Neuropsychology question- Therapy?

[jp1234]

Hello everyone! This is my first time posting. I have a question that might seem obvious, but I want to double check before I make any final decisions. I am applying for graduate school for the Fall of 2018, and I'm interested in doing mostly neuroimaging research with human subjects with some neuropsych testing and teaching. I had thought that the natural progression for me would be to pursue a phd in clinical psychology with a concentration/track in neuropsychology. However, I was talking to a clinical psychologist recently who talked about how being a clinical psychologist is focused heavily (at least in course work and practicum experiences) in administering psychotherapy. Is this true even if you're choosing to go for a neuropsych track? Are there other options for me if that is not what I want to do therapy as a focus for my career. If I'm being honest with myself, I don't think I would have the skills necessary to engage in therapeutic relationships with patients. Should I be leaning more towards something like cognitive neuroscience degrees?

Thanks for the help!

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[WisNeuro]

A good neuropsychologist is a good clinical psychologist first. If you would not be good at clinical psychology, I can almost assure you that you will not be a good clinical neuropsychologist. In any reputable program, you need to build a good foundation as a psychologist first, generalist training. In the mid and latter stages of your training you will specialize, but you need that foundation. Even if you do not want to focus on therapy as a career, you need to have that experience.

 

[psych.meout]

A good neuropsychologist is a good clinical psychologist first. If you would not be good at clinical psychology, I can almost assure you that you will not be a good clinical neuropsychologist. In any reputable program, you need to build a good foundation as a psychologist first, generalist training. In the mid and latter stages of your training you will specialize, but you need that foundation. Even if you do not want to focus on therapy as a career, you need to have that experience.

And isn't the therapy/intervention training an essential part of developing the skills for giving feedback to patients and otherwise interacting with them outside of administering instruments?

 

[WisNeuro]

And isn't the therapy/intervention training an essential part of developing the skills for giving feedback to patients and otherwise interacting with them outside of administering instruments?

Yes, many times. Whether it's telling someone that they have a degenerative neuropathological condition, or telling someone that their mTBI is not causing their current problems (more likely PD, SUD, etc), you are managing that patient's emotional functioning. They need to hear what you have to say, you need to do so much more than just deliver results. A trained monkey can go through results with no context, that's not what you are trained to do.

 

[erg923]

Not to mention being knowledgeable, insightful, empathic about how psychiatric and emotional factors are affecting the patient's clinical presentation and behavior in the room with you.

Comorbid conditions are the rule, not the exception. Neuropsych eval on BPD patient or someone with raging PTSD/insomnia, depression, anxiety, ****ty life syndrome and possible TBI? You bet you better be a good "psychologist."

Having at least basic skills in therapy/counseling is essential for managing these patients, interacting with them, and assessing them effectively.

 

[jp1234]

I think I didn't make my point of concern clear enough. I apologize for that; let me attempt to clarify. A fundamental understanding on how to interact with patients while administering testing or delivering results in an empathetic way makes perfect sense. I would be more than willing to learn how to do that. It's just that it seems very different to me than what typical therapy sessions are like-- what clinical psychologists that I know do with patients. Am I wrong? I just want to make sure that if I'm going for this degree, I can get to my ideal career goal.

 

[psych.meout]

I think I didn't make my point of concern clear enough. I apologize for that; let me attempt to clarify. A fundamental understanding on how to interact with patients while administering testing or delivering results in an empathetic way makes perfect sense. I would be more than willing to learn how to do that. It's just that it seems very different to me than what typical therapy sessions are like-- what clinical psychologists that I know do with patients. Am I wrong? I just want to make sure that if I'm going for this degree, I can get to my ideal career goal.

Except that's not really what you posted about in your OP:

Hello everyone! This is my first time posting. I have a question that might seem obvious, but I want to double check before I make any final decisions. I am applying for graduate school for the Fall of 2018, and I'm interested in doing mostly neuroimaging research with human subjects with some neuropsych testing and teaching. I had thought that the natural progression for me would be to pursue a phd in clinical psychology with a concentration/track in neuropsychology. However, I was talking to a clinical psychologist recently who talked about how being a clinical psychologist is focused heavily (at least in course work and practicum experiences) in administering psychotherapy. Is this true even if you're choosing to go for a neuropsych track? Are there other options for me if that is not what I want to do therapy as a focus for my career. If I'm being honest with myself, I don't think I would have the skills necessary to engage in therapeutic relationships with patients. Should I be leaning more towards something like cognitive neuroscience degrees?

Thanks for the help!

Coursework and practicum experiences in intervention/therapy are mandatory parts of APA accredited programs and you'll likely have trouble matching with good APA accredited internship sites and fellowships if you don't have sufficient therapeutic experience and training.

It's fine if you want to have an assessment, teaching, and research-focused career, but you still have to get robust training in therapy and intervention.

 

[WisNeuro]

I think I didn't make my point of concern clear enough. I apologize for that; let me attempt to clarify. A fundamental understanding on how to interact with patients while administering testing or delivering results in an empathetic way makes perfect sense. I would be more than willing to learn how to do that. It's just that it seems very different to me than what typical therapy sessions are like-- what clinical psychologists that I know do with patients. Am I wrong? I just want to make sure that if I'm going for this degree, I can get to my ideal career goal.

The vast majority of neuropsychologists came up through traditional clinical psychology programs. There's no need for gimmicky "Neuropsychology tracks" or any of that (usually) garbage, as long as the clinical psychology program had quality practica training in neuro. In your case, it seems that you want to also have a program that emphasizes research a good deal, specifically one with imaging research ongoing. So yes, you can still get to where you are going with a clinical psychology degree. In fact, if you want to do research, npsych testing, and teaching, a clinical psychology PhD is pretty much your only way to go.

 

[ForeverJung]

If neuroimaging is your primary interest/goal, why not a degree in neuroscience? I believe those are less clinically focused. I know of several programs that offer doctorates in developmental or affective neuroscience, among others.

 

[Therapist4Chnge]

WiseNeuro covered most of what I'd respond (about needing a solid foundation as a clinical psychologist), so I'd just add that giving feedback is one of the most important things we do, and many of the skills learned in regard to therapy are helpful in that setting. Establishing rapport is necessary for most clinical interactions (if you want to get the best data), but it can be established quickly in most instances.

 

[Fan_of_Meehl]

Hello everyone! This is my first time posting. I have a question that might seem obvious, but I want to double check before I make any final decisions. I am applying for graduate school for the Fall of 2018, and I'm interested in doing mostly neuroimaging research with human subjects with some neuropsych testing and teaching. I had thought that the natural progression for me would be to pursue a phd in clinical psychology with a concentration/track in neuropsychology. However, I was talking to a clinical psychologist recently who talked about how being a clinical psychologist is focused heavily (at least in course work and practicum experiences) in administering psychotherapy. Is this true even if you're choosing to go for a neuropsych track? Are there other options for me if that is not what I want to do therapy as a focus for my career. If I'm being honest with myself, I don't think I would have the skills necessary to engage in therapeutic relationships with patients. Should I be leaning more towards something like cognitive neuroscience degrees?

Thanks for the help!

I'd also wonder--at this stage of your academic and professional development--what sort of exposure you've had to actual, professionally-administered, competent, empirically-supported psychotherapy approaches (vs. what is portrayed as 'therapy' in books, literature, pop culture, and films). I know that, until I actually received training/supervision in modern professional psychotherapy, I had a disinclination to become a practicing clinician doing psychotherapy (I thought I wanted to go into research/teaching). As an undergraduate psychology major, I'd read Robyn Dawes' book 'House of Cards' which was an unfair 'hit piece' against psychotherapy and went into clinical psychology grad school never intending to become a practicing clinician. Once in graduate school and exposed to excellent supervisors who taught me the scientific basis of modern psychotherapeutic interventions as well as dispelling some basic myths about psychotherapy (e.g., that you just sit there and 'listen' to people complain about their problems, or that you have to fix their problems for them), I fell in love with the practice.

If you are passionate about the field of psychology (and all the related fields it touches including neuroscience, medicine, biology, philosophy, sociology) and you like helping people, you just may find that you can tolerate learning to do professional psychotherapy long enough to make it through grad school and acquire generalist training and then go on to specialize in neuropsychology. Or you might, like me, find that you like it a little too much to give up.

 

[erg923]

I think I didn't make my point of concern clear enough. I apologize for that; let me attempt to clarify. A fundamental understanding on how to interact with patients while administering testing or delivering results in an empathetic way makes perfect sense. I would be more than willing to learn how to do that. It's just that it seems very different to me than what typical therapy sessions are like-- what clinical psychologists that I know do with patients. Am I wrong? I just want to make sure that if I'm going for this degree, I can get to my ideal career goal.

Yes and no.

Keep in mind that treatment recommendations are an integral part doing clinical neuropsychological assessments. Nothing is more useless than "patient would benefit from engaging in ongoing mental health treatment." It really helps when you truly know this area (preferably through robust direct experience), even if you are not the primary therapist, or even particularly skilled in that area. You will certainly need to know the details and "ins and outs" of various psychological treatments/therapies if you are to do any real clinical neuropsychology.

If you only want to do imaging research that happens to use some of neuropsychological measures in the scanner or for baseline data, I think it fine. Otherwise, you really need to be truly and broadly clinically trained.

 

[bcliff]

great question OP

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from my experience, neuropsychologists with solid intervention training tend to be highly sought after -- there’s a *huge* need for providers who can use neuro- data to efficiently inform client case conceptualizations and treatment implementation. even when not directly providing intervention services to clients, a firm understanding of behavioral interventions is key to conceptualizing specific treatment recommendations.

one of my first supervisors told me that every therapy session is an assessment session, which has really resonated with me throughout my training -> solid intervention training tends to improve our assessment skills, especially in terms of fluidly, naturally, and efficiently building rapport, listening, and gaining important information that might otherwise be missed. neuropsychological testing data is *one* (very important) piece of data that is often used in the context of a larger neuropsychological evaluation, but without a rich clinical interview, data from clients’ task performance often struggles to stand on its own.

there are also subspecialties of neuropsychology that consist of heavy intervention work (neuro-rehab) -- on my current neuro- rotation, i’m required to keep an outpatient psychotherapy caseload of 3 clients (.. which i’m a big fan of).

 

[AcronymAllergy]

Agree with what everyone else has said--neuropsychologists are psychologists first, just like psychiatrists are physicians first. Proficiency in therapy goes hand-in-hand with being a competent (practicing) psychologist. There are multiple effects/benefits for a neuropsychologist that come from therapy training, even if the provider never actually performs therapy in a traditional sense, and expertise in therapy only comes through the actual supervised provision of therapy.

Establishing rapport, interviewing, observations, feedback, recommendations, conceptualization--these all benefit from experience with therapy. Just as a neurologist or psychiatrist can offer unique insights into the "whole picture" of a patient from a medical perspective, neuropsychologists can (and should) do the same from a psychological perspective.

 

[smalltownpsych]

To see it from the flip side. I primarily focus on providing psychotherapy and some basic assessments and am not a neuropsychologist at all, but my neuropsych experience during both practicum and coursework comes into play when I need to know when to refer and how to read neuropsych assessments and how to get an idea of the neuropsychologist's competency. Recently had a patient who had a neuropsych eval done after a TBI, the patient and the patient's NP have both misunderstood the findings and I was able to clarify for the patient's benefit. When I explain something from the report to the patient and they say, "oh yeah, that's what the neuropsychologist told me, too.", that is a sign of good psychological practice.