The internship, practicum, and field placement handbook: a guide for the helping professions

Preparation

The adventure begins

Internship classes and peer groups

Ethical and legal issues

Supervision

Diversity considerations in practice

Clinical writing, treatment records, and case notes

Stress and self-care

Assault and other risks

Closing cases

Finishing the internship

Frustrations, lessons, discoveries, and joy.

1. Preparation

Theory into practice

First the paperwork-then the adventure

A very brief word about terminology

Meeting with your instructor

Finding and selecting a placement

Institutional agreements

Liability insurance

Individual internship agreements

Evaluation

2. The adventure begins

Anxiety and excitement

First impressions

Euthusiasm meets experience

The role of the intern

The role of the professional

Making the most of your internship

Academia meets the "real world"

Take responsibility for learning

Remember that your do know some things

Get help when you need it

Meeting clients

Age and experience issues with clients and supervisors

Diversity issues with clients and supervisors

Time limits

Fees for service

Clinical and ethical issues pertaining to fees

Is treatment effective?

Evidence-based practice, empirically supported treatments, and practice guidelines

Inoculation: what not to learn on an internship

3. Internship classes and peer groups

Giving and receiving feedback as peers

The importance of empathy

Receiving feedback

Acknowledging imperfection

Structured class or group activities

Video or audio recording of sessions

Role-plays

Introduction to journal work

A record of experiences, reactions, and thoughts

Reflection and exploration

Noting questions, idea, and discoveries

Exercises from the text

Portfolios

4. Ethical and legal issues

Ethical standards of the helping professions

Specific ethical practice and treatment guidelines

Enforcement of ethical standards

Ethics, laws, and regulations

The health insurance portability and accountability act (HIPAA)

Ethical agreement forms for interns

Ethical decision-making and ongoing ethics study and training

Competence

Informed consent

Confidentiality

Release of information

Safeguarding records and the HIPAA security standards

Sharing information with colleagues

Electronic health records

Inadvertent confidentiality violations

Effects of confidentiality violations

Exceptions to confidentiality

Privileged communication

Abuse

Suicide and dangerousness to self

Intent to harm other and the duty to protect

Legal proceedings and court orders

Insurance company inquiries, managed care, and ethical practice

Confidentiality with minors

Dual relationships and boundary issues

Sexual relationships with clients

Maintaining professional boundaries and dealing with feelings of attraction

Nonsexual dual relationships

Post-therapy relationships

Relationships between educators, supervisors, and trainees

Ethics in classes and groups

Liability and insurance

Elements of malpractice

Liability insurance

Technology and ethics

Research ethics

Ethical and professional concerns about colleagues

Establishing a personal, core ethical identity and a central

Commitment to ethical conduct

5. Supervision

What is supervision?

Hopes and fears of interns

Hopes and fears of supervisors

Supervisor liability risks

Supervisor preparation

Clarifying expectations

Frequency and timing of supervision

What happens in supervision

Supervision as teaching

Case notes and discussion

Empathy and experiential considerations in case

Discussions and mistakes to avoid

Video and audio recordings and role-plays

Live supervision

Observing the supervisor in therapy

Remote supervision: internet, telephone, and other technologies

Group supervision

Theoretical orientation

Supervision and therapy: differences and similarities

Differences between therapy and supervision

Exploring the needs and personal qualities of interns

Resistance to self-awareness and change

Transference and countertransference

Suggested guidelines for therapy and supervision

Problems arising in supervision

Ineffective, inadequate, and harm supervision

Guidelines for dealing with conflict

Competency-based training and evaluation

Evaluation of supervisors

Planning for future supervision

6. Diversity considerations in practice

Background

Reasons for diversity training

Resistance to diversity training

Critical concepts in multiculuralism: an evolution

Self-awareness: knowing the diversity within us

Confronting our biases and acknowledging what we don't (yet) know

The historical context must be acknowledged terminology matters

Recognizing and honoring strengths

Understanding gender

Developing culturally sensitive and relevant skills

Advocacy and activism

7. Clinical writing, treatment records, and case notes

Writing skills

Writing can be learned

Improving writing for students whom English is a second language and other culturally diverse students

Focused reading learn writing

Practice and feedback

Rewriting

Common writing problems

Caution: tastes, supervisors, and instructors vary

Keys to good writing

Simplify your writing but not your clients

omit needless words

Choose words carefully

Clarity

Know your audience

The function and maintenance of records

What goes into records

The clinical interview

Treatment plans

What stays out of records

Protecting clients

Protecting yourself

Progress notes and psychotherapy notes

Standards formats

Progress notes

Types of progress notes

Type of progress notes

Structured note formats

Soap notes

Description

Assessment

Assessment

Response

Treatment plan

Psychotherapy and time-sequenced notes

Process notes

Signing notes

Dictation

Progress notes and supervision

Using your notes

Other guidelines

8. Stress and self-care

Client after client, day after day

How common is stress among interns?

Trainees with competence problems

The effects of stress

The effects on close relationships and families

Physical effects

Effects on social relationships

Secondary trauma

Client suicide

Natural disasters, terrorism, shootings, and war

Burnout

Symptoms of burnout

Stages and subtypes of burnout

Causes of burnout

Individual factors

Organizational factors

the state of the world

Recognizing and understanding your own situation and burnout

Burnout as a coping mechanism

Self-care

Time management

Saying no

Saying yes

Closing sessions

Cognitive self-care

Cognition about clients

Cognition about therapy

Cognition about the world

Physical self-care

Physical exercise

Message

Monitoring stresses in the body

Healthy eating and habits

Emotional self-care

Self-checks

Cleansing rituals

Meditation and prayer

Organizational factors and structured stress management

Letting off steam

Multimodal self-care

Personal therapy

Positive effects on therapists

Financial self-care

9. Assault and other risks

Risks of assault or other forms of aggression

Inadequacy of training

Seeking assistance

Strange behavior and strange people are not necessarily dangerous

Understand developmental differences

Understand and recognize motivational factors

Situational factors and violence

History

Stress

Controlled substances and medications

Client mental status

Weapons

Recognize potentially dangerous individuals

Assessing ourselves in relation to violence assessment

Early prevention of violence

Institutional responses to threats of violence

Prevention of imminent client violence

Responding to assault

Clothing

Office layout

Communication

Dangerous and defensive implements

Assault-response training

Aftereffects

Stalking

Social networking, personal privacy, and safety

Communicable diseases

10. Closing cases

Ethical considerations and closing cases

Understanding client reactions

Understanding client reactions

Understanding intern reaction and contributions to termination

Common problems in termination

Toward successful termination or transfer

When and how to notify clients

Issues to address in termination

Techniques for termination

Transferring clients to other therapists

Goodbye means goodbye

Preparing treatment of discharge summaries

11. Finishing the internship

Concluding the supervisory relationship

Reviewing the intern's progress and areas for further growth

Feedback to supervisors

Ending the supervisory relationship

Letters of recommendation

Requesting letters

Guidelines for soliciting letters

Procedures for those seeking letters of recommendation

Concluding relationships with staff

Letters of thanks

Looking ahead

Professional, community, and political involvement

12. Frustrations, lessons, discoveries, and joy

Learning from whatever happens

Lessons we wish were not true

The systems in which we work

The clients with whom we work

The nature of the problems

The limits to our knowledge and tools

The people in the profession

Lessons about ourselves

Lessons about ourselves

Lessons about the lessons

Discoveries and joy

People in the profession

The systems in which we work

The clients with whom we work

The nature of the problems

The limits to our knowledge and tools

Lessons bout ourselves

Closing comments

Appendix: Selecting or establishing an internship site

Finding or selecting an internship site

Community resources

International placement

Choosing a placement

Supervision

Learning opportunities

Treatment approaches

Clients

Programs and settings

Research opportunities

Career plans

Practical issues: location and times

Competence and safety

Preparing your internship application

Letters of application and recommendation

Interviews

Internship agreements

References.