For MFT students, the practicum is where their academic learning is finally applied in the real world. After learning about all the different theories of MFT, as well as other topics such as ethics, practicum is where the student finally gets to use their skills in real-life situations with real clients. For many, the practicum is one of the most rewarding parts of their graduate education. It is also said to be one of the most challenging aspects of learning to be a Marriage and Family Therapist.
There is often a mixture of excitement and apprehension when entering the practicum experience. Many students wonder whether they are ready to work with clients, have difficult conversations with families, and generally manage the day-to-day reality of the clinician. The reality is that nearly every clinician-in-training experiences similar anxieties.
Read on to learn what to expect from a Marriage and Family Therapy Practicum and how to approach it.
What Is a Marriage and Family Therapy Practicum?
The practicum experience for Marriage and Family Therapy students is a supervised clinical training experience where students apply what they have learned in the classroom in real-life professional situations.
In a practicum, students are learning how to help clients in a real-life situation while at the same time, they are receiving supervision from an experienced Marriage and Family Therapist. They learn how to apply their previous knowledge of theories, methods and concepts, to help their clients to overcome difficulties and reach their goals.
Practicum experiences may take place in:
- Community mental health agencies
- Nonprofit organizations
- Schools
- University clinics
- Hospitals
- Private practice settings
While the specific requirements for practicum are determined by individual programs, in addition to hours of direct client contact, students complete hours of supervision with their Practicum Site Supervisor, complete practicum documentation, and participate in various Professional Development activities related to Marriage and Family Therapy Practicum. You can view NU’s practicum resources for MFT students to learn more.
Moving From Theory to Practice
One of the greatest challenges that the practicum experience poses for students of clinical mental health counseling is that of moving from a classroom-based understanding of theories of counseling and psychotherapy to the practice of conducting individual, couple, and family counseling sessions with actual clients.
The student first experiences learning theory in the classroom setting (classroom readings, class discussions, role playing and study of written case studies). This is as opposed to the practicum where the student applies that theory to real client(s) in therapy sessions and experiences the complexity and unpredictability of human behavior.
Students realize that no two clients are ever the same. Every client, whether single, in a relationship or a family, brings experiences, strengths, challenges and goals to the therapeutic process.
This transition often requires students to learn how to:
- Build therapeutic relationships
- Conduct assessments
- Develop treatment goals
- Apply theoretical models
- Facilitate meaningful conversations
- Adapt interventions to client needs
At first, students have some difficulties in applying what they have learned in the classroom to the practical situation of dealing with clients in a clinical setting. However, as they gain experience in conducting sessions with their clients, they become more confident in their clinical competence.
Understanding First-Session Anxiety
Nearly every therapist remembers their first client session.
Most of the therapist-educators on our faculty remember their first session with a client and say it was a mixture of emotions: nervousness, apprehension, excitement, and even a bit of fear. And students now have similar questions and apprehensions, such as: What will I say? What if I don’t know what to say? What if I do if I make a mistake?
Experience and time, not perfection, will be the basis for a therapist’s growing clinical competence. It is rarely, if ever, expected of a student in training that they will have all the answers in their work with clients. What matters is that students are able to establish a safe, respectful, and collaborative relationship with their clients to work effectively with them.
As many supervisors note, effective therapy is largely comprised of a therapist being present, curious, empathic, and a truly human being, connecting with clients in all their complexities and particularities. Skills and confidence will continue to develop with practice.
The Importance of Clinical Supervision
Supervision is one of the greatest assets of the practicum experience.
Supervision of the practicum students is one of the most valuable aspects of their training. Clinical supervisors function as mentors and provide guidance, support, and accountability to and for the student therapist. Together they explore and process complex cases, strengthen core clinical skills and review decisions made by the student to enhance professional judgment.
Supervision often includes:
- Case consultation
- Feedback on recorded sessions
- Ethical discussions
- Treatment planning support
- Professional development
- Self-reflection and growth
Supervision should not be seen by students as merely an evaluative process. It is perhaps more beneficial for the student when viewed as a collaborative learning process.
The most successful clinicians continue to seek out consultation and support from other professionals in the field throughout their careers.
Developing Your Clinical Identity
As an LMFT and Academic Clinical Supervisor, I continue to have meaningful experiences on practicum, especially around the development of my professional identity.
Initially, students often focus on mastering theories and interventions in order to deliver “good” therapy to clients. As students engage in the practicum experience, however, they gain insights into their own strengths and learn how they naturally connect with clients. In addition, students typically become aware of their own values that are in line with certain therapeutic approaches and develop a sense of the therapist that they are.
Questions that often emerge during practicum include:
- What kind of therapist do I want to become?
- Which theoretical approaches align with my worldview?
- How can I continue growing professionally?
- How can I continue growing professionally?
A student’s clinical style evolves as they experience different lessons and challenging situations in their work with clients. It will continue to grow as the clinician gains more experience with their own practice. The therapeutic style that a clinician uses is personal and typical for that individual, thus typically the clinician does not copy another therapist’s style of practice. Instead, the clinician’s personal style is created based on that clinician’s practice, lessons, and growth.
Common Challenges During Practicum
It’s common for every practicum site to have moments and situations of uncertainty and growth for the student.
Imposter Syndrome
The feelings of being an imposter are common in high-achieving graduate students. If I could tell MFT students anything, it’s that there is nothing wrong with you! As you gain more experience, you will become more confident in your knowledge and skills as a clinician.
As your experience increases, confidence typically grows alongside competence.
Balancing Multiple Responsibilities
Many MFT students must balance school with time spent at work, at the practicum site, with their family, and other responsibilities.
Time management, organization, and self-care are all very important for balancing practicum with other responsibilities in one’s life.
Difficult Clinical Situations
Some of the difficult situations that students are exposed to are people dealing with trauma, crisis, relationship problems, grief and other serious life problems.
Supervision, consultation, and ongoing learning will assist you in handling those difficult situations in an ethical and effective manner.
Documentation Requirements
Clinical documentation is a very important part of our work as mental health professionals. Learning to complete accurate progress notes, treatment plans and assessments can feel like a daunting task at first but with repetition and feedback from your supervisor, you will get the hang of it in no time.
Skills That Grow During Practicum
Experience in clinical work during the Practicum enables rapid professional development that cannot be attained in a classroom setting.
Students often experience significant improvement in:
Active Listening
Students can develop the skill of Active Listening. While most people can listen to words that another person is speaking, a good therapist can listen for the underlying emotions, recurring patterns or other meanings.
Case Conceptualization
Students learn how to organize clinical information of their clients and their problems in a conceptualizing framework to better understand their clients’ concerns.
Cultural Responsiveness
Working with people from diverse backgrounds enhances students’ capacity to practice in a culturally responsive and sensitive manner and to practice in an inclusive manner and provide effective, culturally informed care to clients.
Professional Confidence
By doing more clinical work, students can gain more confidence in their professional abilities and respond better in unexpected situations.
Self-Awareness
The effective therapist is able to look at their own experiences, beliefs and reactions in their work with clients.
Prioritizing Self-Care During Practicum
While supporting others can be very fulfilling, it can also be emotionally exhausting and draining for both the supporter and the person being supported. This is especially true when supporting people through tough times or when dealing with difficult situations or emotions.
The habits of a healthy graduate student would be to support the long term well-being of the student, in order to foster their clinical competence.
- Maintaining realistic schedules
- Seeking support from peers and mentors
- Practicing mindfulness or stress management techniques
- Setting professional boundaries
- Engage in activities that assist in the therapist’s renewal and balance.
Note that self-care is not separate from clinical competence. It is an important component of a therapist’s practice and is key to a therapist being able to practice in a sustainable manner.
Embracing the Learning Process
I have found that one of the greatest things that students get from their practicum is the sense that they can learn and grow over time. At first, new therapists are not experts at all. They develop their clinical competence by doing their work, getting feedback from their supervisors, thinking about what happened in their sessions, and learning more about their clients. As therapists, we continually update our knowledge and skills as we work with more and more people. This process takes time, but it is very rewarding.
Every session, every challenge, every success, and every mistake that a therapist has ever had will be brought to the session with a client.
Students who approach their practicum experience with an attitude of curiosity, humility, and willingness to learn and grow will find that the practicum experience is one of the best aspects of their graduate education.
The Beginning of a Meaningful Career
The Practicum is more than just a requirement for graduation. It is the initial step in your professional career helping individuals, couples and families make meaningful changes in their lives.
Through supervised clinical experiences, students in MFT programs are able to develop the confidence, skills, and identity of a professional Marriage and Family Therapist. This journey from student to professional can be challenging at times, but the end result can bring so much growth, learning, and connection to others.
There is a common misconception about experienced doctors. People often believe that they were always 100% ready to practice. But the reality is that every experienced doctor was once a student in training, often unsure if they were ready to practice. However, with good supervision, a strong work ethic, and a commitment to learning, students are often surprised to find that they are more ready than they thought. And then the real journey from student to doctor begins.
