested in (along with that paper linked earlier). Most sites are very clear about what makes a good candidate, including minimum hours via category and what a typical matched applicant has to ensure that neither party wastes their time. Good luck!

 

[AcronymAllergy]

As was said, what's just as important as the number of hours is the quality and breadth of those hours. The linked publication is a great place to start, and you could also look through the materials for individual internship sites to see: A) what their requirements are, and B) what the characteristics of their interns were.

I would also second what summerbabe said--do all you can to get some intervention experience, even if it means completing a non-neuro practicum (e.g., I had 2 or 3 non-neuro practicum sites while I was in grad school, in addition to my neuro practica). It may even be the case that you're able to work in some additional neuro assessment at the non-neuro sites, if your advisor is willing to jointly supervise the case(s).

 

[BrainStormer]

I assume you'll be completing therapy only/focused pracs in the future, no?

I completed a year of intervention prac at a UCC last year but did not get a lot of clients, so my intervention hours are still pretty low (<100). I also didn't particularly enjoy therapy, so the thought of doing another intervention practicum in the future seems discouraging. I can do a supplemental UCC practicum next year but was hoping to use that time towards research and publishing a couple of my projects. Most of my intervention hours at my current placement are coming from neuro intakes, but I assume internships will be looking at therapy-based intervention?

 

[BrainStormer]

Get at least a little bit over the minimum hour requirements for the site. After that, quality and diversity of experiences matter much more than the quantity of hours. Papers like this I think do a much better job of capturing what makes an applicant competitive for neuropsych internships.

A Survey of Doctoral Internships Offering Clinical Neuropsychology Training: Updated Expectations for Competitive Applicants - PubMed

This study updated expectations for competitive applicants from a diverse sample of neuropsychology training programs, underscored the importance of fit between trainee and program, and demonstrated consistency over time for trainees seeking neuropsychology training during internship.

pubmed.ncbi.nlm.nih.gov

This was a fantastic read! Thank you!

 

[BrainStormer]

As was said, what's just as important as the number of hours is the quality and breadth of those hours. The linked publication is a great place to start, and you could also look through the materials for individual internship sites to see: A) what their requirements are, and B) what the characteristics of their interns were.

I would also second what summerbabe said--do all you can to get some intervention experience, even if it means completing a non-neuro practicum (e.g., I had 2 or 3 non-neuro practicum sites while I was in grad school, in addition to my neuro practica). It may even be the case that you're able to work in some additional neuro assessment at the non-neuro sites, if your advisor is willing to jointly supervise the case(s).

Thanks for your input! The average number of intervention hours from the published article was 405, so its looking like I'm going to need to do another non-neuro prac to even get close to that number. I agree that focusing on both quality and breath is going to be key for me.

Any thoughts on cognitive rehabilitation as a means of intervention hours? There might be opportunity there at my site.

 

[jdawg2017]

I come from a clinical science program, so take this with that lens in mind. 100 total intervention hours seems kind of low (basically 2 clients per week all year). I think I had something around 300 intervention and 900ish assessment hours which were direct Face-to-Face, and these hours I think are still on the lower side relative to some of the PsyD programs in the area where students did multiple practica in the same year (that’s bonkers to me but that’s besides the point).

There are a handful of internship programs like the one I went to that are neuropsych-heavy. The limited intervention I did was entirely with a neuropsych angle on it. Many more programs are generalist where neuropsych will be a major rotation, but you’ll also likely have an intervention-heavy minor rotation (or 2nd placement if it’s two 6 month splits). These programs I think won’t favor low intervention hours… in fact, the 3 out of 15 sites/tracks that did not invite me to interview were all 50/50 splits between neuropsych and intervention in the internship. I’m not really a generalist, so it figures that’s how things shook out…

Start looking now at sites you want to apply to and see what their hour requirements are in the manuals. Some, like Brown for example, have notoriously high hours thresholds. I would also see if you do another neuropsych prac if you can run a skills group or two for patients (like a TBI or ADHD group) to get some more intervention hours that are really valuable. TDs liked talking to me a lot about my ADHD group that I ran in grad school and I ran another group intervention on internship for half the year.

 

[summerbabe]

Thanks for your input! The average number of intervention hours from the published article was 405, so its looking like I'm going to need to do another non-neuro prac to even get close to that number. I agree that focusing on both quality and breath is going to be key for me.

Any thoughts on cognitive rehabilitation as a means of intervention hours? There might be opportunity there at my site.

Yes, cog rehab counts as intervention and could give you group experience potentially.

At my VA (which offers neuro but not as a specific track but we definitely have a handful of folks go onto neuro postdocs), if you don't have any group experience, we'll make a note of it. It wouldn't prevent an otherwise solid candidate from an interview but our top candidates are able to check all the boxes (even if some of that is out of people's control sometimes).

The average number of intervention hours from the published article was 405, so its looking like I'm going to need to do another non-neuro prac to even get close to that number.

Not just from an hours perspective but based on my anecdotal experience working with a number of board certified neuropsychologists, I can take some guesses as to which ones were more committed to intervention/therapy training and which ones were probably checking this box and doing the bare minimum or even have disdain for therapy.

While therapy competency doesn't impact neuro competency, IMO the microskills and experience one typically gains from therapy can play a huge role in overall effectiveness with direct patient care, such as more effectively conveying feedback, providing brief interventions that are appropriate for your setting, working with challenging assessment patients, working with families, etc.

Hopefully you can find settings that are a better fit than college counseling and perhaps your DCT & your neuro mentors can provide some guidance on what's available locally.

 

[BrainStormer]

The limited intervention I did was entirely with a neuropsych angle on it.

Can you expand on this? Were your intervention hours through neuropsych placements?

I would also see if you do another neuropsych prac if you can run a skills group or two for patients (like a TBI or ADHD group) to get some more intervention hours that are really valuable. TDs liked talking to me a lot about my ADHD group that I ran in grad school and I ran another group intervention on internship for half the year.

This is helpful thanks for your input. It seems like group experience is desirable... although obtaining that experience is highly dependent on the opportunities of your practicum site.

 

[BrainStormer]

While therapy competency doesn't impact neuro competency, IMO the microskills and experience one typically gains from therapy can play a huge role in overall effectiveness with direct patient care, such as more effectively conveying feedback, providing brief interventions that are appropriate for your setting, working with challenging assessment patients, working with families, etc.

This!! My advisor always says you need to first be a good psychologist before becoming a great neuropsychologist... lol he's not wrong

Hopefully you can find settings that are a better fit than college counseling and perhaps your DCT & your neuro mentors can provide some guidance on what's available locally.

What types of settings would be ideal for wanting to go the neuro route? I'm assuming maybe CBT in a medical setting or something similar. I am more so interested in working with adults and geriatric populations and am wondering if the intervention needs to be more "neuro based" e.g., cog rehab/ CBT with that population is probably a better fit than psychoD at a UCC .

 

[AcronymAllergy]

Thanks for your input! The average number of intervention hours from the published article was 405, so its looking like I'm going to need to do another non-neuro prac to even get close to that number. I agree that focusing on both quality and breath is going to be key for me.

Any thoughts on cognitive rehabilitation as a means of intervention hours? There might be opportunity there at my site.

So long as cog rehab isn't you only intervention experience (and it doesn't sound like that's the case), I think it's a fine option.

 

[summerbabe]

What types of settings would be ideal for wanting to go the neuro route? I'm assuming maybe CBT in a medical setting or something similar. I am more so interested in working with adults and geriatric populations and am wondering if the intervention needs to be more "neuro based" e.g., cog rehab/ CBT with that population is probably a better fit than psychoD at a UCC .

I think your instinct to look for medical settings is right on.

If there are any hospital systems or VAs near you, they will likely provide training in evidence based interventions and may also have training options with adult/aging populations.

Lastly, you might benefit from exploring more time-limited training options. There's definitely a difference between delivering a brief and targeted intervention in 1-4 sessions & the traditional 12-16 session (or longer if truly unstructured) model of psychotherapy that falls closer to the traditional Yalom/Rogers/Freudian school of thought, which I suspect may not be a personal preference for you.

If you think you'd enjoy more structured and behaviorally oriented interventions like cog rehab stuff (which I've done plenty of in my career), there are actually way more links between this kind of work and how one can approach in treatments such as CBT and even Dialectical Behavioral Therapy (which I do plenty of today professionally) than what you've experienced so far in your training.

But if you're able to go into future well chosen therapy placements with an open mind and genuine interest, you might discover those links yourself (such as how to identify and target a specific area of deficit and then using evidence-based interventions driven by thoughtful case conceptualization to provide a meaningful intervention). Good luck!

 

[psych.meout]

Most of my intervention hours at my current placement are coming from neuro intakes, but I assume internships will be looking at therapy-based intervention?

Are you counting the clinical interviews from your neuropsych assessments as intervention?

 

[BrainStormer]

I think your instinct to look for medical settings is right on.

If there are any hospital systems or VAs near you, they will likely provide training in evidence based interventions and may also have training options with adult/aging populations.

Lastly, you might benefit from exploring more time-limited training options. There's definitely a difference between delivering a brief and targeted intervention in 1-4 sessions & the traditional 12-16 session (or longer if truly unstructured) model of psychotherapy that falls closer to the traditional Yalom/Rogers/Freudian school of thought, which I suspect may not be a personal preference for you.

If you think you'd enjoy more structured and behaviorally oriented interventions like cog rehab stuff (which I've done plenty of in my career), there are actually way more links between this kind of work and how one can approach in treatments such as CBT and even Dialectical Behavioral Therapy (which I do plenty of today professionally) than what you've experienced so far in your training.

But if you're able to go into future well chosen therapy placements with an open mind and genuine interest, you might discover those links yourself (such as how to identify and target a specific area of deficit and then using evidence-based interventions driven by thoughtful case conceptualization to provide a meaningful intervention). Good luck!

This was very helpful thank you!!

 

[BrainStormer]

Are you counting the clinical interviews from your neuropsych assessments as intervention?

Yes I count them as "intake interview" on T2T which is categorized as intervention.

 

[WisNeuro]

Yes I count them as "intake interview" on T2T which is categorized as intervention.

Yikes, we'll see those as assessment hours practically speaking. I'd strongly suggest some actual intervention experience, even if set on a purely neuropsych career.

 

[summerbabe]

Yikes, we'll see those as assessment hours practically speaking. I'd strongly suggest some actual intervention experience, even if set on a purely neuropsych career.

To add on, most sites will ask 1-3 individual interview questions related to intervention experience (explain your theoretical orientation, describe a therapy case and how your case conceptualization informed intervention decisions, etc) plus your APPIC essay questions.

It will be pretty evident if you have very little therapy experience or your experience is limited in depth, which could negatively impact your chance of matching to a ‘dream’ neuro site, even if your neuro stuff is solid and the neuro specific facility like you because generalists on faculty may have significant concerns about your overall training.

At a competitive site, that could be a difference in matching there or not.

 

[BrainStormer]

Yikes, we'll see those as assessment hours practically speaking. I'd strongly suggest some actual intervention experience, even if set on a purely neuropsych career.

Agreed, but its the best I've got at my current placement

 

[jdawg2017]

Can you expand on this? Were your intervention hours through neuropsych placements?


This is helpful thanks for your input. It seems like group experience is desirable... although obtaining that experience is highly dependent on the opportunities of your practicum site.

Not sure if you are asking about prac or internship. All of my “intervention” hours in practicum were therapy hours in my program’s in-house clinic, mostly achieved during the 2nd year of my program during my first practicum. The exception is maybe about 50 group hours for the group I ran which was during my 2nd and 3rd year and maybe about 50 hours of additional therapy hours I did virtually early in the pandemic because my first advanced prac basically shut down March 2020 and didn’t have anything for me to do for months. I did two advanced neuropsych placements in the community in years 3 and 4 of my program.

On internship my intervention hours were mostly in a cog rehab setting, but I did some limited therapy as well. My internship was pretty heavy on neuropsych assessment throughout the year. DM me and I’m happy to explain more!

 

[AcronymAllergy]

Agreed, but its the best I've got at my current placement

I know we've recommended going with an intervention-focused practicum in the future, but is there any potential to add intervention experience to the current practicum? Maybe via a dementia caregiver group, chronic pain treatment (individual or group), CBT for ADHD, or anything similar, depending on what type of patients you're seeing?

 

[MPRage]

I don't know if this is feasible, but as an NP person, my offsite pracs were also neuropsych focused however i acquired intervention hours over that year by taking therapy clients in our inhouse clinic. I know this is not a feature of every program so i wonder if it may be an option for you to split your time across future practicums where one is intervention-based?

 

[BrainStormer]

I don't know if this is feasible, but as an NP person, my offsite pracs were also neuropsych focused however i acquired intervention hours over that year by taking therapy clients in our inhouse clinic. I know this is not a feature of every program so i wonder if it may be an option for you to split your time across future practicums where one is intervention-based?

My program offers this too, so I was potentially going to go this route as a backup if I can’t get any intervention experience in a hospital. The only issue is our UCC is heavily psychoD/person-centered and the supervisors are a bit more resistant to other more structured modalities like CBT. I’m thinking it might not be a great fit but it’s there as an option if I truly can’t get other intervention experience elsewhere. I would need to find a way to talk around this in my internship essay since pure PsychoD doesn’t align with my theoretical orientation.

 

[BrainStormer]

I know we've recommended going with an intervention-focused practicum in the future, but is there any potential to add intervention experience to the current practicum? Maybe via a dementia caregiver group, chronic pain treatment (individual or group), CBT for ADHD, or anything similar, depending on what type of patients you're seeing?

There might be an opportunity for cog rehab with TBI patients at my current site. Just not sure how consistent the cases are because it’s not offered as a rotation or supplemental…but worth looking into. I might be able to talk to my DCT about finding me an elective placement at a different site that could offer group experience for spring semester.

 

[MPRage]

My program offers this too, so I was potentially going to go this route as a backup if I can’t get any intervention experience in a hospital. The only issue is our UCC is heavily psychoD/person-centered and the supervisors are a bit more resistant to other more structured modalities like CBT. I’m thinking it might not be a great fit but it’s there as an option if I truly can’t get other intervention experience elsewhere. I would need to find a way to talk around this in my internship essay since pure PsychoD doesn’t align with my theoretical orientation.

That does sound tough since there are so many sites looking for people with CBT/ evidence based modalities. I hope that you are able to find a good fit somewhere! Even like a private practice etc - another way students have accumulated hours in my program is through RCTs and accumulating research intervention hours leading groups etc. There may be some creative ways to achieve this - I truly hope you an find something that meets your needs!

 

[AcronymAllergy]

My program offers this too, so I was potentially going to go this route as a backup if I can’t get any intervention experience in a hospital. The only issue is our UCC is heavily psychoD/person-centered and the supervisors are a bit more resistant to other more structured modalities like CBT. I’m thinking it might not be a great fit but it’s there as an option if I truly can’t get other intervention experience elsewhere. I would need to find a way to talk around this in my internship essay since pure PsychoD doesn’t align with my theoretical orientation.

You're still in training, nothing wrong with getting some exposure to alternate theoretical orientations and intervention styles. Who knows, you might enjoy them, or at the very least, pick up some useful skills. Often, there's more overlap than we realize; we may just use different terms to talk about many of the same things.

That's also easy enough to explain (e.g., in essays or interview responses) by saying the availability of other treatment modalities was limited at your program.

 

[Freud’sMommy]

Please also remember that internship sites don't expect you to be a fully-formed clinician. Gaps in your pre-internship training are okay - expected even - and should make it easy to write your cover letters re: how particular sites can help you reach your training goals!

 

[psych.meout]

Please also remember that internship sites don't expect you to be a fully-formed clinician. Gaps in your pre-internship training are okay - expected even - and should make it easy to write your cover letters re: how particular sites can help you reach your training goals!

Right, but you still need the foundational experiences to build upon. They don't want to have to train you from scratch or undo bad training. This is why some people going for neuro track internships struggle to match if they don't have sufficient intervention experience.