practicum experiences

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I am kind of curious about this as a first-time applicant. There is so much emphasis on the research aspect of programs that I just realized how fuzzy the idea of doing a practicum is. What is a practicum like? How many patients get seen per week? What is supervision like?

 

[Pragma]

I am kind of curious about this as a first-time applicant. There is so much emphasis on the research aspect of programs that I just realized how fuzzy the idea of doing a practicum is. What is a practicum like? How many patients get seen per week? What is supervision like?

It is going to vary a lot depending on where you go and what kind of practicum it is.

For example, in a neuropsych testing practicum, I remember seeing a patient for a full day evaluation every two weeks (early on). The other day of the week was for scoring, didactics, individual/group supervision, case conferences, grand rounds, etc, and it was expected that you would reading a lot of literature and doing some writing on your own to round out 20 hours per week. You had the "off" day the following week to focus on the report. Once you got more efficient with assessments/scoring/writing, sometimes you would do a full evaluation every week (thus you'd get a total of at least 25 and maybe up to 35 full neuropsych batteries done each year).

Therapy practica will also vary. If you are in a setting with a lot of no shows (e.g., CMHC), you might schedule more patients than you need and do a fair amount of case management. I've seen some combined practicums where you carry 4-5 therapy patients, do a group or two, and also do intakes and testing cases (then of course didactics/supervision). I've seen practica through health systems where you generally carry 8-10 therapy cases and spend the rest of the time charting and in didactics/supervision.

I know that there are other models out there as well, but all of the ones I am familiar with have involved 20 hour weeks for 12 months (typically July 1 to June 30). How the time is split up has varied (e.g., two 10 hour days, a few days a week for shorter duration, 2 days + Friday 1/2 day of didactics, etc).

One thing I heard recently was that some practicum sites don't do didactics. My program would never have allowed us to go to one of those sites, but I suppose it is one way to cut down on your weekly time commitment (but probably reflects a poor training environment, and if you are just at the practicum level, don't you actually want training?!).

 

[Ollie123]

Agree with Pragma, there really are no universal criteria for what this entails.

I've done practica with and without didactic components and actually prefer without since I felt the value added rarely justified the extra time, but keep in mind I'm also a heavily research-focused person in a research-heavy program. That said, all involved significant time for supervision, prep, and training opportunities even if they were not formal didactics. I think we also have a much more flexible definition of practica than Pragma's program (where - correct me if I'm wrong - these were usually 20 hrs/week?). Here, upper-level students sometimes do specialized practica for small amounts of time (sometimes as little as 3-4 hours/week) to get focused experience in very particular areas - these are typically just direct face-to-face and supervision. I think the system has its pluses and minuses - mainly added flexibility vs. risk of missing the forest for the trees, so to speak.

 

[Pragma]

Agree with Pragma, there really are no universal criteria for what this entails.

I've done practica with and without didactic components and actually prefer without since I felt the value added rarely justified the extra time, but keep in mind I'm also a heavily research-focused person in a research-heavy program. That said, all involved significant time for supervision, prep, and training opportunities even if they were not formal didactics. I think we also have a much more flexible definition of practica than Pragma's program (where - correct me if I'm wrong - these were usually 20 hrs/week?). Here, upper-level students sometimes do specialized practica for small amounts of time (sometimes as little as 3-4 hours/week) to get focused experience in very particular areas - these are typically just direct face-to-face and supervision. I think the system has its pluses and minuses - mainly added flexibility vs. risk of missing the forest for the trees, so to speak.

Yeah that is interesting and I could see it work well for an advanced student (maybe for a 4th practicum?). Would people piece together more than one of these experiences to have simulatenously? I can see it working to beef up your hours in a niche you have some experience with, but if you are brand new learning basic clinical work, I'd imagine that it would be ideal to have more time to get immersed in each practicum experience. But, more than one way to skin a cat I guess. Heck, these days a lot of people have 5+ years worth of practicum hours sometimes before going on internship.

 

[PHD12]

I am kind of curious about this as a first-time applicant. There is so much emphasis on the research aspect of programs that I just realized how fuzzy the idea of doing a practicum is. What is a practicum like? How many patients get seen per week? What is supervision like?

As others mentioned it is quite variable. From my experience, most practicum training requires 12-20 hours per week time commitment. Hospitals tend to be on the more intensive side (many require 3 days per week). You can also stay late at some places or take work home with you sometimes. The best training is typically at VA hospitals since they have a ton of resources and do not take advantage of their trainees. Good sites will usually provide 4 hours of individual and group supervision, several hours of training/seminars, and audiotape/videotape review. Any site that is only willing to provide you with 1 hour of supervision for 8-10 cases is not a good deal. I would also stay away from sites that do not provide any supervision by licensed psychologists (at these sites you would only get supervision by an intern).

 

[AcronymAllergy]

Yeah that is interesting and I could see it work well for an advanced student (maybe for a 4th practicum?). Would people piece together more than one of these experiences to have simulatenously? I can see it working to beef up your hours in a niche you have some experience with, but if you are brand new learning basic clinical work, I'd imagine that it would be ideal to have more time to get immersed in each practicum experience. But, more than one way to skin a cat I guess. Heck, these days a lot of people have 5+ years worth of practicum hours sometimes before going on internship.

My program sounds to be a bit of a mix between yours (Pragma) and Ollie's--we have a mix of formal and more informal practica, although even the formal ones don't generally involve any type of coursework/didactics beyond perhaps weekly case or topic presentations (although I suppose that counts). We also tend to end up with a decent amount of clinical exposure despite being slightly more skewed toward the research end for a balanced program (maybe a 2.5 or 3 out of 7) owing to the clinical work starting up in year 1.

Students can "mix and match" practica based on what their advisor is willing to let them do, although it also depends on funding. If the practicum placement is paying them, then they're half-time (i.e., two full days/week). If they aren't paid, then often the student will work a day or half-day per week in addition to whatever other class, clinical, and research reqs they've got going on. We were lucky in that our university had "in roads" to pretty much every major type of setting in the state (e.g., civil and criminal forensic, medical, private practice, developmental disabilities, inpatient psychiatric & community mental health, etc.), so if we wanted to work there, we could. Thus, most students for most semesters would have their paid practicum placement along with a part-part-time clinical "elective" practicum. The main requirement was that if there were group supervision meetings at the site, you needed to find a way to make it to said meeting.

As for what to expect, I have to mirror what Pragma, Ollie, and PHD12 have said in that it's going to be highly variable. I agree with the above, though, that in general, you should expect probably 16-20 hours/week of work. Supervision can also vary. For a student just beginning clinical work, you should definitely have structured and dedicated supervision times, whereas once you become more advanced, some of that might swap into more informal and on-the-fly supervision (although still of roughly the same amount, and also with at least a couple hours' worth of scheduled supervision).

 

[cara susanna]

You're really smart to be thinking this far ahead with regards to practica. Make sure that the schools you apply to have good practica opportunities that would match your interests. A lot of applicants are so worried about getting in and also research match that they don't really think about this very important aspect of clinical training.

Like everyone else in this thread, our practica are very different depending on what you get. Some sites will have you at 20 hours per week, some at 8-10. We do paid practica for two years so those tend to be 10-20 hours per week. You can also do unpaid practica on the side, which tend to require less hours. The supervision and format all varies. Most of our practica offerings are assessment, with maybe a handful of therapy ones.

 

[psychRA]

I don't think that a practicum experience necessarily needs to include a didactic component, and I don't think that a site that doesn't offer didactics is a bad training site.

When I was on practicum, I was also finishing up my coursework, and felt like I had gotten plenty of training through my classes. The only thing that I needed from my practicum site was clinical hours. From the site's standpoint, offering didactics to practicum students would have been time consuming and difficult, given how few of us there were, and I don't know that they would have been helpful to me, because it wasn't the type of site that I wanted to work in long-term. When you're in grad school, you're limited to the type of practica that are available in your geographic area. Now that I'm on internship at a site that I've chosen based on my interests and not on reasonable driving distance from campus, didactics are very helpful.

 

[AcronymAllergy]

I don't think that a practicum experience necessarily needs to include a didactic component, and I don't think that a site that doesn't offer didactics is a bad training site.

When I was on practicum, I was also finishing up my coursework, and felt like I had gotten plenty of training through my classes. The only thing that I needed from my practicum site was clinical hours. From the site's standpoint, offering didactics to practicum students would have been time consuming and difficult, given how few of us there were, and I don't know that they would have been helpful to me, because it wasn't the type of site that I wanted to work in long-term. When you're in grad school, you're limited to the type of practica that are available in your geographic area. Now that I'm on internship at a site that I've chosen based on my interests and not on reasonable driving distance from campus, didactics are very helpful.

I would agree, although at the grad school level, I'd say just about any practicum placement could benefit from having students do a mix of weekly case and topic presentations. If nothing else, it provides beneficial experience in professional public speaking, and to the overall format of things like case presentations and fact-findings.

 

[Pragma]

I don't think that a practicum experience necessarily needs to include a didactic component, and I don't think that a site that doesn't offer didactics is a bad training site.

When I was on practicum, I was also finishing up my coursework, and felt like I had gotten plenty of training through my classes. The only thing that I needed from my practicum site was clinical hours. From the site's standpoint, offering didactics to practicum students would have been time consuming and difficult, given how few of us there were, and I don't know that they would have been helpful to me, because it wasn't the type of site that I wanted to work in long-term. When you're in grad school, you're limited to the type of practica that are available in your geographic area. Now that I'm on internship at a site that I've chosen based on my interests and not on reasonable driving distance from campus, didactics are very helpful.

I would agree, although at the grad school level, I'd say just about any practicum placement could benefit from having students do a mix of weekly case and topic presentations. If nothing else, it provides beneficial experience in professional public speaking, and to the overall format of things like case presentations and fact-findings.

I suppose it depends on your training goals to some extent. Not offering didactics doesn't necessarily mean a bad site (I recognize the burden it places on a site). But I definitely think there is something to be said about having a learning culture for your externships during those critical early years.

I credit the vast majority of my basic clinical knowledge to my practica experiences. In fact, I never would have been able to become a neuropsychologist if it weren't for the amazing didactics and trainings at my externship site where I started. Sites that take in several externs, have postdocs and interns around to learn from, and have group experiences are ideal for training, IMO, because you almost get another cohort and you can learn from both your cases and other cases.

A smaller site with no didactics might be a great fit for some advanced people and representative of some clinical settings. But for a brand new student, I think it could be problematic not to have overlap with your training/learning experiences, clinical hours, and supervision. Putting them together makes for some really good development, especially early on. I also think that if you are trying different sites, those experiences are really important to get a sense for the total "culture" of where you are - I loved trying out a CMHC and an AMC, because the experiences were very different and I got very different things from both. Without processing the experience via didactics and having a group of other students to learn with, I doubt I would have gotten as much out of it. But, I guess that is just my opinion (and it was the opinion of my PhD program).

On the flip side, I remember going from these more comprehensive experiences to a different setup on postdoc. The externs there got no didactics and people were extremely isolated. No group learning at all - it depressed me to see. But I had to recognize that not all places have the resources to provide comprehensive training and adjust to this - had I had some different experiences earlier, maybe it wouldn't have been so depressing to adjust to.

 

[MissesKathy]

I've found this thread very useful, because as an MFT Intern I find that the training sites I have been placed at have been...well, kind of useless. My supervisor right now tries to convince us that we need to tell our clients not to have abortions, not to be homosexual, etc... I'm currently working with two under served populations, the Paiute Indian Tribe and Mono County residents, in CA, and while there are therapists and psychologists here, all of them seem to be very poorly trained. This is relevant to the PsyD/ PhD forum because it is this lack of knowledge and lack of respectable training which has really convinced me I need to go back to school and become a psychologist with proper practicum experiences and research training. I of course study on my own time and have actually had great success with a lot of my clients, but that's more due to my ability to build a therapeutic relationship and use some CBT techniques than anything else. My point, I suppose, is that I feel that though focus is typically on research in programs, it is very important to receive good clinical training, unless you only intend on doing research.

 

[erg923]

I've found this thread very useful, because as an MFT Intern I find that the training sites I have been placed at have been...well, kind of useless. My supervisor right now tries to convince us that we need to tell our clients not to have abortions, not to be homosexual, etc....

I hope that's not a psychologist doing that. Sad that some people through away all their professional training and all our knowledge about therapeutic service value so they can be essentially resort to being a "pundit with an attitude." Gross...

 

[AcronymAllergy]

I hope that's not a psychologist doing that. Sad that some people through away all their professional training and all our knowledge about therapeutic service value so they can be essentially resort to being a "pundit with an attitude." Gross...

Or perhaps even worse, go through said training with the sole purpose of gaining an additional credential to add an air of additional authority/weight to their espoused belief. "See, I'm a doctor, that means I have to be right."

 

[PHD12]

I've found this thread very useful, because as an MFT Intern I find that the training sites I have been placed at have been...well, kind of useless. My supervisor right now tries to convince us that we need to tell our clients not to have abortions, not to be homosexual, etc... I'm currently working with two under served populations, the Paiute Indian Tribe and Mono County residents, in CA, and while there are therapists and psychologists here, all of them seem to be very poorly trained. This is relevant to the PsyD/ PhD forum because it is this lack of knowledge and lack of respectable training which has really convinced me I need to go back to school and become a psychologist with proper practicum experiences and research training.

Perfect example of why someone should avoid PhD/PsyD and MFT degrees from free standing professional schools like alliant and argosy. What is scary is that in CA these graduates are the majority of psychologists. I'm sure CA has the highest number of ethical violations.