Tracking hours for Neuropsychology Internships - How much weight on intervention?

[guy248]

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Hi all,

I am a Ph.D. student preparing to apply for internship specializing in Neuropsychology in a few years, and I’ve been feeling a bit confused about how “intervention hours” are tracked. During my first-year therapy practicum, I accrued 131 intervention hours (intake interviews and therapy), and both my DCT and classmates reassured me this was perfectly fine.

Now that I am in my first neuropsych practicum, I was initially told by some students that I would continue accruing intervention hours because intake interviews and feedback sessions could be coded that way. However, after reviewing the APPIC guidelines, that does not appear to be the case.

At my program, the typical neuropsychology track looks like this

1. Year 1 – Therapy practicum
2. Years 2–3 – Neuropsych practica
3. Year 4 – Specialized placement (e.g., rehab)

Our match rate is very high, and most neuropsych-focused students follow this path. Still, I can’t help but worry that I’ll appear to have “low” intervention hours when I apply unless I complete another therapy practicum (or do what other students did which appears to be against APPIC?). I recently spoke with a student who is applying this year, and she said that neuropsych sites are much more concerned with overall face-to-face clinical contact than with therapy-specific hours.

I’d appreciate any clarification or advice from those with more experience. This whole process has left me a bit uncertain, and I want to make sure I’m approaching my training correctly.

 

[WisNeuro]

When I applied, we did not count feedbacks and intakes as intervention hours. But yes, 131 would have been on the lower end for intervention hours at places I was at for neuro. Not the lowest, but probably in the bottom 25%. YMMV, but we liked to have well-rounded individuals, even in the neuro tracks.

 

[AcronymAllergy]

I can see an argument for feedback counting as intervention, but probably not for intakes.

Overall, yes, in my experience, many/most neuropsych track sites seem to understand that many applicants will have fewer intervention hours. I don't know how 131 hours stacks up against the typical applicant, but it certainly couldn't hurt to focus on increasing those hours between now and when you apply. You do want to come across as a well-rounded applicant, and just for your own professional development, actual (therapeutic) intervention experience is important.

 

[BrainStormer]

I’m a Neuro focused PhD student applying for internship this fall. Low intervention hours is a very common concern amongst the Neuro students from what I’ve heard. Myself and others have taken on supplemental practica to boost intervention. Also see if you can do more intervention related activities at your site (cog rehab, groups, etc).

Could be wrong but I thought T2T automatically categorizes “intake interview” under the intervention section.

 

[Dazen]

I’m a Neuro focused PhD student applying for internship this fall. Low intervention hours is a very common concern amongst the Neuro students from what I’ve heard. Myself and others have taken on supplemental practica to boost intervention. Also see if you can do more intervention related activities at your site (cog rehab, groups, etc).

Could be wrong but I thought T2T automatically categorizes “intake interview” under the intervention section.

Yup, T2T puts intake interview under intervention. I generally leave therapy intakes as intervention and put assessment intakes as "other psychological assessment" in T2T, since there's not a specific category.

 

[AcronymAllergy]

I’m a Neuro focused PhD student applying for internship this fall. Low intervention hours is a very common concern amongst the Neuro students from what I’ve heard. Myself and others have taken on supplemental practica to boost intervention. Also see if you can do more intervention related activities at your site (cog rehab, groups, etc).

Could be wrong but I thought T2T automatically categorizes “intake interview” under the intervention section.

Ah, wasn't aware of it; seems a bit strange. Although I can also understand why a therapy intake would count toward intervention hours.

 

[guy248]

I’m a Neuro focused PhD student applying for internship this fall. Low intervention hours is a very common concern amongst the Neuro students from what I’ve heard. Myself and others have taken on supplemental practica to boost intervention. Also see if you can do more intervention related activities at your site (cog rehab, groups, etc).

Could be wrong but I thought T2T automatically categorizes “intake interview” under the intervention section.

When you say boosting intervention do you mean therapy specifically? My research activities will give me hours in cognitive rehabilitation that I know will count under "intervention" but not therapy. I guess I am wondering if I need to get more hours in therapy specifically.

 

[PsyDuck90]

Personally, I think forgoing general therapy training at the predoctoral level still does you a disservice as a neuropsych trainee. General therapy skills help you to quickly establish strong rapport with your patients and to effectively provide difficult feedback. Additionally, if you decide to do anything more rehab-related, you often do intervention in addition to assessment. Having a strong grasp on psychopathology is also super helpful when you get those mTBI cases or “pseudo-dementias” to help you parse out those things. Plus, it can make you stand out later on the job market. I’m finishing up my neuropsych postdoc and when I was interviewing for jobs, some of the rehab-neuro focused places loved that I was trained in cog rehab, had a strong therapy background, and was certified in CPT on internship. It makes you more marketable.

Personally, I think my strength in intervention-focused case conceptualization has helped me a lot in my conceptualization of some of the less traditional evals outside of the run of the mill geriatric memory disorder cases. Lastly, even in a neuropsych track, the predoctoral internship is still a general training model, and sites don’t really love the idea of taking neuropsych interns who are going to go into the second half of their training with the skill level of a 2nd year practicum student from an intervention standpoint. And both sites I trained at preferred that neuropsych interns do their non-neuro rotations in rotations that would give them a breadth of training, such as substance use, PTSD, acute psychiatric inpatient, etc. Neuropsych eval patients get suicidal too. You gotta be comfortable completing a comprehensive suicidal risk evaluation on the fly. It’s rare, but it literally happened to me earlier this month. If you haven’t had a lot of experience with significant MH concerns, you may have a harder time in situations like that. Granted, I’m in the VA, which I think lends itself to some of these issues more than other sites, but neuropsychologists are still clinical psychologists at the end of the day and should have the bare minimum competencies as their non-neuro peers.

Also, 131 hours for a whole year practicum seems kind of low. How many hours/weeks were you there?

 

[BrainStormer]

When you say boosting intervention do you mean therapy specifically? My research activities will give me hours in cognitive rehabilitation that I know will count under "intervention" but not therapy. I guess I am wondering if I need to get more hours in therapy specifically.

Yes, I did a supplemental site one day a week that was specifically therapy. I thought research F2F hours do not count. If they do count, I sure do have a lot more assessment hours I could log. Can anyone speak into this?

Regarding therapy versus other intervention experiences, I'm not sure if internship committees tease apart those hours when reviewing apps. My advice would be to try to meet the general intervention hour cut offs that internship programs list. Previous students in my program were still able to match phase I to VAs and other medical settings with low intervention hours.

 

[guy248]

Personally, I think forgoing general therapy training at the predoctoral level still does you a disservice as a neuropsych trainee. General therapy skills help you to quickly establish strong rapport with your patients and to effectively provide difficult feedback. Additionally, if you decide to do anything more rehab-related, you often do intervention in addition to assessment. Having a strong grasp on psychopathology is also super helpful when you get those mTBI cases or “pseudo-dementias” to help you parse out those things. Plus, it can make you stand out later on the job market. I’m finishing up my neuropsych postdoc and when I was interviewing for jobs, some of the rehab-neuro focused places loved that I was trained in cog rehab, had a strong therapy background, and was certified in CPT on internship. It makes you more marketable.

Personally, I think my strength in intervention-focused case conceptualization has helped me a lot in my conceptualization of some of the less traditional evals outside of the run of the mill geriatric memory disorder cases. Lastly, even in a neuropsych track, the predoctoral internship is still a general training model, and sites don’t really love the idea of taking neuropsych interns who are going to go into the second half of their training with the skill level of a 2nd year practicum student from an intervention standpoint. And both sites I trained at preferred that neuropsych interns do their non-neuro rotations in rotations that would give them a breadth of training, such as substance use, PTSD, acute psychiatric inpatient, etc. Neuropsych eval patients get suicidal too. You gotta be comfortable completing a comprehensive suicidal risk evaluation on the fly. It’s rare, but it literally happened to me earlier this month. If you haven’t had a lot of experience with significant MH concerns, you may have a harder time in situations like that. Granted, I’m in the VA, which I think lends itself to some of these issues more than other sites, but neuropsychologists are still clinical psychologists at the end of the day and should have the bare minimum competencies as their non-neuro peers.

Also, 131 hours for a whole year practicum seems kind of low. How many hours/weeks were you there?

It was at a VA so I dealt with a lot of cancellations and just overall a small case load. We had another student who finished below 100! I agree with everything you're saying. I guess I need to prioritize supplemental pracs ASAP.

Yes, I did a supplemental site one day a week that was specifically therapy. I thought research F2F hours do not count. If they do count, I sure do have a lot more assessment hours I could log. Can anyone speak into this?

Regarding therapy versus other intervention experiences, I'm not sure if internship committees tease apart those hours when reviewing apps. My advice would be to try to meet the general intervention hour cut offs that internship programs list. Previous students in my program were still able to match phase I to VAs and other medical settings with low intervention hours.

I was told by my PI and another student applying this year that research F2F does count. Could you give me an idea as to what "low intervention" hours looked like roughly?

 

[PsyDuck90]

Yeah, VA has a lot of cancellations/no shows, especially for therapy. Does your program have an in house clinic you can get hours at? It may vary with the specific demographics, but I did a practicum at a college counseling center with a a very diverse student body (in terms of SES, chief complaints, etc). I got a lot of quality therapy hours treating individuals for things such as PTSD following a sexual assault, MDD, OCD, GAD, etc. I very very rarely had no shows. I had a friend who did a practicum at a different college counseling center and saw nothing but adjustment disorder, so milage may vary. But she also had very few no shows.

 

[WisNeuro]

From APPIC

"Do intake evaluations count as assessment? Intake interviews leading to psychotherapy are categorized as Intervention. When a clinical interview is completed as part of an assessment battery rather than for psychotherapy intake, that interview time can be categorized as Assessment"

Also, in reading the APPIC FAQs, I would not read it as your research hours counting for intervention or assessment. At several points they specifically mention only practicum hours counting, and that any research related experience should be categorized in the "Non-Practicum Work Experience" section. Considering your PIs likely haven't done this in a long time, and students are usually going by what someone else said, it's always a good idea to read through the material personally.

*Edit, they later say that if work is "sanctioned" by your program and you received regular, scheduled supervision for it by a licensed psychologist, it may count, so there is some grey area here.

 

[guy248]

From APPIC

"Do intake evaluations count as assessment? Intake interviews leading to psychotherapy are categorized as Intervention. When a clinical interview is completed as part of an assessment battery rather than for psychotherapy intake, that interview time can be categorized as Assessment"

Also, in reading the APPIC FAQs, I would not read it as your research hours counting for intervention or assessment. At several points they specifically mention only practicum hours counting, and that any research related experience should be categorized in the "Non-Practicum Work Experience" section. Considering your PIs likely haven't done this in a long time, and students are usually going by what someone else said, it's always a good idea to read through the material personally.

*Edit, they later say that if work is "sanctioned" by your program and you received regular, scheduled supervision for it by a licensed psychologist, it may count, so there is some grey area here.

Thank you. As noted above I did read through these hence the source of my confusion lol. The students who gave me their advise all matched at great internships which just makes me question the point of all this hour tracking. Again, they all used feedback sessions and intake interviews (neuro) as intervention. I bet that was a lot easier than taking a supplemental sigh.

 

[PsyDuck90]

If I remember correctly, the APPI, and maybe even T2T, had a specific section to log any f2f hours your got from research.

 

[WisNeuro]

Thank you. As noted above I did read through these hence the source of my confusion lol. The students who gave me their advise all matched at great internships which just makes me question the point of all this hour tracking. Again, they all used feedback sessions and intake interviews (neuro) as intervention. I bet that was a lot easier than taking a supplemental sigh.

It's variable, some reviewers/interviewers don't pay much attention to this stuff. Some of do, though. If I was asked about some of the hours on interview, I'd want to make sure I had the right answers. I've seen grossly mischaracterized hours tank applications. Similar when people don't understand what constitutes an integrated report. No, giving a BDI/BAI does not automatically make your intake report "integrated."

 

[AcronymAllergy]

Thank you. As noted above I did read through these hence the source of my confusion lol. The students who gave me their advise all matched at great internships which just makes me question the point of all this hour tracking. Again, they all used feedback sessions and intake interviews (neuro) as intervention. I bet that was a lot easier than taking a supplemental sigh.

Honestly, it's more about your professional skillset and development than it is the hours involved, the latter of which I think people sometimes get too caught up with. The hours are just a quasi-proxy for the skillset, after all. In an extreme example--a person might have 300 intervention hours that consist entirely of intake interviews. They might look solid on paper, but their actual ability to competently administer psychotherapy would be about nil.

If previous students have counted assessment intake hours as intervention hours, so be it, that's on them. But if they did so at the expense of actually getting good experience with psychotherapy, that's to their own detriment, regardless of where they matched. I wouldn't personally want to follow in that path.

 

[Therapist4Chnge]

The mix of hours was more what I looked at. Also, there needed to be some productivity, publish an abstract at the least, but ideally be involved in research and know how to break down journal articles critically. For me, it was more about having a well rounded clinician, as generalist training is the foundation to build upon for speciality work. I disliked doing therapy, but it helped me as a clinician.

 

[BrainStormer]

OP check out this article. It’s a breakdown of hour thresholds that make a competitive internship application.

 

[guy248]

OP check out this article. It’s a breakdown of hour thresholds that make a competitive internship application.

Thank you I’ll make sure to take a look.