Practicum & Internship
Welcome to the Grace College Clinical Mental Health Counseling program!
Click on the pictures below to access more information about our field experiences.
What's the difference between Practicum & Internship?
Practicum is the first field experience in Grace's CMHC program and is a 1-semester course. Students complete a minimum of 100-hours with at least 40 hours being direct client care. Students in Practicum are expected to complete intakes, create and implement treatment plans, and provide ongoing care to a small caseload of clients with less severe clinical issues. Practicum students work with clients age 11 and older with the primary focus on clients age 16+. As it is the first clinical experience for most students, Practicum requires a greater level of supervision with either a supervisor present in sessions or all sessions video-recorded.
Internship is a two-semester field experience beginning in the Fall semester. Students complete a minimum of 300 hours per semester with at least 120 hours being direct client care. Students provide theory-based treatment to a (typical) caseload of 10 - 12 clients. Clients can be any age, but primary focus should be on clients age 16+.
Other important field experience details:
Sessions should be traditional 45 - 50 minute sessions occurring weekly or bi-weekly.
Observation hours do not count as direct hours.
Co-therapy is approved for practicum; if the student serves as the primary therapist (at least 50% of the intervention), it is considered direct hours. Co-therapy (direct hours) should be ongoing care of a client, not a one - off session.
Refer to the Practicum or Internship Checklists or Handbook for more details.
What does the student site search process look like?
Students attend an orientation for Practicum and Internship approximately 7 - 9 months prior to their scheduled field experience. This orientation covers all requirements of practicum/internship, such as qualifying hours and activities, supervisor credentials, types of sites, etc. Students are also provided guidance and resources for securing a site placement.
After the orientation, students contact sites who have previously hosted Grace students, or pursue new sites that match their interests. Once a site has indicated interest and desire to host the student, the student will complete the Practicum/Internship Checklist with the site supervisor and submit it, along with the Practicum Application, to Grace's Clinical Coordinator for approval.
If the site has its own affiliation agreement, it should be submitted at this time as well.
Once the Coordinator approves the site, the student will complete the Practicum/Internship Site Agreement with the Site Supervisor and submit within 2 weeks. (The student will attach a copy of the verification of the supervisor's credentials from the state's website.)
So what does this timeline look like?
For field experiences beginning in Fall semester (Practicum or Internship):
Orientation: Late October (the year prior)
Site Application due early March
Site Agreement due 2 weeks after the Site approval
Any remaining paperwork or affiliation agreement should be finalized no later than May 1.
For field experience beginning in Spring semester (Practicum Only):
Orientation: Late May
Site Application due early October
Site Agreement due 2 weeks after the Site approval
Any remaining paperwork or affiliation agreement should be finalized no later than December 1.
Can a student provide telehealth sessions?
Practicum students are not allowed to provide any telehealth or virtual services.
Internship students are permitted to provide a maximum of 20 hours video-based telehealth services per semester, if they have completed the Technology in Counseling course (CPY 6110) AND the student’s state of residence permits students to provide telehealth services.
What is expected of Site Supervisors?
Supervisors must have the time and interest to provide and model a positive supervision alliance, being engaged and available to the student. In some ways, the supervision relationship is like a mentoring relationship. As such, it is expected that the supervisor is a regular part of observing the student's clinical work and providing guidance. Similar to clients, the supervisor also honors the student's right to confidentiality within the practice.
Supervision involves examination of student work using video tapes, observation, and/or live supervision. The supervisor provides honest, on-going, specific feedback to the student regarding counseling skills, approach, and methods. Evaluations accurately assess student competencies and are to be processed with the student to ensure understanding and establishment of a plan for further development. Documented and specific behavioral observations are encouraged. Areas of deficiency should be addressed as soon as evident to allow for remediation, if possible. The supervisor should also consult with the faculty supervisor about remediation needs.
Please watch our brief supervisor training and review the Practicum or Intership Site Agreement for more details.
What is expected of Faculty Supervisors?
Our faculty supervisors provide assistance and consultation to the site supervisor. Faculty supervisors contact site supervisors twice in the semester for the purpose of consultation: once at the beginning of the semester via email and again just prior to midterm evaluations via phone or synchronous online session. Additional support or consultation is readily available as needed.
Faculty supervisors also meet weekly with up to 12 practicum or internship students for 1.5 hours of group supervision. As gatekeepers for the profession, they are responsible to accurately evaluate student competencies and assign a course grade. There are a variety of factors that determine a student's grade in clinical courses, including: foundational skill mastery; professional behavior expectations; conceptualization, diagnostic, and treatment planning skills; and other assignments.
What activities do not count toward Practicum or Internship hours?
The following activities are do not count toward practicum or internship hours:
teaching on topics not related to counseling
psychoeducation, skills, or curriculum-based classes/groups
facilitating groups that are not related to counseling (e.g. 12 step groups, Life Skills groups)
interacting with individuals or groups who have not signed the Grace College Client Information and Consent form
office administrative tasks
any other activity that is not directly related to counseling
clinical work with clients with severe mental illness (such as active psychosis, hallucinations, and delusions): direct hours should take place with clients who are able to benefit from talk/insight-oriented therapy.
Advanced techniques (e.g., EMDR, Neurofeedback, Brainspotting, etc.) have not been approved by the program for practicum and internship due to the need to develop foundational competencies, skills, and techniques prior to integrating these modalities. However, we support the student being exposed to these in their field experiences through observing the supervisor's sessions.
In addition, practicum/internship sites should be familiar with standards for field placements under the Fair Labor Standards Act.
Are the Grace consent forms required?
Yes, all students are required to review and complete a Grace College informed consent document with all assigned clients during the practicum/internship. There are two forms available:
Consent to Work with a Counselor-in-Training (CIT)
Full disclosure / consent
Students should work with their site supervisor to determine which form is most appropriate for their setting or needs. Forms are available in the practicum and internship pages.
Students are also required gain client consent prior to recording any sessions. This should be documented using Grace's "Consent for Session Recording".
Completed consent forms should be kept at the site in the client's records.
Why are session video-recordings required? Is this ethical?
Session recordings are required for both the practicum and internship experiences. These videos are used by site and faculty supervisors to provide feedback and evaluate skills.
The student should also use the videos to engage in deliberate practice and to prepare for supervision by identifying part of sessions that went well and areas s/he would like assistance. The videos are especially helpful if the student has a client in crisis and the supervisor wants to revisit what was said/done to appropriately plan for follow-up care.
Research: Supervision Best Practices
Research shows that direct observation of client sessions and review with the student is a best practice in supervision (ACES, 2011). Simply due to their inexperience, supervisees "find it difficult to comprehend the problems of their clients. Because they do not observe trainees, supervisors find it difficult to correct their errors...[and supervisees] struggle with what they do not understand (Bernard & Goodyear, 2009, p. 221)." Supervisee self-report is only as good as the observational and conceptual abilities of the supervisee. Other challenges are recall/memory accuracy, underreporting of significant issues in session, and pressure felt by the supervisee to distort (rather than report) his or her work, whether intentional or not (Bernard & Goodyear, 2009).
Effective use of session recordings in supervision facilitates changes in supervisee self-perception, enhances self-analysis by supervisees, and helps supervisors more accurately appraise supervisees and their true readiness for the job at hand (Haggerty & Hilsenroth, 2011; Bernard & Goodyear, 2009).
HIPAA & Security
Video-recording sessions is an ethical and HIPAA - compliant practice if students gain client consent and properly store the videos. Students are required to use the Grace College 'Consent for Session Recording' form; signed copies are kept in the agency's client file. Students upload the session recordings to the college's secure learning management system via Kaltura. Kaltura is encrypted during streaming (upload and viewing). The individual file is not encrypted when at rest, but is held in an encrypted storage. While Kaltura files are to be deleted periodically (dependent on the course), the recording of student sessions provides a 'record' of clinical skill demonstration and will be retained until student graduation (or withdrawal from the program). This website addresses Kaltura's security certifications.
Association of Counselor Education & Supervision (2011). Best Practices in Clinical Supervision.
Bernard, J.M. & Goodyear, R.K. (2009). Fundamentals of clinical supervision. Pearson Education.
Haggerty, G. & Hilsenroth, M.J. (2011). The use of video in psychotherapy supervision. British Journal of Psychotherapy, 27(2), 193-210. http://dx.doi.org.heinz.grace.edu/10.1111/j.1752-0118.2011.01232.x
Can a student have more than 1 site during their Practicum or Internship?
In practicum, students are allowed to have a separate site for group hours. Given the small number of direct hours in practicum, all individual direct hours must happen at a single site.
In internship, students are also able to have two sites; both individual and/or group hours can be provided at the second site. The student is responsible to notify supervisors of secondary site and seek agreement on how their time will be split between the two locations.
If there is a secondary site, both sites will provide 1 hour of supervision each week.
Must a Supervisor always be on-site?
A clinician with an unrestricted license should always be on-site with the student. Generally, this is expected to be the approved supervisor. If the supervisor is just headed out for lunch or an errand, then another fully licensed clinician simply should be on-site and aware they are the student's back-up in the supervisor's absence.
If the approved supervisor is away frequently, then perhaps a secondary supervisor who has interest and willingness to be student support in the primary supervisor's absence can be identified.
The primary supervisor provides the weekly 1 hour supervision and evaluations. The secondary supervisor would also complete evaluations at midterm/end of semester. Both supervisors would complete the final site agreement.
Can there be more than 1 supervisor at a single site?
Yes, there can be a secondary supervisor approved for your site. The primary supervisor provides the weekly 1 hour supervision and evaluations. The secondary supervisor would also complete evaluations at midterm/end of semester. Both supervisors would complete the final site agreement.
Can students work with children?
For completing direct hours, Practicum students are able to work with clients ages 11 and older; however, they are able to observe or do co-therapy (as indirect hours) to gain exposure in working with younger children.
Internship students are able to work with any age group, including children. However, the assignments and competencies evaluated in internship are more associated with traditional talk therapy. Interns are encouraged to place a greater focus on work with adolescents and adults in order to sufficiently develop these skills. Interns typically take the Child & Adolescent class during the second semester of Internship.
Can students work with couples and families?
For Practicum, the student's primary focus should be work with individual clients in order to develop their foundational skills prior to adding the complexity of marriage and family sessions. Practicum students are able to observe or do co-therapy (as indirect hours) to gain exposure in working with couples/families.
Interns are approved to work with both couples and families, but also must have a good balance of work with individual clients.
Both Interns and practicum students are required to successfully complete the Marriage & Family course before being allowed to provide these services.
Can a student do both Practicum & Internship at my site?
The internship (fall and spring semesters) is expected to be a distinctly different experience from Practicum. Typically, this is experience with different clients, clinical issues/diagnoses, demographics, supervisors, etc. Occasionally a site is large enough that students are able to be in a different department or location that enables a distinctly different experience.
However, Internship sites are not approved until the Spring prior to Internship. Approval is also contingent on the student having a positive experience in practicum, gaining the necessary skills and experiences, appropriate supervision, sufficient client load to meet requirements, and practicum faculty supervisor approval.
As a program, we want our student to gain broad clinical experiences with not only socio-economic/education/cultures/etc. but even how the mental health issues and advocacy needs present differently among these groups. Community mental health is also vastly different from outpatient work, private practice, or non-profit organizations. Even different supervisors provide a unique perspectives.
We also encourage our students to consider their personal goals after graduation and whether a setting different from their practicum is needed to move toward those goals.
Can a student work in a school-based setting?
A practicum or internship in a school-based setting should be focused on clinical mental health counseling (vs. school counseling).
All sessions are expected to be the more traditional 45 - 50 sessions with consistent (i.e., weekly or biweekly) meetings with clients, guided by a mental health treatment plan. Group hours should be process-oriented (not solely curriculum- or skill-based or psychoeducational).
Students are encouraged to consider an additional or secondary site placement to gain significant experience with adults (as the primary client).
Can a student work in a home-based setting?
Yes, students are able to work in home-based services; however, a clinician holding a terminal, unrestricted license must be with the student at all times. The site is also required to provide training on the specific considerations and risks inherent in home-based counseling.
Is Grace's counseling program accredited?
Grace College's Counseling program has been continuously accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) since 2004. The next accreditation review will be in 2029.
How can I become an Approved Site or Supervisor?
Visit our Becoming a Site page and complete the application.
You can also contact our clinical coordinator.
Who can I contact if I have questions?
Please feel free to contact us if you have questions or concerns:
If you are currently a supervisor for one of our students, your first contact should be your student's practicum or internship faculty supervisor.