How did you prepare for your MSW internship?

[BlackSkirtTetra]

I'm about to start my internship in a few weeks (training begins over the summer, then it picks up during the regular semester), and I'm much more nervous about it than I expected.

It's going to be in a group home for the severely mentally ill and mentally ******ed. I am nervous because I have no real work experience with these groups. I will be working with/under an LCSW who will not be present for about half the time I'm working (I got picked because I'm available to work evenings and weekends).

I spoke to my interviewer a couple months ago and he assured me that this is what interns do--that I'm not expected to have all the answers and be able to know what I'm doing, but then (almost in the same breath) he said I will be doing group therapy on my own "once or twice a week." (!) I told him I did not presently feel comfortable or competent to do that and he laughed and said, "It will come. It will come."

Am I worrying too much? Or did you experience these things when you were working in your internships? The bottom line is that I am excited to have landed a practicum in the mental health field (which I understand is not always possible because of the high number of students applying), but I feel woefully under-prepared at the same time.

Care to share your experience(s)? What was it like for you?

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[lizzy0525]

Although I am not in an MSW program (still an undergrad) and have not completed an internship in the mental health field, I suppose I could speak about my experience as an intern for a youth emergency shelter. I felt the exact same way as you do about starting your internship. I was terrified, felt completely underprepared, and I was afraid to make mistakes. My "training" consisted of shadowing other Residential Youth Counselors during their shifts and then I was on my own, supervising 1-5 kiddos with various anxiety disorders and developmental delays who often had a history of non-compliance, gang involvement, and stealing. Not to mention, I felt a lot of prejudice from my co-workers about my age (I was 20 at the time) and I'm sure I appeared under-qualified to them as I was merely "an intern."

However, after a few shifts, I started to gain confidence and the initial anxiety I felt definitely attenuated. I reminded myself that no one was expecting me to know everything or be an expert at my job. My supervisor hired me for a reason and she knew full well how experienced (or inexperienced) I was and I am sure she anticipated that I would find things difficult at first. But it is all part of the process. You will make mistakes, that is almost guaranteed, but don't let that shake your confidence or make you feel incompetent. Clearly you are smart and capable of this internship; if you weren't, you never would have been hired. Just approach your internship with eagerness and passion for what you are doing and everything will be fine.

 

[MikSWorthington]

I'm about to start my internship in a few weeks (training begins over the summer, then it picks up during the regular semester), and I'm much more nervous about it than I expected.

It's going to be in a group home for the severely mentally ill and mentally ******ed. I am nervous because I have no real work experience with these groups. I will be working with/under an LCSW who will not be present for about half the time I'm working (I got picked because I'm available to work evenings and weekends).

I spoke to my interviewer a couple months ago and he assured me that this is what interns do--that I'm not expected to have all the answers and be able to know what I'm doing, but then (almost in the same breath) he said I will be doing group therapy on my own "once or twice a week." (!) I told him I did not presently feel comfortable or competent to do that and he laughed and said, "It will come. It will come."

Am I worrying too much? Or did you experience these things when you were working in your internships? The bottom line is that I am excited to have landed a practicum in the mental health field (which I understand is not always possible because of the high number of students applying), but I feel woefully under-prepared at the same time.

Care to share your experience(s)? What was it like for you?

I am beginning my first year MSW internship in the fall too, and completely relate to feeling underprepared. My placement will be at an outpatient drug and alcohol recovery center where clients in recovery have a dual diagnosis. Since I've been in recovery myself for several years, I feel comfortable with the idea of working with the population, even as the idea of leading recovery groups and individual sessions inspires no small amount of anxiety at this point. My interviewer also assured me that confidence and skill would build with time and experience.

 

[wigflip]

this is what interns do--that I'm not expected to have all the answers and be able to know what I'm doing, but then (almost in the same breath) he said I will be doing group therapy on my own "once or twice a week." (!) I told him I did not presently feel comfortable or competent to do that and he laughed and said, "It will come. It will come."...but I feel woefully under-prepared at the same time.

This is part of why I quit my MSW program. We started our internships with only several weeks of fall classes under our belts. This prepared us to play "the name game," (every lazy prof's favorite first day time-waster) but little else.

At one point I remember asking to attend a specialized rotation with my supervisor, and this request being met with apparent suspicion. "Why do you want to come on X rotation?" As if I was planning to overthrow the facility or something! What was I supposed to reply? "Actually, I'm not remotely interested in that population or this entire placement, but that's what they do in social werk skool, they stick ya where ya don't wanna be cuz it's gud fer ya." Instead, I expressed an interest in learning about all aspects of the placement, taking advantage of the opportunities to grow, work with new populations, etc. Supervisor says no, I can't shadow. Then two weeks later same supervisor tells me I have to do that very rotation solo because s/he can't be there. "Thanks, uh, but can you please tell me where that building is located...?"

Internship wasn't actually about learning. It was about demonstrating humility and an eagerness to learn so I could get good evaluations and move on to the next thing. For the most part I tried to keep it upbeat, appear eager, conceal my disappointment (until leaving), dumb it down a bit--and I did fine. The other intern wrestled with authority, defended her/himself against criticism, acted pedantic, and got bonged. But I doubt either one of us learned very much.

So...basically, I showed up and provided free labor that required no specialized training, skills, or abilities, and payed the school money (for internship units) for the privilege of doing so. No thanks.

Clearly, I've already outed myself as pretty cynical about all this, but I'd say that the onus is on the student to figure out how to do everything on her/his own. Don't wait for someone to train you--it may never happen. Read up about group therapy, get some basic ideas about how to do what you'll be doing, then play dumb and (at least appear to) be receptive to whatever your supervisor tells you to do (if anything).

 

[BlackSkirtTetra]

Thank you very much. I really appreciate that.

What do you recommend I read re: the group therapy?

 

[Vasa Lisa]

Wigflip
There were both CMHC and MSW interns at my site. My supervisor was an LCSW. The differences in skill set and training between the two groups was painful when we had group supervision. All the CMHC had been well prepared in coursework and practica to lead groups and counsel individuals. The MSW students suffered and felt ill prepared. It was painful to watch AND one measure of the difference in skill set was the rate of no shows and premature terminations.

For me, an important measure of my effectiveness is retention. Therapists can blabber all they want about how great they are or their fine training, but do their clients return and do they improve as measured by objective co-created goals and outcomes.

 

[Vasa Lisa]

Yalom's book AND be a client in a process group yourself. Process observe as many groups as you are able prior to internship. That should be part of your group tx class.

Find a mentor who adores group work and watch their taped sessions.

 

[wigflip]

Wigflip
There were both CMHC and MSW interns at my site. My supervisor was an LCSW. The differences in skill set and training between the two groups was painful when we had group supervision. All the CMHC had been well prepared in coursework and practica to lead groups and counsel individuals. The MSW students suffered and felt ill prepared. It was painful to watch AND one measure of the difference in skill set was the rate of no shows and premature terminations.

Wow--that is validating to hear, Vasa Lisa. Sometimes I think I'm too hard on my social work experience--I was only there a semester (though prior to leaving I made a point of talking to many second year students, all of whom told me to expect just more of the same in the second year). Ultimately I stick to my guns: if you want to do counseling, study counseling. The smart, progressive people I know who finished MSWs are all disappointed: in the politics and/or curriculum.

To OP: I left early in the second term, before we'd gotten anywhere in our class on group therapy. But the prof was psychodynamically oriented (as were many of the profs) and in the few weeks I was there I didn't really see things developing productively. I don't have any seminal text to recommend, I'd just suggest searching for good review papers (and take Vasa Lisa's advice, of course!).

 

[BlackSkirtTetra]

I've already taken a bunch of mental health classes and am also taking drug and alcohol classes, but I've had none so far on group therapy or the dynamics therein, although I do know enough to know that I need to be familiar with that topic.

I have an additional question. If the MSW only sort-of prepares a person for group therapy, why are MSWs so in-demand for those jobs? I don't understand why so many counseling/therapy jobs ask for MSW if MSWs are known to only marginally prepare people for that role!

Vasa Lisa, what is the title of Yalom's book?

 

[Qwerk]

I have an additional question. If the MSW only sort-of prepares a person for group therapy, why are MSWs so in-demand for those jobs? I don't understand why so many counseling/therapy jobs ask for MSW if MSWs are known to only marginally prepare people for that role!

Two reasons. The first (short) is that we're great at lobbying and have been going at it hard since the sixties. For this reason, it's often easier to get jobs at clinics that bill Medicaid, for example -- unfortunately for the other master's-level mental health professions, who are quite competent in the clinical work we all do. This will change. Here in New York, mental health counselors are currently lobbying to be Medicaid-recognized and to be able to diagnose.

Second thing (longer): M.S.W. curricula vary a lot. M.S.W. degrees aren't "known to only marginally prepare people" for individual therapy or group work. It's more that some programs will prepare you very well and some not at all. There are CSWE standards for social work curricula, but they're very general. There's nothing to prevent a school from slapping a "clinical" or "group work" label on a curriculum that will only prepare you for general practice or casework. (IOW, there's a reason the top clinical programs are the top clinical programs. Buyer beware if you choose a middling school.) AFAIK, students from any practice focus, or none, can be licensed to practice psychotherapy in most states. Even worse, not all programs have different tracks for students with different practice focuses, and those that do don't always differentiate between individual and group work students. To me, it's unconscionable. I would actually support creating several sub-degrees (say, M.S.W.Clin., M.S.W.Grp., M.S.W.Org.) for each area of practice, because they're very, very different.

I'm lucky to have only needed to take one course that has nothing to do with direct counseling/therapy (a policy course), and will only need to take two more (in research, which I'm very happy to do). My professors are mostly individual and family therapists. Not every program is like that, and I routinely run into students in other programs who aren't happy about this. Wigflip's bad experience is proof that students need to shop around and talk to graduates of their prospective programs. So what makes a good clinical M.S.W. program different from a counseling/MFT degree? Probably the social justice focus. My cohort hears the phrase "anti-oppressive lens" so often in our classes that we joke about it over drinks. This is what drew me to social work, even though I was sure that I only wanted to be a therapist.

I'm intrigued about your internship throwing you into group therapy without prior training. That would raise a red flag for me, especially if you're working with people with severe and persistent mental illness. Even peer specialists who run groups with no degree usually get some form of training, or have at least attended groups themselves.

 

[wigflip]

there's a reason the top clinical programs are the top clinical programs. Buyer beware if you choose a middling school...Wigflip's bad experience is proof that students need to shop around and talk to graduates of their prospective programs.

Lucky I'm here to serve as an example of what not to do, huh? Because wigflip is so dumb s/he settled for a middling school without talking to any alums--that's the implication, right?

Well, actually no. I went to one of your "top clinical programs" and talked to plenty of people (alums and others). Apparently those people are more easily impressed than I am.

 

[Qwerk]

Lucky I'm here to serve as an example of what not to do, huh? Because wigflip is so dumb s/he settled for a middling school without talking to any alums--that's the implication, right?

Well, actually no. I went to one of your "top clinical programs" and talked to plenty of people (alums and others). Apparently those people are more easily impressed than I am.

I didn't mean that -- I believe you when you say that you did your homework before applying, and I never called you dumb. I also wasn't referring to you at all when I talked about "middling schools." I was trying to make a general point about your experience being bad enough (at least, from the sound of your posts) that students who want to exclusively practice therapy should be careful when choosing graduate programs lest they find that a particular school, or the entire social work field, isn't for them.

But I noticed that you often talk about your single semester at an unnamed social work school, and that you use your experience as a warning to other potential M.S.W. students. What do you think you could have done differently to avoid going to a program that you ended up hating? Or are you suggesting that there's no real way to avoid this -- or that all M.S.W. programs offer shoddy preparation for a career as a therapist?

 

[wigflip]

I think it's a mistake to assume that quality is the sole reason that the "top" clinical programs are the "top" clinical programs. Once you get a certain number of alumni out there, they can shape hiring practices in a certain geographic region and shape perceptions of the school.

I didn't mean that -- I believe you when you say that you did your homework before applying, and I never called you dumb.

I'm not going to go through and do a line by line reading justifying my response, though I acknowledge that you didn't call me "dumb." But my experience was pointed to as an example of why it's important to do one's homework in researching programs. You read my response.

I was trying to make a general point about your experience being bad enough (at least, from the sound of your posts) that students who want to exclusively practice therapy should be careful when choosing graduate programs lest they find that a particular school, or the entire social work field, isn't for them.

Are you assuming that I wanted to exclusively practice therapy? I didn't. Generally speaking, I discuss the clinical piece of the pie here because the MSW is often touted (sometimes here and virtually always IRL) as the superior degree for masters level clinicians. The amount of snobbery I've witnessed social workers (and I'm not pointing fingers in anyone in particular's direction here) display around this issue is absurd (e.g. social workers who perpetuate the idea that MFTs are all big dummies), especially given the low stature that social work is typically afforded by genuinely progressive activists and people in academic disciplines alike.

What do you think you could have done differently to avoid going to a program that you ended up hating?

I won't address that, but here's some general advice:
Something any student should do is to check the ratio of tenured faculty to adjuncts. Who is actually doing the real teaching? Don't just check the website, review the actual schedule of classes, for at least the prior year if possible. If the department has a double tier system (adjuncts teach the hordes of masters students, while t-t faculty teach in the doctoral program), do masters students actually have any access to t-t faculty via research projects, etc.? Think it through, especially if you plan to attend a private institution. Look up the per class adjunct salary at adjunct nation or elsewhere online. Then multiply the number of students by the per class tuition and subtract the likely prof salary. Now think about where the rest of that money might be going and whether tuition is really worth it.

Or are you suggesting that there's no real way to avoid this -- or that all M.S.W. programs offer shoddy preparation for a career as a therapist?

I don't know enough about programs nationwide to make that assertion (and doing so would likely be flouting sdn rules), though I do think my experience with a well-regarded program is telling. I've heard good things about the quality of Cal's program certainly (though I suspect they're more macro). But then again, one of their tenured profs famously compared "date rape" to the common cold, didn't he?

I will say that if I were seeking mental health care I would favor someone with a background in psychology and/or counseling over a social worker unless I'd read the social worker's publications or had another way to vet her/him prior to meeting. Amongst other things, the quality of the undergraduates who ask me to write LORs for MSW programs doesn't fill me with hope. And again, I haven't done a nationwide survey of social work curriculum, but for me personally, the curriculum to which I was exposed was way too dumbed down. The people who seemed happy and impressed were not undergrad psych majors or didn't go to particularly good UG institutions.

 

[BlackSkirtTetra]

Thank you, everybody.

What do you think you could have done differently to avoid going to a program that you ended up hating?

I think this is a good question.

 

[Qwerk]

I think it's a mistake to assume that quality is the sole reason that the "top" clinical programs are the "top" clinical programs. Once you get a certain number of alumni out there, they can shape hiring practices in a certain geographic region and shape perceptions of the school.

I'm not sure how to respond to that. You're saying that certain schools unjustly get reputations for quality based on regional hiring patterns? Or volume of graduates? That seems simplistic.

especially given the low stature that social work is typically afforded by genuinely progressive activists and people in academic disciplines alike.

This is pure snark. Social workers can't be "genuinely progressive activists"? Social workers are scorned by other disciplines? Really?

I don't know enough about programs nationwide to make that assertion (and doing so would likely be flouting sdn rules), though I do think my experience with a well-regarded program is telling. I've heard good things about the quality of Cal's program certainly (though I suspect they're more macro). But then again, one of their tenured profs famously compared "date rape" to the common cold, didn't he?

I will say that if I were seeking mental health care I would favor someone with a background in psychology and/or counseling over a social worker unless I'd read the social worker's publications or had another way to vet her/him prior to meeting. Amongst other things, the quality of the undergraduates who ask me to write LORs for MSW programs doesn't fill me with hope. And again, I haven't done a nationwide survey of social work curriculum, but for me personally, the curriculum to which I was exposed was way too dumbed down. The people who seemed happy and impressed were not undergrad psych majors or didn't go to particularly good UG institutions.

You've been generalizing quite a bit in nearly every thread that mentions master's-level clinical work -- e.g. that M.S.W.s don't make competent clinicians, that we don't come from good undergraduate institutions (where did you go?), or that we're deluded about the amount of clinical training we receive. If you "haven't done a nationwide survey," why do you consistently make blanket statements? Your lone semester at whatever social work school you attended qualifies you to talk about that particular program. It does not qualify you to dismiss social work programs for clinical practice in general, particularly since these programs do vary quite a bit from region to region. I'm sure students and graduates of these schools have at least a little knowledge about their own schools, too.

You do hedge and say that you can't know about every social work program (of course), but in your other statements, you either imply or state outright that you don't trust social workers in general to deliver mental health care. This is a bit like me saying that mental health counselors are all incompetent because the ones I've met IRL have been quite shady (which is true, but they're absolutely not representative of all counselors!), or because the programs in my area aren't all of the best quality (also true, but hardly representative of the entire United States).

I'm going to take a wild guess and say that the resentment you have toward social workers stems at least somewhat from the fact that social workers on this forum go a little overboard in promoting M.S.W.s to prospective students over other degrees, and that social workers in general have unfairly cornered a large portion of the counseling and therapy job market. These are legitimate complaints, but why knock our skills in such a sweeping way? It's getting to be a bit below-the-belt, frankly.

 

[Vasa Lisa]

I've already taken a bunch of mental health classes and am also taking drug and alcohol classes, but I've had none so far on group therapy or the dynamics therein, although I do know enough to know that I need to be familiar with that topic.

I am sure that social work students adhere to something similar - so if you find this publication helpful - I would look for the equivalent from your profession.

http://www.asgw.org/pdf/Best_Practices.pdf

I have seen great harm come to group members when the facilitators were not trained properly and thrown in to "just run a support group."

In my training, I spent hours and hours and hours process observing all sorts of groups. I was required to be in a process group, required to lead a process group, and to study group theory and know my limitations and training. I do find it disheartening to see programs and internship sites assume that anyone who is a helper can be a group facilitator and no harm will come. Hopefully you will have excellent onsite supervision where you can get guidance. My internship site provided me with one hour a week of individual supervision, 1.5 hours a week of group supervision, and one hour every other week of "groups" supervision.

I have an additional question. If the MSW only sort-of prepares a person for group therapy, why are MSWs so in-demand for those jobs? I don't understand why so many counseling/therapy jobs ask for MSW if MSWs are known to only marginally prepare people for that role!

I find this question naive - and innocent - and when you are out the other side and licensed and looking back - I think you will be able to answer this question in a way that has meaning to you. Nothing wrong with being naive - we all are - or I don't know that we would enter into such a demanding profession! Our innocence sustains us.

Vasa Lisa, what is the title of Yalom's book?

Google "yalom group therapy" and you will find lots of resources.

There really is no way to prepare for an internship - and it is heartening that you are aware of the paradox.

Wishing you the best,

Vasa Lisa

 

[Qwerk]

I have seen great harm come to group members when the facilitators were not trained properly and thrown in to "just run a support group."

This is a very important point. Group facilitation can be surprisingly tricky. It's a different animal, so to speak -- not a lot like individual work. This is one of the reasons I don't like to see non-professionals running groups, since they often have only perfunctory training. I've observed peer specialists and non-clinical staff doing a terrible job.

BlackSkirtTetra, AGSW (to which Vasa Lisa linked above) also publishes a journal that might be of help to you if your school provides journal/database access to Taylor & Francis journals.

Good luck on your internship!

 

[wigflip]

I'm not sure how to respond to that.

You don't need to, Querk. You're the one who referenced me and held me up as an example of why folks need to do their research when selecting a grad program. I'm not interested in nursing some Internet grudge match with you or anyone. I didn't even bother to do more than skim your rebuttal because I'm bored with the whole thing and it's not worth my time. I have work to do.

 

[Qwerk]

BST, I found a book that you might want to add to your reading list if you haven't done a lot of practical group work reading (vs. theory). It's called The Group Therapist's Notebook and it's available here: http://www.amazon.com/Group-Therapists-Notebook-Activities-Psychotherapy/dp/0789028514I

I haven't read it yet (I ordered it, but it's still in the mail) but I've heard good things about it.