The CAPS training program has the responsibility to inform the CAPS interns of the program requirements and the expectations for successful completion of the internship year. The primary emphases of this training program are to continually assess the progress of each intern (with a minimum of written feedback occurring twice during the internship year) and provide timely feedback in order to check the intern’s progress for growth and change (APA Handbook, 2013). The CAPS Training Director and the intern’s graduate program have an on-going, working relationship in order to implement these guidelines and procedures.
Counseling and Psychological Services (CAPS) understands the developmental stressors that are inherent in the transition from a graduate school setting to an internship setting. Specifically, interns are exposed to a full-time clinical caseload, which typically includes difficult cases and client crises, while learning new agency requirements, policies, and procedures. Additionally, the interns are provided a quite intensive and concentrated supervision experience. This may increase the interns’ personal and professional vulnerability. While the internship year provides a critical professional opportunity to: (a) learn and refine skills, (b) increase one’s professional confidence and (c) enhance one’s professional identity, it is also a time of increased stress and disequilibrium. Consequently, it is the responsibility of the CAPS training program to provide structure, procedures, and opportunities that can facilitate growth and minimize stress. Some of the preventative measures we provide include, but are not limited to, extensive orientation meetings, clear and realistic expectations, individualized training goals, training seminars on professional development (e.g., transition from intern to professional), clear and timely evaluations with positive suggestions for growth, and support from primary supervisors, the supervisory team, and training director.
The above rationale underscores the importance for the CAPS internship program to respond sensitively to trainees and protect their rights. By following the subsequent procedures, adequate measures will be in place and due process protected.
With regard to intern behavior and performance, the general expectations of the Training Program are that the intern will:
- Function within the bounds of the:
- American Psychological Association Ethical Principles of Psychologists and Code of Conduct and
- American Psychological Association Standards for Providers of Psychological Services and Specialty Guidelines for the Delivery of Services.
Function within the bounds of the laws and regulations of the State of Nebraska.
Function in a manner that conforms to the policies and procedures of Counseling and Psychological Services (CAPS) and the University Health Center (UHC) Policies and Procedures Manual.
Demonstrate proficiency in the requisite clinical skills as required to successfully carry out assigned tasks at CAPS.
Demonstrate proficiency in relevant assessment and evaluative procedures as required to successfully carry out the tasks at CAPS.
Demonstrate the ability to communicate clearly and precisely in both oral and written formats.
Demonstrate the ability to integrate relevant professional standards as a professional psychologist into one’s repertoire of behaviors.
Demonstrate openness and an affirming attitude toward cultural and individual diversity.
Participate in training, service, and continuing education activities with the year-end goal of being able to provide services across a range of activities and with a frequency and quality appropriate to that of a staff psychologist.
Psychology interns are expected to further develop and deepen psychological skills and the ethics of practice during their internship year. The internship year is a time of focusing on intrapersonal and interpersonal processes through self-reflection. At all stages of training, CAPS assumes the responsibility for assessment and continual feedback to the interns in order to improve skills, remediate problem areas, and/or to prevent individuals, unsuited in either skills or interpersonal limitations, from entering the professional field of practice. The CAPS Training Program is responsible for monitoring the interns’ progress to benefit and protect the public and the profession, as well as the intern.
The interns have the right to receive clear statements of the standards and expectations by which they are evaluated. These standards and expectations are thoroughly reviewed during the internship orientation. Throughout the year, the interns receive two hours of weekly individual supervision. In addition, interns receive supervision for group therapy, supervision for the provision of supervision to the CAPS’ trainees, supervision during case conference, and secondary supervision in an intern’s area of concentration. Interns typically receive four to six hours of supervision per week. During these meetings, interns will be given informal verbal feedback on their performance. Interns will have the opportunity to ameliorate any deficiencies or misconduct prior to the mid-term or end of year evaluation, unless continuation of service delivery would be deemed a detriment to clients.
Interns have the right to provide input and suggest changes and modifications of the CAPS Training Program. Regular meetings of interns and the training director enable the training director to assess and discuss the progress and concerns/problems confronted by the interns.
Overview of Intern Performance Evaluation and Feedback
A Preliminary Review is conducted in October. Formal Reviews and evaluations are held two times during the year. The first Formal Review for the interns occurs in December and the second formal review in July.
For the Preliminary Review, primary supervisors, secondary supervisors, and any other staff who have training responsibilities meet to discuss each intern's progress and address any areas of concern. The Comprehensive Evaluation of Intern Form may be used as a guide for feedback by the training staff during this meeting. The Training Director documents the feedback for the intern's permanent file. Feedback is summarized and presented individually to each intern by the primary supervisor. If a concern or problem has been noted, the primary supervisor then discusses the issue with the intern and develops a strategy for dealing with the concern. The Training Director may assist in formulating a plan to address a concern.
Prior to the Formal Reviews and evaluations, the primary supervisor seeks feedback from the intern’s secondary supervisor and other staff who have training responsibilities. Based on the feedback provided by these supervisors, the primary supervisor completes an initial Comprehensive Intern Evaluation Form which corresponds to internship competencies. The primary supervisor presents this information to the supervisory team at the Formal Review. During this meeting, each intern’s progress and Comprehensive Intern Evaluation Form are thoroughly discussed. Finally, feedback from the team is aggregated and summarized on the Comprehensive Intern Evaluation Form for the final and official evaluation of the intern. The feedback is then presented individually to each intern by her/his primary supervisor. If a concern or problem has been noted, the primary supervisor discusses the issue with the intern and develops a strategy for dealing with the concern. The Training Director may assist in formulating a plan to address a concern.
During a designated supervision session, the interns and their primary supervisors discuss the evaluations for that review period. Evaluations are signed and then forwarded to the Training Director. The signatures on these documents do not necessarily reflect agreement with their content but rather indicate that the documents have been presented and discussed between the supervisor and intern. The Training Director uses the evaluations of the intern as a basis for the progress report sent to an intern’s academic program.
The Formal Review and evaluations are not considered to be replacements for informal verbal feedback, which the CAPS staff and interns are encouraged to provide throughout the year. It is expected that interns have been presented with any areas of deficiency or misconduct and an opportunity to ameliorate them prior to any request for a special review.
At the end of each Formal Review, the interns complete the Intern Experience Form, which documents all the activities and trainings the interns have participated in, as well as the services they have provided. Copies of these forms are sent to the academic training programs and are maintained in the interns’ permanent files at CAPS. The Training Director writes a brief letter to the academic program summarizing the intern’s experience and performance evaluations.
Evaluation of Inadequate Performance by an Intern
Inadequate performance is defined as any performance by an intern where she/he is rated a level 2 or less on any of the competency areas in the Comprehensive Intern Evaluation Form. All competency areas should be rated level 3 (minimally proficient) or higher by mid-term Formal Review. Finally, all ratings must be a 5 (proficient) or higher by the end-of-the-year Formal Review for satisfactory performance.
Inadequate performance is also defined as any performance by an intern where she/he is rated a level 1 (Not Acceptable) on three or more items on the Comprehensive Intern Evaluation Form at midterm Formal Review or rated a level 1 on any item on the Comprehensive Intern Evaluation Form at the end-of-the-year Formal Review. In addition, if a staff member has concerns about an intern’s behavior, (e.g., ethical/legal violation, professional competence) this is considered inadequate performance by the intern.
Procedures for Responding to Inadequate Performance:
If an intern performance is defined as inadequate based on the definition above, the following procedures will be initiated:
The CAPS staff member will consult with the Training Director to address performance concerns. The Training Director will determine if there is reason to proceed to the next procedural step and/or if the behavior in question is already being or has been rectified.
If the staff member who brings the concern is not the intern's primary supervisor, the Training Director will encourage the staff member to share the concern with the primary supervisor. The Training Director will also follow up with the intern's primary supervisor.
The primary supervisor or Training Director will inform the intern of the concern and solicit the intern’s perspective on the matter.
If the Training Director and primary supervisor determine that the behavior in question proves to constitute a serious violation, the Training Director will inform the staff member who initiated the complaint, of such violation.
The Training Director will meet with the Training Committee (excluding any trainee members) to discuss the performance/concern of the intern.
The Training Director, primary supervisor, and Director may also meet to discuss potential action steps.
Whenever a decision has been made about an intern's training or status in the agency, the Training Director will inform the intern in writing and will meet with the intern to review the decision. This meeting usually includes the intern's primary supervisor. If the intern accepts the decision, any formal action taken by the Training Program will be communicated in writing to the intern's academic department. This notification will indicate the nature of the concern and the specific actions/plans implemented to address the concern.
The intern may choose to accept the conditions or may choose to appeal the decision. The procedures for challenging the action are described in Areas of Formal Review.
Procedures to Advise and Assist Interns not performing at the Training Program’s Expected Level of Competence:
First, it is important that the intern clearly understands the expected level of competence and how his/her performance, behavior, knowledge, or attitude differs from expectations. This information is provided to the intern during orientation.
It is important to have meaningful ways to address professional deficiencies once they have been identified. Several possible courses of action to remediate skill deficits or inadequate performance may include, but are not limited to:
Increase supervision, shift the focus of supervision, or modify the format of supervision with either the same or a different supervisor;
Recommend personal therapy when the problems are psychological in nature.
Reduce the intern's caseload and/or responsibilities;
Require specific academic course work or tutorial where appropriate and be regularly monitored by a staff member knowledgeable in that area;
Recommend a leave of absence or a second training year at another setting;
An intern will be placed on probation in the event she/he fails to meet or make satisfactory progress toward meeting the general expectations for the training experience. The Training Director and primary supervisor will meet with the intern to review a letter documenting:
the specific behavior or areas of professional functioning that are particularly problematic;
the direct relationship of these behaviors to written evaluations;
various methods by which problem behavior can be remediated (e.g., supervision, readings, didactics);
the specified period of time of the probation period after which a final review will be conducted prior to dismissal, if problems are not remediated, or reinstatement if remediated;
how the intern’s functioning will change during this probationary period (e.g., fewer clients, increased supervision);
due process procedures available and the time frame in which the intern can appeal the decision.
While on probation, the intern will function under a remediation program designed by the Training Committee and approved by the Training Director and the Director of CAPS.
If an intern is charged with violating the APA Code of Ethics, she/he may be temporarily suspended from engaging in any/or all counseling or direct services. Such suspensions can be initiated by the Training Director or Director of CAPS. All temporary suspensions become effective immediately upon written and oral notification of the intern. The written notification, which includes the reasons for the suspension, is expected to be in the hands of the intern within one working day of oral notification. A date will be set for a special meeting, at which time the Training Director will review the conditions imposed and indicate the progress to be made toward remediating the violation(s).
If an intern is unable to meet the criteria outlined for remediation, then the following steps may occur:
- consultation conducted by staff with internal and external sources (e.g., legal consultation, APA, and APPIC);
- subsequent to consultation, follow the University of Nebraska-Lincoln’s procedures for dismissal of a temporary staff employee;
- letter given to intern reiterating probation criteria, intern’s response, and reasons for dismissal;
- copy of letter forwarded to intern’s academic department no later than five working days following dismissal meeting with intern in order to ensure all parties are informed;
- determination of how and when the intern’s status with CAPS will change, with consideration of protecting client welfare;
- specification of due process procedures and time frame in which an intern can appeal decision.
Evaluation of Problematic Behavior, Attitudes, or Characteristics:
This section defines those situations in which an intern has a problem that is serious enough to interfere with her/his professional functioning. If an intern demonstrates one or more of the following behaviors, attitudes or characteristics, the behavior will be considered a serious problem requiring intervention:
- an inability or unwillingness to acquire and integrate professional standards into one's repertoire of professional behavior;
- an inability to acquire professional skills in order to reach an acceptable level of competency; and/or
- an inability to control personal stress, strong emotional reactions, and/or psychological dysfunction, such that they interfere with professional functioning.
- Problematic intern behavior, attitudes, or characteristics typically include one or more of the following:
The trainee does not acknowledge, understand, or address the problem when it is identified;
The problem is not merely a reflection of a skill deficit, which can be rectified by academic, didactic, or experiential training;
The quality of services delivered by the intern is sufficiently affected in a negative way;
The problem is not restricted to one area of professional functioning;
The problematic behavior could have ramifications for ethical and legal concerns if not addressed;
A disproportionate amount of time and attention is required by training staff and/or;
The trainee's behavior does not change as a function of feedback, remediation efforts, and/or time.
It is important to have meaningful ways to address problematic behavior, attitudes, and characteristics once they have been identified. When implementing a remediation plan or carrying out sanctioned interventions, the training staff must be mindful and balance the needs of the intern, the clients involved, other members of the intern cohort, the training staff, and other agency personnel. Possible interventions may include all those previously mentioned in relation to deficits in skill and competence. Due process procedures and time frame in which an intern can appeal decision is provided.
- When a combination of intervention strategies does not resolve the identified problem(s) or when an intern seems unable or unwilling to alter her/his problematic behavior, attitudes, or characteristics, the Training Committee may need to take more formal action for advisement such as:
Recommending and/or assisting the intern in implementing a career shift;
Putting an intern on temporary suspension; and/or
Dismissing the intern from the training program.
Other Areas of Formal Review:
Interns have the right to activate a formal review when they believe that their rights have been infringed upon. The following situations may call for filing a grievance and the activation of a formal review. It is important to note that a formal review may be activated at any time by an intern, the Counseling and Psychological Services staff, or by any other trainee. This list is suggestive of, but not limited to, the types of behavior and events which may arise:
- Sexual Harassment
- Violation of the APA Ethical Principles of Psychologists and Code of Conduct
- Insubordinate behavior
- Exploitive or abusive behavior
- Racial discrimination
- Disagreement about an evaluation
- Other behaviors not listed above but which represent infringement on the rights, privileges, and responsibilities of interns professional and support staff, and other volunteers/employees or clients of Counseling and Psychological Services.
General Guidelines for Due Process
Due process offers protection to interns and ensures that decisions made by the internship program are not arbitrary or personally biased. Due process requires training programs to identify specific evaluative procedures that are applied to all interns and to provide appropriate appeals procedures. All steps need to be appropriately implemented, followed, and documented.
General due process guidelines include:
Presenting, in writing, the program’s expectations related to professional functioning during orientation;
Stipulating the procedures for evaluation, including when and how the evaluations will be conducted; evaluations are to occur at meaningful intervals;
Articulating the various procedures and actions involved in making decisions regarding inadequate performance or problematic behavior;
Communicating with the intern’s academic program early and often about any suspected difficulties with the intern and, when necessary, the training program seeks input from the academic program about how to address such difficulties;
Instituting, with the input and knowledge of the graduate program, a remediation plan for identified inadequacies, including a time frame for expected remediation and the consequence for not rectifying the inadequacies;
Providing a written procedure to the intern which describes how the intern may appeal the action of the program;
Ensuring that the intern has sufficient time to respond to any action taken by the training program;
Using input from multiple professional sources when making decisions or recommendations regarding the intern’s performance;
Documenting, in writing, to all relevant parties the action taken by the internship program and its rationale for such actions.
This section outlines grievance procedures for interns to follow in the case of a serious issue potentially calling for a formal review.
Intern challenges evaluation by primary supervisor
If an intern is in disagreement with evaluation given, she/he first discusses the nature of the disagreement with the supervisor who initiated the evaluation. If the situation is not resolved, the intern discusses the complaint with the Training Director. The Training Director will then facilitate a meeting between the intern and supervisor to resolve the disagreement.
If the situation is not resolved via this meeting, a Review Panel of three CAPS staff (excluding the supervisor if she/he is a member) will consider the grievance and work with the intern to resolve the situation. If the situation then remains unresolved, it is referred to the Director of CAPS who will consider the grievance with the intern and consult as needed.
Intern challenges decisions made by Training Director and/or Supervisory Team
If an intern does not agree with an evaluation completed by the Training Director or decisions (such as remediation) made by the Supervisory Team, the intern brings the grievance to the Director of CAPS. The Director will work with the intern to resolve the grievance in consultation as needed.
Intern challenges staff member or another intern
If an intern has a complaint or grievance concerning a staff member or another intern, the intern is expected to follow the same procedures as other staff. First, it is suggested that she/he discuss the matter with the person in question. If, for reasons of differences in power, this places the intern at risk, this step is bypassed.
The intern should then consult with the Training Director. In the event that the grievance is against the Training Director, the intern will bypass this step and bring the matter to the Director of CAPS for consultation or resolution. The Director will consult as necessary.
Examples of grievances are listed under Other Areas of Formal Review. The University of Nebraska-Lincoln’s procedures for complaints and grievances alleging discrimination or harassment by reason of race, color, religion, sex, national origin, age, marital status, disability, veteran status, or sexual orientation outlined in the Policy and Procedures on Unlawful Discrimination, Including Sexual and Other Prohibited Harassment, available at Human Resources 407 Canfield Administration Building and at http://hr.unl.edu/policies/notice-nondiscrimination/.
Review Panel and Process
When needed, a Review Panel of three CAPS staff members will be formed by the Director of CAPS with recommendations from the Training Director and the intern involved with the dispute.
Within five business days, all parties involved in the complaint will submit a written description of their version of the conflict and the efforts to resolve it.
After receipt of the written documentation noted in step 2, the Review Panel meeting will meet to review written materials and, as deemed appropriate, interview any or all parties involved in the complaint. A written response with recommendations for how to resolve the situation as well as an explanation of how the committee arrived at their decision will be provided to the intern and all other parties involved, within five business days of the Review Panel meeting.
If the intern or other parties remain dissatisfied with the outcome following the decision of the Review Panel, they may utilize grievance procedures detailed for the University of Nebraska-Lincoln at the following url: http://www.nebraska.edu/docs/board/RegentPolicies.pdf. The Office of Human Resources can provide further assistance with steps toward resolution in implementing this system-wide grievance policy.