Psychology Externship Application (2025-2026) |

Part I: Background Information

Name(Required)

First Last

How Do You Identify Yourself?

(e.g. gender, sexual orientation, race/ethnicity, and any other identities which are important to you and include pronouns we should use when talking to you)

Email(Required)

Enter Email Confirm Email

Phone(Required)

In the following section, we ask you to provide details about your clinical experience, specifically focusing on the number of clients you have worked with and the distribution of your hours between intake/assessment and individual psychotherapy. Please provide approximate figures for each category. This information is crucial for us to understand the scope and depth of your practical experience. We appreciate your estimates as they help us tailor the externship to match your current skills and areas for growth.

Total Number of Clinical Hours(Required)

Please enter the total number of direct clinical hours you have completed during your clinical training to date.

Number of Clients for Intake / Assessment:(Required)

Enter the approximate total number of clients you have seen for intake/assessment sessions

Total Individual Psychotherapy Hours:(Required)

Enter the total number of hours you have spent providing individual psychotherapy.

Number of Clients for Individual Psychotherapy:(Required)

Enter the approximate total number of clients you have worked with in individual psychotherapy sessions.

Comments (Optional)

Please use the space below to add any additional information that you think would be helpful for us to know about your clinical experience. This could include unique experiences, challenges you’ve overcome, or specific skills you have developed that are relevant to this externship. Your insights will assist us in understanding your professional background more comprehensively.

Part III: Level of Competency

Select your current level of competence for each common presenting concern

Anxiety(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Depression(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Eating disorder and body image concerns(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Grief and bereavement(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Identity-based exploration/concerns(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Relationship conflicts/challenges(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Stress management and coping skills(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Substance Abuse(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Trauma(Required)

Not Competent	Somewhat Competent	Highly Competent	Extremely Competent

Part IV: Registered Psychology Associate in Maryland- Status

Click the arrow (>) on the side to expand & view a list of requirements to become A Registered Psychology Associate (RPA) in Maryland

Obtain a master’s degree in Clinical, Counseling, or School Psychology from a program accredited by the Council for Higher Education Accreditation (CHEA), or a master’s degree from an APA-accredited doctoral program in Clinical or Counseling Psychology before June 2025.
Complete the Maryland Jurisprudence Exam by July 2025.
Complete a criminal history background check as part of the psych associate registration requirements.

Select the option that best describes your current Registered Psychology Associate (RPA) status in Maryland(Required)

Part V: Document Upload

Upload CV(Required)

Max. file size: 256 MB.

Part VI: Professional References

As part of your application, you are required to submit two specific letters of recommendation. One letter should come from the Director of Training of your doctoral program, attesting to your current academic standing and readiness for an advanced externship. The second letter should be from a recent clinical supervisor, confirming your psychotherapy training and skills within the last 2 years.

You have two options for managing your letters of recommendation:

Provide your references’ contact information now: We will immediately contact your references via the email addresses you provide, requesting them to send their letters directly to the externship program.

Opt not to provide reference information at this time: You will receive an email immediately after submitting this form, which will include a link to a letter of recommendation form. You must complete this form by providing your recommender’s contact information, and we will then reach out to them directly.

Please ensure all letters are received by us no later than Feb 13, 2025. An offer for the externship cannot be extended until both letters of recommendation are in hand. We appreciate your prompt attention to this matter and look forward to receiving your recommendations.

How would you like to submit your professional references?(Required)

I will provide my professional references information now.

I will ensure my professional references send their letters by Feb 13, 2025.

Professional Reference # 1 – Director of Clinical Training (DCT) or Academic Advisor

This letter should include your academic standing and readiness for advanced doctoral externship training

Name of Professional Reference # 1(Required)

Email of Professional Reference # 1(Required)

Enter Email Confirm Email

Professional Reference # 2 – Current or Recent Supervisor

This letter should include reference to your clinical skills/competence

Name of Professional Reference # 2(Required)

Email of Professional Reference # 2(Required)

Enter Email Confirm Email

Part VII: Brief Video Recording

In the section below, please record a video of your responses to the following two questions.

1. What are your externship training goals? And how do you envision a private practice setting like PsychCare can play a role in meeting those goals?

2.What has worked best in terms of supervision and/or what are you seeking in a supervisor?

Brief Video Recording(Required)

When recording your video, please keep in mind the following:

IA. You will need to click on the red circle button (desktop) OR “Record or select a video file” button (smartphone) on the bottom of the Record Video Box.

IB. Once satisfied with your recording you will need to click the save button (which looks like a small disk)

II. You will have up to 5 minutes of recording time.

III. Please state your full name at the beginning of the video

IV. It may be helpful to jot down the two questions below before you start recording as you will likely not have access to these questions during actual recording.

Name

This field is for validation purposes and should be left unchanged.

Psychology Externship Application (2025-2026)