Predoctoral Clinical Internship Readiness Questionnaire
What year did you enter the program? ___________
Please list when and how you have completed each of the program requirements:
Semester
Requirement
Completed or
plan to complete
APA Foundation Courses
Biological Aspects of Behavior (PSYC 603 -Biopsychology)
Cognitive bases for Behavior (PSYC 611 - Cognitive Psychology)
Social Aspects of Behavior (Circle which one completed):
PSYC 620 - Experimental Social Psychology or
PSYC 676 Social-Personality Development(only an option for those with
a child clinical focus)
Developmental Factors that affect behavior (Circle which one completed):
PSYC 665 - Behavior Development or
PSYC 676 Social-Personality Development
History of Psychology (PSYC 581)
Research Tools
PSYC 604 (Analysis of Variance and Hypothesis Testing in Psychological
Research)
PSYC 606 (Correlation and Regression Analysis in Psychological
Research)
Additional Tool Course (list):
Additional Tool Course (list):
Required Clinical Courses
PSYC 640 (Theory and Assessment of Intellectual Functioning)
PSYC 641 (Psychopathology)
Second Assessment Course (Circle which one completed):
PSYC 642 (Personality Assessment) or
PSYC 646 (Psychological Assessment of Children)
PSYC 644 (Cognitive-Behavioral Theory and Techniques)
Second Therapy Course (circle which one completed)1:
PSYC 643 (Theories of Psychotherapy) or
PSYC 647 (Psychological Intervention with Children and Their
Families)
PSYC 649 (Ethics and Professional Issues in Psychology)
PSYC 645 (Developmental Psychopathology)
PSYC 671D (Studies in Clinical Psychology: Clinical Research Methods)
PSYC 672E (Studies in Clinical Psychology: Multicultural Diversity,
Students entering in 2013 or later must take Psychology 643. Child clinical students should take PSYC
647 as an elective.
1
Supervision, and Consultation)
Clinical Training
PSYC 654 :Practicum in the PSC (minimum of 4 semesters)
PSYC 654: Clinical externship (minimum of 2 semesters)
List placement(s):
Research Milestones
Thesis proposal (mark NA if thesis accepted from another program)
Thesis defense (mark NA if thesis accepted from another program)
Candidacy Exams passed
Dissertation proposal
Dissertation defense (not required for internship application)
Child Clinical-Developmental Psychopathology Focus questions:
Have you pursued the Child Clinical-Developmental Psychopathology Focus while at NIU?
____ Yes ____ No If yes, please answer the following questions:
Did you take both Behavioral Development (665) and Social-Personality Development (676)?
__Yes __No
Did you take Psychological Assessment of Children (646)? __Yes __No
Did you take Psychological Intervention with Children and Their Families (647)? __Yes __No
Have you had at least one clinical externship focused on children, adolescents, and/or families?
__Yes __No Please list your child externship(s) here:
In the PSC, how many child assessment cases have you had? ____
In the PSC, how many child therapy cases have you had? ____
Was the topic of your thesis related to children, adolescents and/or families? __Yes __No
Please list your topic here:
Is the topic of your dissertation related to children, adolescents and/or families? __Yes __No
Please list your topic here:
Trauma Psychology Focus questions:
Have you pursued the Trauma Psychology Focus while at NIU?
____ Yes ____ No If yes, please answer the following questions:
Did you take the Foundation Course in Traumatology (Lilly seminar)? __Yes __No
Did you take (or are you taking) the Assessment and Treatment of Trauma course (Orcutt
seminar)? __Yes __No
Have you had at least one clinical placement focused on trauma?
__Yes __No Please list your child externship(s) here:
In the PSC, how many trauma therapy cases have you had? ____
Was the topic of your thesis related to trauma? __Yes __No
Please list your topic here:
Is the topic of your dissertation related to trauma? __Yes __No
Please list your topic here:
Questions for everyone:
1. What is your long-term career objective?
2. How will your internship facilitate your career objective? (Discuss specific training
elements, skills, experiences, or opportunities you are looking for that will help you to
reach your objective, including postdoctoral opportunities.)
3. To how many total sites are you planning to apply?
Please evaluate the competitiveness of the sites you are considering: Attach a table that
provides the following information for each site: Number of applicants, Number (and %)
interviewed, Number (and % of those interviewed) accepted. Also indicate Yes/No
regarding whether the site has special prestige in terms of training or institutional
affiliation.
4. Geography:
a. List states or regions to which you plan to apply
(If “All” or “All except below,” simply note this):
b. List states or regions to which you plan NOT to apply. Provide a rationale for all
states or regions you have excluded:
5. At what types of sites/tracks are you planning to apply? Circle all that apply.
Adult-focused
Child-focused
Medical Centers
VAs
University Counseling Centers
Community Mental Health Centers
Consortiums
Schools
Other:
6. Understanding that these are all clinical internships, circle the relative point on this scale
where the majority of your sites fall:
1
Clinically-oriented
2
3
4
5
Research-oriented
7. How strong is your application in the following domains:
a. Assessment (Total # of hours:
1
Weak
2
3
; # of integrated reports:
4
5
Strong
)
b. Intervention (Total # of hours:
i. Individual (# of hours:
ii. Group (# of hours:
iii. Milieu (# of hours:
1
Weak
2
3
)
)
)
)
4
5
Strong
4
5
Strong
c. Supervision
i. Individual hours:
ii. Group supervision hours:
1
Weak
2
3
d. Research
i. Number of publications:
ii. Number of scholarly presentations:
iii. Dissertation status (Mark one with an “X”)
1. Proposed:
2. Data collected:
3. Data Analyzed:
4. Defended:
1
Weak
2
3
4
5
Strong
8. What are your perceived strengths as an internship applicant?
9. What are your potential weaknesses as an internship applicant? How do you plan to
address these weaknesses in your application?
10. Have you identified your letter writers?
Yes
No
If yes, list the names and positions of your letter writers.
1.
2.
3.
Have you already solicited letters from these writers?
Yes
No
Food for thought: How do your letter writers contribute to your application by providing
complementary rather than redundant information about your candidacy for internship?
11. List the sites to which you plan to apply at this point (sometimes people attach an excel
spreadsheet with a listing):
a. Definite:
b. Considering: