Are There Neuropsychologists Who Also Do Therapy?

[Chris0721]

I'm in a bit of a dilemma as to what direction I want to take my future career. I'm a first year clinical psychology doctoral student. I also have a master's degree in family and marriage/Christian counseling. My conflict is trying to decide which direction I want to go towards with my career in the future.

I'm genuinely interested in neuropsychology. I think neuropsychology is a really fascinating field, and I could definitely see myself enjoying a job where I’m testing clients. On the other hand, I love doing traditional psycho/behavioral therapy with my clients. I don't think I would be very happy in a neuropsychology position where I couldn't do some type of therapy in treating my clients with their emotional and personal struggles in life. I know that finding a pre-doctoral internship or post-doctoral fellowship in neuropsychology where you could do therapy with your clients is very hard to come by. That’s not what I’m concerned about here. That time only lasts a few years. I’m talking about my career after my fellowship has ended and I’m out in the field.

For me finding a job where I’m truly happy is the number one concern in my mind. Even though I know most neuropsychologists make good money, the money is very much a secondary concern for me. I’ve been told by more then a few people that I’m a talented therapist who does an excellent job with my clients. I’ve also been told by others that I have real potential as a future clinical psychologist in therapy. If I go towards the direction of neuropsychology in my studies, I really want to be able to use the talent that God has given me as a therapist in some capacity. Does anybody have information about neuropsychologists who do both testing and more traditional types of therapy with their clients?

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[erg923]

Yes, neuropsychologists can and do do therpay. Certainly not as much as other psychologists however. It just depends on what environment you are working in. Those working in academic medical center/hospital clinics will probably have few if any clients they see on an ongoing basis for interventions. Many don't do any therpay or interventions at all. However, if you are working in rehab hospital, many neuropychologists have duties that include formal diagnostic evaluations, but also see clients on a regular basis for psychotherpay, or cognitive rehab therapies. More and more neuropychologists at VA medical centers (due to the influx from Iraq and Afghanistan) are also seeing and providing counseling services in addition to formal evaluations. Additionally, unless you are working in a private practice, the type of therapy one does within neuropsychology is often different from alot of other psychologists. For example, cognitive rehab therapies, insight and feedback counseling sessions, and brief CBT and rehab type interventions. You should be aware however, that the 2 year post-doc in neuro will consist of very little if any therapy opportunities. Possibly experience with cognitive rehab and feedback sessions after evals, but most places will not have you carrying a caseload of ongoing therapy patients.

 

[PsyDr]

while i agree that neuropsych is fascinating, i would not base our carreer on somethign that interests you rather than what you enjoy. i would recommend the same for anything (e.g., while serial killers are interesting, 99.99999% of forensics is with ordinary criminals, which would be a bummer). if you are truly interested in the field, take a practicuum and see if you enjoy the day to day aspects of the job.

i would also caution you that neuropsychs have a reputation as much less warm and fuzzy than the majority of psychologists, which many therapists have a hard time with.

that being said, if you are happy with being a therapist, i'd say do that. if you love dealing with dementia patients all day and can handle the lack of warm and fuzzies, do that. if you love writing academic papers and can handle that lifestyle, do that. do whatever you actually enjoy. don't get hung up on the other stuff.

i also would like to state that there are ample opportunities to be financially succesful in many specialities in psychology. neuropsychs have a reputation as the ones that make the money, but there are others that make more. i see no reason why a therapist with good business sense cannot make more than your average neuropsych. i know several.

 

[paramour]

Yes, they can do both but most of the ones I know only do assessments. One prof I know advised that assessment in itself can be highly rewarding (for reasons other than financial) but it can also be extremely stressful and people tend to eventually burn out. One of his disappointments was that most of his assessments came from referrals where only the assessment was needed in order for some program, disability, or other type of placement, or simply to confirm or rule-out something for a medical doctor. If there was nothing wrong, then they didn't need to see him again. If there was something wrong, they were usually being treated further by the referring physician or placed in a program of some type where the treatment was built in already, so his services typically were not needed beyond the assessment. Buuut, as they say, n = 1.

 

[Therapist4Chnge]

Yes, though they seem to be in the minority. Three of my clinical supervisors were neuro (though I wasn't officially a neuro person, go figure), and though they all have done therapy in the past....none do it regularly now. As long as you get decent training during your schooling and internship, I don't see why you couldn't do therapy and neuro.

 

[Neuro-Dr]

I would echo PSYDR's comments. It is a little sad how little outpatient therapy seems to be valued within my field. I also think the pay and climate are such that most of us lose money by doing it. Still, no one is going to tell you what to do. Many of my patients need therapy even if it is more family or psychoeducational and I just hired a therapist at the neurology clinic to do it. You certianly could do your own. If you look at the practice survey from 2003 in Archives of Clinical Neuropsychology (Sweet et al.) you can see the practice breakdown. I

 

[MissSPSS]

I was facing the same dilemma as the original poster- I'm applying for internships in the fall hopefully, and I wasn't sure if I should focus on placements that would look great for a neuro-psych post doc, which means lots of testing. I am applying for my final externship in therapy-track sites, more for personal gain, but I know I want to do assessments career-wise, so I'll definitely pick my internship to reflect that.

 

[AcronymAllergy]

I was facing the same dilemma as the original poster- I'm applying for internships in the fall hopefully, and I wasn't sure if I should focus on placements that would look great for a neuro-psych post doc, which means lots of testing. I am applying for my final externship in therapy-track sites, more for personal gain, but I know I want to do assessments career-wise, so I'll definitely pick my internship to reflect that.

Honestly, I've heard from quite a few places that if your neuropsych experiences at the doctoral level are solid, then it could be advantageous (or, at the least, likely wouldn't hurt you) to have a more generalist internship. The neuropsych-focused internships are especially great for helping those who decided on neuropsych late in their grad school careers play "catch up," but they aren't a necessity for securing a post-doc.

Don't get me wrong, they can certainly help, and at the very least you'll want SOME neuropsych during your internship. However, I'd imagine that you could easily justify a less neuro-intensive year (again, assuming you had solid neuro experience coming in) in favor of shoring up some of your other areas of weakness. Remember, even if we never end up doing therapy in our professional careers, we're still clinical psychologists, and thus should have solid training in therapeutic theory and practice.

One of the big advantages to attending a neuropsych-focused internship is that the programs often also have on-site post-docs. Thus, that can definitely give you an advantage come time to apply for fellowships. Then again, there are also some great generalist-type programs that have on-site neuro post-docs.

 

[stigmata]

Remember there is no neuropsychologist license. All NP are licensed clinical psychologists first, and then sub-specialize.

 

[Jegg]

i would recommend the same for anything (e.g., while serial killers are interesting, 99.99999% of forensics is with ordinary criminals, which would be a bummer).

Hey now, maybe it is a bummer for you, but not for us folks who enjoy malingering research...

 

[Therapist4Chnge]

I still have a hard time wrapping my head around a neuropsychologist who does therapy...but they are out there. The "psychologist first, neuropsychologist second" is a very salient point. I have to do a bit of follow-up with my patients that can involve brief supportive therapy (continuity of care req), but that is definitely not common and not the preference of the vast majority of neuropsychologists out there. You can do it, but it will impact your bottom line.

 

[Existenz]

Within a rehab setting you will the two nicely meshed.