Table of Contents

Preface  ix

Chapter 1: Preparation  1

    Theory into Practice, 1

    Terminology, 1

    Meeting with Your Instructor, 2

    Finding and Selecting a Placement, 2

    Peers and Campus Resources for Locating Internships, 3

    Community Resources, 3

    Choosing a Placement, 4

    The Rights of Applicants and Character Requirements for Interns, 10

    Internship Agreements, 10

    Evaluation, 12

    Using This Book, 13

    References, 14

Chapter 2: Getting Started  16

    First Impressions, 16

    Enthusiasm Meets Experience, 17

    The Role of the Intern, 18

    The Role of the Professional, 18

    Meeting Clients, 22

    Age and Experience Issues with Clients and Supervisors, 23

    Time Limits, 24

    Fees for Service, 25

    Altruism versus Money, 25

    Is Treatment Effective? 26

    Clinical and Ethical Issues Pertaining to Fees, 26

    Inoculation: What Not to Learn, 29

    Internship Classes And Peer Groups, 30

    Forming Internship Peer Groups, 30

    Models of Peer Group Learning, 31

    Elements of Successful Classes and Groups, 32

    Video or Audio Recordings of Sessions, 34

    Role Plays, 35

    Introduction to Journal Work, 36

    References, 38                       

Chapter 3: Ethical And Legal Issues  41

    Ethical Guidelines of the Helping Professions, 41

    Competence, 45

    Informed Consent, 46

    Confidentiality, 48

    Exceptions to Confidentiality, 52

    Insurance Company Inquiries, Managed Care, and Ethical Practice, 56

    Confidentiality with Minors, 58

    Dual Relationships and Boundary Issues, 59

    Ethics in Classes and Groups, 65

    Liability and Insurance, 66

    Technology and Ethics, 68

    Research Ethics, 70

    Summary, 71

    References, 71

Chapter 4: Supervision  79

    What is Supervision? 79

    Hopes and Fears of Interns, 79

    Hopes and Fears of Supervisors, 80   

    Clarifying Expectations, 81

    Frequency and Timing of Supervision, 81

    Content of Supervision, 82

    Didactic Supervision, 83

    Case Notes and Discussions, 83

    Tapes and Role-Plays, 85

    Live Supervision, 85

    Observing the Supervisor in Therapy, 86

    Remote Supervision–Internet, Telephone, and Other Technologies, 87

    Theoretical Orientation, 88

    Supervision and Therapy: Differences and Similarities, 89

    Transference and Countertransference, 93

    Suggested Guidelines for Therapy and Supervision, 94

    Conflict in Supervision, 94

    Evaluation, 96

    Planning for Future Supervision, 98

    References, 99

Chapter 5: Working With Diversity  102

    Reasons for Diversity Training, 102

    Resistance to Diversity Training, 103     

    Steps Toward Working with Differences, 105

    Self-Awareness: Knowing the Diversity within Us, 105

    Confronting Our Biases and Acknowledging Our Ignorance, 107

    The Historical Context Must Be Acknowledged, 108

    The Current Context Must Be Acknowledged, 109

    Strengths Must Be Recognized along with Problems, 110

    Ethnic-Identity Development, 110

    Developing Culturally Sensitive and Relevant Skills, 112

    The Culturally Sensitive Counselor, 112

    Culturally Sensitive Intervention Approaches, 114

    Cultural and Organizational Change, 115

    Summary, 116

    References, 116

Chapter 6: Clinical Writing, Treatment Records, And Case Notes  119

    Writing Skills, 119

    Writing Can Be Learned, 119

    Focusing Reading to Learn Writing, 120

    Practice and Feedback, 120

    Rewriting, 121

    Common Writing Problems, 122

    Keys to Good Writing, 122

    The Function and Maintenance of Records, 127

    What Goes into Records, 127

    What Stays Out of Records, 129

    Progress Notes and Psychotherapy Notes, 130

    Standard Formats, 130

    Progress Notes, 131

    Standard Formats, 132

    SOAP Notes, 134

    Time-Sequenced Notes, 134

    Process or Progress Notes, 135

    Signing Notes, 135

    Dictation, 135

    Progress Notes and Supervision, 136

    Using Your Notes, 136

    Other Guidelines, 137

    References, 137

Chapter 7: Stress And Self-Care  139

    Client after Client, Day after Day, 140

    How Common Is Stress among Helping Professionals? 140

    Sources of Stress, 141

    The Effects of Stress, 143

    Secondary Trauma, 146

    Burnout, 149

    Self-Care, 153

    Cognitive Self-Care. 155

    Physical Self-Care, 158

    Emotional Self-Care, 160

    Organizational Measures and Peer Support, 161

    Multimodal Self-Care, 162

    Personal Therapy, 162

    Positive Effects on Therapists, 163

    Financial Self-Care, 164

    References, 164

Chapter 8: Assault And Other Risks  168

    The Risks of Assault, 168

    Coping with Aggression, 170

    Strange Behavior and Strange People Are Not Necessarily Dangerous, 170

    Understand Developmental Differences, 170

    Understand and Recognize Motivational Factors, 171

    Situational Factors and Violence, 172

    Recognize Potentially Dangerous Individuals, 173

    Early Prevention of Violence, 175

    Institutional Responses to Threats of Violence, 175

    Prevention of Imminent Violence with Clients, 176

    Responding to Assault, 177

    Assault-Response Training, 178

    Aftereffects, 178

    Stalking, 179

    Summary, 181

    References, 181

Chapter 9: Closing Cases  183

    Ethical Considerations and Termination, 183

    Understanding Client Reactions to Early Termination, 183

    Understanding Intern Reactions to Early Termination, 184

    Common Problems in Termination, 185

    Toward Successful Termination or Transfer, 185

    Issues to Address in Termination, 187

    Techniques for Termination, 188

    Transferring Clients to Other Therapists, 189

    References, 191

Chapter 10: Finishing The Internship  192

    Concluding the Supervisory Relationship, 192

    Letters of Recommendation, 194

    Procedures for Those Seeking Letters of Recommendation, 195

    Concluding Relationships with Staff, 195

    Letters of Thanks, 196

    Looking Ahead, 196

    Professional, Community, and Political Involvement, 197

    References, 198

Chapter 11: Frustrations, Lessons, Discoveries, And Joy  199

    Learning from Whatever Happens, 199

    Lessons We Wish Were Not True, 199

    Lessons about the Lessons, 201

    Discoveries and Joy, 201

    Closing Comments, 202

Appendix A: Internship Selection Checklist  205

Appendix B: Placement Information Form  209

Appendix C: Internship Learning Agreement Record Form  211

Appendix D: Intern Evaluation: Supervisor Form  215

Appendix E: Intern Evaluation: Intern Form  219

Appendix F: Emergency Contact And Procedures Information  223

Appendix G: Ethical Guidelines  225

Appendix H: Treatment Agreement And Informed Consent  227

Appendix I: Supervisor Evaluation Form  231

Appendix J: Clinical Activities Record Sheet  235

Appendix K: Placement Evaluation Form 237

Indices  241

Author Index, 241