Finding a neuropsych/assessment externship as a first year doctoral student

[jade1234]

Hi,

I am just finishing up my first year at an APA accredited clinical psych program in NYC. We have summer classes as part of my program, but I was able to place out of one of them. This leaves me with plenty of time to pursue other things over the summer, such as jobs and psych-related opportunities.

I would really like to improve upon my assessment skills, specifically on tests geared towards children and adolescents. I know that second and third years get priority though. From what I have heard, there is one place in Long Island that does allow first years, but that place is too far from me. My question is, is it possible to get a summer time volunteer externship geared towards test assessment in NYC and if so, what are some suggestions as to how to go about getting such a placement? I would even be willing to just observe test assessment. I am specifically interested in the WISC, WIAT, and the ADOS. In addition, if anyone knows of specific places, that would be helpful too.

Thanks, looking forward to hearing from you all.

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[erg923]

There is substantial lit on how third party observers effect test scores, so I doubt anyone is going to let you observe assessments just for kicks.
And generally, practica placemets have to be approved by yout training program, so the best answer to this question will come from your program DCT, not us.

 

[OneNeuroDoctor]

I believe NY is one of the few states that has restrictions on hiring neuropsych tech/extenders to administer neuropsych test. Most other states have the provision of hiring bachelor and master's level individuals as neuropsych tech. Being only a first-year clinical psychology student it may be best to discuss your interest in neuropsych assessment with your advisor or the DCT since normally they want you to follow a specific curriculum path in the program. Normally you need to have successfully completed your assessment courses before beginning assessment practicum/externship, so therapy practicum are completed prior to assessment practicum rotations. Clinical neuropsychology is a long road and you have to do a two-year postdoctoral before acquiring independent licensure as a clinical neuropsychologist. It is much more than testing and you have to have a number of courses in biological/physiological psychology and additional pathology and rehabilitation psychology courses. You might be able to get experience working in a rehabilitation facility for TBI as a psych tech/volunteer during the summer. Since you have a reduced course load this summer, you could try to take a course in physiological psychology.

 

[AcronymAllergy]

I believe NY is one of the few states that has restrictions on hiring neuropsych tech/extenders to administer neuropsych test. Most other states have the provision of hiring bachelor and master's level individuals as neuropsych tech. Being only a first-year clinical psychology student it may be best to discuss your interest in neuropsych assessment with your advisor or the DCT since normally they want you to follow a specific curriculum path in the program. Normally you need to have successfully completed your assessment courses before beginning assessment practicum/externship, so therapy practicum are completed prior to assessment practicum rotations. Clinical neuropsychology is a long road and you have to do a two-year postdoctoral before acquiring independent licensure as a clinical neuropsychologist. It is much more than testing and you have to have a number of courses in biological/physiological psychology and additional pathology and rehabilitation psychology courses. You might be able to get experience working in a rehabilitation facility for TBI as a psych tech/volunteer during the summer. Since you have a reduced course load this summer, you could try to take a course in physiological psychology.

Just to quickly clarify--neuropsychologists are licensed the same as all other psychologists (in most cases), with reqs for that varying state-to-state. The two-year postdoc comes into play for board certification, though, and (in my opinion) to allow for competent practice of neuropsychology.

My understanding of NY is that psych techs are prohibited, but students are able to serve as trainees so long as the practicum placement is approved by the grad program and the student is enrolled for credit hours through their university. So I definitely agree--going through your advisor/DCT seems to be necessary in order to allow you to actually administer any assessments. Or as OneNeuroDoctor mentioned, you could see about signing up for an extra class (e.g., NAN offers an online neuroanatomy course; it's not the most thorough/rigorous course out there, and you'd likely have to pay for it out of pocket, but it could certainly help you to gain some knowledge in the subject area).

 

[Therapist4Chnge]

Walk before you run. Take some additional courses (neuroanatomy, neurophysiology), gain additional generalist experience, etc.

 

[gilpin]

I agree with the previous poster. Build the basics (including therapy experience) first, then you will be more competitive for the assessment sites. The better assessment sites in the NY area (e.g., NYU, Columbia, LIJ...) usually want at least one year of past clinical work with patients.

 

[erg923]

Well, isnt doing some mild asessment work (not neuropsych) a good way to build basic clinical/counseling skills though? I was trained to do a standard intake interview/history, diagnostics, and some of the basic IQ and peroanlity stuff before I dove into doing real therapy.

 

[Therapist4Chnge]

Well, isnt doing some mild asessment work (not neuropsych) a good way to build basic clinical/counseling skills though? I was trained to do a standard intake interview/history, diagnostics, and some of the basic IQ and personality stuff before I dove into doing real therapy.

I am a big believer in building the foundation and avoiding the "tech" kind of work that doesn't really allow for the development of those other skills.

 

[cara susanna]

Well, isnt doing some mild asessment work (not neuropsych) a good way to build basic clinical/counseling skills though? I was trained to do a standard intake interview/history, diagnostics, and some of the basic IQ and peroanlity stuff before I dove into doing real therapy.

Yeah, a lot of our incoming second year students do assessment placements over the summer.

 

[jade1234]

Thanks everyone!

Soooo...I did go through my school and believe it or not, I have found an "externship!" I put it in quotes because it is not an externship in the truest sense. I don't get any formal contact with children, and I do not get to administer assessments. I do, however, get to code and enter them into the computer, and write reports. That's enough for me right now. To address some of what some people have said, I've already taken assessment classes, and I don't have money for extra classes, but I definitely would benefit from more practice.

As for the clinical experience/neuropsych argument, I have plenty of clinical experience and plenty of research experience. Assessments (the cognitive and personality types) are my Achilles' heel. I don't necessarily believe that these structured types assessments prepare you for therapy, but I view them as a separate activity that psychologists can perform, and I like to keep as many opportunities open to me as possible.

 

[erg923]

Thanks everyone!

Soooo...I did go through my school and believe it or not, I have found an "externship!" I put it in quotes because it is not an externship in the truest sense. I don't get any formal contact with children, and I do not get to administer assessments. I do, however, get to code and enter them into the computer, and write reports. That's enough for me right now. To address some of what some people have said, I've already taken assessment classes, and I don't have money for extra classes, but I definitely would benefit from more practice.

As for the clinical experience/neuropsych argument, I have plenty of clinical experience and plenty of research experience. Assessments (the cognitive and personality types) are my Achilles' heel. I don't necessarily believe that these structured types assessments prepare you for therapy, but I view them as a separate activity that psychologists can perform, and I like to keep as many opportunities open to me as possible.

Im confused:
1. You are going to write reports, (interpret, draw conclusions, and make recommendations) on instruments you aren't familar with and dont know how to administer. How does that work?Sounds like malpractice to me.
2. You are a first year doctoral student and you have "plenty of clinical experience and plenty of research experience?" Ok? Then what purpose is grad school serving for you?
3. You think diagnostic assessment of psychopathology has no relevance to psychotherapy?

I think your response is probably a textbook example of why complex assessment is best done by those in a more advanced level of graduate training.

 

[AcronymAllergy]

Im confused:
1. You are going to write reports, (interpret, draw conclusions, and make recommendations) on instruments you aren't familar with and dont know how to administer. How does that work?Sounds like malpractice to me.
2. You are a first year doctoral student and you have "plenty of clinical experience and plenty of research experience?" Ok? Then what purpose is grad school serving for you?
3. You think diagnostic assessment of psychopathology has no relevance to psychotherapy?

I think your response is probably a textbook example of why complex assessment is best done by those in a more advanced level of graduate training.

I was also curious about the report writing bit, as that's a much more complex skill than simply administering the measures. Perhaps it's more of just writing up descriptions of the results (e.g., "information processing speed was impaired")? That's the only thing I can think of, although even that just seems a bit odd to be doing before becoming clinically familiar with the measures themselves.

 

[erg923]

I was also curious about the report writing bit, as that's a much more complex skill than simply administering the measures. Perhaps it's more of just writing up descriptions of the results (e.g., "information processing speed was impaired")? That's the only thing I can think of, although even that just seems a bit odd to be doing before becoming clinically familiar with the measures themselves.

I would argue that tech jobs should be given to techs. I would assume (and hope) this wouldn't be a program sactioned practicum experience, as there is zero patient contact.

 

[jade1234]

Jeez Louise. Don't slaughter me. I've taken assessment classes, so I'm not sure why you think I don't have training? Secondly, to clarify, I have sufficient research/clinical experience FOR A FIRST YEAR. Of course I'm not an expert in the field. Finally, was addressing someone's else point about how tech work doesn't necessarily coincide with therapy. I agree that psychotherapy can go hand in hand with assessment but it doesn't have to. I think you have different assessments in mind. I can answer you question more in depth later on.

 

[jade1234]

By the way, I would be supervised for the reports, and they would be edited by the supervisor. I can sit in the feedback session but I can't provide feedback.

 

[erg923]

By the way, I would be supervised for the reports, and they would be edited by the supervisor. I can sit in the feedback session but I can't provide feedback.

No one is slaughering anybody. We are simply trying to make sense of a situation that is confusing, and from your description thus far, appears like sloppy if not not downright unethical clinical practice. Not exactly something you want to start doing as a student. My concerns are as follows:

1. How does one write a clinical report on patient they have never seen? A person isn't just a bunch of test scores!

2. Who does the clinical interview and collaterals? Do you have access to this infomation (records, interviews, the raw test data, behavioral observations)?

3. How does one write reports when they dont even know what the intruments are measuring, how they were developed, how the norms were developed, or how they are administred. There is just little bit more to these measures than what you cover in an asessment course or two.

4. How does one integrate process observations/data in this scenario?

5. What on earth is the logic behind excluding you from every part of the evaluation except the part that is the most complex and requires knowledge of all the previous parts? Its all totally backwards from a training perspective! WHO APPROVED SUCH A THING!?

6. How do you reconcile what you are about to do with code 9.06?

 

[AcronymAllergy]

Jeez Louise. Don't slaughter me. I've taken assessment classes, so I'm not sure why you think I don't have training? Secondly, to clarify, I have sufficient research/clinical experience FOR A FIRST YEAR. Of course I'm not an expert in the field. Finally, was addressing someone's else point about how tech work doesn't necessarily coincide with therapy. I agree that psychotherapy can go hand in hand with assessment but it doesn't have to. I think you have different assessments in mind. I can answer you question more in depth later on.

I can speak to my post--I wasn't suggesting you lacked training, rather that you don't yet have much/any clinical exposure to these instruments. Learning them in an assessment course is of course much different than administering and interpreting them in a clinical context, although it's good that you have some basic foundational knowledge in place. I can speak to my own experience here, and say that despite administering all the measures of our typical psychoed eval as part of my assessment practicum, my first time giving these measures to a patient (and subsequently attempting to interpreting them) was...rough to say the least.

However, I again agree with erg--writing reports is infinitely more complex than administering the measures, so I'm very curious/concerned as to why the supervisor has you doing that first rather than handling the testing and then getting gradual exposure to report writing. Also, as erg alludes, will you be present during the interview and testing at all, or will you simply be coding the data, reading the interview form, and writing the report off of that? If so, as erg has suggested, this seems pretty darn unethical, which (before you think I'm coming down on you) speaks much, much more to your supervisor than it does you. Although if your program is ok with the experience, maybe we're just misunderstanding/misinterpreting the setup.

Heck, I don't even know boarded neuropsychologists who'd feel comfortable writing a clinical report without having laid eyes on the patient. Although perhaps that's because of said boarding. One of the few situations where I could see this being appropriate would be an IME-type review of another practitioner's testing data and report in the context of a forensic eval.

 

[jade1234]

AA,

You're probably right that I likely misunderstand what I will be doing (it likely was oversold to me). I will gather more info about it. Thanks for your feedback and clarification.

 

[WisNeuro]

Yeah, I am also concerned about the report writing here. Besides the ethical considerations, I don't think it will be that helpful from a training perspective to be writing that info up without a better understanding of the measures that comes from the clinical experience of actually administering them.

 

[AcronymAllergy]

AA,

You're probably right that I likely misunderstand what I will be doing (it likely was oversold to me). I will gather more info about it. Thanks for your feedback and clarification.

Very possible, yep. And based on the responses here, you now also have an idea of the sorts of things to look out for, so that you can potentially bring them to your program's attention if the setup is one with which you aren't comfortable.

Edit: and like WisNeuro mentioned, of particular importance for you, the training aspect of basically being a "report tech" of sorts could be highly limited. There's a lot to be said for seeing patients from beginning to end so that you develop some internal norms about what normal/abnormal results look like, what sorts of behavioral observations are and are not particularly noteworthy, etc. It's one of the reasons I wanted to do all of my own testing up until postdoc (and some small portions of internship).

 

[erg923]

AA,

You're probably right that I likely misunderstand what I will be doing (it likely was oversold to me). I will gather more info about it. Thanks for your feedback and clarification.

Again, the main worry here is not YOU... its that this was considered and then proposed to you as an option in the first place. WHO thought this was a good idea (clinically) and an appopriate training experience for a student is my question? How did this slip by your DCT if this is program sanctioned/approved?