Tag Archives: Clinical psychology

The Making of a Therapist

The inaugural Psychology Book Club post is here!

This month’s offering is “The Making of a Therapist” by Louis Cozolino.

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The Whistle-Stop Tour

  • Intended audience: Trainee and early career psychologists
  • Content: A 213 page guide to common pitfalls and experiences of the new therapist
  • Readability: Easy to read and relate to with plenty of ‘take home points’
  • Practicality: Questions posed throughout help you work out how to apply the advice
  • Cost: Kindle $AUD 21.50; Hardback copy from the Book Depository $AUD 35.67
  • Publication details: W.W Norton and Company Ltd. 2004
  • Overall rating: ★★★★★

 

The Extended Review

I’ve read a few books aimed at early career psychologists but this is easily my favourite. Cozolino provides a witty, honest and practical account of the common concerns of new therapists and how to address them. The book is split into three sections: getting through your first sessions, getting to know your clients and getting to know yourself. He covers just about everything from Imposter Syndrome to counter-transference. Don’t be put off by the Freudian language though. I found that it all made sense and could easily be applied in my own clinical work even though I don’t come from a psychodynamic orientation.

The take home points for me were Cozolino’s observations about self-knowledge, the idea that we each need to be aware of, manage and even make use of, our own personal experiences and biases within the therapy room. Cozolino’s stance on this issue was that simply “being professional” by making sure we are aware of ethical codes, guidelines and our own limitations isn’t enough. Too often being professional means staying only “above the neck” and something I’m realising in my own training is that you can’t do therapy well if you’re completely in your head.

I feel I don’t have the words to explain this idea well enough. I guess it’s one of those things you have to experience yourself to truly appreciate the difference but perhaps the infinite wisdom of  Heart and Brain from The Awkward Yeti comic series will help. I think doing therapy above the head is like leaving Brain completely in charge, he gets the job done but sometimes he misses the point entirely and makes things unnecessarily difficult. The view Cozolino and I share is that ideally therapists harness Brain and Heart, allowing Brain to focus on the theory, the science, the ethics and the strategies and Heart to focus on being present, open to experiences and meeting needs to build therapeutic rapport and model healthy coping. This latest offering from Nick Seluk about Brain and Heart seems pretty apt: http://theawkwardyeti.com/chapter/heart-and-brain-2/.

Price wise, ‘The Making of a Therapist’ might be a little out of reach for the student budget. However, I consider this book recommended reading for all trainee and early career psychologists who do therapeutic work, so maybe try to find it in your local university library if you can.

I’d love to hear your feedback on ‘The Making of a Therapist’ if you’ve read it and other recommendations – reading and professional for early career psychologists.

~ Honourable Mentions ~

 

 

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Intermission

By the end of my intermission I’ll have been absent from my PhD for 5 months. Five months are a long time to be MIA from your PhD. When I return, I’ll have to get acquainted with my research, get my head round all the changes in my department and at the same time start the last year of my PhD. It’s all a bit daunting.

I think what scares me the most though, is that I’ve decided that I don’t want to go into academia any more. Don’t get me wrong, I love research; the intellectual challenge and the reward of finding out something new, especially when it has practical applications for helping other people. I was always one of those people who was 100% confident from the beginning that I wanted to be an academic. At university I found “my people,” made lifelong friends and had some fantastic opportunities along the way.  However, I’ve come to the gradual realisation that my priorities: family, friends, being healthy, having job security and enjoying the small things in life, are just not compatible with the path to success in academia. For me, it would mean post-doc hopping around the world on minimal pay for years while clocking the inevitable 50-hour (or more) work week in a highly competitive industry with the odds firmly stacked against me ever gaining a permanent job. I have a lot of respect for the people working within academia or aspiring to work in academia, and acknowledge that it is possible to make it all work, but I now know that it’s just not the path for me any more. I don’t regret doing a PhD and fully intend to complete mine, but I don’t plan to apply the skills I have learned within this degree in a traditional academic environment any more.   It has taken a little while, but I’m genuinely okay with this realisation.

I’ve been working on the ‘what next’ for a little while now. It’s still terrifying but not as overwhelming. At the moment, I’m toying with the idea of working as a part-time psychologist and part-time consultant, perhaps to some disorder or disability orientated organisation. Ideally, the consultant role would involve some research, perhaps developing and evaluating therapy programs. Alternatively, I’ll work part-time as a psychologist and part-time in another field drawing upon my media, communication and generic research skills. Who knows? That’s what I’ve got to work out now and that too is daunting. Which doors do I close? How? When? Who I can talk to about this? Who can offer me guidance about my options and how to proceed? And the more immediate question, what does “being a PhD student” look like for me now when the path I’ve been prepared for, is not the path I’m taking? IMG_1907

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The little black cloud of research ennui has returned

The third year of a Clinical PhD is synonymous with duck feet paddling furiously under the water, juggling balls rolling out of one’s reach and the relationship between student and thesis reflecting that of passing ships in the night. Third year is the year we spend ten months on placement while also trying to juggle research, and for many of us, paid work too.

Objectively, ten months on placement while keeping your thesis inching along might not sound that complicated. Especially when you consider that part of second year required juggling placement, research and a class. So, third year has to be easier because there aren’t any classes, right? Sadly, the third year of my Clinical PhD is living up to its reputation for being exceptionally difficult. I thought it was just me initially and that I was simply “doing third year wrong”, but other people feel the same.

The most sense I can make of why third year seems so much more difficult is that our research is now more demanding. In your third year the most complex studies of a PhD are typically devised, run and analysed and then finally, written up. The stop-start approach that must be taken towards your research due to juggling placement and work  at the same time is therefore a recipe for frustration. You hear that life as an academic is much the same: time pressure and a never-ending to-do list. I hope there is still some scope to engineer your schedule to allow for solid blocks of time to concentrate on your research though (a few hours even?!) even if it is just once a week? I also sincerely hope that the 50 hour work weeks with only a couple of days off each month that I’ve faced for the past six weeks aren’t constant in academia either…

OLYMPUS DIGITAL CAMERASo what is the point of this post? I’m a fan of “keeping it real” when blogging about my PhD journey. So while many parts of doing a PhD are amazing, I also think it’s important to acknowledge that sometimes doing a Clinical PhD is just as difficult as it is rewarding. For the first time I’m finding myself questioning why I am doing this, whether doing a Clinical PhD is really worth the burn out I’m currently experiencing, whether I will be able to submit on time and whether I will be able to find a job that combines research and practice. In the words of the Thesis Whisperer, I’m passing through the “Valley of Shit” and if this resonates with you, I salute you.

 

This post has sat in my drafts folder for over a month. I’d hoped I’d be able to post it with the amendment that I’d gotten out of “the Valley” and things had drastically improved. To be honest, the pace hasn’t improved much and doesn’t look like it drastically will until about Mid-November. There have been a few minor improvements: my placement workload is more manageable and a work commitment will end soon, so I’ll be able to eke back a few hours. I’m also feeling slightly less jaded this week because I was able to work on my thesis properly for the first time in months, but I am still very much burnt out.  In fact, though I’m actually on placement this weekend for a couple of hours, I think I’ll go on strike and actually take the rest of the weekend off!

Honourable Mentions

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Self-care

I remember the first time that self-care came up in our lectures. We were all a bit perplexed about the how-to of it. In a bid to help us get our heads around it, our instructors organised a unit on self-care. We discussed our stress signals and stress relievers and then hit the courts for some endorphin boosting exercise.

I’d like to tell you that after all this, I got it, but if I said that I’d be lying. At the end of the session I did have a good understanding of what self-care was; the rather sensible idea that you can’t help your clients if you’re not in a good head space yourself, but I hadn’t a good sense of what practicing self-care should look like for me.

In hindsight, I can appreciate why I didn’t completely “get'” self-care when it was first introduced. At that point in my training, I had not yet set foot in a therapy room so it was still a bit of an abstract concept in terms of where it fit within my practice as a psychologist, nor was I particularly good at identifying my stress signals, at least not until my immune system – in a last-ditch attempt to send me a smoke signal, packed it in and welcomed in every cold or virus, side-lining me. So it would be fair to say that the how-to of self-care was never going to be an instant click with me!

Thankfully, I “get” the how-to of self-care now. What changed? Well, the process of doing a PhD in clinical psychology and all the juggling it entailed was a steep learning curve. Somewhere between attending classes, coursework and placement; devising, recruiting for, running, analysing and writing up studies, and working at the same time, I learned what my limits were and devised my own personal stress management tool kit.

For me, my self-care tool kit consists of music, dance, and spending time with friends and loved ones. For others it could include jogging, trashy TV, walks by the beach or baking. I might not get my self-care routine perfectly right all the time – does anyone? – but I’ve found one that works for me, helping me to do my work as a therapist, PhD student and employee while also keeping me happy.

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While it wouldn’t have been a bad thing if self-care was something I instantly connected with, I’m not sorry it was more of a gradual learning process for me. In fact, it’s really useful in therapy. I’m more aware the pitfalls that arise when trying out things like behavioural activation (scheduling rewarding activities to boost and maintain your mood) and different ways to explain how it works and why it matters. Maybe you’ve experienced this yourself and found something that comes easier to you is far harder to explain than something that took more time or practice?

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What the heck is a post-doc?

Before I signed up for a PhD, I did my homework. I wrote three different PhD proposals for three different universities and chatted to PhD students and lecturers about the academic career path. Still, it wasn’t until half way through my first-year that post-docs crossed my radar. At first, post-docs were a mystical phenomenon. Something that people spoke of in awed and sometimes despairing tones. It wasn’t until I attended my first conference that it became clear I had it all wrong.  Post-docs were not the optional extra I’d thought they were, but for most aspiring academics of my generation, a necessary step in pursuing an academic career.

So what the heck is a post-doc?

Post-doc is shorthand for a post-doctoral position. Essentially, this is the first academic position you earn following the submission of your doctoral thesis/dissertation. Job descriptions vary, but generally, a post-doc is a short-term contract or scholarship completed by someone 0-5 years post their PhD. They tend to last two to three years and to be geared towards research though there are exceptions. A post-doc can sometimes be more teaching based, reflect a combination of teaching and research and in psychology at least, clinical work too.

So it’s like doing a second PhD?

Not really. As a post-doc you’ve made the jump to independent researcher. Sure, you’ll have a boss to report to, but the buck stops with you as you devise, manage, complete and publish research projects. Unlike a PhD when we tend to pitch a project and apply for a scholarship, most post-docs will do the reverse, accepting a position offered and funded by the university and often with a set project. In the US post-doc salaries range from approximately 39,000 – 51,000 USD, in the UK £25,000 to £40,000, and in Australia from $60,000 to $82,000. As always though, there are exceptions to the rule and some post-doc candidates will  create these jobs, winning grants and using this money to pitch a post-doc to a university that they would like to work from.

How do I get a post-doc?

Honestly, that’s something I’m still trying to work out. This post just reflects what I’ve worked out so far. From what I can tell, hunting for a post-doc is a highly competitive process with many people having to move state or even overseas to secure a position. What can give you the edge as an applicant also varies widely, though publications seem virtually essential. The other trick seems to be having an ear to the ground about what’s on offer. Post-docs typically aren’t advertised in the local paper but through specialist listings (which are often erratic) and word of mouth etc.

All I know is that I’ve decided that for me it’s challenge accepted. It may be near impossible, but I’m going to do my darndest to put myself in the best position I can to get a post-doc, because as much as I like clinical work, I really can’t picture myself not doing research too. Wish me luck.

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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.

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2013 Hopes and dreams

Though the second year of my Clinical PhD is seven weeks away, my second year placement is just around the corner. So, I thought I’d post about the coming year now while I’m not juggling research, coursework and a placement.To put it mildly, 2013 is going to be a big year.

In semester one, I’ll attend classes, complete over 300 hours of placement and continue to conduct my research. By semester two I’ll have completed my first placement, begun a new class and be continuing on with my research. Barring extenuating circumstances, these are the things that will definitely happen, but what might happen? And what would I like to happen?

Sun Drenched

Sun Drenched (Photo credit: Digimist)

My ‘clinical’ hopes and dreams for 2013:

  • I hope that my first placement will be a great opportunity: a chance to put theory into practice; to learn from my supervisor, clients and fellow trainees; to improve and grow in confidence in my clinical skills; to help my clients bring about improvements in their lives; to learn more about where I’d like clinical psychology to take me, essentially to become a better trainee psychologist.
  • In 2013, I hope that my coursework will provide me with a chance to engage: to apply what I’ve learned on placement and first year and vice versa, to learn more about CBT, other therapeutic approaches and presenting problems and the different avenues that psychology may take me, in other words, I want to consume and contribute knowledge.
  • I hope that this year I will continue to foster the friendships I have made with my fellow trainee psychologists.

My ‘research’ hopes and dreams for 2013

  • I’d like to develop my critique and analysis skills: to improve my reading muscle, learn new statistical techniques and become more confident in interpreting and appraising various statistical techniques and study designs.
  • I’d like to write: regularly, the chapter for my first study, my case studies, 30, 000 words of my thesis.
  • I’d like to finish (and in some cases start!): collecting data for my first three studies
  • I’d like to design: a better way to let potential participants know about upcoming research and the overarching study for my PhD.
  • And I hope that I will continue to foster the friendships I have made among my fellow PhD students and the faculty.
Balancing Act

Balancing Act (Photo credit: Digitalnative)

Clearly, I have a big year ahead. So my most important hope for 2013 is balance: to pull it all off and not lose myself or my social life in my to-do list!

It will be interesting to see if my hopes and dreams for 2013 come to fruition. Wish me luck!

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