With the beginning of internship application season for those in Clinical Psychology, and inspired by my friend Tyler who thoughtfully posted her internship essays on her own website, I thought I would share my own internship application essays for those looking for examples.
First some stats. As you know if you have bopped around this website for long enough I am focused on Autism as a subspecialty and sites I applied to reflect this.
I applied to:
Children's National Medical Center (CNMC)
Children's Hospital of Pennsylvania (CHOP)
University of North Carolina CIDD/TEACCH (2 tracks-CIDD, TEACCH)
Duke University Medical Center Na
Friends Hospital
Kennedy Krieger Institute (KKI- 3 tracks; KKI-NBU, KKI-PDD, KKI-ABA)
Mailman Center
Mt. Washington Hospital
Nationwide Children's Hospital
VCU Health/The Virginia Treatment Center for Children (VTCC)
Western Psychiatric Institute and Clinic (WPIC)
Yale Child Study Center
Total applied to: 15
I was somewhat geographically limited because I wanted to remain as close as I could to my family and fiancé. Below are all the sites that offered me interviews in order of how I ranked them:
KKI-NBU
Yale
VTCC
KKI-ABA
KKI-PDD
CIDD
TEACCH
Nationwide
Mailman
Total interviewed at/ranked: 9
Match: VTCC! (I LOVED it there)
I hope the essays below are helpful! As always feel free to contact me if there are specific questions you think I can help with.
Ashley
Please provide an autobiographical statement. There is no "correct" format for this question. Answer this question as if someone had asked you "tell me something about yourself." It is an opportunity for you to provide the internship site some information about yourself. It is entirely up to you to decide what information you wish to provide along with the format in which to represent it.
When I was 21 I spent a year working in an Applied Behavior Analysis based school program. One of my students, 8-year-old Andrew, was completely non-verbal and knew only a few signs. The day that I met Andrew for the first time he signed “hug.” He leaned over to snuggle his face into the ends of my hair as I wrapped my arms around him. From that moment I knew - this kid had my heart. Then he buried his teeth in my arm and, in that moment, I knew this was going to be complicated.
My experiences with my students led me to focus my clinical work on children with ASD, language impairment and severe disruptive behaviors. A paper published by Tager-Flusberg and Kasari in 2013 refers to children with ASD and co-occurring language as “the neglected end of the spectrum.” In my own experience, I’ve often found it difficult to adapt evidence based protocols like Coping Cat and PEERS for children with language impairment. In an effort to help address this problem, I led an effort to adapt an evidence based treatment for specific phobia into a week-long intervention for a child with ASD and language impairment. While this was one of the most challenging experiences, it was also one of the most rewarding. After completing a summer practicum with children with a similar presentation at the Kennedy Krieger Neurobehavioral Intensive Outpatient Program, I was filled with even more questions. Why did children have to come from all over the world to access help here? What could be done to make resources for children more widely accessible? When I returned to my graduate program in the fall, I sought ways to disseminate clinical services to underserved populations in our local community. I was one of the first clinicians to help staff the VT Mobile Autism Clinic, an RV which was modified into a clinic in order to make services more accessible to families in rural southwest Virginia.
To summarize, I’ll use the words of Kingsley Shacklebolt, a character from one of my favorite stories, “every human life is worth the same, and worth saving.” Lives that are hard to reach because of barriers to treatment such as poverty, language impairment, or disruptive behaviors have meaning and are worth helping. In order to continue to overcome barriers in providing service to the children I work with I have several training goals for internship. First, I’d like training opportunities with severe cases of various psychopathology (Depression, OCD, ODD etc.). I would also like to gain experience collaborating with professionals from a wide variety of backgrounds on interdisciplinary teams, and obtain continued depth of training in assessment and treatment of neurodevelopmental disorders.
Many things have changed since I was 21. My experience in graduate school has allowed me to grow in many ways as a person, and professional. There is one thing, however, that has never changed throughout all my training. Andrew, wherever you are now, you still have my heart.
Please describe your theoretical orientation and how this influences your approach to case conceptualization and intervention. You may use de-identified case material to illustrate your points if you choose.
When I sit down with parents to do any kind of parent management training I explain that a child’s behaviors are a result of the interaction between factors brought to the situation by the parents, and the factors brought to the situation by the child. The development of my theoretical orientation has in some ways been a similarly dynamic process between my graduate training program and myself. My program brings to the table a strong commitment to clinical science and a primarily cognitive behavioral orientation. When I arrived on the scene I arrived with several years of training from a purely behavioral perspective and a personal belief in the importance of some humanistic philosophies.
In many ways, perhaps a cognitive-behavioral program was the best possible case-scenario for someone trained in behaviorism with a heavy slant towards the humanistic. During a treatment intake, my approach towards case conceptualization and treatment planning is often initially behavioral. Antecedent, behavior, consequence. Frequency, intensity, duration. This has served me well in graduate school and made me naturally inclined towards treatments such as exposure therapy for anxiety and behavioral rehearsal for social skills training. My supervisors have emphasized the importance of “bringing the issue into the session,” meaning that for effective change to happen the session needs to closely recreate the conditions that the client would experience in his or her natural environment. Incorporating the “cognitive” aspects of cognitive-behavioral therapy has often helped do this. For example, the question, “What are you worried will happen?” will often serve as the springboard to design exposures where children can see that what they worry about might not happen, and even if it does, it might not be as bad as they predict.
With regard to the humanistic, this has always been more of a personal belief system that has influenced my therapy practice, rather than an explicit approach to treatment. Working with children who, in past terminology, would have been considered “low functioning” there is often much emphasis placed on adaptive skills and the goals of their families and caretakers for them. While I know these things are important, I always strive to remember that these children are people themselves with their own sets of experiences, goals, and things that are meaningful to them. In this way, I try to structure treatments that target the goals expressed by caregivers in a way that gives children as much input as they can reasonably have. Often I try to achieve this by playing games, building rapport, and then providing simple choices between activities to give children some say in their own experiences. It is my hope that this ideology creates a balance between giving these children the skills they need but also the knowledge that they are the experts on their own experiences and that their choices and opinions, to whatever degree they can express them, should be taken seriously in their treatment planning. It is my hope that during internship, I can continue to work with children with severe psychopathology and developmental disabilities to continue to develop my behavioral case conceptualization skills, while continuing to explore the best ways to incorporate my client’s values and happiness into their treatment planning.
Please describe your experience and training in work with diverse populations. Your discussion should display explicitly the manner in which multicultural/diversity issues influence your clinical practice and case conceptualization.
When I think about the complexities of diversity and treatment, I often think about Soifra and Ella. Both were young women, 16 and 18 respectively, with ASD whom I treated around the same time. Soifra was referred to our clinic for Oppositional Defiant Disorder. Clever, opinionated, and decked head to toe in Marvel Superheroes apparel, Soifra loved to come to sessions ready to argue. Ella was referred to our clinic for Social Anxiety Disorder. Shy, kind, and fun-loving, on the surface Ella couldn’t have been more different than Soifra. However, as I worked with both these clients, I found myself reflecting on many of the same themes including what it means to be a young woman, the intersection of disability and society, and how my views on these things were affecting my interactions with these clients and my supervisor.
I felt like I was always telling Soifra to tone it down. Don’t yell at your parents; don’t be stubborn; be less aggressive. Finally, one day, Soifra said, “I won’t apologize for expressing my feelings. I have a right to feel whatever I feel.” It reminded me of The Taming of the Shrew: “I am no child, no babe, I have a right to speak the truth of my heart, or else my heart, concealing it, will break.” Being less loud, or less stubborn - what kind of message was this to communicate to a young woman? In the end, we settled into the idea that it was important for her to experience her emotions, and that it wasn’t okay for her to treat people badly, courtesy of skills borrowed from Dialectical Behavior Therapy.
With Ella, at first, I had no conflicted feelings. I felt good about assuring a young woman with social anxiety that she had a right to “Stand Up, and Speak Out” as Albano’s manual says. “I think our goal for the end of treatment, is that no one would look at her in a social situation and think she has ASD,” said my supervisor one day. “Why?” I said. “Why should we not want people to think she has ASD?” “Well,” he said, “I think she might be in more danger of being taken advantage of in a social situation.” “Well, it seems to me,” I parried, “that if someone is going to take advantage of someone with a disability that’s their issue not Ella’s.” We reframed the way we were thinking of her treatment. Instead of telling her to stop engaging in behaviors related to ASD (e.g. rocking) we agreed to focus on telling her how to have “confident” body language (e.g. standing up straight and looking people in the eye).
Each of these cases caused me to reflect on the role that my client’s gender identity and disability status were playing in my approach to treatment. It also prompted me to reflect upon evidence based treatment and how important it is to select and implement these treatments flexibly to be respectful of each of my client’s diverse presentations. On internship, I look forward to continued discussions about the complexities of working with young women with ASD as well as developing a greater understanding of the intersection between neurodiversity and helping my patients develop necessary skills.
Please describe your research experience and interests.
As someone who hopes to one day be considered a specialist in developmental disabilities, I hope to continue to focus my research on treatment and the improvement of the quality of life for children with disorders such as Autism Spectrum Disorder (ASD). However, when thinking about treatment research for these children, an interesting problem presents itself. Developmental disabilities such as ASD, Downs Syndrome, or rare genetic disorders are often life-long and not the targets for treatment in and of themselves. Therefore, I have chosen to focus my program of research on the presentation of co-occurring difficulties in this population such as anxiety and disruptive behaviors.
I began this program of research using my master’s thesis as an opportunity to engage with the current literature on ASD, language, anxiety, and psychophysiology using a previously collected dataset. Concurrently, I utilized another extant dataset in our lab to examine the relationship of restricted, repetitive behaviors to symptoms of anxiety and depression in a sample of children with ASD. The results of this work suggested that children with higher self-injurious behaviors demonstrated higher parent reported symptoms of anxiety and depression. This encouraged my interest in finding reliable behavioral correlates of anxiety that could facilitate diagnosis in children with language impairments. For my dissertation, I focused on my interest in observable correlates of anxiety and designed a feasibility study of an observation-based measure of anxiety, intended for use with children with language impairment. Through this project I have been collecting data on children’s psychophysiology, behaviors, intellectual functioning, and current language development, as well as having parents report their observations of their child’s behavior on several screeners. My goals for this project are to determine initial acceptability and feasibility of collecting this kind of data.
During graduate school, I also dedicated significant time to treatment research, assisting with a project treating specific phobias in children with ASD. Current research suggests that specific phobias are one of the most common anxiety disorders for children with ASD and I was able to work as part of a team on a research project which sought to test the initial effectiveness of One-Session Treatment of specific phobia in a population of children with ASD. While ongoing, preliminary results from a non-concurrent multiple-baseline study, as well as a small-scale randomized controlled trial, suggest that this could be a promising treatment for children with ASD without co-occurring intellectual or language impairment. Additionally, through this project I was able to publish a case study suggesting some promise for a modified version of this treatment’s use with children with ASD with co-occurring intellectual and language impairment as well.
On internship, I hope to continue to develop my knowledge of both assessment and treatment of developmental disabilities, and to use this knowledge to continue to inform possible future iterations of the study I conducted for my dissertation. For example, having collected pilot data I would like to learn more about the process of instrument development and move towards a project that would test the initial reliability and validity of an observational measure of anxiety.
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