This is all true. Again, I didn't get into an R1 program and I doubt I would have even if I had taken a research year before reapplying given the competitiveness of the labs I am interested in. I would have gone to an R1 if I had the chance, but I do feel like I made a valid choice.
The internship and career competition aspect is something I think a lot about. We will see if I match next year. Beyond internship, the impact of a non-R1 school CV depends on the kind of career track someone is focused on. LA DMH is aggressively hiring, for example, and they will pay off a significant portion of debt, if someone had it. I am on my second DMH externship and have excellent relationships with both supervisors, so I feel I could go that route if I wanted to. Also, getting a job in a residential SUD tx center with my resume would not be difficult. I doubt I would be competitive at the VA, but I never wanted to work there anyway. I have TA'd two courses in our program and am already teaching at two master's level programs, so maybe more of that? I have a paper out for publication (fingers crossed) and have presented at three confrences on work I produced without the backing of a lab or any reserach infrastructure. I am on a LACPA committee and an APA division committee. I run two meditation classes that I started and offer for free to the community. I volunteer on skid row. I know that R1 CVs have more to say than that, but I am doing okay. Again, I have no idea if I will match next year but I am doing what I can with what I have. A 10 year aim is to open a Buddhist hospice in Los Angeles and I feel my training and degree will help me secure some funding for that but maybe not.