Overview of Internship in Clinical Psychology

PROGRAM STRUCTURE

The internship year starts on July 1st and ends June 30th. Our program aims to balance both a breadth and depth of training opportunities by utilizing a track-system within a generalist training program. Every Monday, Wednesday, Thursday, and Friday, interns participate in their track-specific rotation(s). Every Tuesday, interns complete their yearlong generalist training activities, including providing outpatient services through the Department of Psychiatry and Behavioral Science’s Advance Clinic, participating in a yearlong elective, meeting with the Training Directors, and attending weekly didactics. The 2026-2027 generalist didactic and the track-specific seminars are included in the Handbook linked below.

TRACKS

Utilizing a track system provides our interns with a stronger assurance of the training experience they will receive when they arrive. Interested participants can apply and rank one or more of our four tracks:

1. Cognitive Behavioral
2. Forensic
3. Integrated Primary Care Behavioral Health
4. Serious Mental Illness

The Cognitive Behavioral Track

The Cognitive Behavioral Track provides training in empirically supported psychological assessments and interventions across treatment settings, presenting problems, and patient populations. Interns on the Cognitive Behavioral Track will rotate at two six-month rotations. For 2027-2028, there will be five full-time positions available through this track.

Institutions/Programs that are affiliated with the Cognitive Behavioral Track include:

New Opportunities for Wellness (6 month rotation)
The UT San Antonio Long School of Medicine, Department of Psychiatry and Behavioral Sciences’ New Opportunities for Wellness (NOW) clinic is an outpatient academic program that offers wrap-around care to community members including psychological, psychiatric, and case management-related resources. This program differs from the Transitional Care Clinic (TCC) in that patients tend to represent the spectrum of presenting concerns that you would find within a traditional outpatient setting (as compared to recent discharge from an inpatient or hospital setting within the TCC). The NOW clinic branches the NOW and NOW-Youth clinics, and the intern will have the opportunity to provide psychological services to both children and adults should they wish to (with service provision to adults as a required component of the rotation). As part of the NOW clinic rotation, the intern will also participate as a member of the DBT team. This opportunity includes regularly attending the weekly DBT consultation team meeting and facilitating DBT skills group(s), which may include DBT and/or DBT-A groups. Should the intern be interested, there may be opportunities to engage in scholarly work to be discussed based upon interest. There is significant heterogeneity in client presentation and diversity, which includes providing services to those without insurance. The intern associated with the NOW clinic will work as part of an interdisciplinary team, provide individual therapy, facilitate group therapy as a primary or co-facilitator, and/or provide reflective training. The primary treatment frameworks include cognitive-behavioral, CPT, and dialectical behavior therapy. Two of the five CBT interns will rotate at the NOW clinic.

STRONG STAR (6 month rotation)
STRONG STAR is headquartered at UT San Antonio Long School of Medicine, Department of Psychiatry and Behavioral Sciences. Interns receive comprehensive training in evidence-based treatments for PTSD while providing clinical services to Veterans and Active-Duty service members with combat-related trauma. Interns serve dual roles as research therapists delivering treatment and independent evaluators conducting assessments for ongoing clinical trials. Training includes instruction and supervised experience in evidence-based psychotherapies including Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and Written Exposure Therapy (WET) delivered in standard or compressed formats. Interns also receive training in evidence-based assessment, including administration and scoring of the CAPS-5, and may have opportunities for additional experience treating trauma-related disorders and common co-morbidities. In addition to research-focused clinical work, interns provide outpatient trauma-focused treatments through the National Center for Warrior Resiliency Clinic, gaining experience delivering evidence-based care to a broader population of trauma-exposed patients in the community. Within the clinic, interns may receive training and supervised experience treating trauma-related conditions and presentations including insomnia, nightmares, chronic pain, and relational difficulties through couples-based PTSD treatment approaches. Depending on patient presentation and training goals, interns may also utilize the Unified Protocol for Transdiagnostic Emotional Disorders to address co-occurring emotional and behavioral concerns. Two of the five CBT interns will rotate with STRONG STAR.

Student Counseling Center (6 month rotation) Student Counseling Center (SCC) – Student Services
The UT San Antonio Long School of Medicine’s Student Counseling Center (SCC) provides psychological and psychiatric consultation to students in the graduate and professional schools within the university, which enrolls more than 4,000 students each year. Clients present with academic, vocational, psychological, and personal concerns. In this setting, interns work with students that are high functioning but are in very stressful environments. The students range from eighteen to fifty years of age. Interventions and diagnostic activities in the SCC include intake evaluations, counseling, study skills consultation, relaxation training, outreach presentations, couples and marital consultation, group counseling, and consultation with faculty and staff. Two of the five CBT interns will rotate at the SCC.

Transitional Care Clinic (6 month rotation)
The UT San Antonio Long School of Medicine, Department of Psychiatry and Behavioral Sciences’ Transitional Care Clinic (TCC) provides outpatient psychological, psychiatric, and social work services to adults and adolescents with the full spectrum of behavioral health problems who have recently discharged from inpatient treatment. Clients also represent wide cultural and socioeconomic diversity, including un- and underinsured clients, as well as commercially insured clients. Interns work within a multidisciplinary treatment team, providing primarily individual and group therapy, as well as intake assessments. Interns also lead therapy skills training sessions for clinic staff and learners. Psychological services are provided within an integrative theoretical model with emphases in: motivational interviewing, cognitive behavioral therapy and dialectical behavior therapy. Interns have the choice to participate in the clinic’s DBT program, psychotherapy research program and/or to be trained and supervised in the delivery of Cognitive Processing Therapy (CPT) for PTSD. Four of the five interns will rotate at the TCC.

The Forensic Track

Interns on the Forensic Track will complete their rotation at Kerrville State Hospital, a 290-bed forensic state hospital. Staff and interns work with patients who are incompetent to stand trial (ICST) or who have been adjudicated not guilty by reason of insanity (NGRI) for felony level offenses that are also contending with severe and persistent mental health issues. Interns participate in clinical and forensic evaluations, a sequence of bimonthly forensic seminars, bimonthly case law reviews, provide individual and group therapy, and collaborate with a multidisciplinary staff to help patients either attain competency or be safely returned to the community. Interns will be asked to work with patients in both maximum security and in the less restrictive facility. Interns on the Forensic Track will also be expected to participate in several training opportunities throughout the year including a mock trial experience at Baylor University Law School and a Crisis Negotiation seminar at Texas State University in conjunction with law enforcement officers. For 2027-2028, there are two full-time positions available through this track.

The Integrated Primary Care Behavioral Health Track

The Integrated Primary Care Behavioral Health Track provides training in the implementation of the Primary Care Behavioral Health (PCBH) consultation model within a community-based Family Medicine setting. Interns will complete a 12 month rotation with UT San Antonio Long School of Medicine, Department of Family and Community Medicine – Family Medicine Residency continuity clinic. More specifically, interns will have the opportunity to screen, assess, identify, and treat physical health, behavioral health and health behavior change concerns within the context of primary care across the lifespan (e.g., children, adults, older adults). Interns will also learn how to consult with primary care providers as well as other primary care team members such as nurses, pharmacists, care managers and community health workers. Lastly, interns will participate in the education and training of family medicine residents as well as psychology externs in primary care. Interns can receive supervision in Spanish. For 2027-2028, there will be 2 full-time positions available through this track.

The Serious Mental Illness Track

The San Antonio State Hospital (SASH) was established in 1892 as the Southwestern Insane Asylum to serve mental health needs in Southwest Texas. It was renamed San Antonio State Hospital in 1925 and has undergone significant modernization, with a new facility opening in 2024 to replace the original structure. The hospital’s mission is to provide hope and healing through compassionate, innovative, individualized care while supporting the vision of providing specialized care for all Texans in need so that they can live meaningful, healthy, and independent lives.

SASH is a 302-bed, public residential psychiatric hospital that serves an area of 56 counties in South and South Central Texas. Patients at SASH may receive services at SASH voluntarily, by civil commitment, or on a forensic commitment as either incompetent to stand trial, or not guilty by reason of insanity. The training program includes the participation and gradually increased responsibility of the intern under careful, direct clinical supervision, and experience with both acute and forensic patients. The trainee will join doctoral staff psychologists in individual clinical interviews and group therapy (such as DBT) sessions and later conduct interviews and sessions without direct observation. The trainee will also administer evaluations with direct observation by the supervisor and will later conduct testing without direct observation. The trainee will provide feedback to the treatment teams and will complete group and individual therapy notes and testing reports. While interns will have exposure to forensically committed patients, this is not a forensic track, and forensic evaluation will not be a focus of training.

The philosophy of the serious mental illness track at SASH is one of moving psychology interns to more independent and autonomous practice within an inpatient setting. This will be achieved by maintaining supervision to support the learning process, applying psychological skills to a serious mental illness population, and nurturing professional and personal growth.

The Serious Mental Illness track, interns can:

• Develop skills in interventions with individuals diagnosed with SMI.
• Develop skills in psychological testing and psychological assessment.
• Adapt learned skills and conceptualizations to an inpatient setting.
• Learn about the institution of an inpatient psychiatric hospital unit and the role of a psychologist within an interdisciplinary team.
• Interdisciplinary Collaboration: Actively participate as a member of the treatment team, which may include presenting cases and providing feedback to other disciplines like Psychiatry and Social Work.
• Documentation: Complete clinical notes and other required documentation in a timely manner.
• Ethical Conduct: Adhere to ethical and legal guidelines for the practice of Psychology.
• Professional Development: Attend required orientations, trainings, and meetings, and engage in ongoing learning to stay current with the latest research and practices.

YEAR-LONG EXPERIENCES

Each intern is involved in a wide range of clinical areas. The training year consists of clinical service rotations with some experiences spanning all rotations. The specifics of your training will be determined by the assigned rotation sites and the Internship Training Directors (TDs). Clinical Activities for the Clinical Psychology Internship include rotation-specific and year-long experiences. Rotation-specific activities were identified above under Track opportunities. Year-long experiences include the following:

1. Outpatient Individual Psychotherapy
   Each intern will be assigned two individual psychotherapy cases through the Department of Psychiatry and Behavioral Sciences ADVANCE Clinic. Patients will be selected to provide the intern with the experience of discovery, formulation, and the attempt to alter symptom constellations. Theoretical orientation for outpatient psychotherapy cases varies by supervisor, though most are expected to be long-term treatment cases. Through the combination of individual supervision and participation in seminars and case conferences, each intern should receive first- or second-hand experience with a wide variety of psychopathology and of therapeutic approaches.
2. Year-Long Elective Rotation
   Each intern will be assigned to one of the following elective experiences.  Prior to the start of the internship year, interns will rank their preferences for these four electives.