Psychology-Externship |

Psychology Externship Application

A form to use when applying for the Psychology Externship position at PsychCare.

Step 1 of 7

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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)

Part II: Theoretical Orientation

Rank your top three theoretical orientations with your level of interest and experience.

Theoretical Orientation # 1(Required)

Level of Interest for Theoretical Orientation # 1(Required)

Moderately Interested

Very Interested

Extremely Interested

Experience Using Theoretical Orientation # 1(Required)

No Experience

Some Experience

Moderate Experience

Considerable Experience

Extensive Experience

Theoretical Orientation # 2(Required)

Level of Interest for Theoretical Orientation # 2(Required)

Moderately Interested

Very Interested

Extremely Interested

Experience Using Theoretical Orientation # 2(Required)

No Experience

Some Experience

Moderate Experience

Considerable Experience

Extensive Experience

Theoretical Orientation # 3(Required)

Level of Interest for Theoretical Orientation # 3(Required)

Moderately Interested

Very Interested

Extremely Interested

Experience Using Theoretical Orientation # 3(Required)

No Experience

Some Experience

Moderate Experience

Considerable Experience

Extensive Experience

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 Counseling, Clinical Psychological and other mental health fields before June, 2024
Complete the Maryland Jurisprudence Exam by July, 2024
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 will need to have two letters of recommendations sent via email. Please contact your professional references as soon as possible and let them know to email their letter to externship@psychcaremd.com.

We understand that the letters will arrive after your submission of this application forms. Please note however that an offer can not be extended until both letters of recommendations are received. Also, if we don’t receive the letters by Feb 12, 2024, we will not be able to proceed with your application.

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)

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)

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.

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

Psychology-Externship