So, I've heard from a few graduate students, and even a POI, that they recommend seeing a therapist while you are in training to be a clinical psychologist. I think this can be helpful for a few different reasons, but I'll table this for the time being. What do you all think?
In therapy while in grad school?
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I have been told that it is a good idea. That is, if you can afford it. Most schools have mental health clinics tied to their clinical or counseling psychology programs, and most prohibit their clinical/counseling students from being clients at those clinics. Obviously, a good idea, but that leaves only the costly options.
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Some programs encourage it more than others. Often times psychologists in the local community will see grad students at a reduced fee. I'd recommend talking to your state/county psych association to see if they can recommend anyone. In S. Fl I knew a couple of psychologists who would see a graduate student or two for a reasonable rate, which seemed like a really nice way to give something back.
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From what I know, this is very true. My program is psychodynamically oriented and one of the first questions I was asked by both faculty members who interviewed me was "How do you feel about the idea of being in therapy during your doctoral studies?" In other words: "Go get a therapist, NOW."
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Huh, interesting. That's kinda cool. Glad I read this thread, though. I think if I hadn't known that was a standard thing many recommend, I might have thought they saw something in me that was a red flag or something and would become all self-conscious. But it is a good idea. Would help with burnout and just making sure the therapist/student is mentally fulfilled/healthy as can be. Might as well not be a hypocrite!
But it is a good idea. Would help with burnout and just making sure the therapist/student is mentally fulfilled/healthy as can be. Might as well not be a hypocrite!
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Huh, interesting. That's kinda cool. Glad I read this thread, though. I think if I hadn't known that was a standard thing many recommend, I might have thought they saw something in me that was a red flag or something and would become all self-conscious.
Slightly OT, but I DO think psychology has a hypocritical bent toward this... Three of the schools (didn't apply, due to unrelated reasons--changing research interests) I looked at required information on psych dx'es and tx on their application, and I don't think they would use this is a "plus" in the applicants favor... My abnormal psych teacher (a clinical grad student) swore up and down that she didn't have any issues at all, even though I know she really did (we had a good mentee/mentor relationship after the class ended and got to knoiw each other pretty well)... granted, they were minor and very subclinical, but they were there... I definitely think the field has a bias, spoken and unspoken, against therapy and dx'es (or even just personal failings) for clinicians. On one hand, I can see why you would clinicians to be quite mentally healthy; on the otther hand, the fact that psych can have such a stigma against the disorders/conditions we study is kind of unsettling in a way.
Wow! That's sad. They would have been defying the Americans with Disabilities Act. They would not have been able to ask questions about one's mental health diagnoses or treatment or would have risked legal action.
I agree with futureapppsy2 that there is a bias against having actual mental health diagnoses. But, I think many schools encourage their mentally healthy students to seek counseling, not for the treatment of a disorder but for personal growth.
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I think everyone one of us has some "issue" whether or not it fits the DSM IV for a diagnosis. It's especially apparent on this board
<--joke Given what we encounter with our clients I actually think it's a great idea for clinicians to get some form of their own therapy to work through countertransferrence, triggers, vicarious traumatization and/or just to understand what it's like for our own clients to experience giving up some of their deepest feelings to a stranger.Furthermore, I can understand and appreciate the bias as I have worked with mentally ill coworkers and came across a few while in graduate school. In one program, one woman in particular was asked to leave to get help and another just never finished. Understand that some enter graduate programs in psychology to understand their own struggles. They get to a point where they either gain some insight and they move forward or they become "stuck". There is nothing more unsettling than untreated mental illness in one of us charged with the upkeep of the emotional well being of another. So I understand the bias.
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I don't see how this can be a bad idea as long as one has the time and resources for it. My dept never recommended therapy but I looked into counseling myself around my 3rd year. Just the process of trying to find a therapist using my insurance system and facing my own stereotypes and feelings of stigma led me to appreciate even more what some of my clients have to deal with (logistically and personally) to come see me.
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Ditto.
ALso, I recommend Nancy McWilliams' Psychoanalytic Psychotherapy book, which has (among other things) a nice chapter on why therapy is such a good idea for the therapist. Easy read and very relevant, regardless of theoretical orientation.
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Going to therapy as a therapist-to-be will do several things. Firstly, it will provide you a framework as to how therapy is "done" and you will likely model your therapist when you provide therapy. It might also give you greater insight into your preferred orientation and how CBT/psychoanalysis are really more similar than they are different. Secondly, you experience others based on your own past experience. How can you be sure of your ability to accurately diagnose and treat patients if your perceptions of them may be related to past unresolved issues? Thirdly, are you comfortable selling a product that you don't believe in? I'm sure money is a big barrier to seeking treatment for grad students but there are clinics with sliding scales and private practitioners that take insurance. If you find yourself still resisting therapy, then what (and why) are you subconsciously avoiding?
If you can't tell, I'm a big proponent of grad students being in their own therapy. It's a long, difficult marathon and you'll appreciate that you took the time to take care of yourself along the way.
If you can't tell, I'm a big proponent of grad students being in their own therapy. It's a long, difficult marathon and you'll appreciate that you took the time to take care of yourself along the way.
From what I know, this is very true. My program is psychodynamically oriented and one of the first questions I was asked by both faculty members who interviewed me was "How do you feel about the idea of being in therapy during your doctoral studies?" In other words: "Go get a therapist, NOW."
My school required 45 hours of individual psychotherapy from a licensed psychologist. There were different tracks available including dynamic, cbt, existential. I believe that it is more common in PsyD program. Also, I personally believe that all therapists should have some experience being on the other side (not necessarily because they are experiencing a major depressive episode
). The institution did not ask for anything from the psychologist providing the therapy except certifying the hours.
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It's never been brought up, either by faculty or students, in my program (VERY CBT/behaviorally-oriented). However, I don't imagine any of the people here would be at all against it; it's just not dictated as an essential aspect of training.
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Yeah, I definitely agree that although seeking therapy for yourself can be very beneficial, you have to weigh it against the other constraints on your life. For this reason, I resent when it is required.
I have decided not to go to therapy because I already have to travel to three different sites during the course of doing my weekly work. Seeing an outside therapist would require an additional trip as well as additional couple hours a week I simply don't have to devote to that.
Additionally, I find I am able to work through many, if not all, of the issues people are bringing up in this thread during clinical supervision (which I receive plenty of each week).
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+1
Even as an undergrad, I've learned to really value clinical supervision, especially when I have particularly difficult clients.
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I'm at a school that leans CBT and is research-heavy, and while we are not told "get in therapy", multiple professors have said that they believe seeing a therapist, particularly as you start to see clients, can be beneficial and would gladly give recommendations to non-university-affiliated places for us to go if we are interested. So, I am surprised to hear that other research-heavy/CBT heavy places discourage it... it is seen as a healthy, normal, smart thing to do here (though not required by any means).
I particularly think it would be helpful to explore one's own biases and blind spots in therapy, in order to help you keep yourself in check as a clinician.
I particularly think it would be helpful to explore one's own biases and blind spots in therapy, in order to help you keep yourself in check as a clinician.
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What clients would you have at the undergrad level?
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I co-facilitate alcohol/substance misuse groups for undergrads here who have received MIPs or campus alcohol citations.
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ARE there programs that discourage it? I am under the impression that it's either encouraged, or not mentioned/explicitly encouraged at all. My program doesn't mention it, but I don't think it would be actively discouraged.
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Self-care is emphasized in my program (though therapy itself hasn't been brought up so far). I don't think it'd be discouraged, though, and I would personally feel comfortable approaching the DCT or faculty for referrals if need be, and I don't think I'd be judged negatively for it.
We are a research-heavy CBT program, FWIW.
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Yeah... I don't think any program would ever in a thousand years discourage anyone from seeking therapy. I mean, think about what we're saying here... a clinical psychology program discouraging a student from seeking therapy. Say it over and over in your head for about 30 seconds... it starts to sound as funny as if you said hippopotamus over and over in your head for 30 seconds.
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Agreed. While my program (as previously mentioned, HEAVILY behavioral/CBT) doesn't actively encourage all students to enroll in therapy solely for the experience of it, I truly doubt anyone here would denounce any student for seeking such services.
I don't doubt that there might be professors here or there who would look negatively on a student for seeking therapy while in grad school, but I don't know that any psychology program would publically take such a stance.
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My research-focused program encourages students to see a therapist if they haven't.
Personally I'm astounded by people who want to do therapy having never been on the other end of it. It's purely anecdotal, but the folks with whom I am personally acquainted who have never been in therapy but are practicing therapy as students are not very good. They're very very leaky, project all over clients, and have no idea how to do their own work.
Personally I'm astounded by people who want to do therapy having never been on the other end of it. It's purely anecdotal, but the folks with whom I am personally acquainted who have never been in therapy but are practicing therapy as students are not very good. They're very very leaky, project all over clients, and have no idea how to do their own work.
D
deleted270468
what about therapy in undergrad?
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My school required 45 hours of individual psychotherapy from a licensed psychologist. There were different tracks available including dynamic, cbt, existential. I believe that it is more common in PsyD program. Also, I personally believe that all therapists should have some experience being on the other side (not necessarily because they are experiencing a major depressive episode
My school does the same thing, but I believe it's 30 hours. At first, I was indifferent in how I viewed the required hours. Looking back on it, I'm grateful my school required me to "be on the other side." Secret keepers need secret keepers.
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This seems like it fits the description of my program as well.
Rimi, I'm curious to hear how being in therapy has helped you as a clinician...
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My own anecdotal experience: I've worked with clinicians who both have, and have not, been participants in therapy, and I haven't noticed a significant and orderly difference in skills between the two groups.
I won't at all argue that the process doesn't help some individuals improve their applied skills. However, I would argue that it's not a necessary component of training above and beyond close supervision.
I see it as being similar to the initial hesitancy some clients with substance abuse problems have toward working with a clinician who hasn't him/herself struggled with substance abuse issues. Not a perfect analogy, but close enough.
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The substance abuse example is given often, and I agree with you that you do not have to have been through it to adequately treat it. I think where going through therapy can be helpful is with improving your own insight into your own "stuff". Having this insight can help guard against blindspots...both in session and outside of session.
On an intellectual level it is easy to overestimate your abilities to seperate your personal feelings from your clinical judgments, and I think that can potentially open up the clinician to problems. Most clinicians are aware of some of their blindspots, but I think far less (particularly early career psychologists) have an in-depth understanding of their own blindspots.
Going back to the substance abuse example....I actually have concerns about people who practice in an area with which they have personal experience. Jung's work on the Wounded Healer really highlights my concerns about countertransference and the dangers of unconscious influence on the therapeutic process. On a more conscious level, Me-Psychology (attempting to solve/understand personal demons) is also problematic, though I think it is easier identified.
Another area where personal therapy is beneficial is to better understand how the patient relates differently to the clinician. The clinican's role is covered in classes, practica, etc....but if you have personal experience from the other side, I think it would help crystalize the difference better.
I could go on, but those are just a few things to keep in mind when considering the Pro's/Con's of personal therapy.
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This. I totally agree.
Yeah. It's nice to have someone actually forcing you to work within your blind spots and really sift through them. I haven't gone to therapy yet, but definitely plan on finding time for it during graduate school... somehow....
I would never knowingly see a therapist who had not gone through therapy him or herself. I share others' concerns about clinicians who go into psychology to solve their own problems (and may not solve them), but that is a separate, troubling issue.
On a very basic level, I don't think you can do very good therapy if you haven't been through the process yourself. I think this is true regardless of the kind of interventions used. The dynamics of the therapeutic relationship are unlike any other kind of relationship, and I think it is crucial to experience both sides of it.
Another issue--and this by no means covers all students (or faculty) who avoid therapy themselves--but it drives me crazy when clinicians look down on therapy as something for other, more troubled people. There is value in acknowledging that you are not "above" the kind of treatment you yourself offer.
On a very basic level, I don't think you can do very good therapy if you haven't been through the process yourself. I think this is true regardless of the kind of interventions used. The dynamics of the therapeutic relationship are unlike any other kind of relationship, and I think it is crucial to experience both sides of it.
Another issue--and this by no means covers all students (or faculty) who avoid therapy themselves--but it drives me crazy when clinicians look down on therapy as something for other, more troubled people. There is value in acknowledging that you are not "above" the kind of treatment you yourself offer.
C
ClinPsycMasters
I disagree. I would only have concern if they had unresolved issues, and I don't know if that's what you meant.
Some similarities between therapist and patient can be actually helpful. The books don't tell us everything so this is where our common experiences and common humanity can be most helpful to the other person. I see this all the time, with therapists of color, writing about their own people and their struggles, giving voice to pain and suffering not to mention common misunderstandings that are finally spoken in a language that we hear and take notice of. Same with sexual orientation, gender, age issues, etc.
Generally speaking, all therapists need to go for therapy if they have unresolved issues or are not self-aware. Some think that it is possible to be completely objective in therapy, never having to face our own demons. Nonsense. You do react to the patient and in fact that's a good thing. You use your reactions (countertransference) as information about patient's state of mind. If your reactions are distorted by subconscious forces that are desperately trying to keep a psychic wound covered up, the therapy suffers.
Therapy (specially psychodynamic version) can be very frightening experience for the oblivious therapist. As long as one's very effective defensive mechanisms are in place, the depths of fear, rage, despair, unreality and nothingness, are not experienced/worked through. We may experience those states vicariously while dealing with particularly disturbed patients such as those with severe personality disorders, psychosis, or those who have endured severe sexual/physical abuse. Of course we can go for therapy at such a time if a need for it ever arises.
I'll end with a reference to a discussion with a friend who did go for therapy but when he was doing masters. He went for psychodynamic therapy and after a couple of years "realized" that he had gone into psych for the "wrong reasons." Of course he tried to ignore this bit of dangerous information but seeing how he wanted to practice psychodynamic therapy in future, he could not very well devalue the very system of inquiry/meaning that he intended to use in helping others.
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I think it's a good idea to have it be required of anyone in a clinical program. I was required to do a minimum of 16 hours. I did probably over a hundred before I got my doctorate. Much better off as a therapist b/c of it.
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It really isn't any different because whether or not a patient is being seen for individual or assessment, they still present with the same symptoms/behaviors. Someone with borderline personality disorder who is acting out can kick up the same counter-transference issues whether they are in therapy or taking a WAIS-IV. A good portion of my assessment work in the main hospital is for suicidal/homicidal/dangerous behaviors.
If I'm doing a neuro assessment to assess for ALZ, and I have not yet addressed my issues with putting one of my parents into a home because of ALZ*, it could actually be WORSE for me because I have to watch as the person across the table continues to struggle and fail everything I put in front of them. The same can be said for someone who has to do a competency hearing for a suspected rapist/murderer, and they still have not worked through their personal issus with our correctional system.
I am a big supporter of everyone in this profession having an outlet for their "stuff". Some people find that in hobbies, others find it in religion, and others have their own therapists to help them deal with day to day stress.
*Not a true event, but my point still holds.
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All very good points T4C. Thanks for posting.
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IA with what most people have said. It is absolutely essential that we gather some experience being the client ourselves. I have been seeing a therapist for the past three years and I have found it very helpful. Not only has she afforded me the opportunity to work through many of my issues but she has also served as a mentor in many respects.
I agree it can be very helpful, and am in a pretty CBT-heavy program that doesn't "require" it but encourages students who want it to seek it out and has made arrangements for it.
That said, I personally would find it a bit invasive if a program "required" it. I have received therapy before, and I obviously feel it is helpful given my career choice. That said, I'm not sure it is the one and only solution to some of those issues - as others have mentioned I think good supervision goes along way. Certainly, reassurance and backup from my supervisor and clinic director when one of my first clients turned out to be a multi-morbid, substance abusing borderline with a list of Axis III and IV as long as your arm went a long way in terms of helping me deal with the....unpleasantness of that particular situation Though there were undoubtedly a few days I contemplated the experimental route (and posted about it) so I could happily play with brain waves and data matrices and not worry about such things.
I'm a believer in continuum models and agree that most people have SOME issues. That said, I'm reluctant to recommend, let alone insist upon therapy for anyone who isn't past a certain threshold on that continuum. Perhaps I will fit the CBT stereotype here, but I'm not convinced psychology's role is with the "Worried well" (so to speak), and I remain somewhat skeptical that formal therapy in such circumstances achieves anything beyond forcing someone to reserve a time slot for self-reflection that otherwise might be filled with work or television. That isn't hypocritical - I can and do say the same thing to clients once they achieve symptom remission and relapse-prevention work has been done, and find it infuriating how many therapists out in the real world seem content to continue seeing someone for as long as they or the insurance keeps paying for it, regardless of whether any change seems to be happening.
Introspection is vital for anyone giving therapy for all the reasons outlined above, but I don't view therapy as the only means of achieving it.
That said, I personally would find it a bit invasive if a program "required" it. I have received therapy before, and I obviously feel it is helpful given my career choice. That said, I'm not sure it is the one and only solution to some of those issues - as others have mentioned I think good supervision goes along way. Certainly, reassurance and backup from my supervisor and clinic director when one of my first clients turned out to be a multi-morbid, substance abusing borderline with a list of Axis III and IV as long as your arm went a long way in terms of helping me deal with the....unpleasantness of that particular situation
Though there were undoubtedly a few days I contemplated the experimental route (and posted about it) so I could happily play with brain waves and data matrices and not worry about such things. I'm a believer in continuum models and agree that most people have SOME issues. That said, I'm reluctant to recommend, let alone insist upon therapy for anyone who isn't past a certain threshold on that continuum. Perhaps I will fit the CBT stereotype here, but I'm not convinced psychology's role is with the "Worried well" (so to speak), and I remain somewhat skeptical that formal therapy in such circumstances achieves anything beyond forcing someone to reserve a time slot for self-reflection that otherwise might be filled with work or television. That isn't hypocritical - I can and do say the same thing to clients once they achieve symptom remission and relapse-prevention work has been done, and find it infuriating how many therapists out in the real world seem content to continue seeing someone for as long as they or the insurance keeps paying for it, regardless of whether any change seems to be happening.
Introspection is vital for anyone giving therapy for all the reasons outlined above, but I don't view therapy as the only means of achieving it.
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C
ClinPsycMasters
Agreed!
I would only consider requiring therapy "invasive" if the school requiring it also required some sort of report on your progress, or to see your therapy notes, or that you got your therapy from therapists that reported to their administration. Aside from that, I think it's a reasonable thing to require of students who become professional therapists, and not "invasive" at all. It's a learning experience.
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I think requiring therapy is invasive in the same way that requiring regular doctor or dental check-ups would be. It may be a good idea, but individual choice has to enter into the picture as well. As Ollie said, there are other routes to gaining self-awareness.
Also, many programs aren't able to provide insurance that covers therapy, especially long-term therapy. In a way, it's requiring students to spend money. This is financially invasive.
I certainly wouldn't support a program discouraging their students from seeking therapy, but I also think requiring it crosses a line.
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I've been following this thread for a while and wasn't sure how to express why I would personally be uncomfortable if a program required it. Ollie expressed my problems with that perfectly. I agree that seeking-therapy should be supported, but I also agree with everything else Ollie said, and personally would find it invasive and agree about the 'worried well' perspective. Granted, Ollie and I seem to be from the same theoretical backgrounds and I work in PTSD treatment research right now, which I feel always has in the back of its mind the risks of impeding upon natural recovery processes (i.e., psychological debriefing etc.).
Anyway, just wanted to echo what Ollie said.
Anyway, just wanted to echo what Ollie said.
That would certainly be MORE invasive, but I pretty much agree with what KD said. I'm not sure it is the schools place to dictate student's health in that way. I agree with you that it can be a learning experience, however I'm not convinced it is the only (or the best) way to learn about therapy. Having rectal exams could certainly be one way for a physician to learn what it is like and how to do it, with the added advantage of being able to be really really really confident you don't have any fissures, polyps, or prostate issues, but I'm not convinced that means med schools should require it in people with otherwise healthy colons
(Kidding....sort of). I don't deny it can have benefits, and I don't deny something could be learned from it. I think therapy is more important as an outlet for the stress and other emotions that go along with being a therapist and grad school in general, and making sure that your own issues don't interfere with the client's well-being. Learning might happen...I'm not convinced it will, at least not beyond what you would get from observing sessions in the school clinic. Either way, it doesn't sit well with me.
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We don't train to be dentists or doctors. We train to be (primarily, as clinical psychologists) therapists. As such, fostering empathy for the clients who are the subject of our ministrations seems to be critical, hence the requirement. I'm not sure if "self-awareness" is the main reason for requiring therapy of clinical psych. candidates - if one is able to develop a greater degree of it through personal therapy, that's great - but I don't think greater self-awareness is necessarily an outgrowth of good therapy (but it can be). But to me, having the experience of patienthood is.
The financial burden of the therapy requirement is a real concern - but can be addressed without dispensing of the requirement.
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I agree with this. At least for psychologists who want to be therapists, I think personal therapy is an experience you cannot get anywhere else -- not in supervision, not by reading, not even by self-reflection on one's own. All of these other pursuits are excellent -- they just are no substitute,
There just are certain aspects of the therapy process that I'd never have fully understood without having gone through them with my own therapist.
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So should medical schools start requiring all of their surgeons to go under the knife in order to foster a better bedside manner? Don't get me wrong, empathy is a good thing, but it is always going to have its limits. A therapist is not going to fully understand the experience of his/her client simply because the therapist has sat in that seat. After having two therapy experiences myself, I'm not convinced it has fostered empathy in me over and above what I already possess simply from being human. I'm also not sure how my experience as someone in therapy talking about non-clinical anxiety and depression helps me better relate to a client with severe mental illness. Even if it does increase empathy, though, should this come at the expense of infringing on someone's personal health decisions? My opinion is no, let the student decide whether or not it is worth it.
Obviously not. In many cases, "bedside manner" (empathy, genuiness, etc.) is sometimes not particularly necessary for being a good physician. Surgeons do their most critical work with unconscious patients. My father is a neuroradiologist. He actually *never* speaks with his patients (and likes it that way, curmudgeon that he is), and is an excellent physician regardless.
We can't do our work without interacting with our clients, and empathy, genuiness, "good bedside manner" is critical for what we do - in fact, some would argue a necessary curative factor.
What's with this idea about "infringing" on someone's health decisions? No one forced you to go to grad school. If you don't like being required to do therapy time, you don't have to go to grad school for clinical psychology.
As an aside, this is probably unfair to say, but it's a little strange to see how a bunch of aspiring clinical psychologists can be so dead-set against therapy....
