early career anxiety

[BuckeyeLove]

Hello all,
So I have a question for the folks on here who have been out and working in the licensed arena. A. did you have early career anxiety? What i mean by this is, did you ever get caught repeatedly second guessing yourself, catastraphizing over the potential implications of your work/opinions and ever having the thought, "what if you're way off?" I have found that for about the first six months after getting licensed, i didnt experience this. However, once i started doing work in an arena in which the stakes have the potential to be a bit higher (i.e., juvenile bindover, sex offender risk asssesment), I've found that my anxiety has gone up progressively. Is this normative? I dont really know, because i have seen so many clinicians' work that seem to be perfectly fine putting things into evaluations without any semblance of evidence, and will often opine on things that I believe we just dont have the ability to reliably and validly provide. Part of me hopes that the fears and worries i have are a good thing, in that they will keep me sharp and clear, but at the same time, I worry about this lasting longitudinally.

Anyway, any thoughts would be much appreciated.

Peace.

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[PsyDr]

When in doubt, read the FRE.

 

[aequitasveritas]

Hello all,
So I have a question for the folks on here who have been out and working in the licensed arena. A. did you have early career anxiety? What i mean by this is, did you ever get caught repeatedly second guessing yourself, catastraphizing over the potential implications of your work/opinions and ever having the thought, "what if you're way off?" I have found that for about the first six months after getting licensed, i didnt experience this. However, once i started doing work in an arena in which the stakes have the potential to be a bit higher (i.e., juvenile bindover, sex offender risk asssesment), I've found that my anxiety has gone up progressively. Is this normative? I dont really know, because i have seen so many clinicians' work that seem to be perfectly fine putting things into evaluations without any semblance of evidence, and will often opine on things that I believe we just dont have the ability to reliably and validly provide. Part of me hopes that the fears and worries i have are a good thing, in that they will keep me sharp and clear, but at the same time, I worry about this lasting longitudinally.

Anyway, any thoughts would be much appreciated.

Peace.

It's best to figure these things out in personal therapy/psychoanalysis.
One man's opinion.

 

[ClinicalABA]

Hello all,
So I have a question for the folks on here who have been out and working in the licensed arena. A. did you have early career anxiety?

"Anxiety" might be too strong a word, but I certainly questioned myself more early career, as well as followoing a return to a more direct clinical role following several years with primarily adminsitrative responsibilities.

What i mean by this is, did you ever get caught repeatedly second guessing yourself, catastraphizing over the potential implications of your work/opinions and ever having the thought, "what if you're way off?"

More questioning and reviewing my training and skills, rather than repeated second guessing and and catastrophizing. I was able to pretty quickly "restructure" and catastrophizing, usual with a few rounds of asking myself (and answering) "what's the evidence?" and "so what if..?" While there are still times I am less confident with a clinical conclusion (e.g. when making a diagnosis), I'm reasonably confident that I'm not "way off." This is largely because I make sure that I am well trained to do what I do, am conservative with how I use the tools and skills ive been trained in, and regularly seek out and receive peer feedback, supports, and supervision.

I have found that for about the first six months after getting licensed, i didnt experience this. However, once i started doing work in an arena in which the stakes have the potential to be a bit higher (i.e., juvenile bindover, sex offender risk asssesment), I've found that my anxiety has gone up progressively. Is this normative?

I have not reviewed any research in this area, so can't say whether or not it is "normative." Anecdotally, I have notices in myself and other (but not all) clinicians more self-questioning when the stakes are higher. In my current work related to diagnosing Autism Spectrum Disorder in young children, this somewhat surprisingly happens more often when I don't give a diagnosis of ASD, when the treatment options are significantly limited and harder to access without the diagnosis.

I dont really know, because i have seen so many clinicians' work that seem to be perfectly fine putting things into evaluations without any semblance of evidence, and will often opine on things that I believe we just dont have the ability to reliably and validly provide.

Clinicians who put things into evals with any eveidence should cause anxiety- It's bad for the field and potentially very damaging to the client. As I mentioned above, being well trained in the use of clinical instruments and techniques, combined with using them only for their intended purposes can give you more confidence in what you do. Supposition and extrapolation beyond supported uses should make you questions things a heck of a lot more.

Part of me hopes that the fears and worries i have are a good thing, in that they will keep me sharp and clear, but at the same time, I worry about this lasting longitudinally.

"Fears and worries" can be motivators. However, I'd strive to reframe them as "questions and scientific doubt". That way they can be addressed more logically through training, ethical practice, research, peer consulation, and supervision.

Anyway, any thoughts would be much appreciated.

Peace.

Best of luck and peace to you as well

 

[Therapist4Chnge]

Hello all,
So I have a question for the folks on here who have been out and working in the licensed arena. A. did you have early career anxiety? What i mean by this is, did you ever get caught repeatedly second guessing yourself, catastraphizing over the potential implications of your work/opinions and ever having the thought, "what if you're way off?"

I think that is a pretty typical reaction. I had a similar experience when I first started, so I sought more consultations from both EC peers and more senior colleagues, which helped me feel more confident about my findings. It helped establish a healthy space to feel comfortable talking about cases and concerns, which I think has helped me become a better clinician. While it may feel like independent licensure is, "practicing without a safety net (of our supervisor)", being able to consult and solicit feedback from colleagues is in fact a safety net of sorts. I was trained with a steady refrain of, "Anything you write/say you better be able to defend in court", so my concern started well before I first became licensed.

As a result of these experiences I actually set aside some supervision time at the end of Y1 fellowship to discuss such experiences with my fellows (more as a, "when you get out you will most likely experience…"). We re-visit the discussion throughout Y2, which further reinforces the importance of consultation (and in some cases supervision/mentorship) while in every day practice. The feeling may still come, but I think it is more manageable because it's been talked about throughout the recent training experience. I'd recommend reaching out to EC contacts and colleagues to discuss their experiences and feedback/support.

 

[Rivi]

I am still within my first year of being licensed, and I can definitely relate, although it has gotten better. It seems that some anxiety is a good thing, as you suggest, as we all know clinicians who are too lax about things.

My biggest thing was involuntary commitment concerns, as many of my patients have acute issues and are on the line of needing to be hospitalized. Speaking with a lot of seasoned clinicians really helped me with this.