Category Archives: Early career

The experience of learning to work with people who are feeling suicidal

There’s not much out there about what it is like to be an early career psychologist. There are books aimed at this demographic well worth a read (e.g. The Making of a Therapist, Letters to a Young Therapist), but they’ve all been written by people towards the end of their careers. I haven’t really found any birds-eye view accounts of what it is like to begin witnessing, learning and knowing things about this profession for the first time, or about the process of navigating all the personal and professional changes that all these firsts bring. The “Life as an Early Career Psychologist” section of this blog was inspired by this gap. This week’s post explores a very important issue for any early career psychologist: the experience of learning to support people who are suicidal. Given the topic, this post does mention suicide so if you feel it may be distressing for you, I encourage you to skip this one.

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“You should be a doctor” the other kids would say to me. Then I’d picture myself, scalpel poised, in the middle of surgery. Ugh!! It was never the blood and gore or years of study that put me off medicine. It was the fact that if I made one wrong move someone might die. Ultimately, I decided to become a psychologist… Because that required no degree of responsibility or that I work with people to help them stay alive, I say with tongue firmly in cheek!

My first experience with suicidality happened as an undergraduate psychology student on a work experience placement, well before any formal training to help with supporting people feeling suicidal. I would be lying through my teeth if I said that that experience had not at all anxiety provoking! Thankfully, my first instinct was to ask myself what do I need to do to keep this person safe? And so I made sure to seek support from the staff overseeing me who had the training that I had lacked.

Things were different when I began my formal postgraduate training to become a psychologist. By this time I had been taught about evidence based practices for supporting people who were feeling suicidal. And so, the next time I encountered someone contemplating suicide, my initial reactions were different, this time I thought about both the meaning of the disclosure and how best to respond. E.g. I am so glad this person has felt comfortable enough to tell me they are feeling suicidal. Am I doing everything I possibly can to get this person the support they need to help them stay safe?

While it is vital to understand the process of what to do when someone discloses suicidal thinking, it’s quite another thing fluently translating this knowledge into action to best support the individual in front of you. Hence, why psychologists are heavily supervised as they find their feet in this arena. Part of this process is about learning how you respond in these situations. I’d been worried I might become anxious and forget what to ask when faced with my first client who was feeling suicidal. I remember bringing these concerns to supervision and, as a result, I learned what I needed to do to remain calm and methodical.

Developing confidence in my approach to asking about suicidal thoughts and feelings didn’t happen overnight. There was just so much to consider. How should I go about assessing suicidality, especially for people who find suicidal thoughts, urges and behaviour difficult to talk about?  How do you go about weighing up what supports to offer and when?  This process got less clunky with time and practice and, as my knowledge of available support services and processes expanded.

My first experiences calling crisis lines and supporting people to present to hospital still stand out clearly though. In the moment I just did what I needed to do to help people keep themselves safe. At the end of the day though, I’d feel wiped out. So looking after myself in these high pressure situations was also a skill to be learned.  How could I balance my case-load and other responsibilities while responding to crises? What things did I need to do to prevent burnout? What did I need to do to look after myself when someone died by suicide? It was a lot of trial and error figuring out the best way to respond to these situations, and it looks different for everyone. You can’t truly know what you need and what works for you until you experience it firsthand but self-reflection and making educated guesses help.

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Developing all of these skills is an ongoing process. I’ve never felt, and will never feel, like I’ve 100% found my feet in supporting people feeling suicidal, or with any other aspect of my work as a psychologist. I’d be deeply concerned if I did feel that way, because that kind of thinking breeds complacency which can be dangerous. In my eyes, when you stop questioning your practice, you stop being the most effective psychologist you can be.

This continual learning and growth as a psychologist is what makes this job so challenging and so rewarding. And I suspect, that this challenge and growth is all the more amplified for those of us in the early years of our career. Not only are we coming to grips with the nuts and bolts of what to do in the face of great complexity, but we are learning about how we cope in often extreme situations, and how these experiences shape us personally and professionally.  I have noticed phenomenal changes myself in my first six months as a qualified psychologist both in my therapeutic approach, clinical reasoning and, in my perspective on life. During this time I’ve faced some incredibly difficult situations that have challenged me on every level. At the same time they have helped me to solidify why I do what I do; why I go about it the way that I do and, to learn about myself and what I need, to be able to do this work.

The one constant in my path as an early career psychologist, especially working with people who are suicidal has been hope. No matter the difficulties I face in doing this work, or the challenges the people I support are facing, I hold the hope that it will get better for them, that change is possible and, that what each of us does, however small, matters. Ultimately, I think that’s what allows me to work in this field, knowing that the challenges are more than worth it.

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Filed under A day in the life, Early career

You’re not in Kansas anymore…

As a psychologist in training you learn from other psychologists who deliver your coursework, assess you and/or supervise your placements. Most of the psychologists who trained me worked in the private sector or in clinical research settings. And most of my placement experiences were alongside other psychologists in the private sector. This meant I learned a lot of valuable things about how to be a psychologist, what we do, and why we do it. What I didn’t learn so much about was how we do all of this within the broader system…

There’s nothing quite like stepping out from the environment of a psychologist in training and into the broader mental health system for the first time.  It’s a Dorothy and Toto moment – you are definitely not in Kansas anymore! There are a dizzying array of professions, services, settings and interventions to work with. You begin to truly appreciate what is unique about the way psychology teaches you to think about and approach things. And, you have to figure out how to navigate all the policies, procedures and systems both as representative of your profession and of your clients. It’s hard work!

Reflecting back now on my training – all those times the various ethical guidelines were hammered home, how every situation became an exercise in critical thinking and how I began to suspect I’d be talking about collaborative evidence-based practice in my sleep, I finally get it. It may have seemed dry, repetitive and even unnecessary at times, but all that groundwork was crucial. Why? Well psychology training can be a bit of an echo chamber. It has to be, without that immersion in your profession you can’t get a strong sense of what it is we do and why. But, once you get Out There and realise how different things are it can be a bit of a shock. You may well find yourself in situations where the way you have always operated and your perspectives doesn’t fit with the broader system or other disciplines.  And that’s okay. You just have to try to figure out where to adapt and when to hold your ground and be able to argue your case either way. And it’s because of all that ground work you did as a student, that you can do this.

Keeping it real…learning to make those calls in the bigger system can be terrifying. You will make mistakes, step on toes, and sometimes it just won’t work. At the same time though, that messiness is how you learn and bring about change if you’re willing.  You might even surprise yourself in the process, I certainly have. Only this week I put forward an alternate formulation to a senior clinician, backing my own clinical reasoning and evidence.  Later, another clinician took me to the side to tell me I’d made a good call and that this ability to assert my case and trust my judgement, even when it differed from my seniors, was a real strength of mine. It was bemusing to realise this skill that I was being recognised for was not one I’d possessed at the start of this year and was probably something I would not have predicted I’d have developed by now. So believe me when I say, anything is possible!

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Filed under Early career, Practice, Reflections

The Transition from PhD Student to Psychologist

Ever wondered what it’s like for to make the transition from PhD student to psychologist? Read on!

What’s it like adjusting to full-time work?

It’s a walk in the park. Across the years of completing my PhD I was regularly clocking in a lot more than a 40 hour work week. Now, I have weekends. My evenings are free from administrative tasks, assignments, emails and extra work. I physically can’t bring my work home with me. It’s amazing! I have so much more time and brain space now. I’m even learning to play the guitar, something I’ve wanted to do for almost a decade but just could never fit in with all the other things I was juggling.

What’s it like getting back into doing therapy?

The gap between the final placement and first job plays on the minds of many a psychologist in training. Why? Well in any post-grad psych degree you juggle coursework, placement and a thesis. Once they’re all passed, you can register as a psychologist and look for a job. However, for many Clinical PhD students there can be a gap of around a year between finishing placements and seeking registration because completing the thesis takes up a lot of time. Many students therefore worry that their therapy skills may become rusty from lack of use and/or that they will be less marketable to potential employers.

From my perspective, I had a gap of about a year between placement and my job search and it did not deter potential employers in the slightest. The transition into getting back into doing therapy again was also so anticlimactic that it was ridiculous. It was just like riding a bike again. Well, what I assume that would be like if I’d ever properly mastered bike riding to being with ;).

What’s it like no longer being a student?

I’m finding that this last aspect of transition takes the most getting used to, and perhaps not for the reasons that you would expect. On a trivial level, I can now officially identify as ‘psychologist’ rather than ‘trainee psychologist.’ It saves time when writing case notes and is a much more readily understandable job! If I had a dollar for every time I had to clarify what being a trainee psychologist meant…

On a less trivial note, the hierarchy I operate in now is different. I have more peers than superiors and my colleagues regularly look to me for insights due to my training or specialty. This stands at odds to the distinct hierarchy of academic research within which I’ve spent the bulk of the last decade! I’m also far less likely to be surrounded by other psychologists now than in the clinics I’ve worked in on placements.

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Filed under A day in the life, Clinical Phd, Early career, psychology, Reflections

The Five Year Plan

McLeod’s Daughters, an Aussie TV show, follows a group of women as they negotiate the challenges of life and running a cattle station in the outback. It’s been a long-time since the show first aired, but it’s definitely worth a watch if you haven’t seen it yet.

Over the past few months as I’ve tried to map out where my career might be headed next, I’ve been reminded of Kate, one of the drovers on McLeod’s Daughters. Kate always had big ideas, tenacity and, a need to organise; she had a massive five year plan taped to her wall complete with short, medium and long-term goals!

Like Kate, I’ve always been a planner, at least when it comes to work or study. So I had a plan for how I would become a psychologist:

1) Get good enough grades in Year 12 to get into an Honours program,

2) Gain experience in the field to test out whether psychology was definitely the right fit and to give me a good chance of getting into a postgraduate program in psychology,

3) Seize every opportunity to develop my research, teaching and psychological practice skills and to develop an area of specialty

4) Walk out of uni being able to research, lecture and/or practice as a psychologist.

I first laid out these plans when I was 17, well at least points 1 and 4. Point 2 was added by the end of my first year of uni. And truth be told my pursuit of point 3 was a mixture of deliberate planning and happy accident. I soon noticed that the happy accidents led me to some really interesting places. And it’d be fair to say that my mantra became “this scares me and will be a logistical nightmare, but it’s really going to teach me a lot of things… Sign me up!”

It is very surreal to look back on all those plans and realise that I’ve more or less achieved them. Sure, some things changed as I went along, as they should with any good plan and the influence of serendipity, but now here I am – a psychologist and soon to be qualified academic. It honestly still doesn’t feel real typing that out.

Having reached the end-game of my decade long plan of becoming a psychologist I’ve had some time to think about where my journey might be headed next. At this stage, I have a broad strokes plan:

My main goal is to move towards working as a psychologist in private practice. There are pro’s and con’s to work in the public and private sector, but longer term I feel that private practice is the best fit for me. Chiefly because it will give me greater flexibility in how I operate as a psychologist and how I structure my work-life balance.

I also have a side project that’s important to me too. I’d like to get my research published and some of its more practical elements being used by other psychologists. Long-term that might even involve some consultancy work, outreach and policy development. Who knows? This particular scheme might well take a good ten years to come to fruition, but that’s okay.

I wonder in another five or ten years, which parts of this broad strokes plan will come to fruition, which will change, and how I’ll get there? In my next post I’ll flesh out the private practice plan and how that links in with my job search. Stay tuned 🙂

 

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Filed under career, Early career, Goals, Reflections