Leaving limbo land

I have been living in limbo these past few months…

As soon as I submitted my thesis, I applied for a part-time job in the public sector. This job, a therapeutic role in adult mental health, would help me build up my clinical decision making skills, pursue endorsement and ultimately  work towards entering private practice. At about the same time, a friend of mine name dropped me to another service who had mentioned they were looking to hire someone. As a result, after submitting my CV, I was offered some intermittent therapy work with children in the new year. I was still waiting for my registration paperwork to come through though and to hear back about the outcome of my other application, so we agreed I would check in with them again in January.

Weeks passed. I found out I had been accepted for a panel interview with three psychologists for the public sector job. I was ecstatic! At the interview, I was given fifteen minutes to read through a series of interview questions and make notes. As a veteran public speaker used to responding off the cuff, this felt like a luxury! And, the questions they asked me were nowhere near as tricky as the ones I’d predicted they would ask. Better still, in contrast to the panel I sat before to gain entry into my postgraduate program, they were welcoming and supportive. I walked out feeling like the interview had gone well.

More weeks passed without news. Soon it was almost Christmas and I was nervous. I’d been told I’d be notified by this point. Out of the blue, I was also offered a part-time job, for one or two days a week doing disability assessments. I couldn’t believe it. It was the type of clinical job that 17 year old me had always planned for myself and I hadn’t even applied for it. Have you ever heard the like of it in your life?!

Receiving this new job was simultaneously wonderful and stressful. I had a lot of weighing up to do. Did I take the job outright or wait to hear back about the public sector job application? Was I willing to risk having to turn down the public sector job if it were later offered to me because the assessment job had specific days that might well clash?  And, what was the likelihood of me finding other part-time therapeutic work with adults to fit around the assessment role if the part-time public sector job fell through? AAAAH!!

After a lot of angst, I was honest with the assessment employee and they were unbelievably kind and accommodating to me. They allowed me to wait and see what the outcome of the public sector job was to figure out how I might be able to make both roles work round each other.

And so I waited, and waited and waited. And I hated it, mostly because it did not sit well with me leaving two other potential employees twiddling their thumbs. I also hated the uncertainty of it all. What if the days in the public sector job were incompatible? What if that job ended up being full-time and nor part time (as was beginning to look likely at one point)? When would they tell me what was going on either way?!

Right before Christmas, I received some information. I finally knew I was in the running, but, because the range of the available roles were caught up in HR, they weren’t sure what they could offer me. So I had to wait. Again.

And so more weeks passed. Before I got The Phone Call and was offered a part-time role in adult mental health.  I remember saying aloud to myself after the call. “That actually just happened!” I just couldn’t believe it. Stranger still, the role was within a team I had previously been involved in. Talk about coming full circle! I accepted the job with the assurance there was some flexibility with days but I still had to wait several days to confirm that the role would fit beautifully round the assessment job. The relief was palpable.

And so now I am leaving limbo land behind. I am no longer routinely checking all my job alerts and job search engines. I’ve politely declined the child therapy opportunity. I have a firm idea of what I will be doing professionally this year. And I even have a start date! I am so very grateful.

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A dream without a plan..

According to Oscar Wilde, a dream without a plan is just a wish. I wholeheartedly agree. It’s important to dream, but if you don’t think about how you’re going to make those dreams a reality, then they usually remain nothing more than a dream. As mentioned previously, one of my dreams is pursuing work in private practice, doing a combination of therapy and assessment work.

Why private practice?

Simplistically, it’s all about the autonomy and flexibility.  First, as a private practitioner you have a lot of say in what type of work you take on. You can therefore choose how you will balance out your case load and whether to specialise or diversify. Second, you also have a lot of input in the running of the practice. This allows for flexibility in your working hours, environment and fee structure.

So why not dive straight in?

You have to walk before you can run

Despite the perks, private practice is typically not the first port of call for an early career psychologist. With all that autonomy also comes a lot of responsibility. I’m not even going to go into the need to manage your own business. Instead, I’ll focus on the flip side of autonomy: isolation.

In private practice you rarely have the benefit of a multidisciplinary team. In fact, you may be a solo practitioner, operating entirely on your own without colleagues onsite to seek informal supervision from.

Supervision is a requirement for all psychologists.  It involves regularly meeting with other psychologists of equivalent or greater seniority to review (de-identified) cases, discuss therapeutic techniques, assessment approaches, updated research and ethical dilemmas etc. The idea behind supervision is to make sure psychologists remain current with best practice and to prevent burn-out. Supervision may happen informally, e.g. dropping in on a colleague for a quick chat or, formally, as regularly scheduled meetings for ongoing professional development.

Well-developed clinical decision making skills are also essential to all psychologists, but perhaps more so to psychologists in private practice who must manage risk and complexity without the benefit of informal supervision and collaboration which are more common to public sector work places.

Clinical decision making skills allow psychologists  to confidently and competently manage the complexities of providing therapy to clients at risk of harm to or from, themselves or other people; clients with multiple presenting issues (fairly common); clients presenting with less common or particularly complex difficulties and any ethically tricky situations that may arise.

Psychologists in the public sector environments typically work in multidisciplinary teams. So, ensuring clients’ safety and care is more of a collaborative process and there are generally more opportunities for informal supervision. This creates a fantastic environment for early career psychologists (graduates with up to five years experience as practicing psychologists) to hone their clinical decision making skills. This is the very reason why so many early career psychologists seek work in the public sector. Some will stay in the public sector their whole careers while others will choose to eventually move into part-time or full-time work in private practice.

The issue of endorsement

Many psychologists in private practice also have an area of endorsement. This means they’ve gone on to do further supervision to really hone their skills in a particular area e.g. clinical psychology, educational and developmental psychology or health psychology etc. This involves quite an intensive process of supervision, day to day practice as a psychologist and professional development that also assists in developing those clinical decision making skills.

Because endorsement takes a further one to years of on-the-job training beyond the years of study to register for a psychologist, it’s something a lot of early career psychologists (people with up to five years of experience working in the field) lack, at least initially. This can happen for a number of reasons. The person may not be eligible to seek an endorsement (there are specific requirements). The training can be tricky to set-up depending on your location and the availability of qualified supervisors  (you need a specially trained and endorsed psychologist to supervise you in my country). Finally, if you are in the private sector, or, in the public sector but without access to an endorsement program, you may have to source one of the aforementioned supervisors externally and/or pay for their supervision.

What’s my plan?

Build up my clinical decision-making skills

  • Seize opportunities to provide therapy to people with common and  complex challenges in a supportive multidisciplinary environment.

    Spoiler alert #1: I think I’ve found myself a bit of a ‘unicorn’ of a first job in just such an environment. Lots of diverse presentations, multidisciplinary input and support. More about all this in another post.

  • Seize opportunities for assessment work that will allow me to diversify my skills e.g. varying ages, presentations, differential diagnosis

    Spoiler alert #2: I actually found myself two jobs! The second is assessment based and should give me lots of scope to do all the above. Plus, it’s also in a supportive multidisciplinary team.

  • As a long-term reader of Study Hacks*, working smarter not harder in building up my clinical decision-making skills is also part of my game plan. What on earth might that look like?
    1. Taking a month or so to identify a particular skill to work on. One that is going to be most useful for my clients and I.
    2. Spending a few weeks educating myself about that skill – who is it most suitable for, when should it be used, how is it used, what’s the best practice protocol?
    3. Spending a few weeks practicing using the skill (role-playing, adopting the skill for some first-hand experience of possible speed bumps in using and applying it).
    4. Introduce relevant clients to the skill, and incorporate into intervention plan if they’re on board with it.
    5. Seek and respond to feedback about the use of the skill from clients, team and supervisor.

Work towards endorsement

  • My Plain-English definition of this process involves completing:
    • Practice: 2000+ actual face-to-face or client related work hours specific to my area of endorsement
    • Supervision: regularly meeting with another psychologist to chat about my approach to intervention, conduct de-identified case presentations, discuss psychological theories, ethical and professional scenarios, assessment approaches, report writing, case cross-cultural competence etc.
    • Professional development: One-on-one and group supervision plus going to training workshops, reading articles and giving presentations etc.

      Spoiler alert #3: One of my jobs has an in-built program to assist me in gaining my endorsement. My contract is shorter than the time required for endorsement but worst case scenario, it’s going to give me a flying start.

And that folks, is roughly where I’m at with my plan. I suspect my move into private practice will occur gradually, probably by the time I’m a mid-career psychologist (5 year + mark).

Disclaimer:

It’s important to note that this is all a very simplistic account of supervision, endorsement and work in the public and private sectors. It varies according to country, training, the employer and the psychologist. Some graduates do go straight into private practice and flourish. Perhaps because they have found a supportive team of practitioners to guide them or, because they have previous experience working in health. Different strokes for different folks as they say. Hopefully this post gives you a bit of insight into one of the pathways of many early career psychologists and why I’ve chosen this particular path myself.


*I’m a big fan of Cal Newport and his blog Study Hacks. He has some really interesting perspectives on applying the idea of working harder not smarter (and deliberate practice) in various fields. I’d strongly recommend browsing through his blog if you’ve ever had career, study or creative aspirations.

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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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So you’re a psychologist, now what?

While my postgraduate psychology training has equipped me with many skills, much less time was spent on the nuts and bolts of setting myself up as a psychologist. Suddenly I have to get my head round registration, indemnity insurance, Medicare numbers, award levels and figure out whether work opportunities are suited to a very early career psych.

Here’s what I’ve learned  in case its of use to anyone else starting out.

Registration

It varies on where in the world you are, but chances are that there is a lot of paperwork between you and being able to call yourself a psychologist.

Tip: Presume nothing and ring the registration board about anything on the form you are unsure about. Generally presume it will take at least a few weeks to get processed.

Indemnity insurance

What is it? Legal protection for you as a professional. In Australia its mandatory. Some work places will cover it for you but you’ll generally need your own if you are working in private practice.

Tip: If you are a member of your local psychology organisation, you may be eligible for a discount on professional indemnity insurance. But do shop around.

Medicare numbers

If you want to provide services under Medicare you need a Medicare Provider number. To get a Medicare Provider number you need to be registered and have a place of work. This can leave you in a bit of a Catch-22 when you are applying for registration, on your first job hunt and therefore without a place of work!

Tip: You need a Medicare Provider number for each place of work. It can take up to six weeks.

Award levels

PUBLIC SECTOR

If you are going into the public sector in Australia and have a postgraduate degree, the entry level positions in the public sector open to you are at AHP2.

PRIVATE SECTOR

There are many different arrangements in the private sector from independent contractor through to salaried staff member. Private practices  often (but not always) advertise positions for people who have previously worked in the field for a couple of years and/or who hold an endorsement in a specialty area.

Tip: Read the fine print. Not all AHP2 jobs are entry level and some private sector jobs are aimed at new grads.

Where to start?

That seems to be the million dollar question, everyone has an opinion and these opinions often conflict. I suspect the only clear answer is “start somewhere.” Having said that, here are some questions that might help you out:

  • Is your CV up to date? Do you have three professional referees? What clearances do you have that allow you to work with specific populations?
  • Do you want to pursue endorsement in a specialty area? How might that work?
  •  Is supervision provided? How might you obtain it?
  • Do you have any preferences? Rural vs metro; public vs private sector; child vs adult; assessment vs therapy; part-time vs full-time; a specific population you particularly enjoy working with?
  • Where are your competencies? Do you have skills in particular techniques, therapy formats (individual vs group) or environments (team vs solo practitioner)?
  • And of course, what opportunities are available?

Best of luck, any hints and suggestions welcome!

 

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The Boy Who Was Raised As A Dog

Now that I’ve some time on my hands, I’m reviving the Psychology Book Club and trying to make a dent in my to-read pile.

This week’s selection is “The Boy Who Was Raised As A Dog” by Bruce Perry and Maria Szalavitz.

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The Whistle-Stop Tour

  • Intended audience: Health professionals, people interested in psychology or trauma.
  • Content: 275 pages of case studies about psychiatrist Bruce Perry’s experiences working with young people affected by trauma.
  • Readability: Easy to understand. Nb. some case studies may be distressing/triggering.
  • Practicality: There are layers here, probably one to re-read to get the most out of it.
  • Cost: Kindle $AUD 9.67; paperback copy from the Book Depository $AUD 13.70
  • Publication details: Basic Books 2006
  • Overall rating: ★★★★★

The Extended Review

I first heard about this book being described as a ‘must read’ for those interested in working with childhood trauma when I was beginning my postgraduate training. It was recommended to me again more recently in the context of trauma more generally. Now that I’ve finally gotten round to reading it, I can say that it does not disappoint.

Perry describes his experiences working with a range of children and their families affected by trauma. These are real people in very challenging circumstances and so this book is not a light read. However, the resilience of the people behind each story really shines through.

The frank and reflective style of the authors provides some great insights into what worked, what didn’t and why. Perry also touches on the evidence base for various approaches and the links between brain and behaviour without presuming any prior knowledge. Really there’s something for everyone in here whatever your therapeutic orientation or stage of career.

Personally, I’ve walked away with some more nuanced ideas about supporting young people through trauma disclosure, a greater awareness of the impact of the timing of trauma and an interest in the neurosequential model.

In sum, the insights in this book translate beyond working with children or people affected by trauma, so if you’re a health professional, it’s really worth a read.

If you’ve read ‘The Boy Who Was Raised as Dog,’ what stood out for you?

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Hello from the other side…

Everyone talks about life after the PhD. We fantasize about what we’ll do with our new found freedom. But what is it actually like?

Week 1 – All systems go

The first week after submitting my PhD was pretty darn weird!

I had none of the “I should be writing my thesis” guilts or the “oh no I stuffed up and should have included X” worries people had warned me about. It was my body not my mind that was firmly stuck in thesis writing mode. I just couldn’t shake the night owl sleeping  habits I’d adopted in the writing up period.

I didn’t do all that much. Well, I did, but none of the things you fantasize about doing like that long awaited Netflix marathon, throwing a party or, running off into the sunset ;). I did compete in an arts competition, donned a celebratory tutu (long story, cool experience) Then I waded straight into a hailstorm of admin to apply for my psych registration, various jobs and to deal with all the day-to-day tasks that had fallen to the wayside. BORING!

Week 2 – Catharsis

The second week was definitely better. I felt like I was on an extended weekend. I walked around my  local area noticing all the changes I’d missed when I’d been holed up with my thesis. I took great joy in lobbing all my old thesis drafts into the recycle bin and realising that I could actually say ‘yes’ to social events without having to factor in writing my thesis.

Week 3 – Lost at sea

I found out I’d gotten a job interview. My sleep was slowly becoming more civilised. But, I was also starting to get pretty bored. So I started doing fun things that had been on my to-do list. I’d fancied having hot chips on the beach, so I did, except there were gale force winds and the surf was so rough there was no sand to sit on! The chips were good though :D.

Week 4 – I’m a what?

To my utter shock my psych registration came through about three weeks early! After nine years of study, I was finally a psychologist. Very surreal. I had my job interview too, I think it went well but learned I would not find out the outcome until Christmas, possibly later. In the midst of it all two of my friends move/d interstate. It was lovely catching up with them and exciting to see them off on their next grand adventures, but I’ll miss them.

Verdict

Life on the other side of my PhD isn’t really at all how I imagined it. I’m not worried about my PhD mark or when I’ll receive it. I have no compulsion whatsoever to write my thesis and it feels sort of wrong being back on campus to run errands or clear my office. It’s almost as if on the day I submitted that part of my life became The Past. As a good friend said to me today, now to just concentrate on enjoying “limbo” the period in between finishing my degree and working as a psychologist.

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I finally did it

I did it. I finally did it. Four years 8 months and 14 days after starting this journey, I finally  submitted my PhD thesis.

The lead up to finishing was horrible; there were lots of last minute revisions requested and red tape. Everything that possibly could go wrong did go wrong with printing it. The whole thing was one giant comedy of errors. Right up to walking in to find the office for submitting PhDs had been inexplicably shut for the day.

This is the day that was, for the sake of posterity…

The day before I handed up, I did the final read through, proofing and formatting. I also ran off one copy to duplicate at the uni the next day.  This last job was a nightmare. My printer would not print landscape pages. Saving the file to a .pdf did not work either. So, I had to manually adjust the settings on the printer for each landscape page and then manually realign the page numbers. Doing so stuffed up all the page numbers on my automatically generated contents page. Every time I shifted between landscape and portrait and back again I gained or lost multiple pages. In the end, I had to manually create my contents page. All in all I was up until about 1:30am printing my thesis. All 264 pages of it.

I woke up at 5:30 am and was at university by 8:30am. I spent the morning photocopying. My university requires three hard copies and a digital copy of each thesis. The fourth is an insurance policy in case anything goes wrong. Which it did. The photocopier jammed and chewed up one of my pages! I finally finished making the copies by 10 o’clock. Due to my aforementioned .pdf debacle I then had to scan the hard copy of my thesis to create the pdf which was also required for submission.

I then wandered down to the library where the binding service was located. The wandering was somewhat difficult as the theses weighed more than my laptop did, and I was already weighed down with that too. It took about 40 minutes for the three copies to be bound. This period was a bit amusing. The silence in the library was broken by the repetitive noise of someone shearing through my thesis to carve out the holes for the comb binding. Everyone was looking around as if to say, what on earth are they doing in there?! During this time I compiled all the .pdf files I had made earlier into one document. The adrenaline had kicked in by that point and my hands were shaking. As you can imagine, that made the task rather difficult! Things became even more laughable when I tried to send the .pdf file to the head of faculty as requested. The file was .6 of a MB larger than that which can be sent via email. Undaunted, I compressed the file but that destroyed the quality of the image. It made reading my thesis look like it would without wearing my contact lenses! VERY BLURRY. I ended up uploading the file to Google drive and sending a link to the file via email.

I returned staggered back to my office with three bound copies of The Beast. I could not believe how thick my thesis turned out to be! I’d assumed it only looked so bulky because the papers weren’t aligned properly. But no, it is actually an epic. It clocked in at about 50K words, minus the references and appendices. I’d thought it would be about 30K. Then I printed out the last bit of paperwork I needed to submit that I’d received that morning and took a few selfies. It was weird. There was no one in my office. In fact, apart from the lovely admin people I’d chatted to briefly while binding, there was not a soul on campus that I knew.

The sun was splitting the trees as I walked across the courtyard with its garden gnome water feature, yes, really. I climbed up the stairs to the place where I submitted my first university assignments to submit my very last one. How poetic eh?

*Cue scratched record noise.* Instead of being greeted with the usual hive of activity up at the office, there was a sign informing me that it was shut, all day, with the suggestion I use the phone to ring someone else. Eventually locating the phone I first rang the person I had previously told I was submitting that day. No answer. Then I managed to get through to a lovely lady who I actually knew. Turned out most of the office was sick but she was able to help me. It was very anti-climactic. She ducked back inside the office with my thesis, signed a form, gave me a copy and it was done.

We chatted for bit and then I wandered down to a secluded spot of the uni with the piece of paper heralding my new found freedom. I took a lot of selfies. I’m not much of a selfie person but you only submit your PhD once. So I improvised a tripod using my handbag and made good use of the phone timer. Being a dancer, there were quite a few leaping for joy shots among them.

That done, I ducked back to my office, submitted the paperwork for the uni to sign me off to apply for my psych registration and finally bumped into a fellow student I knew. I had a quick bite to eat trying to process everything that had just happened and made way down to the seaside to catch up with a friend. She had a present for me from a group of my friends which was lovely. It started sinking in by degrees that I was done. I celebrated with my family that night over dinner.

The whole experience of finishing has been overwhelming. It doesn’t feel real. 22 years of studying done. It’s been exciting, terrifying and at times quite sad. I’d lost a lot of people very important to me over the last couple of years and it just wasn’t quite the same not being able to share my news with them today. All in all though, I was euphoric to be done.

I’ll probably keep this blog going in some shape or form re: the job hunt, settling into work etc. but for now…

Honourable Mentions over and out.

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