Degree In Sight

Unaccredited internship

For two years, Kilianne Kimball devoted a lot of time, energy and money to the internship hunt, buying new clothes, practicing answers to interview questions, reading site materials and spending thousands of dollars on airfare — all while raising two small children.

"It was exhausting and expensive," says Kimball.

But all that work went unrewarded. Two years in a row, she failed to get an internship through the Association of Psychology Postdoctoral and Internship Centers (APPIC) match, forcing her to make a decision: Should she go another round, delaying graduation and again traveling for interviews? Or should she go outside the system and seek an unaccredited slot?

Kimball's quandary has become all too common for psychology graduate students. Since 2004, more than one in five students who've applied annually for an internship through the APPIC match didn't initially get one. In February, 846 students went unmatched.

As a result of the imbalance, psychology's education and training community worries that a growing number of psychology doctoral students may be turning to unaccredited internships. That's a problem because opting for an unaccredited internship can limit students' licensure and employment opportunities down the road, says Catherine Grus, PhD, APA's deputy executive director in education. Students who take unaccredited internships are ineligible for positions with the Department of Veterans Affairs, the single largest employer of psychologists. They are also barred from civilian positions with the military. In addition, a handful of states require aspiring psychologists to have had an APA-accredited internship to be licensed, and many others require them to show that they completed the equivalent of an APA-accredited internship.

Perhaps the greatest concern about unaccredited internships, says Grus, is quality assurance. To achieve APA accreditation, an internship program must submit a comprehensive self-study explaining its structure for supervision and educational programs, and it goes through a site visit with representatives from APA's Commission on Accreditation. Compared with an APA-accredited internship, an unaccredited position has not gone through this rigorous regulatory process to prove its quality, she says. "That doesn't necessarily mean that it's a poor-quality internship," says Grus. "It just means that it's not been subjected to an external review using established standards."

The unaccredited route

So far, psychology educators don't have data on how many students may be taking unaccredited internships outside the match process, Grus says.

Jessica Swope, PhD, stayed within the process but opted to take an unaccredited internship at Catholic University's counseling center in Washington, D.C., in 2008.

She had interviewed at eight sites in the D.C. region during the internship application process and ranked Catholic's program high on her list for the APPIC match, even though she knew it wasn't an accredited internship.

When Swope started the application process in the fall of 2007, her husband, her family's main breadwinner, was working in the Washington, D.C., area and their daughter was 3 months old, so she needed to stay in the region. Also, Swope knew she'd be well-supervised and -trained at Catholic because she had done her practicum training at the university's counseling center. "I spoke with enough people to know that I'd be able to do what I want to do professionally, even with a nonaccredited internship," says Swope.

A year after she completed her internship, Catholic University's counseling center received APA accreditation, but because Swope's internship ended before the accreditation site visit in 2009, the status doesn't include her internship.

Swope, however, feels she received high-quality training at Catholic. She videotaped all her therapy sessions and each week received six hours of supervision from three supervisors who trained her in a range of interventions, including cognitive behavioral, psychodynamic and group approaches to therapy. Because her supervisors had different theoretical orientations, the internship helped strengthen Swope's integrative approach to therapy, she says.

"It was an extraordinarily rich training program, in terms of the quality and quantity of supervision that I received," she says.

She now works as a therapist under the supervision of a licensed psychologist with a private practice in Washington, D.C., and plans to get licensed in Maryland. Under current standards, Swope knows that she won't be able to work for the Department of Veterans Affairs or as a civilian psychologist with the military's health system, but that limitation didn't affect her career goal of being a private practitioner and, perhaps in the future, an adjunct professor, she says.

A job hurdle, for some

Future career flexibility is more of a concern to Renee Patrick, PhD, who in 2003 completed an unaccredited internship in Lawrence, Kan. She didn't match with an internship on her first try through APPIC, and she couldn't afford to wait a year to try again because she had a young son to support. Also, she knew she could be licensed in Kansas without an accredited internship, so she decided to go the unaccredited route.

Patrick found the internship at a community mental health center in Lawrence through the APPIC Clearinghouse. To make sure she'd receive quality training, she read up on the site and consulted a professor who had gone to graduate school with her future supervisor.

As she expected, the internship provided her with solid training. She worked with children, testing them for attention-deficit hyperactivity disorder, mood-related behavior problems and conduct disorder, and applied theoretical knowledge she'd learned in graduate school, she says. However, the fact that it wasn't APA-accredited has come up in her job interviews, Patrick says.

"I think this dampens interviewers' excitement about hiring me," she says.

Patrick got licensed in Kansas without any problems, and now runs the dual-diagnosis outreach program for patients with mental illness and intellectual disabilities at Parsons State Hospital and Training Center in Parsons, Kan. But, she says, if students can afford to keep trying for an accredited internship, they should.

"If they really want maximum flexibility, they should wait," she says.

Kimball's decision

Though it meant another round of essay-writing, grueling interviews and a few thousand dollars in airfare, Kimball eventually decided to try the APPIC match a third time to keep all her future career opportunities open.

"I wanted the career option of working for the government," she says. "I'd really like to work at a VA in the future."

Fortunately, her third try garnered a match. In August, Kimball and her family packed up their home in Palo Alto, Calif., and flew to Detroit, where she started a yearlong training program at Wayne State University's School of Medicine on Sept. 1. The program is a perfect fit for Kimball, who wants eventually to work as a member of an interdisciplinary team of health-care professionals at a medical center.

"The supervisors are fabulous; the training opportunities are abundant, varied and flexible; and the seminars are fantastic," she says.

As far as Kimball is concerned, the two years she didn't match weren't wasted time. She defended her dissertation and passed the Examination for Professional Practice of Psychology exam for master's-level licensure in Kansas.

"Not only is my specific site a great fit for me, its APA-accreditation keeps all doors open for me in the future," she says.