Reflections Outside the Box:  The Internship Crisis
Bob Hatcher, Ph.D.

Bob HatcherThose of us who work daily with doctoral students in professional psychology are acutely aware of the ongoing sense of risk and dread that results from the imbalance between the number of applicants and the number of available internship positions in our field.  Although the situation has improved in the last two years, 20% of applicants failed to place through the APPIC match as of 2014. Until the last two years, there had been a steady rise in the percentage of unplaced applicants, starting in the early to mid-1990’s and reaching a peak of 29% in 2012. It wasn’t always so. In the mid-1960’s, for example, competition among sites for interns was so fierce that the CoA was flooded with applications from internships looking for a leg up and it briefly sought to get out of the accreditation business for new programs! However, during most of the last 20 years unplaced students have been able to find alternative placements outside the APPIC match. Some of these placements are through the California Psychology Internship Council (CAPIC), and others are informally arranged with oversight by the students’ doctoral programs, a process loosely regulated by a CoA Implementing Regulation, IR C-31(c). As a result, virtually any student whose program allows use of unaccredited internship sites could find a position, yielding overall match rates in the low to mid 90% range, as indicated by CoA-required reports on doctoral programs’ websites (IR C-20 data).
     The big issue with these alternative positions is quality control, however. There is no doubt that many of the APPIC-vetted, non-accredited internships to which  27% of clinical psychology applicants matched in 2014 are of high quality – but many of these sites have not applied for accreditation, or have stalled in the process, so their quality level is uncertain. Likewise, many non-APPIC sites obtained informally are likely to be of excellent but unverified quality. This situation poses a challenge for the field.
     Over the last several years the APA has sought to remedy this situation by declaring that all graduates should attend an APA accredited internship, and urging state and provincial licensing boards to add this requirement to their regulations – by 2019. APA backed up this stand with $3 million in funds to aid unaccredited internship programs in seeking accreditation. However, projections over the next five to seven years indicate that providing sufficient numbers of accredited internships for all applicants is a very unlikely outcome – as of 2014, for example, only 60% of APPIC applicants matched to an accredited internship, falling short by over 1,700 positions, and the results of the APA’s $3 million investment are likely to fall far below this number. The APA and related professional bodies such as APPIC and the Council of Chairs of Training Councils (CCTC) have taken on a herculean task, and Hercules left the scene some years ago.
     At this point, the field has two general choices. One is to recognize that the goal of accredited-only internships is unrealistic; the other is to find a way to reduce the number of internship applicants to match the slowly growing number of accredited internship positions. On the side of a more relaxed standard is the fact that there has never been a time in the history of professional psychology that it has been otherwise, since the start of organized training in 1947. Accreditation has always been a valued but optional credential for an internship site. The CoA regulation – IR C-31(c) – loosely formalizes the requirement that doctoral programs ensure that the non-accredited sites attended by their students are adequate to their students’ training needs. APPIC and CAPIC membership criteria serve this role for many programs. Strengthening the IR C-31(c) requirements would help address the quality issue.
    There is no organized method for reducing the demand for accredited internships, what I have called a governance structure after the extensive literature on common-pool resources. In its place we have the moral suasion of the APA, the CCTC, and of individual training councils, all of which have declared their commitment to accredited-only internship training, and some of which have contacted individual programs with lower match rates to accredited internships to raise the issue with them. In addition, the CoA’s IR C-31(c) requires programs with lower accredited match rates to examine the reasons for the lower rates – but the CoA is very clear in stating that match rates are just one of a number of quality indicators that bear on accreditation, so that no program would be disaccredited on the basis of low match rates alone. Over time, these non-binding but persuasive approaches may help reduce the demand for accredited internship positions, but unless other factors intervene, the goal seems likely to be reached slowly if at all.
     Interestingly, recent findings show a decline in total enrollments in accredited clinical and counseling doctoral programs, dropping from 3,700 in 2009 to 3,300 in 2012. I have projected that with this decline, and given the ongoing growth in internship positions, the APPIC match for clinical and counseling students should reach the mid-90% range by 2017 – about as good as it gets. Thus the commitment to accredited-only internships is likely to be challenged by the nearly complete solution of the current internship imbalance problem in just a few years. All of this depends, however, on whether enrollment stabilizes or the decline continues in coming years.

For a fuller account of the points raised in this brief contribution, please have a look at:
Hatcher, R. L. (2011). The Internship Supply as a Common-Pool Resource: A Pathway to Managing the Imbalance Problem. Training and Education in Professional Psychology, 5, 126–140. doi: 10.1037/a0024658.
Hatcher, R. L. (2011). Managing the internship imbalance: Response to commentaries. Training and Education in Professional Psychology, 5, 217-221. doi: 10.1037/a002697.
Hatcher, R. L. (2013). New quality standards for internship training: Implications for doctoral programs, students, the internship match, and beyond. Training and Education in Professional Psychology, 7, 185-194. doi: 10.1037/a0033590
Hatcher, R. L. (2014). The internship imbalance in professional psychology: Current status and future prospects. Annual Review of Clinical Psychology, 10, 53-83.  doi 10.1146/annurev-clinpsy-032813-153737
Hatcher, R. L. (2014).The Internship Match: New Perspectives from Longitudinal Data. Under review.
Larkin, K. T. (2012). Models for reducing the internship imbalance. Training and Education in Professional Psychology, 6, 249 –257. doi: 10.1037/a0030762
McCutcheon, S. M. (2011). The internship crisis: An uncommon urgency to build a common solution. Training and Education in Professional Psychology, 5, 144–148. doi:10.1037/a0024896