Private Practice Model
Our goal is to graduate highly qualified professionals who have a basic understanding of how to provide psychotherapeutic services, who know how psychotherapy differs from counseling, and who are prepared to deliver these services in a private practice setting. Trainees are therefore exposed to all aspects of running a private practice.

The clinical training relies heavily on an object-relations based understanding of internal dynamics with an emphasis on transference, countertransference, and the particular interaction between these phenomena, leading to an approach that is now called Intersubjectivity. Trainees learn what it means to work within the transference. They are able to recognize and work with resistance and know how to respond to acting-out and acting-in clients. They experience what it means to act as a container, and to maintain therapeutic neutrality. The program also includes an ongoing focus on theories related to:

• The development of cognitive and psychic structures
• Psychotherapeutic practice
• The interplay of intrapsychic, interpersonal, and environmental factors.

Upon completion of the program trainees should be able to hear their client's communication in terms of its manifest content and its unconscious meaning. They should have a firm grasp of how a patient's unconscious communications pertain to the therapist, how projective identification is used to convey meaning, and how evoked counter-transferential reactions can be put to therapeutic use.

While the center provides training in dynamic therapy, we recognize that professional psychologists may need to use other therapeutic approaches. We therefore support the trainee's efforts to develop additional skills. In this regard, trainees who have specialized knowledge are encouraged to lead seminars in which they share their knowledge with other interns.

On the business side, trainees learn how to work with insurance companies, prepare invoices and keep all appropriate business records. In the process of setting and collecting fees, they learn how financial issues act as a metaphor for themselves and for their clients. As a professional, each therapist is encouraged to develop his or her own referral sources and establish a fee for direct referrals. Interns learn how to make initial contact with potential clients and are encouraged to do community outreach. This might take the form of providing an in-service at another agency, giving a talk, or teaching a class. Upon completion of the second year of the program, therapists are encouraged to continue seeing their clients in their private practices or take them to their next placements.

Training
We encourage trainees to be aware of their character; who they are and what they bring to the clinical process. For this reason, all aspects of the program allow trainees to explore transference and countertransference issues in depth. Trainees often come to see how their own internal struggles affect their professional development, and they are encouraged to carry such awareness into their own therapies. The didactic aspect of the program provides a cognitive underpinning for the acquisition of new clinical skills. Trainees often experience the program as intense, sometimes difficult, but usually rewarding, and leading to significant professional growth.

Trainees are also encouraged to take courses or participate in clinical workshops as an adjunct to their training at the Center. Such efforts expand their learning and enhance their understanding of what is being taught in the program.

Individual Supervision: Our supervision makes use of process notes and recorded sessions. It includes didactic teaching and, in keeping with an intersubjective approach to psychotherapy, makes use of parallel process. This allows for direct, in-the-room work on the dynamics affecting the client-therapist relationship and the therapeutic process. Interns have a primary and auxiliary supervisor, each providing one hour of individual supervision per week. Interns are exposed to a number of supervisors during the two-year program -- two primary supervisors, each for one year, and four auxiliary supervisors, each for six months. This enables them to experience how the basic tenants of process work and dynamic psychotherapy transcend individual styles.

As might be expected, the exact nature of the supervision varies between supervisors. Some present a stronger theoretical framework and are good at helping the trainees develop a cognitive understanding of their clients. Others are good at identifying those beliefs or emotional issues which are blocking the therapy. However, trainees are always treated as competent professionals and are encouraged to bring into supervision those issues which are important to them.

Administrative / Director's (Tuesday 9:30 - 10:30): All interns participate in a general administrative meeting which addresses both the current issues related to the operation of the Saturday Center and of operating a private psychotherapy practice. Topics vary from month to month include the following:

September:  “The suicidal client.”  Discussions to include: making a competent suicide assessment, the pros and cons of a “suicide contract,” hospital resources, 5150 from a private practice perspective, voluntary hospitalization, dealing with the client’s family and legal/ethical issues of confidentiality, when the client returns to your practice.

October:  “Appropriate and inappropriate clients for a private practice setting.”  Dealing in an intake interview with clients who are: overtly suicidal, overtly psychotic, on heavy doses of medication, substance abusing, court mandated, violent or assaultive.  How to refer out.  Referral agencies.

November:  “How to do an “Intake Session.”  Returning telephone calls: issues of promptness, confidentiality, establishing rapport.  What to say and not to say on the telephone.  Material to cover in an intake meeting.  Issues of rapport building.  Essential issues to cover.  Fee setting.

December:  “HIPAA and State laws.”  Issues of confidentiality and limits on confidentiality.  Informed consent.  Letting the client know what he/she is contracting for.

January:  “Mandated Reporting:”  Child and elder abuse reporting.  Tarasoff reporting.  Repairing the damage to the clinical relationship.

February:  “Third party billing:”  Business issues.  Client responsibilities vs. therapist responsibilities.  Appropriate diagnoses.  Avoiding inadvertent insurance fraud.  Issues of confidentiality of records.

March:  “Practice building:”  Networking.  Reaching into the community: flyers, public lectures, conferences.

April:  “The Business Aspects of the Profession of Psychology:”  Record keeping. Billing.  Appropriate client-therapist boundaries. Building referral sources.  Malpractice insurance.  Other office issues.

May:  Maintaining a practice and avoiding burnout:”  The importance of regular consultation.  Maintaining balance in one’s life. Appropriate practice size and composition of clients.

June:  “Specialization in Practice:”  The pros and cons of specialization.  How one becomes a specialist.  Working in one’s “area of competency.”  Marketing oneself as a specialist vs. as a generalist.

July:  “Giving Back to the Community:”  Issues of pro-bono work.  Ethical issues for psychologists outside of their practices.  Community work and social activism.

August:  “Towards Establishing Oneself as a Professional:”  Issues of termination and transfer of practice.  Helping clients transition to a new therapist or to a new location.  Helping new therapists deal with their anxiety.  Practical considerations of starting a business.  Establishing a post-doc, or a Psychological Assistanceship.

Reading / Clinical Issues Group (Wednesday 9:30 - 10:20): All interns participate in a Didactic-Reading-Clinical Issues Group. The topics covered in this group vary from year to year. Theoretical, practical or professional issues, as well as the process or art of doing psychotherapy are explored. Four to ten week seminars cover the area of listening, object relations from an intersubjective point of view, resistance, transference and countertransference. Time is reserved for outside lecturers on topics such as suicidal clients, working with a psychiatrist, fee setting and other boundary issues. Time is also reserved for an exploration of common clinical issues. These are often discussed in response to a trainee presenting a difficult case, and always deal with the practical difficulties encountered by beginning therapists. The following give an indication of the range of topics:

September  Topic: Introduction to Psychodynamic Theory / Reading: Nancy McWilliams, Psychodynamic Psychotherapy.

October  Topic: Issues in Diagnosis
Reading:  DSM-4T and PDM

November Topic: Legal & Ethical Issues
Reading: Calif. State Laws Pertaining to the Practice of Psychology, APA Code of Ethics.

December Topic:  Object Relations Theory
Reading: J. Greenberg & S Mitchell, Object Relations Theory in Psychoanalytic Theory

January  Topic:  Jungian Theory
 Reading: D. Kalsched, The Inner World of Trauma

February Topic:  Classic Freudian Theory
Reading:  R. Greenson, The Technique and Practice of Psychoanalysis

March Topic: Ego Psychology Theory
Reading:  A. Freud, The Ego and the Mechanisms of Defense

April Topic:  Self Psychology Theory
Reading:  H. Kohut, How Dose Analysis Cure?

May:  Topic:  Developmental Issues
Reading:  C. Yorke et.al., Development and Psychopathology.

June Topic:  Technical Issues
Reading:  P. Giovacchini, Tactics and Techniques in Psychoanalytic Therapy, III: The Implications of Winnicott’s Contribution.

July Topic:  Adolesence
Reading:  B. Brodie, Adolescence and Delinquency: An Object Relations Theory Approach.

August:  Topic: Group Therapy
Reading:  I. Yalom, Theory and Practice of Group Psychotherapy.
                       
 Case Conference (Wednesday 10:45 - 12:10): All interns participate in the Case Conference Group. Trainees present cases on a rotational basis. The task of this group is to focus on the presenter's work with his or her client. Theory, diagnosis, technique, transference, countertransference, and parallel process are considered. The presenter is expected to formulate a coherent case presentation, focusing on the treatment impasse and factors relevant to it. The other trainees are expected to engage the presenter around his or her work with the client and around relevant clinical issues. The supervisor assists the presenter and the group in focusing on the client and the therapeutic dyad. This often

Process Group (Tuesday 10:30 - 11:50): All interns participate in a Process Group in which small-group dynamics are learned through an experimental format. Of particular interest is the response of the group to leadership and authority. This is of critical importance for the trainee's development as responsible and effective clinicians who are able to contain and not misuse the authority inherent in the psychotherapist's role. The leader routinely makes process observations.

Clients And The Clinical Caseload
Referrals to the Center come from a variety of sources in the community and comprise a broad clinical population. We do not accept clients who are currently in need of hospitalization (actively suicidal and psychotic patients). We also don't work with children. Our fees begin at $30.00. Clients are seen during the week and on Saturday.

Entering trainees are given the first five treatment referrals. After reaching a minimum caseload of five clients, treatment referrals are distributed on a rotational basis. Trainees are expected to maintain a minimum caseload of 12 hours that completes the 20 hour per week internship. The majority of clients are seen in individual psychotherapy; about ten percent are couples. Those trainees wishing to start therapy groups receive full Center support. The use of video or audio tapes allow interns to be observed and to observe other therapists at work.

Qualifications
Applicants must be an intern in a Ph.D. or Psy.D. program, be a MFT intern, be eligible for registration as a psychological assistant, or have a license which allows them to provide psychotherapeutic services. They must also have a minimum of one year of supervised clinical experience and one year of individual psychotherapy. We recommend that trainees be in personal therapy during their time in the program and occasionally make continuation in the program contingent upon such therapy.

Length Of Internship And Financial Arrangements
For the first year interns, there is an initial four-month mutual probationary period. A one year commitment is required from the first year interns. Upon completion of the internship, the trainees in good standing are encouraged to continue for a second year.

Interns are required to carry a minimum caseload of 12 clients during their first year at the Center. Interns at the Saturday Center receive no pay. The Psychological Assistants are paid. The range of how much a Psychologica Assistant might earn depends on factors related to any successful private practice, including: carrying a larger case load, attracting referrals, and setting and raising fees. Another financial incentive is to finish the second year of the training program with a full practice such that the trainee can realistically begin a private practice of their own.

Application Process
Applicants wishing to start between June and December use the APPIC matching program. Applicants wishing to join the Center during other times of the year contact the Center directly. In both cases the applicants send a completed application to the Center. They are then invited to an individual interview at which they are asked to present a case. The purpose of this interview is to gain an understanding of the applicants' current clinical abilities and to see how they function in the role of supervisee. The individual interview is usually followed by a group interview with two or three members of the Center staff.

The Saturday Center for Psychotherapy is a member of the Association of Psychology Internship and is committed to folow its guidelines. Intern applicants must register with the APPIC Internship Matching Service @ www.appic.org. This internship site agrees to abide by the APPIC policy that no person at this internship facility will solicit, accept or use any ranking related information from any intern applicant.