One of the biggest barriers to enrollment in a counseling training program is the requirement to complete a 600 hour internship, which is usually unpaid. The internship is often completed over the course of at least two semesters, requiring students to spend about a year providing clinical services under supervision at a training site. Students who are not economically privileged find themselves at a significant disadvantage compared to their more privileged peers when it comes time to complete their internship. They must find a way to complete an internship while also still maintaining an income that can support them and their families. This frequently leads to a situation in which a student is working 60 or more hours a week between a full-time job and internship while also trying to complete coursework. The stress and exhaustion that results for these students creates the impression that the internship experience is both unequal and inequitable.
The requirement to complete an unpaid internship also deters enrollment. Each of us has had experiences in which very promising candidates for admission ultimately decide not to enroll because they could not afford to take the time needed to complete an unpaid internship. These candidates never ask why an internship is required; they understand the importance of having a supervised internship experience as a part of the training process. Rather, they ask why the internships are not paid - and that's a very, very good question.
It isn't that agencies don't want to pay interns - most of them wish they could. However, paid internships require the agencies that offer them to have enough revenue to compensate an intern. Public agencies are chronically underfunded and struggling to pay their own staff, while private agencies only make revenue through billable hours. A big problem in the field right now is that most agencies cannot bill for services provided by an intern. To the best of our knowledge, no private health insurance company will reimburse an agency for mental health services provided by an intern even when the intern is being supervised by a licensed professional. That seems odd, given that hospitals bill all the time for services provided by interns and residents under the supervision of licensed professionals. We know, we know - we're not medicine. But if counseling is considered part of the broad umbrella of healthcare and the industry at large is moving towards integrated care, why aren't we demanding that insurers treat services provided by our trainees like they do services provided by trainees in hospitals? That doesn't seem like a big ask. So why aren't we advocating for that?
Bottom line: If agencies can bill for services provided by interns then interns could be compensated fairly for their time. That would go a long way to reducing the inequalities and inequities associated with internship.
Comments