Clinical Training Manual 2014-2015

8/9/2019 Clinical Training Manual 2014-2015

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Clinical TrainingManual

Clinical PsychologyDepartment:

Clinical CaseSeminar/Practicum

Supervised Field Experience2014 2015

Compiled and written by:Helen Marlo, Ph.D.

Adam Rodríguez, Psy.D.Clinical Psychology and Art Therapy

Faculty, Students, and Staff

NOTRE DAME DE NAMUR UNIVERSITYClinical Psychology Department

1500 Ralston AvenueBelmont, CA 94002-1908



Table of Contents

SECTION 1 – Clinical Training: Information and Policies

Introduction ............ ............... .............. ............... ............. ............... .............. ............... ............. 1Clinical Psychology Degree Programs ............ ................ ............... ............... ............... ............ 2Terminology ............. ............... ............. ............... .............. ............... .............. .............. ............ 2FAQ: Clinical Practicum /Seminar and Supervised Field Experience.................. ................ .... 3Clinical Psychology Seminar/Practicum Overview .............. .............. ............... ............. .......... 10

NDNU Clinical Psychology Practicum/Seminar Course Descriptions ....... ............... .............. . 12Clinical Practicum/Case Seminar and Supervised Field Experience General Guidelines ....... 15Personal Therapy ............. .............. ............... .............. .............. ............... .............. ............... ..... 17

SECTION 2 – Information and Forms for Practicum and Supervised Field Experience 18

Checklist for Practicum/Field Experience Forms ............. ................ ............... ............... ....... 20Checklist for MSCP/MFT/LPCC Students ............... ............... ............... ................ ............... 21MSCP Practicum Placement Verification Form ........... ................ ............... ............... ........... 22Practicum/Supervised Field Experience Agreement Form ............ ............... .............. ........... 23Practicum Placement and Agency Information Sheet .............. .............. ............... ............. .... 26Practicum Information Sheet .............. .............. ............... .............. ............... .............. ............ 27Supervised Field Experience Information Sheet ............ ............... ............... .............. ............. 28Practicum/Field Experience Information Sheet: Student Form ............. .............. ............... .... 29Marriage and Family Therapist Experience Verification ............. ............... .............. .............. 30Liability Insurance .............. .............. ............... .............. .............. .............. .............. ............... . 32Marriage and Family Therapist Weekly Summary of Hours of Experience .............. ............ 34Agency Evaluation: Practicum Students ................ .............. .............. .............. ............... ........ 35Student Final Evaluation of Practicum Field Work and Supervision ................ ............... ...... 40Suspected Child Abuse Report .............. .............. ............... .............. ............... ............... ......... 42

SECTION 3 – BBS Information MFT/LPCC Licensure 43

Critical Reminders for Interns and Trainees ............................................................................ 44Post-Graduation Intern Registration ............... .............. ............... ............... .............. ............... 53Responsibility Statement for Supervisors of a PCC Intern ............... .............. .............. ........... 55Weekly Summary of Experienced Hours for PCC Interns ............. ................ ............... .......... 57LPCC Experience Verification ............... .................. .............. ............... ............. ............... ....... 58

SECTION 4 – Preparing for Practicum 59Preface ............. .............. .............. ............... .............. ............... ............. ............... .............. ......... 60Make Practicum Count................................................................................................................ 61How to Write a Cover Letter ……..............................................................................................

Sample Cover Letters…………………………………………………………………………..

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64How to Write a CV ……............... .............. .............. ............... .............. ............... ............... ....... 69CV Dos and Don’ts.............. .............. ............... .............. ............... .............. .............. ............... ... 70Sample CVs ............ ............... .............. ............... ............. ............... .............. ............... ............... . 72Sample Thank You Letters............ .............. ............... .............. ............... ............... .............. ........ 76Interviewing.................................................................................................................................. 79Supervision…………………………………………………………………………………… 84



Section One:

Clinical TrainingInformation andPolicies:

Clinical CasePracticum/Seminar

Supervised FieldExperience



Introduction Welcome to the Clinical Psychology Department (CPD) and Master’s ofScience in Clinical Psychology Program at NDNU. Whether you are in theMSCP; MFT; or MFT/LPCC program, we are devoted to providing youcomprehensive clinical training that educates you in the art and science ofclinical practice. The “ 5 C’s of the CPD ” include Community, Culture,Character, Clinical Training, and Core Values . Clinical training is, therefore,central to our Mission and we are devoted to providing an outstanding clinicaltraining experience. We are eager to help you discover your own identity,voice, and presence as a mental health professional. We strive to support youthroughout all of the phases of your clinical development.

Congratulations if you are beginning Clinical Case Seminar and Clinical CasePracticum! You have reached a milestone in your professional development.

The following manual has been compiled to support you in the emotionallyand intellectually challenging process of Clinical Case Seminar; Clinical CasePracticum; and Supervised Field Experience. This manual reflects the changes

instituted to the practicum/seminar experience with the new, 2014 academic program--as of 2014, all students (MSCP; MFT; MFT/LPCC) are nowrequired to take two semesters of practicum/case seminar. Please check withyour practicum/seminar professor or the DCT if you are not enrolled in thenew program and have additional questions. Most students find that being inthe field and doing real clinical work, particularly when their exposure to the

profession has been through academic or classroom experiences, is a profoundly moving, life changing, and transformative experience. We wish to provide you with as much information as possible to support you on this path.

The Director of Clinical Training, Dr. Adam Rodríguez, oversees the clinicaltraining experiences, including Clinical Case Practicum/Seminar, andSupervised Field Experience. Dr. Helen Marlo is also part of the “ClinicalTraining Team,” and will be supporting Dr. Rodríguez in his efforts to providea rich training experience for you at NDNU.



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Clinical Psychology Degree Programs at NDNU

1. Master of Science in Clinical Psychology (MSCP)

2. Master of Science in Clinical Psychology/Marriage and Family Therapy (MSCP/MFT)

3. Master of Science in Clinical Psychology/Marriage and Family Therapy/Licensed ProfessionalClinical Counseling (MSCP/MFT/LPCC)

Clinical Training Team:

Director of Clinical Training: Adam Rodríguez, Psy.D.

Clinical Case Practicum/Seminar Professors: Helen Marlo, Ph.D.

Adam Rodríguez, Psy.D.

Jennifer Coloma, Ph.D.

Supervised Field Experience Professor: Adam Rodríguez, Psy.D.

Terminology

APA…………… American Psychological Association

BBS …………….Board of Behavioral Sciences

BOP ……………Board of PsychologyCPD ……………Clinical Psychology Department

DCT…………….Director of Clinical Training

CTT…………….Clinical Training Team

LPCC …………..Licensed Professional Clinical Counselor

MFT …………....Marriage and Family Therapist

MSCP ………….Master of Science in Clinical Psychology

PCC ……………Practicing Clinical Counselor

SFE …………….Supervised Field Experience



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FAQ: Clinical Practicum/Seminar and

Supervised Field ExperienceWhat is Practicum?

Practicum is a 3-unit course taken for two semesters for a total of 6 units. It provides youclinical training and the opportunity to work directly in the field with people. You will

provide a range of psychological services at an approved community site while youreceive supervision from a licensed mental health clinician. Practicum does not meet inthe classroom. All hours are done “in the field.”

What is Case Seminar?

Case seminar is a 3-unit course taken in conjunction with Clinical Practicum for a total of6 units and meets as a weekly course. NDNU professors, who are licensed psychologists,currently teach this course and oversee your supervised clinical work at your practicumsite. Students discuss their practicum experiences; gain knowledge; share their challengesand struggles in the field; and review clinical cases within a small group setting.

What is Supervised Field Experience (SFE) and how does it differ from Practicum/Seminar?

SFE is another practicum course that provides oversight of your field-work outside of theClinical Case Practicum course, while you are matriculated as an NDNU student, asrequired by law. In order to count your hours towards MFT licensure, as permitted byBBS, you must be enrolled in SFE or the Clinical Case Practicum course. SFE allows youto count, towards MFT licensure, any eligible hours that you may accrue outside of theClinical Case Practicum course (before or after Clinical Case Practicum), for example,through volunteer work, or other clinical services, if they are eligible, even if they are not

part of the Clinical Case Practicum course.

To enroll in SFE, you must have completed 12 units of graduate courses, includingPsychopathology and Professional Ethics and Law; and completed all required paperwork,which has been approved by Dr. Marlo or Dr. Rodríguez. Trainees are allowed to count

1,300 hours of their 3,000 fieldwork hours towards MFT licensure after they havecompleted 12 graduate units including hours accrued from an approved SFE site.

What does the Director of Clinical Training and the Clinical Training Team do?

The Director of Clinical Training (DCT), Dr. Adam Rodríguez, develops and oversees theclinical learning and clinical training experiences at NDNU in collaboration with Dr.Helen Marlo, Chair, together comprising the Clinical Training Team. Along with the



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Clinical Training Team, Dr. Rodríguez guides students in securing appropriate sites,completing all necessary paperwork, and in reviewing all practicum/supervised fieldexperience placements. He oversees the Practicum Fair, reviews existing sites, anddevelops connections with additional training sites to support and continually expand theClinical Training experiences for NDNU students. In addition, the Clinical TrainingTeam and Dr. Rodríguez inform students about opportunities for increasing their clinicaleducation and experience including through panel discussions, and speakers.

I am in the previous MSCP Program and only need one semester of practicum and seminar—what are my options?

One option is finding a site that will provide training from Sept. through Dec. However,finding a site that will agree to this arrangement can be challenging. If you cannot find asite that will agree to this arrangement, you may agree to serve at the agency from Sept.through May 15. However, you only have to register for Practicum and attend Seminarfor the Fall semester only. You may continue to serve at the agency as a trainee byenrolling in Supervised Field Experience. You do not have to attend Seminar class duringthe Spring semester. Many students do this and find it is worthwhile for them in building

professional connections and in developing their skills and knowledge.

Under the new, 2014 curriculum, students complete two semesters of practicum andseminar.

How do I pick a Practicum site?

Reflect carefully on your interests. Try to remain open to learning, discovering, andexperiencing. Sometimes we can be very surprised by the people and clinical experienceswe enjoy.

Meeting your future supervisor can be helpful. It is important to feel you can work withthis person and appreciate their style so consider the fit between the site, the supervisorand you. However, part of this process is developing emotionally, learning flexibility, andcultivating emotional tolerance so be careful with quick judgments. There are no perfectsites including the site you thought was perfect for you!



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How do I find a site?

Each year the Clinical Training Team produces and distributes a Practicum Directory viaemail to all students. This is an excellent first resource. This list is not, however,exhaustive. Also, go to the Practicum Fair, which is mandatory if you wish to enroll inPracticum/Seminar. Check with your friends. If you find a site that interests you, youmay pursue establishing a site with them. Discuss this site first with the Director ofClinical Training (DCT) to verify it is acceptable to pursue a connection. If so, you may

begin to establish a connection with the site and develop a placement for your self. Youwill need to meet with a site representative so they can review our contract and paperworkand confirm if collaborating with NDNU is possible.

What is the Practicum Fair?

The Practicum Fair is typically held in January and representatives from numerouscommunity agencies come to NDNU to represent their site and inform students aboutopportunities for trainees. This is a mandatory event for all students who wish tobegin Practicum/Seminar in the Fall although all students are invited andencouraged to attend . You have the opportunity to make an initial connection withagency representatives. At this event, you may locate your future practicum site and,sometimes, future employer, so it is an important event, not to be missed.

What are the next steps after the Practicum Fair?

Get your resume/vita updated in January/February. Emphasize work, including volunteerwork, that pertains to the field, where possible. If you do not have experiences that relateto the field, know you are not alone! Emphasize qualities from your previous academicand/or professional/work experiences that accent desirable traits in trainees. Some ofthese qualities include reliability, dependability, responsibility, your work ethic, a desireto learn, interpersonal skills, and empathy, among others. Sample application materials,including vitas and resumes can be found in this manual in Section four. The NDNUCareer Center also has a good resume/vita format for clinical psychology students who arelooking for Traineeships.

How do I apply?

Send your resume or Curriculum Vitae (CV) to agencies of interest. Professionalism inyour cover letter, resume/vita, and email/voicemail follow up is important. Follow throughon the application procedure, if delineated, by agencies during the Practicum Fair or intheir posting for trainees. It is acceptable to contact the agency by phone, letter, or emailand inquire if they are taking trainees. Follow up with a phone call, email and set upinterviews or visits. Many agencies are using email but not all. Follow through with the



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agency’s preferred mode of communication.

Can I visit a site just to learn about it?

Yes. Inform the site you are curious about serving as a trainee at their agency and wouldappreciate a brief meeting to learn more. Supervisors frequently are busy so requesting a brief amount of time—15-30 minutes, can be effective, convey your interest, and establishan initial connection.

What is the interview like?

Interview styles range from being with a group or one on one. Frequently, interviewersgive you a vignette. Expressing your thought process, self-awareness, awareness ofothers, reflectiveness, and empathy is often more critical than having the “right” answer.

Stating that you do not know but naming some of the issues you would be concernedabout and informing the interviewer that you would consult in this situation is often adesirable response!

When will I learn if I have been chosen?

Most agencies make initial offers in April for placements that begin in the Fall. If youreceive more than one offer, you may ask the site(s) if you could have some time todecide.

How many hours per week is Practicum?

Students are considered “Trainees” by the BBS and usually work between 15-20 hours aweek in the field in their “traineeship.” After graduating, a trainee is considered an“intern.”

How do I get hours?

Work directly and collaboratively with your supervisor letting him/her know your needs.At most sites, students typically start slowly and gradually and build up their hours toinclude more direct patient contact. This is all part of the process. Because you aredealing with human lives, most sites will increase your responsibilities and caseloadslowly. By the spring, your schedule is usually full. You need to obtain 250 hours persemester.

How much supervision do I need?

One hour of individual or two hours of group supervision for every five patient contacthours.



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What qualifications does my supervisor need to have?

The supervisor must be licensed as a Marriage and Family Therapist, a Licensed ClinicalSocial Worker, a Licensed Clinical Psychologist, or a Board Certified Psychiatrist. MFTand LCSWs must be licensed for two years and have supervisory classes in order tosupervise. The psychiatrist must be Board Certified. Verify their license when you begin.

What if I don’t get a site?

Stay in contact with the DCT and keep him informed of your situation. Reach out toadditional sites and make connections. Openings sometimes do emerge in the late springor summer. However, if you do not have a site in place by the beginning of Seminar, youwill not be able to enroll.

I don’t like my site. Can I break my contract?

The CPD encourages you to try to work out any conflicts and find an arrangement thatworks for both of you. We take the site contract seriously and expect students and sites touphold their commitment to one another unless there is a breach of contract with either thesite or the student. Navigating this conflict can be part of the learning process. Please letyour instructor know about any potential problems or concerns immediately so you canreceive support and direction.

How do I count my hours for Practicum at NDNU versus for licensure with the BBS?

Hours that count for academic credit at NDNU and hours that count towards BBS for

licensure often overlap but there are some significant differences. Hours that counttowards the MFT must adhere to the BBS requirements. Hours that count towards the NDNU course which may or may not count towards MFT licensure are subject to theProfessor’s discretion. There is information about how to count hours towards MFTlicensure on the BBS website. Distinctions between hours that count towards MFT hoursand hours that count towards the 250 required hours for the NDNU course will be clarified

by your instructor in Seminar class.

When should I take practicum/seminar? What issues should I consider to be successfulin the course?

Practicum/Case Seminar is taken when the majority of your core courses are completed.The timing for you depends on your personal demands and schedule. Practicum

is emotionally demanding and takes a lot of time (15-20 hours in the field/per week) inaddition to the weekly Case Seminar class (3 hours), so we encourage students to makeacademic choices in consideration of the demands of your other graduate courses,

personal life, job, etc. Please note, however, that this experience is a core learningexperience and please be prepared to make changes to your personal or work schedule, as



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required, so that you may fulfill your practicum hour requirements and attend yourrespective case seminar class.

What paperwork must I complete?Please review this Section and Section two. Please see page 19 for a checklist of required

paperwork.

Do I need to provide medical clearance, proof of immunization, and fingerprinting to NDNU in order to participate in Practicum/Seminar or Supervised Field Experience?

No. This is not a University requirement so the MSCP does not require this for participation in our clinical training program including for Practicum/Seminar orSupervised Field Experience. However, individual practicum sites may require this foryour participation at their site. Please check with your site supervisor. NDNU is notresponsible for any cost you may incur due to site requirements.

What must I do at the end of Practicum so I may receive my Intern Number from the BBS?

Students who are applying to the BBS for an MFT intern number should follow theseinstructions. This process cannot be completed until all degree requirements have beenmet.

1). Contact the BBS and obtain your required forms: All the LMFT and LPCCapplication packets, as well as several other important documents, publications and forms,are accessible online, on the BBS website http://www.bbs.ca.gov/ under the"FORMS/PUBS" tab. ( http://www.bbs.ca.gov/forms.shtml )

1. LMFT materials are found under "IMF / MFT Related"2. LPCC materials are found unter "PCCI / LPCC Related"

You are strongly encouraged to visit the BBS website, and become familiar with itscontents. The BBS website will be a necessary and valuable resource for your entirefuture career as a licensed mental health professional.

Board of Behavioral Sciences 1625 North Market Blvd., Suite S-200,Sacramento, CA 95834 Phone: (916) 574-7830; Fax: (916) 574-8625www.bbs.ca.gov

2). Order an OFFICIAL NDNU transcript (make certain your degree is posted!) from the



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Registrar’s office. You may pick up a Transcript Request Form from the Registrar’sOffice, or you may go online to: www.ndnu.edu (Quick Links / Registrar).

3). Prior to completing Practicum, see the Clinical Psychology DepartmentAdministrative Assistant, in the Ralston Annex, 650-508-3557, to get a ProgramCertification Form. The Administrative Assistant has Forms A & B. The AdministrativeAssistant will need your full name, social security number, and the term of yourenrollment to the program (i.e. Fall 2010). Please provide a current mailing address whereyour form may be sent. Once your degree has posted, your completed form will be mailedto the mailing address provided. This envelope will include: a copy for your records andthe original in a sealed and officially stamped envelope.

4). All other BBS requirements need to be done by you (i.e. application, photograph,fingerprints, etc.). Submit all of your application materials in one envelope. Keep copiesof everything!



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Clinical Psychology Seminar/Practicum Overview

The Masters of Science in Clinical Psychology, MSCP/Marriage and Family Therapy,MFT/Licensed Professional Clinical Counseling, LPCC Programs emphasize experiential andheoretical learning in clinical, educational, and community settings.

Each student in the CPD participates in a supervised clinical practicum and clinical case seminar.MSCP students who remain in any academic program, up to and including the 2013 catalog, areequired to participate in the fall semester of practicum/seminar for a total of 250 hours. MFT/LPCCtudents are required to participate in two semesters for a total of 500 hours. Beginning Fall 2014,wo semesters of practicum/seminar, for a total of 500 hours, are required for MSCP students or for

any MSCP student who elects to transfer to the new, 2014, program,

Practicum hours are determined in collaboration with the practicum instructor and in accordance withhe BBS requirements.

Before Enrollment in Practicum/Seminar :

Clinical Case Seminar and Clinical Case Practicum is taken towards the end ofyour graduate program.

A majority of your core coursework must be completed. Professional Ethics andLaw and Psychopathology are required prior to enrolling in Practicum orSupervised Field Experience.

It is your responsibility to update your paperwork if information changes, i.e. new professor, new site supervisor, new site, etc.

Submit the semester evaluation form to your clinical site supervisor well inadvance of the end of the semester. Submit a copy of the completed evaluationform to the CPD Department in your personal files and your instructor the lastweek of the semester. A copy should also be included in your portfolio.

Practicum Students: TraineesA practicum student trainee is enrolled in both the Practicum and Seminar classes and isaccumulating 500 work experience hours, which are usually unpaid. All students are supervised

by state licensed professionals in agreement with their site. Practicum students are calledtrainees by the Board of Behavioral Sciences. Supervised Practicum trainee hours will onlycount toward MFT licensure; all PCC hours must be obtained once one becomes a RegisteredPCC intern with the BBS.

Interns:An intern is a graduate accumulating supervised work experience hours as an MFT/LPCC.MFT/LPCC interns accumulate 3000 total hours.



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For MFT: 1300 hours may be collected before the degree is awarded. The 1300 pre-graduate hours

consist of a maximum of 750 direct-client and supervision hours, 300 hours of psychotherapy, and up to 500 hours of workshops, case advocacy, paperwork, seminars,or conferences.

1700 hours must then be collected post-degree for MFT hours. Within 90 days after graduation, all MFT interns must apply to the BBS to become

Registered Interns and accumulate hours.

For LPCC: 3,000 hours must be collected post-degree to count toward licensure gathered over a

period no less than 104 weeks. At least 1,750 hours of direct counseling, and at least 150 hours in a hospital/community

mental health setting. No more than a combined total of 1,250 hours in direct supervision and client-centered

advocacy. No more that 250 hours of testing/clinical reporting, and no more than 250hours from workshops/trainings.

Within 90 days after graduation, all LPCC students must apply to the BBS to becomeRegistered Intern to accumulate hours.

Hours accumulated as an MFT intern can count towards LPCC hours as long as one is aregistered as an MFT and PCC intern.

Current MFT practicum trainee hours require 1-hour of individual supervision or 2 hours ofgroup supervision for every 5 hours of client contact, and 1-hour of individual supervision or 2

hours of group supervision for every 10 hours of client contact, post-graduate intern hours.

Current PCC internship hours require 1-hour of individual supervision or 2 hours of groupsupervision for every 10 hours of client contact.

After graduating, you must obtain a BBS MFT number to become an MFT Intern. Similarly,you must register as an intern through the BBS to obtain a PCC registration number.

** LPCC students cannot accumulate hours before graduation. Similarly, practicum hours willnot count toward the 3,000 hours necessary to apply for an LPCC licensure.



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NDNU Clinical PsychologyPracticum/Seminar Course Descriptions

2014-2015 Catalog Description

Clinical Practicum I CPY4420 (3)This two-semester sequence of supervised practicum in the field provides an average of 20 hours weekly (250hours per semester) of supervised training and face-to-face counseling experience with children, adolescents,adults, couples, and families in community agencies, schools, detention centers, and hospitals throughout theBay Area. A practicum packet must be completed and signed by all parties to ensure that the site, student, andfaculty are in agreement of the BBS and departmental requirements. This clinical field placement meets therequirements of the Board of Behavioral Sciences for ongoing experience in the use of applied

psychotherapeutic techniques, assessment, diagnosis, crisis intervention, and the treatment of individuals inneed. Integrated strength-based recovery model, evidence-based and best practices, case management, workingwith co-occurring disorders, and collaborative treatment will be emphasized. Understanding of the impact ofsocioeconomic position and culture will also be emphasized. BBS 4980.40 (b,1,2, B, f, g), 4980.42 4980.43

Clinical Practicum II CPY4422 (3)This two-semester sequence of supervised practicum in the field provides an average of 20 hours weekly (250hours per semester) of supervised training and face-to-face counseling experience with children, adolescents,adults, couples, and families in community agencies, schools, detention centers, and hospitals throughout theBay Area. A practicum packet must be completed and signed by all parties to ensure that the site, student, andfaculty are in agreement of the BBS and departmental requirements. This clinical field placement meets therequirements of the Board of Behavioral Sciences for ongoing experience in the use of applied

psychotherapeutic techniques, assessment, diagnosis, crisis intervention, and the treatment of individuals inneed. Integrated strength-based recovery model, evidence-based and best practices, case management, workingwith co-occurring disorders, and collaborative treatment will be emphasized. Understanding of the impact ofsocioeconomic position and culture will also be emphasized. BBS 4980.40 (b,1,2, B, f, g), 4980.42 4980.43

Case Seminar I CPY4430 (3)This two-semester sequence accompanies CPY4420 and provides an intensive small-group seminar settingwithin which students may discuss their field placement experiences and their cases. Students focus on the

personal issues involved in transference and counter-transference in their cases; develop a better sense of therelationship between the development of personal qualities, their sense of self, values, professional behavior,and ethics; learn to integrate theory with evidence-based practice; benefit from feedback from their colleaguesand instructor; learn how to construct and present case analyses; develop professional writing skills; becomeacquainted with community resources and methods of collaborative treatment; develop psychotherapy,intervention, assessment, and case management skills, including methods for specialized issues; and explore thisopportunity for profound professional growth. It will address many questions that beginning therapists face,including: how to conduct a first hour, make an initial assessment, set up a therapeutic frame, establish atherapeutic alliance, develop a treatment plan, listen to the patient's communications, use one's self in thetreatment process, be alert to danger signals, work with cultural issues, handle crises, decide on which type ofintervention to use, develop a working hypothesis/formulation of the patient's difficulties, termination, andmore. This class augments and supports what students are learning academically and experientially,concurrently, in CPY4420. BBS 4980.42, 4980.43, 4980.40, 4980.37 (a,1-7,b), 4980.81 (a-5)



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Case Seminar II CPY4432 (3)This two-semester sequence accompanies CPY4422 and provides an intensive small-group seminar settingwithin which students may discuss their field placement experiences and their cases. Students focus on the

personal issues involved in transference and counter-transference in their cases; develop a better sense of therelationship between the development of personal qualities, their sense of self, values, professional behavior,and ethics; learn to integrate theory with evidence-based practice; benefit from feedback from their colleaguesand instructor; learn how to construct and present case analyses; develop professional writing skills; becomeacquainted with community resources and methods of collaborative treatment; develop psychotherapy,intervention, assessment, and case management skills, including methods for specialized issues; and explore thisopportunity for profound professional growth. It will address many questions that beginning therapists face,including: how to conduct a first hour, make an initial assessment, set up a therapeutic frame, establish atherapeutic alliance, develop a treatment plan, listen to the patient's communications, use one's self in thetreatment process, be alert to danger signals, work with cultural issues, handle crises, decide on which type ofintervention to use, develop a working hypothesis/formulation of the patient's difficulties, termination, andmore. This class augments and supports what students are learning academically and experientially,concurrently, in CPY4420. BBS 4980.42, 4980.43, 4980.40, 4980.37 (a,1-7,b), 4980.81 (a-5)

Goals, Objectives, and Learning Outcomes:

1. Development of relatedness, clinical skills and confidence in clinical practice.2. Development of professional identity and professionalism in clinical practice.3. Increased understanding of treatment models with an emphasis on how an in-depth understanding of

theoretical concepts can inform clinical work.4. Increased appreciation and awareness of working with clinical process5. Increased ability to utilize clinical interventions in an attuned and related way, coming from greater

appreciation and awareness of clinical process.6. Increased appreciation of various treatment modalities, theoretical orientations, cultural factors, and

ethical issues in clinical work.7. Development of fluency in oral and written case presentations to help increase readiness for the

licensing exams and as preparation for work in professional settings with multi-disciplinary teams and

collegial consults.8. Learn how to work collaboratively with the client’s family members, caretakers, case managers, health

care providers, and peer counselors including participating in the patient’s short and long term goals.9. Become educated in contemporary clinical issues including evidence based practices: illness/case

management and recovery, community treatments, family psychoeducation10. Increased appreciation of various treatment modalities, theoretical orientations, cultural factors, and

ethical issues in clinical work.11. Learn how to work with clients from various social and economic position including refugees, veterans,

and clients with co-occurring disorders.

Responsibilities of Practicum Site Training Supervisor:

A. Coordinate the internship placement and serve as the liaison between the agency and the UniversityB. Evaluate practicum progress at the end of the term, forwarding this information to the CPDC. Allow NDNU supervisory visitations of clinical site and to review student records and other items

pertaining to the clinical education program by the University.D. To maintain adequate personnel and clinical facilities which meet the appropriate standards of national

certification and state licensure.E. To provide at least one hour of supervision for every five hours of direct client contact with a state licensed

clinician.

Responsibilities of the Student:



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A. Under the supervision of the NDNU professor and the practicum supervisor, develop a plan of work andtraining during the practicum.

B. Comply with University and agency policies of practicum placement. C. Maintain communication with University and agency supervisors.D. Turn in all required paperwork in a timely manner to the Ralston Annex.E. To attend and participate in the weekly, NDNU seminar course and with site placement supervisors. F. To abide by all ethical codes and conduct oneself professionally.

Responsibilities of the University Practicum/Seminar Instructor:

A. Coordinate the internship placement and serve as the liaison between the agency and the UniversityB. To mediate between the University and the agency.C. To meet weekly with practicum students, for the purpose of developing clinical skills.D. To provide assistance and instruction in diagnosis, intervention, and treatment in practicum.



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Clinical Practicum/Case Seminar andSupervised Field Experience

General Guidelines

Site Verification Form: The Practicum/Fieldwork Placement Verification Form will need to be signed PRIOR to registering for Practicum/Case Seminar or Supervised Field Experience to ensure your site meets therequirements. This is due April 25 of the Spring semester preceding Fall Practicum enrollment (i.e. Spring ‘11for Fall ‘11 Practicum course).

Documentation: Students are responsible for submitting all original initial paperwork to the DCT by April 25of the Spring semester prior to beginning Practicum/Fieldwork. Copies of your initial packet will then be madeand kept in the Department, with the original (with all signatures) given back to you, the student, for your files.

Required Forms:The following are the forms included in the Clinical Practicum/Field Supervised Experience packet that must beturned in to the DCT by April 25. Please see page 18 for specific requirements.

a. Practicum/Fieldwork Placement Verification form b. Field Experience Information Sheetc. BBS—Responsibility Statement for Supervisors of a MFT Traineed. Practicum/ Field Experience Agreement Forme. Proof of purchase of Professional Liability Insurancef. Semester Agency Evaluation Form –due end of semester to both your professor and in the files

in Ralston Annexg. Hourly log forms (only turned into your file to the Administrative Coordinator, at the end of

each month),h. Marriage and Family Therapist Experience Verification -due end of semester

Please note that it is important to turn in your hourly logs each month for your protection. The Dept.keeps copies of this material if you turn it in. Professors do not keep copies of your licensing materials. Ifyou do not turn this in, you may not have a record of your work when you need it for the future.

Collection of hours : Students who are enrolled in Case Seminar/Practicum in the Fall semester may startcollecting their hours as early as August 16. Hours obtained between the Fall term ending and Spring term

beginning can be counted on the Spring Hourly Logs. All hours obtained for Spring term may be counted onSpring logs up to the May 15 th date. Note that inclusive of students graduating in the Spring semester, takingPracticum/ Case Seminar, all hours must be completed by May 15 th. The University and the Department willnot be liable for students who wish to remain at their site beyond the May 15 th deadline; this is inclusive ofcounting supervised hours; as any hours not under the umbrella of CPY 6992 Field Supervision will not counttowards BBS hours. Please note: you are responsible for putting a copy of your hours in your

Practicum/Fieldwork files, located in Ralston Annex Room 6, each month.

CPY 6992 hours cannot be used to fill the 250 hours for Fall & Spring semester Practicum requirement.



16

Professional Liability Insurance : This is required for all MFT/LPCC and MSCP students completingPracticum or Supervised Field Experience. For proof of insurance, contact CPH & Associates at 1(800) 875-1911 and see the attached application form. Proof of insurance is required before beginning practicum.

All practicum/trainee placements must be approved IN ADVANCE (By April 25 preceding Fall termenrollment in Practicum/Clinical Case Seminar) or by April 25 th prior to each Field Supervision term. Thisapproval is required in order to assure appropriate placements in approved work settings offering maximumtraining and supervision.

Students must submit original signed copies of all documentation; it is your responsibility to work directly withthe DCT to ensure we have all required documentation in place. Please note that students are responsible forsubmitting copies of their hours and field supervisor evaluations to the department at the end of each month;students keep original copies and are responsible for such not the department.

Approved work settings include governmental agencies or entities, non-profit or charitable corporations,licensed health facilities, and/ or schools, colleges, or universities. MSCP/MFT/LPCC students can developopportunities at sites provided the site can meet our academic requirements.

Practicum or Field Experience supervisors must hold a current, valid California license as a Marriage and

Family Therapist, Clinical Social Worker, Psychologist, or Physician certified in Psychiatry by the AmericanBoard of Psychiatry and Neurology and have been so licensed for at least 2 years prior to commencing thesupervision. The supervisor's license must not be under suspension or probation by the licensing board. Thesupervisor must be employed by the agency, and participate in the activities of the agency.

BBS supervision requirements are:1 hr. of individual or 2 hrs. of group (maximum of 8 supervisees) per week, per 5 client hrs.

For MFT and MFT/LPCC practicum placements, a minimum of 250 hours is required for each of the 2semesters needed for graduation. MFT and MFT/LPCC students must sequence both Practicum and CaseSeminar, beginning with the Fall semester and complete all requirements in the Spring semester. The 250hours of clinical work per semester includes hours of face to face psychotherapy (individual, couple, and

group), supervision, and training. A minimum of 150-200 hours per semester must be clinical contact hours per BBS requirements. Requirements for MSCP students in the 2014, 37-unit program are the same.

Additional clinical hours can be accrued by enrolling in CPY 6992. Students may not substitute hours fromField Supervision to fulfill required Practicum hours in the spring or summer.

Students may NOT take more than TWO semesters of Practicum/Case Seminar (6 units). The practicummay be extended by enrolling in CPY 6992 Supervised Field Experience. Note that you must complete allPracticum supervision hours by the May 15 deadline of your Spring graduation date. Students whose siterequires supervised training beyond May 15 and who are not May graduates must enroll in CPY 6992.

Practicum placements must include individual, family, or group therapy and may include milieu or inpatientwork. Trainee must be seeing clients consistently in on-going therapy sessions.

Students are responsible for understanding trainee specifications and following the BBS regulations andNDNU course sequencing requirements, and are responsible for finding the appropriate placement. Aform indicating placement verification must be signed & submitted to the department PRIOR toregistration for practicum (i.e. in Spring semester for Fall semester enrollment).



17

PERSONAL THERAPY

Personal psychotherapy is highly recommended during practicum/case seminar.

Personal psychotherapy (100 hours maximum, to be counted threefold by BBS, thus 300 hours) can counttowards your maximum of 1300 hours while in the Clinical Psychology Master's program here at NDNU, andthe BBS state-mandated 3000 hours of clinical experience.

The mission of NDNU Counseling Services Department, directed by Karin Sponholz, Ph.D., is:"… to promote and enhance the psychological health, well being, personal growth and success of students."

"Counseling Services at NDNU continues to strive to provide quality and timely service to all NDNU students.Counseling is available to NDNU students, at no cost, on a first-come, first-served basis. If a particulartherapist is requested, and he or she has no openings at that time, they will either suggest another counselor whois available, or put that person's name on a waiting list until there is an available appointment time.Additionally, for graduate students (Clinical Psychology, Art Therapy/Psychology) when there has been a largernumber of people on our wait list, we have provided psychotherapy groups, as an alternative, co-led by alicensed staff therapist."

BBS does NOT require that your hours be signed off by the licensed therapist you see. You fill out your hoursand submit the name and license number of the therapist. There is a form available at the www.bbs.ca.gov sitethat you may download. So, all you will need is the name and license number of the licensed therapist you see(here or outside NDNU) in order for the hours to count towards BBS-required hours.

Counseling Services will do their best to accommodate any potential requests on your behalf to see a licensedtherapist, they work on an emergency, first come, first served basis. As such, they have notified us that, in theevent that you would like to (or prefer to) see a licensed therapist in their center, and one is not available, youcan be placed on a waiting list and await further contact from them.



18

Section Two:

Information and formsfor practicum andSupervised FieldExperience



19

ALWAYSKEEP YOURORIGINAL

MAKE COPIESOF EVERYTHING

TURN IN COPIESOF YOUR FORMS

TO THE DEPT



20

Checklist for Practicum/Field Experience Forms

Name:_________________________________ Semester/Year:_____________________Class (please circle): Clinical Practicum/Case Seminar Supervised Field Experience (SFE)

For Practicum/Seminar andSupervised Field Experience:

Master of Science in Clinical PsychologyDepartment Practicum and SupervisedField Experience Placement VerificationForm

Practicum/ Supervised Field ExperienceAgreement Form

Practicum and Supervised FieldExperience Placement and AgencyInformation Sheet

Practicum and Supervised FieldExperience InformationSheet

Practicum/Field Experience InformationSheet: Student Form

Proof of Purchase of Insurance

Due by April 25

Due by Aug. 1

For Practicum/Seminar Only:

Responsibility Statement for Supervisorsof a Marriage and Family TherapistTrainee or InternMarriage and Family Therapist

Experience Verification

Program Certification Form*May needed for SFE if counting hours

Due by April 25

For Supervised Field Experience Only: Supervised Field Experience InformationSheet

Due by April 25



21

Checklist for MSCP/MFT/PCC Students

The forms identified in this Checklist will be needed when trainees graduate and register as interns with the BBS. Students are responsible for completing and keeping these forms.

All BBS forms can be printed from the BBS website at http://www.bbs.ca.gov

BEFORE BEGINNING PRACTICUM: DUE BY APRIL 25Responsibility Statement for Supervisors of a Marriage and Family TherapistTrainee or Intern

Practicum/Supervised Field Experience Agreement Form

MSCP Department Practicum Placement Verification Form

Practicum Placement and Agency Information Sheet

Practicum Information Sheet

Proof of Insurance (DUE BY AUGUST 1)

Returned to DCT for signing.One copy given to Supervisor.One copy kept in student’s Department file.One copy must be kept in your own file.

DURING THE COURSE OF PRACTICUM

Weekly Summary of Hours of Experience

Agency Evaluation (Each Semester; 2 weeks before finals)

Must be signed by supervisor.Must be kept in your own file.

Record Workshops, Seminars, Training Sessions, Conferences*Keep Proof of Attendance

END OF PRACTICUM PLACEMENT

Marriage and Family Therapist Experience Verification

Must be signed by each supervisor who has signed hours.Must be kept in your file.

PRIOR TO GRADUATIONBegin Process of Registering with the BBS to get your BBS Intern Number

Complete Program Certification Form/Packet

This packet can be printed from the BBS website at http://www.bbs.ca.gov



22

Master of Science in Clinical Psychology Department

Practicum Placement Verification FormDate: _________________

STUDENT NAME__________________________is a trainee at Notre Dame de Namur

University’s Master of Science in Clinical Psychology Department.

This is to certify that the student’s field placement site:

_____________________________________________________________ meets the Master

of Science in Clinical Psychology MSCP; MFT; or MFT/LPCC program requirements & Board

of Behavioral Sciences requirements of:

250 semester hours of clinical contact, supervision and training.

A current, validly licensed and insured supervisor with MFT, LCSW, MSW, Psych

license or Psychiatrist will be supervising the student and signing his/her log of hours,

as designated by the Board of Behavioral Sciences and in the Master of Science in

Clinical Psychology Clinical Case Practicum/Seminar and Supervised Field Experience

Manual.

Please evaluate the trainee at the end of the semester. Please review it with the student

before returning it to the University. If you have any questions concerning the trainee,

the University, or the Clinical Psychology Department, please call (650) 508-3557.

Site Supervisor: _____________________________Print Name_____________________

Site Supervisor Printed Name: ________________________________________________

Trainee Signature_________________________________________________________



23

Notre Dame de Namur University MSCP Programs:Master of Science in Clinical Psychology (MSCP)

Marriage and Family Therapy (MFT)Marriage & Family Therapy & Licensed Professional Clinical Counseling

(MFT/LPCC)

Practicum/Supervised Field Experience Agreement FormThis document represents an agreement concerning fieldwork between and among the following:

1. The NDNU Graduate Clinical Psychology Department (represented by a case seminar/practicum or supervised

field experience instructor):________________________________________

2. MSCP; MFT; and MFT/LPCC Trainee or student:_____________________________________________

3. Fieldwork Site:____________________________________________________

4. Licensed Site Supervisor:____________________________________________

This agreement covers the responsibilities of all four parties. Language used in this document is based on California Business andProfessions Code relating to MFT (Marriage & Family Therapist) and all parties agree to maintain compliance with that law. Thesignature of the faculty advisor from the Clinical Psychology Department will constitute department approval of the fieldwork site forspecific trainee. A copy of this document will be kept in the student’s file in the department and the student will keep the original.

The NDNU Clinical Psychology Department:Shall approve the supervised fieldwork setting for each trainee; shall have a written agreement with the supervised fieldwork settingthat details each party’s responsibility, including the methods by which supervision will be provided; shall provide forms for regularreports and evaluation of the student’s performance at each supervised fieldwork setting; shall coordinate the terms of this agreementwith each of the named parties; and shall evaluate the appropriateness and scope of the license of an MFT as set forth in Section4980.02 of the Business and Professional Code.

The Trainee:

Practicum Placements will be limited to master’s candidates who have completed no less than 12 semester units in the NDNUqualifying Clinical Psychology Degree Program, as defined by section 4980.03 © of the Business and Professional Code.

The Marriage and Family Therapist Trainee (student) will participate as required by the training program at the fieldwork site, andwill provide appropriate marriage, family and child psychological services to clients . As required by law, the trainee will maintaina log of all hours of experience and will obtain a “Supervisor’s Responsibility Statement” signed by the licensed supervisor atthe commencement of supervision. The trainee should retain the original copies of her/his weekly hour’s logs after they aresigned by her/his supervisor. A copy of those weekly hours’ logs should be submitted to the MSCP/MFT/LPCC AdministrativeCoordinator at the end of the first week of each month. Students are responsible for keeping originals and submitting copiesof all required documentation for fieldwork, including signed weekly logs of hours by supervisors.

The student will follow the University calendar with respect to holidays, except by prior arrangement between the supervisor and the practicum supervisor.

The Supervised Fieldwork Site:Shall provide the trainee and the supervisor with the documents necessary to verify to the Board of Behavioral Sciences that the

placement is one that is named in law, that the trainee is employed in the manner required by law, and the description of the duties performed by the trainee meet law requirements, shall appropriately evaluate the qualifications and credentials of any employee who provides supervision to MFT/LPCC trainees; shall provide clinically appropriate services to clients; shall orient the trainee andsupervisor to the policies, and practices of the agency; shall notify the qualifying degree program; in a timely manner, of anydifficulties in the work performance of the student; shall provide the trainee with a minimum of 15-20 hours per week of supervisedfieldwork experience within the scope of practice of a Marriage and Family Therapist/Licensed Professional Clinical Counselor,totaling 250 hours in a given semester for students enrolled in Case Seminar/Practicum.

The fieldwork site will provide the trainee with a supervisor who has been licensed in California for at least two years. It will provideadequate resources to both in order that the trainee may provide clinically appropriate marriage and family therapy services to its



24

clients. The fieldwork site will provide the trainee at least 150 hours of client contact during an academic year or at least 250 hours persemester if the trainee is registered in Case Seminar/Practicum, and an average of at least one hour of individual, or two hours ofgroup supervision, for every five hours of client contact.

The signature of the representative of the fieldwork site verifies that the type of setting is: (Circle one)

1. School, College or University

2. Non-profit Charitable Organization (has IRS 501 C tax exempt status)

3. Licensed Health facility (as defined in section 12250, 1250.2 and 1250.3 of Health and Safety Code)

4. Government Agency

Check one:

_____The Trainee will receive a stipend of no more than $500.00 per month.

_____The Trainee will be paid a salary.

_____The Trainee will accumulate hours of experience at this fieldwork site as a volunteer and will not receive pay.

The Supervisor , _________________________________ shall sign and abide by the “Responsibility Statement for Supervisors ofthe MFT License” as described in Section 1833.1 of the California Code of Regulations (CCR): shall describe in writing the methods

by which supervision will be provided; shall provide regular progress reports and final semester evaluations of the student’s performance at the site to the qualifying degree program; and shall abide by the ethical standards for supervisors per the AmericanAssociation of Marriage and Family Therapy, Board of Behavioral Sciences, the California Association of Marriage and FamilyTherapists, and the American Psychological Association.

The licensed site supervisor will provide ethical supervision of the trainee’s services. The licensed site supervisor will provide to thetrainee a copy of written procedures to be used in supervision by completing the following.

The trainee will be involved in the following:

Direct Services Supervision

_______ Individual, couple and/or family therapy _______ Individual (one hour/week minimum)

_______ Group therapy _______ Group (8 or less people, 2 hrs/wk min) _______ Intake interview

_______ Assessment and testing Training

_______ Other - (Indicate) ______________ _______ Training seminars ______________________ _______ Case conferences

Indirect Services _______ Didactic training

______ Administrative paperwork _______ Staff meeting s

Supervision of the counseling or psychotherapy provided to the trainee will be provided by the following(Check all that apply):

_______ Student Verbal Report

_______ Direct Observation

_______ Process Notes

_______ Written Case Report

_______ Other - (Indicate methods) ____________________________________



25

This agreement will remain in effect from:

_____/_____/_____ to _____/_____/_____

Any student who wishes to collect hours beyond May 15 th deadline and who has committed to a site beyond May 15 th, must sign up

for CPY 6992 in SSI and SSII.

Additional Issues:

a. Termination The expectation of all parties is that the trainee will complete the term of this agreement.Termination of this agreement with cause shall be in accordance with the academic policies of the qualifying degree program or theemployment or volunteer policies of the supervised fieldwork setting . Any party may terminate this agreement without cause bygiving all other parties 30 days notice of the intention to terminate. Termination of this agreement on the part of the trainee orsupervisor is separate from termination of his or her employment at the supervised fieldwork setting . Termination of the traineeor supervisor’s employment or this agreement must take into account the clinical necessity of an appropriate termination or transferof psychotherapeutic clients. In any case, it is assumed that if there is an early termination of this agreement on the part of thetrainee, the supervised fieldwork setting or the supervisor that such a decision must include consultation with the qualifyingdegree program .

b. Changes in the Agreement This agreement may be amended at any time but any amendment must be in writing and signed by each party. This agreementcontains the entire understanding of the parties regarding their rights and duties. Any alleged oral representation or modificationconcerning this agreement shall be of no force or effect unless contained in a subsequent written modification signed by all parties.

c. Indemnification The supervised fieldwork setting assumes all risk and liability for, and indemnities, protects, holds harmless and hereby releasesthe qualifying degree program and each and every one of its officers, against, faculty and employees of, from and against allliability, losses, injuries, damages, claims, suits, fees, including attorney’s fees, costs or judgments which may arise from thestudent’s performance of services while at the supervised fieldwork setting . The assumption of risk, liability and indemnificationunder this paragraph shall survive the termination of this contract.

____________________________________________Trainee Date

____________________________________________Licensed Site Supervisor Date

Field Site Representative Date(May be same as Licensed Site Supervisor)

Adam J. Rodríguez, Psy.D.NDNU Director of Clinical Training Date



26

Practicum Placement and Agency Information Sheet

Name of Agency/Unit/Program___________________________________________________________

Street Address ____________________________________________________________

City, State, Zip Code ____________________________________________________________

Phone (include area code) (___) ____-______ Contact Person ______________________________

SUPERVISORS: THEORETICALHIGHEST ORIENTATION

NAME DEGREE LICENSE(S) SPECIALIZATION _____________________ __________________ ______________ ______________________

_____________________ __________________ ______________ ______________________

_____________________ __________________ ______________ ______________________

Description of Agency (be specific regarding population served, treatment modality, and training intern receives)

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Responsibilities and function of student trainee/interns:

individual therapy

family therapy

couple therapy

group therapy

individual supervision

group supervision

staff meetings

additional trainings

case consultation

crisis intervention

intake/admissions

assessments

report writing

treatment planning

case management/referrals

coordination of services

patient education

other: ______________________

other: ______________________

other: ______________________

Specific supervisory methods utilized:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Number of training hours per week required: _________________

Supervisor: Individual hours/week: _________________ Group hours/week: ________________

Specific times interns need to be present: (i.e. staff meetings, case conferences, etc.) ________________

_____________________________________________________________________________________



27

Practicum Information Sheet

Student Name: ______________________ Phone: ( )______________ Wk( )_______________

Address: ___________________________City: _____________________ Zip: ______________

Program: ______________________________________________________________________

Placed as a trainee at:

Name of Agency: __________________________________ Phone _______________________

Address: ______________________________ City: _____________________ Zip: __________

Mailing address: ________________________ City: _____________________ Zip: __________

Supervisor I:

Name: _______________________ Phone: (Cell) ___________ (School Contact) ___________

Address: _________________________ City/State: ___________________ Zip: ____________

Lic #: MFT _______________________________ LCSW ____________________________

Clinical Psychologist __________________ Bd. Certified Psychiatrist ____________

AAMFT Approved? ____ Date license issued: __________ State Issuing: _____ Expiration date: _________

Appropriate verification has been provided _____________

Supervisor II:

Name: _______________________ Phone: (Cell) _____________ (School Contact) __________

Address: ________________________________ City/State: ________________Zip: _________

Lic #: MFT _______________________________ LCSW ______________________________

Clinical Psychologist __________________ Bd. Certified Psychiatrist ____________

AAMFT Approved? ____ Date license issued: ___________ State Issuing: _____ Expiration date: ________

Appropriate verification has been provided_____________



28

Supervised Field Experience Information Sheet

Student Name: _______________________________ Program:_______________Year: _______________

Term:

Fall Spring Summer I Summer II

Student: Field Placement: Name: Agency:

Address: Address:

City: City:

State/Zip: State/Zip:

Phone: Cell: Phone(s):

Email:

Supervisor: Supervisor: Name: Name:

Phone: Phone:

Email: Email:

Clinical License Number: Clinical License Number:

Agreement in effect from:

_____/_____/_____ to _____/_____/_____



29

Practicum/Field Experience Information Sheet: Student Form

Date: ___________________ Semester: __________________ Year: __________

Student Information:

NAME: __________________________________

ADDRESS (Please include complete mailing address):

____________________________________________________________________________

_____________________________________________________________________________

PHONE: ___________________________________________

EMAIL: ___________________________________________

Placement Information:

AGENCY NAME: ___________________________________

WEBSITE: _________________________________________

ADDRESS (Please include complete mailing address):

______________________________________________________________________________ ______________________________________________________________________________

PHONE: ___________________________________________

TYPES OF CLIENTS/PATIENTS: ______________________________

Supervisor Information:

SUPERVISOR: ____________________________________

EMAIL: __________________________________________

LICENSE TYPE: MFT ____ LCSW ____ Licensed Psychologist ____Board Certified Psychiatrist ____ Other___________________

PHONE (if different): _______________________________

If you have a second placement, use a second form and attach it to this one.



30



31





33

2. To be eligible for the Newly Licensed Discount , you must have been licensed or state-certified for the first time within the last 24 months.

NOTE: You do not qualify for this discount if you hold a similar license in another state.

1st year discount (within 12 months) – 50% off premium. To calculate, multiply premium from chart by .50 and subtract the result from subtotal.

2nd year discount (within 24 months) – 25% off premium. To calculate, multiply premium from chart by .25 and subtract the result from subtotal.

Annual Premium ChartChoose Limits Of Liability

& Employment Status,Then Calculate Premium Total

Option 1$1 Million Occurrence$3 Million Aggregate

upplemental


upplemental


upplementalCategory A: Employed and/or up to 10 hours

weekly self-employed $115 $117 $135

Category B: Employed and/or 11-20 hoursweekly self-employed $180 $184 $211

Category C: Employed and/or over 20 hoursweekly self-employed

$320 $326 $374Category E: MFT Intern under supervision

$90 $97 $111

Optional Coverage:If you have Additional Insureds, provide

name(s) and address(es) on a separate sheet of paper or on the back of theapplication. When adding a Landlord,also include the address of the premises

being leased.Category ofAdditional

Insured

AdditionalPercentage of

OriginalPremium owed

Landlord 0%

All Others 10% (for each)

Annual Premium (from above):

Subtract Discounts (if any—see details on page 1) :

Add Optional Coverage (if any – see chart at left)::

Add Administration Fee: +$10.00

TOTAL:

Section V: Please Read and Sign Below

The applicant declares the information contained in the application is true and that no material facts have been suppressed or misstated. The applicant understands that incorrect informationcould void the insurance coverage. The signing of this application does not bind the undersigned to purchase this insurance, nor does the review of the application bind the insurance companyto issue a policy. It is agreed that this application shall be the basis of the contract should a policy be issued. Any person who knowingly and with intent to defraud any insurance company orother person files an application for insurance containing any false information, or conceals, for the purpose of misleading, information concerning any fact material hereto, commits afraudulent insurance act.

Signature: Today’s Date (mm/dd/yyyy):

Total Payment Due: $_______________________ Desired Effective Date: (mm/dd/yyyy):(Coverage cannot be backdated)

Section VI: Payment

Mail With Check or Money Order To:

CPH and Associates711 S. Dearborn Street, Suite 205

Chicago, IL 60605Office Hours:

Mondays & Fridays - 8:30 am to 5:00 pm CSTTuesdays thru Thursdays - 8:30 am to 9:00 pm CSTSaturdays - 10:00 am to 5:00 pm CST

Email: [email protected]

For additional information:

†Philadelphia Indemnity Insurance Company is rated A+ by A.M. Best and Co. and is a leader in providing quality professional liability coverage tothe mental health fields.



34

Copy of form may also be found at http://www.bbs.ca.gov/pdf/forms/mft/mfwkylog.pdf



35

N o t A

p p l i c a

b l e

E x

c e l l e n

t

A b o v

e

E x

p e c t a t i o n

s

M e e t s

E x

p e c t a t i o n

s

B e l o w

E x

p e c t a t i o n

s

U n

a c c e p t a b l e

This form m ust be return ed before semester end .

Notre Dame de Namur UniversityMaster of Science in Clinical Psychology Department

Agency Evaluation: Practicum Students

Student: ____________________ Semester: Fall Spring Summer Year: ________

Supervisor: ____________________ Agency:________________________

A. WORK HABITS

1. Keeps all scheduled meetings and appointments…………………………..

2. Writes accurate and comprehensive reports……………………………….

3. Can be relied upon in a situational/professional crisis…………………….

4. Assumes initiative for developing new projects…………..………………

5. Sets realistic goals…………………………………………..…..…………

Comments:

B. INTERACTION WITH AGENCY AND STAFF

1. Maintains good working relationships with agency staffand fellow trainees or interns……………………………………………...

2. Communicates effectively with co-workers………………..………………

3. Consults with others, as appropriate……………….…….…..……….……

4. Adheres to agency policies and strives to achieve agency goals...……..…

5. Participates actively & responsibly in staff meetings, training,& seminars………………………………………………………………..

Comments:

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 of 5



36

N o t A

p p l i c

a b l e

E x

c e l l e n

t

A b o v

e

E x

p e c t a t i o n s

M e e t s

E x

p e c t a t i o n s

B e l o w

E x

p e c t a t i o n s

U n

a c c e p t a b l e

s form m ust be returned befor e semester end .



C. ASSESSMENT SKILLS

1. Capable of assessing problems accurately & within the firstcouple sessions………………………………………………………………

2. Conceptualizes problem areas within a theoretical framework………..……

3. Provides objective measures (test data) when consultingwith others…………………………………………………….…………....

4. Is sensitive to cultural/ethnic issues when analyzing test results………..….

List each test used by the agency to assess the population servedRate the student’s performance in administering/interpreting these tests.

a. _________________________________________________

b. _________________________________________________

c.__________________________________________________

d.__________________________________________________

e.__________________________________________________

Comments:

D. INTERVENTION SKILLS

1. Makes use of interventions that are appropriate to theclient’s needs………………………………………………..………………

2. Is sensitive to non-verbal forms of communication……..…..……...………

3. Is aware of personal issues which could interfere withtherapist’s role…………………………………………..……..…………...

4. Sets flexible and appropriate long & short-term goals with the client…..….

5. Communicates client information in a manner appropriate toreferral source……………………...…………………..…..………………

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

2 of 5



37

N o t A

p p l i c

a b l e

E x

c e l l e n

t

A b o v

e

E x

p e c t a t i o n

s

M e e t s

E x

p e c t a t i o n

s

B e l o w

E x

p e c t a t i o n

s

U n

a c c e p

t a b l e

is form m ust be returned befor e semester end .



D. INTERVENTION SKILLS

6. Knows when client is able (cognitively/emotionally) to hear &use feedback……………………………………………......…..…………

7. Understands intra-psychic and inter-personal dynamics informulating problem areas……………………………………........……….

8. Evaluate the general intervention skills of the student in working with thefollowing client populations and/or treatment modalities.

Individual Therapy with:

1) Children……………………...….…………..

2) Adolescents……………………….....………

3) Adults…………………………...…………..

4) Elderly…………………………..…....…….

Group Therapy with:

1) Children………………………...….………..

2) Adolescents…………………...…………….

3) Adults………………………..……….……..

4) Elderly………………………………………

Family Therapy:

1) Couples Therapy…….……….…………….

2) Crisis Intervention……………..…………..

3) Intake……………………………..………..

5) Consultation……………………..…………

6) Community Intervention…………………..

Comments:

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

3 of 5



38

N o t A

p p l i c

a b l e

E x

c e l l e n

t

A b o v

e

E x

p e c t a t i o n s

M e e t s

E x

p e c t a t i o n s

B e l o w

E x

p e c t a t i o n s

U n

a c c e p t a b l e

is form mu st be returned before semester end .



E. USE OF SUPERVISION

1. Recognizes & openly discusses problem areaswith supervisor………………………………………………

2. Accepts constructive criticism non-defensively………….

3. Uses supervision to improve understanding and skills…..

4. Can act independently or with minimal supervision withinappropriate limits…………………………………………….

Comments:

F. PROFESSIONAL ISSUES

1. Demonstrates flexibility in dealing with unsettlingmaterial/circumstances……………………..........……………………

2. Recognizes personal strengths and weaknesses as atherapeutic agent………………………………….......………………..

3. Demonstrates sensitivity to and responsible handling ofethical issues……………………………………….......………………

4. Demonstrates mature interpersonal style with all client contacts(e.g. is non-possessive, discourages dependency,shows empathy, sets limits, etc.)……………………........……………..

Comments:

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

1 2 3 4 5 NA

4 of 5



39is form m ust be returned befor e semester end .

Student: __________________ Semester: Fall Spring Summer Year: ________


G. ATTENDANCE

Since our students receive credit units for field placement, we need your verification that this student has methis/her obligation to work in your agency the required hours agreed upon in the Field PlacementContract. Please check the appropriate box below.

The student has worked his/her contracted hours. ( Minimum: 250 hours )

The student has missed certain hours but has made them up satisfactorily in the following manner: ____________________________________________________________________________________ ____________________________________________________________________________________

The student has worked more than 250 hours in the following manner:

____________________________________________________________________________________ ____________________________________________________________________________________

The student has not worked his/her contracted 250 hours.

The student has worked 250 hours from term beginning and extended through.

H. ADDITIONAL COMMENTS

You are encouraged to add any comments you have regarding this student’s performance. Please attachadditional pages if necessary. You may comment in more detail on one or more areas of the evaluationabove and/or suggest academic or practicum experiences you judge necessary for this student at this time.Please be as explicit as possible.

Signature: ________________________________

License # _________________________________

5 of 5



40

Student Final Evaluation of Practicum Field Work and Supervision

(Completed during Seminar Classes)

Agency: __________________________________________ Date: ___________________

Supervisor(s): ___________________________________________________________________

1) Describe your practicum experience:

2) Describe your experience during supervision:

3) Describe forms of training or additional learning experiences:



41

4) How was your workload?

5) What did you like the most about the site?

6) What did you like the least about the site?

7) This site is recommended for student interns who are interested in:



42



43

Section Three:

BBS InformationMFT/LPCC

Licensure



44

Critical Reminders for Interns and TraineesMary Riemersma, Former Executive Director

Revisions provided by Ann Tran, JD, Staff AttorneyThe TherapistJuly/August 2011

The information that follows has been compiled to assist interns, trainees, and applicants in navigating thesometimes complicated intricacies of the licensing law and regulations while pursuing licensure. Understandingthe law and regulations is critical to acquiring hours of experience and subsequently qualifying for the license asquickly and efficiently as possible. Use this resource as a guide to assure the protection of your hard-earnedhours of experience. This information is likewise critical to supervisors to be able to provide the most accurateinformation and to not lead supervisees astray.

BBS’ Current Address:Board of Behavioral Sciences 1625 North Market Blvd., Suite S-200 Sacramento, CA 95834; Phone(916) 574-7830; Fax: (916) 574-8625; Website: www.bbs.ca.gov.

Requests for Applications and Forms can be printed from the BBS Website, which is likely the mostexpeditious way to acquire the forms. Requests for BBS forms and applications may also be made in writing tothe above address or by telephone. If you request by telephone or in writing, be sure to make your requests forforms early so that you are prepared with forms when you need them. Generally allow at least two weeks forrequests by mail or phone to be processed.

Communicating with the BBSWhen communicating with the BBS, especially when submitting forms and applications, it is recommended thatyou mail “certified, return receipt requested.” Likewise, keep photocopies of all that you submit to the Boardand attach the “certified return receipt” to the copy you retain. It is to your advantage to keep accurate records,as you may need these should there be any question about your hours of experience or supervision.

Retain Copies of Application MaterialsOn another note, be sure to keep copies of any applications in perpetuity. One never knows what direction lifeevents will take. Your application may get lost in the mail. You may need the application many years later whenyou, because of life events, wish to relocate to another state and need to apply for licensure within the new

jurisdiction. Expecting to acquire copies of the forms from the BBS, after many years have passed, may bedifficult if not impossible.

Be Truthful on Applications (Even if it Hurts!)Be careful, cautious, and truthful on applications. Do not fail to disclose a past conviction even if you believe itis no longer accessible, or has been expunged. Providing a letter describing what happened, what you haveaccomplished to assure rehabilitation, and enclosing a copy of any disposition would be worthwhile.

Intern RegistrationAllow at least 60 days for processing your application for Intern Registration. Processing may be more rapid,

but it could also be delayed, especially if something is inadvertently omitted from the application or not clear inthe application. Unreadable fingerprinting may also cause a delay and sometimes resubmissions are necessary,which could significantly delay the processing of applications. In other words, apply as early as possible. If one



45

submits an application for intern registration within 90 days of being granted a degree (regardless of how long ittakes to process the application), the hours of experience gained post-degree will count as long as lawfullyemployed and not employed in a private practice.

Intern/Post Degree ExperienceApplicants who are post-degree who did not apply for intern registration within 90 days of their degrees beinggranted will not be able to accrue any hours post degree until the intern registration numbers are actuallygranted. One should anticipate that application processing could take 60 days or in some cases even longer ifthere are unanswered questions, fingerprinting difficulties, or other problems.

First-Time Examination CandidatesThe Exam Eligibility application is where you submit all hours of experience for the Board’s review to qualifyfor the license. Currently, MFT exam applicants should allow a minimum of five months for processing.

Written ExaminationsLicensed Clinical Social Workers, Licensed Educational Psychologists, and Licensed Marriage andFamily Therapists take written examinations that are administered continuously. When you are notified by theBBS of eligibility to take the written examination, you will need to schedule yourself with the entity with whichthe Department of Consumer Affairs has contracted to administer the examinations.

Re-ExamineesCandidates who do not pass either the regular written exam or the clinical vignette written exam will need tosign-up to be re-examined. Candidates being re-examined will be required to pay an additional examination feein a timely manner. Re-examinations are required to be at least 180 days following the candidates’ most recentexamination date. Re-examinees must wait until the next examination cycle to retake a “failed” examination inorder to take a new form of the examination. This “waiting” period also provides ample time to study andfurther prepare for retaking the examination.

Clinical Vignette Examination First Time CandidatesCandidates are considered eligible for the clinical vignette examination after passing the written examination.

Like the regular written examination, candidates schedule themselves to take the exams.

Taking Exams When Offered is ImportantCaution —Generally speaking, a person who does not take an examination or re-examination within one year ofeligibility of examination will have his/her application abandoned, which will require reapplication.If you must re-apply, you may possibly lose hours of experience that may be too old to be countable at the timeof re-application.

Recommendation —Take exams whenever they are available to you even if you do not feel 100 percent prepared. There is no limit to the number of times one can take an exam.

Information for Trainees, Interns, and ApplicantsA “trainee” is a person who is in his/her graduate degree program to qualify for the license and has completed12 semester or 18 quarter units of study.An “intern” is a person who has been granted his/her degree to qualify for the license, has applied for and beengranted his/her intern registration number from the BBS.A “post degree applicant” is either a person who has been granted his/her degree and applies for internregistration within 90 days of being granted that degree or has applied for the license and/or is in the process of

being examined to qualify for the license.

Guidelines on Hours of ExperienceFollowing are requirements for collecting hours of experience for licensure as an MFT in the State of



46

California. These requirements are paraphrased from the licensing law and regulations governing the marriageand family therapist profession. These requirements include changes effective January 1, 2010.A minimum of 3,000 hours of experience is required. Such experience may be gained in no less than 104 weeks,which spans the period from being a trainee through being a registered intern.

Trainee Experience Not more than 750 hours of counseling and direct supervisor contact may be obtained prior to the granting ofthe qualifying degree. [This limitation on hours does not include professional enrichment activities such asworkshops and personal psychotherapy received.] “Trainees” are unlicensed persons enrolled in qualifyingmaster or doctoral degree programs who have completed no less than 12 semester units or 18-quarter units ofcoursework.

As a trainee, one can gain a maximum of 750 hours of counseling and direct supervisor contact, a maximum of300 hours of psychotherapy [100 actual hours x 3 = 300] and a maximum of 250 hours of workshops, trainingsessions, seminars or conferences, as well as a maximum of 250 hours in administering and evaluating

psychological tests of counselees; writing clinical notes; writing progress notes or process notes for a total 1,300hours. A minimum of 1,700 hours must be gained subsequent to the granting of the master or doctoral degree.

Trainees are not required to have completed 12 semester or 18-quarter units of study to receive personal

psychotherapy for countable hours. These are the only hours that do not require supervision. Keep in mind,however, that such experience will only count if the psychotherapist is a licensed professional, but such licenseeneeds only a current and valid license and does not need to be two years licensed. The psychotherapist providesverification for these hours that do not require supervision. There is no BBS-specific form to record these hours.

Maximum Hours Per Week For Interns and Trainees No more than forty (40) hours of experience may be credited for any seven consecutive days. These 40 hoursare inclusive of all categories of experience (e.g., supervision, workshops, client contact hours, etc.).

Minimum Hours for Couples, Families, and Children Not less than five hundred (500) total hours of experience shall have been gained in diagnosing and treating

couples, families, and children. These hours may be in any combination, e.g., all children or a mix of couples,families, and children. The first 150 hours of treating couples and families are double-counted.

Psychological Testing, Process/Progress Notes Not more than two hundred fifty (250) hours of experience will be credited for administering and evaluating psychological tests of counselees, writing clinical reports, writing progress notes, or writing process notes.These hours are optional.

Group Counseling or Therapy No more than five hundred (500) hours of experience will be credited for providing group therapy or groupcounseling. Group counseling hours are optional. When counseling groups of children, you may record the

hours under “children.”

Telemedicine Not more than three hundred seventy-five (375) hours of experience may be counted toward providing psychotherapy, crisis, or other counseling services via telemedicine (Telephone and/or Internet therapy).These hours are optional.

Hours of Supervision—Individual and GroupDuring each week in which experience is claimed and for each work setting in which experience is gained, anapplicant shall have at least one (1) hour of direct supervisor contact or two (2) hours of direct supervisor



47

contact in a group of not more than eight (8) persons receiving supervision. The intern/trainee shall have at leasttwo hours of group supervision in every week in which group supervision is claimed.Group supervision is optional. Group supervision may be acceptable when gaining, for example, an hour onMonday and an hour on Wednesday, as long as the hours are both in the same seven-day period making up theweek. Supervision hours are actual sixty-minute hours, not 45 to 50 minute therapy hours.Each hour of group supervision counts as an hour of experience. If less than two hours of group supervision are

provided within the week, the supervision hours will not count and one’s hours of experience may be jeopardized.

The intern/trainee shall receive at least one (1) hour of direct supervisor contact per week for a minimum offifty-two (52) weeks. These weeks need not be consecutive. Individual supervision means one supervisor andone person being supervised.

Note: In other words, there must be 52 separate weeks within which at least one hour of individual, face-to-face supervision has been provided.

Direct supervisor contact means face-to-face supervision, which also includes contact via two-way, real-timevideo conferencing for interns who work in a non-profit, governmental, or educational institution.

Maximum Countable Supervision per Week Not more than five (5) hours of supervision, whether individual or group, shall be credited during any singleweek. Keep in mind, however, that it may be necessary to gain and record more than five hours of supervisionin a week to be able to credit all hours of experience gained.

Ratios for Interns, Trainees, and ApplicantsTrainees shall receive an average of at least one hour of direct supervisor contact for every five hours of clientcontact in each setting. While there must be supervision within each week, these ratios need not be accountedfor within each week, they are calculated based upon the average gained over the entire period of time oneworks in a given work setting. Interns shall receive at least one hour of direct supervisor contact for the first tenhours of client contact in each setting and one additional hour for any hours over ten in a work setting.

When the hours have been approved by the BBS (following the application to take the regular writtenexamination), it is no longer necessary to meet the ratios of experience to supervision. However, at least onehour of individual supervision or two hours of group supervision continues to be required for each work settinguntil licensed.

Supervision/Professional Enrichment Activities Not more than a total of 1,250 hours of experience for related professional enrichment activities would becounted. Such activities include:

Not more than 250 hours of workshops, training sessions, seminars, and conferences while under

supervision and as approved by supervisor. Two hundred fifty hours is the maximum while as an intern,a trainee, or both. These hours are optional.

Not more than 250 hours of experience in administering and evaluating psychological tests, writingclinical reports, or writing process or progress notes. These hours are optional.

Actual hours of supervision. Actual hours of client centered advocacy. These hours are optional. Not more than 300 hours (when 100 hours are triple-counted) of personal psychotherapy received from a

California licensed mental health professional. These hours do not require supervision. One may not get psychotherapy from one’s supervisor. Psychotherapy hours include group, marital or conjoint, family, orindividual psychotherapy received. The two-year license requirement applicable to supervisors is not



48

applicable to this experience. These hours are optional. There is no BBS form for these hours.Applicants will log these hours on the Exam Eligibility application. Have the mental health professional

provide a letter or statement verifying hours.

Example: 175 hours of workshops, 650 hours of supervision, 125 hours of client centered advocacy, and300 hours of personal psychotherapy equals 1,250 hours, which is the maximum of all the above combined.These hours could be in a multitude of configurations up to 1,250 hours.

Practicum Hours of ExperienceHours of experience gained during the practicum, as required within the educational program, may be countedas hours of experience (i.e., hours of experience gained doing therapy, as opposed to classroom instruction).Further, up to 500 clinical hours of practicum experience is exempt from the “six-year-rule” (see page 61). Eventhough all practicum hours may be countable as hours of experience, only 500 hours may be older than sixyears. Hours gained during practicum, like all other hours of experience, must be accounted for on the BBSWeekly Summery of Hours Forms.

The “new” practicum requirement will increase the practicum experience from a minimum of 150 hours to 225hours of experience, of which 75 hours may be in client-centered advocacy.

Weekly Summary of HoursEach trainee and intern shall maintain a weekly summary of all hours of experience gained toward licensure.The weekly summary shall be signed by the supervisor on a weekly basis. An applicant shall retain all such logsuntil such time as the applicant is licensed by the Board. The Board shall have the right to require an applicantto submit all or such portions of the weekly summary as it deems necessary to verify hours of experience.(These logs are generally not submitted to the Board with the application for licensure.) Interns and traineesshould begin new forms on January 1, 2010.

Note : Make sure your supervisor signs the logs each week. These documents provide verification that youactually gained experience during the periods indicated. Additionally, we would recommend that you retainthese documents indefinitely. You never know when you might need them.

Experience VerificationEach Trainee and Intern shall submit to the BBS a completed and signed Experience Verification form withhis/her exam eligibility application. The supervisor must complete and sign the form. Any changes should beinitialed by the supervisor and the Board may verify such changes. A separate form should be used for eachsupervisor verifying hours of supervised experience and for each employment setting. A separate form should

be used for pre-degree and post degree hours.

“Six Year Rule”All 3,000 hours of experience, with the exception of the practicum hours described above, must have beengained in the six years immediately preceding the date the application for examination is filed. Thus, the

maximum amount of time for which hours may be credited, with the exception of up to 500 qualifying practicum hours, is six years (This is affectionately known as the “six-year rule.”). This “six year rule,” provides that all experience shall be gained within the six years immediately preceding the date the applicationfor licensure was filed, except that up to 500 hours of clinical experience gained in the supervised practicumshall be exempt from this six-year requirement. Another way to view the six-year rule is if you want to countthe first hour you have gained and that hour is not an hour gained in practicum, you would have to apply forlicensure/examination within six years of that first hour. For example, if you applied for licensure on January 1,2020, all hours except for the 500 protected practicum hours would need to be completed between January 1,2014 and December 31, 2019.



49

The Other Six-Year Limit—Intern RegistrationPersons who do not complete their hours of experience within the initial six-year intern registration period mustreapply for a new intern registration. Such persons may not work in private practice. Hours from one internregistration roll into another intern registration period; however, in no case may the hours submitted to qualifyfor licensure be older than six years, with the exception of up to the 500 exempt hours gained during the

practicum.

Note : The six-year intern registration and the six-year limitation on hours may totally or partially overlap, butthey are separate and distinct periods of time that should not be confused. These two six-year periods of timeare critical for applicants to understand. If the initial six-year intern registration is exhausted, one must apply

for and qualify for a new intern registration number. The hours now carry forward into the next internregistration period (which was, at one time, not the case).

Supervision Reminders

Current Valid LicenseMake sure your supervisor holds a current, valid license, which is not under suspension or probation by alicensing board. Sometimes licensees neglect to notify the BBS, or other licensing board, of a move—consequently, they may neglect to renew their licenses in a timely manner. Also, be certain that the supervisorhas been California licensed for two years prior to commencing supervision. The following licensed

professionals may be supervisors: physicians certified in psychiatry by the American Board of Psychiatry and Neurology, psychologists, clinical social workers, and marriage and family therapists. Verify on the licensing boards’ website that the supervisor’s license is current, valid, and not under suspension or probation. Be sure tocheck again at the time of the supervisor’s next renewal to make sure that the license is subsequently renewed.A supervisor’s failure to renew his or her license will result in a loss of hours to the supervisee.

Note: The only exception to the two-year license requirement is supervisors who provide supervision only totrainees at an academic institution that offers a qualifying degree program, where the supervisor has beenlicensed in California and in any other state, for a total of at least two years prior to commencing anysupervision.

Mandatory for Supervision

Continuing EducationSupervisors, licensed by the Board of Behavioral Sciences who are supervising MFT interns and trainees, arerequired to complete each license renewal period, six hours of continuing education in supervision. Thiscoursework is to be taken either prior to or within sixty days after commencing the supervision of an intern ortrainee. However, a supervisor’s negligence in failing to take the required coursework will not result in the lossof hours for the intern or trainee.

Payment for SupervisionAccording to the Department of Labor it is unlawful for an MFT Intern or Trainee to pay his or her employerfor supervision. This restriction would also be applicable to volunteers who would likewise not be permitted to

pay his/her volunteer setting for supervision. An intern or trainee may lawfully pay for offsite supervision inany setting other than private practice.

Offsite Supervision or Supervision Not Paid for by the EmployerIt is permissible to get offsite supervision in any work setting other than private practice. It is also permissiblefor MFT interns, trainees, and applicants to pay for supervision to their offsite supervisors, but only where an



50

appropriately executed letter of agreement exists. This letter of agreement (the original) must be filed by theapplicant with his/her application to take the examinations for licensure. A SampleLetter of Agreement for Offsite Supervision can be found at the end of this article (page 61). This letter ofagreement should be typed onto the letterhead of the employer as it is the employer who is permitting the“offsite supervision,” or permitting the supervisee to get supervision not provided by the employer.

Who May Not Supervise Interns and trainees are not to gain any experience under the supervision of a spouse, relative, or domestic

partner. Any experience obtained under the supervision of a supervisor with whom the applicant has had orcurrently has a personal or business relationship that undermines the authority or effectiveness of the supervisorshall not be credited toward the required hours of supervised experience. Additionally, interns and traineescannot receive supervision from anyone who has ever been their therapist.

Individual SupervisionIndividual supervision means one supervisor and one person being supervised. As regulation specifies,supervision is to be “one-on-one, individual, and face-to-face.” One hour of individual supervision means sixtyminutes of supervision.

Group Supervision

Group supervision means a group of not more than eight persons are being supervised by one supervisor.Again, the supervision, according to regulation, is to be “face-to-face.” Two supervisors for a group of sixteensupervisees would not be acceptable. Two hours of group supervision means one hundred twenty minutes ofsupervision. Each hour of supervision may occur on different days as long as it occurs within the same week inwhich the hours are being claimed.

Exception to Face-to-Face SupervisionAn exception to face-to-face supervision exists for interns working in a government entity, a school, college, oruniversity, or an institution that is both nonprofit and charitable, and such intern may gain supervision by two-way, real-time videoconferencing.

Other Supervision GuidanceSupervisees may have some weeks where they receive solely individual supervision and some weeks wherethey receive solely group supervision.

Separate supervision is required for each work setting in which one is gaining hours of experience. Forexample, intern in setting one gains three hours of experience and is therefore required to have one hour ofindividual or two hours of group supervision in that setting, and in setting two sees five clients and is alsorequired to have one hour of individual or two hours of group supervision for this setting.

For hours of experience to count within a given week, supervision must occur within the same week that thehours are gained. However, for trainees the ratios are not necessarily required to be achieved within the same

week the hours of experience are gained.

A supervisor may supervise an unlimited number of interns and trainees in any appropriate work setting otherthan private practice, but is limited to supervising two MFT interns when those interns are employed in private

practice. Supervisors are limited to supervising groups of no more than eight persons under supervision.

A supervisor shall give at least one week’s written notice to an intern or trainee of the supervisor’s intent not tosign for any further hours of experience for such person. A supervisor who has not provided such notice would

be obligated to sign for hours of experience obtained in good faith where such supervisor actually provided therequired supervision and the supervisee actually gained experience.



51

The supervisor is required to have practiced psychotherapy or provided direct supervision for at least two yearswithin the five-year period immediately preceding any supervision.

The supervisor is required to address with the intern or trainee the manner in which emergencies will behandled. The supervisor is required to obtain from the supervisee, the name, address, and telephone number ofthe prior supervisor and employer. The intent is that the supervisor will address with the prior supervisor andemployer issues and concerns that will benefit the supervision of the intern or trainee. The supervisor is requiredto verify that the site is appropriate for gaining hours of experience.

Miscellaneous Reminders

Employment/Volunteer/Independent ContractorInterns, trainees, and applicants may only perform services as employees (IRS Form W-2) or as volunteers, andnot as independent contractors (IRS Form 1099). Interns, trainees, and applicants who have been hired and paidon an independent contractor basis will have their hours denied. The BBS views independent contractor statusas self-employment, which is the reason such hours are denied. One may only be self-employed followinglicensure. If employed, an applicant for the license shall provide the Board with copies of the corresponding W-2 tax forms for each year of experience claimed when applying for the license. If volunteering, an applicantshall provide the BBS with a letter from his or her employers verifying the intern’s employment as a volunteerwhen applying for the license.

Trainees, interns, and applicants who provide volunteered services or other services, and receive no more than atotal, from all work settings, of five hundred dollars per month as reimbursement for expenses actually incurredfor services rendered in any lawful work setting other than private practice, shall be considered employees andnot independent contractors. The Board may audit applicants who receive reimbursement for expenses, andapplicants have the burden of demonstrating that the payments received were for reimbursement of expensesactually incurred.

DisclosureInterns, trainees, and applicants are required to inform clients, prior to performing professional services thatthey are unlicensed and working under the supervision of licensed marriage and family therapists, licensedclinical social workers, licensed psychologists, or licensed physicians certified in psychiatry by the AmericanBoard of Psychiatry and Neurology.

Remuneration from Patients/ClientsInterns, trainees, and applicants shall not receive any remuneration from patients or clients, and shall only be

paid by their employers.

Where Services May Be ProvidedTrainees, interns, and applicants shall only perform services at the place where their employers regularlyconduct business, which may include performing services at other locations, so long as the services are

performed under the direction and control of their employers and supervisors and in compliance with the lawsand regulations pertaining to supervision. For example, an intern working in private practice may see a patientin the hospital. Or, a trainee may see a patient who is homebound, on behalf of the agency that employshim/her, in the home of the patient.

Private PracticeInterns must be “registered” at the time employment in a private practice begins. Interns must be in their initialsix-year intern registration period while gaining any hours of experience in private practice.

Supervision in Private Practice by Someone Other Than Employer



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The supervising licensee in a private practice shall either be employed by and practice at the same site as theintern’s employer, or shall be an owner or shareholder in the private practice.

Supervision when Supervisor is on Vacation or Sick LeaveAlternative supervision may be arranged during a supervisor’s vacation or sick leave if the supervisionotherwise meets the requirements of the licensing law.

Lawful Employment Settings for TraineesA trainee may gain experience as an employee or volunteer in any setting that lawfully and regularly providesmental health counseling or psychotherapy, provides oversight to ensure that the trainee’s work at the settingmeets the experience and supervision requirements required by law, is within the scope of practice for the

profession, and is not a private practice.

Requirement for Hours Gained as a TraineeFor all hours gained as a trainee, the school must have a written agreement with the employer where the hoursare gained. If no agreement exists, such hours cannot be counted while a trainee.

Lawful Employment Settings for InternsRegistered interns may work in all of the settings in which trainees may work, and in addition, they may, duringtheir initial six-year intern registration, be employed or volunteer in private practices.

Lawful Employment Settings for Applicants for Intern RegistrationA person who is post degree, awaiting intern registration, may work in any setting appropriate for a trainee, andmay not work in private practice. Persons who are in their second six-year intern registration period maylikewise not work in private practice.

Ownership of a Practice or Business

Trainees and interns shall have no proprietary (ownership) interest in their employers’ businesses and shall notlease or rent space, pay for furnishings, equipment or supplies, or in any other way pay for the obligations oftheir employers. This means that interns and trainees will not be signers on joint checking accounts withemployers, pay remodeling costs for office space, pay advertising costs, etc.

Employee vs. VolunteerThe requirements of law and regulation are applicable equally to persons who are employees and persons whoare volunteers. Do not presume that if you are a volunteer and law or regulation says “employee,” that it doesnot apply to you. You are bound by the same requirements whether you are an employee or a volunteer.

Responsibility Statement for Supervisors

This statement is to be signed by the supervisor prior to commencing supervision with an intern, trainee, orapplicant. These forms are on the BBS website at www.bbs.ca.gov. Interns are to submit SupervisorResponsibility Statements to the Board for all supervisors upon application to take the examinations forlicensure.

Notification of Change of AddressLicensees, registered interns, and applicants are required to notify the BBS within 30 days of a change ofaddress. The form is available on the BBS website.

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Mary Riemersma, CAE, is CAMFT’s former Executive Director of 26 years. She is consulting with the new Executive Director through a period of transition.From masters Degree to Licensure

Post-Graduation Intern Registration

IMPORTANT!!*** Please read carefully***

Within 90 days, you need to apply for your Intern Number through the BBS for all yourpost-graduation hours to count as an MFT Intern and/or PCC Intern. If you do not applywithin these time limits, THEN your hours will not count until you receive the Registered

Intern Number.

Students planning to register as an MFT or PCC intern should follow these instructions:

1. Contact the BBS and obtain your required forms.* An MFT Intern registration application can also be downloaded online through the BBS website.

Board of Behavioral Sciences 1625 North Market Blvd., Suite S-200,Sacramento, CA 95834 Phone: (916) 574-7830; Fax: (916) 574-8625www.bbs.ca.gov

2. Order an OFFICIAL NDNU transcript (make certain your degree is posted!) from theRegistrar’s office. You may pick up a Transcript Request Form from the Registrar’sOffice, or you may go online to: www.ndnu.edu (Quick Links / Registrar).

3. See the Clinical Psychology Department Coordinator, in the department office, 650-508-3557, to get a Program Certification Form. The Administrative Coordinator will need

your full name, social security number, and the term of your enrollment to the program(i.e. Fall 2010).

4. All other BBS requirements need to be done by you (i.e. application, photograph,fingerprints, etc.). Submit all of your application materials in one envelope. Keep copiesof everything! All forms can be downloaded from the BBS website.

5. Review the BBS website for any updates, forms, and additional information regardingintern registration, required hours, and FAQs. Remember, MFT and PCC intern



54

applications are separate. Similarly, BBS requirements, including required hours ofexperience, differ between MFT and PCC interns.

This process cannot be completed until all degree requirements have been met.



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Section Four:

Preparing forPracticum







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Know your "readiness" for internship. Students who learn their strengths and weaknesses and determine what they want to pursue after practicum make great internship candidates, said Schreier. Training directors want internship candidates who, among other things, have developed professional goals during practicum, can articulate what they needto work on and know what type of learner and supervisee they are.



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How to Write a Cover LetterKathleen Brooks, Ed.D. Psychology Today

General Guidelines1) Use proper business format : Make sure you include the date, the name and address of the person/organization you’re sending itto, etc. Use a colon after “Dear Mr./Mrs. _______:” (commas are for personal correspondence).2) Keep it to One page : Unless you have a very clear reason for going beyond that.3) Write unique content : The cover letter is a chance to tell your story, to demonstrate some personality, display yourcommunication skills, and highlight your strengths. Is it not the place to simply repeat every that is in your resume.

4) Show rather than tell : Rather than stating, “I am a hard worker” (that’s telling); offer examples of your hard work.5) Establish a relationship with your reader : Be conscious of who may be reading your cover letter; whether it is human resources,your future supervisor, or another intern. Avoid using too much jargon or acronyms.6) Write a targeted letter to each position : Personalize your cover letter to the agency, position, and employer contact. Make surethe cover letter content is relevant to the position you are applying for. Don’t send the same cover letter to every agency. Makeconnections between the job description and previous work experience.7) Plan to create a letter with three-to-five paragraphs : The first paragraph should explain what you are applying for, how you

heard about the opportunity, and why you are particularly qualified. Convey what talents or experience you have that connect to the position. The middle paragraphs expand on your connection to the position as well as highlight any research you’ve done about theopportunities the position and the employers represent to you. The last paragraph closes with the next action step that will be takenand how you can connect in the future.8) Use an active voice, with action verbs : Avoid phrases like “was responsible for”, or “reports that were written by me..”/9) Edit and proofread : Ask a professional to look over your cover letter, and be open to feedback.

FormatYOUR CONTACT INFORMATION:NAME:ADDRESS:PHONE NUMBER:EMAIL ADDRESS:

DATE:

EMPLOYER CONTACT INFORMATION:NAME:TITLE:

COMPANY:ADDRESS:PHONE NUMBER:EMAIL ADDRESS:

SALUTATION:“Dear Mr. or Mrs. (Last Name)”, or Contact Title

YOUR COVER LETTER MAY INCLUDE:NAME OF SCHOOL, Degree (Expected graduation date), Major and MinorPOSITION YOU ARE APPLYING FORINTEREST IN AGENCYSPECIALIZED TRAINING

PREVIOUS WORK EXPERIENCE: Job functions, population served, skills/abilities acquiredINTERESTS, STRENGTHS, SKILLSLANGUAGE ABILITY (Bi-Multi-Lingual)WHY YOU ARE AN EXCELLENT CANDIDATE FOR THE POSITION



64

SAMPLE COVER LETTERS



65

Eager Student4500 Pleasant Place

Redwood City, CA 90000

January 1, 2000

Jane Doe, Ph.D.Training CoordinatorXYZ Psychological Services

12 Main StreetElsewhere, California 90000-0000

Dear Dr. Doe:

I am eager to apply to the XYZ Psychological Services Practicum Program. My career focus is community mental health. I am aclinical psychology masters student at the Psych School. Your multi-disciplinary training provides the diversity anddevelopmental training, short-term therapy emphasis, and crisis experience that I seek.

I am attracted to the practicum program's goal to address multicultural and developmental issues in relation to client presenting problems. I hope to work with individuals of varied ethnicity, nationality, gender, sexual orientation, and socio-economic background. My volunteer experience with a diverse population serves as a foundation for continued learning and professionalgrowth.

The practicum's emphasis on short-term therapy, combined with a few longer-term cases, meets my training goals. I seekintensive brief therapy experience and would benefit from learning about fees and issues specific to long-term psychotherapy. Iam interested in receiving individual and group supervision from multiple sources, including primary and secondarysupervisors. Your program's on-call crisis work, which includes telephone call screening, interviews, drop-in client assessment,consultation, and assistance with hospitalization, would enhance my skills. My training interests include differentiation ofdevelopmental issues from more serious conditions through multi-disciplinary collaboration, consultation, and referral, asneeded.

The XYZ Psychological Services program matches my professional developmental needs and career goals. I am enthused aboutserving a diverse population through brief therapy and crisis intervention. I hope to enhance my skills through multi-disciplinary collaboration and consultation. Enclosed is my curriculum vita, three letters of recommendation, and unofficial

transcripts. Thank you for your consideration. I look forward to hearing from you.Sincerely,

Eager Student



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Me You4500 Pleasant Place


January 1, 2000

Jim Doe, Ph.D.ABC Clinic

12 Sesame StreetSan Francisco, CA 94555

Dear Dr. Doe:

I am writing to express my interest in the practicum position available at ABC Clinic for the next academic year. I am a thirdyear student at the Psych School and I believe ABC Clinic would provide me with valuable experience working with childrenand families, including those in the foster care and adoption systems. I am interested in as broad a caseload as possible and theopportunity to expand my work in family systems, infant-parent therapy, and multi-culturally sensitive assessment. I amespecially interested in the use of "reflecting teams" to help families recognize strengths and challenges. I am highly motivatedto be part of a program that seeks to meet the needs of children and families who cannot afford services elsewhere. I wouldwelcome the opportunity to build upon my growing skills and continue my service to a diverse population of clients. Myultimate goal is to become a child and family psychotherapy in a community based agency.

My previous work experience includes working with families and children in several different capacities. As a former nanny, Ihave had the opportunity to witness cognitive, behavioral, and emotional development first hand, while becoming intimatelyfamiliar with some of the challenges that modern families face. My work involved maintaining open communication with

parents regarding their children's strengths and challenges, as well as helping children develop emotional intelligence and behavioral control. I have also become more acquainted with the structure of school systems and the many different aspects of achild's education. While these experiences have not been directly clinical, they have provided me with invaluable opportunitiesto learn more about family dynamics and functioning. I am eager to receiving training and supervision in an area that will helpme enhance these skills, while developing new ones. Finally, I have recently completed my Master's Thesis, which examines

peer relationships among single-children families, entitled "Kids: Who needs 'em?"

Enclosed please find my curriculum vitae, with two letters of recommendation to arrive under separate cover. It would be my

pleasure to interview with you and your colleagues. I can be reached via phone at (650) 867-5309 or by email [email protected].

Thank you for your considering my application. I look forward to hearing from you soon.

Sincerely,

Me You3rd Year Students, Masters of Science in Clinical PsychologyPsych School



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January 1, 2000

Sigmund Freud, M.D.Director of PsychologyThe Mental Health Center

19 Berggasse Dr.Idville, CA 11111

Dear Dr. Freud,

I am eager to apply for the psychology practicum training program at the Mental Health Center. I am particularlyinterested in the opportunity you provide to deepen my knowledge of assessment and treatment of severely ill adult patients.Enclosed, please find my curriculum vitae and the requested writing sample.

A specific interest in severe psychopathology guided my choice to seek clinical contact with patients diagnosed with a broad range of conditions. As a result, I have volunteer experience working in a county mental hospital with adult inpatients.Patients at the hospital presented with a broad range of issues including the severe psychopathology of psychotic spectrumillnesses, major affective illness, trauma reaction, and character pathology, as well as sexuality and gender concerns, adjustmentdisorders, and neurological illness. My desire to work with individuals and groups in an integrated community mental healthsystem has been strengthened by this experience.

I feel that MHC's faculty and training program is designed to acquaint me with the roles and responsibilities held by psychotherapists working within this type of community mental health care system. Because I hope to form a career in which Iwill be treating and developing therapy protocols for severely ill individuals, my focus for training involves the type of trainingexperiences your program offers. It would allow me to work directly with severely ill patients, while providing a richly diversetraining experience in the context of an urban community mental health care system. I am interested in having the importantexperience of focusing on empirically validated cognitive behavioral treatments for severe psychopathology, and for this reason,am very interested in exploring DBT in the outpatient rotation. In addition, continuing to provide therapy to individuals,families, and couples in an outpatient treatment setting would provide the breadth of experience so necessary to therapists intoday's challenging mental health environment.

I am seeking breadth and depth of clinical experience and the professional development offered by your program. Youwill find that I am an enthusiastic learner, welcome the opportunity to build and develop my identity as a clinician, and increase

my understanding of theoretical and methodological issues. Your practicum training program will complement my interest andexperience and, I am certain, provide me with many challenges and valuable skills.

Thank you for considering my application. I look forward to hearing from you.

Sincerely,

Eager Student



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1 January 2000

Melanie Klein, LMFTClinic DirectorYouth Services Center

1313 Mockingbird LaneRedwood City, CA 90000

Dear Melanie Klein,

I am writing to express my interest in the practicum at the Youth Services Center. I am a third year student in the Masters ofScience in Clinical Psychology program at Psych School. I am highly motivated to be a part of a multiethnic counseling serviceagency for school aged clients and their families throughout San Mateo County. I am attracted to the Youth Services Center’scommitment to strong training in community based and school linked counseling modalities; application of evidence basedtreatments; individual, group, and family counseling as well as crisis intervention; and working collaboratively with otheragencies and providers. Additionally, it is also very important to me that multicultural training is at the heart of my ongoingeducation.

I have particular interests in working with a community-based program that serves individuals from diverse ethnic and socio-economic backgrounds. As a multi-lingual individual, I hope to be able to provide psychotherapy services to a Spanish-Speaking population. I was particularly excited to hear that your program also offers supervision in Spanish, as I feel thattranslation can sometimes provide particular limitations. In my previous experience I worked as a project manager for XCorporation, which developed skills in collaboration, management, teaching and presentation, and taught me how important it isto establish and maintain constructive, supportive, and enjoyable working relationships. I also worked part-time as a

professional musician. This position helped reinforce creative aspects of my personality while also providing valuable insightinto group dynamics. I am eager to begin my clinical training at an agency that will allow me to utilize these skills in mydevelopment as a clinician.

I strongly believe these wide-ranging professional and personal experiences will make me a valuable addition to the YouthServices Center. Enclosed please find my curriculum vitae and one letter of recommendation. Two additional letters of

recommendation are coming under separate cover. It would be my pleasure to interview with you and your colleagues. I can bereached by telephone at (650) 867-5309 or by the address listed below.

Thank you for considering my application. I look forward to hearing from you.

Sincerely,

Eager Student



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How to Write a Curriculum Vitae (CV)www.apa.org/resources/academic

Helpful Hints: In the academic market, a curriculum vitae or CV is very important and, after your cover letter, is you first introduction to thesearch committee. The CV is a summary of your educational background and research and professional experiences. Your CVis a tool to help you move from an application to an interview.

What to Do When Writing a CV: Make your CV visually appealing. Look at how others have done their CV. Ask your professors and colleagues for

examples. Start you CV with general contact information that includes your name, address, telephone, fax, email, and url (if you

have a website about yourself as a professional). Include these sections in you CV: Contact information; Education; and Experience. Include these sections depending

on your strengths and interests: Honors and Awards (from post-secondary school); Teaching and Research Interests;Publications: Professional Activities (committee memberships, intern experiences, relevant volunteer work); Skills(second language and/or computer proficiencies); and References (you may include these or indicate they are availableupon request).

Check your CV carefully for spelling and typographical errors. Use formatting such as bullets, italics, or bold font only sparingly. [Editor's Note]: View many, many examples. Perform an internet search for "Clinical Psychology Curriculum Vita"

and other related terms. Use ideas from examples that you like, and discard things that do not feel appropriate. Themore CVs that you see, the better idea you'll have of what works and what doesn't.

What Not to Do When Writing a CV: Don’t try and do it all by yourself the first time. Seek help from others such as faculty advisors, career specialists, or

colleagues. Don’t worry too much about length – there are no rules on length. The CV should be professional and should include

your important data. Don’t include the following information. These things are not necessary: Age; Ethnic identity; Political affiliation;

Religious preference; Hobbies; Marital status; Sexual orientation; Place of birth; Photographs; Height; Weight; andHealth.

Don’t pad your CV by listing excessively detailed information about research, or teaching. Instead, provide the titles ofresearch projects and course names along with brief summaries of your work.



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CV Dos and Don'tsBy MELISSA DITTMANN

gradPSYCH Staff

What type of curriculum vitae (CV) is most likely to impress potential employers? One that is simple, straightforward,organized and tailored to fit a job ad, experts say.

"Right now

it's

a very

competitive

job

market,

and

a CV

is

your

ticket

to

an

interview,"

says

Tara

Kuther,

PhD,

anassociate professor of psychology at Western Connecticut State University who has given seminars on writing CVs. "A vitae

that is formatted nicely, attractive, looks professional and presents your strengths really stands out to employers."

As such, putting together your CV takes much care and forethought. First off, be sure the job asks for a vitae and not arésumé. A vitae is a detailed record that showcases your career and education accomplishments and can be unlimited inlength, whereas a résumé is generally a one ‐page overview of your career. When applying for most jobs in psychology,employers will request that you send a vitae, not a résumé. Also, depending on the type of job you are applying for ‐a practice or academic one ‐you might need to tailor your vitae. Whenapplying for a practice job, highlight your internship and practicum experience, experts recommend. On the other hand, whenapplying for an academic or research job, highlight your publications, teaching and research experiences, they say.

Here are the essentials of a vitae that impresses:

COMPARTMENTALIZE Organize your vitae with sections such as "education," "professional experience" and "publications," and list each

accomplishment in chronological order with beginning and end dates. Also, if applicable, include sections such as"practica/psychotherapy experience," "volunteer/service work," "awards and scholarships" and "professional affiliations."

When applying for a practitioner job, include a section on assessment measures you have mastered during training,advises Shawn Roberson, PhD, a forensic psychologist at the Oklahoma Forensic Center, part of the Northeastern PsychologyInternship Program. Roberson helps to screen internship applicants at the center.

WEIGHT IF IT'S WORTH INCLUDING What to include depends on what the position entails, experts say. For instance, should you include coursework?

Most advisers say no, but some recommend listing any specialized training ‐you might include coursework in forensicpsychology, for example, when applying for a forensic job. However, experts generally say that coursework, methodologicalskills and software proficiencies should be omitted from a vitae that's geared for full‐time jobs, since it's assumed thatpsychologists have mastered these skills. Still, you might include such skills on applications for internship and postdoctoralpositions, they note.

In particular, any undergraduate experiences you include should be highly relevant to your psychology career and the job at hand, says Mary Kite, PhD, associate dean of the Graduate School at Ball State University and a professor ofpsychological science there. While social fraternities and sororities don't belong on a vitae, students might note membershipin Psi Chi or Phi Beta Kappa and high academic honors, such as magna cum laude, Kite says.

Be creative in relating your experiences to the job, Roberson adds. If the position requires public speaking ororganizational involvement, you might, for example, highlight your work with organizational boards. Experts also say youshould not include your age, relationship status or hobbies on your CV.

KEEP IT SIMPLE AND STRAIGHTFORWARD Too often students try to cram too much information on a page, Kite says. Keep job descriptions clear and concise,

and follow a standard format. Bold the headers of the different sections ‐such as education and professional experience ‐anduse a simple font such as Times New Roman, experts recommend. Also, use quality white or ivory paper, Kite advises. Thesesteps will help employers easily absorb the information on your CV.

HONESTLY REPRESENT YOUR WORK Don't pad your vitae to make it appear more impressive, experts advise. For example, Kuther says, many students

lump publications and presentations together to make the section look longer. But search committees usually prefer to see



71

them separate, she says. "Everyone understands you're a student," Kuther explains. "If you only have one [published] articlelisted, that is still a fantastic thing."

TAILOR YOUR VITAE TO THE JOB Match your background, skills and training to the job you're applying for, Roberson says. For example, clinical

psychologists need to emphasize internship and supervision experience, while academic applicants need to highlight researchand teaching experience, Kite adds. "If a student is looking for both, then they should have two different vitae rather than aone ‐size ‐fits‐all vitae," Kite says.

MAXIMIZE YOUR CV WITH THE COVER LETTER Use the cover letter to highlight accomplishments on your CV, such as clinical, research or education experiences that

match the job, Roberson notes. You can also call attention to work that doesn't belong in the CV: If you have any research inprogress, for instance, use the cover letter to mention it, Kite says. The CV should only contain research that has beenpublished or is in press, she explains. And, just like the CV, the cover letter also needs to be customized for every employer.

FIND AN EDITOR Ask colleagues or faculty members to check your vitae for awkward phrasing, formatting problems and spelling

errors, and to give you feedback on content and organization, advise Kite and others. Ultimately, the vitae should serve as a summary of your education and career experiences, Kite notes, and should becontinually updated throughout your career.

The Vitae Checklist

Name and contact information , including work and home phone numbers, address and e ‐mail

Education , including college degrees, places and dates

Dissertation topic

Licenses/certification , including state and certificate number, if applicable

Internships

Professional experience

Publications

Professional or

academic

presentations

Honors, scholarships, fellowships or awards

Professional organization memberships

Volunteer or service work

Sections for teaching, research or clinical experience



72

SAMPLE CURRICULUMVITAES



73

My Name 1234 56th St., San Francisco, CA 94555 • (415) 867-5309 • [email protected]

Education

Pepperdine University, Graduate School of Education and Psychology; Malibu, CAMaster of Science in Clinical PsychologyAnticipated date of graduation June 2013

Any University; City, STBachelor of Arts in Psychology December 2010

Professional Experience

ABC Community Mental Health; City, ST Marriage and Family Therapist Trainee September 2012 - PresentProvide individual therapy to clients diagnosed with variety of pres enting problems including Schizophrenia, Bipolar Disorder,Generalized Anxiety Disorder and Post-traumatic Stress Disorder. Co‐facilitate domestic violence and anger management groups to provide psycho ‐education and to increase insight into maladaptive co ping mechanisms. Conduct phone intakes and refer clients to appropriate resources based on individual needs. Maintain progress notes for all clients to ensure proper documentation of session content and interventions.

The QRS Preparatory School; City, STVolunteer September 2012 - January 2013Counseled adolescents ages 13 ‐17 by providing support and assistance with life transitions, academic planning and interpersonal difficulties. Impleme nted individualized educational goals and objectives to enhance student responsibility,accountability and independence. Collaborated with teachers, occupational therapists and student advisors to form engaging multidisciplinary team.

Any Agency; City, ST Behavior Care Provider February 2011 - September 2012Utilized cognitive ‐behavioral therapy techniques with children ages 3‐9 with severe emotional dist urbances, autism spectrumdisorders, and developmental delays. Processed disruptive and self ‐injurious behaviors with children to ensure safety and cultivate healthier coping skills. Teamed with special education teachers and parents to increase consis tency between

classroom and home interventions.

Professional Organizations

Phi Beta Kappa Honor Society January 2008Present American Association for Marriage and Family Therapy January 2012 - Present



74

Your Name123 E. 25th Street • Los Angeles, CA 90011 • 310-888-8888 • [email protected]

EDUCATIONPepperdine University, Graduate School of Education and Psychology, Irvine, CAMaster of Arts in Clinical Psychology with an emphasis in Marriage and Family Therapy Anticipated Date of Completion August 2012

Thesis Title: "Kids: Who Needs 'Em?"Thesis Completion Date: August 2011

University of Any School, City, STBachelor of Science in Psychology May 2007

CERTIFICATIONSDomestic Violence Prevention and Treatment June 2010Substance Abuse Detection and Treatment April 2010Eating Disorders Treatment and Relapse Prevention October 2009First Aid and CPR October 2008

LANGUAGE SKILLSFluent in spoken Spanish and proficient in written Spanish

PROFESSIONAL EXPERIENCE

Any Agency, City, STAfter School Trainee January 2011 - Present

Conduct sensory and motor skill integratio n and behavior therapy with children ages 3 – 9 with special needs,including severe emotional disturbances, autistic spectrum disorders, and developmental delays to foster developmentand self-awareness

Incorporate activities such as gardening, art, and swimming to increase socialization and sensory awareness

Process “acting ‐out” behaviors with children to cultivate coping skills and to promote verbalization Collaborate with special education teachers to ensure consistency between classroom and afte rschool programs

Any Agency, City, STBehavioral Specialist September 2010 – Present

Provide individual, group, couples, and family therapy for clients with variety of presenting problems to improveinterpersonal relationships

Co‐facilitate domestic violence and at ‐risk youth group resulting in lower rates of recidivism and increased school performance

Conduct phone intak es and refer clients to appropriate resources in order to address needs Maintain progress notes for all clients to ensure proper documentation of session content and interventions

PROFESSIONAL EXPERIENCE (continued)

ABC Resources, City, STResearch Analyst January 2009 – September 2010

Formatted surveys to obtain crucial patient ‐satisfaction information Analyzed survey results providing statistical scores, charts and graphs to better unders tand strengths and weaknesses

at medical facility Developed customer satisfaction reports to teach medical faculty what service areas need improvement

Any University, City, STTeacher Assistant September 2009 – May 2010

Co-taught introductory psychology course to university freshmen to expand students’ knowledge of subject matter



75

Collaborated with colleagues and professors to successfully follow set curriculum and to provide feedback to students Participated in weekly meetings with professor and other teaching assistants to discuss past lectures, review pending

syllabus, and prepare for following classes Observed by professor and integrated constructive feedback to improve teaching style

Any Laboratory, City, STResearch Assistant August 2006 – May 2009

Analyzed intervention strategies for couples and families facing health crises, resulting in development of empirically ‐based treatments

Researched relevant literature and public ations on couples’ health and compiled reports in order to expedite research processes

Conducted data entry using SPSS to further research on role of ironic processes in couples’ health

Any Family, City, STProfessional Nanny June 2006 - August 2010

Provided safe, caring, nurturing and stimulating environment for twin children. Planned and provided age-appropriate activities Supervised play time with children's friends Prepared meals and snacks for children Maintained parents' values and goals in child's education, play, and behaviors Certified in infant CPR and First Aid

PRESENTATION

Therapist, Maynard. (2011, March). California Technology Assistance Project. Presentation at Emerging TrendsConference, San Diego, CA

PROFESSIONAL AFFILIATIONSCalifornia Association of Marriage and Family TherapistsAmerican Association for Marriage and Family Therapy

Northern California Society for Psychoanalytic PsychologyPsi Chi



76

SAMPLE THANK YOULETTERS



77

Thank-You Notes

Opinions vary about whether or not you should send a thank-you note or other correspondence to follow-up after an interview.Thank-you notes certainly are not required or necessary, and the presence or absence of a note or particular type of note (e.g.,email, typed letter, handwritten notecard, hologram delivered by carrier pigeon) will rarely influence the decision of theadmissions committee or training director. We suggest that you send a follow-up if it is consistent with your personal style andfeels like something you'd like to do. Thank-you notes can be a courteous, appropriate way to express gratitude to your hosts,and therefore the practice is quite common among applicants.

In addition to an expression of gratitude, thank-you notes offer a final opportunity to express your interest in the site andexplicably state your perception of the fit between the site and your interests or training goals. Let the note be an extension ofyour own style and the level of professionalism that you have communicated throughout the application process. Several samplethank-you notes have been included as examples, should you wish to send one.

A couple of suggestions when writing thank-you notes include the following: Thank-you notes may demonstrate initiative and genuine interest, and they may help to make you memorable. Keep

them simple, and make them personal if you are able. Mention something specific from the interview that you learned. Mention how this is in line with your professional

interests. Follow-up can be another opportunity to highlight something positive about your CV, experience, training, or

interview. Send your note within a day or so after your interview so you will be fresh on the mind of the individual whoreceives your note.



78

January 24, 2000

Dear Dr. X,

I enjoyed meeting with you on January 15, and I am very impressed with your program. Speaking with you, Dr. Y., Dr. Z, andthe current interns was helpful to me in forming a more complete understanding of the XXX Consortium.

Overall, I believe that the experiences offered at XXX match my goals for training. Additionally, the teen clinic opportunitiesare another attractive aspect of your training program. I was also greatly impressed by the friendliness and warmth of the people

at XXX. I believe that I would be happy and honored to work with everyone with whom I met during my visit.

Sincerely,

Eager Student----------------------------------------------------------February 1, 2000

Dear Ms. X,

I wanted to thank you for taking the time to meet with me to discuss my practicum application and your program. After hearingso many positive things about the practicum from friends and colleagues, it was nice to leave the interview day with the same

positive feelings myself!

I am very impressed with and excited about the training opportunities your practicum has to offer. I feel that your practicum'sstrong adherence to multicultural training and sensitivity is unique among the practicum programs I have explored. XXX seemslike an ideal place to apply my cross-cultural studies and experience to areas of clinical work. The cases that we discussed wereincredibly interesting and exciting to me.

Again, thank you for your time, and I hope that you will consider me for your program.

Sincerely,

Eager Student------------------------------------------------------------

February 30, 2000Dear Mr. X,

Thank you for taking the time to meet with me to discuss my practicum application and your program. I enjoyed the tour of thehospital and also appreciated hearing about your work. The training opportunities available in the chemical dependency

program sounded particularly interesting. I am very impressed with your training program and think that XXX would be anideal place for me to continue my training.

Again, thank you for your time, and I hope that you will consider me for your program.

Sincerely,

Eager Student



79

INTERVIEWING



80

Interview Strategies: Set Yourself Up for Success By Matthew FitzGerald

APAGS chair

This is the time of year when many students think about upcoming interviews for programs, internships, postdocs and faculty positions.I remember how my own internship interviews last year evoked a curious combination of excitement and terror. These interviews aresome very challenging, high-stakes conversations, so I thought I'd share some strategies that worked for me:

PracticeEven the most outgoing and eloquent students can get tongue-tied at crucial moments. Keep this from happening to you byparticipating in mock interviews with faculty or peers, and make these practice sessions as realistic as possible. Generate or search forlists of common interview questions, but allow your interlocutor to throw in surprise questions so you can prepare for the unexpected.For internships, it's especially helpful to practice talking thoughtfully about past clients and sticky situations you've navigated withsupervisors. If you're interviewing to get into grad school, make sure you can expound on research or specialty areas you'd like toexplore. Practicing your answers to these questions will allow your actual interview to flow more smoothly and you'll sound morepolished.

PrepareInterviews can spark some serious anxiety. While you may not be able to completely block your worries, you can develop a plan tomanage them. For some people, deep breathing does the trick. Or perhaps you can practice a little mindfulness meditation in the lobbywhile you're waiting for your interviewer to arrive. If the timing is right, you might want to center yourself by going for a jog beforehand.Come up with an anxiety management strategy that works for you and plan how you can implement it during the interview. Rememberthat anxiety is a natural part of interviewing, so prepare for it as best you can.

Capture An interview is a chance for you to gather information, not just for others to learn about you. So, while putting your best foot forward,notice details that might help you decide among programs, interview sites or jobs later on. What was the feeling you got from the staff?Did people seem happy to work there? Does your future supervisor or advisor seem to value work-life balance? Could you see yourselfliving and working in the location? Immediately after your interview, write down what you noticed, liked or didn't like. Otherwise, youmight forget important insights that will help you decide among opportunities.

CareI remember being completely exhausted after my internship interviews. The combination of travel, anxiety and excitement left me indesperate need of a nap and some alone time. To keep from burning out, make time for self-care. Plan to take the rest of the day offafter an interview, or at least give yourself an hour or two to recuperate. Caring for yourself will help you stay balanced and prepared toperform your best.

Armed with these techniques, I found that interviewing was not as stressful as I had feared. I even found myself enjoying theexperience a little — it was fun to reflect on what I've learned and show off a little. We psychology students have a wealth ofopportunities to choose from, and interviewing gives you a chance to imagine yourself taking different career paths. So, whether you'reinterviewing for a job, an internship, a postdoc or acceptance to grad school, I wish you success and perhaps even a little bit of fun.



81

How to avoid interview misstepsThe dos and don'ts of internship interviews.

By Christopher Munsey gradPSYCH Staff

A psychology professor interviewing a graduate student for an internship slot once got a surprising reply when he asked,"Why did you apply to our program?"

The student shrugged and said, "It's the only one I could drive to."

"Kudos for candor, but not for social skills," says John Norcross, PhD, a University of Scranton psychology professorwhose colleague was the professor asking the question.

Most graduate students don't make such obvious missteps. At the same time, it's hard to overemphasize the importance ofinternship interviews. A 2009 online survey by the Association of Psychology Postdoctoral and Internship Centers(APPIC) found that 76 percent of internship training directors ranked interviews as "very important" in the selection

process, ahead of letters of recommendation, essays and cover letters.

How can you ensure you have a good interview? Prepare, says Norcross, co-author of "The Insider's Guide to GraduatePrograms in Clinical and Counseling Psychology" (The Guilford Press, 2008).

"Every internship director has the same lament," he says. "Students apply to multiple programs and they come askinggeneral questions that betray a lack of knowledge and preparation."

Here are more dos and don'ts, for your internship interview season:

Don't try to wing it, surviving on charm alone. Interviewers expect you to be conversant about what the training the site offers, as wellas the program's philosophy and theoretical orientation. Find out by studying each site's Web site and APPIC listing and commit thesedetails to memory.

Do develop a list of questions they are likely to ask you. Work out your answers and practice responding out loud, either in front of amirror or in a mock interview with a friend or fellow student.Don't be too honest. In particular, don't say you're interested in a site primarily due to its convenient location, even though that might

be a powerful motivator. Instead emphasize reasons for applying that training directors care about, such as how your skills, interestsand training goals match the site's training opportunities.Do take every opportunity to explain how your training, experience and professional goals fit with the internship site.Don't try to dominate group interviews by talking too frequently or undercutting points made by fellow applicants.Do demonstrate good social skills no matter what the interview scenario or with whom you are talking, including administrative staff,training directors or current interns. Make eye contact, smile and lean forward—and be punctual.

"The people who are doing the interviews want to see people who display all the qualities you'd want to see in a clinician: sensitivity,respect and social skills," says James Johnson, PhD, director of the University of Florida's clinical psychology doctoral program.

Don't schedule interview visits too close together, depriving yourself of time to relax, review and recover for the next round.Do build in time for travel delays due to bad weather—you will be traveling in January, after all. If you're flying, avoid the limbo oflost luggage by packing your carry-on with a nice outfit, copies of your curriculum vitae and work samples, any prescriptionmedication you take and some healthy snacks.

"It's hard to focus on an interview if you're focusing instead on your physical discomfort," says Tara Kuther, PhD, a psychology professor at Western Connecticut University and author of "Surviving Graduate School in Psychology: A Pocket Mentor" (APA,2008).



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Don't get so anxious about doing well that your brain is racing ahead to your next question. Good interviewees don't just talk well,they listen carefully, says Mitchell Prinstein, PhD, director of clinical training at the University of North Carolina at Chapel Hill, andco-author of "Internships in Psychology: The APAGS Workbook for Writing Successful Applications and Finding the Right Match"(APA, 2007). "Sometimes when people feel anxious, they might forget to convey what they're thinking or feeling," says Prinstein. "Alot of people forget to nod and to smile and to say they're excited about what they hear."Do remember that the interview process is a two-way street. Training directors want to assess whether you'd be a good match, butyou're also trying to find a program that meets your needs. "Feel empowered and recognize that this is a chance to be a consumer,"says William Robiner, PhD, training director for a pediatric psychology internship at the University of Minnesota Medical School. So,

on the interview remember that you are likely to have some choices among programs. In fact, if you've been invited for an interview atall, the site's training director probably thinks you'll succeed as an intern.

"They're really shopping for something that's a good match for them. That could take them out of the mindset of being hypervigilantof the evaluation of themselves," Prinstein says.

Don't wear jeans and a T-shirt. Both men and women should wear a suit. "You want to be remembered for what you say and not forwhat you're wearing," Kuther says.



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FINALLY …

Look, dress, and act professionally. First impressions are important! Don’t chew gum. Turn off your cell phone.Maintain good eye contact.

Be on time. Allow more than enough time to get there, and know where you are going. Know the name of the person interviewing you.

Be prepared for the interview. Know something about the agency before you get there, and why you want tointern at that agency.

Bring your portfolio, an extra resume/CV, and references.

Always ask questions about the site, supervision, training, opportunities, etc.

Be ready to talk about past experience (whether clinical or life experience). Know why you want to be aclinician.

Be prepared to hear a clinical vignette; sites will often ask you to evaluate the case and provide a treatment plan.

Understand at least two theoretical orientations, and treatment methods.

Be familiar with crisis assessment. Know what to watch for and some ways to intervene in a crisis.

Know your strengths, and weaknesses. Be honest about your weaknesses, and give examples for how you haveused these qualities to grow as a clinician.

Be succinct and direct; more is not necessarily better.

It is ok to say, “I don’t know, but I’ll find out”, or “I’d like to learn more about it.”

Pat yourself on the back after the interview. Evaluate your interview and use it as a learning experience for thenext interview



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SUPERVISION



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Making Supervision Work For You

On internship, you direct the quality of your mentoring more than you may realize.

By BRIDGET MURRAY

gradPSYCH Staff

As Natasha Howard started her internship last year, a clinical supervisor told her it was Howard's job to

determine what

makes

her

an

effective

therapist.

"Mine

is

just

to

help

you

achieve

that,"

her

supervisor

said.

The comment alerted Howard to just how much she needed to do to benefit from her supervisors at YaleUniversity's School of Medicine.

Of course, much of the responsibility of effective supervision also lies with supervisors. But interns often don'tshoulder enough of the responsibility themselves, largely out of deference, says Catherine Forbes, a George WashingtonUniversity clinical psychology doctoral candidate interning at the Didi Hirsch Community Mental Health Center in CulverCity, Calif.

"Over time I have seen students be afraid to be assertive, but not doing that can hinder your training," Forbessays. "And really, your supervisor won't get mad. They will talk to you about your questions and concerns."

SUPERVISION REDUX Those concerns differ based on your training needs and your supervisor's expertise, says Forbes. Many

internships, she notes, offer students multiple supervisors across areas such as therapy, assessment, trauma, groupintervention, community research, professional issues and career planning, and program evaluation.

The variety means students can tap the most supervision in their areas of least experience ‐and supervisorsexpect them to take that initiative, says Shane Lopez, PhD, a University of Kansas psychology professor who interned fiveyears ago at the Dwight D. Eisenhower Veterans Affairs Medical Center in Leavenworth, Kan. "They realize that you areonly a year away from independent practice, so they may expect more from you," says Lopez.

MAXIMIZING SUPERVISION

Given those expectations, when problems emerge, it often falls to interns to seek solutions. Based on theexperiences of Forbes, Howard and Lopez, here are some likely problems and potential solutions:

Problem: Scheduling difficulties. Interns and supervisors already have packed schedules, so finding time for weekly appointments can be tough. And when supervisors are off ‐site, it's that much harder, says Howard, a University of Georgia counseling psychology doctoral candidate. All too often, she says, weekly meetings get cancelled.

Solution: Hold your supervisor to appointment times and insist on rescheduling. At some sites, phone meetings are also an option. But if nothing works, let your internship director know, advises Forbes.

Problem: Too much focus on theory and not enough on you. "Some supervisors use the time to say how they do therapy, when you want to learn about how best you can do therapy," says Howard.

Solution: Arrive with an agenda. Have a list of questions, and make sure they get answered, advises Forbes.Adds Howard, "Always have in mind to steer the session back to your needs."

Problem: Fear of being faulted. Some interns are leery of letting on what they don't know, in case they might be judged negatively, says Forbes. "There's this fear of, 'Did I do something wrong?'"

Solution: Get over it. Be honest about your weak points and mistakes, advises Forbes. Ask for alternatives toapproaches you have tried, and seek constructive feedback, she says, since "that's how you learn and get



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better at what you do." At some sites, clinical supervisors are even willing to critique your taped or videotaped sessions with clients.

Problem: Being sidelined. Whether because of other priorities or dislike of teaching, some supervisors rarely seem to have time for interns. At one of Forbes's practicum sites, for example, one supervisor never spent more than 15 minutes with interns, which, she says, "just wasn't ethical."

Solution: Don't allow it to happen. Speaking out about the situation may feel like a strong step, but it's

often effective, says Forbes. At her practicum site, the interns insisted on more time from the unavailable supervisor ‐through talks with the supervisor and higher ‐ups ‐and they ended up getting it.

Problem: Not clicking with your supervisor. Being assigned to somebody you clash with can ruin your supervisory experience.

Solution: Try to pick your supervisors. This may sound impossible, since most internships assign them to you, but there are ways to link with people you like, says Howard. One way is to base your internship selection on the supervisors you'd have ‐looking for approachable professional role models, advises Lopez. Another is to pick an internship track or research area where you know you'll have a good mentor.

If you do run into conflicts with current mentors, talk openly and honestly with them about potentialresolutions. Or, if worst comes to worst, ask to be assigned another mentor. Based on her own positive experience,Howard says, "My strongest advice is to really look for one supervisor you can be very open with because that makesyour internship year so much more comfortable."



NOTES:

Documents

Clinical Training Manual 2014-2015