Health Psychology: In the Trenches

[BellaPsyD]

I thought this would be fun. Most of the threads are "What is health psychology", but instead I was hoping interns, post-docs/residents, and licensed health psych could offer true and honest vinettes about what it is to be a health psych. Maybe a story, or a description of the population you particularly work with, something special about your training, etc... SO anyways, if you are a specialized health psych, please share your "average" day!

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[Cosmo75]

I think that it depends on where you work as a health psychologist.

I spent 2 years in an academic hospital on therapy and advanced practicum. So I can say what a typical day is like there, but I'm sure it's quite different than my internship at the VA will be like. Most of my time was in an outpatient tertiary care practice, so I saw a very specialized group of patients. All had a chronic illness of varying degrees of severity. My typical day was seeing 3-7 patients for outpatient therapy. I used CBT with 99% of them, as well as motivational interviewing and some ACT. The average # of sessions I'd say was 12, though I had a few long term clients who I saw for 2 years. Most people I saw had a component of chronic pain, so I would use various relaxation techniques including medical hypnosis.

I interacted heavily with physicians, nurses, and other staff whenever I was in the office. The psych group was well integrated and most docs would seek our advice/opinions. Since it was an academic hospital, I was also involved in clinical research. I enjoyed the integration of both practice and research in that setting quite a bit. It added to my hours also

I also got to work with psychiatry on the inpatient consult-liaison service, which opened up my experience quite a bit. I would go on rounds with the med students and residents and basically had an observer role. On that service, you could see pretty much anything. There seemed to be a lot of substance abuse, failed suicide attempts, and serious MI. I did see one teenager who had been shot in a gang fight and was paralyzed from the waist down. The C-L was more about rapid bedside assessment, which was quite different than my usual day-to-day work.

Finally, I got to run a couple patient groups. One was an intervention/treatment group and the other was a psychoeducation group.

So...depending on what you do your day will look quite different. I enjoyed the outpatient combo with research time. But a health psychologist could easily spend a lot of time on the inpatient side with very few regular clients.

I'm sure there are many other experiences. This is just what mine has been over the past 2 years. I certainly have loved it thus far.

 

[BellaPsyD]

^ thank you for sharing, that is EXACTLY what I was hoping people would do. Sounds like you've had a great experience. I believe I know what VA you are at and I have heard nothing but good things from there!

 

[joshuajason]

for the info. I wished more people would post about their experiences in this capacity. Behavioral Medicine/Health psychology is of great interest to me.

 

[BellaPsyD]

^ agreed. anyone else have a story??

 

[Ollie123]

^ agreed. anyone else have a story??

Welp, just a grad student, but I'm in a pretty large health psych lab. We're pretty much as purely academic as you'll find though, so I didn't post before because it sounded like you were looking for more clinically-inclined folks.

We're primarily doing smoking research, but we do some work with alcohol as well, and most of it is geared towards using smoking as a model for addictive behavior as a whole. We have 3 faculty members here - One is more treatment-oriented, and currently is focused on developing new treatments based off animal research. Another does some cultural work examining treatment efficacy in spanish-speaking populations, and cancer survival as windows of opportunity for quitting smoking and other positive health changes. My advisor is more on the basic science side looking at genetic factors and other underlying processes that contribute to addiction.

We also recently got out first industry-sponsored grant from Pfizer to do some drug research.

Most of our days are spent involved in research activities, though we see clients in the lab too. Grad students are obviously involved in some clinical activities as well, though most of us try and keep our involvement there to a minimum so as not to take too much time away from the research. We do have tons of clinical opportunities through the lab as well (I intermittently help out with a psychoeducational program for kids caught smoking at school, provide brief motivational counseling for homeless/underserved populations once a year, provide brief interventions at numerous health fairs in the area, on top of research SCIDs and the counseling we do in the lab).

If anyone wants more details, just let me know.

 

[erg923]

Welp, just a grad student, but I'm in a pretty large health psych lab. We're pretty much as purely academic as you'll find though, so I didn't post before because it sounded like you were looking for more clinically-inclined folks.

We're primarily doing smoking research, but we do some work with alcohol as well, and most of it is geared towards using smoking as a model for addictive behavior as a whole. We have 3 faculty members here - One is more treatment-oriented, and currently is focused on developing new treatments based off animal research. Another does some cultural work examining treatment efficacy in spanish-speaking populations, and cancer survival as windows of opportunity for quitting smoking and other positive health changes. My advisor is more on the basic science side looking at genetic factors and other underlying processes that contribute to addiction.

We also recently got out first industry-sponsored grant from Pfizer to do some drug research.

Most of our days are spent involved in research activities, though we see clients in the lab too. Grad students are obviously involved in some clinical activities as well, though most of us try and keep our involvement there to a minimum so as not to take too much time away from the research. We do have tons of clinical opportunities through the lab as well (I intermittently help out with a psychoeducational program for kids caught smoking at school, provide brief motivational counseling for homeless/underserved populations once a year, provide brief interventions at numerous health fairs in the area, on top of research SCIDs and the counseling we do in the lab).

If anyone wants more details, just let me know.

Please, please don't take offense OLLIE but i got a chuckle from the highlighted section. I would have been in many of those classes during high school..... Fact is...smoking is cool, and you know it. I'm kidding of course...I quit several years ago.

 

[Ollie123]

Please, please don't take offense OLLIE but i got a chuckle from the highlighted section. I would have been in many of those classes during high school..... Fact is...smoking is cool, and you know it. I'm kidding of course...I quit several years ago.

None taken whatsoever.

Its primary purpose for me has been to highlight the fact that I never, ever, ever want to work with treatment resistant populations. Some additional experiences don't hurt (nor do the oh-so-scarce clinical hours), and I'm willing to help out the labmates, but sooo not my thing. We're trying to get together a class for the parents of the kids too regarding how they can help their kids want to quit, which is much more my thing...it'd be optional so they'd be there of their own volition

There are too many people out there who genuinely want to quit for me to want to spend much time trying to convince those who don't.

 

[PsyDr]

for health psych stuff:

i do pre-surgical evals for individuals seeking bariatric, cosmetic, surgery or pain med pump implantation.

i also do some psychological interventions for pain management.

 

[BellaPsyD]

ollie- Thanks for sharing. Too often I think the research side gets swept away under the "clinical umbrella". I enjoyed your insight!

PSYDR- can you tell more about how you do the pre-surgical evals? That in particular is an area I am interested in.


Thanks everyone for sharing!

T4C- I am not sure if you have done any of your Rx practicums at all, but if you have, I would be very interested in hearing about that as well! (if you don't mind)

Also anyone that has worked in a general hospital- what was the day like? The environment?

 

[PsyDr]

Bella, I do not feel comfortable posting info about what constitutes a pre surg eval in a pubic forum. there are many well known standards for these batteries which i am sure you can get through a lit search.

in general, it is basically a standard psych eval without IQ with some specialty instruments thrown in. if a big "no no" pops up, the individual is either declined or declined until after successful tx of the area of concern (e.g., MDD).


quick report turn around time is mandatory if you work with medical professionals (e.g., 24 hrs).

 

[Therapist4Chnge]

quick report turn around time if mandatory if you work with medical professionals (e.g., 24 hrs).

Definitely true....and often times the clinical recommendations are the focus, so the reams of pages some people like to include in reports are often overkill. I have learned to stick with exactly what is needed, and attach the data if people have questions about something specific.

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Bella, I have yet to start my Rx practicum (I may try and do one this winter or spring...it is TBD because of my schedule). As for clinical work, I've worked both in a health and school settings, and much of what I've read here has held true for my experiences.

Working in the school system was as much about knowing how to navigate amongst the red tape and "the way we do things" as the actual clinical work. For the most part, the clinical and assessment aspects were well received by the teachers, parents, etc (as it usually confirmed what was being seen in the classroom, home, etc), though it was important to know how and when to approach the various people involved with the information.

Working with the parents can be a challenge, as even well intentioned parents can have a hard time with change, not to mention many of the family situations were often complex/messy. Overall it was a good experience, but confirmed that I didn't want to work with children in that setting. I worked with the more severe Dx's, so there were some additional behavioral, educational, and communication challenges, so YMMV.

As for the health/medical setting....there was definitely a focus on being concise, efficient, and flexible. Being on a multi-disciplinary team offered better information exchange than just reading a chart, but it also required to be on the ball and flexible because things can change quickly and often times people aren't going to explain things....you just need to know and/or be able to figure out how that will impact your work (ex. A pt. has a med adjustment, and this may effect their cog. ability, mood, etc.)

Assessments were almost always ASAP and it was important to speak to people in their language, as non-psych folks don't understand/care about how a pt. scored on something....they want to know what it means to them and how it relates to the pt/case at hand.

Overall, I prefer the health/medical setting both for clinical and research work, but it definitely has a different feel to it than something like a counseling center or school.

 

[BellaPsyD]

Definitely true....and often times the clinical recommendations are the focus, so the reams of pages some people like to include in reports are often overkill. I have learned to stick with exactly what is needed, and attach the data if people have questions about something specific.

very true. From working in a strictly neuro setting- I've definitely learned to keep it short.

 

[Cosmo75]

Yes, definitely much shorter on the report writing (which is a definite perk)