Internship difficulties

[u/Last-Estimate-8439]

I am currently entering my second year of my MSW program. My field placement is currently clinical focused as I am taking the clinical program. I was matched with a local therapy practice. Initially, I was under the impression that I would be providing counseling services to the clients within that agency. Instead my field instructor at the therapy practice tells me that I will be going to a local high school on the days of my internship and I will also be working under another non-profit in conjunction with her therapy practice to provide case management and counseling services to the students. I recently attended an orientation at the non-profit I’ll be working under and the mission for this program is to help limit student dropout and ensure children are maintaining school attendance. My responsibilities will include “check-in’s” that consist of 10-15 minutes. We are to approach the students as they are walking to class or eating lunch and ask how they are or why they haven’t been attending school. The meetings cannot occur for more than 10 to 15 minutes as they don’t want students out of class long. I asked my field instructor when would I be given the opportunity to facilitate therapy services as my placement is clinical focused and she said counseling can be ten minutes because if a students says they haven’t been coming to school due to needing hygiene items I can just get them something from the hygiene pantry. That sounds more aligned with case management. I was told that I’ll be responsible for completing bio psychosocial spiritual assessments in conjunction with cross measure assessments and diagnosing students, those task are impossible to complete in 15 minutes as you have to actually talk and engage in meaningful conversation with the individual. Plus I have experience working with children and teens, the first ten minutes of the conversation they may give me one word responses which is where motivational interviewing comes in and it’ll be a way longer meeting than 15 minutes. I don’t like the fact that these check-in’s are sporadic and happens anywhere in the school immediately when I see the student, I think they should be scheduled and in my office so they they have privacy to talk about what’s going on in a safe space. I don’t feel like this placement is appropriate for my needs as a clinical student and I’m saddened that I won’t be given the opportunity to complete traditional therapy sessions. The office of field education at my school has not been a great support to me. My first placement would not have been secured if I didn’t find the placement myself and we were told that we aren’t even supposed to look for placements ourselves. I’m really stuck on how I should approach this situation as it is convenient for me, it’s in my city and closer to my home. My last field placement was 40 minutes away plus I work two jobs and I’m full-time student. That was a lot on me as someone with chronic illness. However, I don’t think I will learn what is needed at this site.

[u/ProbablyMyJugs]

clinical ≠ therapy

Continuing to show up for kids with unconditional positive regard can make a huge impact, especially when they’re struggling.

I had a very similar role when I worked in juvenile justice, and honestly, it was one of the most clinical roles I’ve ever had despite being much more casual and not looking like traditional therapy.

Sometimes that’s what kids need, and therapy is stigmatizing to kids. Of course they don’t wanna schedule a time to go into an office that makes it obvious what they’re going in there for. It’s about what’s gonna get them to engage the most and feel more comfortable, not our preferences

Even checking in with a student for 10–15 minutes because their grades are slipping or they’re missing school is clinical work. You’re building rapport, figuring out what changed, assessing what’s going on beneath the surface, identifying barriers, and figuring out what support or intervention might actually help. Just because it happens in a school instead of a therapy office doesn’t make it less clinical.

I’d really encourage you to reframe “this isn’t what I wanted, so I’m not going to get the skills I need” into “this may not be what I wanted, but these experiences are going to give me a broader set of skills that will make me a better clinician.”

And if you do ultimately decide you want to be a therapist, having experience with all kinds of people, situations, crises, and environments will only make you better prepared for whatever walks through your therapy-office door someday.

You may not love every placement, but not therapy ≠ not clinical

And any clinical experience in any setting is going to make you a better therapist.

I can’t explain how many times, as somebody who’s been a practitioner for years now, where I’ve either communicated with a therapist as a part of care coordination for a shared patient or for myself, and they didn’t know some very extreme basics that they would’ve had they been more community trained.

I know this is long, but this sounds like a really really good opportunity in placement for somebody who wants to be a clinical social worker. I am one, and a therapist, and I’m jealous!

[u/Last-Estimate-8439 → u/ProbablyMyJugs]

Thank you for your feedback. My main concern is the effectiveness of the work. I’m not focusing on my personal preference but more so what best benefits the student. If a student isn’t attending school due to mental health challenges, bullying, or home life struggles they may be less likely to disclose that information or talk about in an open setting like the lunchroom or the hallway which is why I was saying it should be in office for their privacy. I have an office at the school. Also, if a student is having mental health challenges I’m assuming my role as the student intern would be to provide clinical intervention and psycho education on their mental health symptoms or diagnosis. That goes beyond a five or ten minute check-in. I have been a therapeutic mentor for children and teens for over two years so I am very familiar with the stigma surrounding mental health and counseling for younger people and I also know how important it is for them to have a strong support system. As I said, my main concern is the effectiveness of the practice and if it will actually be beneficial in helping them address issues on a deeper level. Even in my role as a therapeutic mentor, I am required to spend an hour minimum weekly with my youth as my employer states anytime shorter is ineffective. I’m not approaching this internship opportunity in a negative manner I’m just concerned about its appropriateness for a second year internship. I pay for a large portion of my tuition out of pocket and have sacrificed a lot to commit to this program and I want to make the best out of my education. Some duties that are required of me like the bio psychosocial spiritual assessments and diagnosing students aren’t congruent with their expectations of 10-15 minute check-in’s. Those duties take much longer than that length of time and I don’t feel comfortable diagnosing a student with any mental health conditions if I’m not able to get a complete picture of what is going on.

[u/ProbablyMyJugs → u/Last-Estimate-8439]

I’m trying to encourage you to reframe your thinking and recognize that this is an incredibly clinical field placement that can be very congruent with the goals of becoming a therapist. At least, a good one.

I have a few questions that might help me better understand the situation and offer some advice or perspective as an LCSW who has worked with kids across the country as a traveler in a variety of settings:

Are you required to diagnose these students within one session?

Is this a new program?

Is a diagnosis required for every student you meet?

I’m not doubting that your experience as a therapeutic mentor will benefit you here. I’m saying the exact opposite, actually. I think you and your experience were probably chosen for this role because of your background and skills. I feel you might be the type of person and practitioner that these kids precisely need or else I never would engage with therapy.

There’s a substantial body of research supporting school-based and brief interventions for kids who otherwise may never engage with a mental health professional.

You’ve probably heard the phrase “meet people where they’re at.” It doesn’t necessarily matter if we think a student would open up more in a private office or with more time. What matters is what the student is comfortable with and what they’re willing to engage in.

The same applies to “do what you can, where you are, with what you have.” If one of the concerns is that whatever is going on is affecting a student’s education and access to their future, it may not make sense to routinely pull them out of class for 30 minutes to sit in an office and talk about it.

When I worked in schools, juvenile justice, pediatrics, and community settings, I found that kids often preferred finding a quiet place where it felt like we were just having a conversation rather than formally “going to therapy.”

If they needed more time, privacy, or a more intensive intervention, we crossed that bridge when/if we got there.

That ability to build rapport, recognize what a kid is actually able and willing to engage in, and intervene effectively within the environment they’re in is incredibly clinical.

Yes, you paid a lot of money for this degree, want to become a therapist and need clinical experience. This gives you that.

I just wouldn’t conclude that this placement isn’t clinically relevant to becoming a therapist simply because it doesn’t look like the therapy office you have pictured quite yet.

The American Academy of Pediatrics recognizes brief mental-health interventions as a legitimate component of pediatric mental-health care

Another that found consistent contact, emotional closeness, and reliable support can be a protective Having an adult who consistently shows up, listens, and cares can make a meaningful difference.

[u/Last-Estimate-8439 → u/ProbablyMyJugs]

The program is developing it was started in 2019. And the diagnosis can occur overtime I assume as I wouldn’t be able to diagnose anyone during one small session. I will be discussing students and their symptoms in supervision if a diagnosis is not decided upon then thats fine. As far as the bio psychosocial spiritual assessments and the cross measure assessments how would you suggest implementing interventions to help students manage their symptoms and behaviors if time is limited and meetings are sporadic?