Breadth or depth in clinical training?

[RayneeDeigh]

Advertisement - Members don't see this ad

So I'm going into second year and we have to rank our top 3 practicum site choices by Friday.

I spent my summer in a clerkship where I was in a correctional/remand facility for young offenders halftime, and assessing neurodevelopmentally challenged children halftime. I have absolutely no interest in doing the latter as a career but the former is my ultimate career goal.

Now that I'm faced with this long list of sites, I'm wondering what my strategy should be. I've ranked a residential addictions treatment centre for adults and youths as #1 because I think it would provide complementary training to my current interests. As for #2 and #3 I'm undecided. The choices that interest me include:

A young offender team
Two different units at a federal correctional facility (adult sex offenders or adult violent non-sex-offenders)
Clinical Psych Services in the Catholic School division (I'm not even Christian but I've heard great things about this placement and think it might be fun to stretch my comfort zone)

I'm assuming the young offender team would likely be redundant since I did it all summer, but would working with adult offenders be overkill as well? I want to be a competitive applicant for internship when that time comes around but I'm not sure whether it's better to have in-depth exposure to a particular population, or a bunch of different experiences. There are other options like very young children, chronic pain centres, and geriatrics, but those just don't interest me as much. Do I need to make an effort to do at least one of those before internship?

PS - as an aside for anyone who followed my nightmare last year, I am pleased to report that I came back to my new apartment on Sunday and it is still beautiful and bug-free and wonderful. It seems that this year will be great as long as I can pick my top 3 damn practicum sites! 😀

 

[erg923]

Optimally, you need both breadth and depth in your clinical training. However, the specifics depend on the types of places you will apply to for match. For example, Neuropsych people need about as much neuropsych prac as we can get, but, can you imagine how it would look if I went to match without any experiences with psychotherapy or working with your garden variety counseling center disorders (eg., depression, anxiety, etc.)? You should be well rounded (breadth) by the time you go for match, but, you should also have more hours (depth) with the particular pop or specialty you are wanting to specialize in.

Overall, I would say try to get rounded, at least on the surface. Maybe get some adults with some garden variety disorders, or maybe kids in a nonforensic setting......then go back to kids and offenders for your next 2 prac placements.

 

[PsyDr]

i would go with the adult sex offender practicuum for the following reasons:

- there is HUGE $$$$ in SO treatment
-recent developments in CA make SO treatment very interesting
-CA is desperate for SO tx providers, offering close to 6 figures for post docs.

 

[JockNerd]

I've heard some pretty impressive psych people independently mention the difference between "model" people and "problem" people. Model people learn some model (psychodynamic, CBT, whatever) and then that's their hammer with which they hit every nail. Problem people learn as much as possible about one area, then hit those nails in a million different ways using varied approaches. Problem people seem to me to be better off finanically, and much happier.

So, I'd say as long as the forensic site isn't more of the *exact* same, continue on that route! Esp. since you love it, and, as PSYDR mentioned, CA (where, as I recall, you want to end up) wants them.

I'm excited for my SVP prac, hopefully next year.

 

[Therapist4Chnge]

It depends what you want to do for internship/post-doc/practice. You definitely need "some" experience if you want to be competitive for an internship in that area.....but spending a few years in one area (say adult sex offenders), means you may not get basic exposure to other populations....which can really limit your options for internship/post-doc, etc.

 

[kyril]

It depends what you want to do for internship/post-doc/practice. You definitely need "some" experience if you want to be competitive for an internship in that area.....but spending a few years in one area (say adult sex offenders), means you may not get basic exposure to other populations....which can really limit your options for internship/post-doc, etc.

I am wondering about this; due to the way things have worked out, i will end up having 4 health-related clinical expereinces (1 VA, 1 Major Med center, 1 community MH but part of a health-sub clinic, and 1 Oncology). I've worked with the worried well and the actively psychotic, and for many of my individual therapy pts the medical illness brought them into therapy but we are talking about longstanding interpersonal issues, the same as at any other site. some are very health focused, although even then i use the same basic techniques to adress contamination phobia in a general outpt as i do when the pt is presenting because they are struggling to recieve an infusion due to the same phobia. i have also done scads of behavioral-health groups (to support behavior change) as well as more therapy-oriented groups. my pts ranged in age from 23 to 88 and were are very diveres ethnic/cultural/ses groups. I am concerend thought that i will have problems when i apply to internship as most of my pts had or have a medical illness. i do want a medical psych career, my masters/diss are health-focused, and intend to apply only to sites with at least a health track. any thoughts about what i can do at this stage (i am a 3rd yr).