Direct Clinical Service

Students interested in starting services with PAWS must attend a same-day appointment. These are offered regularly throughout the week; 3 hours each Monday through Thursday, 11am-2pm or 12pm-3pm. Students may physically come to the PAWS office or call/email prior to 1pm to schedule a same-day appointment. The interview typically lasts 30 minutes and is done in a triage format. The purpose of the same-day appointment interview is to provide students with a prompt mental health consultation resulting in appropriate recommendations. For students whose needs may be best met by a community provider or other campus or community service, appropriate referrals are made. If referred for in-house services, students typically leave with a next appointment scheduled, preferably within about one week. During orientation, interns first observe and then assist senior staff during their same-day times. After an initial period of training, interns are assigned a three hour same-day block each week to gain experience with initial assessment and intervention, crisis assessment and intervention, and referral. Interns are encouraged to consult as needed with the senior staff supervisor who is assigned to provide backup during their same-day coverage. The supervisor is also available to take overflow clients during periods of high volume. 

Interns gain experience with crisis assessment and intervention during their drop-in coverage (there is no after-hours emergency coverage). Trainings regarding suicide and homicide risk and prevention, as well as safety planning, are provided during orientation. Students may also present in crisis outside of drop-in hours, at which time they may be seen as soon as a senior staff member or intern becomes available. Interns also gain experience with crisis assessment and intervention through their own caseloads, as they monitor suicidal ideation or other risk among their individual clients. In keeping with our practitioner-developmental model of training, supervisors are involved in crises as a first line of consultation for interns, providing support as needed, from step-by-step assistance early-on in training (and potentially joining trainees in session) to eventually providing support and any needed direction as a consultant. 

Interns provide therapy to students who present with a wide range of issues such as mood disorders, anxiety disorders, interpersonal relationship problems, grief and loss, suicidal ideation, trauma, identity and self-esteem, substance abuse concerns, eating disorders, and personality disorders. Typically, all students receive preliminary assessment through the same-day appointment service. Students who participate in individual therapy at PAWS are further assessed and diagnoses are made during their First Session with their assigned provider. PAWS uses an intentional model for individual therapy. Rather than setting session limits, clinicians work with clients in a purposeful manner to meet identified therapy goals. Clients are typically seen weekly or every other week. If students opt in, they are also sent a text reminder of their appointment (this also applies to group therapy). 

Interns co-facilitate a therapy group during the autumn, winter, spring, and/or summer quarters, as demand allows. During orientation, interns have an opportunity to choose from several group facilitation opportunities. Interns are paired with a member of the senior staff to co-lead group in the autumn and winter quarters. Depending on their competency in group facilitation, interns may co-lead a group with another intern or facilitate a group on their own during spring and/or summer quarters. Interns may develop a group based upon their individual interests for the spring and/or summer quarter, if such a group meets the center’s needs. Groups are recorded for the purpose of discussion during Supervision of Groups.

Students are allowed to participate in either individual or group therapy, but not both concurrently. For the most part, group members are referred to group after completing at least one quarter of individual therapy. This helps prepare them for the group experience and can help to deepen group conversation more quickly, which can be important when operating on the academic quarter system whereby groups tend to meet for 7-10 weeks. Common group offerings include Understanding Self and Others (interpersonal process for any/all students), Men’s Group (interpersonal process for students who identify as men), and the psychoeducational group Build Your Social Confidence, for those with social anxiety to learn and practice skills through various structured activities.

The practicum program is a 9-month training experience for two doctoral students in counseling or clinical psychology programs. Because the University of Washington does not have a clinically-focused doctoral program in psychology, our practicum trainees come from other universities in the region. We require these students to have at least one year of clinical experience before joining us so that they can jump right into the work with our unique student population (providing individual therapy and occasional outreach). Interns are responsible for providing individual supervision 1.5 hours per week for PAWS practicum trainees, under the supervision of a psychologist. Essentially, we offer interns the experience of co-supervising practicum trainees. A senior staff psychologist sits in with the intern during supervision of the practicum trainee, with the psychologist taking the lead early in the year and the intern taking the lead later in the year. Below is our rationale for this setup.

In the state of Washington, where a postdoctoral training year is not required for licensure in the state (so long as other requirements are met), students typically opt to obtain a “practicum” (first clinical training experience) and then a “preinternship” (advanced/additional clinical experience) before applying for the doctoral psychology internship. If students meet the requirements for each of these, they may be eligible to obtain licensure without completing postdoctoral supervised hours. In order for PAWS to attract strong candidates for our practicum training and ensure that our trainees have already completed some clinical training, we technically offer a preinternship. Thus, we follow the state guidelines for the preinternship described in Washington Administrative Code (WAC) 246-924-053.8 We simply call it practicum out of habit and history (we all completed our doctorates in other states so this language is new to us)! There are specific requirements for doctoral students to meet if participating in a bona fide preinternship, one of which involves being supervised by a psychologist licensed for at least two years. This makes it challenging to involve interns in the supervision of practicum trainees. Thus, we meet the requirements of the preinternship by having a psychologist present in the supervision session with the intern, co-supervising. This, in turn, allows our interns to participate in the provision of supervision.

The outreach work of PAWS is considered an essential service. The Outreach Coordinator is responsible for handling outreach requests, communicating outreach opportunities to the staff, maintaining an updated database of presentations, and posting relevant PAWS activities, such as available groups and workshops or self-care tips, to our social media. Our staff provides outreach to the UW Tacoma campus consistent with demonstrated need and requests. Outreach topics include, but are not limited to: introduction to our services, responding to distressed students, managing stress, coping with imposter syndrome, and improving sleep quality. PAWS frequently collaborates with departments across campus in order to provide pertinent outreach and best meet the needs of our students. 

Interns are expected to engage in all forms of outreach, including the design, implementation, and evaluation of effective outreach programs in response to campus requests. Interns are required to participate in all tabling events prior to the start of classes. Interns participate in at least two outreach activities per quarter other than tabling events. Interns are welcome to observe outreach presentations during orientation or early in the year prior to participating themselves, depending on their level of experience and comfort. Next, interns pair with a senior staff member to co-facilitate outreach presentations. Eventually, interns are expected to either present on their own or assume the lead role. If, after completing the requirements, an intern’s skills in this area do not meet minimum competency requirements, an intern may be assigned additional outreach presentations to help develop these skills.