Navigating Internship as a Research-Oriented Clinical Psychology Student

Navigating Internship as a Research-Oriented Clinical Psychology

Student

Andrew D. Peckham and Jessica Hamilton

Match Day has come and gone, and between July and September of 2017, more than 3,500 students will begin the challenging and exciting experience of beginning their clinical internships. Internship entails a number of challenges, including learning new clinical skills, developing new relationships with mentors, colleagues, and training directors, and for many, relocation to a new region of the country. For research-oriented clinical psychology students, the transition to internship comes with the added challenge of maintaining research productivity while simultaneously undergoing full-time clinical training.

Fortunately, there are many internship sites that provide research-friendly opportunities such as dedicated time to work on scholarly projects, mentorship from research-oriented clinical psychologists, and opportunities for new research collaborations during the internship year. The match process allows research-oriented students to identify and apply to sites that openly allow for such opportunities alongside clinical training, and there are a number of resources (such as the APPIC website and individual program brochures) that allow students to select sites that will maximize their research potential. Yet, even interns at “research-friendly” internship sites often struggle to find the right balance between internship training responsibilities and their ongoing academic pursuits.

In the article below, we provide the results of a series of interviews with current and former research-oriented interns from a number of internship programs located in the Northeast and Midwest. While this is by no means a representative sample of all research-oriented psychology interns, the perspectives they offer represent some common themes and pieces of advice that we hope will be helpful for new interns to hear.

1. How would you recommend interns balance their clinical, research, and personal/life responsibilities?

Intern: Set small research-related goals for yourself that you think will be manageable given your intern schedule. If possible, ask around and choose the rotations that are less demanding if you have a particularly stressful research-related deadline or project you'd like to be working on. However, I would say to keep in mind that this is a demanding clinical year, and you will likely not be able to be as productive as you would like! Also--a huge thing I would recommend if possible is to have your dissertation defended. If possible, try to submit for publication as many of the ongoing projects from graduation school prior to going on internship. It becomes hard to balance old projects with new projects, especially with the limited time!

Intern: I found it important to carve out specific times or activities that I enjoy for each week. For example, putting a fun community activity on my calendar for the weekend to make sure I got out of the house, rather than just lounging in PJs all day feeling guilty about research work! It was also important to me to leave as much of my work “at work” as I could, even if that meant staying a little later to finish up rather than bringing work home with me. 

Intern: This is an exciting and challenging year. Regardless of how much research you want to do (or have done in the past), remember that it is a clinical year even at the most research-oriented sites. I definitely expected to have more research time on internship than I do. However, that is not because of the grueling clinical hours, but rather prioritization of my personal life in a very busy year! It was really important to me to explore my new city, build solid friendships with my fellow interns and postdocs, and maintain my connections with family and friends living farther away. I would say that flexibility is key—and that you should focus on what is important to you and accept that it will change based on the time of year, deadlines, and whatever life throws at you. The biggest thing for me is to remember that this year is a unique balancing act and it does not necessarily reflect anything more than that!

2. What have you learned about yourself from internship? 

Intern: I had some unique clinical experiences prior to internship, but the ability to try working with new types of presenting difficulties, in different settings, and with different therapy modalities has made me really appreciate clinical work! I found that I really enjoy working with clients in intensive outpatient programs, for example. On the flip side, I’ve also learned that I have a very hard time saying no, especially when I’m being asked to do things by multiple different people in different domains (clinical work, research, administrative), so that has been a challenge.

Intern: The internship year confirmed and intensified my desire for a research career, which has been helpful in clarifying my training goals for post-doctoral training and beyond. In addition, my internship provided many opportunities to work with diverse and varied clinical populations, which further opened my eyes to what I do and do not enjoy about clinical work as well as new populations I might be interested in conducting research with in the future.

Intern: I have learned that I know way more than I thought I did prior to coming on internship! I have also learned to be more reliant on and confident in my own decision-making skills. In graduate school I had a really supportive mentor who I would run most decisions by. I still have her guidance, but have had to learn to make more decisions on my own. It's unsettling but with practice and time I'm learning to navigate this better.

Intern: I have learned that it really is possible to balance clinical and research responsibilities in the same career. So often in graduate school, it seemed like clinical work and research were completely different parts of my life, but I’ve learned from internship that it is possible to have both of these roles fully complement each other.

3. How have your own expectations shifted over the course of the year, in terms of your expectations about how much research you expect to get done during internship?

Intern: I think overall my expectations haven't shifted much. In fact I may have had more time than expected to do research. But it takes flexibility - using a couple hours here or there rather than expecting to have half a day. 

Intern: Although the internship program I attended is primarily clinical, there was an emphasis on and time dedicated to research. At the beginning of internship, all interns were required to set research goals for the year, which helped set my expectations for the year. Overall, my expectations were met or exceeded in terms of how much research I expected to get done during internship. 

Intern: Manage your expectations about how much research you can get done during internship! While it is certainly possible to stay productive, there is no way around the fact that you will have fewer hours in the day to work on research. This is a fact that deserves some radical acceptance at first, followed by strategic planning. Once I accepted that there is less time for me to devote to research than I would like, I found that it was easier to pick a few specific projects to focus on.

4. What advice would you give to new interns about settling into a new place, institution, and/or position?

Intern: I think I have a few pieces of advice: 1) Give yourself some time to settle in! If you can move to your internship site’s city before the start of internship, do it. It’s stressful to start a new full-time position regardless, but it’s more stressful when your whole apartment is in boxes and you don’t know how to get to the grocery store! 2) Ask for clarification (from all supervisors - research, clinical, training directors) about expectations up front. It’s much easier to have those conversations when you’re starting a new rotation or working with a new mentor than it is to address miscommunications later on. 3) Don’t sign up for too many projects, patients, etc. right away - it’s easy to feel like a kid in a candy store with a lot of new opportunities in front of you, but it’s much easier to add something a month in than it is to stop doing something you’ve already agreed to. 4) Recognize that you’re new, and that just because things have always been done a certain way in your previous experiences doesn’t mean that will necessarily fly at the new place. Also remember that people may have very different opinions than you (about certain theoretical orientations, for example), especially if you’re starting at an institution or in a city that’s very different from the one where you did your training. Acknowledge the experience and expertise of those around you!

Intern: Enjoy and explore! I found that my internship mentors have been much more likely to encourage me to spend my free time pursuing activities that bring me pleasure and adventure. This exploration led me to feel much more enmeshed in the larger community of my city than I felt in graduate school. 

Intern: Try to find those supportive people, whether it be friends, family, or mentors, especially if you are moving somewhere new. For me, building a supportive network has been the most significant piece of adjusting to a new place, job, home, and people.

Intern: Embrace your cohort! I found that my strongest supports this year came from having a close-knit group of fellow interns who were going through the same challenges that I was. Even though internship doesn’t leave much time for socializing, take advantage of lunch breaks, downtime, and happy hours to get to know your co-interns.

5. What advice would you have for navigating different research mentors (including current and past advisors)?

Intern: I think it’s helpful to have a conversation with your graduate advisor before you go on internship about what their expectations are for you (and what your expectations are for them) during the internship year. Do they want you to write up your dissertation into a manuscript? Do they want you to be Skype-meeting with them weekly? Do you want to be meeting with them a lot when maybe they would prefer to be in less frequent contact? Will you have any responsibilities to your old lab? I think that, if you’ve had that conversation before internship starts, you’re in a better position to set up reasonable expectations with your internship research mentor. I also think that my earlier advice (don’t sign up for too much too early) applies here - it’s better to set limited, reasonable goals for yourself with your internship research mentor and then be pleasantly surprised by being able to take on more later than it is to say you can do 5 projects but only deliver on 2!

Intern: Broadening your research network is both amazing and challenging. Specifying your training goals to your mentorship team is essential as well as making explicit the role you see each mentor playing in achieving those goals. Putting things in writing always helps.

Intern: Your new mentor will undoubtedly be different from your grad school mentor, who you have now known for 5-6 years, at least. So, it takes some time to adjust to a new mentor's style and personality. If a meeting doesn't quite go how you wanted it to, take some time to reflect on how your learned interactional style in these meetings might contribute to any miscommunications. Problem solve about how you might structure the interaction or approach your mentor differently so that you can have a more productive and clear meeting. That being said, from the outset make sure to ask around about the mentor's style and personality prior to making any commitments--it is stressful to have a difficult mentor, especially during internship!

Intern: Don't over-extend yourself. It's good to make some new connections, and keep the old ones in good shape, but don't promise too much too soon. It's easy to get excited and agree to lots of different projects, but you have to protect your time and be realistic. Most mentors understand that. Importantly, just be honest about your time up front. 

6. How would you have approached this year differently knowing what you know now?

Intern: I think I would have set clearer plans for myself about how to balance my own research projects with the clinical work. Even when I’ve had rotations with relatively lower clinical workloads, it’s just very mentally taxing to be working clinically all day, and then try to “switch” your brain to a more research-focused line of thought. I might have done better with research productivity if I’d set specific goals for myself on a weekly basis, with the hope of staying more on track.

Intern: I would have approached the internship year with more purpose from the very beginning. Because I was initially ambivalent regarding the value of a purely clinical year, my approach was to let experiences come to me rather than specifically seeking out certain experiences. This year has made me re-evaluate that approach and led me to be more explicit in my goals for post-doctoral training.

Intern: In retrospect, I would have given myself “permission” to take more time off from the clinic to work on research projects earlier in the year. I was surprised at the amount of vacation time and “professional” days off that my internship site allows, and once I learned how easy it was to ask for a day off to work on writing, I definitely took advantage of that opportunity. I would have approached my training director about taking time off for research earlier in the year if I had been more confident about making this request.

7. How did you decide the next steps in your career? What advice would you give for people in their internship trying to figure out the next steps? 

Intern: I was pretty sure going into internship that I wanted a career focused on research. I think if people are unsure, it's good to think - "could I do this full-time?" or "do I actually miss research?" Because for me, I missed research quite a bit, and I knew that while internship was a good training experience, it wasn't what I wanted to do for my career. I also relied significantly on supervisors for career advice - I highly recommend getting multiple different opinions and perspectives. 

Intern: I decided on the next steps of my career based on balancing my long-term career goals with my personal/family goals. I recommend that future interns consider the setting, location, and fit of their next step (e.g., postdoc) as it could provide opportunities for future employment. 

Intern: So much of the internship year can be thought of as “networking” for postdoc, particularly if you are able to stay at the same institution. So don’t be afraid to set up meetings with researchers at your internship site and ask about ways to get involved with their team, even if you may not have the bandwidth to join their team right away. Go to lab meetings, go to grand rounds or other talks, and see if there are people at your internship institution that might be a good fit for your next steps. It’s also never too early to start looking into postdoc options. It’s a remarkably fast turnaround between starting internship and applying to postdoc positions, so be sure to set aside time early in the year to think about what your next steps might be.

8.  Any other advice that would you give to new interns? 

Intern: Take the clinical opportunities available to you, even if you don’t intend to pursue clinical work as a primary career! First, you might find you really like certain kinds of work, which can inform your career plans or at a minimum where you want to focus your hours for postdoctoral requirements. Second, even clinical work in populations that didn’t seem relevant to my research has helped me develop new hypotheses and new ideas that will benefit me in research in the future. Third, it’s the last chance you get to be fully focused on your own training!

Intern: Be open-minded, use cognitive reappraisal often, and have fun!

Intern: Be open to new experiences, but also remember that you can’t do it all! Prioritize what is important to you – it’s okay to politely decline an offer (clinical/research). Also, remember that this is your training, so you should not hesitate to experience it fully and make it what you want/need!

Intern: Don’t be afraid to (respectfully) rock the boat a little. At many internship sites, you are coming in for only 12 months to work with people who may have been working there for decades. Be open to learn from people who do things a little differently than your training, but also don’t be afraid to speak up if you see ways to make improvements in the way things are done. As clinical scientists, we have a lot of training in evidence-based practices, and it’s important to share that knowledge broadly.

Summary: The interviews in this column represent what many people who have completed internship understand: that despite the stress and challenges associated with this year of clinical training, it is absolutely possible to make progress on your research, to learn new clinical skills, and even to enjoy yourself all at the same time. While everyone’s experiences are different, there is also remarkable consistency across these interviews: many interns would agree that managing expectations about your ability to get research done during internship is important, but that internship includes many chances to elevate your research career. We believe that managing this dialectic is essential to staying happy, healthy, and productive during this exciting time.

Andrew Peckham is a postdoctoral fellow at the Behavioral Health Partial Hospital Clinical Research Program of McLean Hospital, and a clinical fellow at Harvard Medical School. He is a recent graduate of the McLean Hospital/Harvard Medical School internship program.

Jessica Hamilton is a predoctoral intern at Western Psychiatric Institute and Clinic in Pittsburgh, PA. Beginning September 2017, she will be a postdoctoral fellow on a T32-funded fellowship in the Department of Psychiatry at the University of Pittsburgh.

Answers to Student Questions from Dr. Wolitzky-Taylor

Thank you to everyone who submitted questions for Dr. Wolitzky-Taylor.  Below are each of the questions followed by her very thoughtful and detailed responses.  

Tips and Tricks from SSCP Student Members to Create a Healthy Work-Life Balance

Set a Schedule for Yourself – and Stick to It!
One student shared how they use scheduling to maintain work-life balance on a regular basis:
“Setting a schedule for myself and protecting all of my time equally is crucial. In grad school, I had my classes, TA slots, therapy sessions, meetings, etc. all blocked in to my calendar, but I also added in writing time (so crucial!) and times I planned to attend a yoga class, go jogging, meet friends for a drink... whatever. Once it was in my calendar, barring something emergent or incredibly important coming up, I protected it. That really helped me to budget my time and to find specific times in my day to accomplish my work and to make time to have a life.”

Another student described balancing longer work days with work-free weekends:
“My trick for maintaining work/life balance is to work 12-14 hour days Monday - Friday. This allows me to have at least one weekend day clear to enjoy time with family and friends. I’d rather have one or two full days free than, say, every day after 5pm. Having the weekend clear allows me to … spend quality time with important people without feeling rushed. Although it can be grueling to work nonstop from 9am to 11pm Monday through Friday, it allows me to cross a lot off my To Do list so when the weekend rolls around, I’m able to maximize my time and maintain a healthy social life.”

Prioritize Self-Care!
Several students suggested that making sure self-care is #1 on the to-do list is crucial to ensuring a healthy balance.
“The most important part of balancing life in graduate school has been to set aside at least an hour every evening for self-care (e.g., running) except in the most dire of circumstances. I also try to set aside the better part of a full day on the weekend for fun non-school-related activities. Doing this makes me feel more whole, keeps me healthy (and therefore more productive in school), and forces me to use my time on work-related projects more efficiently.”

Another student sent this suggestion for graduate students:
“My advice would be to prioritize self-care at specified periods throughout the week. By “self-care” I mean engaging in activities that you find fun, relaxing/rejuvenating, and that serve as a good distraction from work. My approach this semester has been to set aside (at least) two nights in the week where I schedule in enjoyable activity time and then I honor that time just as much as I’d honor an important work meeting. It’s easy to justify doing work instead of a fun activity, but do everything in your power to set your foot down and give yourself permission to have that free time. … I find that after one of these relaxing nights, I feel refueled and ready to take on my to-do list for the next day.”


Being a parent while in graduate school has its own set of unique challenges. Several of you wrote in to share what works for you in balancing the roles of graduate student and parent.

Katrina Ostmeyer, a student at Viriginia Tech writes: “As a mother of a 1 year old, I’ve learned a lot about this subject in the past. What I’ve done that is helpful is write down my short-term and long-term professional and personal goals. I then develop a schedule taking both into account (i.e. I need to write 2 pages/day and I need to pick my son up from daycare at a certain time). I then work on that plan for a couple of weeks and re-evaluate. The key is re-evaluation. I have to decide whether my goals are feasible or not and whether they are worth it. For example, I may be meeting my goals but am miserable because I am trying to be super-mom and super-student. I then have to decide what changes need to be made to benefit my career and family while maintaining my sanity and I start the process over again.”

Another SSCP student member shared the following: “The biggest thing that has helped me maintain work/life balance is setting strict boundaries. For the most part, I don’t work once my day is over and on the weekends (not possible all of the time, but overall it’s possible). The tradeoff is that I strictly adhere to a consistent work schedule, otherwise I would fall way behind. No more procrastinating like in college! Actually I’ve found that having a family has helped me stick to deadlines and goals better. I know that I have a set amount of time in which to work, and there is no room for procrastination.”

Anne Zhang, from the University of Iowa, discussed approaching work-life balance from an acceptance and commitment perspective: “Over the years, I’ve become a bit more adept at recognizing the “felt sense” that comes with “I have to’s.” For example, if I’m pushing myself to the limit with research, I may begin to feel like it’s no longer meaningful/enjoyable and I get this sense that work is dull/deadened. Or if I’m seeing too many clients and I don’t feel connected, I may begin to blame my clients or resent my clients or just get bored listening to my clients. Or sometimes I’ll even be spending time with my significant other, and I’ll begin to resent them for taking time away from important work that I need to be doing, just a little bit. These are all little flags that my behavior is rule-governed. That’s when I really have to stop and ask myself what’s most important right now. Because obviously, both work and life are important, but right now I have to choose which to act on, realizing that there will be opportunities in the future to act on the other value. I will put a time limit on how long I’ll work, how much time I’ll allot to socializing, how much time I’ll allot to time alone, etc. I try to keep in mind that old adage about fitting stones into a jar. A smart person will put the big stones in first, and then pour the little ones in to fill the spaces. But if you put in the little ones first, the big ones will never fit. So it really is an exercise in prioritizing… If I value my friends/partner/work, I’ll make time for them. If I don’t make time for my friends, then I’m not really valuing them. I guess it’s figuring out what my big stones are, what my medium stones are, and what the little stones are… which is tough in and of itself!”

Work-Life Balance Online Resources

Student Doctor Network – a nonprofit organization comprised of students in pre-health and health professions, including clinical psychology. This web-based forum allows students to initiate and participate in discussions in their field. Within the Psychology forum, topics such as internship, dissertation, finding a post-doc, and even balancing school and home life have been discussed. Joining is free: http://studentdoctor.net/

Lifehack – an online weblog of “life hacks” – or easy tips for productivity and other important areas of life. Each “hack” is a short blog about a topic. Topic categories include productivity, lifestyle, and communication, among others. http://www.lifehack.org/

Getting Things Done by David Allen – in this book, David Allen introduces a “work-life management system” that is very intuitive and easy to implement and maintain. This system targets the management of commitments, information, and communication, and allows you greater focus in each area of your life.

Look locally – are there faculty members, practicum supervisors, professionals, or even other graduate students that you admire or who look like they “have it all together”? Consider approaching them to discuss how they manage to achieve success while maintaining a healthy balance with other aspects of their lives. Creating a panel of such individuals who are willing to share their experiences and advice could be an invaluable resource to graduate students.

Mother in Science – 64 Ways to Have It All – this unique document produced in the UK shows that there is no one path to achieving work-life balance when it comes to being a scientist and a mother. Each page consists of a timeline showing the scientist’s research career on one side and important events in her family life on the other. http://royalsociety.org/uploadedFiles/Royal_Society_Content/about-us/equality/2011-06-15-Mothers-in-Science.pdf

How to Survive and Thrive in the Mother-Mentor Marathon – this article contains excellent tips on how to balance motherhood and academia, but the principles are applicable to anyone seeking work-life balance. http://www.cell.com/molecular-cell/fulltext/S1097-2765(10)00374-6

Landing a Family-Friendly Post –for those on the market for post-docs and faculty jobs, this article discusses how to assess the work-life balance culture at the institutions at which you interview. There are also tips on how to prepare in advance for taking leave after having a baby. http://www.the-scientist.com/?articles.view/articleNo/29557

Negotiating for the Job You Want – most people don’t think of job negotiations as a work-life balance issue, but if you’re able to negotiate for teaching/clinical/service responsibilities, lab space, and start-up money that will allow you to more easily be successful in your new job, your personal life will benefit immensely. Some great NIH tips: https://www.training.nih.gov/assets/Slides_1_14_10.pdf

The Ever-Sought, Seemingly Elusive Work-Life Balance

The Ever-Sought, Seemingly Elusive Work-Life Balance
Sara Stasik, University of Notre Dame
Kristy Benoit, Virginia Tech
(Clinical Science Vol. 15 (3): Fall, 2012)

Perhaps like many of you, I entered graduate school with a somewhat naïve excitement and intense motivation to get started on this academic adventure. Admittedly, I did not spend much a priori time thinking about how I would balance my school commitments and my personal life – in fact, at the time, I probably viewed them as one and the same. Quite quickly, however, I found myself amidst a sea of requirements and deadlines – proposals, defenses, clinical work, writing commitments – and it seemed the line between “work” and “life” became even more blurred, while the need for a distinction had never been more important. Over the past few years, it has been my experience that, the better I am able to balance my work and my personal life, the happier and more effective I am in each. There was a time when I would feel guilty engaging in social activities because I wasn’t working, or would have trouble concentrating on my work because I felt I was neglecting family and friends. Several things have been helpful to me in learning to balance each of these aspects of my life, at both the conceptual and behavioral level. First, I try to schedule several blocks of personal or social time each week and I commit to preserving that time only for the scheduled activity. This allows me to be fully present, without thoughts of the work I “should” be doing. Second, talking to faculty members about their journeys into their careers has been eye-opening and informative. I was encouraged to learn that professionals whom I admire also face similar work-life challenges and were not afraid to insist on balance in their own lives. Finally, as I did when I entered graduate school, I often do come back to conceptualizing my professional and my personal life as one entity. Indeed, I use both to define myself and enjoy my role in each of these domains. Of course, it is important to delineate time to dedicate to each, but I find that the more fluidity there is between how I think about myself within each domain, the easier it is to define the ways in which I can achieve an acceptable balance for myself. Certainly this is an ongoing challenge for each of us and I wish you all the best in finding your personal balance! ~Sara

I had a difficult time writing this article because they truth is, I feel that work-life balance is an ongoing struggle for me and there are many times when I feel I have it completely wrong. That being said, when I reflect back on graduate school and now the first few months of internship, I have learned a thing or two about this topic (even if I don’t always practice what I know is best!). I took an amazing grad.
class on “Work-life Balance in Academia” and one of the first things the professor talked about was the “myth” of work-life balance. The idea is that any given snapshot of your life is likely not going to show a perfect balance between the two. When internship applications are due, “work” is going to feel like it’s taking over your existence; when you are in the midst of plan-ning a wedding, “life” is going to figure more prominently in the equation. So don’t be too hard on yourself when things feel out of sync, the idea is that over time you should be work-ing to even out a balance that is constantly changing. The next thing I learned in this class was the “good enough” principle. With every-thing we have to juggle in graduate school, it is literally impossible to put as much as you would like into every endeavor. So instead of spending 6 hours prepping a lecture when I taught a class the first time, I had to set a limit of 3 hours, tell myself that it was “good enough,” and go to bed so that I was not totally exhausted the next day. The perfectionism that likely helped the major-ity of us get into graduate school, can actually become the bane of your existence in graduate school. The class also pushed me to think about how I define success in my career AND my per-sonal life. It was a sad realization that I found it very easy to delineate what career success looks like (publications, grants, etc.), but I struggled with the personal side. Once I had given both sides equal attention, I worked on goal set-ting: listing goals in both my professional and personal life for the semester, year, and next 5 years. Then I learned to create links across these categories, with the idea being that the majority of my work and personal time should be dedi-cated to short-term goals that will eventually lead to achieving my long-term goals. Finally, I would advise to keep this important issue in mind as you apply for and interview for intern-ships. Ask faculty and current interns how long a typical work week is. Can you write notes and reports from home? Do interns get together for happy hours? Best of luck in your own work-life balance journey! ~ Kristy

Self-Efficacy: The Foundation for Work-Life Balance

Self-Efficacy: The Foundation for Work-Life Balance
Andrew J. Smith, MA & Claire Blevins, BA
Doctoral Students in Clinical Psychology, Psychology Department, Virginia Tech

Originally published in the SSCP Newsletter (Clinical Science Vol. 15 (3): Fall, 2012 12)

Self-Efficacy Enables Resource Conservation

Life for graduate students is accompanied by an endless string of stress-inducing obstacles—when we finish overcoming one (Master’s thesis), another appears in its place (comprehensive examinations, dissertation, internship, post-doc, finding a job, etc.). With each completed step, expectations, complexity, and stress levels increase, all the while we must balance our own expectations with the expectations of others (e.g., significant others, advisors, the scientific community, family members, our dogs) with sobering implications for our future happiness.