Ability to pick and choose what you want to do clinically?

[The Cinnabon]

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So, I've been fortunate enough to have a VA that not only supports me in scholarly output during my RA years, but has allowed me to sit on on suicide prevention groups/ psychotherapy trainings/ etc.

Obviously seeing is a lot different than doing, so take all of this with a grain of salt as its viable to change, but some of the stuff I saw didn't interest me nearly as much as I thought. For example, I was able to sit in on DBT training and have seen a few group treatment sessions. Honestly, in practice, I didn't find it nearly as interesting as I thought it would be.

Now, on the flip side, I found that I've really enjoyed doing columbia's for a big suicide prevention study I'm on, something that's gotten me far more interested in assessment. I've enjoyed how "detective-esque" it can feel, without any obligation to actually administer any treatment, and I've always had an interest in psychometrics.

To finally get to the actual question, is it possible in grad school to just seek training in suicide risk assessment and not really do any actual treatment?

 

[WisNeuro]

So, I've been fortunate enough to have a VA that not only supports me in scholarly output during my RA years, but has allowed me to sit on on suicide prevention groups/ psychotherapy trainings/ etc.

Obviously seeing is a lot different than doing, so take all of this with a grain of salt as its viable to change, but some of the stuff I saw didn't interest me nearly as much as I thought. For example, I was able to sit in on DBT training and have seen a few group treatment sessions. Honestly, in practice, I didn't find it nearly as interesting as I thought it would be.

Now, on the flip side, I found that I've really enjoyed doing columbia's for a big suicide prevention study I'm on, something that's gotten me far more interested in assessment. I've enjoyed how "detective-esque" it can feel, without any obligation to actually administer any treatment, and I've always had an interest in psychometrics.

To finally get to the actual question, is it possible in grad school to just seek training in suicide risk assessment and not really do any actual treatment?

No, but the bigger question is, why would you want to waste your doctoral education that way? The well-rounded education is what makes us psychologists. Without that, you're just an over-educated midlevel.

 

[ClinicalABA]

I pretty much get to do what I want to do, clinically speaking (of course within some guidlines- has to align with the mission of the agency; has to result in a minimum amount of revenue generation; I have to engage in some non-clinical activities such as teaching at the agency affiliated grad programs). I am able to now do what I want because I was originally trained to do a bunch of other stuff that other people wanted me to do, competently did all that stuff for awhile, an earned the trust to be left alone to do what I want. Helps a lot that what I want to do is currently in very high demand and not a lot of other people seem to want to do it as much as I do.

 

[summerbabe]

To finally get to the actual question, is it possible in grad school to just seek training in suicide risk assessment and not really do any actual treatment?

Everybody in doctoral training will do the basics - objective assessment, personality assessment, individual psychotherapy, & group psychotherapy. Even somebody who 100% wants a research career will fulfill a bare minimum of hours in each domain to round out their competency.

You can absolutely focus on suicide related research and/or intervention while in grad school. People like Thomas Joiner, Craig Bryan, Michael Anestis & David Rudd have built research focused careers on suicide/suicide prevention and it's likely their only current clinical exposure is supervision.

Within the VA setting, there are a handful people in research (Denver MIRECC on Suicide Prevention) and some who work in administration (Office of Mental Health & Suicide Prevention, Suicide Prevention 2.0 programs).

But most designated suicide prevention staff are clinically focused.

Suicide Prevention Coordinators do admin stuff like evaluate high risk flags but also engage in a lot of follow-up with veterans who call the crisis line and have flagged veterans on their caseload that they do check-in calls with. Suicide Prevention 2.0 therapists provide EBPs focused on suicide prevention. And of course, all clinical staff do screenings, risk eval, and treatment including administer Columbias.

Now, on the flip side, I found that I've really enjoyed doing columbia's for a big suicide prevention study I'm on, something that's gotten me far more interested in assessment. I've enjoyed how "detective-esque" it can feel, without any obligation to actually administer any treatment, and I've always had an interest in psychometrics.

One thing to think about as you finish your RA and consider grad school: even for people who may not want a clinically focus career, you will do A LOT of clinical work via practicums and predoctoral internship (4000+ hours of both direct f2f contact and indirect prep/learning spread over 5-7 years).

Sitting in and observing treatment is very different than doing the treatment but I always encourage people considering a doctoral degree to think about everything that you'd be committing to and whether that will prepare you for the types of careers that you'll find satisfying.

 

[The Cinnabon]

Everybody in doctoral training will do the basics - objective assessment, personality assessment, individual psychotherapy, & group psychotherapy. Even somebody who 100% wants a research career will fulfill a bare minimum of hours in each domain to round out their competency.

You can absolutely focus on suicide related research and/or intervention while in grad school. People like Thomas Joiner, Craig Bryan, Michael Anestis & David Rudd have built research focused careers on suicide/suicide prevention and it's likely their only current clinical exposure is supervision.

Within the VA setting, there are a handful people in research (Denver MIRECC on Suicide Prevention) and some who work in administration (Office of Mental Health & Suicide Prevention, Suicide Prevention 2.0 programs).

But most designated suicide prevention staff are clinically focused.

Suicide Prevention Coordinators do admin stuff like evaluate high risk flags but also engage in a lot of follow-up with veterans who call the crisis line and have flagged veterans on their caseload that they do check-in calls with. Suicide Prevention 2.0 therapists provide EBPs focused on suicide prevention. And of course, all clinical staff do screenings, risk eval, and treatment including administer Columbias.

One thing to think about as you finish your RA and consider grad school: even for people who may not want a clinically focus career, you will do A LOT of clinical work via practicums and predoctoral internship (4000+ hours of both direct f2f contact and indirect prep/learning spread over 5-7 years).

Sitting in and observing treatment is very different than doing the treatment but I always encourage people considering a doctoral degree to think about everything that you'd be committing to and whether that will prepare you for the types of careers that you'll find satisfying.

I really should have specified in the original post that I am interested in interventions too.

I just found DBT to be a bit on the stale side, but for whatever reason I found the actual suicide ideation assessment work to be way more interesting. I'm actually a PTSD oriented applicant applying to quite a few PE labs, but I work on a suicide prevention study ... with a PTSD VA section chief (or whatever the team lead I called, I forget).

But @WisNeuro is correct in that I should take all the training I should get, should I be lucky enough to get an acceptance somewhere this cycle.

 

[Ollie123]

Agree with the above. It is certainly possible to "specialize" in suicide risk assessment, but any grad program that let you "only" do one thing is failing horribly. If that was all you did, you would be virtually unemployable in a clinical role afterwards - even the busiest Psych ED in the country wouldn't need a dedicated "suicide risk assessment" person who is never asked to do anything else. It is a bit too niche and something that is more typically done in the context of a broader intervention or assessment. Often it comes up in the course of doing other things and needs to be evaluated imminently so it isn't exactly something you can sit on nor is it worth paying a dedicated specialist to just sit around waiting for someone to endorse suicidality and come do a 20-min eval and then go back to sitting around.

Not trying to discourage you from focusing on that. Just saying it is both unrealistic and unwise to have that be your one-and-only trick.

 

[WisNeuro]

Agree with the above. It is certainly possible to "specialize" in suicide risk assessment, but any grad program that let you "only" do one thing is failing horribly. If that was all you did, you would be virtually unemployable in a clinical role afterwards - even the busiest Psych ED in the country wouldn't need a dedicated "suicide risk assessment" person who is never asked to do anything else. It is a bit too niche and something that is more typically done in the context of a broader intervention or assessment. Often it comes up in the course of doing other things and needs to be evaluated imminently so it isn't exactly something you can sit on nor is it worth paying a dedicated specialist to just sit around waiting for someone to endorse suicidality and come do a 20-min eval and then go back to sitting around.

Not trying to discourage you from focusing on that. Just saying it is both unrealistic and unwise to have that be your one-and-only trick.

I have never seen a psychologist doing this in any of the hospital EDs that I have worked at. In reviewing notes, it was almost always a social worker, and occasionally a psychiatrist. Not saying we can't/don't do this, I just haven't seen it enough to make this a viable career path as a majority of your work, clinically.

 

[smalltownpsych]

I love DBT, but would hate running a DBT skills group. 😁 I prefer helping the patients integrate and connect the skills into their everyday life. Also, an assessment is goint to be dependent to an extent on developing rapport and good therapy training helps with that. I am sure you will find some aspects of therapy appealing and beneficial and some less so. Before is started my doctoral program someone asked me what I wanted to do and part of my answer was anything but kids and especially not adolescents. Fast forward a few years and that is a big part of my area of expertise. Also, there isn’t really any aspect of my doctoral training that hasn’t helped in my work as a psychologist even when they are very far from what I typically do.

 

[cara susanna]

Yeah, DBT is not just running skills group. The individual therapy is IMO by no means stale. I would also caution you to consider the difference between DBT as you might have seen it in your VA vs. as it's meant to be, in a full model program.

There is definitely a need for PTSD specialists who also understand how to manage and properly assess for suicidality.