Section 4: Clinical Work

Clinical Practica

Sequence of Practica

Clinical training occurs in the following manner. In the second year, students see clients at the University Counseling and Psychological Services (CAPS) in the fall and spring semesters (taking PSYCH 546) as well as perform psychological assessments (e.g., ADHD and LD evaluations with college students) in the Psychology Clinic (PSYCH 537). The primary practicum placement for third year students is PSYCH 545 in the Psychology Clinic. In years three and beyond, students have some flexibility in tailoring their practicum training sites to their areas of interest, including having both a primary and secondary training site. In addition to the Psychology Clinic, third years may be approved to seek training in a minor practicum at an externship site. Beginning in the fourth year, students may opt for either majors or minors at an externship site or continue to train in the WSU Psychology Clinic. Students completing an externship register for PSYCH 548 (Clinical Externship). Students entering the program with a master’s degree in clinical psychology may have the option of starting their practicum training earlier than is typical and should consult with the DCT about this option.

Unless granted an exception, all students beyond the second year must be involved in one of these practica placements. Students must also be involved in at least one clinical practicum each semester in years three and four.

Students are encouraged to be involved in summer practicum each summer starting in the summer after the second year but are not required to register for courses.

Practicum experiences are coordinated by Hsin-Ya Liao.

Important: The CTC may require that a student complete additional semesters of in-house practicum before being permitted to participate in off-campus clinical externship experiences.

Practicum Evaluations

At the end of each semester, the practicum supervisors (in the WSU Psychology Clinic or at other sites) will provide each student with a formal evaluation. Appendix I provides copies of the practicum evaluations completed on students. These evaluation forms highlight the 9 Profession-wide Competencies identified by APA and cover the skills that students are expected to demonstrate in their clinical training. Students will be rated as Exceeds Expectations, Meets Expectations, or Development Required on these skills. In addition, students are given written, qualitative feedback on their strengths, and suggested areas for future growth. In addition, once the semester is completed, students complete an evaluation on their practicum supervisor.

Clinical Work Outside the Program

Because the clinical faculty have a responsibility to the profession of psychology to ensure that students show appropriate professional behavior during their training years, it is required that all student work of a psychological nature outside of the Clinical Program be approved by the clinical faculty. Regardless of their prior training, students will not be approved for such work prior to the successful completion of their first full year of practicum training at the Psychology Clinic (i.e., no earlier than the summer following their third year in the program) and then only if:

• they are meeting all of the program milestones,
• they are in good standing, and
• their major professor approves.

Thus, students should not engage in research, therapy, assessment, or the teaching of psychology without the prior approval of the clinical faculty. Students are required to make such requests in writing to the DCT who will then present the request to the clinical faculty.

Clinical Case Conference

The clinical case conference portion of the Clinical Program Meeting is considered an important part of the clinical training experience. Students participate both as a presenter (during their third or fourth year) but also gain valuable knowledge through participation as an attendee at the clinical case conferences all other years.

During the third or fourth year of the program, students will present a clinical case conference (therapy or assessment case) at a program-wide meeting, which will give them the opportunity to demonstrate their case conceptualization skills and articulate their theoretical orientation to therapy. The format involves a presentation and question and answer period (described in more detail below). The clinical case conference will be attended by the CTC and other non-presenting students in the program.

General Outline for Clinical Case Conference Presentation

1. Provide a brief overview the presenter’s theoretical orientation. What are the presenter’s beliefs and assumptions about the mechanisms of change/how therapy works? This orientation should inform the case conceptualization and treatment approach under point 5.
2. Provide general identifying information (but not names or other distinctive identifying information) and reason for referral for the case.
3. Provide background history that is relevant to case conceptualization (keep brief).
4. Provide assessment information and behavioral observations.
   1. All cases should have some type of assessment information even if seen for therapy.
   2. If a full psychological assessment preceded treatment, it would be appropriate to present that data as well.
   3. Provide a good description of the onset, duration, and severity of symptoms, the level of impairment, and the settings in which both symptoms and impairment take place.
5. Provide a coherent case conceptualization that informs evidence-based approaches to treatment.
6. Describe the main treatment objectives (for assessment-only cases, describe assessment-informed recommendations).
7. Describe the outcome goals.
8. Describe the client’s response to treatment thus far (for assessment-only cases, describe assessment-informed recommendations).
9. Describe any anticipated or encountered barriers to treatment (or implementation of assessment recommendations) and plans to overcome them.

Clinical Case Conference Format

1. Each student will be scheduled for an individual case conference, which will be held over zoom. Students may present a case either from our on-campus clinic or an externship site. The case must be cleared with your supervisor to be presented in case conference. Regardless of the origin of the case, only pseudonyms should be used during the case conference (no names or other obvious identifying information).
2. The case conference will be attended by the clinical faculty and all of the students. Students must clear any case conference absences with the DCT and their major professor. Such absences would only be allowed for extraordinary circumstances or sickness (just like a class).
3. The presenting student will deliver a formal presentation (using visual aids, i.e., PowerPoint). The presentation should start promptly and not exceed 30 minutes.
   1. Attending students should not ask questions during the presentation but are encouraged to take notes and ask questions at the end.
   2. Faculty will also ask minimal questions during the presentation but may raise a question for a point of clarification if deemed necessary.
4. A question-and-answer period will follow the case presentation. It will last for no more than 20 minutes.
   1. First, faculty will ask a series of questions for up to 15 minutes.
   2. In the final 5 minutes of the question-and-answer session (or earlier if faculty have completed all questions), the floor will be opened for questions from students.
5. After 50 minutes (30-minute presentation and 20-minute Q&A), attending students will be dismissed, and the faculty will provide oral feedback to the presenting student.
6. Brief written feedback (see “Written Evaluation Form”) and objective performance ratings will also be given to the presenting student within 2 weeks of the presentation. A copy of the feedback will also be placed in the student file.

Clinical Case Conference Evaluation

All attending faculty will complete the Clinical Psychology Case Conference Evaluation Form (Appendix J), which includes ratings for up to 11 items on a scale from 1-Fails to Meet Expectations to 3-Exceeds Expectations, with 2 representing a performance that Meets Expectations. The DCT will aggregate the ratings across all attending faculty for each item to obtain a mean for each item and will average the ratings across all items means to obtain a grand mean. A grand mean (i.e., an average total score, rather than a summed total score) will be used because not all items will be applicable to all students. To pass the clinical case conference, the student will have to earn a grand mean of 2.0 or higher.

Clinical Internship

The completion of a full-time 12-month internship is a requirement for graduation from the clinical program. The Ph.D. degree is awarded only when both the internship and dissertation are completed. Students are expected to begin the internship at the start of their fifth year. The clinical program fully conforms to the APPIC (Association of Psychology Postdoctoral and Internship Centers) procedures and requirements pertaining to doctoral clinical internship application and acceptance. You should be versed in those policies and procedures early in the academic year immediately preceding your internship year. These policies and procedures can be found online at the Association of Psychology Postdoctoral and Internship Centers and the APPIC Internship Matching Program. Students should track their clinical hours and experiences using a format that is compatible with the APPIC applications (currently Time2Track or an appropriately formatted Excel sheet). The CTC requires that the internship agencies to which you apply be accredited by the American Psychological Association (APA). If you do not Match in Match I and wish to apply to an internship that is not APA accredited in Match II, you must receive approval from the CTC before submitting the application. Please provide a written justification to the CTC, who will then consider your request.

With some exceptions, students usually apply for internship in the fall semester of their fifth year. Students cannot apply for an internship until they have passed their preliminary examination, their dissertation proposal has been approved by their committee, and they have passed the clinical case conference. See Appendix H for specific deadlines for the preliminary exam and dissertation proposal. In addition, the CTC uses the Council of University Directors of Clinical Psychology (CUDCP) Expectation for Internship Eligibility (Appendix K) to determine internship eligibility. The only exceptions are:

1. #5 (completed all coursework) if a student has one or two remaining courses to complete due to the timing of course offerings;
2. #7 (published an article or a book chapter as an author or co- author or presented at least three papers, etc., at conferences) as only submissions of articles and/or book chapters is required.

However, you will only be endorsed as internship eligible if you will have all coursework completed at the time of leaving for internship. The student’s clinical readiness for internship is evaluated by the clinical faculty in the semester prior to the application process. You are not permitted to apply for internship until the CTC has judged you to be internship ready.

Please note that if you entered the program with a master’s degree from another institution where you gained supervised clinical hours that you plan to report these terminal master’s hours on your AAPI, you need to have your training director, major professor, or primary supervisor from your master’s program communicate in writing to the DCT to verify the terminal master’s hours that you have recorded. This information is necessary for the DCT to be able to later verify your terminal master’s hours at the time that you apply for internship. Without verification from a representative from your master’s program, the DCT will have to choose the option stating that the terminal master’s hours cannot be verified.

Either in the summer (if everyone is available), or early in the Fall semester, the DCT will meet with the prospective interns for the purpose of discussing the internship application process and communicating guidelines. As internship deadlines are approached, the DCT will meet with prospective interns a second time during the Fall semester to answer any questions. The DCT, as well as the other CTC members, will help you identify potential internship facilities that might be a good match for you and assist you with specific items on the internship application form. The CTC understands that the internship interviews can be inflexible and time-intensive, and your schedules (e.g., clinic duty, assistantship hours) will be adjusted accordingly. On APPIC Phase I Match Day, the DCT and other members of the CTC will be available to consult with any students who receive notification that they did not match with an internship program. The DCT and CTC can provide further information and assistance with the application for APPIC Phase II Match, if the student decides to apply for the Phase II Match.

Your doctoral clinical internship agency will provide the DCT with periodic evaluations (e.g., mid-year) of your progress. These evaluations, in turn, will be made available to the CTC. We will not award credit for internship until the director of training at the internship site has informed us that you have fully completed all requirements. The PhD will not be awarded until all program requirements have been met, including completion of the doctoral clinical internship. Thus, you will not graduate from the clinical program when even a small portion of your internship requirement remains to be completed. The DCT will not certify to the Graduate School or Registrar’s Office that your internship has been completed until confirmation of that fact has been provided by the appropriate authority.

Supervision and Consultation Series

Each academic year, three of the Clinical Program Meetings will be reserved for topics that are part of the Supervision and Consultation Series. Unique topics will be presented each year during a four-year period (no repeated topics). Thus, students will be exposed to 12 unique topics related to supervision and consultation during their first four years in the program. The topics in this series will be presented by clinical faculty or qualified guest speakers. Readings will be provided in advance of the presentations, which students are required to read prior to attending the meeting. Students are expected to attend all 12 meetings (their attendance will be documented on Zoom) and are required to do make-up work if they miss a meeting. Presentation notes will typically be provided to the students via the clinical listserv after each meeting. Following each topic, students will take a Supervision and Consultation Written Assessment Quiz to assess their knowledge of the material presented. Handouts and readings may be used as a reference for the written assessment quizzes. Participation in the written assessments is mandatory; however, its purpose is to provide program outcome data, and the results of the written assessment do not impact the students’ grades. Nevertheless, if the results of the written assessment indicate that a student requires some remediation in knowledge, the student will be provided additional materials and instruction as necessary.