What Others Are Saying About The Beginning Counselor’s Survival Guide
This is the one book that every new mental health professional should pick up as soon as they enter graduate school. The Beginning Counselor's Survival Guide is a road map, a friend, and a security blanket all rolled into one. It's a book I wish I had had and one I will pass along to others needing to navigate the path to licensure and beyond.
Tamara Suttle, M.Ed., LPC
This is truly a ground-breaking work for the counseling profession. Stephanie Adams, MA and Carol Doss, PhD leave no stone unturned in this intoxicating book that will leave you inspired and armed to the teeth with resources and information. It should be required reading for every counseling student.
David P. Diana
The Beginning Counselor’s Survival Guide:
The New Counselor’s Plan for Success from Practicum to Licensure
By Stephanie Ann Adams, MA and Carol R. Doss, PhD
Copyright 2011 by Stephanie Ann Adams and Carol R. Doss, all rights reserved.
Published by Beginnings at Smashwords.
Quotes from Please Understand Me II: Temperament Character Intelligence by David Keirsey used by permission from the author.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the United States Copyright Act, without either the prior written permission of the Authors.
This book is available in print at most online retailers.
Cover art and jacket design by Stephanie Ann Adams, with thanks to Amy K. Harris.
This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you're reading this book and did not purchase it, or it was not purchased for your use only, then please return to smashwords.com and purchase your own copy. Thank you for respecting the hard work of these authors.
Also by Dr. Carol Doss
Should I Leave Him? How to decide whether to move forward together – or move on without him. Adams Media, 2010. ISBN 978-1598699692
Acknowledgements
Stephanie would like to thank:
My husband, Tim, for supporting me and believing in my writing dreams. My parents, Andy and Patti Smith, for encouraging me from birth, educating me, and for thinking that everything I do is interesting and brilliant. My brothers, Sam, Shawn and Scott, for creating in me the desire to be someone they can look up to. The Smith family, the Adams family and the rest of my amazing in-laws for prayer and love. Diana Pitaru and all the members of The Counselors and Psychotherapists Network of North Texas, for their support and friendship. All the generous people that selflessly gave their time to help me edit the book: Sue Jamison, Leonard Stevens, K. Hill and Patti Smith. Tamara Suttle and David P. Diana, for reviewing the book and sharing their feedback. Dr. Roger Doss and Debbie Lee, for welcoming me into the Family Counseling Center, befriending me, and teaching me. And of course my writing partner Dr. Carol Doss, for being an amazing clinical supervisor, the voice of wisdom, and a perfect example of work-life balance. I still want to be like you when I grow up!
Carol would like to thank:
All the interns who've shared their growth with me.
From the both of us, thanks to:
David Keirsey and the Prometheus Nemesis Book Company for permission to use quotes and information from the book Please Understand Me II: Temperament, Character, Intelligence and Naomi Quenk and John Wiley & Sons for permission to quote the book Essentials of Myers-Briggs Type Indicator Assessment.
Dedication
We would like to dedicate this book to beginning counselors everywhere. May you find your path and enjoy your journey.
Introduction
Why this book?
Honestly, I can’t believe I get to be the first to write it. In my opinion, the need for this book has been a long time coming.
Individuals enter the counseling field eager, motivated and excited. Unfortunately, by the time they leave their internship (if they are even lucky enough to get there) they are more often than not disillusioned, indebted and discouraged.
Why has that been acceptable for so long? In my mind, it’s not. After all, we are the group of people responsible for the mental health and well being of others. If we’re not healthy, we’re transmitting that unhealthiness to our clients, our co-workers, and our families. Emotional health is catching – as is emotional dysfunction. So why aren’t we doing all we can to increase counselor support?
And why are we instead creating a culture of poverty and failure?
I can’t count how many times I’ve heard:
“Clients will drain you dry.”
“You can’t make any money in this business.”
“You’re going to end up hating people in this job.”
Well, that’s encouraging, isn’t it?
It’s also – excuse me – absolute B.S. It doesn’t have to be this way. I know very many healthy, happy, and well-adjusted counselors.
But the reason that these counselors became that way was hard work, self-care, and determination. Not because that was how they were trained in the beginning. Our schools teach us theories and research but not, as a matter of course, how to be healthy counselors. Why not? There could be any number of reasons. Some professors have been in academia so long they have lost the real-world experience with counseling. Other professors, those that do have knowledge and the desire to share, are not supported by grad school curricula in passing along these valuable insights to students. I do not believe it is a case of any individual professor’s rebellion or lack of feeling. It is simply that a reliable, effective method for supporting new counselors is not built into the system. And as a result, it is not valued.
The reason I love the Beginning Counselor movement (the unofficial name for the collection of wonderful new counselors at beginningcounselor.webs.com) is that I believe we can eventually change this system. Through peer support, accurate, helpful resources, and the power of unity, we can make a difference.
But until that point, new counselors are missing out on what they need to SURVIVE and THRIVE in the amazing, challenging and wonderfully unique world of professional counseling.
That’s why The Beginning Counselor’s Survival Guide came into being. What you will find in this book is not more theories. It’s not a quick-fix solutions manual, either. It’s a practical how-to guide to the day-by-day information you need to grow into the counselor you want to be.
It provides what’s been missing from traditional counselor training. The book is divided into three sections, three critical areas that really matter at this stage in your career as a counselor. I call them “core competencies,” because it is my belief that these areas must be mastered in order for a new counselor to grow into one who is confident in their vocation.
The first core competency is professionalism. Very, very few graduate programs provide any real help with basic professionalism, as I define it. In my estimation, professionalism is the practice of the laws of one’s chosen occupation, as well as the necessary steps that must be taken to master these laws. You know, things like applying for appropriate licensure, setting up an office, working with a supervisor, and more.
The second core area focuses on client relationships. Though most counselors have better-than-average people skills, many begin their careers with no idea how to manage the new challenge of the therapeutic relationship. The counseling relationship has its’ own unique rules. These rules aren’t that hard to master, but new counselors are often not exposed to them early enough in their careers.
The third and most essential core component is counselor self-care. Unfortunately, of all the competencies, it’s also the one LEAST likely to be covered in your graduate program. This section focuses on the steps you must take in order to have a long and successful counseling career: preventing burnout, planning for your future, and developing your own counseling style.
I started this book because I was frustrated with the lack of practical education out there. But I kept writing because I got to know many of the new counselors out there and I was inspired by their amazing compassion and hope. I have seen, too many times, new counselors burn out for simple lack of information. When that happens it is not only the new counselors that lose out, but also all the clients that they could have eventually helped.
I was so fortunate in this process. I had a fabulous supervisor, whom you will get to know as the co-author of this book, Dr. Carol Doss. Her insights and witticisms are sprinkled through this book in the form of “Carol’s Comments”. I’ve heard a lot of horror stories about bad supervisors, and I always wished I could share my supervisor with the poor interns in those stories! Through this book, I finally can. I don’t think I made it through this process of licensure by accident. I firmly believe that if I hadn’t had Carol as my supervisor, I could have easily been one of the disillusioned new counselors left by the wayside.
The Beginning Counselor’s Survival Guide was outlined and the majority of it was written while I was still a counselor intern. Through the combination of this perspective (which is also YOUR perspective) and that of a seasoned counselor supervisor with decades of experience, this book will give you everything you need to get licensed and to love your work.
I hope you’ll enjoy this book, but most of all that you will benefit from it. I will consider the project a resounding success if “just” one person feels more confident in their abilities after reading it. I want to continue to support you personally, so I invite you to come and join the BeginningCounselor website at http://www.beginningcounselor.webs.com. It’s a free social networking website where you can read helpful articles, connect with other new counselors, and share ideas. I strongly encourage you to subscribe to the BeginningCounselor mailing list as well. Mailing list members get exclusive access to the new counselor chat room, and advance knowledge of freebies and special deals from leading counselor educators, coaches and mentors. Mailing list members will also receive the bi-monthly Question & Answer column chock-full of tips, tricks, and answers to your most pressing concerns.
Also available along with this book is The Beginning Counselor’s Survival Guide Workbook. Though either can be used independently, the workbook enhances the book’s content by providing step-by-step work pages and tip sheets that correspond with the chapters of the book. You can find out how to order your instant .pdf download by flipping to the last page of this book.
If you absorb only one piece of information from the following material, let it be this: You, beginning counselor, have something special to offer, something that no one else has. I believe in you. Thanks for letting me be a part of your life. I can’t wait to see what you do next!
Sincerely,
Stephanie Ann Adams
Table of Contents
Core Competency One: Professionalism
Site Search
Sites Unlimited
Supervisor Savvy
Applying for Licensure
Beginning Counselor Marketing
Choices In Counseling
A Day In the Life of a Beginning Counselor
Core Competency Two: Client Relationships
The First Session
Boundaries in the Therapeutic Relationship
Population Primer
Core Competency Three: Counselor Self-Care
Counselor, Heal Thyself!
Refining Your Counseling Style
Preventing Burnout
Your Future as a Professional Counselor
Appendix: Beginning Counselor Resources
Core Competence One: Professionalism
Chapter One
Site Search
This is it! You’ve finally achieved a level of education that will allow you to put aside some of the classroom work and begin the practice of counseling. Many rewarding things are coming your way, not the least of which is the ability to tell your concerned relatives that their perpetual student is now finally working a “real” job.
A lot of things are running through your head right now. Do I have what it takes to be a successful counselor? Will I pass my NCE? Will I find a job after my internship? These kinds of questions are completely normal. But you need to put all but one of those things aside for the moment. (I promise, we will get back to the rest later.) The one thing that has to be top priority upon starting out is finding a place to host your fledgling counseling skills: a site. A site is fundamental to your new career as a beginning counselor.
Why Do I Need A Site?
To answer that question most simply, counseling students must have an internship or practicum site because it is not legal for them operate independently. Practicum students do not have their degree yet, and clinical interns only have what is called a “temporary” or “provisional” license. There will be more on the difference between the practicum and internship later, but for now it is sufficient to say students need a site because they are in the infancy of their career. A site provides a location for them to begin testing their wings.
Other benefits a site often provides are:
A physical location to meet clients.
An office to conduct sessions.
Clients to work with, or at the very least an established venue to refer them to.
A site supervisor.
Administration, such as phone services and filing systems.
In some cases payment for your time and services.
Specialized equipment and meeting places such as group therapy rooms, play therapy rooms, and art or music therapy equipment.
And of course, a real-life model of the counseling profession in action.
The last point encompasses the greatest benefit to be gained from a practicum or internship site. No classroom experience can replicate a day in the counseling field. This will be the first chance to see if you’re ready for the life of a professional counselor. It will help you explore your particular calling within the counseling field and decide if that is the right area for you to focus on. It will change your life.
Learning the Lingo: Practicum vs. Internship
Practicum. Internship. What’s the difference? A lot, as I came to find out the hard way! I had only a vague idea how to describe exactly what I was looking for when I started looking for a site. As a result, many of the counseling organizations I called were very confused about my needs. It ended up delaying my placement and frustrating me to no end! Here’s what you need to know in order to not make the same mistake:
Carol’s Comments
Consider sites that will give you a variety of types of clients to see what you like best. You may enjoy working with a different population or age group than you’ve thought. A variety of client ethnicities or ages can help you realize your strong points.
Your practicum is the course taken usually the last two semesters of your graduate degree. It will be focused more intensely on the actual experience of conducting a counseling session than anything else in the curriculum prior to it. As part of the requirements for completing this course, you will spend a certain number of hours doing counseling. Usually some of these hours (or all) must be video or audio recorded for classroom and supervisor perusal.
As a practicum student, you have no official title. You are there to learn by doing. You must have an on-site supervisor for your work there, but for some aspects of your learning your professor or the counseling program director at school may also be considered your supervisor. It is more likely than not that you won’t be paid for practicum work. Sorry.
When you are on the phone with a potential site or site supervisor, the correct terminology to use when referring to yourself is “practicum student.” The people at the sites you will be calling have likely been through counseling training before, and even if you reach someone with a different background, like the receptionist or a child advocate, that is the way they will best understand your status. This label conveys the message that you don’t have a degree yet and this will be your first time doing face-to-face counseling. It also tells them you will not require as many hours as a counselor intern and that you need a shorter time commitment than an intern would require.
An intern, on the other hand, has completed a master’s or doctoral degree and is temporarily licensed by the state to operate as a counselor under supervision.
There is one big glaring exception I need to note before I proceed: there are some programs in which a student does complete one or more “internships” before graduation in addition to practicum work. This seems to be most common in school counseling and when the student is seeking additional credentials, such as certification as a play therapist. If this is the case for you, please read the rest of this section with the understanding that in my wording a pre-masters internship is functionally equivalent to a practicum. If you’re seeking pre-masters internship placement over the phone, just make sure you are clear that you’re working towards a degree and not (right now) towards licensure.
Both interns and practicum students require liability insurance in order to practice. However, often as a practicum student, your tuition will cover insurance costs. As an intern you’re solely responsible for the premium.
As a state-licensed intern you are allowed to use a title to refer to yourself on business cards or in professional correspondence. This title is different from the one you will receive as a fully licensed counselor. For example, in Alabama, the intern is called an “Associate Licensed Counselor.”
In my state of Texas, the independent licensure title is Licensed Professional Counselor. For those still under supervision, we tack on the word “Intern” to the title. (LPC-Intern) The reason why it is done this way is so important because it is unethical to represent yourself as anything more than what you are. In fact, right before I started my internship, the rules were changed regarding this title. Previously, we were allowed to use “LPCI” as a designation of our status, but it was found that the letter alone at the end wasn’t enough. Clients didn’t know what that meant. So, as long as I was an intern I was required to always represent myself with a combination of the initials and the last word, like this: LPC-Intern.
Practicum
Fewer Hours, Pre-Graduation, No License, No Title, Less Likely To Be Paid
Internship
More Hours, Post-Graduation, Must Have Temporary License, Titled, More Likely To Be Paid
Some other terms you might hear are: Registered Intern, Post-Graduate Intern, Clinical Intern, Counselor Intern or Student Counselor, among others. Other counseling disciplines will use different terms, changing the description to suit the type of study. For example, you might be an MFT-Intern, School Counseling Intern, or Licensed Chemical Dependency Counselor Intern. Then, of course, if you are training for one specific type of job, you might have a certain kind of title there, such as Advocacy Intern Therapist, or Caseworker. Here’s the bottom line: check your state and know your status. Then you can introduce yourself as whatever you are with confidence!
Before You Look
Some practicum students seem to think that the perfect counseling site is just lying around waiting to be picked up, like a quarter at the beach. Unfortunately, you will need a little bit more than a metal detector to find the right site for you.
I’d firmly recommend before you start calling around looking for sites that you research and compile a “master list” of sites to contact. It’s tempting to think, “but what if I do all this work and the first person I call accepts me?” I know. It’s fun in the sparkly happy land where everything works out right the first time. But it’s just not very likely to happen in real life.
In finding an internship or practicum site, you are most definitely in a time crunch. Some sites only look for interns at certain times of the year, and practicum students must have a site before too far into their practicum semester or else they’ll be forced to drop the class. Don’t think this can’t happen to you. A student at my school, who started the program the same time I did, ended up being dropped by his site right before we were supposed to start as a group into our practicum class. He had to wait and delay his graduation another semester because he didn’t have the practicum site secured before the class started. Graduate schools don’t exclude people like my fellow student to be cruel, but they simply cannot work with a student to teach skills as a practicum counselor if the student is not actually seeing clients.
So, with this in mind, it is more advantageous for you to have several interviews and more than one potential offer. Not only that, but it also gives you more opportunities to find the site that’s best for you.
Another good reason to make a list is if you’re like me and get a little nervous when cold-calling people. After you call two or three people in a row, you will develop a rhythm, and it will get much easier to make those difficult calls. Trust me, for those of us who are more shy with job-seeking, it will make it so much easier to “get it over with” in one sitting than to call at random.
Having a master list allows you to come back to it for reference if you need to make a follow-up call to a particular site and forgot the phone number. As you come across further site possibilities, you can scan through the list to see if you’ve already called the site while looking somewhere else. The list can also serve as a first-round elimination for unsuitable prospects. For example, if you know you can’t work nights, and a particular site requires that, don’t even write it down.
The final stop on the train is the telephone call. Unless a particular site stresses that they only accept e-mail communication, DO NOT use it. It is so much easier to get an answer via telephone conversation than email, and it is much more professional. Even though you will still be a student when you start looking for your practicum site, searching for an internship should be treated like a search for a job. Request to speak with the person in charge, and if you are lucky enough to get an interview, show up on time and be professionally dressed. The more seriously you take this process, the more seriously potential sites will consider you.
Carol's Comments
Think of your site search as practice for when you start looking for a professional job.
Remember – whether or not you’re accepted at a site probably has more to do with the site’s needs than anything about you. Even counselor gender may be considered, depending on the site.
How To Look For A Site
Most schools, thankfully, will have a resource list of potential sites that their students have used before and with which the school has a positive relationship. This is the place to start and will make your site search easy – if you are the first to call!
Here’s the thing about school site lists: invariably, some of the information is outdated or incorrect from the previous year. In addition to that, the number of students needing sites is usually larger than the number of sites on the school’s resource list. You do the math.
Outside of a school list the easiest way to start a site search is to go on the Internet and search “counseling” and your zip code. It will come up with several sites to start off your list close to your area. You can also add additional elements to your search: “crisis counseling," “play therapy," “animal-assisted therapy," “addiction center” and your zip code. And don’t forget to check the phone book for listings of counselors and facilities in your local area.
Internship locator websites might also offer sites that are prepared to take on counseling interns, but when I did some practice searches they didn’t have anything in my area and very little to offer for counseling in general. I think the problem is that counseling sites just don’t tend to advertise their internships. Counseling facilities don’t have the staff and resources to advertise for interns, and let’s face it, we need them more than they need us. So try these if you like, but don’t expect a whole lot.
A more concentrated form of a search would be to use a therapist finding tool like PsychologyToday.com’s Find A Therapist search engine. I might be a little biased about it since I’ve been listed on it before, but I think the number of therapists and clients that also benefit from it speaks for itself. It’s well organized, with all the pertinent information up front – phone numbers, addresses – with room for a personal statement by each therapist. This will help you see what kind of person you might be working under. You can also search different kinds of facilities with different specialties, and search therapists by specialties.
Lastly, don’t underestimate the power of networking. If you know someone who recently graduated and is working as a counselor, ask him or her for referrals or tips. If your cousin’s friend is a counselor, see if they will call and recommend the counselor accept you as a staff intern. Talk to your church, your high school, and your doctor’s office, and try to find someone who can put in a good word for you. Some will say no, but you never know! One of these people might just be the “in” you need to get started.
Questions to Ask
You have found a site that wants to meet with you. You are excited and nervous, and not sure what to wear. But remember that even though the site is considering whether or not to accept you, you are doing the same thing with them. There are a lot of options as far as site types, as we will see in the next chapter. Not all of them will be ideally suited to your needs as a practicum student or intern.
In some ways it might seem like you had better accept any site that offers you a position. You do have to get those hours in, one way or another. It may come to the point in which you do only have one option. In order to start the semester on time, you may feel you have to take it. But before you take that step, you will need to make sure the proposed site can meet your basic site requirements. If not, it would be a pointless exercise for both you and the site to continue a working relationship. In order to differentiate effectively between the sites that will work and those that won’t, I suggest that you start with a rough idea of which are the crucial questions (aka deal breakers) and which are the mere “wants.”
One more thing: even though I encourage you to ask as many questions as possible, beware of one thing. Before you ask questions in an interview, make sure you do the research. If you waste time during your interview asking questions that are clearly answered on the counseling site’s website or phone book ad, it will look like you don’t care. And you do care. You care very much!
Carol’s Comments
You don’t have to take whatever site you can find. Make sure it’s a good fit for you and does the kind of therapy that interests you.
How many hours can you offer me as a practicum student/intern?
As an intern in Texas I had to accrue 3000 clock hours, 1500 of which had to be face-to-face counseling sessions. As a practicum student, my school required 300 hours total, again half of which had to be face-to-face. Your site must be able to meet your needs in regards to hours or else you will have to add another site to make up the difference. How many hours do you need?
Do you supply clients for your practicum students/interns, or do you require students to find their own?
It never occurred to me that as a complete novice, I might be expected to bring in my own clients to counsel right off the bat. Regardless, several people in my practicum class ended up at sites that expected them to do this. This factor directly impacts your ability to deliver on the hours required for graduation and/or licensure. You must consider carefully whether you will be realistically prepared to take on the challenge. If you do choose to contract with a site that requires you recruit your own clients, read my section on marketing as soon as possible.
Do you have a supervisor on-site, or would I have to find my own?
Seems obvious, but trust me, you’ll want to ask.
What are my (prospective) supervisor’s credentials?
In order that you get credit for your hours, your supervisor must almost always be specially approved as a counselor supervisor. You can look up any counselor or counselor supervisor on your state licensing board to see if they have any violations on record. And you should do that.
Carol’s Comments
Trust your gut. Not every supervisor is terrific. If you don’t feel comfortable (or sort of comfortable) with this person, keep looking.
How much is the supervision fee?
Check the supervision chapter for details on how supervisor pay structures work. Keep in mind that usually state requirements dictate at least one supervision session per week. That can add up pretty quickly. Still, you have to have supervision, so build it into your budget.
Carol’s Comments
Insurance companies do not reimburse for services performed by unlicensed counselors.
The sites themselves can be squeezed in getting no funding (unless by grant or government program), but are expected to train you without billing for your services. This isn’t fair for anyone, but it’s reality.
Will I be paid or a volunteer?
It is far easier to find a site that will take you on for free plus a supervision fee, than one that will pay you. I think it’s fair to expect that almost no practicum services you provide will be paid. You don’t have a degree to offer, and you don’t have the flexibility you will have if interning is your full-time job. After you graduate though, it’s a different story. I personally don’t understand how people expect counselor interns to accrue the kind of hours they need to apply for licensure without being paid, but some sites still are indignant when you ask for compensation for your work. If you are lucky enough to be supported by a spouse or parent during your time of internship, then you have the luxury of accepting an unpaid position. Otherwise, you’ll probably have to decline sites that aren’t offering payments to their interns. Or take a second job.
Even at the paid sites – I have to be honest here - it’s not going to be a good living for a while. The reason it’s so hard to earn an adequate amount is that interns usually can’t accept insurance, and aren’t credentialed to the degree where they can charge a whole lot per session. That doesn’t make for a good income. However, after you finish, the situation will get better. No one gets into this job to be wealthy, but after your internship you should be able to take care of your needs and at least help support a family. In my opinion, this career is what you make of it.
If you are going to be paid, all the usual questions related to money apply. Will I be paid by the hour or by a salary? How often will I be paid? How would I file my taxes? And so on…
Carol’s Comments
Remember this is part of your education, not an actual paying job. The site is helping you even if they’re not paying you.
What kind of counseling happens here?
Will you be seeing couples, individuals, or adolescents? How long does a typical session last? Will you be expected to do group counseling? Art therapy? Agencies often have specific methods of counseling that they will expect you to comply with. This may be a part of their vision, or simply what they are required to do based on the guidelines of the insurance they accept. Either way, you have to plan on following their rules.
Every site also has some semblance of a theoretical orientation. For example the “Adlerian Center for Family Therapy” will follow Alfred Adler’s ideas about emotional wellness and healing. So you will want to ask your poential site if you will be expected to adhere to a site’s main theory (such as Adlerian therapy) strictly, or if there is room for your individual approach.
By the way, when your interviewer asks you, as they will, what your theoretical orientation is, do not say eclectic. While everyone today is eclectic in reality, saying it makes you look wishy-washy. Counselors supervisors tend to hate it. Just say your primary orientation and pull out a few things you like about other theories, if you must.
Who are my clients?
“Which categories of people make up my major demographic?” Is it kids, adolescents, or the elderly? Are the people you will see women, men, or both? What ethnic groups, income brackets, and religious preferences dominate the population? Knowing what kind of person you will be counseling helps you to be sensitive to their particular needs.
How much counseling will I be able to do in proportion to case management or paperwork?
An agency, or any type of practice that takes insurance, will have paperwork. Social work-type sites and domestic violence shelters especially are known for this. However, usually at least half of your total hours for state licensure have to be with clients in counseling, not case management. Consider the amount of paperwork when choosing whether or not to accept them as a site.
How will I be supervised?
In addition to reporting on difficult cases in supervision sessions, your supervisor will most likely wish to have another way of monitoring your progress. There’s nothing personal in this. Remember that he or she is liable if you get sued, so they need to be aware of what’s going on.
Some of the methods your supervisor may choose to utilize are video and audiotapes, direct observation, observation through a one-way mirror, and counseling together in a group setting. Audiotapes are probably the most common method, and the least intrusive for your client. My school required that videotapes be submitted to view and critique in our practicum class. Sounds daunting, but in the end it was a really effective teaching tool. Remember: Any video or audiotaping must be done with the full written consent and awareness of the client. No hidden cameras should ever be used.
When I was in my practicum, my clients were handed an authorization form at intake explaining that I might be using tapes. Even though I had the signatures on file for each of my clients, I reminded clients on the days I would be taping them and reassured them that they had the right to tell me again if they weren’t comfortable with it. No grade in class is worth making a client feel threatened in counseling. Despite my worries that they would decline, more often than not it wasn’t the issue I thought it would be.
Whether you use video or audio, it is your responsibility, not your site’s, to see that all tapes you have made during session are destroyed at the end of the semester. How would you feel if your secrets were on record somewhere and you entrusted them to another person’s care? Protect your client and get rid of them properly.
I don’t think it is common practice to have your supervisor sit in on sessions with you, simply because he or she is a very busy person already, but it might happen. One of my co-interns at the Family Counseling Center, Brooke, shared a story in a group supervision in which it happened to her. She was working a school counseling job at that time, and was observed directly in play therapy sessions. Her supervisor was also trying to counsel another child in the same room at the time. It was very distracting to the children and to Brooke and ultimately proved to be not a great match for her.
If this is how your site desires to conduct supervision of you, I would carefully consider the possible negative impact this might have on your counseling ability. If a supervisory counselor is in the room with you while you’re counseling, you will be more flustered and the client will not know whether they should speak to you or to the counselor supervisor. If this scenario comes up in your interview, you might ask why your potential supervisor feels this is preferable to another method of supervision.
For the same effect but less distraction, another choice might be observation through a one-way mirror. Many sites use this, and it can be useful outside of the supervision process as well. Our play therapy room at the Center has a one-way mirror, and play therapy was something I really wanted to learn about. I was able to observe many sessions of play therapy conducted by experienced interns and LPCs and hone my expertise in that area. Which brings me to the next question I would ask.
Carol’s Comments
If a client freaks out and seems really uncomfortable with taping (even after you’ve explained that it’s really for your benefit and you’ll be the one being judged) you’re better off not taping.
The more matter-of-fact you are in the taped session, the more likely your client is to forget the tape altogether.
How do you feel about my observing you (or another counseling professional employed at this location) in session to learn more about a particular type of therapy?
As I stated previously, one thing I really wanted to become proficient in during my practicum and internship was play therapy. Dr. Roger Doss, the executive director of the center, received his PhD at UNT with Dr. Garry Landreth, a play therapist who is legendary in the field. I was able to observe sessions guided by Roger and other interns already trained in play therapy through our one-way mirror.
Carol’s Comments
Try new things. Isn’t that what you’re suggesting to your clients?
Stretch your comfort zone a little, whether that be in the age range you see or in the counseling techniques you use.
Is there an opportunity for me to create and lead groups of my own?
This also tests your site’s devotion to developing you as a counselor. I do believe that most people who choose to be licensed as a supervisor primarily do so because they enjoy nurturing and training others. But if you are dealing with a site that doesn’t have a supervisor on staff, they may be less interested in this process. You just never know. Perhaps they would enjoy someone taking the initiative. Why not ask them and see?
What do you focus on developing in your supervisees as far as therapeutic skills?
I believe this coincides with the previous question in that it is about what you will learn as a result of contracting with this site. You will be able to tell from the interviewer’s answer whether their desires correspond with or enhance your own.
What will the hours be?
Can I set my own? Will there be situations in which I need to be “on-call?" Is it nine-to-five? Saturday mornings? Overnight? If you have a family, another job, or like sleeping, you will need to know what your site expects of their interns as far as hours worked. You should expect crisis centers, hospitals, and residential treatment centers to have odd hours and certain times you might need to be on call. Agencies will probably have set office hours with the potential for you to sometimes put in additional hours here and there. In private practice, you might set your own hours completely, or your supervisors might request that you inform them of your available times. In the latter case, they then fill those available times for you in accordance with client availability.
Another question you might add on to that one is: if you are on-call, how much do they expect you to interact with clients over your private phone line? If a potential site demands that you be accessible to clients or staff for an excessive amount of time over the phone, I wouldn’t think it would be unreasonable to question if they will provide you some kind of stipend for the additional charges you might incur on your phone bill.
Are you open to a practicum student continuing to work here as an intern after graduation?
For me, this was a pretty important question. It wasn’t absolutely necessary, but I like staying put when I find someplace I enjoy. And by the point at which I had my practicum interview, I knew the heartache of scrambling for a site. I was very invested in not having to repeat the process in a year’s time. For me, it worked out, and I stayed on after practicum to finish my internship.
Even if you don’t know if you will be able to take it now or not, it’s good to know if there is a possibility.
Is there a specific length of time you usually take interns for?
The purpose behind this is to discover if you have a chance at coming in right away or if you will have to wait till the next “hiring cycle." Some of the practicum sites I contacted over the latter half of the summer said to “call back in December." It also answers the question of whether or not your period of service ends after a certain amount of time has passed. If it ends before you have accomplished the hours you needed, you're in trouble.
What will be discussed during supervision sessions?
Case studies are to be expected. But there is always more to it than that. Will you be able to volunteer information? Will your supervisor ask you specific questions? Will you have forms to turn in? Are you able to ask questions or expected to mostly listen to a lecture-style delivery?
How many interns do you take on at a time?
This question helps you find out exactly how thinly stretched your potential supervisor might be among needy novices. How long might it take to get an audience should you need one? Or, conversely, if you are the only intern the place supports, how much of a burden will that place on you?
Carol’s Comments
States typically have a number of interns one supervisor can have.
How much group time versus individual counseling time?
Most states will only allow so many group counseling hours to be counted towards your total number of face-to-face counseling hours. You will need to know if your potential site could give you enough individual hours to qualify for graduation or licensure.
Carol’s Comments:
Make sure the site can meet your needs as to client hours.
How much group supervision time versus individual supervision time?
It’s the same situation here as it is with counseling hours. There is a limit to group supervision hours; a certain number of them must be one-on-one with your supervisor.
How should I stay in contact with my supervisor?
Will you only see your supervisor once a week at supervision? What about questions that come up after that? And of course, what if you need to consult with your supervisor in a truly dire situation? You need to find out what your supervisor would recommend, and who might be a second person to consult if they are not available for a time.
Though Dr. Carol Doss was my clinical director and supervisor, I have discussed some situations with Dr. Roger Doss when I was unable to reach her on a day I had fairly urgent questions. He was just as qualified to answer the question for me as his wife, and he was available at that time.
For emergencies, I have consulted Carol in-office and called her at home. She was understanding and supportive of doing so, as these instances were truly urgent situations. What would your supervisor recommend in cases like these?
Carol’s Comments
Even if you’re desperate for a site, make sure you’re comfortable with both the supervisor and the clientele served. This is huge. If you’re going to take risks in your internship and learn, you need to feel comfortable with where you are.
Final Question to Consider
Will this internship opportunity adequately prepare you for licensure and the plans you have for your career after your internship?
Chapter Two
Sites Unlimited
Traditional
When a person speaks of a “counseling site," probably the typical idea that comes to mind is the stand-alone counseling center model. The site I used for my practicum and internship falls into that category. It’s a privately run, not-for-profit group office consisting of two PhD counselors and a rotating number of interns. Outside of the offices of my supervisor, Dr. Carol Doss and her partner and husband, Dr. Roger Doss, there are several offices open for interns, a staff kitchen, a receptionist’s desk, a filing office, and a play therapy room. There are two waiting areas and the building has other rooms that can be rented out or used for other purposes. Theirs is probably a pretty typical setup, and it worked great for me. However, as we will soon cover, there are many, many other options available.
Traditional counseling centers are unlikely to provide crisis services or 24-hour availability. This will be preferable for those of you desiring more “regular” working hours and who are unable to provide “on-call” services,
Solo practice counselors may also at times choose to incorporate interns into their office. Should they agree to take on an intern, that intern would share the office space the counselor rents with them, generally 1-2 session rooms and a seating area. This setup has the benefit of being a more private and intimate setting. The downside is that offices of this size often cannot support staff for answering phones and authorizing payments, so that may be something their intern is required to take charge of for themselves. For the more experienced counselor, I would argue that it is necessary to have a good handle on the administrative side of things, but for beginners it can be overwhelming to take on the whole process at once! Other interns might also prefer to keep the therapeutic experience separate from the administrative one. It’s a matter of personal preference.
Carol’s Comments
Beginning counselors may not yet know what specialty they prefer, if any. Doing your internship in a larger group that will give you exposure to multiple services might be worthwhile.
While these individually practicing counselors may have specific therapeutic tools available for interns to use, this type of site is not likely to have the space for play or group therapy. I have noticed in my research that many counselors who work individually tend to emphasize one particular service within or in addition to general counseling services: hypnosis, weight control behavior modification, and the like. It makes sense, as each counselor should find a way to make the treatment they offer distinctive from their competitors. But that may require that an intern focus exclusively or primarily on that service as well, which may be too narrow for their interests at this point in their career.
While every situation is different, most of the single-office counselors I spoke to when looking for my internship site were not prepared to take on the responsibility of an intern. Some even seemed surprised I was asking! One reason for this may be lack of space, but another might be that the law requires interns to be supervised by a licensed or otherwise state-endorsed counselor supervisor. This is a special designation outside of the qualifications required of a licensed professional counselor. For smaller places, pursuing supervisor status often isn’t really in the scope for the vision that counselor has for their business.
In cases like these you may still be allowed to work at one place and have a supervisor that works elsewhere, as long as that supervisor agrees in writing to take on the responsibility for you working at that site. (Check with your state counseling board!) I’ll tell you more about supervisor’s responsibilities later.
Medical
Another place that can work as an internship site but may not provide a counselor supervisor on-staff is a hospital or medical facility. Medical sites occasionally use counselors for bereavement and pain management counseling and it is possible to count those hours towards your licensure goals. Of course, the situations you would end up dealing with would be rather limited, but at the same time you would be developing a specialty that could be used later on to market yourself. At hospitals, bilingualism is a plus and the hours may be more irregular.
A private mental hospital or the mental health ward of a general hospital may also be a potentially fruitful site to work from. Financial compensation for hours spent as an intern counselor is often difficult to find. However, employment as a psychiatric aide, or “psych tech," is paid and does allow accumulation of counseling hours. These types of places are likely to offer group counseling to their patients, and possibly individual counseling as well. An intern in a mental hospital will have to be more vigilant in making sure they have opportunity for hours since no college degree is required for the job, making the psychiatric aide who is looking to become a counselor an anomaly rather than a common occurrence.
Most of the work as a psych tech is taking care of suicidal or seriously mentally ill patients’ physical needs, such as bathing, helping them eat or put on clothes. If you have physical difficulties yourself, this is probably not the job for you because you must be able to restrain patients who are dangerous to themselves or others, as well as support a patient’s weight when taking care of them. There is much opportunity for interaction with the patient, but the nature of the interaction may quite different from that with outpatient clients. However, psych techs are the ones who get the most time and experience with a particular patient. It might be a great opportunity to hone your observation and diagnostic skills by recording and reporting on patient behaviors to treatment staff.
Whether drug and alcohol addiction is your specialty or you are simply looking for options, addiction centers also make reliable and interesting work sites. In addition to group counseling, many recovering addicts are required to attend individual counseling sessions on-site – with counselors like you! Addiction work is more specialized, but at the same time, everyone there has a history that led up to this point. You won’t be “just trying to help them stop using," as some might fear, you will be plumbing their past for factors leading to their drug use and helping them set up methods to keep themselves clean. Additional or alternate licensure/certification in substance abuse counseling is available if you find you like this line of work.
Crisis Care
Domestic violence shelters and help centers are a major employer of counseling students and interns, most likely because the need is so great and fresh counselors have such a yearning to help others. This is also usually in an office setting, although sometimes you might be asked to go to the shelter itself to visit a woman who has just come in. I have heard from my friends in the business that space can be rather crowded in a domestic violence help center, and they may find themselves squeezed in an office the size of a broom closet and negotiating time there with a dozen other interns! But despite that, they feel very useful to be dealing with such an immediate problem. Domestic violence centers tend to emphasize intake forms and be particular with paperwork, and in many cases each client is limited to a certain number of sessions with any counselor, whether student or licensed. While the main population served will be women, sometimes the children and teenagers exposed to violence will need help as well.
Speaking of children, I had a chance in my own site search to look closely at a children’s advocacy center. This particular center offered group therapy, counseling individually for parents, and in many cases forensic interviews on-site. (I should note that any intern counselor is not likely to be allowed to conduct these interviews, used for court cases, but it is a priceless opportunity for observation.)
The purpose of advocacy centers is to pinpoint cases of child abuse and protect the child or children involved to the best of their ability. They work closely with the legal system, which can sometimes be frustrating to a counselor’s purposes, as the law seeks justice, and counselors seek healing. They are not always the same thing. But working alongside legal processes can also feel very rewarding if and when “right is done.” There will be a high volume of children you will be able to help, but along with that a great deal of sad stories and shattered families. It is never easy to see people suffering, but seeing a child suffer is different than seeing an adult suffer because adults have choices that help them get out of their situations. Children often don’t. Be aware of the emotional challenges when seeking an internship in this type of site.
Reproductive health centers, such as Planned Parenthood and crisis pregnancy services, employ counselors to help the women and their partners or families deal with reproductive challenges. This can be a sensitive issue, and you will want to consider your personal stance on the options you’ll be asked to provide at each place. There is nothing wrong with saying you can’t be objective on this issue, but not if you’re going into a position that requires objectivity! I have a hunch that it will probably be easier for female counselors than for male counselors to get positions in these organizations, but you never know. Your time there is likely to be short except in rare occasions. If the client is working through issues outside reproductive choices and challenges, you will probably be asked to refer them out.
If you’re a type that thrives under pressure, a crisis call line or rape crisis center may be the place for you. This kind of job usually requires specialized training in interventions outside of “regular” counseling techniques, which may feel constricting to those who have been enjoying working with a certain theoretical orientation in school. The hours are more unpredictable in this type of work, and it is much easier to get involved with crisis counseling as a volunteer than a paid employee.
As you can imagine, the potential for burnout is high. You will at times come to work in the middle of the night, and routinely see people immediately post-trauma. It can take a toll on your personal life, as you might have to be “on call” at late or odd hours. There might be some issues as well with qualifying the hours spent on the phone at a hotline as “counseling hours.” Most states stipulate that at least a third of the hours required for licensure be face-to-face, and phone counseling might not suffice. Beware of the challenges before you agree to take on the job.
Carol’s Comments
One aspect of effective supervision is that the supervisor needs to help you be aware of your own reactions. Self-care should be addressed.
One of the more out-of-the-ordinary settings among the very diverse group of potential counseling sites is that of the residential treatment facility. As issues like eating disorders, cutting, and adolescent chemical dependency have risen, so have locations geared to meet the needs of those in this type of crisis. These will not be located in every U.S. town and often require live-in staff, as their goal is to provide structure and consistency for troubled youth. Obviously, this can be ideal for the single person, but cause difficulties for those with families. It can be intense and high-stress, and most of the people there will probably not want to be in anyone’s care. Regardless, like crisis work, it provides an immediacy of relationship. This might be ideal for those who despise routine and stagnation. However, if you like waking up knowing what’s going to happen in your life each day, try something else.
There’s a lot to consider with this kind of site. But the fact remains: crisis work is very exciting. It can also be intensely rewarding when you are someone’s lifeline at a time when everything is at stake. It can remind you that you’re alive, and create a feeling of purpose that’s hard to duplicate in “regular” work. An option to manage the potential for high stress might be to make this a part-time pursuit, dedicating only certain days, and not the majority of your week or month, to crisis work.
Spiritual
Churches, synagogues, and other religious facilities can sometimes support counselor interns as well. This is where it is important to be careful that you have the proper supervision, as pastoral counselors and Biblical counselors will not be considered sufficiently credentialed to provide intern supervision. You can resolve that by talking to your supervisor. Simply ask your supervisor if he or she would agree to provide supervision and be responsible for your actions on this additional site. If they agree to support you, get the agreement in writing and then submit it to your state licensing board for approval.
Churches are a great place to get started and can be easy to get into if you have a relationship with the staff or are a member of the congregation. The challenge with church counseling consists primarily of the century-long disagreement between psychology and organized religion. Some Christians believe it is not trusting God to go to a counselor for help with their problems, and if you are going into this setting you must be prepared to defend yourself (kindly, of course) against this type of objection. Another issue of concern would be the ethical issue of dual relationship, meaning outside of just being the person’s counselor, it is likely you will also be their fellow church member or work in the nursery together! You must consider for yourself how you will keep the professional relationship separate from any personal relationship.
Others in the church may also feel entitled to question you about what your client talks about in session. They might feel that the camaraderie of shared faith and friendship gives them the right to know, but the rule of confidentiality still applies. Unless the person you are counseling chooses to share or releases you in writing to disclose information, you cannot break their confidentiality.