Speaker 1: Welcome to Grad Life Grind. If you're new to this channel, thank you for checking it out. And if you're already a subscriber, thanks for being back again. My name is Arielle, and I'm a PhD student in clinical psychology. And in this channel, I bring you information about the mental health field and talk about my journey as a PhD student. There are so many jobs in the field of psychology, but one of the primary career goals of psychology graduate students is to become a licensed therapist. And in order to become a therapist, you have to learn how to do therapy with actual clients. In this video, I'm going to explain how students are trained to become therapists, or what student therapists actually do. Some of the things I'm going to cover include where psychology students get training and see clients, how they're supervised, how they're evaluated, and at the end, I'll also talk about how you can get low-cost therapy by seeing a student therapist. So first of all, like I said, graduate students in psychology programs, if they're in a counseling or clinical or even school psychology type of program, they will learn to do actual clinical work. And programs have different names for this. In my PhD program and a lot of others, it's referred to as practicum. And you can think of this training similar to the training that med students or nursing students get, where they actually see patients. So graduate students in psychology, either at the beginning of their program or after they reach a certain point in their program, will start seeing clients for therapy. It's important to know that at this time, the graduate students are not licensed therapists. In fact, they're working under a supervisor who is a licensed psychologist. So my supervisor is a licensed psychologist, and she has many roles and many jobs, but one of her primary positions is as a clinical supervisor. And she works at the practicum site where I'm training, and we meet on a regular basis about the clients that I'm seeing under her license. That means that supervisors are responsible or liable for the clients that their trainees are seeing. So the main takeaway here is, yes, graduate students do see clients for therapy, but they are not licensed, they are working under someone who is licensed, and they are getting regular supervision. So what happens in supervision? Every supervisor has a different style. Most graduate students are meeting one to two times a week, maybe more, with their supervisor to go over the cases that they're seeing. And in addition to regular supervision, many sites also audio and or video record the sessions. At my site, all the sessions are video recorded, and that means that the clinic directors and my supervisor have access to the videos and can see what is going on during my sessions. Right now, everything is on Zoom, but I record all of my Zoom sessions. And when the clinic was open, all sessions were audio and video recorded. That's actually a requirement for our clients to be seen at that clinic. So that means that student therapists have multiple types of supervision. One is they're meeting one-on-one with their supervisor probably at least once a week. They're also meeting in group supervision, which means that their supervisor, who is a licensed psychologist, is meeting with all of their trainees, usually also once a week. And in addition, the supervisors and clinic directors have access to the recordings of each session that a trainee does. So there are multiple layers to make sure that clients are getting the best care possible, even though they're seeing a trainee. My supervisor has a different style for our one-on-one sessions versus the group supervision. And basically what we do in individual supervision is we talk about some important things that come up in therapy with my clients. If I need questions asked, if I'm not sure what to do with something, if I want to take the client in a different direction and I need advice on how to go about that, that's what we discuss. If there's a clip of a session that I think that my supervisor should see, I can let her know beforehand so that we can talk about it in individual supervision. In group supervision, my supervisor likes for each of us to play a clip of one of our sessions, and we talk as a group about how to conceptualize the case, what things went well, what things we could work on. And supervisors, like I said, have different styles. I know that some of my friends have supervisors who like to do didactics or actual training, kind of like a lecture style in their supervision, so that they're learning about different types of therapies. And of course, whether a therapist is licensed or unlicensed, training, or has years of experience, the main priority is the well-being of the client. So even though student therapists are in training, they're grad students, the main focus of these therapy sessions is not for the therapist to learn a ton, it's really for the client to get the best care that they can get. One common question is, are student therapists seeing clients alone? In my experience, yes. I see clients alone, one-on-one, or if I'm with a couple, two-on-one, on Zoom, or in person once things open back up. And like I said before, the only way for supervisors or clinic directors to see what's actually going on in the sessions is to watch the recordings. Maybe there are some sites out there where the training requires that a licensed psychologist is in the room with their trainee. I haven't experienced that personally, but I could see the possibility of maybe bringing in my supervisor to talk to a client with me if there's something that I'm really struggling with. So what are student therapists actually doing? They're seeing clients for therapy, and there are tons of different types of therapies. And basically what graduate students do in therapy with these clients is really contingent on the supervisor. So some supervisors have a certain treatment orientation. For example, they only like to do CBT, and they may require that their students only do CBT as well. And just for the record, CBT is cognitive behavioral therapy. Some supervisors, like mine, are super open, and they would like to see what their trainee comes up with in terms of the therapy they think is best for each client. But in general, student therapists should be doing treatments with their clients that are evidence-based. They're doing therapy styles or treatment plans that are relevant to their client based on the literature or the research that's available. So even though my supervisor is flexible and she wants to know what I think would be best for the client, that decision is based on what's in the literature. So if I have a client with depression and I know that CBT is the number one treatment based on the research, then I can present that to my supervisor and say, I think I want to do CBT because this is the research and I think it applies well to my client. What do you think? Ultimately, what's important here is that the last call is always on the supervisor because their license is on the line here. But I just want to make sure that you know that student therapists are not just doing whatever they want in sessions with clients. They should be following a treatment plan that they develop with their supervisor. They should be looking at the literature or the research that's out there to figure out what's the best thing for their client. And of course, they should be asking their client what they're looking for and what their goals are. So student therapists are not winging it, or at least they shouldn't be. They do have a method and that method is typically dictated by the supervisor. So the next thing is where do students train to become therapists? So different graduate programs do this differently. Some graduate programs have a mental health clinic within their university and that's where they have their students train. I interviewed for a PhD program where that was the case. I was going to be working primarily in that university's clinic seeing clients that they get from the community, college students that go to that school, and so forth. Some universities do not have their own training clinic so they will place their students out at different practicum sites. And there are really a huge range of practicum sites. Some students go to community mental health clinics. Some students can also train at shelters for people experiencing homelessness. So there's a big range of where students are trained. At my program, we do have a university clinic and that's where we do our first year of practicum. So that's where I am now. In the next couple of years, I will go to a different practicum site each year and my program is really involved in helping me to apply to those sites that I want to get to. So long story short, the design of the program that someone is in pretty much dictates how their practicum or clinical training will go, whether they're going to be internal, external, or both. And most graduate programs that lead to licensure require an internship and for PhD programs, that's a national match. So we can do internship anywhere in the country where we apply to. So what's really nice about doing practicum at a different place every year like I'm doing in my program is that I can really decide how I want my training to look. In order to be a competitive internship applicant, I really want to make sure that I'm well-rounded clinically and so that means I'm picking different places each year that are going to fill gaps in my training so that I can learn the things that I haven't done before. And in the future, once I go through the practicum application process for next year, I can do a video on what that is like. But for now, just know that students can get a huge range of clinical experiences based on where they do practicum. And just know that at every practicum site, there is a training director or a supervisor that is in charge of the students that are seeing clients there. So one question that may arise is, if students are seeing therapy clients by themselves, even though they're being recorded, what about a crisis? What happens if a client is really distressed, really not doing well, or maybe is suicidal? What do students do then? And these protocols depend on the training site, but typically there's going to be an on-call supervisor that is available either in person, and the student therapist can call that supervisor in immediately, or there's an on-call supervisor that's available by phone if the sessions are remote. Right now, since all my sessions are remote because of COVID-19, there's always an on-call supervisor that I can reach out to by phone in case I need to do a risk consult. And there's a number of reasons why a student therapist might do a risk consult, and I won't get too much into that, but some of the reasons are if a client is suicidal, if a client is homicidal, if a student therapist finds out about any type of suspected abuse. This is a situation where you would want to consult a supervisor, and consultation is something that is very important in the field of psychology. Consultation just means that you're reaching out to another licensed psychologist and running something by them to ensure that you cover all your bases in terms of providing the best care for that client. And consultation is something that psychologists should do throughout their career, but it's especially important for trainees because we aren't licensed. So the takeaway here is that even though student therapists are seeing clients on their own, there's always that buffer to fall back on because supervisors are available all the time. Another major part of clinical training is clinical writing or documentation. So student therapists or graduate students who are seeing clients are not just doing therapy. They are also writing progress notes, treatment plans, risk notes if they're applicable, and also assessment reports. And the reason why this is a huge part of clinical training is because documentation is a big part of what therapists do on the back end. So when you're paying for a therapist, you're not just paying for their one-on-one time with you, you're also paying for time spent on writing their notes, planning the treatments, looking at research for what would be best, and so much more, including consultation. So I can only speak for my program, but as a trainee, I'm required to submit progress notes for every session that I do. I also am required to write treatment plans after I've seen a client for four to six sessions, and I work on this treatment plan with my supervisor to figure out what are the factors that brought this client into therapy, what kinds of things can I work on with them, what goals do they have, what does the research say, what diagnosis might they have, and so forth. I'm also responsible for administering assessments during therapy, and that's a whole other thing that I won't get too much into, but they're basically questionnaires that I administer to the clients, and I also have to write out what the results of those questionnaires are when I do my progress notes. And all this documentation is reviewed by my supervisor. That means that student therapists are doing therapy, doing clinical writing, doing treatment planning, hopefully also looking at the literature and research on the type of therapy that they're doing and the types of problems they're trying to solve with their clients, and they're also attending supervision regularly. Now, how are student therapists evaluated? Basically, training directors, supervisors, advisors are all people who will review how a student therapist is doing based on a lot of different things. But essentially, graduate students are evaluated on a regular basis, and training directors and supervisors have the power to decide whether a student should move on in their clinical training or not. What that means is that graduate students are not just seeing clients in therapy to go through the motions, and then once they've seen a certain amount of clients, they're good to go. We're actually being evaluated on the quality of the therapy that we're doing, on our professionalism, on our writing, and so much more. But I want to make sure that it's clear that student therapists are definitely evaluated on a regular basis. And finally, like I promised, I want to provide some information about how you can see a student therapist. So since student therapists are not licensed, they don't have their own practice, they don't have their own website, they just work at the training clinic where they are placed at that time. So there is no fancy database where you can find a student therapist and pay them for low-cost therapy. What you can do is if you're looking for therapy at a hospital or a mental health clinic, or really anywhere, you can ask when you're calling to make an appointment if they have trainees, and if they offer therapy for a lower cost. If you choose to see a student therapist. And of course, since student therapists are not licensed, therapy with them can cost a lot less than with a licensed professional. And of course, the clinic or hospital will let you know that the person you are going to be seeing is a trainee and that they're supervised under a licensed clinical psychologist, and you should get a lot of information about what that means for you as a client. So that's pretty much everything that you need to know about graduate students who are training to become therapists in the future. And if you want more information about how clinical psychologists are trained in general, not just on the clinical side, I did record a video about that in the past. You can check that out. In addition, if you found this video helpful, if you learned anything, please do hit the like button and also subscribe to this channel. I really appreciate you checking out Grad Life Grind. Again, my name is Arielle, and my goal is to inform you, to inspire you, to spark an interest in you, and hopefully also entertain you. So I hope you'll check back in next time. ♪