What I've learned as a clinical intern therapist: apparently, I know nothing.
I was going to title this “what I’ve learned as an amateur therapist,” but I suspect my professors, supervisor, and the State of Illinois would all prefer “clinical intern.” There are many rules in this field, and I’m doing my best to follow them.
That is part of why it’s been a while since I’ve written on here. The other part is because I also feel I’ve lost my voice a bit lately.
Not in the “oh, I’m sick and can’t really talk” way you get when you have a cold, but more so in the “oh, I’m questioning everything I know” way.
I started my practicum as a therapist in May. I have been waiting for this since I started school, and it’s finally here. I am sitting across from clients and doing my very best to help them. I have been studying formally for two years now and informally for much longer.
Yet every time I sit across from someone, I am reminded of how little I actually know and how little I can actually do for clients.
That is a sobering feeling.
My new role has boundaries, and for good reason. I cannot become a client’s friend, rescuer, chauffeur, babysitter, or emergency support system. I cannot step into every practical gap simply because I can see it and desperately wish someone would. Even ordinary human gestures have to be considered through questions of power, safety, consistency, dependence, fairness, and what ultimately serves the client in the long run.
I understand why those boundaries exist.
Still, when you can see clearly that the person across from you needs a break, and that the world has offered them very few, it can feel deeply frustrating to sit inside the limits of what therapy can provide. What do you do when someone has come to you for answers and direction, and all you can see is how the world is failing them and how little there is that you can do to help them from the position you’re in?
Sometimes my insecurity whispers that I’m glad my clients are not paying out of pocket to see an intern. I know that thought is not an objective assessment of the work we are doing. It is the voice of someone realizing that care, attention, and training do not create the power to repair every circumstance.
Still, the thought can haunt me.
I can help people identify their patterns and start to break out of them. I can guide them into taking practical steps to solve problems. I can listen to clients and truly believe them when no one else will. I can empathize all day long until my heart feels like it’s been squished.
But what does that actually do for someone who needs a safe place to lie down and close their eyes, for a child who is overwhelmed by the world around them, or for someone who has been treated unjustly by the systems around them?
Over the last few months, I feel that I have learned a great deal from my clients. The problem is that I’m not entirely sure how much I am giving them in return.
I have learned a great deal of modalities and theories. And I’ve also learned to recognize when they probably won’t work for particular clients. But I never assume that. I talk them through it and see how they react.
Because as I have learned very quickly, assumptions are the absolute wrong way to go in this field. I stay open to critical feedback, frustration, and objections, and I learn from them. I am very grateful to anyone who offers any of those to me!
I also can tell when they have a very healthy mindset, according to all the books I’ve read. I point that out to them to keep encouraging them to think that way, and to show them their own wisdom and intuition.
Also, I have a ton of worksheets. I have started building up an arsenal of online tools on my website to make some of the stuff we do a bit more modern and interactive.
It still doesn’t feel like enough.
Maybe the lesson I’m learning is that therapy isn’t everything. It can’t solve some of the practical things people need help solving, like safe housing for everyone, affordable childcare, and paid, enjoyable, values-aligned work for everyone.
But it also isn’t nothing.
It is a space for people to feel heard and believed, and to know the person sitting with them has their best interests at heart. It is a place to help make sense of things or see them in a different light. It is a place to explore your own thoughts and beliefs and to decide what to do next based on what is actually best for you, not for the world around you. It is a place to connect with yourself. And that is so important in a world that moves as fast and is as loud as ours is today.
P.S. Now that I’m writing as an actual practicing clinical intern, I’m going to add a disclaimer to all of my posts! Yay. Here it is:
I am a graduate counseling student and clinical intern practicing under supervision in Illinois. This newsletter reflects my personal experiences and perspectives and is not therapy, clinical advice, or a substitute for mental health care. Any clinical examples are generalized or composite, and identifying details are never shared.
P.P.S. Originally published on my substack, Wicks. https://withamybrown.substack.com/p/what-ive-learned-as-a-clinical-intern