Internship Training Model and Philosophy
The underlying philosophy for the training program is a Practitioner-Scholar model that
emphasizes the value of both science and practice with the practical application of scholarly
knowledge to practice. For the Practitioner-Scholar, “Psychological science is viewed as a
human practice and psychological practice is construed as a human science, and the two inform
each other (Rodolfa, E. et al.).” This model integrates theory, research, and clinical practice to
help interns develop as strong generalist practitioners. Furthermore, we believe that sensitivity
to individual differences and cultures in a diverse society and openness to self-reflection and
life-long learning are necessary to bring these all together.
As part of this model, we believe the development of reflective skills and a reflective practice are
essential, for trainers and trainees alike. Together we will focus on building supervisory and
training relationships that self-examine and continually reflect on, discuss, and explore ways to
grow and meet the needs of the trainee more effectively. Similarly, we will assist interns to selfexamine, reflect on, discuss, and explore the therapeutic alliance and ways to meet the needs
of their clients more effectively. We are training psychologists who gain clinical experience to
inform his or her practice, rather than conducting laboratory science. We are training
psychologists who will think critically and engage in disciplined inquiry that focuses on the
idiographic needs of an individual client, but in the context of society and cultural
considerations.
We will emphasis internship learning as a relational and reciprocal process, with an emphasis
on the process versus the content of learning and valuing the use of self and creativity. While
this may be viewed as incorporating elements of a Practitioner, Apprenticeship, or Mentor model
of training, and we do highly value the training characteristics of these models, the mutually
informative emphasis on both clinical practice and on science is what we strive toward for our
primary training model.
Interns will be trained in an empirically-based and self-reflective clinical practice to gather
information from clients, reflect upon and evaluate the process and outcome of their
interventions, and plan future interventions based upon an integration of this experience. To
accomplish this goal, psychological theory and research will be incorporated with supervised
clinical experiences and self-reflective learning. Supplementary learning methods will include
didactic presentations, skill-building seminars, small group discussions, behavioral rehearsal
and modeling, and consultative guidance.
This training approach to clinical work is trans-theoretical, multi-cultural, and processoriented. Growth comes by attention to the process of interns’ work, as well as attention to their
personhood. We are helping interns to find their own path as a clinician and as a
professional. So, our overall training focus for Interns will be exploring and discovering answers
to the two questions, “Who am I as a therapist?” and, “How am I therapeutic?” In this manner
they shall explore both the self-awareness/self-reflection part of a therapeutic alliance and the
ways they express these parts of themselves in skills and techniques. Interns will explore these
questions as they apply to the overall goals of the internship. Answering these questions, on a
continual basis is vital to the process of becoming a therapist and a psychologist. These
questions will be explored in trainings, workshops, and the supervisory process.
Rodolfa, E. R.; Kaslow, N. J.; Stewart, A. E.; Keilin, W. G.; and Baker, J. (2005). Internship
Training: Do Models Really Matter? Professional Psychology: Research and Practice, Vol
36(1), Feb, 2005. Models of Internship Training. pp. 25-31.
A “Use of Self” Approach
Balancing the tension between our two training questions, 1) “Who am I as a therapist?” and 2)
“How am I therapeutic?” is a primary thread running through all of our training activities. By
focusing our training on the concept of “Use of Self” we are able to integrate interventions with
the personhood of the therapist. By this we mean that in assisting the trainee in exploring and
understanding the qualities and dynamics that he or she brings to each interpersonal encounter
and how these facilitate or hinder effective interactions the intern will grow as a therapist. The
intern will be encouraged to become more attuned to his or her thoughts and feelings in working
with clients, and recognize how this increased self-awareness can be used to better understand
client dynamics and develop effective treatment strategies. We believe in the working alliance
as an indispensable ingredient in any helping relationship, and therefore we encourage trainees
to recognize, improve and employ those personal qualities that will assist in forming effective
working relationships with clients, peer, center staff, and other members of the university
community.
Because our training program emphasizes self-reflection and the “use of self” we believe that
optimal professional development occurs within the context of personal exploration. Our training
activities ask interns to appropriately disclose personal information such as reactions to
experiences they are having with a client, within supervision, or in another training activity. Our
training staff take very seriously their responsibility to foster and maintain a safe, trusting, and
supportive environment that will allow such disclosures to occur in accordance with the goals
and objectives of our training model. Interns have full discretion over the personal information
that they disclose within the training process.
We believe that training is the most useful when it occurs within a supportive environment in
which questions and differences can be explored openly, and where diverse viewpoints are
respected and valued. Our staff strive to create an environment in which both supportive and
challenging feedback can be provided with the goal of furthering professional growth. In
addition, we ask trainees to provide us feedback about their experiences while involved in the
training process.
A Relational-Cultural Approach
Training and supervision do not occur unilaterally or in a vacuum, but in the context of layered
relationships (with power differentials) that are also full of cultural diversity and complexity. This
can enrich the experience and create a growth producing dyad. In this dyad, all parties are
balancing the same human needs for both connection and safety, but with an intentional focus
on the process and repairing ruptures they can move in and out of connection with each other in
a relational dance that produces personal and professional change for the trainee – as well as
for the trainer.
We credit a prior Training Coordinator at the Baylor University Counseling Center, Dr. Roderick
Hetzel, for initially focusing our training program on “how the rich and complex inner worlds of
supervisee and supervisor, which lie just beneath the veneer of skills-based training and clinical
formulations, invariably shape the ebb and flow of the supervisory relationship.” According to
Hetzel & Kroll, in their article titled, Relational Psychotherapy Supervision: A Shared
Supervision Story (2006), “Relational-Cultural Theory (RCT) offers a useful conceptual model
for understand the relational dimension of psychotherapy and supervision (p.22).” They
conclude their article with, “Whether acknowledged or not, supervisor and supervisee engage in
a relational dance as they attend to the professional work of supervision as well as the more
personal (yet rarely mentioned) business of working out their own needs for connection and
disconnection. When established as a central focus of supervision, however the supervisory
relationship can form the very crucible in which supervisees learn how to become
therapeutic. This relational learning can empower both supervisee and supervisor (p.27).”
This conceptualization remains highly valued by the current Training Director and by our training
program, and we will focus intentionally on the relational aspects of the training process
throughout the internship year.
The Supervisory Relationship
The supervisory relationship is fundamental for the growth and change process of a developing
therapist. A personal connection is developed that creates a safe place for exploration and
trying new ways of being therapeutic for clients. As humans, clients, developing therapists, and
supervisors are all very similar in our basic needs for connection, safety, belonging, and
challenge. It is incumbent upon the supervisor to create this type of a safe mentorship
atmosphere. Evaluation is always present, but is not so much focused on the personhood of
the trainee as it is focused on the development of awareness and values, increasing knowledge,
and application of these through behavioral interventions and skills.
The most effective supervisory relationship is one in which an approach that acknowledges the
power differentials in the relationship is taken. From this perspective supervisors work to share
that power. This approach views the supervisor-trainee as a dyad, which is exploring, learning,
growing together as part of this process. Rather than critiquing a trainee out of a position of
authority and power, a supervisor will invite the trainee to examine the supervisory dyad
together, and explore ways to enhance the safety of the relationship, and find ways to leave
each person’s comfort zone and try new things that will help the trainee grow and flourish. This
will help the supervisor grow and flourish too. Supervision should never be a stale, intellectual,
handing down of information from an expert to a novice, but rather an energized, engaged
relationship, where all members learn and grow, bringing all aspects of their diversity and
individual uniqueness together, to create a supervisory relationship and culture that is
empowering for everyone.
A Transtheoretical & Common Factors Approach
We offer a generalist internship informed by a Common Factors approach to therapy. Described
by editors Duncan, Miller, Wampold, and Hubble in The Heart and Soul of Change the Common
Factors framework takes into account decades of empirical psychotherapy research as well as
the most recent research on what works in therapeutic practice. The conclusion is that therapy
outcomes are influenced in degrees by four variables
40%: client and extra therapeutic factors (such as ego strength, social support, etc.)
30%: therapeutic relationship (such as empathy, warmth, encouragement of risk-taking)
15%: expectancy and placebo effects
15%: techniques unique to specific therapies
This framework shows that the bulk of client improvement is attributable to factors common to
all different types of counseling and psychotherapy.
The common factors approach will be reviewed and discussed in several didactic trainings.
Interns will gain an understanding of the empirical bases of therapy through this framework, and
how their previous course and training experience apply to the therapeutic process considering
the four factors outlined in the approach.
As outlined by the Common Factors approach, the largest factor of therapeutic outcome that is
directly influenced by the clinician is the therapeutic relationship (30%). With this understanding
we seek to intensively train interns on the interpersonal process in therapy, so that they can
develop their own answers to the two questions. Interns will be provided with concentrated
didactic and experiential training targeting skills related to interpersonal processes evident in
therapeutic relationships. This will involve 1) understanding the process dimension, 2) the role
of anxiety, 3) the corrective emotional experience, 4) client response specificity, 5) a
collaborative relationship, 6) empathic understanding, 7) immediacy interventions, 8) honoring
client resistance, 9) an internal focus for change, 10) placing the locus of control with the client,
11) working with affect, 12) providing a holding environment, 13) addressing and repairing
ruptures, and last, but not least, 14) an intensive focus and understanding of accurate and
thorough conceptualizations that include the process dimension.
Interns will also be trained in interventions from various theoretical orientations and schools of
thought. They will be provided with micro-skills training on intermediate-advanced interventions
that will compliment a generalist therapy skill set. Specific populations, presenting diagnoses,
professional issues, procedural competencies, and organizational functions will be addressed
through the training program. Short term and time-limited models of therapy will be highlighted
in training. Interns will also receive supervision regarding long term therapy modalities and will
have the opportunity to work with a limited number of long term patients. The content of these
trainings create the remaining 30% of therapy outcomes influenced by the clinician composed of
expectancy and placebo effects (15%) and techniques unique to specific therapies (15%).
The early training schedule is designed to provide interns with a strong foundation in
understanding the therapy process from a generalist perspective while giving them a range of
skills to utilize as they work interpersonally with clients.
Over the course of the training year, both the training content and the expectations from interns
will be increasing, in a developmentally targeted manner that builds on prior experiences and
trainings, and is focused on more complex competencies for mastery.