“Practicum and Internship is a must have for students in the clinical phase of their counselor

education program. It’s an incredibly comprehensive and practical resource for students
emerging into the field of clinical counseling and therapy and is a wonderful supplement to
the information students receive in their educational programs. It’s the type of book that won’t
be sold back!”
Carol A. Corbett, PhD, LPC, NCC, assistant professor, Chestnut Hill College

“Practicum and Internship is the most comprehensive and practical guide for students in their
practicum/internship experience! Rather than offer generic advice, this textbook provides
concrete tools, tailored to real-world needs and situations. If you’re a student preparing for
practicum/internship or an early career counseling professional, this book is an invaluable
resource.”
David Delmonico, PhD, LPC, professor of counselor education, Duquesne University
PRACTICUM AND INTERNSHIP

The seventh edition of Practicum and Internship is a practical resource that provides students and
supervisors with thorough coverage of all stages and aspects of the practicum and internship
process.
New to this edition are:

„ Extensive revisions and updates to appendices and downloadable, customizable online

forms, contracts, and other materials
„ New material on transitioning to internship
„ New discussion of evidence-based approaches to all aspects of the counseling process,
including clinical assessment, case conceptualization, and counseling techniques
„ An expanded exploration of teletherapy and distance counseling and highly reported
ethical and legal issues, such as record-keeping and billing
„ Thoughtful review of contemporary cultural issues across the core therapeutic and
supervisory processes
„ Updated review of risk assessment procedures, particularly for suicidal and homicidal
clients
„ New information on mentorship and self-care
„ Updated research and scholarship throughout

With comprehensive information that spans across therapeutic approaches, concerns, and
topics, this remains an essential foundational text for counseling and psychotherapy students
and their supervisors.

Christin M. Jungers, PhD, LPCC-S, is a licensed professional counselor and professor of clinical
mental health counseling at Franciscan University of Steubenville, where she has taught and
supervised master-level students for over 15 years.

Judith Scott, PhD, is a professor emeritus at the University of Pittsburgh. She is a licensed
psychologist with more than 40 years of clinical experience and currently is in private practice
in Pittsburgh, Pennsylvania.

Jocelyn Gregoire, EdD, is a contributing faculty member at Franciscan University of Steubenville

and has been involved in the counseling field as an educator, supervisor, and counselor for
over 35 years in the United States and internationally.
 PRACTICUM AND INTERNSHIP

Textbook and Resource Guide for

Counseling and Psychotherapy

Seventh Edition

Christin M. Jungers, Judith Scott, and Jocelyn Gregoire

Seventh edition published 2025
by Routledge
605 Third Avenue, New York, NY 10158

and by Routledge
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN

Routledge is an imprint of the Taylor & Francis Group, an informa business

© 2025 Christin M. Jungers, Judith Scott, and Jocelyn Gregoire

The right of Christin M. Jungers, Judith Scott, and Jocelyn Gregoire to be identified as
authors of this work has been asserted in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.

All rights reserved. The purchase of this copyright material confers the right on the
purchasing institution to photocopy pages which bear the photocopy icon and copyright
line at the bottom of the page. No other parts of this book may be reprinted or reproduced
or utilised in any form or by any electronic, mechanical, or other means, now known or
hereafter invented, including photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.

Trademark notice: Product or corporate names may be trademarks or registered trademarks

and are used only for identification and explanation without intent to infringe.

First edition published by Accelerated Development, 2008

Sixth edition published by Routledge, 2019

ISBN: 978-1-032-54566-0 (hbk)

ISBN: 978-1-032-54560-8 (pbk)
ISBN: 978-1-003-42866-4 (ebk)

DOI: 10.4324/9781003428664

Typeset in Stone Serif

by Apex CoVantage, LLC

Access the Support Material: www.routledge.com/9781032545608

 To my family, who have brought so much happiness to my life and especially to my nieces,
Natalie, Rebecca, Eleanor, and my nephews, Nicholas and Benjamin, and Gabriel. May you
grow up to know how special each one of you is and how much you have to offer this world.

Christin M. Jungers

To my children and their spouses: Kristin and Bill Pardini; Troy and Kristin Scott; Megan and
Adam Swift; and Neil and Shannon Scott for their loving support of my life and work.

To my grandchildren: Brenna, Katrina, and Nate Scott; Josie and Mica Swift; Riley,
Aiden (AJ), and Ellie Scott; and Roman and Levi Pardini, who bring me constant joy and
hope for the future.

Judith Scott

I dedicate this work to all students who are engaged in the journey of becoming
professional counselors. May you be open to each learning experience that comes your
way to humbly learn how to be an instrument of change and healing for the persons you
encounter as clients.

Jocelyn Gregoire
 CONTENTS

List of Figures and Tables xix

About the Authors xxi
Prefacexxiii
Acknowledgmentsxxv
Overview of the Book xxvii

CHAPTER 1 Preparing for Practicum and Internship 1

Introduction1
The Professional Counselor 1
Becoming a Counselor 2
Role of Accrediting Bodies in Counselor Development 2
CACREP Standards for Practicum and Internship 4
MPCAC Standards for Practicum and Internship in Counseling 5
Counselor Certification 5
National Board of Certified Counselors 6
NBCC Specialty Certifications 6
Commission on Rehabilitation Counselor Certification 6
Other Specialty Counseling Certifications 7
State Licensure for Mental Health Professionals 7
Securing a Practicum or Internship Site 7
Guidelines for Choosing a Site 7
Criteria for Site Selection 8
Professional Staff and Supervisor 9
Professional Affiliations of the Site 9
Professional Practices of the Site 9
Site Administration 9
Training and Supervision Values 9
Theoretical Orientation of the Site and Supervisor 10
Client Population 10
x Contents

Negotiating the Practicum and Internship Placement 11

The Interview Process 12
Getting Oriented to Your Site 13
Role and Function of the Practicum and Internship Student 13
Phases of Practicum and Internship 14
Development Reflected in the Program Structure 14
Development Reflected in the Learning Process 15
Development Reflected in Supervisor Interaction 15
Summary16
References16

CHAPTER 2 Starting the Practicum and Internship 19

Introduction19
Tips for Beginning the Practicum Experience 19
I Have Taken the Classes, but Do I Really Know What to Do? 20
What If I Say Something Wrong? 20
How Do I Know When to Use the Right Techniques? 21
But I’m Just a Rookie! (Learning to Trust Yourself and Your Inner Voice) 21
When in Doubt, Consult! (Your Faculty and Site Supervisors
Are There to Help You) 21
Becoming Part of the Professional Counseling Team 22
Preparing to Meet Your First Client 23
Privacy Rights and the Health Insurance Portability and
Accountability Act (HIPAA) 23
Contemporary HIPAA Considerations 24
Informed Consent 24
Pre-Therapy Intake Interview 28
Pre-Therapy Interview Style 28
The Initial Counseling Session 29
Establishing a Therapeutic Alliance 29
Applying Basic and Advanced Helping Skills 30
Procedural Skills 31
Structuring Counseling Sessions 32
Closing the Initial Session 33
Counseling Session Summary 33
Preparing to Lead Your First Group 34
What Does It Take to Be an Effective Group Counselor? 35
Things to Know About Running Groups 35
Skills to Practice When Running Groups 35
 Contents xi

Dispositions Suited to Running Groups 36

Tips for Co-Leading a Group 36
Client Record Keeping 37
Progress Notes 37
The DAP Format 37
The SOAP Notes Format 38
Record Keeping and the School Counselor 39
Summary40
References40

CHAPTER 3 Assessment and Case Conceptualization 43

Introduction43
Goals of Psychological Assessment 44
Evidence-Based Assessment 44
An Ethical Approach to Assessment 45
An Aware and Collaborative Disposition 45
Appropriate Knowledge Base and Skill Set 45
The Initial Psychological Assessment 46
Gathering Family History Data 47
Gathering Personal History Data 48
Assessing the Client’s Mental Status 49
Mental Status Categories of Assessment 49
Gathering Additional Data Through Tests, Inventories, and Secondary Sources 50
Theoretical Influence on Assessment 51
Diagnostic Assessment 52
DSM Diagnosis 53
Diagnostic Classification 53
Subtypes and Specifiers 54
Other Specified and Unspecified Designation 54
Emerging Measures and Models in Diagnosis 54
Summarizing and Using Initial Assessment Results 55
Case Conceptualization 55
The Linchpin Model 56
The Integrative Model 57
Culturally Informed CBT Case Conceptualization Model 57
Assessing the Client’s Progress 58
Reporting Therapeutic Progress 59
Summary60
References60
xii Contents

CHAPTER 4  oal Setting, Treatment Planning,

G
and Treatment Modalities 63
Introduction63
Purposes of Goal Setting 63
Goals and the Stages of Change Model 64
Types of Goals 65
Developing a Treatment Plan 65
A Review of Philosophy, Theories, and Theory-Based Techniques
of Counseling 68
Identifying Your Theory and Technique Preferences 72
Extending the Counselor’s Theory-Based Approaches: Brief Therapies
and Evidence-Based Practices 77
Brief Therapies 77
Solution-Focused Brief Therapy 78
Strategic Solution-Focused Therapy 80
Brief Rational Emotive Behavior Therapy 80
Evidence-Based Practices and Third Wave Therapies 81
Mindfulness-Based Cognitive Therapy (MBCT) 81
Mindfulness-Based Stress Reduction (MBSR) 83
Acceptance and Commitment Therapy (ACT) 83
Dialectical Behavior Therapy (DBT) 84
Motivational Interviewing and Cognitive Behavioral Therapy 85
Summary86
References86

CHAPTER 5 Supervision in Practicum and Internship 89

Introduction89
Definition, Purpose, and Practice of Supervision in Practicum
and Internship 89
Administrative Supervision 90
Distinguishing Effective from Ineffective Supervision 90
Models and Methods in Supervision 92
Models of Individual Supervision 92
Psychotherapy-Based Supervision: Psychodynamic
Model of Supervision 92
Developmental Models of Supervision: The Integrated
Developmental Model 93
Process-Oriented Supervision Models: The Discrimination Model 93
 Contents xiii

Group Supervision Models and Methods 94

The Structured Group Supervision Model 94
The Structured Peer Group Supervision Model 95
Peer Consultation 96
Triadic Supervision 96
The Supervisor–Supervisee Relationship 98
The Clinical Supervision Process 99
Informed Consent in Supervision 99
Assessment of Counseling Skill Areas in Supervision 102
Skill Area One: Counseling Performance Skills 102
Skill Area Two: Cognitive Counseling Skills 103
Skill Area Three: Self-Awareness/Multicultural Awareness Skills 103
Skill Area Four: Developmental Level 104
Self-Assessment of Skills and Goal Setting 105
The Supervision Contract 106
Supervision Session Formats 108
Evaluation in Supervision 109
Formative Evaluation 109
Mid-Point Evaluation 109
Summative Evaluation 111
Summative Evaluation in Practicum 111
Summative Evaluation in Internship 112
Supervisee’s Evaluation of the Supervisor and of the Site Experience 113
Documenting Practicum and Internship Hours 113
Summary115
References115

CHAPTER 6 Ethical Issues in Counseling 119

Introduction119
Morality, Ethics, and Law 119
Ethical Codes for Counselors and Mental Health Professionals 120
Ethical Decision-Making 122
Ethical Principles and Decision-Making 122
Virtue-Based Ethics and Ethical Decision-Making 123
Professional Wisdom 124
Models of Ethical Decision-Making 125
Self-Tests After Resolving an Ethical Dilemma 126
xiv Contents

Selected Ethical Issues for Consideration by Beginning Counselors 127

Ethics of Counseling Culturally Diverse Clients 127
Building Awareness 127
Becoming Knowledgeable 128
Choosing Culturally Appropriate Strategies 129
Managing Issues Related to Self-Care 130
The Ethical Use of Telehealth, Technology, and Social Media 131
Phones, Texting, and Related Technologies 132
Electronic Mail and Digital Communication 132
Telehealth, Distance, and Online Counseling 133
Social Media 134
Web-Based Professional Discussion Groups 135
Summary135
References135

CHAPTER 7 Legal Issues in Counseling 139

Introduction139
The Law 139
Classifications of the Law 140
Types of Laws 140
The Steps in a Lawsuit 141
Legal Aspects of Selected Professional and Ethical Issues 141
Malpractice and Competence 142
Privacy, Confidentiality, and Privileged Communication 143
The Duty to Protect: The Suicidal Client 145
The Duty to Warn: The Potentially Dangerous Client 147
Suspected Child Abuse and Neglect 148
Suspected Harm to Vulnerable Adults 149
Fee-Setting, Billing, and Other Business Practices 150
Client Records 152
Why Clients Sue 153
Risk Management and the Counselor 155
Summary156
References157

CHAPTER 8  orking with Clients in Crisis

W
and Other Special Populations 161
Introduction161
Defining Crisis and Trauma 161
 Contents xv

Crisis Intervention and Trauma Response in Clinical and Agency Counseling 162
The Kanel Model of Crisis Intervention 163
The James and Gilliland Model of Crisis Intervention 163
Evidence-Based Treatments for Trauma Response 165
Prolonged Exposure Therapy 165
Cognitive Processing Therapy 166
Cross-Cutting Ingredients for Effective Trauma Counseling 166
Crisis Intervention and Trauma Response in Schools 167
School Counselor as Crisis and Trauma Specialist 167
Tasks of the School Counselor in Preventing and Responding to Crisis 168
Practical Recommendations for Limiting School Violence 169
Post-Crisis: Understanding Children’s Responses 170
The High-Risk Client: Understanding and Assessing Harm to Self 170
Defining Suicide and Debunking Common Myths 171
Risk Assessment for Suicide 171
Assessment of Current Symptoms Point 1: Desire to Die 172
Assessment of Current Symptoms Point 2: Capacity to Commit Suicide 172
Assessment of Current Symptoms Point 3: Suicidal Intent and Plan 173
Assessment of Current Symptoms Point 4: Other Risk Factors 173
Assessment of Current Symptoms Point 5: Buffers Against Suicide 173
Evaluating and Documenting Suicide Risk: Putting It All Together 174
Suicide Risk Assessment Instruments 174
Intervention and Planning 175
Suicide Risk Prevention and Assessment in Schools 176
Basics of Suicide Prevention Programs in Schools 176
Learning About and Responding to Potentially Suicidal Students 177
Suicide Risk Assessment for Students 177
The High-Risk Client: Potential Harm to Others 179
Risk Assessment for Potentially Dangerous Clients 179
Task I: Risk Assessment 179
Task II: Selecting a Course of Action 181
Task III: Monitoring the Situation 181
Clients’ Past Criminal Acts 182
The Client Who Is Being Abused: Responding, Reporting, and Intervening 182
Risk and Mediating Factors for Child Abuse 183
Making a Report Related to Child Abuse 184
Interviewing Children Who May Have Been Sexually Abused 184
Counseling the Sexually Abused 186
The Client Who Is Dealing with Addiction 187
xvi Contents

Understanding Addiction 187

Diagnosing Alcohol and Drug Use 188
What Is Treatment? 189
What Is Recovery? 190
Stages of Recovery 190
Counseling Recommendations for Clients with Addiction 190
Preventing Relapse 192
Summary193
References193

CHAPTER 9  onsultation in Mental Health Agencies

C
and Schools 199
Introduction199
What Is Consultation? 199
Types and Delivery Methods of Mental Health Consultation 200
Consultant Roles 201
The Expert Consultant 201
The Trainer/Educator Consultant 201
The Collaborative Consultant 202
Cultural Issues in Consultation 202
Consultation in Mental Health Agencies 203
School Consultation 204
Competencies in School Consultation 205
Dimensions of School Consultation 207
Consultation Models and Practices in Schools 207
Developmental Counseling and Therapy-Based Consultation 207
Solution-Focused Consultation 209
Positive Psychology Approaches to Consultation 209
Emerging Evidence-Based Approaches to Consultation in Schools 210
General Guidelines for Consultation 211
Preentry211
Entry into the System 211
Orientation to Consultation 212
Problem Identification 212
Consultation Intervention 213
Assessing the Impact of Consultation 214
Resistance to Consultation 214
 Contents xvii

Contracting and the Forces of Change in the Organization 215

Summary216
References217

CHAPTER 10 L ooking Ahead to a Career in

Professional Counseling 221
Introduction221
The First Steps Towards Licensure 221
Licensure Law 221
Licensure and Certification Exams 222
Securing a Supervisor for Post-Graduate Training Supervision 223
The Counseling Compact 224
Longevity in the Profession 224
Self-Care, Wellness, and Burnout 225
Recommendations for Sustaining Personal and Professional Excellence 225
References226

APPENDIX I: Psychiatric Medications 227

APPENDIX II: Forms235
Form 1.1: Practicum Contract 237
Form 1.2: Internship Contract 239
Form 1.3: Student Practicum/Internship Agreement 242
Form 2.1a: Parental Release Form: Secondary School Counseling 243
Form 2.1b: Elementary School Counseling Permission Form 244
Form 2.2: Client Permission to Record Counseling Session
for Supervision Purposes 245
Form 2.3: Initial Intake Form 246
Form 2.4: Psychosocial History 248
Form 2.5: Case Notes 253
Form 3.1: Mental Status Checklist 255
Form 3.2: Elementary School Counseling Referral Form 258
Form 3.3: Secondary School Counseling Referral Form 259
Form 3.4: Therapeutic Progress Report 261
Form 4.1: Counseling Techniques List 262
Form 5.1: Peer Rating Form 266
Form 5.2: Interviewer Rating Form 267
Form 5.3: Self-Assessment of Counseling Performance Skills 269
Form 5.4: Self-Awareness/Multicultural Awareness Rating Scale 271
xviii Contents

Form 5.5: Directed Reflection Exercise on Supervision 272

Form 5.6: Supervisee Goal Statement 273
Form 5.7: Supervision Contract 274
Form 5.8: Supervisor Notes 276
Form 5.9: Supervisee Notes on Individual Supervision 277
Form 5.10: Recording Critique Form 278
Form 5.11: Supervisor’s Formative Evaluation of Supervisee’s Counseling Practice 279
Form 5.12: Supervisor’s Final Evaluation of Practicum Student 281
Form 5.13: Supervisor’s Final Evaluation of Intern 282
Form 5.14: Evaluation of Intern’s Practice in Site Activities 284
Form 5.15: Client’s Assessment of the Counseling Experience 285
Form 5.16: Supervisee Evaluation of Supervisor 286
Form 5.17: Site Evaluation Form 288
Form 5.18: Weekly Schedule/Practicum Log 289
Form 5.19: Monthly Practicum Log 290
Form 5.20: Weekly Internship Log 291
Form 5.21: Summary Internship Log 293
Form 8.1: Suicide Consultation Form 294
Form 8.2: Harm to Others Form 297
Form 8.3: Child Abuse Reporting Form 300
Form 8.4: Substance Abuse Assessment Form 301

Index305
 LIST OF FIGURES AND TABLES

Figure 5.1 Sample Weekly Practicum Log 114

Table 4.1 Overview of Theories of Counseling and Psychotherapy 69
Table 4.2 Counseling Techniques List 73
Table 9.1 Brief Stages and Goals of Consultation 206
 ABOUT THE AUTHORS

Christin M. Jungers, PhD, LPCC-S, is a professor at Franciscan University of Steubenville

in the Clinical Mental Health Counseling Program. She also is the Dean of the School of
Professional Programs at Franciscan University. She is a licensed professional clinical counselor
who has experience working with a variety of life span issues faced by individuals and couples.
Dr. Jungers has co-authored two other books and numerous articles. She served two terms
as a governor-appointed member of the Counselor, Social Worker, and Marriage and Family
Therapist Licensure Board in Ohio.

Judith Scott, PhD, is a licensed psychologist, certified school counselor, National Certified
Counselor, and professor emeritus of the Department of Psychology in Education at the
University of Pittsburgh. During her tenure at the University of Pittsburgh she served as director
of doctoral studies and as field site coordinator in the CACREP-accredited counseling programs.
She is a past president of Pennsylvania ACES and was awarded Counselor Educator of the Year
by the Pennsylvania School Counselors Association. Dr. Scott maintains a private practice that
specializes in outpatient individual psychotherapy in women’s issues and infertility counseling.
Her research focuses on counseling supervision and women’s adult development.

Jocelyn Gregoire, Ed.D., CSSp, has been a Roman Catholic priest for more than 35 years and
has been involved in the counseling field as an educator, clinician, and supervisor for decades.
In addition to his doctoral degree in Counselor Education, he holds two additional graduate
degrees. Through his expertise as a professional counselor, Dr. Gregoire has helped people
across the world in their journey towards personal growth and healing. He has authored and
co-authored numerous articles on the topics of spirituality, grief, cultural identity development,
and ethics and is the co-editor of two other textbooks.
 PREFACE

Since the publication of the first edition of this text in 1988, each new edition has evolved to
provide materials that support the many changes and developments in the counseling profes-
sion and the preparation of professional counselors. In particular, the experiences and com-
petencies required of counselors-in-training while involved in their practicum and internship
placement have been and continue to be the focus of this book. As counselor educators, it has
been exciting and our privilege to have been a part of participating in a process that enhances
the education of those who become licensed and certified as professional counselors. This
seventh edition has benefited greatly from new views and new voices that reflect the evolving
nature and areas of study within the profession. We are excited about the new additions to this
text, respectful of the maturation of our profession, and hopeful about the many contributions
of the new professional counselors.
Christin M. Jungers, Judith Scott, and Jocelyn Gregoire
 ACKNOWLEDGMENTS

The authors gratefully appreciate the efforts of the following individuals, who were instrumen-
tal in the development of the seventh edition of this textbook:
The graduate counseling students at Franciscan University of Steubenville and the Univer-
sity of Pittsburgh for all they have contributed to our professional growth and enhancement;
Anna Moore, editor at Routledge, whose understanding and editorial suggestions were
invaluable in the development of the textbook; our reviewers who provided valuable recom-
mendations about how to update and streamline the text, as well as thoughtful insight into
new topics that might be addressed;
John Boylan, PhD and Patrick Malley, PhD, for their many contributions to the develop-
ment of this text, especially the first four editions, and for the many conversations regarding
essential elements that contribute to the preparation of competent counselors; and Brenna
Wilson and Lydia Lamm, graduate assistants for the Clinical Mental Health Counseling Pro-
gram at Franciscan University, for their careful review of the references, citations, and head-
ings, among other aspects of the manuscript.
 OVERVIEW OF THE BOOK

The seventh edition of this text guides students through important pre-professional training
experiences, from the selection of an appropriate practicum site to the final evaluation of the
internship. The text is organized according to a skill-based and developmental approach to
the practicum and internship experience. Separate chapters relate to counseling performance,
cognitive skills, and supervision. Selected topics in professional practice include related profes-
sional resource materials; practical self-assessment instruments; and guidelines, formats, and
forms to assist in applied counseling and supervision practices.
Chapter 1 focuses on the preparation, identification, and application process to secure a
field site placement. It provides foundational information that students must consider as they
prepare to identify their practicum/internship placements, especially the accreditation and
licensure standards that inform the structure of this learning experience. The chapter guides
students through the process of selecting, applying for, securing, and orienting to a site appro-
priate to their professional goals and specializations. We provide multiple sample contracts in
the Forms appendix related to this chapter so that students can prepare for setting up their site
experience.
The second chapter takes students from preparing for and securing a placement site
to helping them get ready for initial sessions with clients. Chapter 2 discusses common
experiences of practicum students who are entering a field site for the first time and
encourages them to persevere in the knowledge that they have been readied for working
with clients through their training experiences. It also reviews key aspects of starting ini-
tial counseling sessions, such as informed consent, intake, and record keeping procedures.
The chapter provides basics of leading group therapy sessions as well, because this is an
expected delivery format for students to participate in during practicum and internship.
It includes a sample informed consent statement and current HIPAA (Health Insurance
Portability and Accountability Act) guidelines.
Chapter 3 focuses on assessment and case conceptualization practices, references, and
models to be used in practice with clients. We have added new content related to the ethical
use of assessments and a brief discussion of evidence-based assessment practices. We also have
included a new discussion of culturally-informed case conceptualization. Finally, the chapter
offers an overview of the newest revision of the Diagnostic and Statistical Manual of Mental Dis-
orders (DSM, 5th edn., TR) coding and classification system.
Chapter 4 content areas include goal setting, treatment planning, and theory-related
approaches to treatment. The chapter starts with a discussion of the purpose of goal setting and
xxviii Overview of the Book

treatment planning before proceeding to an overview of some treatment planning approaches.

Most of the chapter is dedicated to an overview of classic counseling theories and a section
on brief and “New Wave” theories, such as brief solution focused therapy, brief REBT, accep-
tance and commitment therapy, and dialectical behavior therapy. These new wave theories are
an introduction to well-known evidence-based practices in the counseling field. Students are
invited in this chapter to begin reflecting on how theory informs treatment planning and what
their personal theoretical orientation is.
In Chapter 5, the text focuses on clinical supervision, which is a critical and required com-
ponent of practicum and internship. The purpose of this chapter is not to make students into
supervisors, but to help them to be prepared for the supervision element of the field, as well as
to help them become good consumers of supervision. The chapter begins by defining the pur-
pose of clinical supervision and then describes several models of individual and group super-
vision that students may encounter. It also includes an expanded section about the triadic
model of supervision. We discuss key elements of supervision, such as the informed consent
process, goal setting in supervision, and evaluation. To help students think about what their
supervisory goals might be, we offer a skills-based approach to evaluating one’s competencies,
including several self-assessment exercises and forms. Finally, the chapter includes a review
of the evaluation aspect of supervision and how that applies in practicum and internship, as
well as information about how to document learning experiences in the field training courses.
Forms that support the application of best practices, such as supervisor notes, supervisee notes,
and evaluation checklists and formats are included.
Chapters 6 and 7 focus students’ attention on ethics and the law. Training in ethics and
legal issues is a framework that encompasses all that counselors-in-training do, even if aspects
of this area of education seem subsidiary to working with clients. Our goal in these two chap-
ters is not to prepare students for all ethical and legal issues they might encounter; rather, we
focused on issues and topics that research has shown to be particularly in need of attention.
The chapters include updated information on the ethical use of technology in online counsel-
ing, particularly because telehealth is becoming increasingly prominent. We also added new
information about legal aspects of billing and record-keeping, as this somewhat mundane
aspect of practice tends to be one of the common areas in which ethical concerns are raised for
new and seasoned counselors.
In Chapter 8 and 9, we review practice issues related to special populations of clients that
can be challenging to work with for new counselors, and we address the area of mental health
and school consultation. Chapter 8 deals with crisis and trauma, and the clinical issues that
often relate to or become crisis events, such as threatened harm to self or others, abuse, and
substance addiction. We look at trauma prevention strategies and remediation treatments in
clinical and school settings. Risk and mediating factors for child abuse have been updated.
We also have updated the risk assessment criteria for suicide in light of new literature in this
area. The risk assessment tools related to self and other harm, abuse reporting, and substance
abuse screening have been reviewed and updated. An explicit inclusion of material related to
evidence-based practices and cultural issues is incorporated in this chapter and across the text.
Chapter 9 helps students think about themselves as consultants, which is a role that is increas-
ingly familiar to counselors, especially in schools. We have reorganized this chapter and added
new literature drawing out cultural aspects of consulting. Finally, in Chapter 10, we empha-
size practical information about licensure and certification, offer tips for seeking supervision
post-graduation, and make recommendations for how to enhance longevity in the profession.
 Overview of the Book xxix

This chapter includes information about the emerging counselor compact in the U.S. that will
enable clinicians to practice easily across state lines.
This edition of the text has undergone a significant revision that also includes a focusing
and streamlining of the content and approach to help the reader transition easily from chapter
to chapter. Our goal in transitioning the text to fewer chapters was not to eliminate key con-
tent, but to combine it in such a way that it will be even more helpful for students. Forms and
samples of completed forms have been referenced throughout the text. A complete set of avail-
able forms is provided in the Forms appendix at the end of the text. They can now be accessed
for download on the website for this edition of the text at www.routledge.com/9781032545608
We are very pleased with this new edition and hope that the information, materials,
and resources included will provide the student, counselor, and supervisor with a useful and
reader-friendly approach to the practicum and internship experience.
 CHAPTER 1

PREPARING FOR PRACTICUM AND INTERNSHIP

Introduction

The goal of this book is to assist students in the process of becoming qualified, competent
professional counselors with a specific focus on supporting students as they enter the practi-
cum and internship component of their training programs. As you prepare for practicum,
this likely is the first time it feels real that you are entering a profession with specific skills,
knowledge, and dispositional expectations, as well as a vocational identity. Elements such as
educational accreditation standards and professional certification and licensure requirements
help to define the professional world you are entering as a mental health counselor trainee.
Accreditation, certification, and licensing standards also inform the practicum and internship
structure and experience. This chapter provides you with an outline of some of these markers
of your professional world. We also describe the requirements of practicum and internship and
offer recommendations on how to identify, apply for, and secure a field placement.

The Professional Counselor

Counseling is a professional relationship built on a wellness model that supports, empowers,

and advocates for individuals, families, and groups to meet their mental health, education,
and vocational goals (Kaplan et al., 2014). Over the last 75 years, counseling has achieved a rec-
ognized professional status through the efforts of many members of the field who have worked
to establish counseling as a profession and discipline. Efforts that have been central to the
professionalization process include the creation of associations (e.g., the American Counseling
Association and its various subsidiary associations), changing names and using terminology
that reduces counseling’s identification with other similar occupations, developing a code of
ethics, and obtaining public authorization through the passage of counselor licensure laws in
all 50 states. Instituting specialized accrediting bodies and educational standards has also been
part of the process to shape counseling as its own unique profession. Over the last 30 years, a
variety of changes have taken place in counselor preparation standards, including increases in
the credit hours required for the awarding of a master’s degree in counseling, restrictions on
degree requirement types for core faculty in counselor education programs, and revisions to
the educational standards for accredited programs that both reflect current knowledge in the
field and help to distinguish counseling from other related mental health disciplines (Remley
& Herlihy, 2020).

DOI: 10.4324/9781003428664-1
2 Preparing for Practicum and Internship

From a philosophical standpoint, professional counselors apply a wellness model of men-

tal health in their work that emphasizes helping people maximize their potential rather than
simply reducing their symptoms or curing their illness. Counselors emphasize prevention and
early intervention over remediation even if remediation is part of a counselor’s job. In addi-
tion, the training of counselors focuses on counseling skills rather than physical health care,
psychological testing, and psychopathology, even though these elements also are aspects of
a counselor’s work (Remley & Herlihy, 2020). As you consider where you will begin your field
placement, it is important to identify a site that understands and respects the foundational
values of the professional counselor.

Becoming a Counselor
The process of becoming a professional counselor takes a significant investment of time,
requires successful completion of educational and post-educational standards, and involves a
fair bit of mentoring and supervision in the early years of work (Schweiger et al., 2012). As with
any aspect of identity formation, professional identity development unfolds in a long, winding
journey spanning many years of practice. In a seminal work, Skovholt and Ronnestad (1992)
described common themes or qualitative experiences that shape the creation of a professional
self, including things such as feeling like an imposter in the early years, moving from wanting
answers from supervisors to becoming an autonomous helper, and recognizing the value of
life wisdom in the role that counselors play. In addition to these qualitative experiences, most
counselors also tie their professional identity to certification or licensure, which is the outward
facing aspect of professional identity. Both certification and licensure are privileges granted to
people who meet identified benchmarks that enable them to hold themselves out to the public
as counselors. From a pragmatic perspective, becoming a counselor involves some common
expectations:

1. Graduating from a master’s degree program in counseling inclusive of a supervised

practicum and internship. The program may or may not be required to hold a
specialized-accreditation per state licensure laws.
2. Passing a certification or licensure examination.
3. Being found to be of upstanding moral character.
4. Completing supervised clinical hours during the educational program and post-graduation.
5. Applying to the national certification board or the appropriate credentialing association
to obtain certification.
6. Applying to the state board and obtaining state licensure.

Given that requirements for educational programs, credentialing and licensure exam eligibil-
ity, certification, and licensure are regularly reviewed and updated, you are advised to proac-
tively educate yourself on these, particularly licensure requirements in the state in which you
hope to practice.

Role of Accrediting Bodies in Counselor Development

Historically, accreditation bodies were established by professional associations whose members

were invested in providing students with the best possible education considering contemporary
 Preparing for Practicum and Internship 3

needs and existing research. For example, the American Counseling Association’s (ACA) divi-
sion on counselor education and supervision developed educational standards that eventu-
ally led to the establishment of the Council for the Accreditation of Counseling and Related
Educational Programs (CACREP). The Council on Rehabilitation Education (CORE) was estab-
lished as the accrediting body for rehabilitation counselors, though it has now merged with
CACREP into a single accrediting body. The American Psychological Association Commission
on Accreditation (APA-CoA) is the accrediting body for psychologists. The Council of Applied
Master’s Programs in Psychology formed the Master’s in Psychology and Counseling Accredita-
tion Council (MPCAC) as an alternative to CACREP. Each accrediting body establishes program
and educational criteria that must be met before a program is granted accreditation approval. If
a university’s academic department offers more than one specialty program in counseling (e.g.,
school counseling and clinical mental health counseling), each program must be evaluated
separately for accreditation. Thus, a department may have some programs that are accredited
and others that are not.
Specialized accreditation of counselor preparation programs in the United States is a largely
voluntary process, and accreditation bodies operate independently from federal and state gov-
ernments. This means that educational programs normally are not mandated by law to be
approved by a specialized accreditor. There are a few exceptions (e.g., Ohio and Kentucky)
in states that have opted to pass legislation requiring counselor preparation programs to be
CACREP-accredited. Practically, this means that programs established in these states must be
approved by CACREP if the program’s graduates are to be eligible for licensure.
Besides licensure, there are other connection points between accreditation organizations
and governing bodies that can motivate programs to seek accreditation and students to choose
a program that is accredited. For example, three federal agencies in the U.S., the Veteran’s
Administration, TRICARE, and the Army Substance Abuse Program all require licensed coun-
selors to have graduated from a CACREP-accredited program, and in some cases, a clinical
mental health counseling program, to be an approved provider or to receive reimbursement
for services (CACREP, 2023). Thus, graduation from an accredited program has a number of
significant advantages for students. For example, accreditation:

„ provides assurance that programs meet high professional and educational standards;
„ provides periodic review of programs;
„ offers enrolled students some advantages, such as sitting for the national certification
exams prior to graduation; and
„ provides a source of pride for faculty, students, and the college or university as they
become involved in a nationally recognized program (Schweiger et al., 2012).

In all counseling programs, and especially in accredited programs, the major applied com-
ponents of counselor preparation are the practicum and internship. Supervised professional
practice offers students the richest opportunity for professional formation and identity devel-
opment; thus, accreditation standards for these components of a program set parameters for
knowledge and skill acquisition, as well as structure on the learning experience itself (CACREP,
2023). For example, practicum and internship students are expected to counsel clients in their
specialty program area who represent the ethnic and demographic diversity of the community.
Hours of direct service must be with actual clients rather than peers in one’s educational pro-
gram or other acquaintances. Developmentally, the practicum is the initial applied field expe-
rience, and this is followed by the internship, whose direct service opportunities must reflect
4 Preparing for Practicum and Internship

the comprehensive work of a professional in the designated program specialty, including both
individual and group counseling.
Educational standards for practicum and internship requirements have undergone a num-
ber of changes since the inception of CACREP in 1981. The number of hours allotted in practi-
cum and internship has increased; the settings in which the experience can take place have
become more tailored (e.g., for clinical mental health programs, the field site must offer stu-
dents the opportunity to both diagnose and treat mental and emotional disorders); the speci-
fications for the supervisor providing clinical supervision of practicum and internship have
become more stringent; and the number of supervision hours has increased. These four aspects
make major differences in the job opportunities, types of practice, clientele, philosophical ori-
entation, and techniques emphasized throughout the student’s professional life. For these and
other reasons, each student needs to give considerable attention to practicum and internship,
especially under whose clinical supervision it occurs and for what period of time.
If a student is attending a counselor preparation program that is not accredited, it may be
wise to consider standards established by the appropriate national credentialing association
regarding practicum and internship when fulfilling the professional practice requirements of
the counselor preparation program. Additionally, we encourage you to keep careful records of
total practicum and internship hours, client contact hours, supervision hours, and supervisor
credentials – both on-site and on campus. The forms in this textbook can be helpful for such
record keeping.

CACREP Standards for Practicum and Internship

CACREP accredits entry-level counseling programs at the master’s degree level. The 2024 CACREP
Standards (CACREP, 2023) outline general expectations for all programs and specific educa-
tional standards for each speciality program area. Upon acceptance, counseling students can
enroll in one or more of these speciality programs:

„ Addictions Counseling
„ Career Counseling
„ Clinical Mental Health Counseling
„ Clinical Rehabilitation Counseling
„ Marriage, Couple, and Family Counseling
„ Rehabilitation Counseling
„ School Counseling
„ Student Affairs and College Counseling

The newest CACREP standards require 60 semester or 90 quarter hours of all programs. In most
cases, program faculty of accredited programs verify that students meet and follow the stan-
dards for practicum and internship. Here is a high-level summary of key aspects of practicum
and internship, including supervision:

„ Setting: An agency, institution, or organization appropriate to the program in one of the

above identified specialties.
„ Practicum: Minimum of 100 clock hours over a minimum 8-week academic term with
40 hours of direct contact with actual clients in the area of specialty; weekly average of
 Preparing for Practicum and Internship 5

one hour of individual or triadic supervision with site and/or faculty supervisor; and
weekly average of 1.5 hours of group supervision by faculty.
„ Internship: Minimum of 600 clock hours with at least 240 clock hours of direct service,
including leading groups; weekly average of one hour per week of individual or triadic
supervision, usually by site supervisor; and weekly average of 1.5 hours per week of group
supervision by a faculty supervisor.
„ Supervisor: Faculty supervisors must have relevant experience, professional credentials
and counseling supervision training and experience for face-to-face and distance
supervision. Site supervisors must have a minimum of a master’s degree, preferably in
counseling or a related profession; relevant certifications and/or licenses; a minimum
of two years of pertinent professional experience in the specialty area in which the
student is enrolled and/or appropriate counseling preparation; knowledge of the
program’s expectations, requirements, and evaluation procedures; and relevant training
in counseling supervision. Graduate student supervisors of entry-level programs must
have completed an entry-level professional degree consistent with CACREP standards;
have completed or are receiving training in counseling supervision; and be under the
supervision of a counselor education program faculty (CACREP, 2023).

MPCAC Standards for Practicum and Internship in Counseling

The Master’s in Psychology and Counseling Accreditation Council (MPCAC) accredits counsel-
ing and psychology programs located in regionally accredited colleges and universities in the
United States. Master’s degree students are educated in the science-based practice of counseling
and psychological services. The MPCAC accredits entry-level programs that prepare graduates
to practice in a variety of settings (schools, community and mental health agencies, pastoral
care, and others). Programs are required to have a minimum of 60 semester credit hours or
equivalent quarter hours and to be designed with consideration to licensure and certification
requirements in their state (MPCAC, 2023). With regard to supervised clinical experience, the
MPCAC 2024 Standards (MPCAC, 2023) require:

„ Setting: Schools and agencies that provide mental health counseling services.
„ Internship: A minimum of 600 hours across two semesters. At least 40% of the supervised
experiences should be direct contact hours.
„ Supervisor: Supervisor must be appropriately credentialed (commensurate with program
goals and relevant state requirements).

Counselor Certification

Counselor certification indicates to the public that the counselor has met national standards
established by the counseling profession, is an upstanding individual who practices in line
with an established code of professional ethics, and identifies with the counseling profession
and its core values. Certification is not a license to practice, although in some states national
certification can help with getting a state license. There are a variety of national certifications
that beginning counselors can pursue through the pre-eminent certifying body, the National
Board of Certified Counselors (NBCC).
6 Preparing for Practicum and Internship

National Board of Certified Counselors

The NBCC offers a generalist certification known as the National Certified Counselor (NCC)
credential as well as several specialty certifications. To qualify for the NCC credential, applicants
must graduate from a CACREP accredited entry-level master’s program with at least 48 credit hours
or from a regionally-accredited university whose program curriculum can be verified by the NBCC
(NBCC, 2024). In addition to these educational requirements, applicants must have documented
supervised clinical experience within their educational program, work experience post-graduation,
a professional recommendation, and a passing score on one of two exams: the National Counselor
Examination (NCE) or the National Clinical Mental Health Counseling Examination (NCMHCE).
Applicants who have graduated from a CACREP-accredited program in any of the eight specialty
areas may sit for the NCE or the NCMHCE immediately upon graduation or in the last semester
prior to graduation. After passing the exam and submitting a final transcript indicating conferral of
degree, they will be awarded the status of National Certified Counselor (NCC).
Applicants graduating from programs that are not CACREP-approved must complete a mas-
ter’s degree in counseling or master’s degree with a major focus in counseling from a regionally
accredited institution. Their program must meet specified course requirements. They also must
complete 3,000 hours of counseling experience and 100 hours of supervision by a supervisor
who holds a master’s degree or higher in a counseling field in their specialty or a related mental
health field. These hours must be completed in a two-year post-master’s time frame (NBCC,
2024). Individuals who complete the requirements may then be approved to sit for the NCE or
the NCMHCE to complete the pathway to certification as an NCC.

NBCC Specialty Certifications

NBCC awards specialty counseling certifications in three areas: addictions, clinical mental
health, and school counseling (NBCC, 2024). The requirements for specialty certification build
upon the NCC credential, which is a pre-requisite for each of the speciality certifications. In the
case of the Certified Clinical Mental Health Counselor (CCMHC) and the National Certified
School Counselor (NCSC), a minimum of 60 hours of master’s degree coursework is required,
with unique courses for each speciality area. The CCMHC requires passage of the NCMHC
Examination, while the NSCE requires passage of either the NCE or the NCMHCE exam. Both
credentials require post-graduate, supervised work experience. The Master Addictions Coun-
selor (MAC) credential also requires additional coursework (12 credit hours or an equivalent
in continuing education) in the addiction field, plus a passing score on the Examination for
Master Addiction Counselors. For more information regarding specialty certification, see the
National Board of Certified Counselors website.

Commission on Rehabilitation Counselor Certification

The Certified Rehabilitation Counselor (CRC) credential is offered by the Commission on
Rehabilitation Counselor Certification (CRCC). Counselors may sit for the CRC exam upon
completion of a CACREP-accredited master’s degree program to be awarded the credential of
CRC. Alternatively, students who graduate from a non-CACREP-accredited program can also
qualify for the certification if their educational coursework is verified and they also pass the
CRC certifying exam (CRCC, 2023). For information regarding additional requirements visit
the CRCC website.
 Preparing for Practicum and Internship 7

Other Specialty Counseling Certifications

Several other professional organizations offer special designations and digital badges that stu-
dents may find helpful to their professional career development. In the area of marriage and
family therapy, the American Association for Marriage and Family Therapy (AAMFT) offers
digital badges for clinical fellows, supervisors, and in the area of leadership (AAMFT, 2023). For
more information regarding these badges, visit the AAMFT website. The National Career Devel-
opment Association (NCDA) offers five specialty professional certifications, including the Cer-
tified Career Counselor (CCC) credential. Similar to other counselor certifications, eligibility
requires a master-level counseling degree with specialized coursework or continuing education
in career counseling, or, alternatively, passage of a career counseling assessment exam (NCDA,
2023). Graduates from a CACREP-accredited degree program can be fast-tracked for eligibility.
For more information visit the NCDA website.

State Licensure for Mental Health Professionals

Government-sanctioned credentialing is called licensure. Passage of a state licensure law for a

given profession restricts or prohibits the practice of the profession by individuals not meeting the
state-determined qualification standards (American Counseling Association [ACA], 2024). In the
United States, all 50 states and Washington, DC, Puerto Rico, and Guam have passed licensing laws
for counselors and psychologists. Although generally similar, the laws are not the same from state to
state, so you must go to the counselor licensure website of the state in which you intend to practice
to find information about licensing requirements for that state. Generally, school counselors are
certified but not licensed by each state. Other credible sources to learn about state licensing stan-
dards are the websites of the NBCC for mental health counselor licensure, AAMFT for marriage and
family therapists, and the National Certification Commission for Addiction Professionals (NCCAP)
for addiction counselors. In the United States, all states require psychologist licensure in order to
practice as a psychologist, and a doctoral degree is required.

Securing a Practicum or Internship Site

With this background information in mind, we turn now to consider the pragmatic aspects of pre-
paring to enter a field site, including securing a site. All individuals involved in the applied training
components of counseling and psychology need to carefully examine the expectations they bring
to the practicum and internship. The practicum professor, practicum student, site supervisor, and
professional accreditation agencies all have expectations about practicum and internship, which
may vary. We therefore provide a list of questions that counseling students should research and
answer for themselves before selecting a field site for a practicum and/or internship.

Guidelines for Choosing a Site

The practicum placement is often the first opportunity that a student has to gain experience
working with a client population. Approval to proceed to a field site placement usually occurs
after the completion of academic prerequisites and pre-practicum or practicum lab situa-
tions with volunteers or with peer counseling interactions where students can demonstrate
and practice basic counseling skills. Many counselor preparation programs offer students an
8 Preparing for Practicum and Internship

opportunity to have some say in determining practicum placement. For example, you may
prefer to complete your initial practicum at one site and move to a different site for your
internship. Or you may wish to do half of your internship hours at one site and the rest at a dif-
ferent site. Some school counseling training sites prefer that you split your internship between
the elementary or middle school and the high school. Some mental health agencies provide
both outpatient services and partial hospitalization treatment programs, and you may wish to
have experience in both settings. Your career and specialization goals, the expectations of the
university program, as well as the flexibility of the training site can all influence how you may
wish to pursue these options. Variations of your site hours and patient population are best
accomplished by negotiating for different placements in one system.
Although some programs may recommend students to find a site that fits their career goals,
it is more often students’ responsibility to identify and secure their field placement. Students
are required to contact the appropriate person at the site and go through an interviewing
process at the field site of their choice. The field site coordinators are responsible for selecting
students who they believe will benefit from the placement and who will best serve the needs of
the site’s client population. The student is responsible for obtaining a field site, but the train-
ing program establishes the guidelines and procedures for approval of the site. Most counselor
training programs have established guidelines and procedures for procuring a field placement
that can be approved by the program, and they provide a list of possible sites where students
have successfully completed practicum and internship. If you identify a possible practicum
or internship site that meets your career and specialization goals, but the site has no previous
connection to your university program, check with your university coordinator about how and
whether to proceed. An important consideration is always the credentials of the site and those
of the proposed site supervisor, as well as the site supervisor’s knowledge of the university’s
practicum and internship course requirements.
Identifying and applying for a field placement normally begins the semester before the stu-
dent begins the practicum. At this time, the student should purchase malpractice insurance if
the university has not purchased it as part of course enrollment. Your professional counseling
organization can provide you with information regarding insurance options. The student must
also obtain appropriate state clearances prior to beginning the placement, including a crimi-
nal background check. Clearances can take several weeks or even a few months to process. Be
sure to obtain these clearances before beginning your field experience as your university may
choose not to allow you to accrue hours until they have received your clearances, and the site,
likewise, may not allow you to see clients.
Prior to applying to the site, the student should thoroughly research each field placement
of interest. Some of this information can be obtained by reviewing the website of the school or
agency. Other information can come from informal sources, such as students who are further
along in the program or other professional counselors. The selection and application process
for practicum and internship sites can be confusing and at times overwhelming. To alleviate
some of the frustration, you might find it helpful to have a set of criteria in mind.

Criteria for Site Selection

In the sections that follow, we provide sets of questions and points of reflection pertaining to
key aspects of the field experience that may be helpful in determining the selection of a practi-
cum or internship site.
 Preparing for Practicum and Internship 9

Professional Staff and Supervisor

„ What are the professional credentials of the site personnel?
„ Do their credentials meet the standards of your professional credentialing bodies and
program accreditors?

Professional Affiliations of the Site

„ In what association does the site hold membership?
„ Does the site hold the approval of national certifying agencies?
„ What is the reputation of the site among other organizations and your university
program?
„ Does the site have affiliations or working relationships with other institutions?

Professional Practices of the Site

„ Does the site follow the ethical guidelines of the appropriate profession (e.g., American
Counseling Association)?
„ How much time does the site allow to be spent in direct service with individual clients?
With groups? With other professional activities?
„ What kinds of resources are available to personnel (e.g., a library, electronic resources,
ongoing research, professional consultation)?
„ What are the client procedures, treatment modalities, and staffing and outreach practices?
How are these practices consistent with the goals of the practicum/internship?
„ What are the policies and procedures regarding recording (audio/video) and other
practicum and internship support activities?
„ Do the staff members regularly update their skills and participate in continuing education?
„ Are continuing education opportunities available to counselor trainees?
„ How does the site supervisor communicate with the university training program?

Site Administration
„ What resources, if any, are directed toward staff development?
„ Does the administration of the site provide in-house funds for student and staff
professional development training?
„ How stable is the site? (Does the site receive hard money or soft money support? What is the
length of service of the director and staff? What is the site’s mission statement or purpose?)
„ Does the site expect students to complete hours over official university breaks (e.g.,
summer and winter holiday)?

Training and Supervision Values

„ What values regarding training and supervision are verbalized and demonstrated?
„ Will the supervisor be available for individual supervision for a minimum of one hour
per week?
„ Will practicum/internship students have opportunities for full participation?
10 Preparing for Practicum and Internship

„ What kinds of counseling and professional services are offered by the site, such
as individual counseling and/or therapy, group counseling and therapy, couples/
family therapy, psycho-educational group guidance or workshops, consultation with
professionals or families, career counseling, proposal writing, or student advising?
„ Are adequate facilities available for practicum/internship students?

Theoretical Orientation of the Site and Supervisor

„ What are the special counseling or therapy interests of the site supervisor(s)?
„ What supervisory models do the site supervisors use?

Many therapists are eclectic in their counseling practice, but many may also favor a particular thera-
peutic approach over others. Thus, if students are exposed to a supervisor who favors and supports
the use of a particular theoretical approach, it benefits the student to have knowledge of that the-
ory. Naturally, the advantage of having one approach to counseling is that it affords the student the
opportunity to become more proficient at it. Also, in mastering one approach, the student begins
to develop a clearer professional identity and advanced counseling skill set. Conversely, the disad-
vantage of learning only one counseling approach is that it may limit the student’s opportunity to
measure other approaches that could be more in keeping with his/her own style and personality.

Client Population
„ What are the client demographics in the placement site?
„ Who is the client population served and what are the primary clinical issues? Is the age range
narrow or wide? Are clients predominantly of a low, middle, or high socioeconomic level?
„ Do clients require remedial, preventive, and/or developmental services?
„ What opportunities exist for multicultural counseling?
„ Do the site and its professional staff demonstrate regard for human dignity and support
the civil rights of clients?

Multicultural counseling skills have become increasingly important for the practicing pro-
fessional counselor (Singh et al., 2020). The American Counseling Association’s Code of
Ethics (ACA, 2014, F. 11.c) asserts, “Counselor educators actively infuse multicultural/diversity
competency in their training and supervision programs. They actively train students to gain
awareness, knowledge, and skills in the competencies of multicultural practice.” The American
Mental Health Counselors Association’s Code of Ethics (2020) and the American School Coun-
selor Association’s Ethical Standards for School Counselors (ASCA, 2022) similarly emphasize the
importance of multicultural competency in the practice of counseling.
The demographic composition of clients whom you will serve across the United States
continues to diversify, a trend that is projected to last in the coming decades. The 2020 United
States census revealed interesting facets of the American population. For example, the nation
is aging due to the cohort of baby-boomers moving into older adulthood. About 55.8 million
people or 16.8% of the population are over the age of 65. Older adults tend to be among the
least served population with mental health needs and will require special attention and skilled
competence from counselors. Among all racial groups, the White-alone group is the oldest with
a median age of 43 years (U.S. Census Bureau, 2023). The White-alone racial group is still the
 Preparing for Practicum and Internship 11

largest in the U.S. at 204 million people or 61.6% of the total population, but this number has
decreased over 8% in the last 10 years (Jones et al., 2021). The Black-alone or African American
racial group comprises 46.9 million people or 12.1% of the total population. The third largest
racial group in the U.S. is the Asian-alone or Asian in combination with some other race, which
comprises about 24 million people (Jones et al., 2021). The most prominent ethnic group in
the U.S. is the Hispanic or Latino community, which makes up 62.1 million people or 18.7%
of the population (Menchaca et al. 2023). The Hispanic/Latino group is the fastest growing in
the United States in the past decade, with a 23% increase. There are a number of states where
the Hispanic or Latino population comprises the majority of a state’s demographic, including
most states in the U.S. southwest (e.g., California, Arizona, Nevada, and New Mexico).
Studies have suggested that counseling students’ “exposure to multicultural issues may
increase their sensitivity to and effectiveness with racially and ethnically diverse clients” (Con-
stantine & Gloria, 1999, p. 21). It is important to realize that age, race, and ethnicity are only a few
of the important variables about which you must be aware when considering diversity. Culture
must be defined broadly to include many variables and aspects of culture, such as social class, gen-
der, sexual orientation, disability status, educational attainment, geographic origin, marital status,
language, religion, and citizenship status (Remley & Herlihy, 2020). Counselors recognize that a
variety of cultural markers shape identity and these intersect with one another in unique ways,
affecting clients’ lived experience, including of privilege and disempowerment (Ratts et al., 2017).
Counselors also develop multicultural and social justice competence in the areas of:

„ Attitudes and beliefs, or awareness of one’s own cultural conditioning and how this
conditioning affects the personal beliefs, values, and attitudes of a culturally diverse
population.
„ Knowledge, or understanding the worldview of culturally diverse individuals and groups.
„ Skills, or an ability to determine and use culturally appropriate intervention strategies.
„ Advocacy, or an ability to empower clients or, when necessary, speak on their behalf to
those with whom a counselor has influence (Ratts et al., 2017).

It is clear that the majority of counseling and psychology programs have responded to mul-
ticultural imperatives by examining their curricular offerings and reacting positively to the
need for counselors to develop cultural competence. Some training programs recommend that
trainees have caseloads of at least 30% minority clients or other clients who represent diversity.
As a practicum or internship student, you might want to consider the client population of the
field site you choose in order to ensure you will have the opportunity to increase your under-
standing and application of multicultural counseling skills. It is also important to consider
the practices and policies of schools and agencies where you will be doing your training to
determine how these practices and policies support culturally competent practice. Considering
client systems is important particularly when problems are systemic rather than intrapersonal
(i.e., bias, prejudice, racism, sexism, homophobia, etc.).

Negotiating the Practicum and Internship Placement

After reviewing the resources available from your university with regard to practicum and
internship sites, and after considering the points of reflection offered here, you will want to
identify two or three field sites where you will apply. In many instances, several students may
be applying for the same practicum/internship site, which may have only a limited number of
12 Preparing for Practicum and Internship

openings. Consequently, you must approach the application process the same as you would in
applying for a job in the profession. Start by preparing a résumé that identifies your objectives
and the relevant educational, work, and volunteer experiences that support your application as a
counselor-in-training at that site. Thinking this through will prepare you for a face-to-face inter-
view with the contact person who will be making the decision about whether your background,
goals, and personal impression seem to be a good fit with their site. Contact the identified site
liaison to set up an interview. The contact person may be a supervisor of outpatient services at
an agency, a director of counseling or student services, an administrator at a school district, or
a specific supervisor at the site. When you go to the interview, dress as other professionals do at
that site. Remember, you are the one who is to be interviewed at the site. Be prepared to answer
questions about the skills, interests, and experiences that make you a good fit for the site.

The Interview Process

As with any interview, it is important to prepare in advance. We offer a few questions that you
may be asked during the interview. You may want to work with some of your peers to brain-
storm other possible questions and give thought to how you may respond:

„ Tell me what you know about the students/clients we serve. What makes you want to
work with them?
„ What do you hope to gain from training at this site?
„ What is your comfort level working with diverse clients?
„ How would you describe your role as counselor to a student/client?
„ Is there a theory that influences your practice as a counselor?
„ Have you had any life experiences that help you relate to the concerns that students/
clients may have?
„ What student/client concerns are you ready to begin seeing now?
„ Are there any problems that a student/client might present in counseling that would be
challenging for you to work with?
„ Describe your strengths as a counselor.
„ How can a supervisor support your development as a counselor?
„ Why did you choose our agency/school to do a practicum/internship?
„ What types of professional experiences are you most/least interested in?
„ What do you consider to be a rewarding practicum/internship experience?

In addition to answering questions in the interview, you may want to ask questions to clarify
information you have gotten from your research about the site. You may need more information
about how audio or video recording of sessions is permitted and managed. Are there any releases
to be signed or guidelines to follow, and how is confidentiality safeguarded? This can be a con-
cern if you are required to bring recorded session material to university-based supervision. You
might ask about what population of students/clients you would begin working with and how
you will make initial contact with them. In a school setting, counselors sometimes do outreach
by introducing themselves through classroom guidance activities, or they shadow another coun-
selor before seeing students one-to-one. In general, you will want to know what kind of applied
experience occurs at the beginning of the placement, and what range of practices are gradually
added to the trainee’s responsibilities, including individual and group therapy opportunities.
 Preparing for Practicum and Internship 13

When you are accepted as a counselor-in-training at the site, a written exchange of agree-
ment is made so that all parties involved in the practicum/internship placement understand
the roles and responsibilities involved. With regard to written contracts, most counselor or
psychology training programs have developed their own contracts. Specific guidelines fol-
lowed in the practicum or internship are part of the agreement. Guidelines identified by
national accrediting agencies are often used or referenced in formalizing the practicum/intern-
ship placement.
In the 2024 CACREP Standards (CACREP, 2023), the development of counseling skills is
emphasized. We suggest that the counselor preparation program identify the guidelines and
standards that it follows and include these in the contract. An example of a formal contract
between the university and the practicum/internship field sites is included in the Forms appen-
dix at the end of the book for your review. The sample Practicum Contract and Internship Con-
tract (Forms 1.1 and 1.2) can be adapted to the specific needs of your training program. The
contract includes a statement concerning guidelines to be followed, conditions agreed on by
the field site, conditions agreed on by the counselor preparation program, student responsibili-
ties, and a list of suggested practicum/internship activities. Form 1.3 is a Student Practicum/
Internship Agreement, which the student submits to the university practicum/internship coor-
dinator. The agreement form demonstrates the formal agreement entered into by the student
at the commencement of practicum and internship.

Getting Oriented to Your Site

Some field sites have a specific orientation for all new personnel to acquaint them with policy
and procedures for working with clients/students. Other sites have no formal orientation, and
you must seek out the needed information. When you meet with your site supervisor, start
by asking what you need to know about operations at the site in order to begin. Information
about site operations is related to space (offices, study areas); support people (receptionists, sec-
retaries); and access to resources (computer, phone, email, forms). Site operations also specify
how client records are kept (what is in the record, what notes and in what form, where and
how records are kept and secured).
It is helpful to know about the process a client/student follows when coming for counsel-
ing. How does a client/student get an appointment? How are they assigned to a particular
counselor? What is the intake process, and how and with whom do they schedule a next
appointment? Inquire about site policy regarding phone, e-mail, texting, social media usage,
or other media-related contact with clients/students.
You will want to know what a typical day’s schedule looks like for a counselor at the site.
Often, a new practicum/internship student will shadow the supervisor or another staff mem-
ber as an orientation. This gives the student an opportunity to experience the range of pro-
fessional practices at the site and the procedures associated with them. Finally, you will need
information about policy and protocols related to managing crisis situations or dealing with
client/student behaviors of concern.

Role and Function of the Practicum and Internship Student

The student who has been accepted to the field site will start as a novice in the counseling
profession but at the same time is a representative of the university training program and of
14 Preparing for Practicum and Internship

other student counselors. Unless explicitly employed by the site, the student is working in the
setting as a guest of the practicum/internship site. The site personnel have agreed to provide
the student with appropriate counseling experiences with the clientele they serve.
Although the individual freedom of the student counselor is understood and respected, the
overriding concern of the site personnel is to provide role-appropriate services to the client popu-
lation. The role of the practicum/internship student is to obtain practice in counseling or psy-
chotherapy in the way it is provided in the field site setting. The student counselor is expected to
adhere to any dress code or expected behaviors that are existent at the field site. In some instances,
the student may disagree with some of the site requirements; however, the role of the student
counselor is not to change the system but to develop his/her own abilities in counseling practice.
Occasionally, tension or conflict may arise between the student and site personnel.
Although such events are upsetting to all involved, these events can provide an opportunity
for the student to develop personal insight into and understanding of the problem. After all,
practicum/internship placement is real-life exposure to the realities of the counseling profes-
sion. Should the tension or conflict persist, the student should consult with the faculty liaison,
who is available to assist the student in the process of understanding his/her role within the
system and to facilitate the student’s ability to function in the setting.

Phases of Practicum and Internship

We conclude this chapter by providing you with a broad view on the phases of practicum and
internship that you will encounter once you have secured your site and begin practicum. The
transition from practicum through internship can be described from a variety of perspectives.
For example, one might describe the practicum and internship from the categories of level
of skill, such as beginning, intermediate, or advanced. Another way of categorizing phases
of practicum might be according to functions, such as structuring, stating goals, acquiring
knowledge, and refining skills and interventions. We prefer to describe practicum and intern-
ship phases from a developmental perspective. Several principles regarding development can
be identified within practicum and internship:

1. Movement is directional and hierarchical. Early learning in the program establishes a

foundation (knowledge base) for later development in the program (applied skills).
2. Differentiation occurs with new learning. Learning proceeds from the more simplistic and
straightforward (content) toward the more complex and subtle (process).
3. Separation or individuation can be observed. The learning process leads to progressively
more independent and separate functioning on the part of the counselor or therapist.

These developmental principles can be identified within the specific program structure, the
learning process, and the supervisory interaction encountered by the student. As you move from
practicum through internship, your field experiences will become increasingly complex, and
you will begin to see yourself as a differentiated counselor with a unique professional identity.

Development Reflected in the Program Structure

Students in a counseling or psychology training program can expect to proceed through a
well-thought-out experiential component of their programs. Generally, experiences are orderly
 Preparing for Practicum and Internship 15

and sequentially planned. A typical sequence begins with pre-practicum and moves to practi-
cum, internship, and full professional status (obtained after graduation and after receiving
post-graduate supervision hours).
Some variations exist in counseling and psychology programs regarding the number of
clinical hours required in each component of training. Some variations also exist in training
programs regarding the range and depth of expected skills and competencies that are neces-
sary before a student can move to the next component in the program. Generally, programs
begin with courses that orient the student to the profession. The history of the profession
and its current status, including ethics issues, might well be a beginning point. Early courses
tend to be more didactic and straightforward. As students enter the pre-practicum phase of
the program, they can generally expect more interaction and active participation with the
professor. In this stage, the focus is on basic skill development, role playing, peer interac-
tion and feedback, and observation activities in a classroom or counseling laboratory. In the
practicum component, the student is likely to be functioning at a field site with supervision
and on campus in a practicum class with university faculty. The focus in both settings is on
observation by functioning professionals as well as on initial interactions with clients. As time
progresses, the student becomes more actively involved with a range of clients and is given
increased opportunities to expand and develop the full range of professional behaviors. At
the internship end of the continuum, the student is expected to be able to participate in the
full range of professional counseling activities within the field site under the supervision of
an approved field site supervisor.

Development Reflected in the Learning Process

As students progress in their training, they tend to develop across several stages or steps of
learning. Initially, counselors-in-training often lack confidence in their skills and therefore
imitate the type of supervision they receive. They look to others for an indication of how
they should function in the setting. Counselors-in-training also tend to question their level
of skill development. As time passes, they may fluctuate between feeling competent and
professional and feeling inadequate. At this point, most students see the need to develop an
internalized theoretical framework, to give them a sense of “grounding” and to help them
to develop their own approach to counseling. Further learning helps counselors-in-training
develop confidence in their skills and an awareness of their strengths, weaknesses, and moti-
vations. Finally, students internalize and integrate their personal theories with their counsel-
ing practice.

Development Reflected in Supervisor Interaction

Supervisory interaction between supervisor and student begins with a high level of depen-
dence on the supervisor for instruction, feedback, and support. This interaction is mod-
ified as skill, personal awareness, and confidence increase for the student. The student
becomes more likely to explore new modes of practice that reflect his/her own unique
style. The interaction continues to move more gradually toward a higher level of indepen-
dent judgment by the student and a more collegial and consultative stance on the part of
the supervisor.
16 Preparing for Practicum and Internship

Summary

In this chapter, we described the current accreditation, certification, and licensing standards
that apply to students in counseling training programs. Specific attention was directed to the
CACREP and MPCAC guidelines for practicum and internship. In addition, we provided guide-
lines on researching practicum and internship sites, offered interview recommendations, and
provided suggestions for acclimating to your chosen field site. Students need to give careful
consideration to (a) the selection of sites where practicum and internship are experienced,
(b) the potential supervisor’s supervisory credentials, (c) the amount of supervisory time
available, (d) site opportunities to work with one’s chosen population and specialty area, and
(e) knowledge of state licensure requirements in the state where you intend to practice, espe-
cially as they relate to practicum and internship.

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Ethical Issues in Counseling

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Legal Issues in Counseling

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Working with Clients in Crisis and Other Special Populations

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Looking Ahead to a Career in Professional Counseling

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