PhD/PsyD Can I be a neuropsychologist and a therapist at the same time?

[ejr149]

Hello everyone!

I'm about to graduate with a bachelors degree in chemistry and psychology and I'm in the process of deciding what exactly to go to graduate school for. I'm a little stuck making this decision because I feel like I have two sides to myself. On the one hand, I love science and I find neuroscience/neuropsychology fascinating. The human brain is incredible and I'd love to learn all about how it functions and why we experience the world the way we do. On the other hand, I also love working directly with people and helping them in a very humanistic way. I think I have a fairly natural talent for making people feel safe and I think it's incredibly interesting to break down why people think and do the things they do.

For these reasons, I'm confused. I could be a neuropsychologist (sticking to the more scientific side of myself), which might be a more intellectually stimulating and interesting career but not as humanistic (I wouldn't have long term clients). I could also be a therapist (sticking to the more humanistic side of myself), which might be more emotionally fulfilling but potentially not as scientifically interesting.

First, do you guys have thoughts on my evaluations of these two careers? Are they accurate?

Second, would it be possible for me to conduct both neuropsychological assessments and therapy (perhaps one two days a week and the other three days a week)? What kind of education would be necessary for this kind of a career?

Thanks for any thoughts and input!!

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[Ollie123]

Look into rehab psych, might be a reasonable blend.

Not clear if you want to actually "do" science or just view neuro as more scientific (its not, just different methods/topics). It is perfectly plausible to be a therapist whose research focuses on brain mechanisms, if that helps.

 

[AcronymAllergy]

Short answer: yes.

I second what Ollie said: you're likely to get more time in your schedule for therapy and therapy-type activities in rehab-centric settings.

Neuropsychologists are psychologists first, and if you have an interest in therapy, you can make a concerted effort to get more training in it than the typical neuropsych trainee does. At the same time, aspects of your practice will be dictated by your employer (unless you work for yourself). When looking for jobs, you would want to be sure to negotiate for allotted/reserved time to provide therapy. Although keep in mind that with most hospitals, the majority of your time will be budgeted for neuropsych.

I also second what Ollie said that neuropsychology isn't inherently more scientific than (most) other aspects of psychology, it's just different. There are often more numbers involved in day-to-day practice, but that doesn't make it more scientific. Therapy is based on science, after all, and psychologists conduct research just the same as neuropsychologists. You may get more biological sciences-heavy courses in your training, though, if that's perhaps what you were thinking.

 

[pediatric_psydoc]

Short answer: yes.

I second what Ollie said: you're likely to get more time in your schedule for therapy and therapy-type activities in rehab-centric settings.

Neuropsychologists are psychologists first, and if you have an interest in therapy, you can make a concerted effort to get more training in it than the typical neuropsych trainee does. At the same time, aspects of your practice will be dictated by your employer (unless you work for yourself). When looking for jobs, you would want to be sure to negotiate for allotted/reserved time to provide therapy. Although keep in mind that with most hospitals, the majority of your time will be budgeted for neuropsych.

I also second what Ollie said that neuropsychology isn't inherently more scientific than (most) other aspects of psychology, it's just different. There are often more numbers involved in day-to-day practice, but that doesn't make it more scientific. Therapy is based on science, after all, and psychologists conduct research just the same as neuropsychologists. You may get more biological sciences-heavy courses in your training, though, if that's perhaps what you were thinking.

I’m glad you pointed out that therapy is based on science. I think sometimes psychologists get a reputation for going rogue and not basing therapeutic interventions on evidence, but I think that stems from the “eclectic” folks out there...

 

[Sanman]

Agreed with the others for the most part. Something to think about, how much do you like writing papers? Neuropsych involves a good deal more writing than therapy based positions, imo.

 

[AcronymAllergy]

Agreed with the others for the most part. Something to think about, how much do you like writing papers? Neuropsych involves a good deal more writing than therapy based positions, imo.

Also a good point. If you dislike writing, I probably wouldn't opt for a career in neuropsych.

 

[Therapist4Chnge]

It is *a ton* of writing and documentation review. I joke w. patients that I'm a professional homework do'er bc I get to review what everyone else has done, do my piece, and then write a long report.

As for providing treatment... which includes therapy...it's possible, but it can take multiple forms. In my current private practice i'm 90% assessment and 10% treatment. I have an in-house counselor that handles all of my traditional talk therapy follow-up, while I provide education about the injury/neurologic condition and carry a small (5-6 pt) caseload that I see every 2-3wks, depending upon their goals. I utilize almost exclusively behavioral interventions with some coping skills mixed in. Traditional therapy all goes to my counselor or referred out (higher severity).

I could see traditional follow-up treatment, but it hurts my income bc assessment work pays much better, which is why I utilize a counselor. If you work for a hospital, they likely will want you to maximize your billing, so doing any kind of significant follow-up work as a neuropsych would likely be difficult. Rehab psych positions may offer more options for treatment, but you may not do enough neuropsych; only a small portion of rehab psych clinicians mostly do neuropsych...it really depends on the job. Treatment can include therapy, but also patient and family education, etc.

 

[WisNeuro]

I carry some hand picked PTSD and other anxiety disorder patients for therapy in addition to my mostly assessment work.

 

[PsyDr]

Things you may be interested in:

1) Functional Analytic Psychotherapy. Uses traditional behavioral and mathematical psychology in the transference.

2) Allan Schores work on attachment; if you want neuroscience stuff about Treating more problems of living.

3) Dollard and Milners book on behavioral explanations for why other forms of psychotherapy work.

4) Rehab psych if you’re looking at brain injury populations. Ruffs book on psychotherapy for brain injured populations is a decent and very easy read.

5) Kaplan and Solms book. I’d recommend not reading further in the subject. It’s fringe and going further is ... maybe going too far.

 

[jdawg2017]

An important point that I think has been missed (given you are just graduating) is that you WILL receive training in both neuropsychology and psychotherapy in any (most?) clinical psychology PhD programs. To be a neuropsychologist, it helps to train in a lab doing research on neuropsych-related topics, and it’s helpful to train in a program known for their neuropsych faculty and practicum opportunities. This will ensure you get a lot of good training in areas that would not normally be covered by the relatively basic neuropsych training that students interested primarily in psychotherapy receive (e.g., doing 2-3 evaluations for primarily ADHD/learning disorder referral questions). So, though you’ll get training in both regardless, it’s good to go to a program where you can “specialize” in neuropsych, but you will still likely get 150+ face-to-face therapy hours in your early practicum.

I’d also like to add that, as a neuropsychologist in training, I don’t think being a neuropsychologist is dichotomous with being a “humanist.” A lot of what we do day in and day out is get to know people, their struggles, and through the testing, hopefully provide useful diagnostic impressions and recommendations. The feedback session, in particular, is a unique experience in which a neuropsychologist can meet the patient and, through humanism, help the patient figure out what the next steps are for them.

 

[Therapist4Chnge]

The feedback session, in particular, is a unique experience in which a neuropsychologist can meet the patient and, through humanism, help the patient figure out what the next steps are for them.

Excellent point.

Carrying a small caseload of patients has really enhanced my assessment work bc it makes me think through treatment plan recommendations more carefully bc referrers really appreciate more info than "follow-up counseling is recommended." I never *just* wrote that, but specifying modality per the research, topics covered, goals, etc. is more than I used to recommend. I adapted to what my referral sources wanted, and it definitely has helped establish solid referral relationships.