Dear Supervisee

A Blog for Mental Health Interns and Associate Clinicians

I remember exactly how it felt. My first internship was starting and I was equal parts terrified and thrilled in the way that only happens when something you have worked toward for years finally becomes real.

I was fortunate. I was placed alongside a group of seven other interns: MFT, social work, and PsyD students all dropped into the same training environment at the same time. I did not know it then, but that cohort would become one of the most important professional gifts of my early career. Kristy and Gloria were also students in my program, and the three of us leaned on each other constantly. We debriefed after hard sessions. We reminded each other about deadlines. We asked each other the questions we were too nervous to ask anyone else. “I don’t know how to do this.” “When is that form due?” “Did that session go the way you think it went?”

That is what happens when colleagues become friends and feel safe enough to be honest with each other. That psychological safety is not a soft thing. It is a professional survival tool.

We were managing school, family, and internship obligations all at once, which meant we were always slightly behind on something and perpetually exhausted. What saved us was a strong training program, a knowledgeable field liaison, individual supervision with our own field instructors, and group supervision that actually felt like learning. I was working with clients who were chronically and persistently mentally ill. It was hard and it was formative and I would not trade it.

I wish that experience for all of you. Not the exhaustion, but the learning. Not the anxiety, but the growth. And especially the colleagues who become the people you call when things get hard twenty years later.

Eight Things I Want You to Know Before You Walk Through That Door

1. Take notes during supervision.

You are new to this supervisory relationship and you may be tempted to just sit there and absorb the conversation as it happens. That is understandable. Supervision can feel like a lot of information coming at you quickly, and your instinct may be to just listen and process later.

Do not skip the notes.

Your supervisor is going to give you recommendations, flag clinical concerns, and point you toward things you need to act on before your next session. If you do not write it down, you will lose it. I put together a note template specifically designed to help you organize your thinking during supervision. You can find it [here]. Use it as a cognitive organizer, not a transcript. You will not need it forever, but you need it now.

2. Ask for help. Ask often.

Ask your clinical supervisor during supervision. Ask them during other points in the day when something comes up that cannot wait. Ask your colleagues and your peers. You are a learner, and asking questions is not a sign that you are underprepared. It is a sign that you are paying attention.

The interns who struggle are rarely the ones who ask too many questions. They are almost always the ones who stayed quiet when they should have spoken up.

3. Stay flexible.

Some interns arrive at their practicum sites with significant performance anxiety, and when that happens, structure and procedure become a safety net. I understand that impulse. Structure is comforting when everything else feels uncertain.

The problem is that mental health work is unpredictable by nature. A day you carefully planned will be interrupted by a crisis call, a no show, a walk-in, and an unexpected staff meeting, sometimes all before noon. If rigidity is a pain point for you, bring it into supervision and talk about it directly. Your supervisor can help you build tolerance for the unexpected. In the meantime, let it flow as much as you can.

4. Focus on your role, not the system.

Mental health programs often bring interns in during a period of growth, which means the infrastructure around you may still be catching up. Procedures change. Systems are not always well thought out. You will notice things that seem disorganized or inefficient and you may feel an impulse to help fix them.

That impulse is admirable. It is also not your job right now.

You were brought in to do micro level clinical work with clients. The macro level systems work belongs to the director and the leadership team. Stay in your lane, do your clinical work well, and resist the pull to become the intern who is reorganizing the filing system instead of building therapeutic relationships.

5. Network and make friends.

Your practicum site might hire you after you graduate. Your fellow intern might know about an open position that is perfect for you two years from now. The supervisor you impress today might be a reference when you apply for licensure.

Professional networks are built in moments like this one, and the relationships you form during your training years tend to be some of the most durable ones in your career. Get to know people. Show up as someone worth knowing. It will come back to you in ways you cannot predict.

6. Take time off when you are sick.

Do not come to practicum sick. Take the day. That is it. That is the whole tip.

7. You are a priority too.

Your clinical supervisor will always prioritize client care, and so should you. That is non-negotiable. But understand that you are also a priority. Your field instructor is responsible for protecting you, training you, supporting you, and challenging your growth. They should also never lose sight of the fact that you are a student, not an employee.

If the supervision you are receiving does not feel like supervision, if it feels more like management or task delegation than actual clinical training, pay attention to that feeling. We talked about this in an earlier post and we will keep coming back to it. You deserve to be taught.

8. Onboarding is not the same as training, and training is not the same as supervision.

Your first few weeks will feel like constant orientation. Learning the forms, reviewing the procedures, understanding the workflows. That initial onboarding experience is genuinely valuable and you should absorb as much of it as you can. The process is what you do. The procedure is how you do it. Both matter.

But here is what to watch for: in the months after that initial onboarding period, your supervision experience should shift. It should start feeling less like “the paperwork is due by Friday” and more like actual clinical work. Processing what you noticed in a session. Thinking through a diagnostic impression together. Sitting with something difficult that happened in the room and figuring out what it means.

That shift is what good supervision looks like when it is working. If it never comes, that is worth naming.

This Is Not the Auxiliary Activity. This Is the Point.

I want to say something directly before you walk into your first day of practicum, because graduate programs do not always say it clearly enough.

Your internship is not the thing you do alongside your education. It is the heart of your education. You take classes so that you can practice mental health. You do not go to practicum so that you can go to class. That distinction matters more than it might sound.

Field education has a formal name in social work. The Council on Social Work Education designated field education as the signature pedagogy of the profession in 2008. Signature pedagogy is the term scholars use to describe the form of teaching that is most central to how a profession trains its practitioners. For lawyers it is the case method. For physicians it is clinical rounds. For social workers and mental health clinicians it is the practicum. It is the place where everything you have read, discussed, and written about in your coursework becomes something you actually have to do with a real person sitting across from you.

What that means practically is this: you can pass every class in your program and still fail to graduate if you do not perform well in field education. The classroom prepares you for the practicum. The practicum is where you become a clinician.

So please take it seriously. Show up prepared. Be present with your clients. Build real relationships. Practice professional responsibility. Develop what field educators call the professional use of self, which is the capacity to bring your whole trained, grounded, self-aware self into the therapeutic relationship in a way that serves the client rather than yourself.

That last one takes years. It is also the thing that separates a competent clinician from a truly skilled one. Your practicum is where you start.

I am rooting for you. I always am.

Gracias,

Dr. Vero

References

Council on Social Work Education. (n.d.). Field education. Retrieved from https://www.cswe.org