Is it possible to create your own training opportunities (externships) during graduate school?

[neil32]

I have read on various forums that students can tailor their practicum and externship experiences during graduate school towards their area or populations of interest. Does this include being able to organize your own externship experience, at say a private practice or clinical site that does not have an established externship program? Is it just a matter of getting a licensed psychologist, with specialization in your area of interest, to agree to supervise and train you? I am asking because I am considering a PsyD program that doesn't really have established training opportunities in an area I am interested in, and as far as why I am considering the program despite this, it's because this program is offering substantial funding, tuition waiver, health insurance, etc. So, I want to know if I can attend and still find a way to create my own training opportunities, so to speak. My understanding of how clinical training is organized is limited. Seeking your expert advice. Thanks in advance!

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[PsycIntern2021]

It really depends on the program and the area and how they handle externships. For instance, this was possible at my PhD program to create a new externship if you had a licensed psychologist specialized in that area; but other areas, there is a dearth of practica or people that would be willing to supervise. Some programs might also not allow you to do this at all - there is some oversight by the DCT needed to make sure that the externship can count toward your hours, particularly for an APA-accredited program.

Short answer: ask the program you are interested in. We won't know the answer.

 

[neil32]

It really depends on the program and the area and how they handle externships. For instance, this was possible at my PhD program to create a new externship if you had a licensed psychologist specialized in that area; but other areas, there is a dearth of practica or people that would be willing to supervise. Some programs might also not allow you to do this at all - there is some oversight by the DCT needed to make sure that the externship can count toward your hours, particularly for an APA-accredited program.

Short answer: ask the program you are interested in. We won't know the answer.

Thanks! I will reach out to the DCT. I was curious if it was at all possible, but you've verified that it is possible but program specific --that helps.

 

[AcronymAllergy]

Yes, it's possible, but like PsychIntern2021 said, it's very dependent on the specific program--some may allow it while others may not. And it requires formal agreements be put in place between the training program and site.

 

[psych.meout]

The biggest factor is going to be what's available in your area and less on the willingness of your program to allow this. Even if your program is very eager to help you create new practicum sites based on your interests, it's not going to work if there isn't a licensed psychologist in your community that specializes in that area and is willing and able to supervise trainees. And even if there was someone in the community willing to try working with you, it might just not work out logistically.

This is why you should be cautious about accepting an offer from a program where they don't have those training opportunities and just hope you can establish your own practica once you get there. This isn't to say that you should necessarily decline the offer, but rather that you should only accept it if not having those opportunities would still be acceptable to you and it would just be a nice addition if they do come to fruition during grad school. And just because your grad program might not have a given clinical training opportunity doesn't mean it's impossible for you to ever have this. You could look for internship sites and post docs with rotations in that area(s) to round out your training later on.

 

[Sanman]

Possible, yes? I would just caution you about whether you think it is probable. Externship experiences do not generally earn money for the sites that accept them. Unless you have a family member willing to jump through hoops, I would consider how you are going to convince a private clinician to spend time and money on you for no return. If it was that simple, I can guarantee your DCT would likely have already done it. Think carefully before committing to any program with this hope in mind.

 

[psych.meout]

Possible, yes? I would just caution you about whether you think it is probable. Externship experiences do not generally earn money for the sites that accept them. Unless you have a family member willing to jump through hoops, I would consider how you are going to convince a private clinician to spend time and money on you for no return. If it was that simple, I can guarantee your DCT would likely have already done it. Think carefully before committing to any program with this hope in mind.

Yeah, when I think about how much time and energy and opportunity cost from seeing their own patients dedicated by my supervisors, I don't know how this would be practical for any PP to do. Well, at least not at any reputable PP that isn't just going to use prac students as workhorses for testing or something.

So, I guess it depends on what specifically OP is looking for in terms of training, because certain things that are more likely to be at an AMC or VAMC (e.g., various health psych foci) are probably going to be more feasible than something more specific to private practice or which isn't offered at some large organization which incentivizes and encourages psychologists to supervise trainees.

 

[Ollie123]

Absolutely possible in some places. I did exactly that.

All that said, I would be extraordinarily cautious about this - especially if getting this training is "crucial" to your eventual career goals. I was on an academic path so while this particular externship was nice, it was not strictly necessary to get me where I wanted to go.

For reasons noted above, you will likely have far more success creating ones in established training systems. e.g. if your local VA takes practicum students but you really want to work in one particular specialty clinic that historically hasn't had a practicum students (my case) that can be a pretty easy lift. Convincing someone in private practice to supervise you will likely be much more difficult. Also note that even if you successfully do so, there is no guarantee the program will allow it as there are often other considerations. My program carefully vetted placements. If students were engaging in treatments my program didn't deem evidence-based, said placements were barred from taking students, regardless of whether they were the only one who offered experience in XYZ.

 

[neil32]

All great advice. Thank you guys! Thankfully I think I would still be able to achieve my career goals if creating my own externship opportunity is not possible. I will also look towards internships and post-docs if necessary. I was leaning towards generating a training opportunity in a medical center more than a private practice, so it's reassuring to read that the likelihood of success may be greater there. In any case, I understand it's not an outcome to rely on, but I'm someone who just wants to explore all options!

It really depends on the program and the area and how they handle externships. For instance, this was possible at my PhD program to create a new externship if you had a licensed psychologist specialized in that area; but other areas, there is a dearth of practica or people that would be willing to supervise. Some programs might also not allow you to do this at all - there is some oversight by the DCT needed to make sure that the externship can count toward your hours, particularly for an APA-accredited program.

Short answer: ask the program you are interested in. We won't know the answer.

Yes, it's possible, but like PsychIntern2021 said, it's very dependent on the specific program--some may allow it while others may not. And it requires formal agreements be put in place between the training program and site.

The biggest factor is going to be what's available in your area and less on the willingness of your program to allow this. Even if your program is very eager to help you create new practicum sites based on your interests, it's not going to work if there isn't a licensed psychologist in your community that specializes in that area and is willing and able to supervise trainees. And even if there was someone in the community willing to try working with you, it might just not work out logistically.

This is why you should be cautious about accepting an offer from a program where they don't have those training opportunities and just hope you can establish your own practica once you get there. This isn't to say that you should necessarily decline the offer, but rather that you should only accept it if not having those opportunities would still be acceptable to you and it would just be a nice addition if they do come to fruition during grad school. And just because your grad program might not have a given clinical training opportunity doesn't mean it's impossible for you to ever have this. You could look for internship sites and post docs with rotations in that area(s) to round out your training later on.

Possible, yes? I would just caution you about whether you think it is probable. Externship experiences do not generally earn money for the sites that accept them. Unless you have a family member willing to jump through hoops, I would consider how you are going to convince a private clinician to spend time and money on you for no return. If it was that simple, I can guarantee your DCT would likely have already done it. Think carefully before committing to any program with this hope in mind.

Absolutely possible in some places. I did exactly that.

All that said, I would be extraordinarily cautious about this - especially if getting this training is "crucial" to your eventual career goals. I was on an academic path so while this particular externship was nice, it was not strictly necessary to get me where I wanted to go.

For reasons noted above, you will likely have far more success creating ones in established training systems. e.g. if your local VA takes practicum students but you really want to work in one particular specialty clinic that historically hasn't had a practicum students (my case) that can be a pretty easy lift. Convincing someone in private practice to supervise you will likely be much more difficult. Also note that even if you successfully do so, there is no guarantee the program will allow it as there are often other considerations. My program carefully vetted placements. If students were engaging in treatments my program didn't deem evidence-based, said placements were barred from taking students, regardless of whether they were the only one who offered experience in XYZ.

 

[summerbabe]

I am asking because I am considering a PsyD program that doesn't really have established training opportunities in an area I am interested in, and as far as why I am considering the program despite this, it's because this program is offering substantial funding, tuition waiver, health insurance, etc.

As others have said, contact the current DCT and ask if this is possible for this program.

However, if things don’t work out (and many reasons can contribute to this - some program specific and some non-program related), you won’t have any recourse so weigh your choice carefully as transferring to a different doctoral program may be quite challenging, if not impossible in some instances. Good luck!

 

[BuckeyeLove]

I had a supervisor for one of my grad school practicums that had a private practice of his own specializing in sex offender assessment and treatment. Dude liked me during practicum and offered to have me train at his practice. I forget if these hours were able to be used on the AAPI but I can state with definitiveness that it made me VERY competitive. Very very competitive. (My internship sites were all forensic treatment and/or assessment related).

 

[ClinicalABA]

We had an externship/practica minimum stipend per semester that was required for us to get a tuition waiver. It was part of our grad student union CBA. Not sure how common this is, but our union (a local of the United Auto Workers, of all things!) did not take kindly to it's members working for free (or for peanuts).

 

[WisNeuro]

We had an externship/practica minimum stipend per semester that was required for us to get a tuition waiver. It was part of our grad student union CBA. Not sure how common this is, but our union (a local of the United Auto Workers, of all things!) did not take kindly to it's members working for free (or for peanuts).

As in the prac students were working for free?

 

[AcronymAllergy]

We had an externship/practica minimum stipend per semester that was required for us to get a tuition waiver. It was part of our grad student union CBA. Not sure how common this is, but our union (a local of the United Auto Workers, of all things!) did not take kindly to it's members working for free (or for peanuts).

Yeah, our graduate school (at least at the time) did not have a union for the students. We had a small number of practica that were unpaid as best I can recall, although the associated commitment was small (e.g., one day or a half-day per week). Most practica provided a tuition waiver.

 

[psych.meout]

Yeah, our graduate school (at least at the time) did not have a union for the students. We had a small number of practica that were unpaid as best I can recall, although the associated commitment was small (e.g., one day or a half-day per week). Most practica provided a tuition waiver.

So you didn't have to teach, TA, or RA while you were doing practicum?

 

[ClinicalABA]

As in the prac students were working for free?

We didn't, but it may have been more common in other departments. Union didca great job of getting us paid fairly. We needed a 10 hour per week (considered half time) TA, RA, or practicum position with a stipend ~8500/semester (roughly 15000 in 2022 dollars) to qualify for a tuition waiver. Most students had a paid TA/RA plus a practicum position (or 2 practica) for a total of 20 hours per week. Summer was extra, but usually available. Small cohorts (mine had 7 students, with 2 respecialization students grouped with us for clinical coursework), so plenty of paid positions to go around. There were always extra TA gigs if youwanted one- flagship state U with huge undergrad psych major and multiple sections of 100-200 level courses.. I created my own paid practica for 2 semesters.

 

[AcronymAllergy]

So you didn't have to teach, TA, or RA while you were doing practicum?

For funding, no. But some people (including me) taught for the experience. And of course everyone still participated in their usual research lab. During my first year, for example, my funding came from being a TA. I might've TA'd for my second year as well (it's been a while). For every other year, my funding was through practica, but I also taught in my third or fourth year.

On the flip side, people whose funding came through TA/RA/teaching still had practica (including those that provided funding for other students), they just didn't have the same time commitments.

 

[WisNeuro]

We didn't, but it may have been more common in other departments. Union didca great job of getting us paid fairly. We needed a 10 hour per week (considered half time) TA, RA, or practicum position with a stipend ~8500/semester (roughly 15000 in 2022 dollars) to qualify for a tuition waiver. Most students had a paid TA/RA plus a practicum position (or 2 practica) for a total of 20 hours per week. Summer was extra, but usually available. Small cohorts (mine had 7 students, with 2 respecialization students grouped with us for clinical coursework), so plenty of paid positions to go around. There were always extra TA gigs if youwanted one- flagship state U with huge undergrad psych major and multiple sections of 100-200 level courses.. I created my own paid practica for 2 semesters.

We had stipends for RA/TA work, but no compensation for practica, which you did on top of the other work. Frankly, if we demanded payment from practica, many would simply go away. Based on what trainees can and cannot bill for, and what the payer mix is, many places lose lots of money and time on trainees.

 

[ClinicalABA]

We had stipends for RA/TA work, but no compensation for practica, which you did on top of the other work. Frankly, if we demanded payment from practica, many would simply go away. Based on what trainees can and cannot bill for, and what the payer mix is, many places lose lots of money and time on trainees.

A lot of ours were at University Counseling Centers (five colleges in the area). I did one where I worked for the University Alcohol Education program (get caught drinking in the dorms and you had to go talk to the guy who now regularly posts about what he's drinking for the weekend on psych forums!). The prac I created was at an ABA agency. Pretty much all of them operated outside of regular insurance pay models, so it was a "service added" arrangement in most cases. Later when I moved back to the area post licensure, I created a practicum at my agency (adult residential program with mainly state funding). Again- outside of the insurance reimbursement, CPT code world. We have non-paid practica at my current agency, and find that you frequently get what you pay for.

 

[WisNeuro]

A lot of ours were at University Counseling Centers (five colleges in the area). I did one where I worked for the University Alcohol Education program (get caught drinking in the dorms and you had to go talk to the guy who now regularly posts about what he's drinking for the weekend on psych forums!). The prac I created was at an ABA agency. Pretty much all of them operated outside of regular insurance pay models, so it was a "service added" arrangement in most cases. Later when I moved back to the area post licensure, I created a practicum at my agency (adult residential program with mainly state funding). Again- outside of the insurance reimbursement, CPT code world. We have non-paid practica at my current agency, and find that you frequently get what you pay for.

Definitely area dependent, but at least for neuro, where many of the pracs are hospital systems, AMCs, etc, where insurance and medicare are rule rather than the exception, we are very limited on what trainees can bill for. So, it's essentially donating time and money to train students. Obviously different in the VA, so at least there is that.

One of the reasons I always encourage students to get involved with federal advocacy. Want better stipends and some prac pay? Stop blaming prac and internship sites that lose money on you and work to get medicare rules changed.

 

[neil32]

We didn't, but it may have been more common in other departments. Union didca great job of getting us paid fairly. We needed a 10 hour per week (considered half time) TA, RA, or practicum position with a stipend ~8500/semester (roughly 15000 in 2022 dollars) to qualify for a tuition waiver. Most students had a paid TA/RA plus a practicum position (or 2 practica) for a total of 20 hours per week. Summer was extra, but usually available. Small cohorts (mine had 7 students, with 2 respecialization students grouped with us for clinical coursework), so plenty of paid positions to go around. There were always extra TA gigs if youwanted one- flagship state U with huge undergrad psych major and multiple sections of 100-200 level courses.. I created my own paid practica for 2 semesters.

This sounds similar to the program I am considering, except the stipend is not that high for 10 hours per week or half time!

A lot of ours were at University Counseling Centers (five colleges in the area). I did one where I worked for the University Alcohol Education program (get caught drinking in the dorms and you had to go talk to the guy who now regularly posts about what he's drinking for the weekend on psych forums!). The prac I created was at an ABA agency. Pretty much all of them operated outside of regular insurance pay models, so it was a "service added" arrangement in most cases. Later when I moved back to the area post licensure, I created a practicum at my agency (adult residential program with mainly state funding). Again- outside of the insurance reimbursement, CPT code world. We have non-paid practica at my current agency, and find that you frequently get what you pay for.

There seems to be a lot of ABA agencies looking for graduate students to provide therapy to their clients for pay in my area. Can paid experience with an ABA agency be considered practicum training? Your experience interests me because I am interested in specializing in early intervention and neurodevelopmental disorders.

 

[ClinicalABA]

This sounds similar to the program I am considering, except the stipend is not that high for 10 hours per week or half time!

There seems to be a lot of ABA agencies looking for graduate students to provide therapy to their clients for pay in my area. Can paid experience with an ABA agency be considered practicum training? Your experience interests me because I am interested in specializing in early intervention and neurodevelopmental disorders.

It depends on the type of ABA experience. In-home ABA with children with ASD is almost exclusively reimbursed at the masters level credential. My position was was more senior clinical consultation with adult residential ID population. I'm also "an old", so it was before the BCBA credential existed and ABA was still the domain of psychologists. I received supervision from a psychologist, doing clinical work that a psychologist typically did, so it counted. Itvwas the same for my internship, where I did a major rotation 3 days per week doing school consultation ( which was primarily ABA). Today, most school districts in my area have an on staff BCBA (MA level) who does some of what I did but not all, as I was also trained in educational assessment, curriculum based measurement, and treated mental disorders in children). The internship was APA Accredited at the time, but the school consultation part no longer is because there is not always a licensed supervisor on site. Long story short- ABA program experience can be very useful given your carreer goals, but if you're not doing the work of and being supervised by a psychologist, it likely won't count as clinical hours towards licensure or intern applications. I will say, if you want to work as a psychologist in the EI/neurodevelopmental realm, a BCBA credential (in addition to psych) is a great idea and very marketable. Of the 5 psychologists whonwork for my assessment center, 3 of us are BCBAs and licensed behavior analysts as well, and one is a licensed behavior analysis, though never got the BCBA. Feel free to pm me if you want more info on this topic.

 

[PsychPhDMama]

A number of my peers have done this without any problem in our department, especially for assessment training. What I’ve been trying to figure out is how to make these hours count towards licensure. My understanding is, in my state, you can count hours after your first prac, but it’s not crystal clear. I’ve reviewed the state requirements and talked with folks and, maybe I’ve got rocks in my head, but I can’t sort it out. I contacted the licensing board multiple times and no one responded.

 

[ClinicalABA]

A number of my peers have done this without any problem in our department, especially for assessment training. What I’ve been trying to figure out is how to make these hours count towards licensure. My understanding is, in my state, you can count hours after your first prac, but it’s not crystal clear. I’ve reviewed the state requirements and talked with folks and, maybe I’ve got rocks in my head, but I can’t sort it out. I contacted the licensing board multiple times and no one responded.

This is something your director of training (or practicum coordinator) at your school should be on top of (at least for the jurisdiction the school is located in). It's kinda their job to prepare you to meet licensure standards.