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As Natasha Howard started her internship last year, a clinical supervisor told her it was Howard's job to determine what makes her an effective therapist. "Mine is just to help you achieve that," her supervisor said.

The comment alerted Howard to just how much she needed to do to benefit from her supervisors at Yale University's School of Medicine.

Of course, much of the responsibility of effective supervision also lies with supervisors. But interns often don't shoulder enough of the responsibility themselves, largely out of deference, says Catherine Forbes, a George Washington University clinical psychology doctoral candidate interning at the Didi Hirsch Community Mental Health Center in Culver City, Calif.

"Over time I have seen students be afraid to be assertive, but not doing that can hinder your training," Forbes says. "And really, your supervisor won't get mad. They will talk to you about your questions and concerns."

SUPERVISION REDUX

Those concerns differ based on your training needs and your supervisor's expertise, says Forbes. Many internships, she notes, offer students multiple supervisors across areas such as therapy, assessment, trauma, group intervention, community research, professional issues and career planning, and program evaluation.

The variety means students can tap the most supervision in their areas of least experience-and supervisors expect them to take that initiative, says Shane Lopez, PhD, a University of Kansas psychology professor who interned five years ago at the Dwight D. Eisenhower Veterans Affairs Medical Center in Leavenworth, Kan. "They realize that you are only a year away from independent practice, so they may expect more from you," says Lopez.

MAXIMIZING SUPERVISION

Given those expectations, when problems emerge, it often falls to interns to seek solutions. Based on the experiences of Forbes, Howard and Lopez, here are some likely problems and potential solutions:

  • Problem: Scheduling difficulties. Interns and supervisors already have packed schedules, so finding time for weekly appointments can be tough. And when supervisors are off-site, it's that much harder, says Howard, a University of Georgia counseling psychology doctoral candidate. All too often, she says, weekly meetings get cancelled.

    • Solution: Hold your supervisor to appointment times and insist on rescheduling. At some sites, phone meetings are also an option. But if nothing works, let your internship director know, advises Forbes.

  • Problem: Too much focus on theory and not enough on you. "Some supervisors use the time to say how they do therapy, when you want to learn about how best you can do therapy," says Howard.

    • Solution: Arrive with an agenda. Have a list of questions, and make sure they get answered, advises Forbes. Adds Howard, "Always have in mind to steer the session back to your needs."

  • Problem: Fear of being faulted. Some interns are leery of letting on what they don't know, in case they might be judged negatively, says Forbes. "There's this fear of, 'Did I do something wrong?'"

    • Solution: Get over it. Be honest about your weak points and mistakes, advises Forbes. Ask for alternatives to approaches you have tried, and seek constructive feedback, she says, since "that's how you learn and get better at what you do." At some sites, clinical supervisors are even willing to critique your taped or videotaped sessions with clients.

  • Problem: Being sidelined. Whether because of other priorities or dislike of teaching, some supervisors rarely seem to have time for interns. At one of Forbes's practicum sites, for example, one supervisor never spent more than 15 minutes with interns, which, she says, "just wasn't ethical."

    • Solution: Don't allow it to happen. Speaking out about the situation may feel like a strong step, but it's often effective, says Forbes. At her practicum site, the interns insisted on more time from the unavailable supervisor-through talks with the supervisor and higher-ups-and they ended up getting it.

  • Problem: Not clicking with your supervisor. Being assigned to somebody you clash with can ruin your supervisory experience.

    • Solution: Try to pick your supervisors. This may sound impossible, since most internships assign them to you, but there are ways to link with people you like, says Howard. One way is to base your internship selection on the supervisors you'd have-looking for approachable professional role models, advises Lopez. Another is to pick an internship track or research area where you know you'll have a good mentor.

If you do run into conflicts with current mentors, talk openly and honestly with them about potential resolutions. Or, if worst comes to worst, ask to be assigned another mentor.

Based on her own positive experience, Howard says, "My strongest advice is to really look for one supervisor you can be very open with because that makes your internship year so much more comfortable."