Is it possible to go back into health psychology?

[psychstudent5]

Currently, I work in a partial hospitalization program where most of my clients have trauma. However, in graduate school and on internship, my work was health psych related. I did a lot of research in health psychology and most of my internship consisted of health psych rotations. I had an existential crisis after internship. i wanted to have a research only career, at least I thought i did. I ended up doing a research only postdoc that was health psych related. During postdoc, I decided that I wanted to do research in a non-academic setting.

After postdoc, I struggled in doing research in a non-academic setting. It was very difficult. I eventually got a position as a government contractor at a govt hospital, where I work now. I miss health psychology work and want to get back into that world - both research and clinical wise. However, at this point, it has been 6 years since I did clinical health psych and 2 years since I've done any research related to health psych.

Is it too late for me to go back to being a clinical health psych? If not, what can I do better my chances of getting a position because I haven't done health psych clinical work in over 5 years?

---

Members don't see this ad.

 

[deleted343839]

You're essentially talking about respecializing since you have no postdoctoral training or experience in clinical health psychology. It's not too late, though. I would suggest looking into an academic medical center position in a psychiatry department where you might be able to get some C/L experience or develop a niche for working with medical populations in an outpatient practice. You'll need some mentoring and continuing education but it's doable. Primary care is another setting you might consider, but it's more of a long shot if you lack experience in that setting.

 

[erg923]

You're essentially talking about respecializing since you have no postdoctoral training or experience in clinical health psychology. It's not too late, though. I would suggest looking into an academic medical center position in a psychiatry department where you might be able to get some C/L experience or develop a niche for working with medical populations in an outpatient practice. You'll need some mentoring and continuing education but it's doable. Primary care is another setting you might consider, but it's more of a long shot if you lack experience in that setting.

The VA is so horny for primary care mental health (PCMHI) right now, I'm sure some of the more rural CBOCs and medical centers wont really require any formal training and specialization in it or health psych to hire.

 

[Justanothergrad]

The VA is so horny for primary care mental health (PCMHI) right now, I'm sure some of the more rural CBOCs and medical centers wont really require any formal training and specialization in it or health psych to hire.

That's 100% true.

Even at major VAMC, I've seen folks with only pre-internship health psych focus shift into that role from non-VA/non-health psych jobs because of a willingness to do PCMHI (although, they had substantial training [numerous health courses, practicum, and teaching] as well as health pubs)

 

[psych.meout]

Is PCMHI just really en vogue in the VA or is it difficult to keep people in those positions (e.g., burnout) or something else?

 

[AcronymAllergy]

Agreed with the above posts RE: VA. You could look specifically for a VA that has another health psychologist already on staff who might be willing to offer some peer-to-peer mentorship.

Edit: and to psych.meout's question--it's en vogue, it can sometimes be tough to retain folks (depending on many factors, including geography and that particular VA's administrative "health"), and there's near-perpetual understaffing in MH in many VAs.

 

[Justanothergrad]

Is PCMHI just really en vogue in the VA or is it difficult to keep people in those positions (e.g., burnout) or something else?

A few things about it
1. It's en vogue
2. Interventions are not the traditional long-term therapy so many who are not pure health focused use it to transition around in the VA and don't like the lack of long term interventions since most therapy is behaviorally focused brief intervention. Although given the change in typical therapy lengths (see WET for PTSD, average allowable session max at counseling centers, etc.), it's not entirely inconsistent with many of the trends in the field towards abbreviated interventions. A lot more consultation role is one of the bigger differences in my eyes.
3. It represents a long term stable part of our field is growing because of increasing 'medicalization' of our work (e.g., managed care, greater emphasis/awareness of neuropsych etc.) and the market is adapting to enable that process. Gero is another area seeing this trend. If you want absolute job security, specialize in health psych and gero. You'll always have a job and they complement one another well.

 

[PsyDr]

Is health psych going towards more formal post docs, like every other specialty?

 

[Sanman]

Is health psych going towards more formal post docs, like every other specialty?

For the more specialty jobs, pain clinic,liver transplant, surgical evals, etc I would say yes at the VA and academic centers that I have seen. PCMHI and anything with "primary care" in the title not as much since it is a mixed bag.


I will follow up on @Justanothergrad and his third point. If you are struggling to find a way into health psych and are interested in that type of work, Geropsych is more willing to train and accept people with less experience due to the need and lower interest level. I would say that a Home-based primary care/CLC positition is on the more attainable side at the VA. Also, there are many private geropsych groups that do LTC/ALF work willing to work with those without a specialized background and provide some clinical supervision. My doctoral work was largely health psych and neuropsych before veering into gero during internship and beyond as there was work everywhere and it was easier to manage the real world transition.

 

[WisNeuro]

Is health psych going towards more formal post docs, like every other specialty?

Yep, and if I had to guess, it stands a good chance at being the next ABPP specialty board cert.

 

[Sanman]

Yep, and if I had to guess, it stands a good chance at being the next ABPP specialty board cert.

Next? There was ABPP in clinical health psych before geropsych became a specialty cert. I would say that clinical health is ahead of gero and just behind rehab psych on the push for formal post-doc and specialty requirements.

EDIT: For alot of jobs, formal post-doc seems to be the requirement for "first-tier" jobs (VA specialty clinics, Academic medical centers, specialty hospitals, etc). However, it does not seem quite as important for "second-tier" jobs (non-profit, primary care psych, private practice gigs in clinics,etc) if you have a relevant background. At least this seems to be the case now.

 

[cara susanna]

I work part time in PCMHI and I have very little health background (just a rotation on internship). But I'm at a CBOC, not a major medical center.

 

[WisNeuro]

Next? There was ABPP in clinical health psych before geropsych became a specialty cert. I would say that clinical health is ahead of gero and just behind rehab psych on the push for formal post-doc and specialty requirements.

Whoops, my bad. Apologies. For some reason I thought they hadn't yet. I need to update my knowledge on the non-neuro ABPP specialties. I mostly interact with other neuro, gero, rehab and general clinical psych people.

 

[AcronymAllergy]

For the more specialty jobs, pain clinic,liver transplant, surgical evals, etc I would say yes at the VA and academic centers that I have seen. PCMHI and anything with "primary care" in the title not as much since it is a mixed bag.


I will follow up on @Justanothergrad and his third point. If you are struggling to find a way into health psych and are interested in that type of work, Geropsych is more willing to train and accept people with less experience due to the need and lower interest level. I would say that a Home-based primary care/CLC positition is on the more attainable side at the VA. Also, there are many private geropsych groups that do LTC/ALF work willing to work with those without a specialized background and provide some clinical supervision. My doctoral work was largely health psych and neuropsych before veering into gero during internship and beyond as there was work everywhere and it was easier to manage the real world transition.

That's been exactly my (observed) experienced as well. Transplant and other pre-surg evals, etc., are usually folks who have postdoc experience (or substantial doctoral experience). PCMHI...it's typically been whatever warm bodies they can find (psychology and otherwise).

Edit: That isn't to say the PCMHI folks have been bad clinicians. Most of the ones with whom I've worked have been excellent. Just that administration seems more interested in filling the positions with someone than they do requiring any specific training, or even, you know, properly implementing the PCMHI model. This includes making hires that aren't a perfect match, such as filling psychologist positions with social workers or psychiatrist positions with NPs. Which might also be why the positions are sometimes tough to keep filled (e.g., the person took the job to get their foot in the door, and they move on as soon as something else is available).

 

[deleted343839]

That's been exactly my (observed) experienced as well. Transplant and other pre-surg evals, etc., are usually folks who have postdoc experience (or substantial doctoral experience). PCMHI...it's typically been whatever warm bodies they can find (psychology and otherwise).

In fairness, PCMH can be pretty generalist in its scope. My observation has been that the work of most primary care consultants is a lot of first-line mental health intervention. How much “real” health psych you do depends on the culture on the practice and physician buy-in. Still, it’s a good way into the field for someone without other relevant experience. ABPP now even has a mechanism for boarding clinical health psychologists working in primary care.

 

[AcronymAllergy]

In fairness, PCMH can be pretty generalist in its scope. My observation has been that the work of most primary care consultants is a lot of first-line mental health intervention. How much “real” health psych you do depends on the culture on the practice and physician buy-in. Still, it’s a good way into the field for someone without other relevant experience. ABPP now even has a mechanism for boarding clinical health psychologists working in primary care.

Agreed, and great points, thank you. As you've said, PCMHI certainly fields a broader array than might someone working in a more traditional health psych role.