Becoming a Neuropsychologist (Brain Injury)

[hopefullyneuro]

I'll try to make this as quick to the point as possible. I had a few brain injuries while on active duty. I went to a brain rehabilitation facility and it completely changed my life. The neuropsychologist was amazing and I found out it founded by a neuropsychologist as well. They told me they love having past patients work and intern there. Fast forward to today, I make 95k in a job I hate, I want to go back to school but literally have maybe a semester of classes done.

My main question is after reading a lot of the stories on here, I'm a little wary of not making it into a program after 6 years. I kinda nervous even with my gi bill to go through schooling and then not getting into a program. I really want to go into the cognitive side. Any advice or other paths?

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[borne_before]

I don't have any specific advice, but I'm rooting for you!

 

[summerbabe]

I'm not a neuropsychologist but this is the most difficult specialty within clinical psychology. If you only have a handful of undergrad credits, you're likely looking at a minimum of 11 years of education/formal training before you're practicing independently as a neuropsychologist and that's if things go according to plan.

You'll need to complete your bachelors and gain psychology research experience which includes contributing to articles to peer reviewed journals and posters at professional conferences. While in undergrad, you'll also need to find an active lab in your psych dept that is productive and can provide you with the right mentoring. Some people may need postbac experiences to round out their CV before being competitive for doctoral admissions.

Then you're looking at a minimum of 4 years in a doctoral program (not unheard of for people to do 5 years to be competitive for neuro) + 1 year required predoctoral internship that will provide enough neuropsych experience --> required 2 year neuropsychology postdoc --> licensure and board certification. Additionally, the research productivity requirement will be higher than the typical PhD or PsyD so expect to be quite busy.

Outside of psychology, you could look into occupational therapy which requires a masters degree. OT covers a lot of ground but you can definitely work with patients with brain injury, stroke, and other related conditions.

Your GI bill is a huge asset and anything in healthcare is gonna require you to use that advantageously if you think a change in career is fit. Good luck!

 

[PsyDr]

Must be a hell of a rehab program....

 

[Sanman]

As with others, I assume you mean 1 semester of undergrad is complete? @summerbabe did a good job explaining the process. The question then becomes after over 10 years of schooling and licensing exams are you okay with making the same $95k again to start? This is ballpark (maybe less or maybe more) that you will start at if you work for a VA hospital or similar.

 

[hopefullyneuro]

T

I'm not a neuropsychologist but this is the most difficult specialty within clinical psychology. If you only have a handful of undergrad credits, you're likely looking at a minimum of 11 years of education/formal training before you're practicing independently as a neuropsychologist and that's if things go according to plan.

You'll need to complete your bachelors and gain psychology research experience which includes contributing to articles to peer reviewed journals and posters at professional conferences. While in undergrad, you'll also need to find an active lab in your psych dept that is productive and can provide you with the right mentoring. Some people may need postbac experiences to round out their CV before being competitive for doctoral admissions.

Then you're looking at a minimum of 4 years in a doctoral program (not unheard of for people to do 5 years to be competitive for neuro) + 1 year required predoctoral internship that will provide enough neuropsych experience --> required 2 year neuropsychology postdoc --> licensure and board certification. Additionally, the research productivity requirement will be higher than the typical PhD or PsyD so expect to be quite busy.

Outside of psychology, you could look into occupational therapy which requires a masters degree. OT covers a lot of ground but you can definitely work with patients with brain injury, stroke, and other related conditions.

Your GI bill is a huge asset and anything in healthcare is gonna require you to use that advantageously if you think a change in career is fit. Good luck!

Thank you. I should've prefaced that I'm 26. I appreciate your response and it's very helpful. The thing that worried me not being competitive enough or a PsyD or PhD program.

 

[hopefullyneuro]

Must be a hell of a rehab program....

Life-changing. I was told I wasn't going to get better and my symptoms were permanent.

 

[PsyDr]

Life-changing. I was told I wasn't going to get better and my symptoms were permanent.

That’s not what I meant.

I don’t know about your situation. But I’ll tell you that the field generally recognizes that mild traumatic brain injuries have no neuropsychological effect. It was this whole thing between 1996-2016.

But moderate -severe TBIs create rather bad impairments in cognition. Like bad enough to make grad school an impossibility

Then there was this entire literature base where we saw that cognitive rehabilitation doesn’t work, luminosity got sued for it, and the textbooks had to be revised. What did work for people complaining about symptoms following a mild traumatic brain injury, was cognitive behavioral therapy. Oh, and lying to people and putting them in a fake hyperbaric chamber... that caused people to say they felt all better.

Again, I don’t know your situation. But I wouldn’t want a cognitively impaired student and I wouldn’t want a student who wanted to give non validated treatments.

 

[hopefullyneuro]

That’s not what I meant.

I don’t know about your situation. But I’ll tell you that the field generally recognizes that mild traumatic brain injuries have no neuropsychological effect. It was this whole thing between 1996-2016.

But moderate -severe TBIs create rather bad impairments in cognition. Like bad enough to make grad school an impossibility

Then there was this entire literature base where we saw that cognitive rehabilitation doesn’t work, luminosity got sued for it, and the textbooks had to be revised. What did work for people complaining about symptoms following a mild traumatic brain injury, was cognitive behavioral therapy. Oh, and lying to people and putting them in a fake hyperbaric chamber... that caused people to say they felt all better.

Again, I don’t know your situation. But I wouldn’t want a cognitively impaired student and I wouldn’t want a student who wanted to give non validated treatments.

I have post-concussion syndrome. I had multiple concussions in a short amount of time. I never said luminosity-type therapies worked. I can tell you already have a strong opinion about the subject before I even explained what I went through, do you actually want me to tell you what kind of therapies I had?

 

[AbnormalPsych]

I have post-concussion syndrome. I had multiple concussions in a short amount of time. I never said luminosity-type therapies worked. I can tell you already have a strong opinion about the subject before I even explained what I went through, do you actually want me to tell you what kind of therapies I had?

Thank you for your service.

To jump in, some here specialize in this stuff. Although I am not one of them right now, I do know a bit about this. I would recommend re-reading the prior messages. There is important stuff there. Some folks we work with do not want to hear it... but it is based in science.

And perhaps, a suggestion given your interest in the field and this area to look more into the MTBI literature and also why PCS isn't really a thing anymore.

Curious too, what 'therapies' did you have?

 

[WisNeuro]

Thank you for your service.

To jump in, some here specialize in this stuff. Although I am not one of them right now, I do know a bit about this. I would recommend re-reading the prior messages. There is important stuff there. Some folks we work with do not want to hear it... but it is based in science.

And perhaps, a suggestion given your interest in the field and this area to look more into the MTBI literature and also why PCS isn't really a thing anymore.

Curious too, what 'therapies' did you have?

Well, it's still kind of very much a thing. It's just that at present it would be more accurately named "Iatrogenic Damage Syndrome." IDS for short. I'm trademarking it. IDS risk factors include exposure to OT providers, Amen Clinics, and most "concussion" clinics in the US. The usual treatment regimen is SSDI or civil litigation. Thus far these treatments do nothing to alleviate symptoms or increase QOL for the patient, but do increase the wealth of trial lawyers and people like me who generally work for the defense.

 

[PsyDr]

I have post-concussion syndrome. I had multiple concussions in a short amount of time. I never said luminosity-type therapies worked. I can tell you already have a strong opinion about the subject before I even explained what I went through, do you actually want me to tell you what kind of therapies I had?

Absolutely, but I doubt it will do anything to advance anything to do with your original question

 

[psych.meout]

That’s not what I meant.

I don’t know about your situation. But I’ll tell you that the field generally recognizes that mild traumatic brain injuries have no neuropsychological effect. It was this whole thing between 1996-2016.

But moderate -severe TBIs create rather bad impairments in cognition. Like bad enough to make grad school an impossibility

Then there was this entire literature base where we saw that cognitive rehabilitation doesn’t work, luminosity got sued for it, and the textbooks had to be revised. What did work for people complaining about symptoms following a mild traumatic brain injury, was cognitive behavioral therapy. Oh, and lying to people and putting them in a fake hyperbaric chamber... that caused people to say they felt all better.

Again, I don’t know your situation. But I wouldn’t want a cognitively impaired student and I wouldn’t want a student who wanted to give non validated treatments.

But isn't that the point? These kinds of places are like MLM or Scientology. They want people who drank the Kool Aide, because then they'll be more enthusiastic about selling it to others an won't question the effectiveness or underlying assumptions, even when confronted with data.

 

[DynamicDidactic]

I'll try to make this as quick to the point as possible. I had a few brain injuries while on active duty. I went to a brain rehabilitation facility and it completely changed my life. The neuropsychologist was amazing and I found out it founded by a neuropsychologist as well. They told me they love having past patients work and intern there. Fast forward to today, I make 95k in a job I hate, I want to go back to school but literally have maybe a semester of classes done.

My main question is after reading a lot of the stories on here, I'm a little wary of not making it into a program after 6 years. I kinda nervous even with my gi bill to go through schooling and then not getting into a program. I really want to go into the cognitive side. Any advice or other paths?

Hey there, this is a great example of putting-the-cart-before-the-horse syndrome. Before you get all caught up in getting in a doctoral program, you should first start by going back to college. Find a solid local university that provides some evening classes (most state universities will have a variety of times that classes are scheduled). Take a class or two next fall (make sure that Intro Psych is one of those classes). See how it is to be back in the higher ed world (readings, assignments, exams, leaning new information, being exposed to novel ideas, being challenged on your prior beliefs). If you like your first semester than do it again in the second semester. If you actually do well and like taking Psych and science courses (you will definitely need to get the intro bio and eventually more advanced neuro-related courses) then come back in a year and ask us whether you should committee to full time study.

Being 26 is not too late for a career change but it is more important that you make an informed decision. Don't worry about getting into a doctoral program before you even take undergrad courses.

Some advice:
1. A GI bill is catnip to predatory universities, be careful. If you need assistance finding a good local school, feel free to ask here (we just need to know your general geographic area and we can tell you if it is a crap school).
2. I highly recommend taking in-person classes. Getting into grad school involves more than getting good grades. It is best to get to know your faculty and your campus to later find the necessary research and other supplemental experiences that will help you in the future (another reason to stay away from crappy or predatory schools). You can start with online classes (from a good school) but eventually it would benefit you to go in-person.
3. As you learn psychology, start recognizing the difference between what you hear out in the world and even your own personal experiences with how a psychologists would study that phenomenon scientifically to understand what is truly happening.

 

[deleted75966]

That’s not what I meant.

I don’t know about your situation. But I’ll tell you that the field generally recognizes that mild traumatic brain injuries have no neuropsychological effect. It was this whole thing between 1996-2016.

But moderate -severe TBIs create rather bad impairments in cognition. Like bad enough to make grad school an impossibility

Then there was this entire literature base where we saw that cognitive rehabilitation doesn’t work, luminosity got sued for it, and the textbooks had to be revised. What did work for people complaining about symptoms following a mild traumatic brain injury, was cognitive behavioral therapy. Oh, and lying to people and putting them in a fake hyperbaric chamber... that caused people to say they felt all better.

Again, I don’t know your situation. But I wouldn’t want a cognitively impaired student and I wouldn’t want a student who wanted to give non validated treatments.

Moderate to severe TBIs CAN be bad enough to make grad school an impossibility. But, they do not do so for everyone. Variability. Certainly possible.

Repetitive concussions are potentially an issue long term and there is such a thing as a complicated mTBI.

 

[futureapppsy2]

I personally know some successful psychologists with (non-mild) TBI, and per this new TEPP article (Lund, E. M. (2021). We must do better: Trends in disability representation among pre-doctoral internship applicants. Training and Education in Professional Psychology. Advance online publication. https://doi.org/10.1037/tep0000361), there are an average of 9 internship applicants who self-report cognitive disabilities each year. Also, I have a pretty severe congenital brain injury myself--I certainly think I deserve to be in the field, ngl.

 

[PsyDr]

But isn't that the point? These kinds of places are like MLM or Scientology. They want people who drank the Kool Aide, because then they'll be more enthusiastic about selling it to others an won't question the effectiveness or underlying assumptions, even when confronted with data.

I'd buy that line of reasoning for psychoanalysis. Not so much this stuff.

Also, I have a pretty severe congenital brain injury myself--I certainly think I deserve to be in the field, ngl.

Not possible. Either it's congenital or it's an injury. Not that it matters, as kennards principle would suggest early injuries produce less severe cognitive effects and self report of cognitive impairment is an unreliable metric.

 

[borne_before]

Not possible. Either it's congenital or it's an injury. Not that it matters, as kennards principle would suggest early injuries produce less severe cognitive effects and self report of cognitive impairment is an unreliable metric.

Imagine lecturing someone about their experiences. You’re kind of being a dick, dude. You burnt out?

 

[futureapppsy2]

I'd buy that line of reasoning for psychoanalysis. Not so much this stuff.


Not possible. Either it's congenital or it's an injury. Not that it matters, as kennards principle would suggest early injuries produce less severe cognitive effects and self report of cognitive impairment is an unreliable metric.

I guarantee you my brain damage is severe (and imaging-confirmed) and noticeable and causes significant disability. I’m also a successful researcher, professor, and clinician. Disability, even brain damage, is not universally incompatible with that in and of itself.

 

[boba_psych]

Not possible. Either it's congenital or it's an injury. Not that it matters, as kennards principle would suggest early injuries produce less severe cognitive effects and self report of cognitive impairment is an unreliable metric.

Kennard's work applies to motor recovery after early injuries (she did ablations in premotor and motor areas in young primates). Different patterns are found in respect to cognition. Generally, earlier injuries are actually associated with poorer cognition (though I'm hesitant to even make this statement). But of course we know not to make blanket statements about early injury and cognition as there are too many factors at play (like when an injury occurs relative to sensitive and critical periods in development).

Edit: if you have a perinatal stroke is that not considered both congenital and an injury? Wouldn't it be both?

 

[ExecutiveDysfunction]

Kennard's work applies to motor recovery after early injuries (she did ablations in premotor and motor areas in young primates). Different patterns are found in respect to cognition. Generally, earlier injuries are actually associated with poorer cognition (though I'm hesitant to even make this statement). But of course we know not to make blanket statements about early injury and cognition as there are too many factors at play (like when an injury occurs relative to sensitive and critical periods in development).

Edit: if you have a perinatal stroke is that not considered both congenital and an injury? Wouldn't it be both?

Not to derail the thread too much, but that’s my read of the literature as well. Some small focal lesions within the first year can be relatively benign and well-compensated. But in general, lesions sustained in the early years are much riskier to development than those sustained later.

 

[WisNeuro]

Kennard's work applies to motor recovery after early injuries (she did ablations in premotor and motor areas in young primates). Different patterns are found in respect to cognition. Generally, earlier injuries are actually associated with poorer cognition (though I'm hesitant to even make this statement). But of course we know not to make blanket statements about early injury and cognition as there are too many factors at play (like when an injury occurs relative to sensitive and critical periods in development).

Edit: if you have a perinatal stroke is that not considered both congenital and an injury? Wouldn't it be both?

It's not quite this simple. Highly dependent on severity, type/etiology of injury, and some post-injury factors. Also some interesting data on injury in critical period. In short, sometimes its better to have the issue earlier, when reorganization and plasticity can play a bigger role, and sometimes later is better, say in visual development.

 

[futureapppsy2]

Kennard's work applies to motor recovery after early injuries (she did ablations in premotor and motor areas in young primates). Different patterns are found in respect to cognition. Generally, earlier injuries are actually associated with poorer cognition (though I'm hesitant to even make this statement). But of course we know not to make blanket statements about early injury and cognition as there are too many factors at play (like when an injury occurs relative to sensitive and critical periods in development).

Edit: if you have a perinatal stroke is that not considered both congenital and an injury? Wouldn't it be both?

There’s also the issue of not always being able to tell in premature infants to what extent neurological damage occurred prenatally vs. perinatally/postnatally (e.g., in the NICU).

 

[mdwpsyd]

@hopefullyneuro - I also appreciate you risking your life for the rest of us by serving in our armed forces. (I am making an assumption that you served in the U.S. military. If I'm wrong, please correct me.)

Please disregard the petty sniping, members hijacking your thread to advance their own agendas, and the 60% of responses that have nothing to do with your question. I don't understand why SDN has moderators if they sit idly by—or even participate in—such falderal.

Although I perceived @DynamicDidactic 's tone to be at times patronizing, I think he/she/they gave you generally smart, good advice.

There are many professions and jobs where you could help people with neurocognitive disorders.

If you do enroll in a university, I highly recommend vocational assessment and counseling. Many college counseling centers provide such services for free, although you might want to also see a well-regarded counseling psychologist who understands veterans' needs and strengths, even if you have to pay for their expertise.

I wish you all the very best,

Mark

P.S. Counseling psychologists receive more education and training in vocational assessment and therapy than clinical psychologists, and they do most of the research in the area. I completed vocational assessments and met with counseling psychologists three times over the years—undergrad, grad school, and after I was a licensed psychologist in private practice. I am very grateful that I learned the value of such help early on, as each time the assessment results and counseling I received proved immensely beneficial.

Edit note: I added text and removed a word, upon reflection. See below.

​

 

[DynamicDidactic]

Although DynamicDidactic's tone was at times patronizing, I think he/she/they gave you generally good advice.

Understandably, online posts lose a lot of detail in comparison to face to face, and often reading something allows people to add in their own interpretations but I would love feedback on what was patronizing about my tone?

Similarly, I wonder if the OP also thought that.

 

[mdwpsyd]

@DynamicDidactic - I agree, and I apologize for assuming that your post was "patronizing", when (a) that was probably not your intention, and (b) the OP (and others) might not have perceived your words in that way. Plus, you did give smart, helpful advice.

The parts that contributed to my impression were:

• this is a great example of putting-the-cart-before-the-horse syndrome
• Before you get all caught up in ...
• If you actually do well - "since you might not do well, you dolt" was the unsaid part I read into that phrasing
• then come back in a year and ask us - "because you are so woefully premature currently" was the implied message I heard.

Thank you,

Mark

 

[DynamicDidactic]

@DynamicDidactic - I agree, and I apologize for assuming that your post was "patronizing", when (a) that was probably not your intention, and (b) the OP (and others) might not have perceived your words in that way. Plus, you did give smart, helpful advice.

The parts that contributed to my impression were:

• this is a great example of putting-the-cart-before-the-horse syndrome
• Before you get all caught up in ...
• If you actually do well - "since you might not do well, you dolt" was the unsaid part I read into that phrasing
• then come back in a year and ask us - "because you are so woefully premature currently" was the implied message I heard.

Thank you,

Mark

Appreciate the feedback. Though I love my "putting-the-cart-before-the-horse syndrome" idea but I can let it die.

 

[psych.meout]

@DynamicDidactic - I agree, and I apologize for assuming that your post was "patronizing", when (a) that was probably not your intention, and (b) the OP (and others) might not have perceived your words in that way. Plus, you did give smart, helpful advice.

The parts that contributed to my impression were:

• this is a great example of putting-the-cart-before-the-horse syndrome
• Before you get all caught up in ...
• If you actually do well - "since you might not do well, you dolt" was the unsaid part I read into that phrasing
• then come back in a year and ask us - "because you are so woefully premature currently" was the implied message I heard.

Thank you,

Mark

Seems like quite a bit of that if you "reading into" what they wrote instead of taking it at face value.

 

[PsyDr]

I guarantee you my brain damage is severe (and imaging-confirmed) and noticeable and causes significant disability. I’m also a successful researcher, professor, and clinician. Disability, even brain damage, is not universally incompatible with that in and of itself.

I’m sure you recognize that the terms congenital and injury are mutually exclusive. And I’m sure you recognize that injury and effects are two wholly different things. And I’m sure that you recognize the known literature about the effect sizes of brain injuries, the correlation between effect sizes and OTBM, the correlation between g and GRE scores, and the overall need for a relative high cognitive reserve in order to perform at the highest levels.

And I’m sure you know the exact diagnostic criteria for PCs, which excludes cognitive impairment.

 

[futureapppsy2]

OP, I agree with @DynamicDidactic 's advice to take this one step at a time--that's good advice for anyone. I've known plenty of people, for example, who thought they wouldn't like research, did it, and loved, or who thought that they wanted their clinical work to focus on kids, did one child clinical practicum, and hated it. And that's fine... it's why getting experience is so important throughout your education and training. Also, have you been involved with VA VR&E at all?

 

[mdwpsyd]

Seems like quite a bit of that if you "reading into" what they wrote instead of taking it at face value.

1. I apologized.
2. I said that patronizing was "probably not your intention".
3. I acknowledged that "the OP (and others) might not have perceived your words in that way".
4. I took responsibility for "my impression",^α including that I may have read meaning into a statement.

What more would you have me do?

- Mark

Footnote
α. Webster's Third New International Dictionary of the English Language, Unabridged, ed. Philip B. Gove (Springfield, MA: G. & C. Merriam, 1961; Merriam-Webster, 1993; periodically updated as Merriam-Webster Unabridged), s.v. "impression" ("impression noun ... 7 : a usually indistinct or imprecise notion, remembrance, belief, or opinion ....").