Remote Counseling
by Faythe R. Newberry, MSW, and Hellen Gerolymatos McDonald, MSW, LCSW
If you had asked me more than a year ago to consider a remote internship, I would have given you a blank stare. I do not mean that in a negative way. I could not envision completing clinically-sound direct practice with my clients without providing face-to-face interventions. The COVID-19 pandemic propelled us all to think creatively, and in spite of the challenges faced, I just graduated by fulfilling my internship requirements, 100% remotely!
My final requirement toward MSW degree completion was a one-semester, full-time, 500-hour block placement internship. Preparation for this placement began in October 2019, with an original start date of May and an August 2020 graduation. During the initial phases of internship planning, my field liaison and I worked to create connections with more than a dozen agencies—with no luck in securing a placement. The COVID-19 pandemic and a shelter-in-place gubernatorial executive order contributed to the difficulty of finding a site by April 2020. Most affiliated organizations were transitioning to remote status and were unsure as to if they could accommodate interns—and if so, how many. Just in time to spice things up even more, I voluntarily moved out of my childhood home, found a job in a correctional facility, and jump-started independent living.
Although this was a difficult decision, I deferred to a Fall-semester start, which meant I would graduate in December 2020 but gain three more months to plan. My field liaison and I considered alternative ways to fulfill the internship requirements. The entire summer went by with no internship in sight. It was time to consider a not-so-typical internship model, otherwise known as a remote internship.
Another student in my cohort had already completed a remote placement, and my field liaison was open to considering this. A completely remote placement is exactly what it sounds like—all learning experiences are conducted online or via telehealth means, through recorded simulations, on Zoom and phone conferences or client meetings, and with a lot of computer work. I was overwhelmed with emotions—nervousness, worry, excitement, doubt, and uncertainty.
Three weeks into my internship rotation, I noticed that it was difficult fulfilling the 30-hour per week requirement. Perhaps the lack of physical parameters or boundaries, resulting from the virtual spaces in which I was interning, were contributing factors. I do not know for sure. However, the best decision was to prioritize my remote internship and reduce my work hours. This was a tough decision with obvious fiscal effects on my household. My partner and I made it work, though—it was only temporary. As my internship hours increased, so did my confidence. I felt proud as I gradually progressed toward achieving competency in my internship goals. Work, school, and my home schedule all started to fit together nicely.
You might wonder: what kind of advanced clinical learning activities could I experience remotely and how would I get hands-on learning if my site was my actual professional school, instead of the affiliated organization? My field liaison and I worked avidly and creatively to find projects or activities that would count as internship learning. We both reached out to at least six potential sites, most of which were already affiliated with my school. My liaison would make the connections and suggest a collaboration. If sites were interested, I would follow up to finalize the details. Many of the sites were open to taking on such projects with us, mainly because they would be able to offer new programs or finally complete tasks that had been set aside for years.
I chose to work with three agencies. The first agency asked me to create a mental health resource guide for its offender population. This would be a resource for offenders who were on track for parole or release within 30 days. The second agency asked me to provide counseling services to older adults over the phone. The individuals I telecounseled were feeling isolated at home because of the pandemic, and they were not able to see family or complete their daily living activities. The third agency facilitated a weekly support group for new moms who might also be experiencing postpartum depression. I co-facilitated that group. I gained unique learning experiences with each agency.
To create a narrative and reflective base for this article, we added weekly journaling to my learning plan goals. Through these reflections, learning plan activities, and supervision, I was able to understand how I implemented the social work competencies into my remote client interactions. I specifically used the telephone and Zoom in the delivery of telehealth services. In preparation, I completed a two-hour, online telehealth training offered by Indiana University (Wilkerson et al., 2020) and reviewed the NASW Technology in Social Work Practice Standards (2017). I referenced both throughout my internship. My field liaison became my field instructor, and to minimize conflict of interest, partnered with another clinical faculty member at the school, who became my field liaison.
Finally, to gain a deeper understanding of the processes of clinical assessment, intervention, and evaluation, my field instructor and I read a book of my choosing. K. A. Cory’s (2015) book Can Someone Help Carry My Baggage? provided deeper insight into the lives and experiences of foster youth or those aging out, as well as their biological, foster care, and adoptive families. We read one chapter each week, and while processing the ethical implications during supervision, we critically analyzed hypothetical assessments and best-practice interventions.
I also had access to an online course module that our field education office had developed, offering supplemental learning activities. By viewing recorded simulations of clinical practitioners and clients in enacted sessions, I learned so much more about interventions and the unique style of each expert therapist.
In my case, supervision with my field instructor occurred weekly via Zoom. There was additional supervision provided by the primary facilitator of the new moms’ group, one of the agency’s clinical supervisors, and my online seminar class instructor and classmates during the concurrent and integrative seminar class.
Toward the end of the semester, I started attending group supervision with three other MSW students, facilitated by my field instructor. I preferred individual supervision, because I was able to talk about more than just the struggles of my internship, but I learned about others’ challenges at their sites, as well, and perhaps did not feel as isolated during this remote experience.
Ultimately, this was an amazing internship experience and one that I never expected. I can honestly say that I think I gained more through a remote learning, not-so-typical internship than I possibly could have at an on-site, typical placement:
- I worked with more than just one organization and one community.
- I got to work with populations I had never worked with before.
- I obtained micro-level experience, or one-on-one experience, by working with individuals over the phone to provide supportive counseling
- I received mezzo, or group, experience by co-facilitating the support group for new moms.
- By creating the mental health resource guide for a corrections re-entry program, I learned from a macro lens and lived the experience of how macro social work aims to enhance advocacy and policy skills.
- I was able to work through ethical dilemmas via a multi-varied lens (multiple and diverse academic, clinical, and peer supervisors).
- I was influential in creating ideas for remote projects.
- I felt included and was an active participant in the planning and development of my learning plan goals.
- I gained knowledge from a variety of social work practice levels, supervisors, and organizations.
- Most importantly, I built up confidence in myself to see my experiences through to the end.
As with any learning experience, a remote internship model is not a one-size-fits-all model. Should you consider trying it out for yourself, here are a few tips you might take into account:
- First, make sure that your field education office is willing to consider such individualized learning experiences.
- Learn to be okay with uncertainty. Parts of this unique internship model will continuously be shifting.
- Make sure that you have multiple methods of self-care. One will never be enough.
- Take charge of your experiences. This is your education.
- Make it a #1 priority.
- Work on time management. Use a planner, print calendars, set aside time for breaks.
- It is okay to worry and stress about what is to come. The feeling will come and go.
- Communicate with your field instructor about your needs, worries, concerns, and successes.
- Journal your feelings and how experiences affect you during your time as an intern.
Remote learning is overwhelming. To struggle during this journey is completely normal—after all, you are human.
References
Cory, K. A. (2015). Can someone help carry my baggage? A journey from abuse to unconditional love and a forever family. CreateSpace Independent Publishing Platform.
National Association of Social Workers. (2018). Code of ethics of the National Association of Social Workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
NASW, ASWB, CSWE, and CSWA technology in social work practice standards (2017). https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf
Wilkerson, D., Wolfe Taylor, S., Deck, C., & Hitzeman-Crampton, J. (2020). Telebehavioral practice basics for social work educators and clinicians responding to COVID-19. Indiana University, School of Social Work.
https://expand.iu.edu/browse/socialwork/courses/telehealth-basics-for-social-work-educators-behavioral-health-clinicians-responding-to-covid-19
Faythe R. Newberry, MSW, is an inpatient rehab social worker at Memorial Medical Center. Faythe is a motivated learner, changer, and adapter with a passion for medical social work.
Hellen Gerolymatos McDonald, MSW, LCSW, was elated to support Faythe on her unique internship journey as her field instructor. Hellen has been a clinical faculty member of an incredibly creative and collaborative field education team since 2009.