The internship experience in graduate school
Helena Horvat and Jim Stellar
In our latest blog post, I (HH) reflected on applying to my first internship in my clinical PsyD program. While I have mastered taking college and graduate-level courses, excelling in the classroom is quite different from working with real clients. Before starting my internship, I felt scared, anxious, and overwhelmed about how novel the experience would be. The application process was demanding, as I did not match in the first round and had to apply to a second round of sites quickly. Although this was disappointing at the time, it has led me to an internship experience that is far more rewarding than I imagined. I am currently working as a diagnostic psychology intern at a therapeutic day school. Before beginning my work here, I wanted to work with adults, as I find working with children to be much more emotionally difficult. I was put in a situation where I had no choice but to feign confidence and embrace the challenge.
Experiential learning
For those who may not be familiar, a therapeutic day school accepts students who have developmental or mood disorders that require more care and attention than an average school can offer. My role is to conduct psychological evaluations, which determine the students’ individualized education plan (IEP). In class, I was required to take two assessment courses in which I learned to conduct, score, and interpret intelligence tests and several personality tests. At internship, I am required to learn new assessments on my own, and this time, my clients are real people in real environments. When practicing in school, my classmates pretended to be children by making funny comments, looking distracted, and asking lots of random questions. This resulted in some giggling, as it was far from what testing an actual child looks like. The children I work with are often easily distracted, unmotivated, or irritable. This new setting has required me to develop new skills in real time. I have managed to work with children who have run out of the room during testing, started throwing things, or given me test answers that I was unsure of how to score. This requires adaptability, patience, and creativity, which cannot be manipulated in a classroom setting. I am now halfway through my internship, and I cannot believe how far I have come since beginning in August. The learning curve has been stressful, but surviving these nerve-wracking experiences has instilled a new sense of confidence in me.
Professional development
One of the reasons my internship experience has been so positive is the support and mentorship of my two supervisors. Their supervision highlights the development of my professional identity and pushes me to be independent while also prioritizing my well-being. They do well to acknowledge that I also have classes to complete while working for them. I am allowed to write my psychological reports in my own style, I pick the tests I will conduct, and I am treated as an expert in the data of the children I work with. Based on what I have heard from my colleagues at other internships, this is rare. My supervisors’ trust in me has been surprising, but it has also inadvertently built the confidence I now have in myself. This kind of relationship eases the typical grad school imposter syndrome. I now have a better sense of my strengths in time management and professionalism, as I have developed them while working with real clients, therapists, and students’ parents. Although working with kids has been entertaining, this experience has also solidified my goal of working primarily with adults in the future.
The brain and a developing maturity in the profession
In this blog series, we often talk about how the limbic system communicates a value judgment to ideas, plans, actions, formulated in the neocortex, probably in the frontal cortex. After HH graduated, my group even wrote a long blog about the regions of the frontal cortex and how they might process such limbic input. Here, we too want to make the point that a serious internship, like the one HH is on now, offers an excellent opportunity for what we can colloquially call that heart-head integration. Why is that? While HH is the developing clinician here, I (JS) want to make the simple point that being present in the rich context of an internship is key to that integration.
Most of our education uses classes, and that is efficient, but it is remote personally. A student could daydream a bit in a class, and it would matter little. But imagine if HH were sitting across from a patient or client and she started daydreaming. They would notice, and it would just not work. So the limbic system and the cognitive system are both on during the active engagement in such an internship. While the theoretical clinical overview might be better conveyed in a classroom or by reading, the impact of it is really felt in this real-world application. In her Psy.D. program, where she is applying theory to actual practice at the graduate level, the effect is huge. That is why in all medically-related fields, one can never practice without actually first doing the skills in an internship. This kind of internship is more than just reviewing a learning moment; it is essential, and all of us recipients of this medical care simply expect it. JS thinks that professional development comes because in these moments, the “head and heart” are dancing together and learning each other’s moves. Ultimately, this internship has become much more than a training requirement. I began it seeing myself as a psychology student and have now grown into a developing clinician. I had the grades needed to get into a doctoral program, but I now have the confidence of knowing that this field is truly where I am meant to be. The “subjects” of clinical research I have read about over the years have become real people whom I impact directly. As JS said, internship is when my head and heart have begun to move in synch, and through embracing discomfort, I have solidified my interests and built authentic clinical skills.
