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Nearly There... When Peers Disappear

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I took for granted all the peer support I have had since beginning my pre-licensed hours.   I marvel at how I missed the wise minds and supervisors I had at my disposal since the beginning.  Mind you, some supervisors were better than others for sure, but the wealth I stumbled upon evaded me until it grew less bountiful.  As I’m nearing the end of these long, hard-earned 3000 hours, I notice an icy stillness and silence beginning to creep in. At hour number one, it started out like a race. Sprinting as fast as you can to get away from the very beginning, hoping to outrun your shame of inexperience. I wanted to know more, do better, be the best. I had very little tolerance for mistakes or missteps. I needed to be seen as gifted. In order to do this, I had to seek out the flaws associated with my peers. Peers who were also running their own race, running away from their own inexperience.  This is the conflict I created, I loved their support, their understanding, the...
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The Lost Art of the Generalist

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During my second year in grad school I was confronted with the dreadful task of picking the topic of my thesis.  It felt insane to me at the time and looking back - I still think it's an insane thing.  I had no clinical experience, I had only just completed psychopathology II, and I hadn't even the faintest notion of what I might do for practicum which was another semester away.  What in the world am I supposed to be interested in enough to plunge myself into studying and researching for a year? People around me seem to have it figured out.  A good friend of mine at the time was deeply interested in childhood sexual abuse, another friend of mine was interested in autism, another was interested in vicarious traumatization of therapists.  They all seemed to have one thing they wanted to know about, they wanted to throw themselves into.  Amazing!  I envied their certainty and their concise, decisive passion.  The problem with me is that I wanted to...
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The Dangers of Gratification: Clinical Considerations for the Advanced Intern

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One of my favorite things about being an intern has been in the opportunity to come together as a group with other pre-licensed clinicians. It has been a tremendous place for learning and sharing in my experience.  Whether it's group supervision, group trainings, clinical case conference, or a consultation group - it's always been one of the best parts of the job for me.  I've benefited both from receiving support and giving it.  There is a shadow side, too.  You don't always get along with colleagues, group facilitators, etc. I've been a part of groups that totally didn't work for me for a number of reasons.  For the most part, I think these kind of groups tend to be really good.  Even in groups that haven't worked for me, I've learned something really valuable. I thoroughly enjoy connecting with therapists - but I'm also picky with who I keep the closest. Among many things, there has been a thing of particular importance that I've noticed ...
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Private Practice Hustle

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I'm on month 2 of this private practice internship.  It was not nearly as hard to set-up as people warned me it would be. In fact, logistically, it was pretty simple and straight forward.  My supervisor and I went through the process together - we did our research, met with the payroll company, filled out the necessary paperwork, and boom! It was done! We're still working out some details but the clinical work has begun, a trickle of money is precariously rolling in. Referrals - that's the hard part. I've never been a good sales person.  I don't really like putting myself out there, especially on my own behalf.  Thank goodness I have kids to worry about feeding which motivates me to put them ahead of my own fears.  My sense of worthiness in this field is still young, inconsistent, not yet reinforced with many years of experience - and I maintain a sense that seasoned clinicians can smell it on me... the lack of “seasoning” perhaps. My emails and phone call...
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The Adolescent and The Intern: Parallel Process

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I was sitting in the car the other day after my mother (who isn’t in the field of mental health) gave me a long talk about my career choices.  Having just left an unpaid position I love due to an unplanned pregnancy, at the very least I needed to decrease the cost of childcare and figure out how to round up some extra cash before baby number two comes along.  As an MFTi, this isn’t so easy.  Even as a Spanish-speaking MFTi, it’s hard to find a position that will pay you more than the cost of child care in the Bay Area.  It’s a very real struggle. I feel stuck between my career dreams and my family dreams.  Private practice seems like a good option but it takes sacrifice, building, commitment, and time to pay off. I was also thinking about my work with adolescents over the years. As one of my very first gigs when I started doing clinical work I was assigned to a middle school in San Rafael.  “Crap...” I thought, “not  middle school... anything but mi...
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Intern Termination

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The week of Thanksgiving I had to terminate my entire, full caseload at a site for long-term depth therapy that I had been at for over two years.  Still reeling from this the following week, I was talking to a colleague of mine, a fellow MFTi, who reminded me that termination experience for interns can be very different than for those who are licensed in a set career in private practice or otherwise.  If a client goes to see an intern therapist, they will be very likely guaranteed an untimely ending to their therapy unless they initiate termination.  Interns shuffle around, they often move to different placements, they branch out, they stagger around, they have life events that come up.  And if an intern is a woman in her child-bearing years and is like myself - she may leave to have babies and develop her family in the window of time she has to do so. My friend and I concluded confidently: It’s more likely that as an intern you will encounter termination as a ma...
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Forging a New Identity

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My first thought as I begin to write is, "Oh my God - Who cares what an intern has to say?"  I imagine this is appropriately reflective of my overall experience as an intern. Nevertheless, here I write with a vague notion and blind faith that it's the right thing to do. The first two years of my journey were a steep learning curve - relying heavily on theory to lend me ego strength as I navigated my way through first sessions with clients, supervision, paperwork, countless hours of training and so on.  More recently, something has shifted for me.  I find myself guided by my own intuition and sense of humanness.  This is both exhilarating and completely terrifying. It came about only recently when I sat with a supervisor who was going over a session with me.  I was doubting my own judgment on a particular intervention I used when he asked me, "What makes you so unentitled to your own authority?" I was pissed he would even ask this perfectly placed question....
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