Ending the Internship Crisis

Awareness

• Share this page with at least five people. Post it on social media or send the link by email to colleagues (e.g., internship training directors, doctoral directors of clinical training, leaders in your state psychological association, colleagues in your department or agency, and graduate students).
• Sign a pledge to stay active and aware about the internship crisis.
• Join the APAGS internship-focused action listserv and contribute your ideas.
• Hold a brown-bag lunch or summit with your colleagues and/or students on the internship crisis, the local landscape for training, and challenges and opportunities to help bring more positions to qualified students in need. Brainstorm new ways to work together and take action.
• Talk candidly with doctoral students about the crisis. For example, hold regular meetings about internship preparation with students from their first year of entry into the program. Learn from your students. Check in about any stressors or experiences they may be going through, relevant to attaining an internship.
• Help students attend the APA annual convention where they can meet internship training directors and attend a four-hour workshop on internship preparation through APAGS.

Advocacy

• Advocate for Medicaid/insurance reimbursement for trainees. This could happen at the state level in concert with the advocacy and policy team of your state psychological association and/or through consultation with your agency or hospital’s billing and Medicaid/Insurance compliance office(s) if your state already allows this possibility. APA developed a toolkit with a state-by-state report of permissibility to seek intern service reimbursement, examples, and action steps (see the toolkit’s “What can you do” section for specific questions to ask your state association).
• Request continued and expanded federal monies to support internship training through the Graduate Psychology Education (GPE) program and the Mental and Behavioral Education and Training (MBHET) program.
• Advocate for state investment in internships as other states have done. For example, Nebraska passed a law in April 2014 that would require the state to fund at least five interns per year, and up to 10 within three years. Alaskan education authorities banded together to form a consortium with continued funding.
• Advocate for private foundations to invest in mental health and intern services. For example, Texas’s Hogg Foundation funded $3.2 million to develop six APA-accredited internship sites and two consortia in the state.
• Work with your state psychological association to develop a position statement about the internship crisis and short- and long-range goals to address it. For guidance, you can refer to the nuanced APAGS position statement (further described in a 2014 journal article). Leading to the adoption of a position statement, consider (a) a state snapshot on the internship crisis with variables such as the number of sites and positions lost/gained over time, the number of yearly internship applicants from doctoral programs in the state, the number of accredited versus nonaccredited programs, and so forth; and (b) holding a state stakeholder meeting to address the data and begin to shape an official position or policy.
• Advise student advocacy groups on campuses, at internship programs, and/or at the state and regional levels about the internship crisis. Assist students to mobilize strong responses for the development of more training positions.

Action

• Help start an internship. There are three types: affiliated (an internship that solely or partially admits interns from a specific doctoral program), independent (a single site open to all qualified applicants) and consortia (multi-site training partnerships).
  1. For resources, consult the Psychology Internship Development Toolkit online, as well as key articles listed on the further reading tab.
  2. APA offers several free webcasts to help programs gather the resources they need to develop APA-accredited psychology internships.
  3. Request mentorship through APPIC .
  4. If you are interested in creating an affiliated internship, view the Palo Alto University/Marin County partial-affiliation case study (PDF, 153KB) regarding a community mental health program.
  5. If you are interested in exploring the consortium path, please contact APAGS, which will work to connect you with someone for advice.
• If you do start an internship, be a mentor to colleagues and help them get started. Consider disseminating strategies, materials, and more. APAGS would be happy to highlight your story through its blog; email us.
• If you represent a school psychology internship, Division 16 (School Psychology) has a new grant program. If you represent an unaccredited but APPIC registered program, also stay tuned for potential funding from APPIC and WICHE (PDF, 96KB).
• If you are an internship training director, consider the possibilities of adding an additional internship spot, which may be even more viable if your site can seek reimbursement for intern services.
• If you teach in a doctoral program, consider how your program may be contributing to or alleviating the internship crisis, and bolster efforts for continued improvement in match rates at the local level.

Awareness

• Share the shortened link to this page (on.apa.org/internshipcrisis) with at least five people. Send the link by email to colleagues (e.g., graduate student peers, faculty, internship training directors, and leaders in your state psychological association), or post it on your social media accounts using the hashtag #EndTheInternshipCrisis.
• Sign a pledge to stay active and aware about the internship crisis.
• Join the APAGS internship-focused action listserv and contribute your ideas.
• Take to social media about the internship crisis using the hashtag #EndTheInternshipCrisis.
• Hold a brown-bag lunch or summit with your peers, faculty, and/or colleagues on the internship crisis, the local landscape for training, and challenges and opportunities to help bring more positions to qualified students in need. Brainstorm new ways to work together and take action.
• Help prospective students (undergraduates and career changers) shop smartly:
  1. Consider hosting an informational panel at your university/college for undergraduate or master’s level psychology students considering pursuing doctoral programs. In the panel, help prospective students learn differences between graduate programs and how to find a program that helps them get an accredited internship. Your local Psi Chi chapter or undergraduate psychology club might be a good place to begin planning the event.
  2. APAGS has a checklist and worksheet on its Resources page under “Applying to Graduate School.” Feel free to distribute these at informational events, or via email to prospective students.
• After you graduate, continue to educate your colleagues about the crisis and the importance of creating more internship positions and sites.

Advocacy

Federal level

• Request continued and expanded federal monies to support internship training through the Graduate Psychology Education (GPE) program and the Mental and Behavioral Education and Training (MBHET) program.

State level

• Encourage your state psychological association to take up the issue of Medicaid/insurance reimbursement for trainees.
  1. Become a member of the association.
  2. Send a message to the president and executive director.
  3. Join an advocacy or policy committee and/or email list.
  4. Build additional support in your association by getting your faculty members to join and weigh in.
  5. View these specific questions that you can ask within your state psychological association.
• Advocate for your state psychological association to develop a position statement about the internship crisis and short- and long-range goals to address it. For guidance, you can refer to the nuanced APAGS position statement (further described in a 2014 journal article). Leading to the adoption of a position statement, ask leaders to pull together (a) a state snapshot on the internship crisis with variables such as the number of sites and positions lost/gained over time, the number of yearly internship applicants from doctoral programs in the state, the number of accredited versus nonaccredited programs, and so forth; and (b) a state stakeholder meeting to address the data and begin to shape an official position or policy.

On campus

• Advocate for strong mentoring from your director of clinical training around internship selection and applications.
• Request that your department hold regular meetings about internship preparation with students from the first year of entry into the program.
• Create an atmosphere of trust and support among your peers by checking in with each other about any stressors or experiences related to attaining an internship. If you have peers that don’t match, provide them support and encouragement, and speak up if you hear others shaming those who end up without placements.
• Advocate for funding support to attend APA’s annual convention where you can meet internship training directors and attend a four-hour workshop on internship preparation through APAGS.
• If you’re in an unaccredited doctoral program, advocate for accreditation to protect students, maximize licensure and employment possibilities, and guarantee the public is receiving the highest quality training based on standards adopted by the profession. Direct your department to the Psychology Internship Development Toolkit online. APA also offers several free webcasts to help programs gather the resources they need to develop APA-accredited psychology internships.
• Advocate for the development of a campus affiliated internship program. For example, Marin County and Palo Alto University created a partially affiliated internship (PDF, 153KB).

On internship

• Educate your supervisors and other psychologists about the crisis.
• Learn what, if anything, you can do at your site to help expand the number of positions for future cohorts.
• If you are in a school psychology internship, Division 16 (School Psychology) has a new grant program. If your site is unaccredited but registered with APPIC, tell your staff to stay tuned for potential funding from APPIC and WICHE (PDF, 96KB).

Action

• Get involved in APAGS and make your voice and opinions heard.
  1. Run for an elected position on the APAGS committee or as a member or chair of one of five subcommittees.
  2. Serve as a campus representative to the APAGS Advocacy Coordinating Team, meanwhile strengthening and maximizing your advocacy skills.
  3. Write to your APAGS elected officers, subcommittee chairs, and staff with your ideas and input.
  4. Write a guest blog post about your experiences with the internship process to support other students, or to document your advocacy and actions to end the internship crisis.
• Attend APA’s convention and search the schedule for resources to help you prepare for and succeed on internship.

Helpful data about the internship crisis:

• Respondent comments about the match imbalance.
• Match rates from accredited programs to accredited internships from 2011–12 to recent
• Match rates for all participants in the APPIC match
• APAGS declares that the internship imbalance is a crisis
• APAGS provides its position on the internship crisis
• Why accreditation matters
• APA’s $3 million Internship Stimulus Program

• APAGS maintains resources on its website, blog, and through a frequently updated internship workbook available in print form.
• Extensive coverage of the internship crisis over the years appears in gradPSYCH, the magazine of APAGS and in the Monitor on Psychology, the magazine of APA.
• If you are focused on internship and training issues at the state level, consider joining APA Division 31, which is free for students, and look at examples (PDF, 2.5MB) of state associations and students working together on advocacy issues.

Journal articles

• Baker, J., McCutcheon, S., Keilin, W. G., & Peranson, E. (2007). A growing bottleneck: The internship supply-demand imbalance in 2007 and its impact on psychology training. [Special issue]. Training and Education in Professional Psychology, 1(4), 229–237.
• DeHay, T., Ross, S., Williams, J., & Ponce, A. N. (2016). Factors associated with accreditation: A comparison of accredited and nonaccredited psychology doctoral internship programs. Training and Education in Professional Psychology, 10(3), 125–132.
• Doran, J., Meyerson, D., & El-Ghoroury, N. H. (2014). Promoting the highest quality graduate training experience: A student perspective on the HSPEC Blueprint. Training and Education in Professional Psychology, 8(1), 12–17.
• Hatcher, R. L. (2011). The internship supply as a common-pool resource: A pathway to managing the imbalance problem. [Special section]. Training and Education in Professional Psychology, 5(3), 126–140.
• Hutchings, P. S., Mangione, L., Dobbins, J. E., & Wechsler, F. S. (2007). A critical analysis of systemic problems with psychology pre-doctoral internship training: Contributing factors and collaborative solutions. [Special issue]. Training and Education in Professional Psychology, 1(4), 276–286.
• Lally, S. J. & Paszkiewicz, W. B. (2011). Are there fish in the sea as good as ever came out of it? A response to using the common-pool resource paradigm to resolve the internship imbalance. [Special section]. Training and Education in Professional Psychology, 5(4), 205–208.
• Madson, M. B., Hasan, N. T., Williams-Nickelson, C., Kettman, J. J., & Van Sickle, K. S. (2007). The internship supply and demand issue: A graduate student’s perspective. [Special issue]. Training and Education in Professional Psychology, 1(4), 249–257.
• McCutcheon, S. R. (2001). The internship crisis: An uncommon urgency to build a common solution. [Special section]. Training and Education in Professional Psychology, 5(3), 144–148.
• Meyerson, D. A., Meyerson, L. N., Bolson, A., & Wilson, G.A. (2013). A legal “case” against the internship placement system and a proposal to fix the system and the internship imbalance. Training and Education in Professional Psychology, 7(3), 174–184.
• Miville, M. L., Adams, E. M., & Juntunen, C. L. (2007). Counseling psychology perspectives on the predoctoral internship supply-demand imbalance: Strategies for problem definition and resolution. [Special issue]. Training and Education in Professional Psychology, 1(4), 258–266.
• Parent, M. C., Bradstreet, T. C., Wood, M., Ameen, E., & Callahan, J. L. (2016). “The worst experience of my life”: The internship crisis and its impact on students. Journal of Clinical Psychology. Advance online publication. doi:10.1002/jclp.22290.
• Rodolfa, E. R., Bell, D. J., Bieschke, K. J., Davis, C., & Peterson, R. L. (2007). The internship match: Understanding the problem-seeking solution. [Special issue]. Training and Education in Professional Psychology, 1(4), 225–228.
• Rozenzky, R. H., Grus, C. L., Belar, C. D., Nelson, P. D., & Kohout, J. L. (2007). Using workforce analysis to answer questions related to the internship imbalance and career pipeline in professional psychology. [Special issue]. Training and Education in Professional Psychology, 1(4), 238–248.
• Schaefer, M. R., Newman, G. H., Perl, R., Morrison, A., Jordan, V. B., Wong, J., Ribner, N., & Montenegro, H. (2011). Shifting the paradigm: Alternative perspectives and solutions to increasing the availability of quality internships. [Special Section] Training and Education in Professional Psychology, 5(4), 209–212.
• Stedman, J. M. (2006). What we know about predoctoral internship training: A review. Training and Education in Professional Psychology, S(2), 80–95.
• Tuma, J. M., & Cerny, J. A. (1976). The internship marketplace: The new depression? American Psychologist, 31(9), 664–670.
• Wells, S. R., Becker Herbst, R., Parent, M. C., Ameen, E., El-Ghoroury, N. H., Mattu, A., Wilson, G. A., Mereish, E. H., & FitzGerald, M. E. (2014). The internship crisis: Graduate students look back and plan ahead. Training and Education in Professional Psychology, 8, 112–118.