People who did clinical work and found it wasn't for them, what happened next?

[gohogwild]

So I am an undergrad who is en route to apply for Clinical Psych PhD program, and am looking to be mostly clinically oriented. From my reading all these boards, it seems that most if not all people who set out to be mostly clinical find it boring or that it burns them out quickly or that they couldn't do it everyday.

I was wondering if anyone here was that person who set out to be all clinical, found it was not for them and then moved on to something else in psychology: Are you still satisfied with your work or do you wish you had done something different all together?

I love the idea of being the odd duck who does self care perfectly and falls in love with doing clinical work everyday, but a part of me wants to prepare if that ends up not being the case.

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[Quarter25]

I'll give my 2 cents. I went into grad school fully committed to being a clinical neuropsychologist. I went to a PhD program because 1) there are a lot more of them that are reputable and 2) I didn't want to take on more debt. In grad school, I did well research-wise and for some time thought I'd pursue an academic research career. Towards the end of grad school, I decided that academic research was not for me, mostly for quality of life reasons, but still fully intended on a clinical career. Throughout internship and especially in postdoc, I came to fall out of love with neuropsychology as well.

Right now, I've gone full circle and have a full time job as a researcher at a non-profit research organization and see a handful of patients for therapy. I am presently very happy with this mix, and really enjoy the diversity. I don't do full neuropsych batteries, but my neuropsych training has not gone to waste. It's by choice that I don't neuropsych evals, but the knowledge helps set the context for certain therapy patients. I don't wish I had done something different all together, but it's amazing how long it has taken from undergrad until now - a point where I feel satisfied with my career and no longer feel like a trainee. But compared to my non-PhD colleagues, there are a lot more doors that open with this degree.

Best of luck in your journey, and there are a lot of things one can do with this degree, you just have to get out there and pave that path for yourself.

 

[WisNeuro]

So I am an undergrad who is en route to apply for Clinical Psych PhD program, and am looking to be mostly clinically oriented. From my reading all these boards, it seems that most if not all people who set out to be mostly clinical find it boring or that it burns them out quickly or that they couldn't do it everyday.

I was wondering if anyone here was that person who set out to be all clinical, found it was not for them and then moved on to something else in psychology: Are you still satisfied with your work or do you wish you had done something different all together?

I love the idea of being the odd duck who does self care perfectly and falls in love with doing clinical work everyday, but a part of me wants to prepare if that ends up not being the case.

I haven't gotten the impression that "most if not all" clinical people feel this way. I think there are some who do not like to be doing something like 100% therapy every day. But, many people in clinical are able to vary their schedule with things like supervising trainees, some clinical research time, varying clinical (groups, individual, OP, IP, etc), some consultation, IME work, teaching, etc.

 

[gohogwild]

I haven't gotten the impression that "most if not all" clinical people feel this way. I think there are some who do not like to be doing something like 100% therapy every day. But, many people in clinical are able to vary their schedule with things like supervising trainees, some clinical research time, varying clinical (groups, individual, OP, IP, etc), some consultation, IME work, teaching, etc.

I think that's a good point. I think it's easy to forget the whole "the internet is an anonymous place to vent" thing when it's concerning issues that are sometimes worth worrying about. Good food for thought, thank you.

 

[gohogwild]

I'll give my 2 cents. I went into grad school fully committed to being a clinical neuropsychologist. I went to a PhD program because 1) there are a lot more of them that are reputable and 2) I didn't want to take on more debt. In grad school, I did well research-wise and for some time thought I'd pursue an academic research career. Towards the end of grad school, I decided that academic research was not for me, mostly for quality of life reasons, but still fully intended on a clinical career. Throughout internship and especially in postdoc, I came to fall out of love with neuropsychology as well.

Right now, I've gone full circle and have a full time job as a researcher at a non-profit research organization and see a handful of patients for therapy. I am presently very happy with this mix, and really enjoy the diversity. I don't do full neuropsych batteries, but my neuropsych training has not gone to waste. It's by choice that I don't neuropsych evals, but the knowledge helps set the context for certain therapy patients. I don't wish I had done something different all together, but it's amazing how long it has taken from undergrad until now - a point where I feel satisfied with my career and no longer feel like a trainee. But compared to my non-PhD colleagues, there are a lot more doors that open with this degree.

Best of luck in your journey, and there are a lot of things one can do with this degree, you just have to get out there and pave that path for yourself.

Thank you for taking the time to write that out. Yes, I think I'm also concerned about what it's like to devote a good chunk of my 20s to a PhD program, but I don't see myself doing anything else. I think right now I'm just understanding the reality and variability of what can be done with this degree and your response was definitely some insight into that. Thank you! Also, if I may pry because neuropsych is something that I am dancing around right now, what made you fall out of love? Right now I really enjoy my neuroscience coursework but know that learning new interesting things about neuroscience is not necessarily a good example of what a neuropsychologist does. Did you get bored? Too data heavy? Thank you again.

 

[foreverbull]

So I am an undergrad who is en route to apply for Clinical Psych PhD program, and am looking to be mostly clinically oriented. From my reading all these boards, it seems that most if not all people who set out to be mostly clinical find it boring or that it burns them out quickly or that they couldn't do it everyday.

I was wondering if anyone here was that person who set out to be all clinical, found it was not for them and then moved on to something else in psychology: Are you still satisfied with your work or do you wish you had done something different all together?

I love the idea of being the odd duck who does self care perfectly and falls in love with doing clinical work everyday, but a part of me wants to prepare if that ends up not being the case.

I think your question applies to a few folks here, but not the majority of psychologists. I’m an ECP who shifted to teaching and part-time practice after realizing full time clinical practice wasn’t going to work for me (didn’t realize this until internship/postdoc stage, when I provided fulltime psychotherapy) but am in transition trying to find off-the-beaten path types of work.

It is not easy to shift, at least, not for me (it took several ignored applications to even get an adjunct teaching gig initially), and adjunct teaching is just not sustainable longterm. I’ve also been rejected for jobs that seemed like a good use of my skills but in other areas (ie summarizing research and presenting it but in another field) where they’re just more skeptical of my clinical/teaching path being relevant. It’s challenging to market myself for nonclinical jobs (and the clinically-related jobs like utilization reviewer are few, far between, and extremely competitive). I’ve mentioned this before—flexibility is an advantage to doctorates, but if you switch paths after your doctorate, it’s still hard to get a foot in the door into another niche without connections, at least in my experience and in my neck of the woods. I can’t overemphasize how important networking is at all stages of the process from grad school to beyond.

Maybe I’ll have it all figured out in a year and can have more helpful advice for folks in a similar boat. I’m extremely fortunate that I have a spouse who is working fulltime while I am in a bit of a professional limbo, but there are limits.

We’ll see what happens!

 

[gohogwild]

I think your question applies to a few folks here, but not the majority of psychologists. I’m an ECP who shifted to teaching and part-time practice after realizing full time clinical practice wasn’t going to work for me (didn’t realize this until internship/postdoc stage, when I provided fulltime psychotherapy) but am in transition trying to find off-the-beaten path types of work.

It is not easy to shift, at least, not for me (it took several ignored applications to even get an adjunct teaching gig initially), and adjunct teaching is just not sustainable longterm. I’ve also been rejected for jobs that seemed like a good use of my skills but in other areas (ie summarizing research and presenting it but in another field) where they’re just more skeptical of my clinical/teaching path being relevant. It’s challenging to market myself for nonclinical jobs (and the clinically-related jobs like utilization reviewer are few, far between, and extremely competitive). I’ve mentioned this before—flexibility is an advantage to doctorates, but if you switch paths after your doctorate, it’s still hard to get a foot in the door into another niche without connections, at least in my experience and in my neck of the woods. I can’t overemphasize how important networking is at all stages of the process from grad school to beyond.

Maybe I’ll have it all figured out in a year and can have more helpful advice for folks in a similar boat. I’m extremely fortunate that I have a spouse who is working fulltime while I am in a bit of a professional limbo, but there are limits.

We’ll see what happens!

Very nice! Thanks for sharing your story. Can you tell me what an ECP is? Googling it generated "emergency care practitioner" or "emergency care psychologist".

 

[Quarter25]

Thank you for taking the time to write that out. Yes, I think I'm also concerned about what it's like to devote a good chunk of my 20s to a PhD program, but I don't see myself doing anything else. I think right now I'm just understanding the reality and variability of what can be done with this degree and your response was definitely some insight into that. Thank you! Also, if I may pry because neuropsych is something that I am dancing around right now, what made you fall out of love? Right now I really enjoy my neuroscience coursework but know that learning new interesting things about neuroscience is not necessarily a good example of what a neuropsychologist does. Did you get bored? Too data heavy? Thank you again.

I think there are a few practicing neuropsychologists on this board, so they may be able to provide additional insight. I agree that neuroscience != neuropsychology. It's just like biology 101 != practicing medicine. For me, it was a very personal choice based on my own opinions and biases. I don't think that neuropsychology is boring, per se. It's kind of interesting trying to figure out what's up with the patient. Neither was it data heavy, I presently work as a quantitative researcher and have always enjoyed numbers and data. Ultimately, I enjoy getting to know the patient, seeing their trajectory and growth, and feeling like I had a role in their journey as their therapist. I also felt like my hands were tied most of the time doing assessments - I can deliver bad news about a diagnosis, but I don't have the medical training to take it a step further. Yes, I can tell the patient what's wrong with their cognition due to epilepsy, but I can't perform brain surgery or prescribe medications. I especially disliked delivering the news that someone has [insert some form of dementia] and have to have their license taken away, or go take a driving test, or should be under supervision at all times. I didn't enjoy making these and other potentially life-altering recommendations based on spending 3-5 or even 8 hours with the patient and telling them to draw some lines and do some mental gymnastics. But for every reason why I disliked neuropsychology, there are many others why people love it, so take my personal opinions with a grain of salt.

 

[WisNeuro]

Very nice! Thanks for sharing your story. Can you tell me what an ECP is? Googling it generated "emergency care practitioner" or "emergency care psychologist".

Early career psychologist. Typically less than 10 years from degree conferral.

 

[Quarter25]

I think your question applies to a few folks here, but not the majority of psychologists. I’m an ECP who shifted to teaching and part-time practice after realizing full time clinical practice wasn’t going to work for me (didn’t realize this until internship/postdoc stage, when I provided fulltime psychotherapy) but am in transition trying to find off-the-beaten path types of work.

It is not easy to shift, at least, not for me (it took several ignored applications to even get an adjunct teaching gig initially), and adjunct teaching is just not sustainable longterm. I’ve also been rejected for jobs that seemed like a good use of my skills but in other areas (ie summarizing research and presenting it but in another field) where they’re just more skeptical of my clinical/teaching path being relevant. It’s challenging to market myself for nonclinical jobs (and the clinically-related jobs like utilization reviewer are few, far between, and extremely competitive). I’ve mentioned this before—flexibility is an advantage to doctorates, but if you switch paths after your doctorate, it’s still hard to get a foot in the door into another niche without connections, at least in my experience and in my neck of the woods. I can’t overemphasize how important networking is at all stages of the process from grad school to beyond.

Maybe I’ll have it all figured out in a year and can have more helpful advice for folks in a similar boat. I’m extremely fortunate that I have a spouse who is working fulltime while I am in a bit of a professional limbo, but there are limits.

We’ll see what happens!

I transitioned out of academia and have been working in "industry"/research consulting-type organizations (I see therapy patients solely out of interest and not necessity). If you're interested in this or similar paths or want to chat about transitioning out of the academia/clinical mold, send me a PM! I have a lot of colleagues who are trying to do the same so happy to help or commiserate.

 

[WisNeuro]

I think there are a few practicing neuropsychologists on this board, so they may be able to provide additional insight. I agree that neuroscience != neuropsychology. It's just like biology 101 != practicing medicine. For me, it was a very personal choice based on my own opinions and biases. I don't think that neuropsychology is boring, per se. It's kind of interesting trying to figure out what's up with the patient. Neither was it data heavy, I presently work as a quantitative researcher and have always enjoyed numbers and data. Ultimately, I enjoy getting to know the patient, seeing their trajectory and growth, and feeling like I had a role in their journey as their therapist. I also felt like my hands were tied most of the time doing assessments - I can deliver bad news about a diagnosis, but I don't have the medical training to take it a step further. Yes, I can tell the patient what's wrong with their cognition due to epilepsy, but I can't perform brain surgery or prescribe medications. I especially disliked delivering the news that someone has [insert some form of dementia] and have to have their license taken away, or go take a driving test, or should be under supervision at all times. I didn't enjoy making these and other potentially life-altering recommendations based on spending 3-5 or even 8 hours with the patient and telling them to draw some lines and do some mental gymnastics. But for every reason why I disliked neuropsychology, there are many others why people love it, so take my personal opinions with a grain of salt.

I have kind of the opposite feeling with my dementia patients, I love doing those evals. Often, they have never had another provider actually have an honest conversation about such a diagnosis. I'm also tied into a lot of the gero services in town, so we have an depth conversation about the best ways to maximize QOL with the resources available. By far the most positive feedback I get in assessments is by dementia patients and their families.

 

[cara susanna]

I'm definitely not someone who could enjoy or sustain a full time therapy gig. I'm in the VA so I am mostly doing therapy, but I'm also involved in teaching, consultation, and some administrative work. I also find that the type of therapy matters. For instance, I feel far more energized and happy when I'm seeing people for evidence-based therapies for PTSD than other types of therapy cases. Supportive therapy especially drains me.

 

[foreverbull]

Very nice! Thanks for sharing your story. Can you tell me what an ECP is? Googling it generated "emergency care practitioner" or "emergency care psychologist".

Whoops, should have clarified, but @WisNeuro got to it first! Yes, ECP = “early career psychologist.” My doctorate is in counseling psychology.

 

[clausewitz2]

I'm definitely not someone who could enjoy or sustain a full time therapy gig. I'm in the VA so I am mostly doing therapy, but I'm also involved in teaching, consultation, and some administrative work. I also find that the type of therapy matters. For instance, I feel far more energized and happy when I'm seeing people for evidence-based therapies for PTSD than other types of therapy cases. Supportive therapy especially drains me.

What, you mean amorphous, aimless talking with no clear goal, purpose or endpoints is more taxing than following clear guidelines using well-described techniques to achieve specific objectives?

 

[futureapppsy2]

What, you mean amorphous, aimless talking with no clear goal, purpose or endpoints is more taxing than following clear guidelines using well-described techniques to achieve specific objectives?

IME, it's also that EBP tends to be more effective and thus more rewarding for the clinician.

 

[futureapppsy2]

I'm definitely not someone who could enjoy or sustain a full time therapy gig. I'm in the VA so I am mostly doing therapy, but I'm also involved in teaching, consultation, and some administrative work. I also find that the type of therapy matters. For instance, I feel far more energized and happy when I'm seeing people for evidence-based therapies for PTSD than other types of therapy cases. Supportive therapy especially drains me.

Assessment, too. Mixing assessment and therapy can really break up the potential monotomy, as can supervision of trainees.

 

[cara susanna]

Assessment, too. Mixing assessment and therapy can really break up the potential monotomy, as can supervision of trainees.

Yes! I also have an assessment clinic, although it's only a few times per month.

 

[summerbabe]

I was wondering if anyone here was that person who set out to be all clinical, found it was not for them and then moved on to something else in psychology: Are you still satisfied with your work or do you wish you had done something different all together?

I'm ECP and happy with full-time clinical role. In general, I'd encourage you to observe the type of work that future supervisors and other staff have as you train in different settings and try to imagine yourself in all of these positions.

For example, I did pracs at 2 residential programs that had PhD program directors. One was practically 100% admin/supervision while the other had maybe 25% clinical duties. CMH, hospitals, and VA sites will also offer outpatient admin positions with similar work duties.

There are also full-time clinical roles that don't operate on a traditional outpatient model, such as inpatient and rehab, where there will be more interdisciplinary team duties, consultation, and assessment, which can increase variety.

I absolutely loved the VA Spinal Cord Injury rotation that I did during postdoc. It had a great mix of intensive team work, inpatient therapy, outpatient biopsychosocial evals, work with families and caregivers, and a ton of variety for outpatient therapy (adjustment, couples counseling, career counseling, depression, etc).

 

[futureapppsy2]

I absolutely loved the VA Spinal Cord Injury rotation that I did during postdoc. It had a great mix of intensive team work, inpatient therapy, outpatient biopsychosocial evals, work with families and caregivers, and a ton of variety for outpatient therapy (adjustment, couples counseling, career counseling, depression, etc).

Rehab psych *is* the best!

 

[PsyDr]

Although I love what I do, I started out as a child psychologist. But when I turned 18 years old, I turned into an adult psychologist.

(I’ll see myself out)

 

[Sanman]

I will add that I really think that the type of clinical work you do will impact how sustainable things may be for you. I am 100% clinical and do a variety of different things in my job. Being in geriatrics, I provide a lot of caregiver support and behavior management, which I enjoy doing. It is a lot more like teaching (without the grading) than it is like traditional clinical work. I also carry a contingent of long-term geriatric PTSD and depression patients. This is okay in small quantities, but I could not do it all day. Generalist outpatient therapy work often means supportive therapy or a lot of prep for a variety of issues and that can be difficult. My suggestion is to try some things and develop a niche that you enjoy. Do the other work to fill in the gaps.

 

[AcronymAllergy]

I agree that finding clinical work consistent with your interests can be crucial. Also, I don't think it's unusual for folks to begin branching out into other activities in some capacity after a few years of "only" 100% clinical work. For example, many people become involved in training/teaching, professional advocacy, consulting, or research. They may also mix up the clinical work itself, such as by including assessments, seeing different types of patients, or becoming trained in other interventions (as mentioned above).

I personally still enjoy clinical work, but I keep up my morale and avoid burnout by including some of the other activities above. Who knows how I'll feel 10 years from now, but I suspect I will still be involved in clinical work in some capacity. Unless I hit the lotto or find the next Tesla/Amazon. Then all bets are off.