Shortage of psychology internships: ‘The uncertainty is very stressful’
A year’s delay is no exception for many students in the Psychology and Mental Health Master’s program. There are not enough internships in the clinical mental health field, and so students sometimes bend over backwards in strange ways just to be able to graduate anyway.
Fleur van Bokhoven, a forensic psychology student, has been applying for an internship since February 2022. ‘It’s officially a one-year Master’s degree, but because of this problem, many students do not finish it in one year.’
‘This is costing me a delay of more than a year,’ sighs Fenne Linskens, a neuropsychology student, too. ‘I hear from many people around me that they have spent more than a year searching.’
No time for guidance
Demand outstrips supply: ‘There are currently not that many psychologists who get the time and budget to train someone,’ Fleur thinks. ‘Very logical that if you have a super-high workload, you can’t have a student there as well.’
‘For example, no new psychologists are being trained,’ says Fenne, ‘so there won’t be time to supervise anyone soon either. It’s a very awkward circle you’ve fallen into.’
Reservoir of students
Mercedes Almela, one of the academic directors of the Psychology and Mental Health Master’s program, can attest to the picture painted by the students: ‘The workload in mental healthcare in the Netherlands is high, so naturally the priority is patients and skills learning comes second or third.’
Practicing with real patients
In clinical vocational training, students are trained as professionals, or scientist-practitioner, in addition to being scientists. And for that, you have to be able to ‘practice’ with real patients during the internship. To be allowed to call oneself a basic psychologist, it is mandatory to gain experience in both diagnosis and treatment of real patients. For this, upon successful completion, a so-called vLOGO certificate is issued.
The Master’s programs in Psychology and Mental Health to which this applies are Clinical Psychology, Clinical Forensic Psychology, Clinical Child and Adolescent Psychology and Clinical Neuropsychology (English-taught).
‘It is a nationwide problem (in Dutch) caused by the coronavirus crisis, which caused many internship organizations to stop hiring interns. Students had to catch up on their internships later. This created a ‘backlog’ of students. And clearing that backlog takes time.
‘It is important to mention that the job prospects are good,’ Almela wants to emphasize: ‘Some students already have two or three offers in their pockets to choose from, and with their Master’s, they often start working within a month or two. But the internship has become a bottleneck.’
What makes it more difficult for students is that internship organizations can raise the bar because of the large supply; students who already have experience in the field have an edge. ‘It’s very important to stand out compared to other students,’ Almela stresses. Even if that is with experience outside of clinical psychology: the point is that students learn to care for, and communicate with, people. And that they can demonstrate that.
The students indicate as much. To get an internship, they must already show experience on their resume, preferably in a related work environment. Fleur: ‘I started working at the tbs clinic in Amersfoort, not yet as a psychologist but as a sociotherapist/resident supervisor. I was allowed to do that.’ Actually that is strange, she thinks: ‘They are willing to take the risk of allowing an inexperienced person to be alone in a ward with tbs patients, but not allowing someone to come along for treatment and diagnostics.’
‘I really broke down’
Fleur has been applying for jobs since February 2022. Since last July, she finally has an internship position, but it only covers diagnostics. Now she still has to find an internship for treatment. ‘I thought the stress was not that bad, but there was one thing I was really struggling with and that was that I had to apply for a job for the third year in a row.
‘I so couldn’t bring myself to do it. When I had to explain that during a intervision group about internships I really broke down. And all because there is a shortage of internships and at twenty-one you have no experience in the forensic field. What can I do about that?’
But there is hope: ‘Two weeks ago I had an interview at another tbs clinic,’ Fleur confesses. ‘I am allowed to start there in March. That would overlap a month with my current internship and my supervisor thinks that’s okay. But I still have to get permission from the program. I really hope it’s allowed.’
Almela acknowledges the problem of dual placements. ‘In the past, our students could not do placements at all at places with only diagnostics or treatment, but we have made agreements with these organizations and have increased the number of placements.’
To get out of the impasse, the program is working on several more intermediate solutions. Almela: ‘We pay a lot of attention to how students can present themselves and where to look for internships. We try to increase skills in that area, and students can make appointments with internship coordinators and Career Services coaches to check their application documents.’ This is not a real solution, Almela acknowledges because students remain in competition with each other.
‘Therefore, we also constantly contact placement organizations and ask them to hire more students. We suggest hiring at least two students, with several months of overlap, so that the more experienced student can help train the new student in the most basic tasks.’
An interim solution for the Master’s in Clinical Neuropsychology is a so-called internal internship. Almela: ‘Here students can practice clinical skills within Tilburg University, such as conducting intake interviews with actors and digital interventions on patients, or training in performing EEG measurements. And starting in the new academic year, three programs will have additional courses, in which we teach the same learning objectives, and students can graduate without doing an internship.’
These courses are primarily for students who do not necessarily want to work in the mental health field, Almela said. ‘We have more than seven hundred students with very diverse interests. In the current academic year, forty percent of the new students in the Master’s in Clinical Neuropsychology decided to register for the internship.’
‘But then you don’t gain experience with real patients,’ Fenne notes. Those who still want to go into practice really need the coveted vLOGO certificate. ‘You can also obtain that certificate after your studies,’ notes Almela, ‘but of course the best and cheapest option is to obtain the certificate during an internship.’
Almela acknowledges the difficulties students may encounter, but says the program does everything it can to help students. In doing so, she believes Fleur and Fenne’s story does not apply to the majority: ‘More than half of the students finish their internship in one year or find an internship in one year.
Since last year, additional information has also been provided during open days for prospective students. ‘We want all new students to be aware of this before they decide to enroll in a Master’s with a clinical internship,’ Almela adds. ‘With all the information available, they can then make their own considered choice.’
Whether that will dissuade prospective students from studying psychology and a decrease in pressure for internships remains to be seen: ‘When I started my Bachelor’s, I didn’t know about the shortage of internships, but I don’t think it would have dissuaded me from studying psychology,’ Fenne admits.
And a numerus fixus is not an option at this time. Other universities did decide to admit a limited number of new students. But that intervention also has disadvantages because how are you going to select new students, based only on their grades, for example?
‘We see that not always the students with the best grades are also the ones who do best in clinical practice,’ says Almela. ‘You need other skills for that, too. And how do you measure those? We want to leave the choice to the students themselves.’
Dealing with uncertainty
Meanwhile, students must learn to deal with disappointments and frustrations. Fenne only just missed the boat in a round of applications late last year but did receive a commitment to finally start in September 2024. It puts an end to an uncertain period that she has found very stressful.
Fleur hears after this interview that the study program has also given permission to start in March at her ‘treatment internship’ in Zeeland, the village near Uden. It will be busy with two different internships. And it will cost her her summer vacation again, just like last year, if she wants to finish in September. But the relief is enormous; at last she will soon be able to call herself a basic psychologist.
Translated by Language Center, Riet Bettonviel