The health service psychology education and training community has regularly expressed a commitment to quality internship training. The Psychology Internship Toolkit was originally developed at a time when there was an imbalance in the number of students seeking internships and the number of available internship positions, with the most significant imbalance occurring in 2012. At the time of this writing (June 2024), current data indicates a solid ratio of intern candidates to internships. Nevertheless, the importance of having a resource available to programs seeking to develop APA-accredited internships remains paramount to ensure quality training of psychology doctoral students.
The internship toolkit is intended to collect resources that can be used to gain institutional and financial support for creating and expanding internship programs. The framework of the toolkit is organized around individual modules, each of which represents a core component related to the structure of an internship program: rationale for developing internships; internship settings and structures; funding; administrative issues; legal and ethical considerations; quality assurance mechanisms; mentoring resources and emergency recovery procedures. Although it is hoped that many will find the entirety of the toolkit useful, each section was designed to be a stand-alone source of information such that the user of the toolkit could readily access the specific information desired.
expand allThe toolkit is intended to provide resources that can be used to facilitate institutional and financial support for creating and expanding internship programs.
Originally published February 2010, this November 2013 revision adds new information, deletes outdated information, and provides updated web links to various resources. The work group members are committed to the development of quality internships in professional psychology, and because of this commitment to our students and the profession we collaborated in providing significant and sustained energy to complete this revision in a timely manner. Our hope is that the toolkit will help ameliorate the imbalance between the numbers of students seeking internships and the number of available positions, and thereby serve the public and profession effectively.
Disclaimer: Much of the information contained in the toolkit is a compilation of existing resources. However, it has been developed and arranged in a manner that should facilitate easy use by those professionals interested in creating an internship in professional psychology. The reader is encouraged to follow web links to other documents in order to obtain additional information about specific areas. As a living document, the toolkit will need to be updated from time-to-time so that it is relevant and current. We believe that the CCTC will assure this updating process.
The Psychology Internship Development Toolkit was envisioned by CCTC to assist psychologists with information about developing internships in professional psychology. CCTC is composed of training councils in professional psychology, and therefore the vision for the toolkit was broad-based and designed to partially address concerns with the current internship imbalance. A work group of CCTC compiled the toolkit in 2010, and revised it in 2013:
Together, these psychologists represent several groups that participate in CCTC and have a vested interest in professional education and training in psychology:
The first widespread doctoral internships arose out of a need for psychologists to provide services to veterans of World War II. Financial resources from the federal government through the Department of Veterans Affairs were provided for training to develop the needed workforce. Federal support from the National Institute of Mental Health later provided large scale, additional, financial support for internships. However, federal support for internships has declined; consequently the economic structure of internships has dramatically changed. Complicating the reduced support from the government is the reality that many third-party payer systems, including Medicare, will not reimburse for services provided by a psychology trainee.
Thus, as the number of doctoral internship positions has grown, funding for such positions has, of necessity, come from more diverse sources. At the same time, doctoral training in professional psychology has attracted more and more students at a rate that has been greater than the creation of new internship positions. Consequently, as early as the 1970s and continuing most years up until the present there has been an imbalance between the number of students seeking an internship and the number of available positions offered in the APPIC match. Considerable efforts have been devoted to decreasing this imbalance; however, it is difficult to determine what impact these efforts have had. Although both the numbers of available internships and applicants seeking internships continue to increase, growth in the number of applicants exceeds creation of new internships. In the ten-year period from 2002–2012 the number of positions offered in the match grew by 16 percent (438), while the number of applicants increased by 44 percent (1,362). Specifically, 3,073 applicants were registered in 2002 and 2,752 positions were offered. In 2012, there were 4,435 applicants for 3,190 positions, although 426 of these individuals withdrew or did not submit rankings for the match. The results of the 2013 internship match were released on Feb. 22, 2013 and a total of 3,094 applicants were matched. There were 957 (24 percent) individuals who did not match; this is 84 fewer than in the 2012 match. A total of 282 positions were unfilled in phase 1 of the match. The number of internship positions offered in the 2013 match increased by 186 from 2012.
Rationale for Developing InternshipsTo the profession and the public. Internship provides the capstone experience in doctoral training in professional psychology, and psychologists involved in that training have the opportunity to help improve the profession. In addition to providing needed internships for current and future graduate students, an agency that develops an internship can help maintain quality control within the profession by ensuring that psychologists entering the field are competent.
To staff. The addition of an internship program to an existing organization can increase staff diversity in terms of demographic and cultural factors and expertise. This in turn may increase the number of professionals available to treat a specific population. Interns are often energetic and excited about their work and can help staff reconnect with their own passion for the field of psychology. Having interns who can provide clinical services may also free up staff to do research, pursue other interests, or assume other tasks and roles within the agency.
To professional growth and development. Supervising interns keeps staff members on their toes and may lead them to strengthen their own competencies. Enhanced competencies, especially in the area of supervision, may be of benefit to psychologists as they advance within an agency or in their careers.
To service provision. Psychology interns can provide quality services which expand the ability of an agency to serve its clients/patients. Developing an internship program is a cost-effective way of increasing staff and services in this tight economic climate.
To quality. Being a recognized training site within the field is often viewed as a measure of quality of the agency itself and accreditation is frequently linked to grant funding eligibility. This prestige may also lead to an increased ability to attract high quality staff to the agency.
It is a good idea to first gather information about what will be needed to create a successful, quality internship:
When looking at the costs of an internship program, look also at the financial benefits (cost-benefit analysis):
Next, determine what resources you already have and what additional resources are easily accessible:
Outline the benefits of developing an internship program:
Enlist the aid of staff members who are in favor of developing an internship to assist in gathering and presenting this information to administrators.
Developing an internship program may seem like a daunting task, but once in place it can be easily updated and improved as needed. Sites wishing to develop internships have access to assistance and resources from many sources — professional organizations, doctoral programs and other internship programs. Additionally, they can collaborate with potential partners to form a consortium internship, which may allow a site to pool their resources (funding, space, supervision and training) to form one collective, larger program. The remainder of this toolkit contains an abundance of useful information regarding the ways an internship can be structured, potential costs and sources of funding, legal and administrative issues, quality assurance, mentoring resources and additional tips for handling potential problems that might arise. We hope you will find developing an internship program to be an exciting and rewarding endeavor.
Internship Structures and SettingsIn structures we consider:
Structural and administrative components must allow for depth, breadth and intensity of training appropriate for the internship level of training — more advanced than practicum and less specialized than postdoctoral training.
Independent. Defined above as a “non-affiliated independent training structure,” these internships function within an independent institutional setting. While students train at internships that are distinct from their academic program, the internship and doctoral program work together in a collaborative manner given that the internship is a requirement of the degree in professional psychology.
Consortium. A consortium is comprised of multiple independently administered entities that have established a formal agreement to share resources to conduct a well-rounded, comprehensive and unified training program ( APA Guidelines and Principles for Accreditation (G&P) (PDF, 151KB) — all domains, but particularly B, C and F). Consortia are possible in the integrated, allied and capstone configurations. Consortia hold several advantages for internship development, notably fiduciary and shared resources. Sites that do not meet accreditation standards alone can be part of an APA-accredited internship. A consortial partner (member entity) of an accredited consortium may not publicize itself as independently accredited unless it also has independently applied for and received accreditation.
The G&P stipulate that the training institution has “among its primary functions the provision of service to a population of recipients sufficient in number and variability to provide interns with adequate experiential exposure to meet its training purposes, goals, and objectives” (G&P, B. Domain A).
There are no formal definitions for site types and settings. Sites are categorized by programs to best describe their institution, training emphasis, services and populations served. Many sites fit into multiple categories. In an overview of internship structures, Stedman et al. (2005) note that traditional internship training prepares students for the delivery of individual psychotherapy to adult outpatients, followed by work with child, adolescent, low-income, and seriously mentally ill patient populations, group therapy and brief therapy, and to conduct assessments with some or all of those patient populations. Less traditional and newer categories in listings for internship training include HIV/AIDS, administration, public policy/advocacy, primary care, eating disorders, sex offenders, feminist therapy, etc. Therefore, examples listed in Addendum A are not comprehensive, but illustrate major categories of internship settings.
Funding for internship training programs includes consideration of staffing (including training/supervision), office space, technology (computers, phones, recording equipment) and financial support (travel, support services, salaries, benefits). Traditional sources of funding for internship programs and intern stipends include department and agency operational budgets, revenue from service positions, grants, VA training fund, and others. In order to seek funding for internship programs and positions, consider investigating new or innovative sources of funding in addition to advocating for increased funding from traditional services. Most support for internship training has been provided by the agency offering the training program, but some non-traditional funding ideas might involve funding the intern regardless of the location or setting in which the training takes place.
Sources for grants include:
In seeking funding to support an internship training program, it will be helpful to develop a cost-benefit analysis. Jane Levin, in her cost-benefit analysis of the University of Minnesota Counseling and Consultation Center internship program, reports that there are four models of evaluating cost and benefit:
The information below is borrowed from a range of training related sources including, but not limited to APPIC (Association of Psychology Postdoctoral and Internship Centers), APA’s CoA (American Psychological Association Commission on Accreditation), CPA (Canadian Psychological Association) and CCTC (Council of Chairs of Training Councils).
Training programs are typically sponsored by an institution or agency whose primary functions include providing services to clientele of sufficient number and variability to meet training goals and objectives. A program may consist of, or be located under, a single administrative entity (institution, agency, school, department, etc.) or may take the form of a consortium. A consortium is comprised of multiple independently administered entities, which have, in writing, formally agreed to pool resources to conduct a training or education program.
The program has a designated director or leader who is a psychologist, appropriately credentialed (i.e., licensed, registered or certified) to practice psychology in the jurisdiction in which the program is located, who is primarily responsible for directing the training program and has administrative authority commensurate with those responsibilities. The program director’s credentials and expertise should be consistent with the program’s mission and goals.
The program has formally designated intern training supervisors who:
There is no formally agreed upon criteria for who can supervise. However, the core two hours of individual supervision must be provided by a doctoral psychologist licensed in the jurisdiction of the internship program. In addition, as noted above, supervisors’ background and training must be appropriate to the setting and services provided and have competency in clinical supervision.
There are a number of legal issues facing training programs, with several resources available through the APPIC website. In addition, APPIC provides informal problem consultation (IPC) when training directors, graduate program directors or psychology trainees would like assistance in exploring options and possible solutions to a variety of issues and concerns.
Users may find the following resources helpful in addressing legal issues in training:
All parties relevant to internship training — trainers, trainees and consumers including the general public — are concerned with the quality of psychology internships. Any proposed internship has two basic requirements:
Embedded in these requirements are assumptions that all services and training are ethical, that training experiences lead trainees toward completion of their doctoral degree requirements and licensure as psychologists, and that internship sites strive to meet the highest professional standards, including American Psychological Association (APA) or Canadian Psychological Association (CPA) accreditation. In fact, the APA Council of Representatives voted in July 2013, to adopt the resolution on accreditation for programs that prepare psychologists to provide health services, affirming,
“that health service psychologists must be trained in APA/CPA accredited doctoral and APA/CPA accredited internship programs or programs accredited by an accrediting body that is recognized by the U.S. Secretary of Education for the accreditation of professional psychology education and training in preparation for entry to practice.
APA also affirms that graduation from an APA/CPA accredited doctoral and APA/CPA accredited internship training program, or programs accredited by an accrediting body that is recognized by the U.S. Secretary of Education for the accreditation of professional psychology education and training in preparation for entry to practice, be a prerequisite for licensure in independent practice as health service psychologists.
Unaccredited programs that train health service psychologists are expected to obtain APA/CPA accreditation in a timely fashion following APA Council of Representatives approval of this policy, no later than five years for doctoral programs and no later than seven years for internship programs.”
All training programs are encouraged to undergo ongoing internal self-assessment to monitor continuously their own growth and development. That includes comparing the program to local, regional, state/provincial and national standards. Important steps to internal quality control include:
One critical first step in external quality assurance is making certain that any internship experience prepares the intern for eventual licensure as a psychologist. As licensure requirements vary by jurisdiction (state, province and territory), it behooves the internship to consider a broader geographic area than just the jurisdiction in which it is located, as it will likely draw interns who will become licensed in other jurisdictions.
There are a number of organizations, memberships and accreditations that can aid in quality assurance for internship training, and even provide mentorship in the accreditation process:
For psychologists who are considering starting an internship — or who are further into the process of developing an internship or trying to improve or expand an already existing internship — some of the most important help available is through speaking directly with other psychologists who are already involved with internship training. Several established organizations such as APPIC, APA and ACCTA have both formal and informal programs established to help with the internship process, and many graduate programs and training organizations stand ready to consult with potential internship directors.
While most of the organizations listed above under mentoring could also be helpful in a serious glitch or a major crisis, APPIC is your best resource for this, especially since many of these kinds of issues involve the viability of the internship itself. Please see Problem Consultation at the APPIC website. APPIC's email lists also offers informal problem solving with other APPIC members.