To complete a doctoral degree in Clinical or Counseling Psychology, a year-long internship during the final year is required (American Psychological Association [APA], n.d.). Yet, the process to obtain an internship accredited by the APA is competitive, with many students needing to relocate to other states across the country due to historical imbalances between available internships and student applicants. In 2011, only 52% of students in accredited doctoral programs nationwide matched to an accredited internship through the Association of Psychology Postdoctoral and Internship Directors (APPIC) national match (Doran & Cimbora, 2016). Despite APA’s and APPIC’s efforts to improve the internship crisis by increasing the number of accredited internship sites, in the most recent match, 14.6% of students from accredited doctoral programs and 72% of students from non-accredited doctoral programs matched to internships that were not accredited (APPIC, 2016). According to Doran and Cimbora (2016), one proposed way of increasing more sites is for doctoral programs to create affiliated internships through the program’s mental health clinic or through affiliated practicum sites.
An affiliated internship is an internship that selects students from a specific doctoral program. Although these internships are closely associated with their home programs, as with all internship programs, they are independently accredited by the APA Commission on Accreditation. According to current listings in the APPIC Directory Online, of the 770 total internship sites, 17 are partially and 10 are fully affiliated (APPIC, n.d.).
Internships affiliated with doctoral programs may elect to create a consortium of sites. An internship consortium consists of multiple independently-administered sites that have agreed to pool resources to provide a training or educational program (Illfelder-Kaye & Knauss, n.d.). A consortium model can provide a variety of training opportunities for interns. In an affiliated consortium, the doctoral program selects sites from the community, and pools their resources to create a training program (Erickson Cornish et al., 2005).
The University of Denver Graduate School of Professional Psychology (DU GSPP) established an APA accredited exclusively affiliated internship program in 1998. This program was developed to meet the needs of GSPP doctoral students who wished to remain in the Denver area for internship (Erickson Cornish et al., 2005). Initially, the program was affiliated solely with the Counseling Center at DU. However, to meet the needs of students who sought specialty training, the program decided to move to a consortium model in 2001. The internship training director recruited additional sites to join the consortium, resulting in the conglomeration of six sites and ten internship positions (Erickson Cornish et al., 2005).
The DU GSPP Internship Consortium follows the “sun model” of internship consortia, a model in which the sites are the “rays” and the academic program is the “sun” (Erickson Cornish, personal communication). Interns apply to and are matched to specific sites within the consortium during the APPIC matching process, and work exclusively at that particular site. Interns come together to meet at DU on Fridays for didactic seminars focused on professional issues, research, multicultural issues, and psychological assessment. These seminars take place either on the DU campus or at one of the eight sites within the consortium (two university counseling centers, a large community mental health center, a health maintenance organization, a residential treatment facility, a police psychology agency, an agency focused primarily on assessment and treatment of autism spectrum disorders, and an agency assessing and treating sex offenders).
The current format of the DU GSPP Internship Consortium consists of eight internship sites with 13 internship positions. In 2015, the DU GSPP internship consortium matched only six of the 13 internship positions during Phase I of the APPIC match, leaving six spots vacant, with one site declining to participate. For the first time since becoming exclusively affiliated in 1998, the DU GSPP Internship Consortium opened the remaining spots to the Phase II National Match. Following the Phase II National Match, five additional consortium spots matched with doctoral students from clinical and counseling psychology PhD and PsyD programs across the United States. The 2015-2016 internship cohort marked the first year since 1998 in which the internship class was partially rather than exclusively affiliated with GSPP.
The idea for the current paper originated from the 2015-2016 intern cohort of the DU GSPP Internship Consortium during the weekly research seminars, which require the development of a shared project. As part of the first cohort blended from various doctoral programs in clinical and counseling psychology, we were curious about our own experiences and whether those might help inform similar programs. Thus, the aim of this paper is to capture the varied experiences from the members of the internship class and to provide future recommendations for other exclusively affiliated programs who may open their programs up to the national match in the future.
Data were collected from 11 pre-doctoral interns from the DU GSPP Internship Consortium. Six participants (54.55%) were from the DU GSPP doctoral program and five participants (45.45%) were from PsyD or PhD programs across the United States. The sample was composed of eight females and three males, ranging in age from 26 to 37 years (M = 30 years, SD = 3.74). All participants (100%) self-identified as White/Caucasian. Nine participants self-identified as heterosexual, one participant self-identified as gay and one self-identified as lesbian.
An author-derived questionnaire was created for all participants that contained demographic questions and open-ended prompts for participants to write narratives. These prompts included the best and worst aspects of consortium, diversity, group cohesion, and novelty and added value of didactics compared to program of origin.
Questionnaires were distributed to participants who were instructed to respond to prompts on the questionnaire. Participants were instructed to not include their names on the questionnaires in order for the data to remain anonymous. After data collection, the narratives were analyzed for common themes.
Given that the data were phenomenological in nature (i.e., involving a description of a phenomenon), the goal was to arrive at an understanding of the essential themes of each participant’s subjective experience. We reviewed the narratives and highlighted significant statements, key words, and quotations that were relevant to understanding each participant’s experience. Upon examining the narratives, we developed clusters of keywords and statements based on the themes (Creswell, Hanson, Plano, & Morales, 2007; Sandelowski & Barroso, 2003).
With regard to positive aspects related to our partially affiliated consortium year, themes included having a strong support system of peers (6), interpersonal diversity (6), and professional diversity (11). Many students commented on how much they enjoyed spending the Friday consortium time together with their peers and viewed this as supportive. As one person wrote,
Coming together at the end of the week to share in each other’s experiences, whether suffering or celebrating, has been both a pleasant way to end my week and feel connected to others during a year which seems to universally be viewed as difficult.
The two other common themes focused on the diversity brought both by the mixed consortium group and the exposure to the diversity of different sites and seminar topics. In regards to interpersonal diversity and the richness it brings, one person wrote, “I have loved having folks from different programs, as it exposes me to totally different ways of thinking about psychology.” Another stated, “It has been especially nice to have some new students in the group from programs other than GSPP. They have brought a diverse and interesting perspective that would likely be missing if the group consisted only of GSPP students.” Students also commented on the diversity of the training experience provided by different speakers and sites. For example, one student described enjoying the “exposure to different theoretical orientations, interventions and training experiences with the mixed cohort. Site visits provide exposure to new psychological positions and jobs” and another commented, “one of my favorite parts has been the exposure to different topic areas not covered at my internship site, such as sex offense treatment or risk assessment.”
There were also some negative themes that stood out from the student narratives. In particular, the majority of the students (6) commented on the experience of “forced intimacy,” especially during the diversity seminar, which included experiential “target journeys” focused on sharing personal experiences in order to better understand oppression and privilege. The varying levels of familiarity with one another seemed to bring about a sense of artificial bonding, or a superficial intimacy, which many students found uncomfortable. This also may be due to the fact that some individuals come from less “process oriented” programs and were unfamiliar with the procedures associated with target journeys. As one student wrote, “It is uncomfortable to listen to people divulge such intimate information about themselves because I feel as though many of these stories require a significant amount of vulnerability that I haven’t earned because I am essentially an acquaintance.” Another student commented:
Some of the same aspects that make the mixed consortium a positive experience may also contribute to some negative components. For example, since we are a mix of different cohorts there does not exists the same group cohesion and relational history that was shared with other GSPP students. This may create a sense of a false intimacy between the group members, who may feel more pressured to disclose something but not feel fully comfortable.
Some students, including those from both GSPP and outside programs, commented that their sense of not belonging might be due to the fact that they are alone at their sites, which made it more difficult to bond with other consortium members. The importance of having other GSPP interns with whom to bond seemed particularly true for students from outside programs.
Discussion and Recommendations
There were varied program affiliation among the students, and these differing affiliations may have had an influence on the themes that stood out in the narratives. Due to the nature of this project, it is difficult to say which themes may be truly unique to a mixed consortium group, and which arise regardless of whether the consortium is composed of a group from mixed universities or only DU. Due to the small number of participants and the fact that students would be reading each others’ comments, the nature of this project may have made the participants particularly self-disclosing or self-filtering. Further, some students were alone at their individual sites, while others had opportunities to bond with as many as three other interns at their site. Some of the GSPP students came from the same cohorts. This unique compilation of people allowed for many of the positive aspects to be brought forth, but in some cases also lead to some negative experiences.
We have several recommendations for future consortia. Overall, our results endorse the general notion of having a partially affiliated consortium; however, there are several considerations to keep in mind. First, our results indicate that the ratio of affiliated and non-affiliated students is important; a cohort with only one or two non-affiliated interns could prove difficult for those from outside programs. If the ratio of affiliated and non-affiliated interns is not balanced, we hypothesize that the ratio should be in favor of a larger proportion of non-affiliated interns. In the event that the match process does not produce a balanced ratio, we recommend employing some of the strategies listed below, such as the “buddy” system.
Second, our results imply that it may be important to expose national candidates to the culture of the affiliated doctoral program before the internship year starts. Comments from non-affiliated students described how their programs were less process-oriented, how they were unfamiliar with some of the psychotherapy theories taught at GSPP but not in their home programs, and how the concept of “target journeys” was completely foreign to them. Additionally, something as small as calling professors and seminar leaders by their first names and not using the prefix “doctor” was unfamiliar to many non-affiliated students. It may have been helpful to provide these students with information about how the affiliated doctoral program curriculum includes studying the science of marginalization, and how students have historically explored their own marginalization through target and non-target journeys. This background would have provided context for the non-affiliated students, and likely decreased the feelings of being “outsiders.” Some non-affiliated students also commented how they expected a more didactic experience based on the description in the training handbook. Students commented on being surprised at the amount of experiential learning in the diversity seminar. Again, being provided materials at the beginning of internship describing the culture and “what to expect” would likely be beneficial. Additionally, more team-building events at the beginning of internship would help build group cohesion.
Third, regardless of whether a consortium is fully or partially affiliated, we recommend that no student be the sole intern at a site. Interns tend to make the strongest connection with other individuals at their same sites, and interns who are alone may miss out on this important sense of connection. Feeling less close to other students likely contributes to the sense of “forced intimacy” about which several participants commented. If students feel more genuinely connected, they more likely to believe they have “earned the right” to hear other people’s deeply personal experiences. Similarly, we recommend that individuals are not required to share comments after intense experiential exercises, (such as the journeys) as this may also contribute to a feeling of disingenuousness and “forced intimacy.”
Another possible adaptation to increase cohort cohesion, particularly between affiliated and non-affiliated students, would be to match affiliated with non-affiliated interns in a “buddy” system. Providing non-affiliated students with a liaison who is intimately familiar with the affiliated doctoral program and its system and culture and would help these students more quickly feel part of the community and would provide them a contact person for any questions or concerns the non-affiliated student may have. Matching of non-affiliated and affiliated students could be done based on clinical interest, theoretical orientation, past life experience, or a number of other factors.
Overall, interns reported varied experiences with a mixed cohort. Our results indicate that partially affiliated internship consortia may be beneficial, but future research is needed to clarify how they should be organized to provide the best training experience possible for interns during years that include both affiliated and nonaffiliated interns.