Tag Archives: Psychology

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 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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Filed under Book Club, psychology

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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Filed under Clinical Phd, Reflections

Therapy as a learning experience for both client and therapist

Every psychology placement teaches you something. While you expect to build your therapy and assessment skills, you might not anticipate the things you’ll learn about yourself. My first placement taught me that I love working with kids, that a 50+ hour work week is just not my calling, and that I’m a practical therapist; no one leaves my sessions without something concrete to use or work on. My second placement hasn’t stinted on personal insights either. For the first time, I’ve had the chance to work with adults and in the public sector. Along the way I’ve met many brave, kind and wise people; clients and practitioners alike, I’ve also learned about Acceptance and Commitment Therapy (love it!), and visited hospitals, hostels and everywhere in between. But what have I learned about myself?:

1) I like freedom and autonomy – the ability to tailor therapy and assessment techniques to the client.

The individualised approach can be tricky to provide whether you are a psychologist in the private sector and limited by time and resources, or a psychologist in the public sector and expected to follow a particular assessment protocol. Regardless, I now recognise that I like the idea of individualised therapy and assessment, within my means. Why? One size does not fit all. That, and I like efficiency 😀

2) Sometimes psychologists get concerned, and that’s okay. 

At this point I may have thrown you.. Why is that okay? Aren’t psychologists supposed to be non-judgemental and accepting? How can you expect someone to talk to them about the tough stuff if they are worried or uneasy?  Well, bear with me because I agree. Psychologists should be open and non-judgemental so they can objectively understand and support their clients’ journeys. They also need to make sure that the biases and feelings that come along with being human don’t interfere with their work. BUT, at the same time they need to respect that some feelings, such as a sense of unease, might be an important signal that something is not as it should be; that the client, someone they know or even the psychologist themselves, may be at risk. This information can then be used to prompt further assessment to understand what is going on and to develop a plan to keep everyone safe. So in a nutshell, I learned that objectivity as a psychologist isn’t so black and white, it’s a balancing act of being accepting and non-judgemental while not entirely dismissing your own reactions insofar as they are helpful to therapy.

3) I’m a specialist, not a generalist.

The fact that I’m doing a PhD and therefore learning a lot about a teeny tiny area should have made this revelation a no-brainer, but it was still a bit of a surprise. Having had the opportunity to try lots of different things has shown me that while I could work in other areas – I get the most enjoyment working in my specialty area. This certainly helps with narrowing down what I’d like to be doing next!

So it’s true what they say about therapy being collaborative because client and therapist are teachers and students alike. The therapist may bring a raft of tools to share, but the client also brings lived experience to the table which adds to and shapes this toolkit. And in the process of learning how best to use these techniques to address the issue at hand, the strengths, weaknesses and preferences of both client and therapist can be highlighted.

Who knows what lessons my next placement will lead me to!

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Filed under Clinical Phd, milestone, Reflections, Teaching

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

 

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Filed under Clinical Phd, Practice, Reflections, Research

Taking stock: Semester 1, Year 2.

Semester 1, Year 2, 17 months in…

If I could sum up this semester in one word, it would be contradictory. When this semester started I’d  a work-study-life balance but towards the end I found myself working most weekends just to wade through placement, assignment and research related jobs. In between this feast and famine, I discovered I really enjoyed placement, despite having little prior experience working with children and that I’m often more capable than I think, though well aware I’ve a long way to go! I also learned that despite loving what I do, 50 hour weeks are not my thing, at least not over a sustained period. There’s definitely something to be said for having time to recharge your batteries. Finally, from interacting with other researchers and realising how much I’ve learned relative to last year, I’ve begun to appreciate that even though I’m  just a second year PhD student, I do have something to bring to the research table.  I’ve  a feeling that I’m going to look back on this semester in the future, remember all the amazing experiences and lessons learned but wonder how on earth I did all that I’ve done.

Placement related musings

Last year one of our lecturers told us that there shouldn’t be too much of a difference between who we are as a person and who we are as a therapist. The idea is that though your sessions should obviously be evidence-based and professional, they also need to reflect your style, not the style of someone you’ve decided to mimic or a persona you think you need to put on. When I was first introduced to this idea, finding my therapeutic style was the least of my worries, I just wanted to get a handle on the nuts and bolts of therapy! However, having since watched other therapists, gotten a feel for the way I like to conduct therapy and feedback from my supervisor about my approach, I can see what our lecturer meant. We do all have our own styles. I can’t really speak to other professions having only worked in hospitality or community/mental health services previously, but there is a lot of scope for having your own stamp in the profession for psychology. My own brand, from all reports, is practical, task orientated and flexible. I find this pretty funny, task orientated just about sums me up.

Placement was an incredibly positive experience. I learned a lot, about myself, people, how to help and how far I have to go. I don’t feel like I’m playing at being a trainee psychologist now. I am a trainee psychologist. Placement was also a fantastic opportunity to really get to know the other students I was working with. There’s nothing like being stuck in the office long after 5pm writing reports; the nerves of first clients, first assessments, first case presentations etc. and sharing the challenging, rewarding and hilarious (kids say the cutest things!!) to really bond with people.

Next placement I’d like to seek out some experience working with adults using traditional CBT approaches so I’ve got that grounding. I mainly worked with younger children and so the emphasis was more on the behavioural than cognitive aspects of CBT. Given I’ll spend almost all of next year on placement, ideally I’d also like one closer to home and with more of a 9-5 structure rather than the intense schedule I chose to cut-down on travel.

Research related musings

In a funny way, placement also taught me how much I loved research. As much as I loved placement, I still craved the short exchanges about the PhD journey with my fellow placement colleagues and the PhD students I bumped into on campus.  Having a whole day to spend on my thesis was heaven. I think I got through three days worth of work in one on one of my ‘thesis days’, given that was all I had to spend on it between coursework, work and placement some weeks! Some people who do a Clinical PhD want a more clinical/practice than research orientated focus to their careers, some want the reverse and others want a balance. I’m definitely between the latter two categories, I would feel like a big part of me was missing if I was doing clinical work only, but at the same time I’m grateful my research area is clinically orientated.

Now that I’ve finished up my first study of my PhD and my second is finally in the ethics pipeline I’m looking towards other research outputs: getting my head more clearly round stats, presenting a poster at another conference, co-authoring a paper, potentially dipping my toe into writing a paper and chipping away at those 90,000 words.  In the short-term though I’m just trying to get back into a research routine. I’ve gone from overwhelming time pressure to the other extreme!

Miscellaneous news

Someone other than my markers, supervisor, parents, one of my closest friends and two of the people whose measures I used in my study has read my Honours thesis. Yes, really. I was shocked, even more so when the student in question said she wanted to chat about it! I felt like the world was spinning the wrong way round its axis.

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Who know what the coming semester will bring?

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July 5, 2013 · 12:55 am