Expectations vs. Reality

First Week (5/18-22): Expectations VS Reality

I have officially completed my first week as a MSW/MPH therapist intern. My emotions from the week have ranged from excited to quickly overwhelmed. My expectations of clinical therapy, from classroom learning, were unrealistic. In the classroom you read perfect scenario case studies with easy solutions. This unfortunately is not the reality for most clients.

Throughout the week I observed therapy sessions with clients who came in for drastically different issues. There is often a quick turnaround between back-to-back sessions, leaving little time for clinicians to process what occurred during those 53 minutes. Most of the therapy sessions I observed, left me with more questions than answers on how to give the most effective therapy session. I noticed my mind quickly jumping ahead to what’s next or further down the line for the client, when it is recommended for therapists to remain present during client sessions.

Based on Geller and Greenberg's Model of Therapeutic Presence, being present as a therapist means being fully attentive and engaged with the client while connecting with their experience on physical, emotional, cognitive, and spiritual levels (Malet et. al, 2022). This self-awareness identified an important area for growth in my clinical practice, as remaining present can foster deeper understanding and an authentic therapeutic connection with the client.

It is challenging to consider as a therapist-in-training that I will be helping clients sit through discomfort and that silence is okay. I found the silence during sessions very uncomfortable, although the clients and the therapist did not mind it all. Through observation I’ve learned quickly that silence and reframing is a powerful tool for client growth.

As the week continued, feelings of "imposter syndrome" have slowly creeped into my mind. As a second year graduate student, I know I am well equipped at this point in my educational journey to be a successful intern, however it feels like most days I have no idea what I am doing. I have never done this before so some of these feelings are to be expected.

Imposter syndrome is where an individual may doubt their abilities and for a social worker these thoughts may start to undermine their professional practice (Apgar & Zerrusen, 2026). Through daily journaling and ongoing supervision, my imposter syndrome has become much quieter compared to my first day of work. With the support of my supervisor and the clinicians I work alongside, I feel reassured that I will continue to grow into an effective and compassionate therapist.

References: Apgar, D., & Zerrusen, L. (2026). Imposter syndrome in social work practice: Clinical considerations and implications. Clinical Social Work Journal, 54, 69–79. https://doi.org/10.1007/s10615-024-00971-w

Malet, P., Bioy, A., & Santarpia, A. (2022). Clinical Perspectives on the Notion of Presence. Frontiers in psychology, 13, 783417. https://doi.org/10.3389/fpsyg.2022.783417