Want to make the most of the required 3000 hours of supervised experience, especially the post-Masters’ internship phase?
You CAN DO IT!
C = Clinical Competence
A = Advocacy
N = Networking
D = Diplomacy
O = Optimism
I = Integration
T = Therapy
This essay was written by Rajani Levis, in collaboration with Laura Siniego & Veronika Gold.
With over two decades of cross-cultural experiences on two continents, Rajani is an EMDRIA Approved Consultant in EMDR therapy. She is passionate about making EMDR therapy more culturally attuned and universally accessible to clinicians and clients. She is sought out by clients for her nuanced attention to diversity issues, and specializes in the impact of childhood and historical trauma, as well as immigration narratives. As a writer, counselor-educator and a psychotherapist, Rajani is actively working to build community for therapists in private practice.
For the past two decades, Laura Siniego has worked in California as a licensed MFT and in Mexico as a research psychologist, university professor, licensed psychologist. Her areas of focus include immigration narratives, intimate partner violence and trauma work using EMDR. Laura offers supervision to prelicensees who are eager to traverse the rich contextual layers of gender, culture, race, sexuality and other diversity.
Don’t forget to read Laura’s guest blog on The Prelicensee Paradox.
Veronika Gold is a therapist with offices in San Francisco and Menlo Park. She specializes in the treatment of trauma and relationship issues. She is a Somatic Experiencing Practitioner and EMDRIA approved EMDR Consultant and Certified Therapist. Veronika volunteers as an Assistant in Organic Intelligence HEART training and on the EMDRIA membership committee. She is a Certified Realization Process Teacher, has an Advanced Training in Emotionally Focused Therapy, supervises MFT interns and enjoys supporting new therapists.
Rajani: I have spent many years now, chewing on the challenges of the prelicensed professionals who hold the future of psychotherapy in their tired, stressed-out hands. Given the stresses of time and money, here are some true and tried tips to help you make the most of your 3000 hours, whether paid, unpaid or a combination of both.
Use the phrase "CAN DO IT" as a way to get the greatest benefit from your prelicensed hours ~ you'll come out ahead of the game!
C = CLINICAL COMPETENCE
“For the things we have to learn before we can do them, we learn by doing them.” - Aristotle
In graduate school, I learned about hundreds (maybe even thousands) of concepts such as narrative therapy, schizophrenia, motivational interviewing and post-traumatic stress disorder. It was the 3000 supervised hours that transformed this clinical information into clinical knowledge and finally into clinical competence. Along the way, each placement, each supervisor, each client, each colleague, each supervision meeting, and especially each mistake became an opportunity to transform “learning” into “knowing” through experience. Graduate school can only take us so far, but it is in the doing of the work and in the practice of therapy, that we truly understand and integrate the textbook learning and make it our own.
Working toward your license is an opportunity to work with a variety of clients and presenting issues. This pushes you not only to increase your knowledge in those areas, but also to notice how these issues touch you personally and culturally. I recommend that you work in a variety of settings and with a variety of clients, even if you already have a specialized interest.
I encourage you to attend different trainings and expose yourself to a variety of approaches. Many trainings offer scholarships and discounts for trainees and interns that can make it more affordable.
A = ADVOCACY
“Life always waits for some crisis to occur before revealing itself at its most brilliant.”
― Paulo Coelho
Although Client-Centered Advocacy is one of the official categories in which interns can accrue hours, we rarely give this skill its due. Whether it is an adult child who is learning to set boundaries with an intrusive parent, or a client who is afraid to ask her boss for a raise; we are consistently empowering our clients to advocate for themselves. Advocating for your clients allows you to discover new details, new narratives, other perspectives and parralel realities.
You will also have many opportunities to practice advocating for yourself during your 3000 hours. For example, I often encourage prelicensees to advocate for a more manageable case load, or for additional training in areas of weakness. It is in the challenging moments that we have an opportunity to be empowered to seek a new outcome.
Learn to advocate for yourself and ask for what you need from your supervisors. Your supervisors, consultants, peers, and your therapists are the ones you will be bringing into the room with your future clients. I cannot express enough how important it is to find a variety of these supportive people and advocate for yourself, so you can, in time, become the best supervisor, consultant, colleague and therapist for others.
In our work with clients who feel marginalized & disenfranchised, often we begin by supporting and validating the client’s perspective. Over time, we allow new narratives to unfold, which in turn, empower our clients to advocate for themselves. In my experience, even clients who perceive themselves as trapped, have choices in reality. Limited though the choices may be, we need to capacitate our clients to perceive the element of choice in their actions. If a client complains about being in a mandated therapy group, I point out that they chose the mandated group over jail time, and that therefore, they are here as a willing volunteer and not a victim.
This is just one way of advocating for our clients so that they can feel empowered by viewing other, more expansive perspectives.
N = NETWORKING
“Relationships are all there is. Everything in the universe only exists because it is in relationship to everything else. Nothing exists in isolation. We have to stop pretending we are individuals who can go it alone.~ Margaret Wheatley
When I was new to the field, even though I expected to get turned down, I would email some of my established colleagues to invite them to tea. I was surprised by how warm, friendly and approachable my senior colleagues were as well as their willingness to mentor me. I encourage you to take the chance and reach out to local therapists whose work you admire. You may find out that networking can be interesting, invigorating and illuminating.
As I established myself in private practice, I realized that by staying in touch with former professors, supervisors, colleagues, and mentors, I had created a large relationship base, which generated so many referrals that I could share the abundance with colleagues. For me, networking is a fancy name for staying in touch.
As therapists, we are the instrument of our trade, and we are our own brand. Increasing the visibility of our brand and making our name familiar is a useful marketing strategy. Teaching at the university, offering trainings and workshops, writing articles and mentoring prelicensees are just some of the ways in which doing what I love can also be a marketing and networking tool.
It takes time to figure out what is your favorite marketing and networking style: meeting in-person, email communication, blog posts, articles, giving workshops or talks, leading groups, etcetera. Many interns say that they are hesitant to start marketing as they are not sure what their style is, who they want to work with. I encourage you to do it anyway, doing so will speed up the process. It is not about being perfect and having it figured out but staying with the process and moving forward.
D = DIPLOMACY
“The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.” ~ M. Scott Peck
You’ve probably already discovered that even therapists end up in sticky situations. Exiting a placement without burning bridges or requesting a change in supervisor without blaming or shaming anyone, are just two of the many scenarios that quickly come to mind.
In the moments of holding ambivalence and learning to articulate ourselves skillfully, we come to a new understanding of diplomacy. Artful negotiation & skillful word-choice become our allies in our work. Learning to work through disagreements and problem situations requires exemplary communication skills. Not only will your personal and professional relationships benefit from learning this, you can also model this for your clients.
Interns are regularly faced with the dilemma of being new to the profession, while also needing to maintain a professional demeanor of competence. Finding the balance between staying open to feedback and training, while holding the space for clinically challenging cases, is only one example of the prelicensee’s need to learn skillful communication.
As an intern, I remember being assigned far more cases than I could handle, and I found it hard to say “No”, because I did not want my supervisor to see me as unwilling or incompetent. My desire to be omnipotent got in the way of my realistic perception of my own abilities. Finding a way to skillfully communicate this to my supervisor without blaming her, or shaming myself, was the skill I needed to learn time and time again. This diplomacy, this skill of balanced communication and perspective-taking is a vital therapeutic skill.
O = OPTIMISM
“It all depends on how we look at things, and not how they are in themselves.” ~ C.G. Jung
Nancy Bavis, who has helped thousands of San Francisco State University students graduate with a Masters Degree in Counseling talks about how each student encounters at least one significant life-event during their training. From changes in relationship status to developmental life events of aging, birth and death, from financial issues to traumatic events, life continues to happen while we navigate our three thousand hours. It appears that we are all confronted with challenges that have the power to become either the stumbling block or the turning point in our journey.
The two significant turning points in my journey were an assault by a client that led to learning about EMDR Therapy, and a vicious encounter with vicarious trauma that led to deep insight and integration. Through it all, optimism helped me to stay present.
Today, as I sit with clients, I value that my optimism was earned through my own life experiences, and doesn’t wax and wane with the phases of the moon. I am grateful for the hard-won tool of optimism and encourage you to use your most challenging moments to refine this tool.
To me, optimism is not about being happy all the time, or being unrealistic about life and its challenges. Optimism is about seeing reality in a way that helps you to continually step forward. Irvin Yalom listed “Hope” as one the most significant therapeutic factors, and I believe that my job as a therapist is to hold the hope and optimism for a client during their darkest moments. I see optimism as an act of positively reframing subjective reality within the therapeutic framework: a way of highlighting the goal, rather than the obstacles.
I = INTEGRATION
“You must find your dream, then the way becomes easy. But there is no dream that lasts forever, each dream is followed by another, and one should not cling to any particular one.” ~ Herman Hesse
As a prelicensee, I sometimes hid behind my therapist persona, and at other times, I felt completely raw and vulnerable. The various conflicting parts of me were often activated and I struggled to figure out who I was. In those moments, all I could hold onto was that I was in the process of transformation. This is a common experience of becoming a therapist.
As we move through this journey, we need to find ways to integrate our personal and professional identities, our wounded child, our disowned parts, our shadow and more. Three thousand hours encompasses many phases in our professional and personal growth, and therefore it is important to acknowledge that this journey is a process of synthesis. Our goals, motivations, dreams, desires, fears and hopes often change during this time of transformation and the process will not be hurried. Although 3000 felt like such a huge number, as I look back, I don’t think I could have been ready any sooner. My journey of integration took me to India and back, not to mention the unexplored vistas within me. So I encourage you to be patient with your own journey of integration, and allow it to unfold in its own timing.
I remember that all my early interventions were based on how I experienced things in my own therapy. It took many years for me to look back and recognize that originally, I was following the template that I was most intimately familiar with: the ways in which I was receiving support in therapy.
Initially, how I was as a therapist, was different than how I was as a person. Over time, I developed my own style which was more congruent with who I am. I learned over time that integration is the work of a lifetime and that my personal and professional identities continue to evolve every day.
T = THERAPY
“Sometimes, reaching out and taking someone's hand is the beginning of a journey. At other times, it is allowing another to take yours.”
~ Vera Nazarian
I am a firm believer that we must allow ourselves to be metamorphosed by the very mechanisms that occur in the therapy room, in order to earn the right to sit with our clients. Three thousand hours provide us ample time and opportunity to resist and to engage in our own personal therapy.
Joseph Campbell spoke about how no tribes have ever created any rituals to keep winter from descending, but that all rites are a preparation to endure the season of terrible cold. As you go through the cold winters of your licensure process, consider therapy as a vital ritual that can nourish your spirit to endure the challenges.
I believe that personal therapy and continuing personal work are prerequisites to being a successful therapist. There is no hiding from our unresolved issues and, as challenging as that can be, I find it incredibly rewarding. I have witnessed over and over again that we can only take our clients to and through places that we have been and have worked through in our own process. If you are not in personal therapy, this is the time to make a phone call and set up your first session.
Like I said above, I believe that personal therapy is the best template from which to learn to be a good therapist. If we do not know how challenging it is to be on the client side of the couch, we cannot fully empathize with our client’s experience. Learning to be a client is a vital ingredient in learning to be a therapist.
Many interns struggle with the financial challenges of living in California. Yes, it is hard to take on the added expense of personal therapy. On the other hand, I also hear interns complain about how hard it is to find high-functioning clients who want to be in therapy. So be a part of the solution by making your own therapy a priority. Knowing the client side of the couch intimately will make you a much more compassionate and competent clinician.
As Lawrence Block said:
“Our happiest moments as tourists always seem to come when we stumble upon one thing while in pursuit of something else.”
You never know how your niche will emerge, and your internship hours are a wonderful way of exploring the unexpected, which could lead to brilliant new discoveries and stunning vistas. In spite of the enormous challenges, we are lucky to be in a profession where none of life’s experiences are wasted upon us. From the banal to the most exhilarating, from the maudlin to the terrifying, all of our life experiences have meaning and power in the therapeutic encounter. Our personal understanding of pain, sorrow, anger, frustration, fear and boredom, help us to be more present with our clients each and every day.
The practice of being a therapist is a practice in synthesizing and making meaning of our life experiences. The road to licensure is just the beginning of the life-long journey of synthesis. As you encounter stresses and delays, frustrations and life’s trials on this 3000 hour journey, I’d like to remind you again: