COVID-19 Impact on Internship Sites

[GradStudent2020]

Just got word my internship site is temporarily moving to telehealth only.

I’m hoping this doesn’t impact internship completely but feel I’m in a better position than interns at schools or UCC’s at the moment.

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[R. Matey]

I'm at a UCC for internship and I'm totally fine, but my position is a little unique. I front loaded my hours in the beginning of internship with the intent to coast in the Spring/Summer so I've got very few face-to-face hours left. We'll be providing tele-health next week and clients are already contacting me to confirm their appointments for next week.

What I was more worried for is the interns in hospitals doing consulting work or assessment who have just been sent home. The chatter I'm hearing suggests that those would be harder services to do remotely.

 

[R. Matey]

We can also do mental health outreach via distance and count it as direct service. We're brain storming opportunities here.

 

[GradStudent2020]

We can also do mental health outreach via distance and count it as direct service. We're brain storming opportunities here.

Please share if your site has any creative ideas!

 

[irishgoodbye]

The APA released some helpful info yesterday.

APA Accreditation COVID-19 Updates and Information

This page will be updated as more information becomes available.

www.accreditation.apa.org

Sent from my iPhone using SDN

 

[futureapppsy2]

As faculty, I can tell you that we are pulling our hair out to try to figure out to get our students F2F hours as best we can without creating a public health risk. Also, some students' practicum and masters'-level internship placements have simply shut down entirely, which is even more of a bind.

 

[Jxz]

Pennsylvania waived a requirement that a certain percentage of CEs be “live.” But that was Governor/State Legislature. You are right that State Boards are slow but when their masters tell them to do something they have no choice.

As for waiving the requirements for CEs period, we’ll you’ve got years to get them and you can do them all online (with that change) so I’m guessing they’ll be less sympathetic to that. But if this goes on for a year or 18 months...we’ll then we’re really in a whole different world.

 

[AcronymAllergy]

As faculty, I can tell you that we are pulling our hair out to try to figure out to get our students F2F hours as best we can without creating a public health risk. Also, some students' practicum and masters'-level internship placements have simply shut down entirely, which is even more of a bind.

Some internship sites are in a similar bind, although with relaxing standards and a push toward telephone appointments, that should hopefully help open things up, at least in terms of therapy hours. Neuropsych assessment has pretty much ground to a halt for the time being; if this extends for a long period of time, that would probably be one area trainees will hopefully be able to address either later in grad school, or while on internship. If already on internship, it's just going to require some creative thinking (e.g., practice administrations, case conceptualizations, etc.).

 

[BubuB]

I'm an intern at a state hospital. The hospital is taking people's temperature when they walk in the door and canceled groups combining patients from different units, but is otherwise operating normally. ER admissions continue to talk in the door. The area I work in has workstations for 20 people and we ran out of hand sanitizer here (not in the whole hospital) a couple of weeks ago. No gloves, no masks (unless actively coughing), no reduction of staff as far as I can see. There are certainly failures on federal and state levels, but APA and APPIC could play an active role instead of providing suggestions. They could, for example, declare that required internship hours are going to be slashed by X%. Making an across the board declaration would put the pressure on licensing boards and other players.

 

[WisNeuro]

I'm an intern at a state hospital. The hospital is taking people's temperature when they walk in the door and canceled groups combining patients from different units, but is otherwise operating normally. ER admissions continue to talk in the door. The area I work in has workstations for 20 people and we ran out of hand sanitizer here (not in the whole hospital) a couple of weeks ago. No gloves, no masks (unless actively coughing), no reduction of staff as far as I can see. There are certainly failures on federal and state levels, but APA and APPIC could play an active role instead of providing suggestions. They could, for example, declare that required internship hours are going to be slashed by X%. Making an across the board declaration would put the pressure on licensing boards and other players.

That declaration is useless. They can and are in discussions with licensing bodies, but the bodies all have different rules and regs, most written into state law, which would need to be changed first. APA is actually doing a TON of work to navigate this. I know people in the lobbying area, these people are essentially putting in 18 hour days. Luckily, they are focusing on actionable items, rather than things which will have no impact.

 

[BubuB]

That declaration is useless. They can and are in discussions with licensing bodies, but the bodies all have different rules and regs, most written into state law, which would need to be changed first. APA is actually doing a TON of work to navigate this. I know people in the lobbying area, these people are essentially putting in 18 hour days. Luckily, they are focusing on actionable items, rather than things which will have no impact.

I have a great deal of respect for individuals trying the affect change (regardless of the method), but neither APA or the legislature strike me as a quick or efficient bodies. My impression is that there are a great deal of individuals who would benefit from practical and immediate guidance. So far there has been an overly broad statement about telehealth, but I think more can and should be done. Perhaps greater attention to these lobbying efforts or the changes being proposed. Regardless, it feels like APA is being very quiet at the moment.

 

[WisNeuro]

I have a great deal of respect for individuals trying the affect change (regardless of the method), but neither APA or the legislature strike me as a quick or efficient bodies. My impression is that there are a great deal of individuals who would benefit from practical and immediate guidance. So far there has been an overly broad statement about telehealth, but I think more can and should be done. Perhaps greater attention to these lobbying efforts or the changes being proposed. Regardless, it feels like APA is being very quiet at the moment.

Quiet? As an executive member of my state's association, we are passing along APA stuff daily. APA is sending out multiple releases and guidelines on a daily basis. There's actually too much. We actually have to read it, parse it down, and send that out to our members so that they know what to do quickly. Are you a member of APA or your state association?

 

[R. Matey]

As faculty, I can tell you that we are pulling our hair out to try to figure out to get our students F2F hours as best we can without creating a public health risk. Also, some students' practicum and masters'-level internship placements have simply shut down entirely, which is even more of a bind.

That's unfortunate to hear. At my site, we've been able to find a way for us and pracs to use tele-therapy and still receive supervision.

I've been doing tele-psychology for a few days now and it's going pretty well. I'm fortunate to not be concerned about meeting my DSHs and F2F hours for internship.

 

[R. Matey]

Please share if your site has any creative ideas!

An update to this is that we're talking about doing mental health workshops for students to join via tele-health. Much like an open psycho-educational group for anxiety, depression, etc...

 

[mypointlesspov]

I'm very lucky to have an internship site that embraced telehealth early on. Getting my clients to transition has been pretty easily (except when they forget about the appointment, but whatever). We actually had an all staff (50+) meeting on Zoom this morning too which ran pretty smoothly. My supervisors and the directors have been extremely supportive throughout this process.

 

[MiniLop]

I'm an intern at a state hospital. The hospital is taking people's temperature when they walk in the door and canceled groups combining patients from different units, but is otherwise operating normally. ER admissions continue to talk in the door. The area I work in has workstations for 20 people and we ran out of hand sanitizer here (not in the whole hospital) a couple of weeks ago. No gloves, no masks (unless actively coughing), no reduction of staff as far as I can see. There are certainly failures on federal and state levels, but APA and APPIC could play an active role instead of providing suggestions. They could, for example, declare that required internship hours are going to be slashed by X%. Making an across the board declaration would put the pressure on licensing boards and other players.

This is more or less the situation I'm in (just replace "state hospital" with "inpatient psychiatric hospital"). We have multiple patients on units displaying COVID symptoms and we have at least two staff members displaying the same symptoms (and currently home awaiting testing results). The site is making no effort to reduce patient contact for interns (or anyone else, for that matter). We have made our concerns known, but they are continuously minimized. I am, frankly, freaking out here. What are the options, aside from complain to APA/APPIC/JCo? I feel like every day I am having to choose between my safety and finishing grad school.

 

[norbert44]

For folks who are currently interning at VAs and required to show up in person, what is that looking like right now? Have only heard from VA interns in heavily hit areas that have been doing tele-therapy from home.

-someone supposed to start a VA internship this summer

 

[Seven_Costanza]

For folks who are currently interning at VAs and required to show up in person, what is that looking like right now? Have only heard from VA interns in heavily hit areas that have been doing tele-therapy from home.

-someone supposed to start a VA internship this summer

Looks like telehealth in the office vs telehealth at home. I am holding all individual and group therapy sessions over the phone or video-chat. I basically hide in the office all day with the door closed off to everyone. All meetings, supervision, and didactics are also held over the phone or video chat.

 

[norbert44]

Looks like telehealth in the office vs telehealth at home. I am holding all individual and group therapy sessions over the phone or video-chat. I basically hide in the office all day with the door closed off to everyone. All meetings, supervision, and didactics are also held over the phone or video chat.

Thanks for the reply. What are they doing about folks on inpatient or primary care rotations?

 

[beginner2011]

Thanks for the reply. What are they doing about folks on inpatient or primary care rotations?

I am in a similar situation at my site. I believe primary care is operating as usual, just doing tele from the office. Inpatient has directed interns to make other on-site training arrangements. Currently, many staff members are working from home one or more days per week but interns and fellows are not being allowed to work from home.

 

[AcronymAllergy]

Looks like telehealth in the office vs telehealth at home. I am holding all individual and group therapy sessions over the phone or video-chat. I basically hide in the office all day with the door closed off to everyone. All meetings, supervision, and didactics are also held over the phone or video chat.

This. Our leadership is asking training to essentially eliminate trainee contact with known or suspected COVID patients, which applies to all trainees (i.e., not just psychology). Outpatient, nearly all work is being done remotely (telehealth or telephone). Our boss is adamant about minimizing exposure risk for providers/trainees and patients.

Primary care is reviewing and rescheduling most/all regular check-up type visits, and doing whatever else they can by telehealth I believe. I believe PCMHI is doing most visits via telehealth. All patients who come in person are screened before entering the facility.

 

[thebalmofhurtminds]

Thanks for the reply. What are they doing about folks on inpatient or primary care rotations?

I'm on a primary care rotation right now. We are also transitioned to telehealth.

 

[HarlenPhD]

This is more or less the situation I'm in (just replace "state hospital" with "inpatient psychiatric hospital"). We have multiple patients on units displaying COVID symptoms and we have at least two staff members displaying the same symptoms (and currently home awaiting testing results). The site is making no effort to reduce patient contact for interns (or anyone else, for that matter). We have made our concerns known, but they are continuously minimized. I am, frankly, freaking out here. What are the options, aside from complain to APA/APPIC/JCo? I feel like every day I am having to choose between my safety and finishing grad school.

Wow, that sounds really scary. Also, seems to go against guidelines released by the Council of Chairs of Training Councils: https://www.appic.org/Portals/0/dow...2020-03-24-073249-060&timestamp=1585053447039 Specifically: "CCTC strongly recommends that during the period of active novel coronarivus spread, training sites limit or halt trainees’ in-person contact and, whenever possible, allow trainees to conduct their work remotely.... Although there may be unique circumstances in which trainees are considered essential in the provision of services that require in-person contact, these circumstances should be atypical and time-limited. The CCTC recommends that essential services be provided by administration, faculty, and staff."

 

[MiniLop]

Wow, that sounds really scary. Also, seems to go against guidelines released by the Council of Chairs of Training Council: https://www.appic.org/Portals/0/dow...2020-03-24-073249-060&timestamp=1585053447039 Specifically: "CCTC strongly recommends that during the period of active novel coronarivus spread, training sites limit or halt trainees’ in-person contact and, whenever possible, allow trainees to conduct their work remotely.... Although there may be unique circumstances in which trainees are considered essential in the provision of services that require in-person contact, these circumstances should be atypical and time-limited. The CCTC recommends that essential services be provided by administration, faculty, and staff."

Yeah, it is, frankly, terrifying. We have contacted APPIC and are hoping to get some kind of change soon.

 

[futureapppsy2]

This is more or less the situation I'm in (just replace "state hospital" with "inpatient psychiatric hospital"). We have multiple patients on units displaying COVID symptoms and we have at least two staff members displaying the same symptoms (and currently home awaiting testing results). The site is making no effort to reduce patient contact for interns (or anyone else, for that matter). We have made our concerns known, but they are continuously minimized. I am, frankly, freaking out here. What are the options, aside from complain to APA/APPIC/JCo? I feel like every day I am having to choose between my safety and finishing grad school.

Heard them same from an acquaintance who is an attending psychologist at a state hospital--no PPE, direct contact with suspected cases expected and required, etc.

 

[GradStudent2020]

Yeah, it is, frankly, terrifying. We have contacted APPIC and are hoping to get some kind of change soon.

Please reach out to everyone who is in a position to advocate for you. Interns are not employees. We are subject to power dynamics in a very different way. If this occurred while you were an employee, you would be able to weigh the pros and cons of taking leave or leaving a position that you were not comfortable with. As interns, we rely on our supervisors to make these decisions (to some extent) on our behalf. We cannot walk away from these positions without risking our degrees and our careers.

Have you spoken to your DCT? There is also a document going around about how different training sites around the country are handling covid-19 and trainees. That may help frame any requests you make. I’ll try and find it.

 

[GradStudent2020]

Training sites around the country are contributing to this list. This is how different sites are adapting to protect their trainees.

COVID-19_TraineeDocument- Sdn.docx

docs.google.com

 

[MiniLop]

Please reach out to everyone who is in a position to advocate for you. Interns are not employees. We are subject to power dynamics in a very different way. If this occurred while you were an employee, you would be able to weigh the pros and cons of taking leave or leaving a position that you were not comfortable with. As interns, we rely on our supervisors to make these decisions (to some extent) on our behalf. We cannot walk away from these positions without risking our degrees and our careers.

Have you spoken to your DCT? There is also a document going around about how different training sites around the country are handling covid-19 and trainees. That may help frame any requests you make. I’ll try and find it.

Yup, I'm contact with my DCT. I also am scheduling a time to have a consultation with APPIC. I have a meeting with higher-ups soon. THANK YOU SO MUCH for posting that doc. That is exactly what I was looking for to help me during the upcoming meeting.

 

[GradStudent2020]

Yup, I'm contact with my DCT. I also am scheduling a time to have a consultation with APPIC. I have a meeting with higher-ups soon. THANK YOU SO MUCH for posting that doc. That is exactly what I was looking for to help me during the upcoming meeting.

You might also pull info from your own internship cohort. I know what most of my peers sites are up to right now. Good luck!

 

[PsyDr]

You whippersnappers might want to data gather on some emergency psych stuff. This is an extremely opportune time for some papers that are cited ad nauseum.