How to strengthen my clinical skills?

[Childdoconeday]

I am looking for guidance as to how to strengthen my clinical skills? I find that I constantly doubt myself, although I have had good feedback from supervisors and have done good work with cases.

I have an almost obsessive like tendency to do trainings, workshops, pay for supervision, watch videos, but my insecurity comes down to my clinical skills in session. How do I know if I'm doing a good job? Although I can learn about a topic (example- OCD) i am not sure how to actually strengthen my clinical/intake skills now that I am far post grad school. I want to improve, be great at what I do, and I find myself feeling insecure about how I articulate questions or if I'm doing a good job with those whole therapy thing

Looking for guidance? Any videos I can watch of actual sessions? etc

---

Members don't see this ad.

 

[WisNeuro]

I am looking for guidance as to how to strengthen my clinical skills? I find that I constantly doubt myself, although I have had good feedback from supervisors and have done good work with cases.

I have an almost obsessive like tendency to do trainings, workshops, pay for supervision, watch videos, but my insecurity comes down to my clinical skills in session. How do I know if I'm doing a good job? Although I can learn about a topic (example- OCD) i am not sure how to actually strengthen my clinical/intake skills now that I am far post grad school. I want to improve, be great at what I do, and I find myself feeling insecure about how I articulate questions or if I'm doing a good job with those whole therapy thing

Looking for guidance? Any videos I can watch of actual sessions? etc

If you want to do it informally, you could always seek out a peer consultation group. We have several of these floating around for various practice areas. If you want something more formal, as in someone reviewing your work, you could always get patient consent to audiotape some sessions and pay for more supervision. But, I'd start with some more informal consultation and see how you feel there before going the more costly route.

 

[futureapppsy2]

What level are you in terms of training/licensure?

 

[Ollie123]

Following with interest.

I've moved into a purely academic role and am now effectively 100% research. Still licensed in my previous state and may pursue licensure here if it doesn't prove too annoying. Clinical work has never been my focus, but there is some confidence that comes with knowing I can fall back on it should the need arise and I want to make sure I don't become too rusty. Probably need to pick a pretty narrow subspecialty just to make it easier to maintain some semblance of competency.

 

[AcronymAllergy]

If you want to do it informally, you could always seek out a peer consultation group. We have several of these floating around for various practice areas. If you want something more formal, as in someone reviewing your work, you could always get patient consent to audiotape some sessions and pay for more supervision. But, I'd start with some more informal consultation and see how you feel there before going the more costly route.

This is what I was going to recommend as well. If you're in VA, there's the option of pursuing certification, which involves audio taping sessions with patients and reviewing them with your trainer.

@Ollie123 The only real, true way I can think of would be to carry a very, very small clinical load (i.e., one or two patients). Outside of that, maybe see if there are any group supervision meetings (i.e., involving trainees) you could attend? I definitely learned a lot just observing group supervision of interns' therapy cases and listening to my much more therapy-experienced peers.

 

[Fan_of_Meehl]

I am looking for guidance as to how to strengthen my clinical skills? I find that I constantly doubt myself, although I have had good feedback from supervisors and have done good work with cases.

I have an almost obsessive like tendency to do trainings, workshops, pay for supervision, watch videos, but my insecurity comes down to my clinical skills in session. How do I know if I'm doing a good job? Although I can learn about a topic (example- OCD) i am not sure how to actually strengthen my clinical/intake skills now that I am far post grad school. I want to improve, be great at what I do, and I find myself feeling insecure about how I articulate questions or if I'm doing a good job with those whole therapy thing

Looking for guidance? Any videos I can watch of actual sessions? etc

1) keep that sense of humility (but don't let it turn into overwhelming anxiety or indecisiveness)
2) keep up on the literature relevant to the disorders/conditions you are treating
3) never be afraid to say 'I don't know' (if you don't know), but let's come up with hypotheses (educated guesses) about what's going on here and see how we can try to gather evidence for/against these hypotheses
4) always be cognizant of the 'treatment utility' or (lack thereof) of a diagnosis or element in your case formulation; you can always fall back on a generic cognitive-behavioral assessment procedure such as having the patient describe their patterns of thinking, feeling, and behaving in response to events
5) learn a little bit about the philosophy of science and the differences between the scientific task of DESCRIPTION vs. the scientific task of EXPLANATION; keep in mind the basics such as correlation not equaling causation, an 'effect' can never be its own 'cause,' etc.
6) practice, practice, practice while keeping one foot in the library, one foot in the clinic, and wearing down a path between the two as a result of constant running back and forth

 

[Sanman]

Beyond what has been already listed, I will say this. There are two kinds of jobs in the real world. Those that prize quality and hope to charge a premium and those that charge a lower fee and hope to have large volume. Large volume providers seldom care about quality. So, I would start to look at how to get more involved in jobs that prize quality. Places like Children's hospitals and VAs can be good places to start a career for a reason. After that, providing quality care generally involves being engaged in continuing education/ self-improvement, managing your finances/personal affairs, and taking stock of your ethics.

 

[R. Matey]

Somewhat of thread hijack, but related...what's the general SDN take on postgraduate certification as a method to sharpen clinical skills? For instance, I contemplated obtaining ACBT certification as a master's level clinician, and have found myself recently considering it again. But, I also don't want to go down an endless credentialing sinkhole because it sounds expensive and probably not necessary, but where do you draw the line?

 

[WisNeuro]

Somewhat of thread hijack, but related...what's the general SDN take on postgraduate certification as a method to sharpen clinical skills? For instance, I contemplated obtaining ACBT certification as a master's level clinician, and have found myself recently considering it again. But, I also don't want to go down an endless credentialing sinkhole because it sounds expensive and probably not necessary, but where do you draw the line?

I'm sure there are certain areas where the certification matters. But, there are a lot of areas where the certification is pure marketing gimmick. For example, recently someone posted about some sort of geriatric certificate. A couple of us who have worked in the field of geriatrics have never actually seen this certification in the wild.

So, I think it's a caveat emptor situation. Do your due diligence. For example, got a recent mailer about Cognitive Processing Therapy training that entailed a certificate. There's a lot of junk out there, but this workshop is being personally taught by Kathleen Chard, so I'd be much more willing to believe that it's quality training. Now, if it was being led by some SW with an alphabet soup of acronyms behind their name, that's a different story.

 

[summerbabe]

I have an almost obsessive like tendency to do trainings, workshops, pay for supervision, watch videos, but my insecurity comes down to my clinical skills in session. How do I know if I'm doing a good job?

I’m wondering what your take is on the quality versus quantity of these efforts. I’ve done my fair share of 1-4 day trainings which have ranged from pretty helpful to barely being able to remember a thing afterwards.

However, I’m currently in a VA EBP rollout (4 days of training + 1 year of weekly consultation with somebody certified by the VA in this treatment). My consultant reviews tape each week and I get great feedback that’s increasing my understanding of this treatment, tips on general areas for growth, pointers on specific skill-based things I can apply in future sessions, and I have the opportunity to do case conceptualization/reflection.

There is a ton of prep work on my part compared to previous trainings that I’ve done but it also results in a depth that I haven’t experienced previously.

 

[Spydra]

I am looking for guidance as to how to strengthen my clinical skills? I find that I constantly doubt myself, although I have had good feedback from supervisors and have done good work with cases.

I have an almost obsessive like tendency to do trainings, workshops, pay for supervision, watch videos, but my insecurity comes down to my clinical skills in session. How do I know if I'm doing a good job? Although I can learn about a topic (example- OCD) i am not sure how to actually strengthen my clinical/intake skills now that I am far post grad school. I want to improve, be great at what I do, and I find myself feeling insecure about how I articulate questions or if I'm doing a good job with those whole therapy thing

Looking for guidance? Any videos I can watch of actual sessions? etc

From my vantage point as an intern I am not much help with the constant doubt, but if you're putting forth so much effort to learn and stay up to date I wonder if you've considered ABPP. That process would encompass much of what you're already doing and each subspecialty has its own requirements for demonstrating competency. Once done, perhaps the process and the board certification letters added to your name will help with the insecurity. ABPP also has advantages that you may find beneficial depending on your larger career plans.