Category Archives: Practice

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!

Leave a comment

Filed under Early career, Practice, Reflections

I’m still here

It’s been a tumultuous year. I’ve discussed some of this before, but 10 months out I’ve some more perspective. Here goes nothing.

In January, I took an intermission from my PhD to travel overseas with a family member with a chronic health condition to assist them in helping another sick family member. I spent three months there. In those three months I did not work on or even think about my PhD. I didn’t have the time!

It took those three months just focusing on the day to day, removed from the world of academia to finally process what I had begun to realise in the the third year of my PhD; I wanted out of academia. It was a scary and a liberating realisation. It was liberating to decide that I wanted out because I could get off the merry-go-round of publish or perish and extra-curricula commitments designed to make me a competitive candidate for academia. Instead, I could focus on finishing my Clinical PhD and pursuing clinical work both therapy and assessments full-time rather than predominantly assessment work part-time as I had previously intended.

IMG_0400

I took some more time off when I returned home to recuperate from all the care-taking I had been doing. Then I began to consider how equipped I was for my new game plan. I had some concerns. Across the placements I’d completed and my research, I’d gained considerable experience with diagnostic and assessment work and good grounding in therapy for supporting children and their families. However, I had relatively less experience providing therapy to adults.  I felt that I had not yet had enough experience with adult therapy to rule this sort of work in or out, and that I could do with more exposure working with this population in an in-patient clinic setting to complement my previous experience in  community based psycho-social rehab work.

I voiced my concerns to someone in the department and was offered an extra placement that would give me the chance to support people with some of the most complex difficulties you can encounter as a psychologist and give me a greater breadth and depth of experience. The catch? The placement would clearly be very challenging, involved a very long commute and would finish just three months before my thesis was due. The placement was exactly what I needed, but the timing was awful. What did I do? I took the opportunity anyway.

IMG_2716

I’ve since started the placement and it was a good move. The challenges the clients who attend the clinic present with are complex but the supervision is excellent and I’m learning so much. Thankfully the commute is a little quicker than anticipated too. The work is also less difficult than I anticipated too.

As for the impact on my research, I can’t deny that there has been an effect. I’ve not written a thing towards my thesis, but data collection is getting there, slowly. So I just remind myself to do what I can and be kind to myself. It’s bittersweet watching my cohort enter the final weeks before they submit, knowing they will soon be gone and I will still be here. But next year, that will be me too: thesis submitted, job applications in, freedom awaiting.

This past year and my clinical work has reminded me of a favourite maxim of mine that I would like to share with you:

Everyone you meet is fighting a battle you know nothing about. Be kind. Always.

IMG_2978

3 Comments

Filed under academic culture, career, Clinical Phd, PhD, placement, psychology, Reflections

Surviving the PhD

I’ve thought about posting again several times over the last few months, but haven’t really known where to begin. This year has been hard, really hard. I’ve had a rough year in my personal life and with my PhD, not a great combination! I’ve finally settled on posting about how to survive the PhD, with the full disclaimer that this sort of thing is often a case of “different strokes for different folks,” and at times this year, surviving the process has been pretty touch and go!

 

 

 Participate in something outside of academia that you enjoy learning to master (bonus points if it has a social component)

  • It doesn’t matter how much you love research or what your skill level is because in academia you will constantly hear what you are doing wrong and rarely about what you are doing right. It’s also true that some aspects of your progress will be outside of your control e.g. your supervisor might be ill while your other supervisor is overseas, perhaps a computer glitch will corrupt your data; including the back-up copies (this happened to me), or recruitment might be painfully slow despite your best efforts.

 

  • Over time, skewed feedback and having continual hurdles to jump, tends to result in second guessing your abilities and even your personal worth, since we invest so much of ourselves into the PhD. This is why I believe it is really important to have something outside of academia that you enjoy learning, and which is less vulnerable to circumstances beyond your control. Personally, I dance and play musical instruments. I can honestly say that without these things, I probably would have given up my PhD a long time ago. When the going gets tough with my PhD these other activities help to remind me that there is life outside my PhD, more to myself than my PhD, and that I am capable of learning and improvement. You might be thinking, I don’t have the time though. This is what I thought for the first 18 months of my PhD, but when I made the time, I also found that I felt so much better and was actually more productive. Trust me, it’s worth it!

Create a support network

  • They say it takes a village to raise a child, I think it’s the same for completing a PhD. Have you ever met someone who is a brilliant agony aunt, full-time thesis draft reviewer, scientist, statistician, career and crisis counsellor, red-tape navigator, fount of institutional knowledge, advocate AND friend that you can let your hair down with, all at the same time? As PhD students, and human beings, we all need a support network and I feel that a big part of doing a PhD is about working out who is in your network and remembering that is okay to seek them out when you need them.  My “village” is another reason I credit to having made it this far! You know you’re very lucky when you have friends that spot you’re going through a rough patch and respond by sending you a care-package, complete with a mix-CD of your favourite songs and inspirational books.

Normalise

  • The only people who truly get what you are going through are other post-grad students. I find it really helpful chatting to masters, PhD and Clinical PhD students as each group gets different aspects that we’re going through. It’s oddly heartening to find that other people have also reached that point in the year where you just want to run away and join the circus! At the same time though, I find it helps to keep in mind that what is working for someone else may not work for you, and it is never a good idea to compare your progress to other students given everyone’s studies, placements, skill sets and other commitments are so diverse.

Subscribe to the bush telegraph

  • I’m not sure how well “bush telegraph” translates across cultures, but what I mean is sharing information so you have a sense of where the land lies and what might be happening next. It’s been great getting to know the other students who I share my supervisor with, both earlier and further on in their PhD than I am, and in the process, to form our own bush telegraph. The little scraps of information we share amongst ourselves about everything from whether our supervisor is in their office, is particularly snowed under that week or, mentioned an upcoming conference in passing, are invaluable.

Expect the worst

  • If you expect the worst, you’ll be as prepared as you can be. This goes for every aspect of your PhD – thesis drafts, ethics approval, recruitment, analyses, writing up and paperwork; it will all take longer than you expect. There’s nothing like discovering a couple of days before your grant is due that in order for it to be sent off, it needs to go through a week-long bureaucratic process as it bounces between various departments. Or, that the department that usually processes your clearances for working with various vulnerable populations have all gone on holiday, so it will now take months instead of a week for those forms to clear. True story.  Generally, I and my fellow PhDs try to get our paperwork sorted out ridiculously early and resort to asking everyone with a pair of ears whether there is some hidden process we might not know about that needs to be followed and then pass this information along.

Embrace the idea that balance is the ideal, but rarely when completing a double degree

  • Particularly for those of us managing clinical work and research, balance is difficult. In the early years everyone spoke about juggling commitments, but that lends itself to the idea of equity. Sometimes doing a Clinical PhD is not about equity but a good old-fashioned tug of war. You might not see your research or clinical work for weeks at a time because one or the other aspect of your degree is demanding your full attention. This tug of war happens no matter how organised, efficient and hard-working you are, and from personal experience, tugging back by putting in extra hours to compensate for the imbalance can be really counterproductive. While there are times when you may need to work more than a 40 hour week, I don’t feel that this is a long-term solution or a healthy “normal”. In sum, the experience of my fellow Clinical PhD students has been that it is okay to switch your focus to one or the other part of your degree and that the balance between them is best left to sort itself out in the end for the most part.

This list is by no means exhaustive, please feel free to chip in your own survival tips.  All the best for surviving YOUR PhD.

Leave a comment

Filed under academic culture, Clinical Phd, placement, Reflections, Research, running a study

2013: The year in review

I’m officially on my short but much needed Christmas break (YAHOO)! Hopefully taking some time to recharge my batteries before placement begins in early January will clear away the rest of that little black cloud of research ennui that’s still hanging around. Now that I’ve finally got some time to call my own though, I thought I’d revisit my hopes and dreams for the year to see how they played out.

In terms of the clinical components of my degree, I’d wanted to soak up as much experience and knowledge as I could on my first placement  from my supervisor, clients and fellow trainees to develop my skills and confidence in practice psychology.  I definitely achieved all of the above and consequently feel much more confident about my upcoming second placement than I did with my first.

The outcomes of my coursework aspirations were a bit of a mixed bag though. In many respects, the coursework component of my degee exceeded my expectations. My final topic, which was about health psychology, proved to be my favourite and exposed me to another area of psychology that I might like to work in at some point in my career. As I had hoped, I gained the classes and assignments provided me with a deeper knowledge of psychology and reiterated that I’m more competent than I give myself credit for. However, I had wanted to apply the theory I had learned. Though case conceptualisation and our self-examination of our therapy skills proved useful on placement, I wasn’t able to put my cognitive therapy knowledge into practice as much as I would have liked. Hopefully that will change in the coming year. It still seems surreal to think that next year there won’t be any more coursework. Though I’ll miss the discussions and seeing my classmates each week (we had some great extra-curricular celebrations too 🙂 ), after 19 straight years of formal lessons, I’m more than ready to step out of the classroom!

Similarly, I had mixed outcomes in achieving the goals for the research components of my degree. Some of my aspirations didn’t quite come to fruition as I had planned. For instance, I didn’t manage to write regularly, but I did almost complete the first chapter of my PhD and make a start on the second. Other things can clearly be crossed off my list of goals however, including finding better ways to let potential participants know about my studies, meeting data collection quotas and fostering friendships with fellow students. I can’t recommend using social media enough to promote your research and, I can attest that there’s nothing like exploring a foreign country to really get to know people!  Perhaps my biggest success was in developing my critical analysis skills. Thanks to my work as a research assistant, my own research and a bit of a stats boot camp by another student, I’ve developed my reading muscle, ability to critique and understand studies and I’ve been introduced to new analysis techniques.

But did I achieve my most important goal for 2013, to pull off all the above and not lose myself or my social life in the process? Well, yes and no. Work, placement and classes certainly drove me into hermitude at times. My immune system packed its bags on me several times this last semester as well, to the extent that one of my eyes decided that a conference workshop was the perfect time to begin watering so profusely that it looked like I was crying!! How embarrassing. Despite all that, I did have a lot of fun along the way too, making time to catch-up with family and friends, see Muse in concert and join a dance class. So, I think I’ll give myself a B minus on the achieving balance assignment… Onwards and upwards for next year.

I hope you had successful 2013, and that you have a Merry Christmas and Happy New Year 🙂

Honourable Mentions

 

Leave a comment

Filed under Clinical Phd, Practice, Reflections, Research

Lessons learned on placement

I’ve now passed the half way mark of my first placement as a trainee psychologist. So, it’s time to pull together the threads of all the lessons I’m learning.

  • The unexpected is challenging. While it goes without saying that the unfamiliar is  challenging, I’ve also learned that a number of little things I never anticipated being difficult are deceptively tricky. For example, my placement’s EFTPOS machine and I are not yet friends nor is calculating ‘age at testing’ on the Wechsler Scales intuitive for me yet. 
  • Everything is heightened. My four years of undergraduate training taught me about psychological theory, writing, statistics, critical thinking and gave me an appreciation that while I know more now than before, there is always so much more to learn. My first forays into becoming a trainee psychologist have brought me right back to the beginning again as I develop another set of skills. With this return to being a complete novice  comes the heightened frustration and excitement. On the one hand, I can clearly see the gap between where my skills are now and where I would like them to be when I’m a fully fledged psychologist, but on the other hand I have the excitement of slowly watching this gap become smaller and realising that I’m now achieving the milestones in my learning that just a month ago seemed daunting.
  • You need a balanced picture. Picture for me if you will a see-saw. On one side is your sense of competence and on the other your awareness of  the things you can’t yet do, or not as well as you would like. Reviewing therapy sessions with my supervisor has helped me gain a balanced picture of areas for improvement and my current competence.
  • I’m really enjoying this. Yes, it’s challenging. Yes, it’s a lot of work. And yes, I’ve had to dive right out of my comfort zone, but I am really enjoying my placement. There are so many positives: the camaraderie with my fellow students and supervisors, working with parents and children, schools and other health professionals and those moments when I can see myself, one day not so far from now, as a registered psychologist. I’m still adamant that for me this picture will also involve research/lecturing, but I would like to incorporate practising as a psychologist too.

For anyone out there about to dive into their own placement adventures, I thought I’d finish off by sharing what a wise person said to me before I started placement: you’re going to love it!

thread

thread (Photo credit: *Sally M*)

2 Comments

Filed under Clinical Phd, placement, Practice

Placement through the eyes of a Clinical PhD student

What people think being on a psychology placement is like…

1 Oh doctor the dream is so horrible

1 Oh doctor the dream is so horrible (Photo credit: Edith Ogleby)

What I thought it would be like…

English: A man diving into Lake Michigan off o...

English: A man diving into Lake Michigan off of his boat, which is anchored off shore of South Haven, MI. (Photo credit: Wikipedia)

What it’s actually like…

Maybe you’re studying psychology, about to start your first placement or just plain curious. Regardless of how you found your way here, if you’re anything like me, you might be interested in what doing a psychology placement is like. Wonder no more because with all the authority of having five weeks of placement under my belt, I’m going to tell you a bit about the things I do…

Let’s dispel some myths. Apart from the couch in the waiting room, there isn’t another in sight. In fact you’re more likely to find a rocking chair than a therapist’s couch. And as for Rorschach blots and dream analysis, I’ve never studied or used either of them. To my knowledge, they’re not used very often if at all in my country, despite what you might see on TV.

Thankfully, placement  isn’t quite the ‘diving into the deep end’ experience that I thought it might be either. In fact I spent most of my first two weeks observing therapy and educational assessments. These were good opportunities to learn more about how therapy is structured, to familiarise and re-familiarise myself with assessment tools and to see a range of different therapeutic techniques. I’ve since spent the last few weeks administering and scoring an educational assessment and conducting therapy and initial consultations with children and parents under supervision. It’s challenging, but it’s also rewarding and a lot of fun. I’m also lucky to be in a training clinic and therefore surrounded by other people at varying stages of their placement and by supervisors from whom to learn.

Then of course there’s the glamorous side of placement: admin and prep! I’ve been taking referrals, ringing families and schools for updates,  reading about disorders and therapy techniques and putting together a therapy resources folder. For anyone starting their own resource folder, here’s a tip for you; Some people have pinned some handy therapy resources on Pinterest.

So, in sum, I’m really enjoying being on placement and can already see myself growing in confidence and competence as a psychologist in training. For those of you about to embark on your first placement, good luck and if your experiences are anything like mine, you’re going to love it!

Leave a comment

Filed under A day in the life, Clinical Phd, placement, Practice

You know you’re studying to become a psychologist when…

  • You catch yourself identifying the automatic thoughts and core beliefs of soap opera characters
  • You use WISC/WAIS/WIAT/WMS/WPSI (intelligence, memory and achievement tests) as verbs, i.e. I’m WISCing today
  • Your clinical psychology “handbook” text would give the Gutenberg bible a run for its money, it’s huge!
  • You know what Dx, Ax and Rx mean
  • You’ve actually used the phrase “so what brings you here today?”
  • You know your psychological ABCs
  • You’re in touch with ‘what’s in’ with primary and high school kids again
  • People start asking you to weigh in about all sorts of things i.e. schooling, parenting, relationships, work etc., with “great power” comes great responsibility
  • Your class-size has shrunk from 150 to 15.
  • You understand percentile ranks
  • You know that we don’t actually “psycho-analyse” everyone we meet!
  • You realise that designing a therapy program is equal parts theory and creativity
  • You know who Padesky, Carr and Sattler are
  • You paraphrase, reflect and validate during  everyday conversations
  • The number of acronyms you know has increased exponentially: GAD, SAD, BD, PD, CD, ACT, ECT, CBT, FAB, DSIQ, PRI, VCI, DMI, RCT, I/C…
  • Everyone who knows you offers to be one of your clients, a great boost for the morale, until you have to explain to them why they can never be your clients!
  • You’ve endured watching tapes of yourself conducting assessments and therapy
  • You know what the NICE and the Cochrane Collaboration are
  • You’ve practised what you’re (learning to) preach i.e. meditation, behavioural experiments etc. because you can’t really ask a client to do anything you wouldn’t!
  • You won’t be selling your textbooks at the end of the year because you’ll be using them for years to come
  • You have an opinion about the DSM-5
  • You start collecting therapy resources
  • If you’re doing a Clinical PhD, you always have to explain what that actually is
  • You’ve discovered that as with any health profession, there’s a lot of paperwork involved
  • People don’t ask you what the difference between psychology and psychiatry is any more 
  • You have muscles from carrying psych tests around – you really could make a mint designing “Lite” versions!
  • You’ve sat behind a one-way mirror
  • And if my experiences are anything to go by, you get to hang out with a really perceptive and caring bunch of people from all walks of life

Anything to add?

A photo of a group conducting psychotherapy.

Leave a comment

Filed under A bit of fun, A day in the life, classes, Clinical Phd, Practice