Practice Matters: The Design and Teaching of an Introductory Clinical Seminar
by Christine Zalecki, Psychology

As a student in the Clinical Science Graduate Program--which emphasizes both research and clinical practice in psychology--I was an intern in the Psychology Clinic for my second and third years. For those two years, I provided psychotherapy to adults and children who had a wide range of mental health problems. I entered the program, however, with no training in how to conduct psychotherapy sessions, and little training was provided in my first year. Courses were offered on theoretical models of psychotherapy and psychopathology, but there was limited instruction on how to be a therapist. As such, high levels of apprehension and self-doubt marked the beginning of my clinical work. Discussions with classmates revealed that these feelings were common, that we all had felt ill-equipped to handle the task of being a novice therapist. Expert clinical supervisors guided us through that difficult learning period, and we eventually became competent, confident clinicians, but afterward I wondered whether there was a better way to prepare students for their clinical work.

During my fourth year, while I was working as a Clinic Assistant, I seized the opportunity to address this apparent need in our program. With the support and supervision of the Clinic Coordinator, I designed and implemented a semester-long, introductory seminar for first-year Clinical Science graduate students. My goal for the seminar was to provide students with a knowledge base on which they could build once they became interns, as well as to help allay students' inevitable anxieties and concerns about their impending work as clinicians.

I employed a variety of strategies to achieve these goals. For example, I taught students how to handle crisis situations (e.g., suicidality, reporting child abuse) by explaining, step-by-step, the procedures they would have to follow, as well as their legal responsibilities in such situations. To teach students about various psychotherapeutic techniques, I invited several psychotherapists (all of whom had worked with interns in our clinic previously) to guest lecture on how to conduct a first session. Therapists from a wide range of theoretical backgrounds were chosen, so that students could learn about a diverse array of therapeutic methods. Each student also was required to watch videotaped therapy sessions and present to the seminar the techniques that were used in the session, as well as how those techniques mapped onto particular theoretical models. I intentionally did not assign reading for this class--students were reading plenty of material in other psychology seminars--but instead focused on how the theories they were learning about translated into actual clinical practice.

The course culminated with each student assigned to conduct a therapy session, in which advanced graduate students in the program role-played the part of "patient." The students had to conduct the session as though it were an actual case, and then had the opportunity ask questions and get feedback from the advanced student who had just acted as their patient. Following these sessions, students had to present their "case" to the rest of the seminar, discussing the therapeutic tools they employed, as well as the challenges and strengths of their session.

At the end of the semester I asked students for anonymous feedback, and it was overwhelmingly positive. They reported that guest lectures from actual therapists about the range of clinical approaches was very informative, and that role-playing an actual session was an invaluable way to practice the role of therapist. The success of the seminar is also evidenced by the fact that I was requested to teach it again the following year, and it is now being taught by the current Clinic Assistant. The Clinic Coordinator reports that she has noticed a huge improvement in the confidence and readiness of the interns as they begin their second year, indicating that I did, indeed, achieve my goals for this seminar.