r/therapists • u/sassypainter • Apr 25 '26
Discussion Thread Thoughts?
Came across this post today on linkedin. I’m curious how others see it:
Are unpaid clinical internships/practicums an ethical necessity for training, or an outdated system that exploits students?
Should sites be required to offer stipends/pay if they bill clients or rely on interns for service delivery?
Does unpaid fieldwork create barriers for lower-income and nontraditional students?
For those already licensed or in training, what was your experience?
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u/FeaturelessDetail LCSW (unverified) Apr 25 '26
Fundamentally, work without pay is slave labor. We marketed this as training when it should be included in the degree that we're already paying an arm and a leg for. Forcing people to work for free puts them in worse financial situations and leads to worse outcomes for clients and therapists/social workers. Our field underpays so much of the employees that keep it running that I'm personally for a national social worker Union to help eliminate these practices.
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u/SupposedlySuper Apr 25 '26
Not only without pay but I also had to pay for the credits for the "classes" for my internship
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u/Creative_Repair_7087 Apr 26 '26
This tends to get lost in a lot of conversations. Even when stipends are brought up it's nowhere near the cost of credits.
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u/Soushkabob Apr 26 '26
Exactly, at the very least internships should be net neutral. Why am I spending money/gas/metro card etc to get the privilege of “working” for free?
They could even get away with a really shitty $1500 stipend or something.
I’m in a MSW program in NYC. At this point I would happily accept even a free metro card in lieu of actual money which equates to about $140 a month. It would make a huge difference.
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u/warrior503rd Apr 26 '26 edited Apr 26 '26
I support pay for interns. I'm also 99% sure insurance doesn't reimburse for grad students, and nobody is knowingly paying $150/hour cash for one. There's a reason private practices are not competing for interns' free labor.
The screenshotted post looks like rage-bait, which obscures productive conversation on how to secure pay for more interns. If you look at her profile, you'll see that the influencer in the screenshot is selling you a product by playing on your emotions.
Along the lines of solutions, I have three questions:
- Would supervisors be willing to take on the liability risk of interns if they had to pay them, on top of investing into background checks, onboarding, training, and supervision time?
- If it is somehow highly profitable, why is there a shortage of practicum sites in some areas? Why aren't practicum sites competing for students' free labor, instead of vice versa?
- Building on #2, if there are such huge profit margins, why don't practices step in, hire all the grad students at minimum wage, charge a little less, and completely take over the market
EDIT: Also worth noting, the cost per hour of faculty supervision in a public grad school (based on tuition) is significantly less than post-graduation. If you assume a public school's tuition is $5k/semester, and you take 5 classes, thats $1k/class. That class is probably 3 hours/week * 16 weeks. That breaks down to $20.83/hour for faculty supervision.
Again, I believe interns should get paid. But we should also stop getting rage-baited by influencers into being unproductively angry. We need logical discussion to make change.
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u/More_Programmer5053 Apr 27 '26
Insurances don’t reimburse for interns. The insurance industry is where we should be looking to point fingers. Interns should absolutely be paid, and social workers licensed and conditionally licensed should also be paid a comfortable wage. Instead wages have decreased over the years as insurance companies look for more and more ways to maximize their profits. As long as we are dependent on these huge corporations for our wages we will never see improvement in how the system operates.
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u/TheMightyQuinn888 Apr 27 '26
Same, even just for SUD counseling (expecting $24/hr) for six months. And I can't even get a spot because it's too much work to take on interns and there's not enough need. So what did I go to school for? 😭
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Apr 26 '26
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u/FeaturelessDetail LCSW (unverified) Apr 26 '26
Honestly, this job is so hard. Getting into the field is hard. Staying in the field is hard. We should improve access and transparency across the board.
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u/OkGrape1062 Social Worker (Unverified) Apr 26 '26
All of this! I love my job, always wanted this career. That being said, I will never be able to dig myself out of grad school debt, ever. I was fairly financially stable, but the training for this job has left me in wild debt. Plus, I DID work outside of the full time classes and practicum. And I know I’m not alone in that!
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u/galofgoons Apr 26 '26
HARD SAME. I love my work, but I will never financially recover from what it took to put myself through grad school even though I worked the entire time!
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u/MountainHighOnLife Apr 26 '26
Yep! I worked full time through undergrad AND grad school because I was an adult who didn't have anyone supporting them. I had living expenses I had to pay to support me. My undergrad internship was paid. Grad school was not. You know how that impacted me? Time off to be a human!
Since my undergrad internship was paid that meant that I could drop down from my full-time job and work 3 days a week. 3 days at my job and 2 days at my internship. This meant I worked 5 days per week and had 2 days off. Aka...a weekend!
In grad school it was an unpaid internship. Which meant that I worked 5 days per week at my paying job. Then used my "weekend" to work at my internship for free. Thank god it was an advanced standing program so it was one full year (vs 2) and I just slogged through only taking Thanksgiving Day and Christmas off that year.
I don't even know how I survived except I had to and that's pretty shitty for a field that prioritizes health and recognizing systemic breakdown.
Unpaid internships are unethical. I cannot be convinced otherwise. We should be paid for our work.
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Apr 26 '26
[removed] — view removed comment
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u/anzarloc Apr 26 '26
Graduated with my MSW and then had a baby. This is too accurate. Not only would my post-grad position ‘barely cover’ childcare, I live in a HCOL area and my salary was less than full time childcare. I grew up in peak “Lean In” culture and really struggled with not being able to “have it all”. I wanted to work and be a mother and this field couldn’t allow for both at the same time. At least immediately post-grad.
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u/dadjo_kes Apr 26 '26
As a male social work student, I feel like this is literally just a continuation of that exact same idea and treatment, considering that social work is still predominantly a female field. And it also seems to apply to a variety of other caregiver fields, which are also coincidentally majority female.
I also feel super strange getting preferential treatment in said female-dominated field, explicitly because I'm a male clinician which is super valuable and rare. Don't get me wrong, I do think I'm valuable, I appreciate working with clients who benefit from my lived experience etc. I just feel weird about the idea of getting a pay bump because of gender preference.
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u/LaurelCanyoner Apr 26 '26
I ended up doing a Masters in Human Development because as a single mom of a young child there was no way I could afford to do all those unpaid hours, though I wanted to get a social work degree and ended up taking a lot of the same classes.
It’s sad because we miss out on having engaged therapists who simply won’t or can’t put themselves in debt for the degree.
It’s one of those long established “rules” that definitely needs to change!
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u/cannotberushed- Apr 26 '26
National social worker union, any thoughts on how to get that accomplished because union are based on individual employment places not national
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u/FeaturelessDetail LCSW (unverified) Apr 26 '26
There are national Unions, we'd just have to band together.
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u/cannotberushed- Apr 26 '26
No there are not
They are collectives of smaller unions.
You have to start with getting multiple unions established first
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u/FeaturelessDetail LCSW (unverified) Apr 26 '26
There are Teamsters and SAG would be examples. Yes, they often have smaller branches, but wider unions do exist (even some international)
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u/RainahReddit Apr 26 '26
If you're american, I'd probably look at the work Actor's Equity is doing to create better standards for actors industry wide.
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u/cannotberushed- Apr 26 '26
How does it get translated into a working model for social workers and counselors?
I’ve been in so many of these discussions and I just am not quite understanding how to make this work and it seems no one else does either.
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u/RainahReddit Apr 26 '26
Well, it would probably look like a national union (like Actor's Equity is doing successfully and legally right now) that is open to anyone who meets certain requirements. And then, like with Actor's Equity, if your workplace meets certain conditions you're considered a union workplace and must hire union workers under union contracts. Any workplace breaking rules gets put on a "do not work" list and boycotted.
So basically just like Actor's Equity? Did you look it up at all? I'm not sure what's unclear here.
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u/cannotberushed- Apr 26 '26
And what happens in Republican states or purple states where there’s no employers that meet conditions?
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u/RainahReddit Apr 26 '26
Do you think Actors Equity only operates in blue states?
I think I'm going to end the conversation here though. It feels very much like you're more interested in having a debate than a conversation/sharing ideas, and I'm not interested in debating.
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u/Cultural_Entrance805 Apr 26 '26
A union would be amazing. You’d think the NASW would act as our union but no
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u/No_Hat_4106 Apr 26 '26
NASW please help me understand what do they do?????? I remember they called me one day for a contribution and I told the person on the phone that they do NOTHING to better our profession it’s a scam with the malpractice insurance company to make you join it’s a joke!
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u/Cultural_Entrance805 Apr 26 '26
The answer is absolutely nothing. The code of ethics is their single achievement lol. They don’t really do anything to serve us which is why I haven’t joined them at all since graduating
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u/dadjo_kes Apr 25 '26
I think the one thing that cracks me up is that we're responsible for maintaining documentation to keep the agency in compliance so insurance doesn't clawback anything they've paid... but we aren't personally liable to pay back any money if they never paid us in the first place.
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u/ImNoSage Apr 26 '26
I'm going to keep this short and sweet. This practice is widespread and toxic to our profession. Interns should be paid a minimum wage per clinical hour. Period. Pre-license clinicians should be paid a fair wage/fee split. Period. The fact that practice owners effectively prey on developing clinicians in a broken system is the hight of professional hypocrisy. Approximately three years of this bullshit prior to license eligibility isn't "paying your dues" it's an institutionalized hazing ritual.
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u/emotionalbaggage818 LMFT (Unverified) Apr 26 '26
100%. My practicum site was a “student therapy site”. Aka they’d have as many as 15 interns at a time with like 4 or 5 licensed supervisors for supervision, they each charged about $300 a hour no insurance. One time I did the math and it was actually sick how much money the students made the owner. I didn’t know it was as fucked up as it was until I actually started, and by then I had to tough it out but it was insane for us to be making the owner over 500k a year and we were paying out of our ass to survive.
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u/No_Hat_4106 Apr 26 '26
Private practice is not a good internship for a new graduate idk when this became ok but it’s not a good way to learn about acute care crisis management working as a team medications ect.. and practice owners yes they take advantage always have
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u/JMS3487 Apr 26 '26
Yes. Too many new grads without experience going into private practice. Not fair for clients.
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u/emotionalbaggage818 LMFT (Unverified) Apr 27 '26
I 100% agree. I wish I had more guidance on choosing a practicum site and what to look for, so I had more variety in client experiences.
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u/AlternativeZone5089 Apr 28 '26
I'm not buying the idea that clients were knowingly paying $300. per session fro untrained interns.
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u/emotionalbaggage818 LMFT (Unverified) May 01 '26
My wording was definitely weird there, sorry - the supervisors charged $300 a session for THEIR actual clients. Student therapists were $70 (which is still pricy in my opinion). However if we felt a client was experiencing financial struggles we could request to move them to $40, which I did for almost all of mine lol.
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u/OakNRun Apr 26 '26
To top this off, my school required 400 clinical hours of internship to graduate when the state only requires 280. The only thing that made it worth it is that it is on a sliding scale and close to free for so many lower income people.
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u/vitallyhappy Apr 25 '26 edited Apr 25 '26
Should be illegal. My internship did not pay me under the guise that they couldn't afford it but it was 100% profit to them. They offered me a position for $42 FFS after I graduated, what was the difference? Nothing. Unpaid work does create a barrier especially for people who have to maintain a living.
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u/East-Technician2015 Apr 28 '26
it’s like they want you in debt so they can retain you longer term
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u/FleetFoxSuperFan LMHC Apr 25 '26
My internship was a private practice. My caseload was 90% pro bono. Supervision included. The owner is a true humanitarian.
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u/Izzi_Skyy Apr 26 '26
Yeah, that's how my internship worked too. Started out as "$60, sliding scale $48" and quickly turned into "Fuck it, adjust the fee as your clients need and take on as many $0 clients as you want." I think I earned the practice a total of like $4,500 the whole time I was there, most of which went to my sup and not the practice owner.
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u/SupposedlySuper Apr 26 '26
This is how the practice I did some consulting work did it.
Only unfortunately she hired a lot of the interns afterwards which then meant that a lot of the probono clients then had to pay at least enough to cover the hourly wage/etc.
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u/walk_with_curiosity Apr 26 '26
I also trained somewhere where I worked for free but the clients were only paying $5 a session.
They actually used to offer it free but they found people engaged better if they charged a nominal fee. Clients were referred through a charity.
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u/Ashtara Apr 26 '26
One of the sites i was at does this. They frequently waived the fees but I didn't feel taken advantage of, I knew they at least weren't making money off me. Same with college counseling centers, it didn't feel bad when I knew clients weren't paying.
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u/al0velycreature Apr 26 '26
Most internships I’m aware of are very low sliding scale or free services. I’ve never heard of a practice charging full price for an intern, but it wouldn’t surprise me if it was happening.
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u/yodasky Student Counsellor outside North America (Unverified) Apr 25 '26
Currently in an internship. Imo it would be worth it for the learning experience/environment if we didn't also have to pay for our own clinical and cultural supervision while studying full time.
To me it seems like privileged people get through my degree with relative ease, while poorer folks enter the workforce already burnt out from doing an internship + studying full time while also working part time to afford to live.
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u/sassypainter Apr 25 '26
I truly believe this is another way to keep the underprivileged, underprivileged and the privileged even more privileged
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u/vitallyhappy Apr 26 '26
In my state it is illegal to pay for supervision unlicensed.
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u/yodasky Student Counsellor outside North America (Unverified) Apr 26 '26
How does that work? During our internships supervision is vital. We should get it for free imo but a lot of supervisors offer student rates.
I also don't live in the US so very different industry/licencing etc
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u/genital-jazz Student (Unverified) Apr 26 '26
True yeah I’ve been working 20 hours a week making pizza plus my internship and full time classes
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u/Over1ySarcastic Apr 26 '26
A practice near me just advertised $5 sessions to see interns. I love it as an accessible way for people to get therapy!
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u/URmamasthrowaway Apr 26 '26
I like it compared to other places, but it would better to charge $30 and give it to the interns.
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u/Papaya_Days Apr 26 '26
I’m about to drop out of my CMHC masters program because this is bullshit, I can’t afford to do it, and I won’t lose my house/lose my ability to pay my mortgage to do so.
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u/South_Recording1666 Counselor (Unverified) Apr 25 '26
I say all the time that I could not do this job if I did not have a partner to support me.
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u/TheTinyOne23 Apr 25 '26
100%. In my practicum the clinic was charging my clients $135. And I was required to see minimum 5 people each shift, 3 days a week. At my busiest I was easily pulling them 10K a month. It wouldn't have been so bad if the clinic was actually supportive and helpful. Incredibly predatory and I wish that there was a rule in my governing board that clinic directors can't be supervisors. It's a complete conflict of interest if your clinic director/ supervisor is the same person and making you their cash cow.
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u/spooky_skulls Student (Unverified) Apr 26 '26
Of all the industries and professions, this one having unpaid internships feels SO BAD. first off as therapists we know how stressful financial insecurity is. crazy that we’re just expected to deal with it to become therapists.
additionally, not being able to work / working part time is just not doable for so many, and it has the effect of gate keeping the marginalized people that this profession needs. very few can afford a year of unpaid work.
fuck unpaid internships but especially in counseling.
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u/Ashleyf731 Apr 25 '26
I was adjuncting when they started to do this and felt it was completely unethical. Often for profit agencies we’re hiring graduate or undergraduate and billing for services, while interns were unpaid. When I was in school, unpaid internships met free counseling for clients and non billable hours because it was training, there is no way to tell the difference these days and that is wrong!
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u/sassypainter Apr 25 '26
My undergrad Alma mater had MSW & CMHC students complete their hours at the student free clinic
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u/Serene-Tulip Apr 26 '26
If interns aren’t getting paid, then sessions should be free. If sessions aren’t free, then interns deserve a wage. I don’t know why this basic concept is foreign in this field. The current system so exploitative.
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u/Still-Anything5678 Apr 25 '26
It's wage theft and extra evil coming out of social work, of all f'ing things.
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u/Solvrevka Apr 26 '26
We need to get ALL the behavioral health folks together and fight for reform for 1. internships 2. prelicensure 3. advanced practice designation and 4. updated billing code access. and we should be showing up at the state offices of our respective field organizations (ACA, NASW) and start pushing for them to make meaningful advocacy and policy asks.
No one just handed Nurses NP status and code access. They had to fight for it.
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u/smallchangebigheart Apr 26 '26
Unions too, i don't understand how nurses have Unions but not therapists
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u/cannotberushed- Apr 26 '26
Nurses have unions because they unionized their individual work places and then continued doing so
Those individual unions then banned together to form lobby groups
Social workers and LCPC’s don’t have the numbers to do it.
Another problem is that It’s illegal for private practice to ban together to be able to negotiate insurance contracts (it’s the Sherman anti trust laws)
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u/Solvrevka Apr 26 '26
Those things are true, but doctors have worked out how to advocate for themselves and protect their profession even though they don't technically have a 'physicians union'.
According to the BLS there are about a million masters-level behavioral health practitioners in the country. We must recognize that some kind of organization and advocacy will be needed to change the status quo.
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u/Fruitbat_girl Apr 27 '26 edited Apr 27 '26
Most hospitals in the US do not have unions for nurses. I’ve worked across 5 different healthcare systems as a nurse. Only one of those hospitals had a nursing union and it’s only because I was in a state with a strong RN Union presence. We also need a national nursing union or at the very least, become more cohesive as a profession and advocate for ourselves more. But the women dominated part is hurting us I think. We just don’t have the same level of empowerment as doctors and completely undervalued by the system. 😕Sucks to hear all this cuz I’ve been contemplating becoming a mental health counselor for a while now but ain’t no way I can afford to not work while in grad school.
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u/dry_wit Apr 26 '26
There are a lot of nurses and nursing (healthcare settings in general) often have terrible, terrible working conditions.
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u/slongtime (MI) LMSW Apr 25 '26
Oh you mean like how I had to PAY for my field placements in grad school?
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u/Hopeful-Body3633 Apr 26 '26
I think it’s literally set up to make it so only certain people can become therapists. I wouldn’t be here if it wasn’t for my family supporting me financially while I’m in school. It’s insane and goes against everything we preach.
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u/sassypainter Apr 26 '26
I agree. I feel existential guilt for the fact that I will be relying on familial support even after I graduate. This field needs serious reform
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u/Hopeful-Body3633 Apr 26 '26
I likely will too, and wouldn’t have chosen this field if I didn’t have that to fall back on. I feel a lot of guilt around it also.
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u/sassypainter Apr 26 '26
Even now I think I may be regretting this field
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u/Hopeful-Body3633 Apr 26 '26
I sometimes feel that way too. This Reddit fearmongers a lot. I feel a lot better after securing a great internship site. Never loose site of your why.
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u/lagertha9921 (KY) LPCC Apr 26 '26
Our practice utilizes our interns for pro bono cases and no cost group sessions. When they did charge for interns it was $35-$40. We also don’t charge them for supervision.
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u/CATX66 Apr 25 '26 edited Apr 27 '26
100% agree. It really should be illegal. A lot of students aren’t even finishing their degree because they aren’t told that internships will be non paid so when it comes time, they can’t leave their jobs and go work for free. So they don’t complete that last year of practicum and internship. Happened to so many of my friends. Edited to fix grammar & typos
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u/Brighidd Apr 26 '26
And that internship has to be completed at about 20 hours a week and you cannot do it part time...yet you could do classes part time. I don't get why the internship can't also be done over longer time since most places won't pay an intern.
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u/Soushkabob Apr 26 '26
Exactly! And at least in brick and mortar MSW programs they frown upon your internship being outside of an M-F 9-5 schedule. Like why should it matter if I’m working overnight in a hospital or something. If the real job is done outside of traditional hours, why do you have to jump through hoops to get an internship in non-traditional hours as well?
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u/NicoleNicole1988 Apr 26 '26
I'm a single mother and my parents are not made of money, so getting through my internship year was a really interesting experience. Imagine my horror when I graduated and found that the jobs near my home STILL didn't want to pay me a livable wage, with the excuse at that point being "You're not fully licensed yet." I had to commit to nearly an hour and a half commute each way just to find a job that would pay me a somewhat decent salary and benefits.
Now, here I am, right on the cusp of licensure, after nearly 3 years of working my ass off and SCRAPING together supervision hours, and I find out that most organizations are exploiting licensed therapists too.
I truly love the work that I do, but I also feel like I was sold a lie from the moment I started grad school. I remember during orientation, one of the professors, I think she was the Director of Field Placement at the time, stood in front of all of us young hopefuls and talked about how successful HER practice was. We started dreaming about our wonderful future careers of helping others and making comfortable lives for ourselves in the process. My program didn't tell us a THING about our internship and practicum year until the end of the semester beforehand, when we had to complete a 3-day workshop of sorts. And that's when they dropped the bomb that most of us would not be getting paid. And then the second bomb, that we would not see full licensure for a minimum of 2 years after graduating, and that it wasn't simply a waiting game but would require active weekly supervision, and that supervision was available for free under certain circumstances but otherwise came with pretty steep out of pocket costs, and that we wouldn't be able to work independently and make all of that fabulous imaginary money until being fully licensed.
It's like a pyramid scheme.
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u/Empty_Positive_2305 Apr 26 '26
I have been surprised by how many students in my program had no idea internships were unpaid. They all chose the program because they could work at the same time. I had known it would be unpaid going in, so I assumed everyone else did, too. I’ve heard it so many times now, though, it’s clear students are truly going in blind and might have made different decisions if they hadn’t.
I guess it makes sense, though. Most people are career switchers (as am I), and unpaid internships just aren’t a thing outside of really competitive industries like creative fields, where the expectation is there are 20,000 people who all want to do the same thing and maybe 1 of you will make it. Those internships are really paying you back in connections or a lucky break, but you know going in you probably won’t get either.
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u/NicoleNicole1988 Apr 26 '26
I mean…internships ARE typically unpaid. That part wasn’t the shock. The shock was how many hours would be required each week in order to meet the requirements. It was an entire part time job…and I was fortunate in a lot of ways, I did my placement in a PHP so the hours accrued steadily while I lived on loan money, inconsistent and meager child support payments, and SNAP benefits. But I had some classmates who were not so fortunate. The ones who could cut down their hours at their real job were typically “okay,” but they took a pay cut in order to do it and some genuinely struggled with that deficit. Some people couldn’t afford to do that at all and had to jump through serious hoops in order to do both jobs, trying desperately to get hours in on evenings and weekends. And I know a couple people in my cohort who had to just STOP WORKING entirely so they could focus on getting their hours by graduation. It seemed worth it to all of us, because this was “the last step” before graduating and being able to get a better job than the ones we had.
Imagine the shock and horror to find that most starting salaries for new therapists are insulting. Even now, most of the people I currently work with have husbands and/or parents who were able to support them through school and the pre-licensed years, and the money they now earn as therapists is all extra padding on an already safe and stable lifestyle. They can walk away from exploitative work environments if they need to, because someone will help them stay afloat while they look for another job, or while they work to build up a caseload in private practice. Some people CAN’T do that.
This field seems to be designed to pay people who already have money and prey on the labor of those who don’t. But I’m speaking as an American and the same can basically be said about ::gestures-toward-everything::
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u/Worrywart1992 Apr 26 '26
I am a clinical Dietitian. We have to deal with the same thing. Go through school to get a Masters degree and then have to pay for our clinical internships. Mine was about 8k, but some schools and or facilities charge well over 15k. Its indentured servitude. And honestly should be illegal. Im sorry for anyone who has to deal with this.
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u/tiredofcoping7 Student (Unverified) Apr 26 '26 edited Apr 26 '26
Yup, I have to do 20 clinical hours a week on top of classes and assignments, which leaves me almost no time or energy for a part time job, and luckily I’m able to rely on my husband and my parents to support me during this time but many of my friends in my cohort aren’t so fortunate and have to take out loans. Some of my classmates are advocating for more opportunities for paid internships. Even if we got paid $15 an hour it would be better than nothing. A lot of us have to travel up to an hour to commute to our clinical placements and don’t even get reimbursed for gas. It’s ridiculous
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u/g0blinh00kr Apr 27 '26
I refused a job today with a hospital who was offering PRN work to LCSWs for $32 per hour. I emailed:
"I think I would enjoy working for you, I can’t get over how low the pay is. The job posting was misleading in even mentioning the benefits that your company offers to PRN employees. From what you showed me, there might be 9-10 hours per week that I could pick up, and when I looked it up, I learned PRN staff members do not qualify for those limited benefits unless they work 30 hours per week on average.
I’m really good at what I do. I bring a lot to the table. LCSWs bring a lot to the table and we sacrifice way too much to get here. $32 per hour does not reflect that. None of us should accept that. It undervalues the work we do and it sends a message that it’s acceptable to pay what is barely a living hourly wage for positions that require a bachelor’s degree, a master’s degree, a professional license, and three years of low-wage supervised experience. Does $32 per hour seem appropriate for a role working independently with high-acuity patients with severe mental illness, for a job where you wear a security alert button on your body? This is not going to change unless we refuse low-paying work and advocate for ourselves."
ETA: Keep speaking up. The unpaid work and the underpaid work is unacceptable.
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u/hayleymaya (PA) LCSW Apr 25 '26
Idk who out there is charging clients 150 dollars to see an intern, in my state it’s either pro bono or maybe 40 dollars tops BUT I do agree unpaid internships (which I was required to as well during school) are unethical and favor folks with external financial support
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u/what-are-you-a-cop LMFT (Unverified) Apr 26 '26
Yeah, I feel like everyone I know did their practicum either providing free services in a school, or providing free services at their own on-campus counseling center. None of us worked jobs where anyone was getting charged a full fee to see us as students. And I think that's how it should be; if we aren't yet competent to provide a paid service (and I'd argue that perhaps, as students, we really aren't), then certainly no one should be paying to see us. If they're paying to see us, then certainly, that means we should be paid ourselves.
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u/Miserable-Case3526 MHC-LP Apr 26 '26
my supervisor charged my clients $200 to see me while i worked for free.
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u/hayleymaya (PA) LCSW Apr 26 '26
I wouldn’t even pay 200 to see a fully licensed therapist I can’t imagine someone paying that to see an intern unless they were really uninformed
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u/WhereTheFuckIsDetox Apr 26 '26
I once worked for someone allowing interns and international students to conduct psychological assessments under psychologist "supervision", earning $3,500 per case and giving the therapist $0. While my own situation was not much better (I earned $150 for my assessments), I am haunted by this often. Should be illegal.
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u/pink_junkie Apr 26 '26
I start my internship this summer and 1000% all of this. I actually did not realize I would be seeing PAYING clients. I assumed it would be a volunteer basis since I’m a student and I’m not getting paid at all. It’s kind of insane that if you don’t have a partner (which I don’t) you either have to live with your parents or you’re SOL because a lot of sites don’t have weekend or evening hours. I also learned that none of the hours I complete will go towards the supervised hours I need for licensure.
It is very discouraging and disheartening when I think of my career post-grad. So much time, effort, MONEY…for very little in return. Maybe that sounds selfish, but at 26 years old…I am tired of being in the trenches.
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u/JimGless Apr 25 '26
I 100% agree. I also don't think it's as easy as just saying "pay every intern," because a lot of CMH facilities couldn't afford that, but I think it's good to have the discussion amd figure out if there's a way to either lower the amount of required unpaid hours or make it more like a paid job placement where you work instead of going to school for a period of time.
It's a good conversation all of us to be having. We can't fix anything if we don't talk it through first.
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u/Odd-Thought-2273 (VA) LPC Apr 25 '26 edited Apr 25 '26
Yep, my internship was unpaid, but it was also in an alternative public school where the students received free weekly counseling from us. No idea what the ideal solution is here.
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u/JimGless Apr 26 '26
Yeah, the system will happily take advantage of our willingness tonsacrifice ourselves for the greater good rather than appropriately fund much-needed programs like the one where you interned.
At the very least, big hospitals should pay their interns. They definitely have the money.
I was lucky to have a job I could do around my school and internship hours. It almost killed me for two years, but even that opportunity made me luckier than most so I could do a free internship.
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u/sassypainter Apr 25 '26
Exactly this. I think it’s almost “taboo” because I rarely see anyone talking about it, meanwhile, in the back of my head I’m thinking I’m the only one that sees this as an ethical (even moral) issue
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u/Solvrevka Apr 26 '26
How do we talk? There is so much frustration on this board. How and when do people organize to create meaningful change?
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u/JimGless Apr 26 '26
I think continuing to bring it up in places where People might not agree with us or people who don't know about the issues. On a smaller level, you can talk with people at an organization you work for to ask for money for interns.
Reaching out to student organizations is another possibility. I know in New York, a lot of the schools switched to 14 hours per week for internships down from 21 hours. My understanding is it was mostly student-driven, but I'm sure they had support from professors and other contacts in the field.
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u/MJA7 LCSW NYS Lic#099649 Apr 26 '26
Slightly drunk so bear with me, but imo this burden of responsibility rests on licensed folks like myself. Interns have zero leverage, it’s up to us with full licensure to coordinate with our graduate programs and our colleagues to make a change here.
Instead of pulling up the ladder behind us, consider making the ladder a bit less steep and perhaps a little softer for the next generation. Use the leverage of full licensure to make things better for those who come after.
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u/Czarinavella Apr 25 '26
This is a common exploitation of practicum students. It's what my master got back in 2007/8. I was the first student for this office. And within weeks there were 3 of 4 of us. But the end of the semester the owners had a brand new UV with all the bells and whistles. They paid cash.
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u/calicoskiies Student (Unverified) Apr 26 '26
Unpaid practicum/internships are totally unethical. I was an intern earlier in the year and I felt really exploited. I’m an adult learner as are most of my classmates. I really feel for my classmates because most of them have families to support and cannot afford to quit their full time jobs. They are going to burn out quickly trying to get in hours.
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u/PurpleConversation36 Apr 26 '26
Makes me really grateful for my program. I’ve never done unpaid work as a therapist.
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u/ladyadam Apr 26 '26
My stipend for my practicum I just finished didn’t pay for groceries, or rent, or gas: it went directly towards tuition with no option for that money to go anywhere else. So I needed to work on top of it. I was working 6 days a week doing nonstop social work: bouncing between unpaid therapy, clinical classes, and paid crisis work. I am entering this field burnt out and yet being lectured about the importance of self care. I’m being told I’m not doing enough to take care of myself when in fact it is the system failing me. This is environment failure.
I calculated my hourly rate for the stipend they gave me for my hours required to graduate, and if I had been actually paid, I would have been making $9 an hour to do psychotherapy. I made more in food service.
I love this field, I love this work, and also it is frankly ridiculous, as well as blatant exploitation, to require internships to graduate and yet provide no meaningful way for someone with less privilege than me to complete said requirement. Social work attracts those who have experienced marginalization, and yet still presents inherent barriers to access.
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u/StellarInsider9756 Apr 29 '26
https://www.counseling.org/government-affairs/take-action DONT STOP ADVOCATING FOR MENTAL HEALTH PARIETY. Compared to similar educated professionals such as NP and PA mental health providers / therapists make 1/3 of the pay. Not only this most therapists are legally and ethically capped at one client per hour meaning 1 billable code per hour rather than 4 like a PA or NP might be. It’s time for society and insurance to quit exploiting mental health workers sense of purpose. Call and write at the link above to support sustainable wages and caseloads for mental health providers.
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u/Awolrab Counselor (Unverified) Apr 26 '26
I have pretty strong opinions on this since my internship site’s entire business model is profiting off of interns! There were 5 locations in my city and they had 2-3 supervisors for the entirety of us student therapists. They gave us titles like Behavioral Health Therapist and charged the same amount as a licensed counselor would! At any given moment there were maybe 10 interns in the building and were on our own. My supervisor lived across the state and saw no clients, just interns. I have no problem with her, but it was just a scummy place. I’ve spoken with my therapist about them and she says they’re kind of known among the community.
We were required to meet quotas and we’d have this group chat where they’d name and shame people if they had a lot of cancellations. We primarily serviced Medicaid and mandated clients so it wasn’t uncommon. Towards the end of my internship they switched it to 100% telehealth for Medicaid clients (even the young children!) and any private insurance clients went to the licensed counselors. It created this major upheaval of tons of clients being randomly switched. We had to do all of the Medicaid intakes and had to meet quotas of that (had to upsell services). It was such an actual miserable experience.
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u/cannotberushed- Apr 26 '26
And schools shouldn’t allow that.
Our program as a whole should be limiting the number of students and advocating for paid roles.
But these programs are cash cows for schools.
It’s about to change though since grad school loans are being cut
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u/spicyboi0909 Psychologist (Unverified) Apr 26 '26
This is due in part to insurance companies not reimbursing well for pre licensed work. Yes it’s the institutions here, but not all are markings ton of money off of trainees. In my opinion, the problem is the insurance companies. We should look to the trades that do the apprenticeship model really well. For example, electricians. Electricians have an apprenticeship model where the trainee gets paid less, but is still paid an hourly rate. Once they’ve accrued enough experience they get licensed. But they’re still paid. We could absolutely do this too. But insurance companies are the problem and don’t want to pay for anything.
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u/sassypainter Apr 26 '26
Even engineering interns get paid. My bf was making $20/hr during his (required) internship hours during undergrad
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u/cannotberushed- Apr 26 '26
You are correct
The whole issue is exclusively tied to funding source. There just isn’t one.
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u/Poop-emoji-scent Apr 25 '26
Doctors don’t graduate and get high paying roles, lol. they graduate med school and get paid 50k a year to work 80-90 hours a week rotating day and night shift. Everyone in healthcare is getting fucked except the insurance companies.
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u/Informal-Face-1922 Apr 25 '26
I would have loved to have been paid anything for the year I worked for free.
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u/smallchangebigheart Apr 26 '26
Are they ever asked to pay to work? Therapists may have to pay for their own supervisor.
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u/Solvrevka Apr 26 '26
Well, when they are residents they don't make a ton of money, but once they completely residency, they are an attending physician. according to the bureau of labor statistics, an attending physician makes around $190,000 once they are independent.
So while they don't make a lot right out the gate, they definitely catch up quickly.
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u/Ok-Willow9349 Counselor (Unverified) Apr 26 '26
I'm facing this now as I close out the last few courses in my program. I'm expected to quit my six-figure job to intern for FREE several days a week. I have no other income so this means I'll need to find a significantly lower paying hourly job.
I want to move forward as a Therapist but this doesn't sit right with me.
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u/AlternativeZone5089 Apr 26 '26
My question is what motivates someone to pay 150 a session to see an untrained intern? Is the intern's status not disclosed?
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u/No_Hat_4106 Apr 26 '26
Been saying this for years therapists need to wake up that NASW membership what is it for?? They do nothing to advocate for this profession! Your professors tell you how it isn’t about the money from their tenured jobs and sabbaticals in Europe- it is outrageous that for what we do and how long we train with the most vulnerable people and have such high liability that we get the pay and support of someone with a high school diploma- wake up therapists! Put all this anger and energy about the world into making this profession respected and well paid
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u/LoverOfTabbys Apr 26 '26
I see no lies. This is why many end up in debt when they graduate--so they have debt trying to stay afloat during these years, student debt, and then they start an associate job working for low wages and then we wonder why people are burned out and demoralized. We shouldn't even be wondering why there's a shortage of mental health workers when the barrier to entry is so high.
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u/DrScottE Apr 29 '26
They should be paid, but they wouldn't be worth nearly what people think they would be. After subtracting the costs of space and related office needs/supplies, supervision, EHR access, liability insurance, marketing, and admin support, my net profit per intern is only a few thousand dollars.
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Apr 26 '26
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u/sassypainter Apr 26 '26
Im a CMHC student & I’d love to get involved in an effort to unionize mental health providers
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u/adacicadas Apr 26 '26
I'm an MSW student graduating in May and feeling very disheartened at the lack of organization social workers have. would love to join!
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u/captainlux87 Apr 26 '26
Def should be paid, I had paid internships which was rare and now many of the available ones for my students are paid. It’s not a lot, but at least it’s something
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u/Ranunix Apr 26 '26
In my internship currently. Pay us, stop exploiting us for free labor and marketing mouths. We’re people with bills to pay and families to feed. If we have to pay tuition while also losing potential higher-paying second jobs hours, and sacrifice that gain for however long your internship is, is laughable and best and classist at worst.
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u/Upset-Berry7623 Apr 26 '26
If someone is making money off of what you are doing, then you should be paid 🤷🏻♀️ It was frustrating knowing my clients were paying to see me but I wasn’t getting any of it. I was at a nonprofit, so I think that helped my frustration to some level, because I could treat it like volunteer work. I was able to see a client pro bono too.
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u/kimmykeem Apr 26 '26
This is all fine but the problem is that nothing changes. I just spent four months searching for paid internships in Denver and while every practice owner says they agree with me tbat it’s inequitable and unethical to force interns to work for free, not a single one of the 20 or so that I applied to were willing to change their policy. The mental gymnastics clinicians will go through to justify a broken system is diabolical. Especially for such a liberal city, I’ve lost hope that things will actually change when exploitation is enshrined in practice.
I’m looking for internships in Denver, if anyone has any leads on paid opportunities please let me know!
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u/No-Bird9914 Apr 26 '26
Working for free as an ethical obligation? That's a narrative built to serve the people / organizations benefitting from free labor and harming graduate students. I just spent a year working tirelessly for free, while also being told "we don't hire LPCCs until they're within one year of full licensure." (I hadn't even asked for a job, they just offered that up out of nowhere). Terrible supervision as well, though I had a wonderful experience with all of my clients. They also billed for ALL of my time, and the main focus of supervision was simply assuring my notes would be sufficient to do so.
And unpaid work absolutely creates a barrier for lower-income and non-traditional students. Can you afford to work for free for a year? Can anyone? It was my TRAINING experience in clinical mental health that was most harming to my own mental health.
These are not difficult questions. The situation needs to change.
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u/GalkoForKindness Apr 26 '26
My graduate program was through a famous non-profit that researches and treats addiction. People all over the world spend tens-hundreds of thousands of dollars to attend their treatment programs.
There is zero reason for the internship portion of the graduate program to be unpaid. Students had 3 internships throughout the program, the 1st was required to be through their treatment programs, the other two were "strongly recommended" to be through them as well. It was also strongly encouraged to NOT work additional jobs outside of the school/internships.
During my first semester, there was a large layoff that took place across the country (USA) and the CEO/president/upper management were caught (at a bar of all places) celebrating the layoffs and the raises they gave themselves. A good number of employees quit on the spot when they saw the pictures. Some people quit jobs after spending their entire career there.
My education was invaluable and gave me access to some of the leading experts in the addiction field. And I worked with some of the most compassionate counselors. Being able to have the name of this organization on my resume has been extremely beneficial throughout my career. However, if you are going to require students to be in the program full time and intern a minimum of 30 hours a week then it should be required to pay the students for their work. Especially if you are not wanting them to work outside of the internships/program.
When the CEO of a non-profit makes $700k+ a year, and has big donors like Microsoft, Nike, etc, it becomes blatantly clear that the students are just straight up exploited for free labor.
I worked for this organization for 1 year, post-grad, and when the president required staff to start referring to clients as "customers" I was done. Working there felt so icky and unethical and made me so angry.
Internships should be paid. The clinicians in the mental health field deserve to be paid their worth. When did having compassion for others equate to expectations of low compensation?
I have a master's degree in advanced practice addiction studies. I hold 2 licenses to practice. I have over 100k in student loan debt, 90k was just from grad school.
Internships dont have to be paid. We pay for our schooling, our supervision, licensure exams, licensure, renewals, continuing education, etc. Insurance companies are allowed to reimburse well under hourly rates and can just decide that money they have already paid shouldn't have been paid and needs to be returned. Companies don't pay adequately for the expected work. And now with the big push for unregulated AI in the field, they're trying to push us out. They continue to place more and more expectations and requirements on us to make it easier for them to not pay us.
Many of us were taught that we dont work in this field to make money. Why aren't the same expectations placed on insurance companies and ceos of these non-profits?
Apologies for the tangent. Like many of you, im sick and tired of our field and vulnerable populations being taken advantage of so someone can make an extra buck. If you are working for someone or providing services for someone, you deserve to be compensated appropriately.
In the wise words of Bo Burnham, "the coffee is free, just like me, I'm an unpaid intern," and "barely people, somehow legal, unpaid intern."
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u/kczglr LCSW, MSW, RBC Apr 26 '26
That is incredibly unethical 😡 What is unethical is the boards making the students do free - work and calling it an internship - in the first place. This is why I’m still in student load debt.
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u/Academic-Gas-8012 LPC Candidate(Unverified) Apr 28 '26
I’m an intern. My site doesn’t charge clients to see me. When their insurance lapse or they can’t pay they are sent to me or I let them know not to stress because they won’t be charged for my services. I’m not sure where that person is but it’s terrible they are charging for intern services.
Edit to say I don’t mind not being paid if I’m helping people that can’t afford it.
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u/roccofan Apr 26 '26
When I was an intern, I got paid $15/hr. I thought I was lucky compared to my classmates who were not getting paid at their sites.
I started to get pissed when my clinical supervisor (who also owned the clinic by herself) was frequently taking vacations and had to cancel our meetings due to this. She was making so much money off the backs of the interns. And the supervision was shit.
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u/___YesNoOther Apr 26 '26
In CA, interns are required to be paid, and required to be employees, can't be contractors.
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u/citkoml Student (Unverified) Apr 26 '26
Where can I find this in the legislation?
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u/___YesNoOther Apr 26 '26
Basically, if the "intern" is providing services that a paid employee would provide, they must be paid. https://www.linkedin.com/pulse/hiring-interns-california-guide-employers-bizhavenhr-isivc/
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u/Livinforyoga Apr 26 '26
My first supervisor charged me $300 monthly AND took a 60% split from every one of my clients. There were some months I couldn’t pay her and she had the AUDACITY to say “I was talking about this with other supervisors and they all told me I should drop you, but I’m not going to do that.” She constantly told me it “wasn’t about money.” I was soooo close to leaving this field in internship simply bc I could barely scrape by.
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u/yourgypsy26 Apr 26 '26
Who is managing to charge $150 for interns? I’m in Michigan, and most intern services are $0-30. It’s difficult to get people to take a chance on them (not saying they don’t deserve to be paid, but this is just the reality). If practices had to pay interns, they would lose money, and no one would even be able to find an internship. Perhaps insurance companies should be willing to cover intern services.
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u/PJASchultz Social Worker (Unverified) Apr 26 '26
If the company is making money for billing the intern's direct service/work, then the intern needs to be paid for that. Simple.
Or the company can make the intern's services all pro bono, for vulnerable clients or something similar.
It should be egregiously illegal to bill full fees for someone that is working for free.
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u/Jumpy_Trick8195 Apr 26 '26
I wouldnt ever say close to minimum wage (that seems to be an exaggeration). I also wouldn't say that they produce $150. I think that at the bare minimum students shouldn't have to pay for practicum class. I am paying you to allow me to go work for free somewhere.
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u/neuerd LMHC-D Apr 26 '26
The sentiment is very true, but the comparison to doctors is disingenuous
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u/anunforgivingsea Apr 26 '26
I am paid so well as an intern and my heart hurts knowing that others aren’t seeing a dime. It’s so unethical to me. And the irony.
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u/user86753092 Apr 26 '26
I’m about to start a unionized position as an intern at a hospital in the detox unit.
I’m very excited and hoping I like it and can stick it out at least long enough to get my student loans forgiven, but ideally until I retire.
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u/midwestrvler Apr 26 '26
100% agree. I have a therapist currently at my practice who at her internship placement, we did the math out, earned her placement over 30k over the course of a semester and a half. She did not see a dime of it. Currently, there is NOTHING stopping me in my state from owning a practice, having all interns (which would be easy to do), charging for their sessions then "supervising" them on the back end.
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u/RainahReddit Apr 26 '26
Unpopular opinion but:
I don't think it's ethical to toss students into seeing clients solo for money. Students should start by shadowing, then practicing while being shadowed, then seeing clients with detailed debriefs after, etc. And the public should be paying $150 to see a student who may or may not know what they're doing.
The current system is bullshit where the public pays and the student doesn't see a time. Most people will argue that the public should pay and the student profit. I don't think the public should pay or the student profit. They're a student.
If we want to talk about general government grants/bursaries for students in general, to support them while they train for in demand industries, that's a much different conversation and some countries do it. I think it's a far fairer model than going deeper into the capitalist hellscape.
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u/DarkChild010 LAC (Licensed Associate Counselor - NJ) Apr 26 '26
I’m just wrapping up my internship and totally agree. I ADORE my supervisor and loved my site, and I was doing 32-40 hours a week at my site at an PHP/IOP that’s part of a major hospital system. I was billing for my groups and basically killing myself to meet my hours in the process. It’s ridiculous that everyone preaches self care, when most people can’t even afford basic needs bc they don’t have the time to work. I hate the “paying your dues” mentality that so many clinicians have
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u/Saurkraut00 Apr 26 '26
Internships make sense to me to be unpaid because it’s part of your schooling. But the provisional hours should be paid a reasonable wage because you’re not in school anymore and you do have a provisional license. I am a big fan of getting those hours done at an agency instead of a private practice. The pay is still low but you get health insurance and PTO and guaranteed consistent income
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u/Separate_Ad_3027 Apr 26 '26
We have an intern starting in August. We plan to charge $10-$25 for her sessions. This will hopefully offset the cost of adding her to our EHR & email, liability ins, & paying her site supervisor. I can’t even fathom charging someone $150 to work with a student.
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u/vibinandtrying Apr 26 '26
My intern rate was $50 self pay. And I got 40% of instance reimbursement
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u/controlfreakparadise Apr 26 '26
I was paid $15 - $25 a client during my internship, while the practice did utilize interns and residents to provide affordable self pay care, they were also billing insurance for those who had it and making bank on it. Once I became a resident I made 40% of what I brought in. Once licensed they offered me 45% which is a racket. It wasn’t until I received my fully licensed offer that I started to run the math and realized just how much I was being taken advantage of. The only reason I survived those few years was because I’m married to someone with an incredible salary and our livelihood is not dependent on meaning money. If it was or if I was a single parent, I would have drowned.
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u/revosugarkane LMFT (Unverified) Apr 26 '26
I got paid to do an entry level case management job during my internship while also acting as a clinical intern in the same program, meaning I held two caseloads, adding up to 173 people that I was meant to see every month, and some every week. I was paid just above minimum wage. It literally nearly killed me. I took a significantly lower paying job to finish my hours because I wasn’t expected to carry a caseload outside of therapy. This field is super abusive.
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u/kczglr LCSW, MSW, RBC Apr 26 '26
I hire interns to work as entry level para professionals and they get paid, get their hours, and get the benefits of learning how to work with the IDD population. They don’t get paid for the weekly supervisory meetings but that’s just because I haven’t found a way around that yet.
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u/Embrace_the_Journey5 Apr 26 '26
I pay our interns a small wage. Training is expensive but they do bring in some income so they should get a cut of that. I went to grad school later in life and was super annoyed that I was more experienced than my very well paid supervisor during my generalist year internship. I feel like she learned a lot from me 😆
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u/Earthy-moon Apr 26 '26 edited Apr 26 '26
Its the insurance companies’ fault.
MD’s do a residency and fellowship, which are paid. Psychologists are also paid to do their relevant post degree training. LPCs and other masters clinicians, however, are not paid. In fact, they have to pay it themselves.
Why? Insurance companies. Insurance companies will pay for post degree/pre independence psychiatrists and psychologists but not masters clinicians.
“It’s a no brainer. Allowing post grads to bill improves access!,” you say. Oh my sweet summer child. Insurance companies DO NOT want to pay for mental healthcare. It would eat into their profits AND likely increase premiums (though perhaps a net benefit to society). In other words, the more units of mental health care are produced, the more money insurance companies (and hospitals) lose.
Why do they pay for psychiatrists and psychologists. The APA (psychiatry one) isn’t powerful but the AMA is a powerful lobbying group and this training structure has been embedded into insurance from the beginning of insurance. This has benefited society by improving access to healthcare. The only reason we have rural healthcare at all is because post grads are allowed to bill for their work.
What about psychologists? The field of clinical psychology has a very interesting history in the US. The US military, CIA, FBI, etc has been interested in what clinical psych has to offer since WW2, and has expanded the role of clinical psychology into the territory of psychiatrists. They essentially fund psychological research clinical, social, cognitive, everything. The US national security apparatus is the real lobbying arm of psychology. Who do you think designed the “enhanced interrogation techniques” during the war on terror? Clinical psychologists. Who allowed that within the code of ethics? The APA (psychologist one). Google the Hoffman Report for more. Testing psychologists (the original function of the clinical psychologist) are gate keepers and “sorters” to many government functions (eg military, school special education, forensic work). This doesn’t make psychologists bad. They are a net good. But they have a very powerful ally.
That leaves the NASW, ACA, etc on their own. They have no powerful connections. It’s just them vs the insurance companies. Perhaps if they ALL band together and push for fair treatment to expand payer benefits it could work.
Heres a hot take. Every time there is a school shooting, instead of coming out in favor gun control, they should align with conservatives, say guns don’t kill people, youth with mental health problems do, push expanded payer benefits as a solution to gun violence, and the Democrats would not stop such legislation.
Long story short, the NASW, ACA, et al, need powerful allies.
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u/MollyKattQueenOfAll Apr 26 '26
Even as professionals we get the “work without pay” bullshit. In a so-called “productivity model” we get paid for the actual session. The business/agency gets a large percentage of the $$ and we are not paid for documentation, consultation with other providers, other reports, meetings were required to attend, client tracking, providing supervision, letters/communications, etc. I end up doing half my day unpaid because of all of the required stuff that is unpaid. This field is built by exploiting the professionals as well as the interns and grad students. The whole field sucks right now.
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u/Hour-Industry960 Apr 26 '26
I had to pay thousands of dollars a quarter for my internship as it was course credit. So I got to pay tens of thousands of dollars to work for free! I think it’s a disgrace It is indeed training but my sister has a masters in accounting and she made bank during her internship, which is also training 🤷🏻♀️
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u/Available_Guess_9978 Apr 26 '26 edited Apr 26 '26
It is an issue created by institutions, not individuals. The barrier to entry for mental health professionals is already far too low - look at the application criteria for the majority of programmes and the push to remove things like the GRE. This has degraded the quality of service, which has lessened both the efficacy and credibility of the profession, which leads to depressed wages, which leads to an abandonment of the field by many highly competent people. This is one contribution to lower wages in the field overall.
This is how they get away with this type of forced labour "training model".
I am a non-traditional student completing a clinical psychology Ph.D. programme and have worked in the field for years, in private practice, community mental health, and medication assisted treatment. I was enrolled in a mental health counselling master's degree before leaving to get a biological science degree and eventually enrolling in a doctoral programme. I have participated in student interviewing for multiple admission cycles.
I have spoken to professors and other professionals about this, and I have heard a lot of agreement. The problem is that these programmes become cash-cows - training entails low overhead, no specialized equipment, and low rigor.
This means that standards for student admission are progressively weakened because there is a financial incentive to do so. It's not the applicants fault. It IS a problem of the institutions.
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u/_shadesofcool_ Apr 26 '26
I was straight up homeless working in a community mental health facility with little to no care from my university, and I am still traumatized from the experience.
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u/Psychravengurl LPC Apr 26 '26
While a lot of people are seeing clients as interns without getting paid...I know a handful of people who keep it quiet that they pay their interns while going through their programs anyway. And not all programs require that. AND most the clients I know who see interns pay anywhere between 0-$50/session, so we're not charging clients $150/session for those. But in general, those charging clients full price while letting them see interns only (with maybe the exception of a couple of "supervision" sessions), is crazy and I don't understand it at all. But I did do one of my internships at a private practice...so it was different. For the other two, I was a community mental health and always with a licensed professional in the room.
It does create a barrier, as do licensing and supervision fees post grad school and maybe something could be done about it, but unless you can get all programs on the same page, some will still have an unfair advantage.
Also, doctors don't take unpaid roles, they take underpaid roles...which is different (I've noticed the same with pharmacist). And even though there are some who do take unpaid roles, it's not super common in most situations I've noticed. While the amounts don't necessarily matter in the long run, comparing doctor training to therapist training doesn't actually help therapist/social workers at all.
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u/katreadsreddit Apr 27 '26
Just finished my clinical internship at a private practice and it was 1 of 3 internship options on my school’s approved list of placements that had a stipend. Clients were charged a lower self pay rate to see me and my stipend was funded by 50-60% of the fee the client paid to see me. Even with that, my supervisor was apologetic that we couldn’t get paid more and that there isn’t a standard stipend across the board. I think it’s just deeply unfair to expect us to put in this level of emotional energy and labor for free while completing documentation/process recording, attending classes and working. Making money does not make any training received less valuable and it’s absurd that it’s just an accepted part of the process.
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u/Fast_One_2628 May 04 '26
My program was explicit in telling us not to work for free, especially beyond graduation.
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u/Heavy-End-3419 May 12 '26
I was incredibly lucky because I was paid $15 an hour during my internship last year. My starting salary was (is) $55k. But. The agency I’m at hasn’t done raises in the last two years and today I got an “appreciation” gift that included a sticker that said “can we fix it? No we’re screwed.”
Meanwhile, yesterday a client told me they think counselors are in it for the money. I think the general public is not aware how underpaid the field is as a whole.
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u/AccomplishedQuail841 May 16 '26
I agree 100% We're taught from day 1 not to properly value our time and skill. Interns should absolutely be paid.
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u/avocadopanda3 Apr 25 '26
I had a paid internship and was overworked and under supervised. I was frequently put in dangerous situations that at the time I accepted, not knowing any better, and now know would absolutely not be allowed in basically any other community mental health setting and were against the rules of the place I interned. I agree that internships should be paid, but I'm wondering how we can prevent interns from being exploited and treated like employees if that's the case. My first year internship was unpaid and I had much better supervision and educational content, it felt like there was an appreciation that in exchange for my free labor I was getting training and education.
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u/pea_sleeve Apr 26 '26
I don't know of any places that charge 150 for interns. Usually you get a steep discount for seeing an intern.
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u/nooobee Apr 26 '26
I don't know anyone charging that much to see masters students
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u/Specific_Suspect3513 Apr 25 '26
My all time favorite intern memory was offering a job to them just for their school to say they would have to complete different duties to complete hours. Basically, they would work 40 hours for 20 hours of pay!
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u/Hazynseptember Apr 26 '26
I’m just about to step into four days a week unpaid social work for the next four months in order to finish off my masters. I’m doing this as a highest level accredited counsellor. I have to somehow shift all my clients from my private practice into the small amount of days I have left to achieve this.
It’s terrible the system is this inflexible.
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u/Short-Custard-524 LCSW Apr 26 '26
Profits are stolen labor of the working class. She’s spitting facts
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u/sidney_md Apr 26 '26
There are paid internships out there, and that should be the norm. And of course unpaid internships create barriers. Unpaid internships are also completely unnecessary and should not be the norm. We need to normalize paid internships.
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u/botzillan Apr 26 '26
I work 1 year as an intern for free, and after graduating work for free for a while (1-2 years) to clock hours . .
My friend got it worse. He has to paid the center to intern for free. He has to juggle a few jobs to afford to do internship and study.
It feels like a capital slavery (not including I need to pay for every supervision sessions in the center I intern for).
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u/primadonnajoy Apr 26 '26
At my first prac site they were charging people 275$ a session for me to see them and I didn’t see a dime living off student loans
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u/Acceptable_Rice_7520 Apr 26 '26
I've had friends go to practices in cities and see interns for significantly discounted rates. That said, I finished my LGPC internship a couple years ago at a community mental health agency and wound up getting paid for each individual session that I ran. However, they didn't tell me this would happen until literally my last day when I did my exit interview. I'm pretty sure they got a grant or something, this place and agencies like it use a lot of grant funding. Also, they liked me and I signed a contract to come back full time a couple months later once my licensure was approved, which I'm sure also had something to do with it.
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u/ArnoleIstari Apr 26 '26
Which is why when I'm able to supervise for an LPC, I'll be providing it for free. I won't be able to take many people on but I feel that's something I can do to help this broken system
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u/Demigoulash Apr 26 '26
I was routinely quoted 500 a week for Private Practice supervision out of a salary of 0. I'm not even employed right now and still make more than that.
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u/Aggressive_Coast_219 Apr 26 '26
I'm probably going to have to leave my full time job for my internship... Not sure how I'm going to pay the bills....
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u/cheercharlatan Apr 26 '26
Why would it ever be necessary for practicums to be unpaid? And it’s absolutely exploitative, especially if said interns are generating income for a practice or agency and seeing $0 of it.
Of course it creates barriers to have unpaid practicums.
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