How to Prepare for a Mental Health Internship

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Mental health internships allow students to learn hands-on clinical skills in various settings. Most graduate-level psychology programs require students to complete a practicum and an internship experience before graduation. A successful mental health internship can be achieved by knowing what to expect, having clear goals, and preparing.

Before an internship, mental health counselors may be required to do a practicum. Most practicums are short-term and focused on observation rather than direct counseling contact. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) states:

Policy A.2.f. Duration of Practicum:

The duration of a student’s supervised practicum experience is to extend across a full academic term, as defined by the institution, to allow for the development of basic counseling skills and the integration of knowledge.

During this time, the student shadows other counselors to learn the ins and outs of the business. Some agencies may want their practicum students to perform a little clinical work, such as co-leading a therapy group. Students can ask questions about the site before beginning the practicum experience to clarify expectations.

When a student enters a counseling session to observe, the counselor will ask the client for permission. A client can refuse to have a student come into their session. If the client agrees, the student sits off to the side and listens. During this observational training time, the student will witness how counselors establish trust and ask clarifying questions. They can also notice how different clients present in session and in what way to clinically respond.

After the session is complete, the student can ask the counselor any questions about what was observed. Often, schools require students to keep a log or journal of their observations.

The hours completed at these sites will be included as part of the application for when a counselor applies for state licensure. For this reason, it is important to keep all records of the clinical and supervision hours received at the practicum and internship sites. Check your school’s requirements and state licensure laws concerning whether a practicum is required for your educational and career goals.

Internship Requirements

The internship is a direct clinical experience with clients. Most mental health internships require 600 clock hours, of which 240 hours are spent in direct contact counseling clients. The internship spans two semesters and can be up to fifteen to twenty hours a week. The student needs to prepare for the time commitment involved and know most internships for mental health counseling are unpaid.

If the student wishes to graduate with two specialties in counseling, such as mental health counseling and family therapy, the student is required to complete two different internships (CACREP 2024):

Policy A.3.k. Completion of multiple accredited specialized practice areas.

If a student wishes to graduate with multiple counseling specialized practice areas concurrently, the student must meet the degree requirements of each CACREP-accredited specialized practice area. This includes meeting the curricular requirements for each specialized practice area, and a minimum of a 600-clock hour internship for each specialized practice area. All specialized practice areas must be included in the degree at the time it is awarded

Supervision is a must for internships. When researching potential sites, students need to keep in mind supervisors are required to have at least three years of experience to supervise an intern and be licensed. Interns can expect to have individual and group supervision. Group supervision is with other interns and a qualified supervisor. Supervisors meet once a week with interns to address client issues, countertransference, and clinical skills development.

Self-Reflection

Before beginning a search for an internship, it is important to engage in self-reflection. Setting goals will help define your search. For example, if you want to work as a college counselor, you would focus your search on internship experiences in a college setting. Think about what populations you are passionate about and focus on those.

Sometimes, a student isn’t able to get into their ideal setting. If this occurs, focus on the population you want to work with. For example, is the work you want to do with adults, adolescents, or children? If you cannot get into a college setting, consider a mental health clinic working with adults. Students may need to be flexible. All the skills learned in a counseling internship can help a counselor in the future, no matter where the counselor works. After the internship is complete, the student can focus on applying for jobs in their most desired setting.

Where to Find Internship Opportunities

Most graduate schools offer a list of potential sites or businesses looking for mental health interns. Mental health internships often occur in hospital settings, clinics, colleges, or organizations. You should take the initiative and inquire into other local opportunities. Networking with established mental health professionals can lead the student to a placement or a suggestion to a site. Many people find job prospects from people they know and trust or consider referrals from those with whom they have an established relationship.

The American Counseling Association has a list of practicum and internship sites listed by state.

Craft Your Resume and Fill Out Applications

The resume needs to be tailored for each site. List your education, skills and relevant experiences regarding counseling. Mention any skills related to the counseling profession. For example, communication, listening, leadership, resolving conflicts assertively, goal setting, and goal completion.

In the application, it may ask for references. Include references that speak to your counseling skills or previous employment. Ask your professors for a letter of recommendation.

Apply to Multiple Sites

Internships can be competitive. It is best to plan on having three or four sites to apply to. If an offer falls through, it is a good plan to have a backup strategy.

Plan for and Attend Interviews

Come prepared and research the business you are applying for. Look at their website for any recent news stories. Find out about their mission statement and values. Learn about their various services, such as group, individual, or family counseling. What populations do they work with? Is it a general practice or specialized to treat one form of mental illness? Think about how you can contribute to their company as an intern. Why are you a good fit?

Practice common interview questions. Think about specific examples from your past work experience or counseling experiences. What skills do you offer? You may be asked about specific examples of ethical dilemmas or how to handle confidential communications. Take some time to practice with a friend or family member to increase your confidence.

Come prepared with a few of your questions about the organization. This is your opportunity to see if this placement best fits your career/learning goals. Consider inquiring about the caseload an intern is expected to have or if they offer continuing education opportunities. Ask how many years of experience your supervisor has to ensure it matches with your school’s or state’s requirements.

End the interview with your interest in the position and express your gratitude for their time. You will want to leave with a good impression. After a few days, you may want to follow up with an email thanking them and expressing your interest.

After the interview, use this time to examine your own thoughts and feelings. Think about what you liked about the company and any concerns you have. How do you feel your interview skills were? Are there areas you can improve upon?

Increase Self-Care

Before you begin a counseling career, you will want to increase your self-care. A healthy work-life balance is key to your mental health and those you serve. The more you care for yourself, the better you can be present and conduct therapy for others.

Self-care decreases burnout and compassion fatigue. It is essential to give yourself time and space away from the counseling work you do in order to process and integrate. Make five to ten minutes each day to connect with yourself free from distractions.

Be Open to Learning

Reading and class instruction will be only one type of learning toward a career in mental health. An internship is hands-on clinical experience. Many situations encountered while counseling won’t be covered in class. This is where supervision becomes an essential part of a counselor’s newly emerging career.

Look into any readings, groups, or educational opportunities your supervisor suggests. For example, if you are working with clients who are experiencing substance misuse, it can be helpful to attend AA (Alcoholics Anonymous), NA (Narcotics Anonymous), or SMART recovery groups. These groups can help you learn about the daily struggles of addiction and recovery.

Counselors can also learn from their clients. Transference and countertransference are a part of the counseling process. Clients often teach counselors about life and healing. We are all learning from each other.

Ask your supervisor questions. An intern is not expected to know everything or be the perfect counselor. Make the most of the experience and learn as much as possible. Supervision and continuing education will be important throughout a counselor’s career because counseling is a dynamic field in which something can always be learned.

Obtain Liability Counseling Insurance

Students who are interns are recommended to obtain a student liability insurance policy. This coverage will protect an intern’s work in the event of a malpractice lawsuit. Each agency has their own lawyer. That lawyer’s interest is to serve the company, not each employee. Student policies are sold at a reduced rate from other counseling professional policies.

Before starting a clinical internship, look into various insurance policies and sign up.

Lisa Hutchison, LMHC

Writer & Contributing Expert

Lisa Hutchison, LMHC, is a licensed mental health counselor for the Commonwealth of Massachusetts. She works for professionals who want to treat and prevent compassion fatigue. With over 20 years of psychotherapy experience, she helps her clients assert themselves, set boundaries, and increase their coping skills. Her specialty is decreasing stress, anxiety, and depression while increasing realistic methods of self-care for those who help others. Ms. Hutchison’s psychological advice has been featured in Reader’s Digest and the Huffington Post. Her articles have been published in numerous magazines, including Grief Digest and Today’s Caregiver.

Lisa is the bestselling author of I Fill My Cup: A Journal for Compassionate Helpers and a faculty member writer for NetCE. Her latest continuing education unit publication is “Setting Ethical Limits for Caring and Competent Professionals.” She has taught creative writing in colleges and presented on boundaries for the compassionate helper; the use of expressive art to heal grief, anxiety, and depression; inspirational and motivational topics; and creative writing techniques.