Good resources for a beginner clinician?

[PsyDocNess]

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Hey there,

Wanted to start off by saying thank you guys for the book recommendations! I was able to score a few books and read up on them over my summer break. I have begun my first practicum experience and wanted to know if there were any resources you guys recommend? To be specific, I have already looked into TherapistAide and got some stuff there, but I am looking for some additional resources (such as maybe things that helped with client intake, diagnostic interviewing or things you would have liked to have in your toolkit when beginning your practicum journey). I have my first client interaction today and I am so nervy, lol.

I just want to be a good clinician and you guys have been really helpful, so anything is appreciated.

Thank you! 😀

 

[Fan_of_Meehl]

Hey there,

Wanted to start off by saying thank you guys for the book recommendations! I was able to score a few books and read up on them over my summer break. I have begun my first practicum experience and wanted to know if there were any resources you guys recommend? To be specific, I have already looked into TherapistAide and got some stuff there, but I am looking for some additional resources (such as maybe things that helped with client intake, diagnostic interviewing or things you would have liked to have in your toolkit when beginning your practicum journey). I have my first client interaction today and I am so nervy, lol.

I just want to be a good clinician and you guys have been really helpful, so anything is appreciated.

Thank you! 😀

For assessment/ intake/ diagnosis,

I think that James Morrison has some solid ones, especially 'The First Interview' and 'DSM-5-TR Made Easy'

A bit more advanced (but excellent) is Christopher Shea's book, 'Psychiatric Interviewing: The Art of Understanding.'

In terms of intervention, I'm a big fan of the following titles:

'Making Cognitive Behavioral Therapy Work' by Ledley, Marx, and Heimberg (Beginner)

Judith Beck's, 'Cognitive Behavior Therapy: Basics and Beyond' (Beginner/Intermediate)

Jesse Wright's, 'Learning Cognitive Behavior Therapy' (Beginner/Intermediate)

David Tolin's, 'Doing CBT' (Advanced)

David Barlow has a good one of CBT approaches broken down by disorder/protocol, 'Clinical Handbook of Psychological Disorders' but even he takes more of a transdiagnostic approach and is shifting in his writing (most recent edition) to appreciating a 'process-based' approach to CBT where we utilize more individualized clinical case formulation and implementation of procedures to address maladaptive 'processes.'

Whatever you do (in my opinion), don't make the mistake of taking the approach of treating disorders (not people).

For a little interpersonal theory/flavor to your case formulations (as well as focus on interpersonal process in therapy), you can't beat Teyber & Teyber's, 'Interpersonal Process in Therapy: An Integrated Model.'

And the 'Motivational Interviewing' book by Miller and Rollnick. Don't forget that one. You will soon discover that nothing works if your client doesn't want to change or participate in a self-evaluation/self-change process.

We need to treat people (not disorders). The protocols have their place (a very solid place) in intervention, but they are not the 'be all end all' of therapy. The 'protocol-for-syndrome' approach ('get diagnosis' --> 'treat diagnosis' (run manualized protocol) --> 'sx self-report checklist go down, Grog win') has been pushed near exclusively in graduate training (apparently) for the past 20 years and it has really (in my opinion) lowered the quality of case formulation and sophisticated treatment of individuals. Just an editorial from a frustrated old clinician, take it for what it's worth.

 

[PsyDr]

 

[oliversacks4thewin]

OP, I love that you are so motivated to "do this right" but the truth is you are going to be learning how to do "your style" of an intake/interview. The previous book recommendations made by @Fan_of_Meehl are excellent resources (and I'll add Kaplan and Saddock's Synopsis of Psychiatry has a decently digestible section on helpful strategies), but at the end of the day, I strongly recommend seeking support and guidance from your supervisor, as they will understand the population, setting, and intent of your intake and can probably offer significantly more helpful advice that would be better than what you would find in a book.

Having said that, the basic advice I often offer to nervous trainees is typically start by asking what the patient's perception of the purpose and goals from seeking care are ("So, I reviewed the chart, but a chart rarely tells me about the person themselves. What brings you in today?"). This will often result in endorsement of symptoms. Pull on the threads of those symptoms, with a goal to determine severity, duration, and functional impact ("how long has that been going on?, Has the decreased energy made it difficult to work/pay attention in school?" etc.). Consider and flex if it appears the patient responds better to direct or open-ended questions. I recall hearing that sleep and appetite are considered "hidden vital signs" in psychiatry, so it can always be helpful to ask about them. And most importantly, be a compassionate human in the room.

 

[PsyDocNess]

For assessment/ intake/ diagnosis,

I think that James Morrison has some solid ones, especially 'The First Interview' and 'DSM-5-TR Made Easy'

A bit more advanced (but excellent) is Christopher Shea's book, 'Psychiatric Interviewing: The Art of Understanding.'

In terms of intervention, I'm a big fan of the following titles:

'Making Cognitive Behavioral Therapy Work' by Ledley, Marx, and Heimberg (Beginner)

Judith Beck's, 'Cognitive Behavior Therapy: Basics and Beyond' (Beginner/Intermediate)

Jesse Wright's, 'Learning Cognitive Behavior Therapy' (Beginner/Intermediate)

David Tolin's, 'Doing CBT' (Advanced)

David Barlow has a good one of CBT approaches broken down by disorder/protocol, 'Clinical Handbook of Psychological Disorders' but even he takes more of a transdiagnostic approach and is shifting in his writing (most recent edition) to appreciating a 'process-based' approach to CBT where we utilize more individualized clinical case formulation and implementation of procedures to address maladaptive 'processes.'

Whatever you do (in my opinion), don't make the mistake of taking the approach of treating disorders (not people).

For a little interpersonal theory/flavor to your case formulations (as well as focus on interpersonal process in therapy), you can't beat Teyber & Teyber's, 'Interpersonal Process in Therapy: An Integrated Model.'

And the 'Motivational Interviewing' book by Miller and Rollnick. Don't forget that one. You will soon discover that nothing works if your client doesn't want to change or participate in a self-evaluation/self-change process.

We need to treat people (not disorders). The protocols have their place (a very solid place) in intervention, but they are not the 'be all end all' of therapy. The 'protocol-for-syndrome' approach ('get diagnosis' --> 'treat diagnosis' (run manualized protocol) --> 'sx self-report checklist go down, Grog win') has been pushed near exclusively in graduate training (apparently) for the past 20 years and it has really (in my opinion) lowered the quality of case formulation and sophisticated treatment of individuals. Just an editorial from a frustrated old clinician, take it for what it's worth.

Thanks for the recommendations! I also appreciate the feedback, I have noticed some peers obsessed with the ideas of treating a diagnosis rather than their client, which gave me the heebie-jeebies lowk. I'll look into this!

 

[PsyDocNess]

OP, I love that you are so motivated to "do this right" but the truth is you are going to be learning how to do "your style" of an intake/interview. The previous book recommendations made by @Fan_of_Meehl are excellent resources (and I'll add Kaplan and Saddock's Synopsis of Psychiatry has a decently digestible section on helpful strategies), but at the end of the day, I strongly recommend seeking support and guidance from your supervisor, as they will understand the population, setting, and intent of your intake and can probably offer significantly more helpful advice that would be better than what you would find in a book.

Having said that, the basic advice I often offer to nervous trainees is typically start by asking what the patient's perception of the purpose and goals from seeking care are ("So, I reviewed the chart, but a chart rarely tells me about the person themselves. What brings you in today?"). This will often result in endorsement of symptoms. Pull on the threads of those symptoms, with a goal to determine severity, duration, and functional impact ("how long has that been going on?, Has the decreased energy made it difficult to work/pay attention in school?" etc.). Consider and flex if it appears the patient responds better to direct or open-ended questions. I recall hearing that sleep and appetite are considered "hidden vital signs" in psychiatry, so it can always be helpful to ask about them. And most importantly, be a compassionate human in the room.

Thank you! I have my first session with my individual supervisor soon, so I will definitely pick their brain about what to do.

 

[smalltownpsych]

Avoid trying to follow up on diagnostic criteria questions that you might have as they arise or getting to bogged down in one problem that they might have. It is probably more important to get the biographical info. School, work, family hx, psych hx. I am always gently redirecting back to that stuff and let the person know that in order to help it is important for me to get an idea of who they are. If it is a complex case they won’t expect a quick fix so they will appreciate that you are already taking your time with it. During supervision, the supervisor will ask a million questions that you could have asked and that you’ll get better at asking so don’t worry too much about it. The first time is always going to be a bit difficult as the person is coming to us for help and we are internally aware that we have never done this before and we have very little idea what we are doing. Fortunately, getting to know about somebody is the goal and we have actually done that before if we are human at all so we find that we are actually better at it than we think. Good luck and enjoy the process. 😊

 

[PsyDr]

1) Learn to suppress a yawn through your nose
2) Memorize the components of one of the FSIQ regression equations, hit those factors in the initial interview.
3) Memorize the components of one of the suicide risk assessments, hit those factors.
4) Look up the Single Alcohol Screening Questionnaire, incorporate that into your interview.

 

[futureapppsy2]

OP, I love that you are so motivated to "do this right" but the truth is you are going to be learning how to do "your style" of an intake/interview. The previous book recommendations made by @Fan_of_Meehl are excellent resources (and I'll add Kaplan and Saddock's Synopsis of Psychiatry has a decently digestible section on helpful strategies), but at the end of the day, I strongly recommend seeking support and guidance from your supervisor, as they will understand the population, setting, and intent of your intake and can probably offer significantly more helpful advice that would be better than what you would find in a book.

Having said that, the basic advice I often offer to nervous trainees is typically start by asking what the patient's perception of the purpose and goals from seeking care are ("So, I reviewed the chart, but a chart rarely tells me about the person themselves. What brings you in today?"). This will often result in endorsement of symptoms. Pull on the threads of those symptoms, with a goal to determine severity, duration, and functional impact ("how long has that been going on?, Has the decreased energy made it difficult to work/pay attention in school?" etc.). Consider and flex if it appears the patient responds better to direct or open-ended questions. I recall hearing that sleep and appetite are considered "hidden vital signs" in psychiatry, so it can always be helpful to ask about them. And most importantly, be a compassionate human in the room.

“What made you decide to come in now?”/“why now?” is also a fruitful question a lot of times.

 

[Sanman]

“What made you decide to come in now?”/“why now?” is also a fruitful question a lot of times.

Take a deep breath and work through the basics of getting to know your patient. The biggest question I have learned to ask is not in most textbooks:

What has your experience with psychotherapy been like in the past? What have you learned? What do you hope to accomplish with me?

 

[futureapppsy2]

Also, ask patients what anxiety/depression/meltdown/etc looks like for them—I drill this into my supervisees’ heads, as people use the terms to mean wildly different things, and it’s important to understand what they are actually describing.

 

[R. Matey]

Also, ask patients what anxiety/depression/meltdown/etc looks like for them—I drill this into my supervisees’ heads, as people use the terms to mean wildly different things, and it’s important to understand what they are actually describing.

In a similar vein, inquiring how often symptom x occurs and how does it impact their life are very important.

 

[Fan_of_Meehl]

Take a deep breath and work through the basics of getting to know your patient. The biggest question I have learned to ask is not in most textbooks:

What has your experience with psychotherapy been like in the past? What have you learned? What do you hope to accomplish with me?

'telos,' I love it.

 

[cara susanna]

There's a book called The Adult Psychotherapy Treatment Planner that I don't really use, but it gave me a lot of comfort to have when I was starting out because it suggests evidence-based treatment plans for pretty much any diagnosis.

Amazon.com: The Complete Adult Psychotherapy Treatment Planner (PracticePlanners): 9781119629931: Jongsma Jr., Arthur E., Peterson, L. Mark, Bruce, Timothy J.: Books

Amazon.com: The Complete Adult Psychotherapy Treatment Planner (PracticePlanners): 9781119629931: Jongsma Jr., Arthur E., Peterson, L. Mark, Bruce, Timothy J.: Books

a.co

There's also a homework planner that you can buy along with it

Amazon.com: Adult Psychotherapy Homework Planner, 6th Edition (PracticePlanners): 9781119840848: Jongsma Jr., Arthur E., Bruce, Timothy J.: Books

Amazon.com: Adult Psychotherapy Homework Planner, 6th Edition (PracticePlanners): 9781119840848: Jongsma Jr., Arthur E., Bruce, Timothy J.: Books

a.co

And corresponding kids' versions, but I work with adults so I don't know as much about those

 

[The Cinnabon]

Just wanted to chime in that I think I'm in very similar shoes to OP right now and now have a great reading list to power through over the next few weeks.

These are amazing resources and insights from you seasoned folk!

 

[PsyDocNess]

There's a book called The Adult Psychotherapy Treatment Planner that I don't really use, but it gave me a lot of comfort to have when I was starting out because it suggests evidence-based treatment plans for pretty much any diagnosis.

Amazon.com: The Complete Adult Psychotherapy Treatment Planner (PracticePlanners): 9781119629931: Jongsma Jr., Arthur E., Peterson, L. Mark, Bruce, Timothy J.: Books

Amazon.com: The Complete Adult Psychotherapy Treatment Planner (PracticePlanners): 9781119629931: Jongsma Jr., Arthur E., Peterson, L. Mark, Bruce, Timothy J.: Books

a.co

There's also a homework planner that you can buy along with it

Amazon.com: Adult Psychotherapy Homework Planner, 6th Edition (PracticePlanners): 9781119840848: Jongsma Jr., Arthur E., Bruce, Timothy J.: Books

Amazon.com: Adult Psychotherapy Homework Planner, 6th Edition (PracticePlanners): 9781119840848: Jongsma Jr., Arthur E., Bruce, Timothy J.: Books

a.co

And corresponding kids' versions, but I work with adults so I don't know as much about those

Just got these from Amazon, treatment planning feels so much less daunting omg thank you!!