Dismissal from Doctoral Internship - What does this mean for career?

Started by JakiraJakira
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JakiraJakira

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Hi everyone!

I am in a pretty rough predicament right now on internship. For context, I am a School Psychology PhD student from an R1 university who matched at an academic medical center in the area of Pediatric Psychology. My internship started in July and goes till next June. I have not encountered hiccups from past supervisors about my clinical abilities or performance, and having seen some of my LORS for internship, know that others perceptions of me were good.

I knew that internship was going to be a difficult experience, and going into Pediatric psychology, integrated primary care, and seeing a wide range of ages/clinical concerns as a generalist would be challenging. It is evident to my supervisors on internship early that I was well below where they expected me to be in several areas (knowledge of interventions for different concerns, ability to think on my feet in fast paced scenarios like abuse/risk screenings, and my interpersonal skills).

There has definitely been some skill gaps in my training (I mostly worked with adolescents and young adults individually, and now am working with a good amount of younger children and families/caregivers). However, two things that have been challenging to me are my personal situation (split up with my long-term fiance of 6 years once we moved to the internship location but still stuck living with him which has been stressful and led to depressed mood earlier in internship) and then myself having more moderate ADHD, combined which has been something I have had to reckon with when I consider some of my supervisor's concerns (that I sometimes struggle to actively listen in session when juggling different things, that it is harder for me to pick up social cues in session, my EMR documentation needs some work, and that my working memory is taxed in sessions to the point that I take copious notes to be prepared to precept with my supervisors in visits). I am working to get disability accommodations since September, but it has been incredibly slow, and I won't get them in time for anything to help.

I was notified in early October at the 3 month mark of internship, that I was below expectations and would be placed on a remediation plan. There were quite a few areas noted for me to make up in and several deadlines for me to meet to stay (one at the end of November, and the other in late December). They have put in effort in training me, giving extra supervision, and slowing down my schedule (which has also made it harder for some of my skills to be observed). I met the November deadline they had for me, and at the end of that deadline, have about 3 weeks to meet the last deadline, which also has the potential for me to be dismissed.

While I am trying to stay hopeful, it seems very likely that I will be asked to leave. I believe that I have made substantial progress towards my plan since it was implemented and believe that if given time I can meet the goals they have for me (independence) by the end of the training year. This is also evident by my supervisor's reporting and my ratings on evaluations. However, they are hoping to remove the supports they have put in place in January, and expect me to be mostly independent.

I am posting here because I am kind of at a loss for what being dismissed from my internship would mean for my career. I am interested in going into academia and had applied to positions prior to being placed on a remediation plan that led to virtual interviews and several campus visits at R1/R2 PhD programs. I am afraid that being dismissed from internship will be a gigantic red flag that will be hard to dismiss from my record. Especially, because my PhD program's plan B for me is to complete an unaccredited internship in a local school district next year after doing another practica to prove my skills in the Spring. The alternative is adding an additional 2 YEARS to my training by going back to my program and participating in APPIC again. I have a hard time believing that places will want to interview me after this experience, despite how much growth and learning I have demonstrated and had while here.

Any advice or words of wisdom would be appreciated.
 
1) Dismissal will be a significant problem for your career. Acceptance will make this easier. It will be bad for 2-3 years, and then it won't matter much.
2) However, academic careers are substantially more influenced by your publication history.
a. What do you mean by "academic career"? Are you someone that has published a ton, and wants to continue that? Or are you wanting to be a "clinical associate professor" in some AMC? The former will accommodate internship BS better than the latter.
3) Do you know where Lillenfield did his internship? Me either. End of day, just complete your degree and get licensed in any way possible. Students get all involved in this world where presenting a poster at a conference, or getting the prestigious practica is a big thing. In the real world, almost none of that matters. Is a PhD from Louisiana Technical College "better" than a PsyD from Midwestern? I don't know, and I've never even thought about until I googled random programs from crappy states just now.
4) Honestly, the "getting disability accommodations, late in your career, only after you start getting in trouble" is a bad look.
5) Something doesn't make sense here. You're saying that they can't observe you, AND that 2/3rds of your feedback is about in session behaviors. That doesn't make a lot of sense.
a. If I had to guess, you're giving them too much information.
b. And you're trying to predict what your preceptors want rather than doing exactly what they say. Take a "good note" or 5 from your supervisor, and make a template.
 
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PsyDr said:
1) Dismissal will be a significant problem for your career. Acceptance will make this easier. It will be bad for 2-3 years, and then it won't matter much.
2) However, academic careers are substantially more influenced by your publication history.
a. What do you mean by "academic career"? Are you someone that has published a ton, and wants to continue that? Or are you wanting to be a "clinical associate professor" in some AMC? The former will accommodate internship BS than the latter. At one of the places I held a research position, there were a few psychologists and physicians who didn't complete their licensing stuff because they were only interested in research.
3) Do you know where Lillenfield did his internship? Me either. End of day, just complete your degree and get licensed in any way possible. Students get all involved in this world where presenting a poster at a conference, or getting the prestigious practica is a big thing. In the real world, almost none of that matters. Is a PhD from Louisiana Technical College "better" than a PsyD from Midwestern? I don't know, and I've never even thought about until I googled random programs from crappy states just now.
4) Honestly, the "getting disability accommodations, late in your career, only after you start getting in trouble" is a bad look.
5) Something doesn't make sense here. You're saying that they can't observe you, AND that 2/3rds of your feedback is about in session behaviors. That doesn't make a lot of sense.
a. If I had to guess, you're giving them too much information.
b. And you're trying to predict what your preceptors want rather than doing exactly what they say. Take a "good note" or 5 from your supervisor, and make a template.
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Thanks for the reply! I had meant academic career as in working as a professor in a School psychology PhD program. My interests in research do go across clinical and school settings which is why I sought out a more clinical internship after several years of more clinically based practica during my program.


I could see the disability accommodations piece being a point of contention. The thing is that I’ve been medicated for years and throughout undergrad and graduate school so far, been able to manage all the tasks assigned to me without accommodations.

The difficulty here being the intensity of my clinical caseload (I haven’t managed this many patients before), the expectation that I see patients back to back each day (8 patients in 8 hours), and my own struggles at times with working memory/executive functioning. I am unsure what accommodations would be possible on internship, but anything to make note taking in session easier could help.

I am getting a lot of 1:1 supervision right now in primary care (them seeing patients with me). However they would like me to be independent to the point where I step out to precept and go back in (without need for them to stay for the whole visit). Right now things have been going well, but there have been a few complex cases where they have stepped in.

What do you mean by create a template? I come prepared for each session but it’s more of the in the moment, pivoting that has been hard since I’ve had to learn more strategies to pivot towards. They ask a ton of questions while I am precepting, so a templated answer would only work so far.
 
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1) I am sorry for your struggles.

2) Do some perspective taking: End of day, they want you to do the job, without hassle to them. You go into a room with a patient, mostly unobserved. You walk out of that room. Your preceptor asks you some questions, presumably in addition to their own duties, which presumably means they want the answers quickly and succinctly. You answer them.

a. If you are talking about yourself waaaay too much, rather than directly answering the question, fix that (e.g., "You asked how I approached their comment about SI. I was prepared about this, but my WM started being limited, and I got overwhelmed, and then I started... I, I, I."; OR "I used the Columbia measure questions." ). The former is annoying AF if you are time crunched, the latter is a direct answer.

b. The questions your preceptor asks you can likely be categorized into categories. You have to be smart enough to figure out, they ask about X or Y. And you know how to play the game with those questions (e.g., "That's really smart! I did consider doing that, but decided to gain further data before doing that. Do you think I should....?"). You can literally write down their common questions, and what you should say in that moment, and practice that.

3) You've said you're in trouble for 3 things. However you've said you are observed and then you're saying you're not. Of the observable things:

a. you're really not explaining the objective observable behaviors that are pissing off the preceptor. Are you fiddling with something? Are you not saying something specific? Are you looking down? Are you....? You can identify those, and do it. Just physically do the physical behaviors that are desired, and don't mention amorphous things.

b. That leaves late documentation. Your preceptor has clinical notes, and they think the structure is great. Get some of those notes. Change the ID'ing information to some low frequency letter (e.g., change "boy" to "YY"). Now you have a template that read likes "Johnny is a 9 year old, right handed boy, who presents with depressive symptoms in the context of whatever". Instead it reads "YY is a YY year old, YY handed YY, who presents with YY symptoms.....". You can change that stuff in like 30 seconds for each appointment.
 
Agree with all of the above. Life will go on after a dismissal, but it is going to be a huge roadblock to overcome. I'd do everything to avoid it. I don't know if the documentation issues are about quality or timeliness, but if the latter....this is one of those situations where I'd bite the bullet and stay as late as needed to get it done.

For whatever its worth, I was miserable at my internship and strongly considered leaving of my own accord but only because my program offered a specific pathway for clinical students to nope out of internship entirely and graduate with an experimental degree instead. Still not sure if it was the right choice, but I stuck it out.
 
PsyDr said:
1) I am sorry for your struggles.

2) Do some perspective taking: End of day, they want you to do the job, without hassle to them. You go into a room with a patient, mostly unobserved. You walk out of that room. Your preceptor asks you some questions, presumably in addition to their own duties, which presumably means they want the answers quickly and succinctly. You answer them.

a. If you are talking about yourself waaaay too much, rather than directly answering the question, fix that (e.g., "You asked how I approached their comment about SI. I was prepared about this, but my WM started being limited, and I got overwhelmed, and then I started... I, I, I."; OR "I used the Columbia measure questions." ). The former is annoying AF if you are time crunched, the latter is a direct answer.

b. The questions your preceptor asks you can likely be categorized into categories. You have to be smart enough to figure out, they ask about X or Y. And you know how to play the game with those questions (e.g., "That's really smart! I did consider doing that, but decided to gain further data before doing that. Do you think I should....?"). You can literally write down their common questions, and what you should say in that moment, and practice that.

3) You've said you're in trouble for 3 things. However you've said you are observed and then you're saying you're not. Of the observable things:

a. you're really not explaining the objective observable behaviors that are pissing off the preceptor. Are you fiddling with something? Are you not saying something specific? Are you looking down? Are you....? You can identify those, and do it. Just physically do the physical behaviors that are desired, and don't mention amorphous things.

b. That leaves late documentation. Your preceptor has clinical notes, and they think the structure is great. Get some of those notes. Change the ID'ing information to some low frequency letter (e.g., change "boy" to "YY"). Now you have a template that read likes "Johnny is a 9 year old, right handed boy, who presents with depressive symptoms in the context of whatever". Instead it reads "YY is a YY year old, YY handed YY, who presents with YY symptoms.....". You can change that stuff in like 30 seconds for each appointment.
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This is very helpful thank you! Sorry, when I said I wasn’t being observed enough, it was more so that they have reduced my clinical caseload, and with no shows in a hospital that doesn’t punish patients for this, it’s made it difficult for them to evaluate my progress since there hasn’t been as many cases.

Actually the documentation piece isn’t about things being late. My previous practicum supervisors said it was not important that I learn how to be perfect at notes. I took them, but got limited feedback and did not do them at the same time I led sessions. Right now, I work on my notes at home to make sure they get done. At work, I focus on getting supervision and seeing my patients. It’s more so that it’s been hard for me to understand the voice they want me to use in writing them. I often report what patients say in an updates section of the note and they have a clinical impressions piece at the end.

They want me to be better at describing patient mental status exam and reporting through a clinical lens. Rather than reporting what the patient says, I should be applying my own assessment of things as I write the note, not just at the end.

Which has been difficult for me since I’ve not done that before and they’ve had to be very explicit with me to give me feedback. It’s taken me longer to understand this and several other things they want from me because directions aren’t concrete or specific and often given verbally in a longer conversation, and it’s hard for me to catch everything when I try to take my own notes. I’ve been working to circle back with supervisors to make sure I had understood, but it’s still hard sometimes.

Mostly my preceptors had complaints about my assessment of clinical cases in terms of psychopathology and what interventions were best. This was a bit easier of a fix since it involved me brushing up on common primary care concerns, as there were specific content areas I was weak in both diagnostically and for intervention. Now their complaints are about being more succinct, and definitely like you mentioned above not inserting myself into things as doing so has led to people think I’m being defensive.
 
LM02 said:
If you haven’t already, I would reach out to the APPIC informal problem consultation service, who can consult with you. They have a form on the APPIC website that you can fill out and request a phone call.
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I connected with Greg, and he was surprised that I was thinking about being dismissed as much. However my site made it seem like it was very likely to happen. Things have shaped up since but it’s still very worrisome for me to have fast deadlines for my growth.
 
As you may have noticed, the focus of the responses here and I would assumes the remediation plan is to help you make it through this hurdle. When I supervise people, I find that some of them struggle with expressing their thoughts and opinions about patients and haven’t had the fear of giving a wrong answer trained out of them yet. It leads to a dynamic of me being pulled into what feels more like an interrogation which makes them more anxious and more vague which leads me to have more questions. I don’t know if that is a similar dynamic with yourself, yet I do find myself having lots of questions when I read what you right as opposed to understanding what is going on. With one of my supervisees, the written communication was actually very clear, but it takes lots of time for them to do it so we are working on how to abbreviate that aspect and also become more comfortable with expressing thoughts and feelings and opinions about the case without censorship. Ultimately, figuring out what the bottleneck is and how to address it is going to be more useful than thinking about what happens in worst case scenario aka being removed.
I was also placed on a remediation plan during my internship and it was an emotional nightmare for me. I got through it by implementing CBT and some ACT strategies and focusing on the letter of the recommendations and fulfilling them. For me the problem was a clash between my casual yet fairly clear communication style and my supervisors highly structured but very ambiguous communication style. I made it through and since you are looking for improvement and guidance and likely didn’t make it this far without some skills and strengths, I sincerely hope you can make it through as well. One of my better supervisors during training used to always say tongue in cheek when we confronted a particularly challenging case, “this is a valuable training experience”. Man, I hate those!
 
JakiraJakira said:
This is very helpful thank you! Sorry, when I said I wasn’t being observed enough, it was more so that they have reduced my clinical caseload, and with no shows in a hospital that doesn’t punish patients for this, it’s made it difficult for them to evaluate my progress since there hasn’t been as many cases.

Actually the documentation piece isn’t about things being late. My previous practicum supervisors said it was not important that I learn how to be perfect at notes. I took them, but got limited feedback and did not do them at the same time I led sessions. Right now, I work on my notes at home to make sure they get done. At work, I focus on getting supervision and seeing my patients. It’s more so that it’s been hard for me to understand the voice they want me to use in writing them. I often report what patients say in an updates section of the note and they have a clinical impressions piece at the end.

They want me to be better at describing patient mental status exam and reporting through a clinical lens. Rather than reporting what the patient says, I should be applying my own assessment of things as I write the note, not just at the end.

Which has been difficult for me since I’ve not done that before and they’ve had to be very explicit with me to give me feedback. It’s taken me longer to understand this and several other things they want from me because directions aren’t concrete or specific and often given verbally in a longer conversation, and it’s hard for me to catch everything when I try to take my own notes. I’ve been working to circle back with supervisors to make sure I had understood, but it’s still hard sometimes.

Mostly my preceptors had complaints about my assessment of clinical cases in terms of psychopathology and what interventions were best. This was a bit easier of a fix since it involved me brushing up on common primary care concerns, as there were specific content areas I was weak in both diagnostically and for intervention. Now their complaints are about being more succinct, and definitely like you mentioned above not inserting myself into things as doing so has led to people think I’m being defensive.
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I think I might see part of the problem.

Is it possible it's your sentence structure? Look at the sentence structures above. You're using multiple conjunctions, multiple "me" statements, multiple conditional sentences, etc (e.g., I'm doing this and this has been hard"; "Rather than doing something, I should be doing something").

Clinical work uses a simple sentence structure "SUBJECT VERB PREDICATE". Usually, it's preferable to not write in the first person. "Affect is blunted. Attention is unremarkable. etc etc etc". That clinical structure is preferable to writing, "I made a joke about the weather and the patient did not seem to think this is funny, stating, "oh, okay." in a monotone".

Maybe I'm totally off. Something to think about.
 
cara susanna said:
I think it's helpful to remember that the internship site really doesn't want to lose you. If they do, they lose a lot of labor (I mean, let's be real here), and it doesn't look great for them, either. They want you to succeed.
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Agreed. Our interns were slight service extenders, but more than that, throughout all my time in internship training and leadership, the training staff was invested in the interns' success. We wanted to do all we could to help interns complete the year successfully and proceed along in their careers. But we also felt a strong sense of duty to the field to ensure that everyone who finished internship was ready to start as an entry-level psychologist.

It's a lot of work to implement a probation/remediation plan, on everyone's part. And it's even more work to dismiss an intern. It's not something sites take lightly, and they'll generally do all they can to avoid it when possible (e.g., assuming there's not an egregious ethical misstep).
 
You're probably catastrophizing a little about getting dismissed. If you just do the performance improvement plan, they literally cannot dismiss you. A ton of good psychologists got a PIP on their internship. I'm school psych PhD as well. Are there any in your cohort you can reach out to? Ask if you can observe supervisors, come clean to them about what's going on in your life. As for the daily things, hourly things, SMART goals you can do. See if they can give specific behavioral examples.
 
borne_before said:
You're probably catastrophizing a little about getting dismissed. If you just do the performance improvement plan, they literally cannot dismiss you. A ton of good psychologists got a PIP on their internship. I'm school psych PhD as well. Are there any in your cohort you can reach out to? Ask if you can observe supervisors, come clean to them about what's going on in your life. As for the daily things, hourly things, SMART goals you can do. See if they can give specific behavioral examples.
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To piggyback off this, one of my grad school peers who I always considered to be a strong clinician got a PIP as a neuropsych intern at a competitive internship placement. She took the feedback, did not get dismissed, and went on to complete internship and fellowship just fine. They’re practicing as a neuropsychologist now and seem to be doing well. I think there is a lot of really good and actionable advice in this thread.
 
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PsyNeuro37 said:
To piggyback off this, one of my grad school peers who I always considered to be a strong clinician got a PIP as a neuropsych intern at a competitive internship placement. She took the feedback, did not get dismissed, and went on to complete internship and fellowship just fine. They’re practicing as a neuropsychologist now and seem to be doing well. I think there is a lot of really good and actionable advice in this thread.
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I also had a PIP during internship, and I’d say it was only partially my responsibility. In hindsight, it came down to two main factors: (a) relocating cities while switching to Strattera, which clearly was not an effective fit for me, and (b) a supervisory situation I only fully understood later, my primary supervisor was struggling with alcoholism and was rarely present on site, yet I was expected, as a brand-new intern, to function independently in a new school setting.

A PIP is not a career-ending event.
 
To add to what everyone else is saying, one of my previous externship supervisors (who is very successful and one of the most competent and empathetic clinicians I have ever worked with) had a PIP in his grad program and didn't match for an internship on his first round. Things happen during training, and there are bumps in the road.
 
The Cinnabon said:
I suspect these are more common than we think. I just accomplished/completed a PIP I was on and felt it was necessary, in hindsight.
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I think it varies pretty wildly by site. I was involved in prac/intern/postdoc training for about a decade (mostly VAs and one non-VA non-profit hospital system) and I think I saw 4-5 PIPs across all of the slots/specialties. Granted, there were at least another handful of people I felt needed to be on a PIP, but not my call at the time.
 
futureapppsy2 said:
I think a massive problem with PIPs is that some sites/employers do treat them as a formality on the path to firing, rather than a legitimate way to improve performance, so a lot of people on both sides of a PIP treat them with suspicion and a lack of honest support.
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I will add to this that use of PIPs is completely arbitrary. Some supervisors will be too lazy to ever write one. On the other hand, there are some that will use them capriciously.
 
This too, is now my experience. I’ve followed my current supervisor around to three companies since and every time she warns the higher ups that I’m a “spicy one”, whatever that means 🙄
 
chicandtoughness said:
This too, is now my experience. I’ve followed my current supervisor around to three companies since and every time she warns the higher ups that I’m a “spicy one”, whatever that means 🙄
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Psychologists have developed some social norms, that have nothing to do with science (e.g., "therapist tone", the prevalence of indirect communications in supervision, office decor, etc). They don't like those norms to be violated in any mild form.
 
PsyDr said:
Psychologists have developed some social norms, that have nothing to do with science (e.g., "therapist tone", the prevalence of indirect communications in supervision, office decor, etc). They don't like those norms to be violated in any mild form.
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Come to mention it I get lots of comments about how I don't decorate my office from patients and staff. I have no idea why it matters.
 
PsyDr said:
Psychologists have developed some social norms, that have nothing to do with science (e.g., "therapist tone", the prevalence of indirect communications in supervision, office decor, etc). They don't like those norms to be violated in any mild form.
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As an intern, I definitely struggled with the duality of being a man and a therapist. It took until internship for me to have a male therapy supervisor/role model (many male assessment supervisors though). Female supervisors definitely had some feedback for me which I appreciated. However, it did not really jive with being a young single man of color.
 
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PsyDr said:
Psychologists have developed some social norms, that have nothing to do with science (e.g., "therapist tone", the prevalence of indirect communications in supervision, office decor, etc). They don't like those norms to be violated in any mild form.
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It feels like every therapists' office is required to have some house, a mediocre impressionist painting, and maybe an inspirational quote if we get cheesey.
 
futureapppsy2 said:
I think a massive problem with PIPs is that some sites/employers do treat them as a formality on the path to firing, rather than a legitimate way to improve performance, so a lot of people on both sides of a PIP treat them with suspicion and a lack of honest support.
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For jobs, sure. But, for training programs, in my experience they do everything in their power to not fire/dismiss someone. It looks bad, and there's huge liability risk, even if justified. If anything, I've seen much more often people being passed through that are in no way competent in the areas they should be, as opposed to someone being dismissed without just cause.
 
OP, I would also suggest that you be documenting/having some sort of formal documentation of everything that is occurring on your end. It probably won't be needed, but better be safe than sorry just in case. They are keeping a file on you (as is required), so might as well keep a file on your side of things. PIPs can for sure be very helpful, but not every program/site uses them in appropriate situations.
 
It sounds like I need to hit up a TJ Max STAT for some “live, laugh, love” wall inspiration! All o have up are drawings of brains, anatomical models, and a wall of diplomas et al. Better than a generic medical office, but no family photos and the like bc that would feel weird.
 
I have some pretty awesome idiosyncratic stuff that reflects my nerdy interests, as well as the typical "live laugh love" therapist stuff and pretty paintings of flowers
 
You all are way off topic, but in my cash pay private practice, I believe that good decorating is helpful. Tasteful, comfortable, pleasant colors. I think there might be some research to support that as being important, probably more in the market research segment than the psychological research, but gotta pay the bills. New patient yesterday said, “this is a comfortable space” when entering the room. He then felt comfortable with me. In the past I have relied on therapy skills to build rapport and have done therapy in some pretty ugly places, broken chairs under a stairwell being one of my practicum experiences so I know that design doesn’t trump skills, but in this challenging field, I try for every bit of positive momentum I can get. Something like a comfortable and pleasant space os like low hanging fruit in my mind.
 
smalltownpsych said:
You all are way off topic, but in my cash pay private practice, I believe that good decorating is helpful. Tasteful, comfortable, pleasant colors. I think there might be some research to support that as being important, probably more in the market research segment than the psychological research, but gotta pay the bills. New patient yesterday said, “this is a comfortable space” when entering the room. He then felt comfortable with me. In the past I have relied on therapy skills to build rapport and have done therapy in some pretty ugly places, broken chairs under a stairwell being one of my practicum experiences so I know that design doesn’t trump skills, but in this challenging field, I try for every bit of positive momentum I can get. Something like a comfortable and pleasant space os like low hanging fruit in my mind.
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Not sure about decorating, but I had a supervisor that got me into the effecte of paint colors on anxiety. Earth tones, especially blues and greens, were more calming. Red can be more anxiety inducing, IIRC. It definitely effected the paint choices in my home and will in any future office. Ambiance is important to any business.

This maybe of interest to others, it is definitely a rabbit hole I fell down:

PORTRAITS — FIFTY SHRINKS
 
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Sanman said:
Not sure about decorating, but I had a supervisor that got me into the effecte of paint colors on anxiety. Earth tones, especially blues and greens, were more calming. Red can be more anxiety inducing, IIRC. It definitely effected the paint choices in my home and will in any future office. Ambiance is important to any business.

This maybe of interest to others, it is definitely a rabbit hole I fell down:

PORTRAITS — FIFTY SHRINKS
Click to expand...
I have this coffee table book. I wouldn’t recommend buying it. The majority of the offices are ugly. A slight minority are classy AF. And inside looks like he bought two folding chairs, put them in the back room of a bodega, and called himself a genius .
 
Wondering how this worked out? I’m at a site that I learned had a reputation that was shady AF after I committed. One intern who was similar to me disappeared early. I’m an excellent BS detector and what directors reported I knew was a lie (confirmed by the intern after weeks of tracking them down on social to get real story - they were too afraid to file legit accommodations). The day they “left” I called a disability lawyer and said, “The second I file my ADA forms they will 1000% retaliate.” A few days after submitting I got the PIP. So the lawyer tracks their attempts to get rid of me and writes my responses. The mind**** and gaslighting I endure daily with a smile is truly insane. They document my every move, trying to find anything to get rid of me. It makes me second-guess everything I do every second… the wrong tone, being too serious, not being serious enough, maybe it should have been a semi-colon instead of a comma, too many questions, not enough questions. I’ve never been treated like this and I’ve had real jobs. The labor violations are unreal and everyone is suffering (it’s amazing what buying the crew a round of shots will do). The others are just quieter and more importantly, don’t have disabilities. From my lawyer’s perspective, the PIP is a legal move that simply protects them in case you sue them after they fire you. Or in her words, “These people are not your friends. They are not trying to help you, they are trying to get rid of you.” There are certain impt details about the exploitation that I can’t put here that would help you understand why they do this to interns. But come contract end, it’s going here in detail so interns don’t have to endure what I’m going through.
 
PsyDr said:
I think I might see part of the problem.

Is it possible it's your sentence structure? Look at the sentence structures above. You're using multiple conjunctions, multiple "me" statements, multiple conditional sentences, etc (e.g., I'm doing this and this has been hard"; "Rather than doing something, I should be doing something").

Clinical work uses a simple sentence structure "SUBJECT VERB PREDICATE". Usually, it's preferable to not write in the first person. "Affect is blunted. Attention is unremarkable. etc etc etc". That clinical structure is preferable to writing, "I made a joke about the weather and the patient did not seem to think this is funny, stating, "oh, okay." in a monotone".

Maybe I'm totally off. Something to think about.
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Thank you for this advice! I will admit that my grammar and clinical writing has been a work in progress, but has improved substantially since your comment per my supervisors.
 
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borne_before said:
You're probably catastrophizing a little about getting dismissed. If you just do the performance improvement plan, they literally cannot dismiss you. A ton of good psychologists got a PIP on their internship. I'm school psych PhD as well. Are there any in your cohort you can reach out to? Ask if you can observe supervisors, come clean to them about what's going on in your life. As for the daily things, hourly things, SMART goals you can do. See if they can give specific behavioral examples.
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The hard part was that they told me if I followed the PIP but my scores were lower than what they expect of all interns at specific points in the year they would move to dismiss me. When I consulted with APPIC and my program's DCT, it seemed like my internship site's TD had the final say.

The other advice is definitely helpful and doing several of those things has helped me in making continued progress since I posted here previously.
 
Caviland said:
Wondering how this worked out? I’m at a site that I learned had a reputation that was shady AF after I committed. One intern who was similar to me disappeared early. I’m an excellent BS detector and what directors reported I knew was a lie (confirmed by the intern after weeks of tracking them down on social to get real story - they were too afraid to file legit accommodations). The day they “left” I called a disability lawyer and said, “The second I file my ADA forms they will 1000% retaliate.” A few days after submitting I got the PIP. So the lawyer tracks their attempts to get rid of me and writes my responses. The mind**** and gaslighting I endure daily with a smile is truly insane. They document my every move, trying to find anything to get rid of me. It makes me second-guess everything I do every second… the wrong tone, being too serious, not being serious enough, maybe it should have been a semi-colon instead of a comma, too many questions, not enough questions. I’ve never been treated like this and I’ve had real jobs. The labor violations are unreal and everyone is suffering (it’s amazing what buying the crew a round of shots will do). The others are just quieter and more importantly, don’t have disabilities. From my lawyer’s perspective, the PIP is a legal move that simply protects them in case you sue them after they fire you. Or in her words, “These people are not your friends. They are not trying to help you, they are trying to get rid of you.” There are certain impt details about the exploitation that I can’t put here that would help you understand why they do this to interns. But come contract end, it’s going here in detail so interns don’t have to endure what I’m going through.
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Wow, I am not sure what to think about your internship site but it sounds rough.

I am still at my internship site and was not dismissed. I was able to make continued progress towards my learning plan that led to them continuing it a bit longer. They were looking to dismiss me at one point, but in the month that it took for them to consult with HR, APPIC and my program about doing so, I continued to make progress and they reconsidered (unsure if it was because of me or other factors).

For right now, I am cautiously optimistic and working hard to continue meeting their expectations and growing as a clinician.
 
JakiraJakira said:
Hi everyone!

I am in a pretty rough predicament right now on internship. For context, I am a School Psychology PhD student from an R1 university who matched at an academic medical center in the area of Pediatric Psychology. My internship started in July and goes till next June. I have not encountered hiccups from past supervisors about my clinical abilities or performance, and having seen some of my LORS for internship, know that others perceptions of me were good.

I knew that internship was going to be a difficult experience, and going into Pediatric psychology, integrated primary care, and seeing a wide range of ages/clinical concerns as a generalist would be challenging. It is evident to my supervisors on internship early that I was well below where they expected me to be in several areas (knowledge of interventions for different concerns, ability to think on my feet in fast paced scenarios like abuse/risk screenings, and my interpersonal skills).

There has definitely been some skill gaps in my training (I mostly worked with adolescents and young adults individually, and now am working with a good amount of younger children and families/caregivers). However, two things that have been challenging to me are my personal situation (split up with my long-term fiance of 6 years once we moved to the internship location but still stuck living with him which has been stressful and led to depressed mood earlier in internship) and then myself having more moderate ADHD, combined which has been something I have had to reckon with when I consider some of my supervisor's concerns (that I sometimes struggle to actively listen in session when juggling different things, that it is harder for me to pick up social cues in session, my EMR documentation needs some work, and that my working memory is taxed in sessions to the point that I take copious notes to be prepared to precept with my supervisors in visits). I am working to get disability accommodations since September, but it has been incredibly slow, and I won't get them in time for anything to help.

I was notified in early October at the 3 month mark of internship, that I was below expectations and would be placed on a remediation plan. There were quite a few areas noted for me to make up in and several deadlines for me to meet to stay (one at the end of November, and the other in late December). They have put in effort in training me, giving extra supervision, and slowing down my schedule (which has also made it harder for some of my skills to be observed). I met the November deadline they had for me, and at the end of that deadline, have about 3 weeks to meet the last deadline, which also has the potential for me to be dismissed.

While I am trying to stay hopeful, it seems very likely that I will be asked to leave. I believe that I have made substantial progress towards my plan since it was implemented and believe that if given time I can meet the goals they have for me (independence) by the end of the training year. This is also evident by my supervisor's reporting and my ratings on evaluations. However, they are hoping to remove the supports they have put in place in January, and expect me to be mostly independent.

I am posting here because I am kind of at a loss for what being dismissed from my internship would mean for my career. I am interested in going into academia and had applied to positions prior to being placed on a remediation plan that led to virtual interviews and several campus visits at R1/R2 PhD programs. I am afraid that being dismissed from internship will be a gigantic red flag that will be hard to dismiss from my record. Especially, because my PhD program's plan B for me is to complete an unaccredited internship in a local school district next year after doing another practica to prove my skills in the Spring. The alternative is adding an additional 2 YEARS to my training by going back to my program and participating in APPIC again. I have a hard time believing that places will want to interview me after this experience, despite how much growth and learning I have demonstrated and had while here.

Any advice or words of wisdom would be appreciated.
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Hopefully, your internship experience has improved since you posted this thread. Similarly, my internship was highly stressful with ups and downs during that year, but I survived, graduated and passed the EPPP and became a licensed psychologist and neuropsychologist.

I was on a remediation plan as during my second rotation focusing on Forensic Psychology with an adjunct psychologist who contracted with my internship site, I received an unsatisfactory review. I received satisfactory reviews in the other three rotations. I had to complete some research over diversity and ethic's as part of the remediation requirement.

As I finished my internship back in 2013, no one asks me now about my internship when I apply for jobs, as there is such a severe shortage of licensed psychologists they want to know when I can start. Being you have interest in working in academia in School - Pediatric Psychology there are positions that have been opened for months and even years and they have had to resort to having MS-EDS trained adjunct faculty fill the positions in the interim.

You may need to have your program Clinical Director involved if there are accommodations needed for you to successfully complete your internship. I have not heard of interns not completing the remediation plan, but I have heard of interns discontinuing internship due to life issues or health issues such as divorce- relationship breakup or having health issues that year and either reapplying the next year or finding a different internship site to finish up their internship.

Just don’t give up, and seek out help and support to complete your internship and graduate, so in 15-20 years you will be a positive mentor helping your students get through their internship and complete their PhD program.
 
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mypointlesspov said:
Forget everything else going on in the country, I'd totally leave PP if the feds let me paint my office in Federal Standard 17142.
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I'm partial to the slightly cooler toned 17155, with 17043 gold trim / molding.

But primarily wanted to point out the naming situation - some have no name at all, others are straightforward or logically descriptive (Black. Gold. Silver. Purple. Aircraft Gray. Light Gull Gray. Sky Blue. Insignia White.) and then there is 16515 - "Canadian Voodoo Gray."

Canadian Voodoo Gray? I don't know what to make of that at all. Are they throwing shade?
 
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