How does having a unlicensed resident as a supervisor affect internship?

[annel]

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Hey all,
I'm a 3rd year in a Psy.D. program, I am in my second practicum at a college counseling center. My supervisor, a licensed psychologist, is leaving my site to work somewhere else. Consequently, the admin at the University I'm working at have scrambled to find a replacement. Given the short notice, finding a licensed psychologist to supervise me seems unlikely.

The practitioner my site is going to hire to supervise me and run the counseling center is a recent graduate from a Psy.D. program. He has his own supervisor.

I'm trying to understand how this arrangement will affect my internship possibilities. As I understand it, my hours from this year will all translate into "doctoral" hours on the APPIC internship application. In terms of supervision, I will have to list the supervision I receive this year in the "other" category(rather than licensed psychologist or allied mental health professional).

Here are some questions:
1) Is my assessment above correct about how this change will affect the way I fill out the internship app?
2) How, if at all, will this change negatively affect my chances of getting an internship?

Thanks for your input.

 

[AcronymAllergy]

I believe that technically, when it comes down to it, you're actually being supervised by the resident's supervisor, and the resident is serving as essentially an "in-between" supervisor. This is how things work at my postdoc, for example, where we (fellows) provide some supervision to grad students and interns as part of our own training, and are in turn supervised on this by our bosses. Without a license, though, we can't "sign off" on things, and likely the same is the case for your resident.

You can check with APPIC itself and see what they say, but if the resident is still being supervised by a licensed psychologist, you may still be able to count the hours/assessments in the normal spot.

 

[Doctor Eliza]

Agree with AA above. However, I also wanted to suggest that you advocate for yourself a little here. If you are so early in your career, it would be much better to have an experienced supervisor and not someone who hasn't even been around long enough to get their own license. Perhaps there is a creative solution here. Couldn't you just have the supervisor's supervisor?

Although I have never had an unlicensed supervisor, I did have one newly licensed supervisor when I was on postdoc. He was essentially useless and I felt dumber for every hour I sat with him. Some of that was him personally, but it was also his inexperience. I ended up seeking supplemental consultation with an experienced therapist and I learned so much more.

Best,
Dr. E

 

[KillerDiller]

I don't think the APPIC application has any specifications for individual supervision that relate to licensing. I could be wrong, but I'm pretty sure you could just count that as regular individual supervision.

 

[annel]

Thanks for the replies, all.

According to my DCT, the hours would go under the "other" category and then I would have to specify that I was being supervised by resident. I can check with APPIC and investigate further.

Agree with AA above. However, I also wanted to suggest that you advocate for yourself a little here. If you are so early in your career, it would be much better to have an experienced supervisor and not someone who hasn't even been around long enough to get their own license. Perhaps there is a creative solution here. Couldn't you just have the supervisor's supervisor?

Although I have never had an unlicensed supervisor, I did have one newly licensed supervisor when I was on postdoc. He was essentially useless and I felt dumber for every hour I sat with him. Some of that was him personally, but it was also his inexperience. I ended up seeking supplemental consultation with an experienced therapist and I learned so much more.

Best,
Dr. E

Thanks. I've tried to advocate for myself the best that I can--including trying to arrange for additional supervision from a former supervisor. According to my DCT, that won't work. I also asked the resident if he could check with his supervisor to see if they would supervise me as well. I haven't heard back about that, but I'm not too optimistic.

Dr. E, when you say you got supplemental consultation, did you pay for that out of pocket? Did your site provide that?

I'm not worried about my own training in a way. I have lots of support outside of my prac site including a consultation group (that doesn't count for supervision hours but is still extremely helpful), a two-year training program in my orientation of choice, and my own therapist who was trained in the orientation I'm focusing on.

My main concern is how this arrangement will look when I apply to internship? Will I be at a disadvantage vs. people who had a licensed psychologist as their supervisor for all three years of practicum? I'll likely have a licensed psychologist as my supervisor for a little over two years of my training.

 

[Doctor Eliza]

I was fortunate and had a family friend who understood my situation and was willing to consult pro bono.

I wouldn't think it would be a big deal to internship sites. It's just a shame that you cannot maximize this training opportunity because the site is not holding up their end of the deal. 🙁

Good luck,
Dr. E

 

[Pragma]

I think it matters for APA accreditation. At least in my program, we were not permitted to participate in practica (at least for the purpose of fulfilling program requirements) where we were not directly supervised by a licensed clinical psychologist. There were also strict standards about things like didactics, etc.

 

[Therapist4Chnge]

I am surprised your DCT did not push for the licensed person to be your primary, as that should be the expectation/(requirement?) for practica training. It seems like the counseling site would be failing to provide the expected training experience to not have you work directly with the licensed provider. I have seen this setup on internship, but the primary supervisor was still the licensed person. The post-doc/fellow also worked with the student, but in addition to the required supervision hours provided bu the licensed clinician.

 

[paramour]

Same here; we're not allowed to work at practicum sites unless we're supervised by licensed clinical psychologists. No exceptions.

They usually have reasons for this (and they tend to cite accreditation issues; and if not accreditation, then I'm finding that states that allow you to use (some) practicum hours for licensing have stringent requirements for supervision--and they're going to require that your supervisor be licensed...). I'd check into this more carefully with your program.

 

[annel]

I was fortunate and had a family friend who understood my situation and was willing to consult pro bono.

I wouldn't think it would be a big deal to internship sites. It's just a shame that you cannot maximize this training opportunity because the site is not holding up their end of the deal. 🙁

Good luck,
Dr. E

Thanks

I think it matters for APA accreditation. At least in my program, we were not permitted to participate in practica (at least for the purpose of fulfilling program requirements) where we were not directly supervised by a licensed clinical psychologist. There were also strict standards about things like didactics, etc.

You mean it matters for getting an APA accredited internship? Where could I look up this information for certain?

I am surprised your DCT did not push for the licensed person to be your primary, as that should be the expectation/(requirement?) for practica training. It seems like the counseling site would be failing to provide the expected training experience to not have you work directly with the licensed provider. I have seen this setup on internship, but the primary supervisor was still the licensed person. The post-doc/fellow also worked with the student, but in addition to the required supervision hours provided bu the licensed clinician.

I tried to ask for all available options in this regard. The DCT said our school is trying to move away from having licensed supervisors supervise students when the licensed person is not physically at the site. I know students receiving off-site supervision this year, but apparently my school is trying to phase that out and that's the main reason I can't get additional supervision. So I think I'm at a dead end...any ideas for what else to do?

 

[erg923]

My main concern is how this arrangement will look when I apply to internship? Will I be at a disadvantage vs. people who had a licensed psychologist as their supervisor for all three years of practicum? I'll likely have a licensed psychologist as my supervisor for a little over two years of my training.

How/why would they (and internship site) ever know about this situation anyway? Its not like internship sites have time to check the licensing status of the person's LOR writer?

And if asked for some weird reason about this, I would simply point out that the supervision was supervised by your supervisors supervisor. heh...

 

[erg923]

Thanks. I've tried to advocate for myself the best that I can--including trying to arrange for additional supervision from a former supervisor. According to my DCT, that won't work. I also asked the resident if he could check with his supervisor to see if they would supervise me as well. I haven't heard back about that, but I'm not too optimistic. .

Wait, now I am confused. When you are "supervised" you are practicing under the umbrella of someones else's license. That's the definition. Are you saying the residents supervisor is in no way involved in any of this? Who signs off on your reports then? Someone (someone's license) has to be legally responsible for your actions. If not, its a HUGE liability if a lawsuit was filled.

 

[AcronymAllergy]

Wait, now I am confused. When you are "supervised" you are practicing under the umbrella of someones else's license. That's the definition. Are you saying the residents supervisor is in no way involved in any of this? Who signs off on your reports then? Someone (someone's license) has to be legally responsible for your actions. If not, its a HUGE liability if a lawsuit was filled.

That'd be my question as well. Sounds like it might be a situation where the resident's supervisor, in addition to the resident and OP, sign the report, although the OP never actually spends any F2F time with said supervisor. If so, it seems like that's just asking for trouble.

 

[erg923]

That'd be my question as well. Sounds like it might be a situation where the resident's supervisor, in addition to the resident and OP, sign the report, although the OP never actually spends any F2F time with said supervisor. If so, it seems like that's just asking for trouble.

I do this. I supervise a student, but am only provisionally licensed in my state. So, I have a supervisor, technically speaking. I have a very small clinical load of my own, so the vast majority of MY clinical supervision is spent discussing (and watching tapes) of my supervision of the student. My supervisor ALSO meets with the student sporadically, and meets all her testing cases face-to-face as well. My student is thus practicing under my supervisors license. My supervisor has final approval via signature over all her assessment reports too, of course.

 

[Therapist4Chnge]

On the flip side...if I am signing for someone, you bet I'd want to have regular contact with them to ensure they are providing proper interventions because it is MY license on the line. Our practica training required 1 (licensed) faculty member be involved in supervision, and if it was an off-site placement that there also be an on-site licensed supervisor. The faculty supervisor could offer group supervision if you had a primary supervisor, but this still allowed for more oversight than having someone blindly sign off on notes.

 

[Pragma]

I do this. I supervise a student, but am only provisionally licensed in my state. So, I have a supervisor, technically speaking. I have a very small clinical load of my own, so the vast majority of MY clinical supervision is spent discussing (and watching tapes) of my supervision of the student. My supervisor ALSO meets with the student sporadically, and meets all her testing cases face-to-face as well. My student is thus practicing under my supervisors license. My supervisor has final approval via signature over all her assessment reports too, of course.

Is your program APA accredited?

I ask because the program I graduated from was really strict about this. I always assumed that it was based on our accreditation standards, but perhaps it was an incorrect assumption.

 

[Pragma]

You mean it matters for getting an APA accredited internship? Where could I look up this information for certain?

I mean it might matter for your actual doctoral program. At least for my program, the supervision situation you described would not be satisfactory and that practicum would not have counted towards my satisfying my degree requirements.

 

[erg923]

Is your program APA accredited?

I ask because the program I graduated from was really strict about this. I always assumed that it was based on our accreditation standards, but perhaps it was an incorrect assumption.

Yes.

 

[Pragma]

I do this. I supervise a student, but am only provisionally licensed in my state. So, I have a supervisor, technically speaking. I have a very small clinical load of my own, so the vast majority of MY clinical supervision is spent discussing (and watching tapes) of my supervision of the student. My supervisor ALSO meets with the student sporadically, and meets all her testing cases face-to-face as well. My student is thus practicing under my supervisors license. My supervisor has final approval via signature over all her assessment reports too, of course.

Yes.

Well then it isn't an accreditation thing, I assume. I wonder how common this form of supervision is, or if it varies by state at all. My PhD program's policy was airtight that you had to have face to face supervision with a licensed clinical psychologist for all of your required supervision hours.

 

[psychRA]

Our department didn't allow us to do any off-campus clinical work that wasn't supervised by a licensed psychologist. They were definitely not flexible on that requirement.

We did have some unlicensed immediate supervision in our in-house clinic. When the department was really tight on supervision slots, I met with someone who wasn't yet licensed, and she was in turn supervised by the clinic director, so it still "counted." However, it didn't occur to me to report this differently to APPIC.

 

[AcronymAllergy]

Our department didn't allow us to do any off-campus clinical work that wasn't supervised by a licensed psychologist. They were definitely not flexible on that requirement.

We did have some unlicensed immediate supervision in our in-house clinic. When the department was really tight on supervision slots, I met with someone who wasn't yet licensed, and she was in turn supervised by the clinic director, so it still "counted." However, it didn't occur to me to report this differently to APPIC.

My program, like yours and Pragmas, was fairly strict on this as well. We were required to have regular, direct face-to-face supervision by licensed psychologists. For new faculty who weren't yet licensed, the faculty under whose license they were practicing had to be present for weekly grad student supervision meetings.

 

[cara susanna]

My program allows you to be supervised by unlicensed psychologists if they are being supervised by a licence psychologist. Some of our dept clinic supervisors are actually working towards licensure at the moment.

 

[DynamicDidactic]

I don't think the APPIC application has any specifications for individual supervision that relate to licensing. I could be wrong, but I'm pretty sure you could just count that as regular individual supervision.

just so it is clear, you are very wrong. The APPIC is very careful about who supervises you, there are three concrete categories.

Supervised by a Licensed Psychologist:

Supervised by a Licensed Allied Mental Health Professional:

Other Supervision (e.g., supervision provided by an advanced graduate student who is supervised by licensed psychologist). Please specify type of license and mental health discipline of supervisor(s) in comment box below:

 

[DynamicDidactic]

another note about APPIC

Individual supervision is defined as regularly scheduled, one-on-one, face-to-face supervision with the specific intent of overseeing the psychological services rendered by the supervisee.

 

[KillerDiller]

just so it is clear, you are very wrong. The APPIC is very careful about who supervises you, there are three concrete categories.

Yes, I was wrong that the APPIC guidelines do not mention licensing. However, it's still the case that, given these categories, the OP should be able to count this as regular individual supervision and not have to use an "other" category.

 

[Pragma]

Yes, I was wrong that the APPIC guidelines do not mention licensing. However, it's still the case that, given these categories, the OP should be able to count this as regular individual supervision and not have to use an "other" category.

I don't know what the AAPI looks like these days, but my understanding is that they still just combine your supervision hours to a total. I guess it is kosher for some of that supervision to come from unlicensed people. That really is news to me - I wouldn't have been comfortable with that I think. If some student one or two years above me was supervising me, how could I really know if they are even doing it properly? I am very happy that my program had seasoned, licensed people doing it.

As far as the actual internship goes (as some people mentioned this earlier in the thread), I read the guidelines for APPIC sites as you need to have all of your formal supervision (e.g., one on one) performed by a licensed supervisor at the site. Some supervision on top of that from unlicensed people (such as fellows) is fine.

http://www.appic.org/About-APPIC/Joining-APPIC/Members/Internship-Membership-Criteria

The internship agency training staff consists of at least two full time equivalent doctoral level psychologists who serve as primary supervisors and who are actively licensed, certified, or registered as a psychologist by the Board of Examiners in the jurisdiction where the program exists.

Clarification: "Full time equivalent" typically refers to 40 hours/week. However, there may be a range of hours that qualify as "full time equivalent" depending on the norms of the program. 35 hours/week is the minimum that will qualify for "full time equivalent" for APPIC member programs. "Full time" for interns could also be set at 35 hours/week if this meets licensure requirements in your jurisdiction. APPIC believes supervisor expectations should be similar to intern expectations.


It is expected that interns receive supervision during the year from at least two different supervisors. Interns' primary clinical supervision and role modeling must be provided by psychologists on the program's staff members who are licensed (certified or registered) for independent practice at the doctoral level and who are:

1. Officially designated as psychology intern supervisors.
2. Significantly involved in the operation of the training program.
3. Intern supervision is provided by staff members of the internship agency or by qualified affiliates of that agency who carry clinical responsibility for the cases being supervised. Regularly scheduled individual supervision is provided by one or more doctoral level licensed psychologists, at a ratio of no less than one hour of supervision for every 20 internship hours. Supervision is provided with the specific intent of dealing with psychological services rendered directly by the intern.
   
4. Clarification: Supervisors need to be clearly designated by the agency as clinically responsible for the cases (for example, countersigning documentation or having their name on the treatment plan or case summary). Depending on clinical needs, increased hours of supervision are expected. The required hours shall be through face-to-face individual supervision (rural sites may use visual telecommunication technology in unusual circumstances and when face-to-face supervision is impractical, but must demonstrate that such technology provides sufficient oversight). Programs shall adhere to all requirements of their state licensing boards.

 

[KillerDiller]

That really is news to me - I wouldn't have been comfortable with that I think. If some student one or two years above me was supervising me, how could I really know if they are even doing it properly? I am very happy that my program had seasoned, licensed people doing it.

I'm ambivalent about the issue. I think it depends on how far along the doctoral student is in his/her clinical training. There is a world of difference in clinical skill between a postdoc and a student doing his/her first or second year of prac. That arrangement doesn't bother me as long as the postdoc receives supervision of supervision. It strikes me that this may actually benefit the prac student more than having a licensed supervisor who is new to supervision and who isn't being supervised by anyone.

On the other hand, a situation where an intern or even a postdoc is supervising an advanced prac student would make me a bit uncomfortable.

 

[DynamicDidactic]

However, it's still the case that, given these categories, the OP should be able to count this as regular individual supervision and not have to use an "other" category.

maybe I missed something, how so? The OP is not getting supervised (as defined by APPIC, F2F) by a licensed psychologist or Licensed Allied Mental Health Professional. Thus, they are receiving the "other" category.

 

[KillerDiller]

maybe I missed something, how so? The OP is not getting supervised (as defined by APPIC, F2F) by a licensed psychologist or Licensed Allied Mental Health Professional. Thus, they are receiving the "other" category.

Oh, I guess I had a different interpretation of the "other" category. I took a look at the APPIC regulations you quoted, and my understanding was that these three categories all fell under the tracking domain of "individual supervision" even though it fits the sub-category of being supervised by an "other" supervisor, which you then have to specify on the application. On my hours tracking sheet (which doesn't correspond 100% to the APPIC application), there is also actually a category for "other supervision experiences" which is meant for supervision that, for some reason, does not fit under the individual or group categories. I assumed that was what the OP's TD saying was meaning when he/she said it would need to be counted as "other." However, it would make complete sense of he/she is talking about the "other" category within individual supervision.