Question regarding training post-postdoc

[sike2b]

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Hello,

I am completing my postdoc in the next few months and am currently applying and interviewing for jobs. I will soon be interviewing for a position that I'm pretty excited about, and, in many ways, seems like a great fit. However, a percentage of the job responsibilities include provision of intervention services in a modality that I don't have training in. I am really conflicted... I am excited about this opportunity (for several reasons I'd prefer not to share here) and feel that I'm able to handle most of the responsibilities, but I don't want to accept a position and then be unable to deliver competent services (even in a minority of my clinical responsibilities).

Has anyone been in this position, and if so, how did you handle it? Is it possible to do a lot of research/read treatment manuals/attend workshops and conferences and get competent in a new approach?

I have considered asking if temporary supervision is possible; I am not yet sure if this is an option.

Thanks for your thoughts!

 

[Therapist4Chnge]

I guess it depends on how much training and supervision would be needed for you to gain competency in the modality. At the least you'd want to do some reading, try and find continuing ed, and line up formal supervision and then later do case consultation to ensure competency.

If it is in a related area, you can probably be okay with some reading and consultation for the first handful of cases. For something like DBT (implemented as designed), that will require extensive training. In many places they offer DBT-informed treatment (that utilizes aspects of DBT, typically skills training, but isn't a true DBT program), which may be doable with a lot of reading, continuing ed, and consultation....though it isn't ideal.

 

[WisNeuro]

If it is in a related area, you can probably be okay with some reading and consultation for the first handful of cases. For something like DBT (implemented as designed), that will require extensive training. In many places they offer DBT-informed treatment (that utilizes aspects of DBT, typically skills training, but isn't a true DBT program), which may be doable with a lot of reading, continuing ed, and consultation....though it isn't ideal.

Yeah, I've done DBT work in the past. Lots of training and close supervision is key there. Without that, I don't know if just reading up on it can make up for no supervision in the area. Now, something like simple in-vivo and interoceptive exposure for clean panic disorder, yeah, a lot of people can pick that stuff up if they know how to do therapy in general. But I'd be wary of someone saying that they are doing DBT with no formal training or supervision.

 

[AcronymAllergy]

My take--it's certainly possible to become well-acquainted with principles of different therapeutic interventions via self-study (to include attending seminars/workshops), although I personally don't know that I'd feel competent to deliver a particular treatment without having also received at least some peer supervision of actual patient cases.

This is how training often occurs in the VA (e.g., via established trainers and regular supervision teleconferences), so perhaps something similar would be available to you, even if done informally with a colleague who's proficient in the area(s) of interest.

 

[Ollie123]

Thing my wife has taught me: If you only do things you are fully confident you can do, you will severely hinder your career growth. She's constantly reaching and stretching and has more than doubled her salary in ~4 years time by doing so. She is in a completely different field, so obviously that is a somewhat different situation but I think the same concept applies.

Obviously professional ethics dictates exactly how far you can go with this. Its important to know your strengths and weaknesses. With pretty much any job there will be things you are better at and things you aren't as good at. Working on the latter is how you grow as a person and professional. I'd be cautious, but open during the interview. Maybe they are comfortable with hiring someone who doesn't have much experience in that area. Maybe the resources to help bring you up to speed and would be happy to do so. There is a lot of grey area with these things, so it will really just depend on circumstances. I'd be extremely uncomfortable supervising students doing full blown neuro evals. I'd feel reasonably comfortable supervising students administering brief screeners even though I don't have tons of experience in that area. Yet even for the former, if it was 5% effort in a particular niche role (evaluating comorbid substance use in the context of larger evaluations) with extensive backup from actual trained neuropsychologists, that would be a very different scenario from me spending 100% of my time doing dementia evals that I am grossly unqualified to do.

 

[deleted343839]

Would you feel comfortable sharing what the new therapeutic modality is that you'd be asked to learn? We might be able to point you to some resources.

 

[sike2b]

Would you feel comfortable sharing what the new therapeutic modality is that you'd be asked to learn? We might be able to point you to some resources.

Thanks for all the helpful replies!

My fellowship is entirely neuropsych assessment, although I have some therapy experience from externships and internship (mostly CBT and PCIT). My understanding is that the position will involve some CBT, PMT, and maybe cognitive rehabilitation. It's the latter that makes me a bit uneasy... I know I have CBT experience even though I haven't done it the past few years, but I have no experience with cog rehab outside of the classroom.

 

[WisNeuro]

Thanks for all the helpful replies!

My fellowship is entirely neuropsych assessment, although I have some therapy experience from externships and internship (mostly CBT and PCIT). My understanding is that the position will involve some CBT, PMT, and maybe cognitive rehabilitation. It's the latter that makes me a bit uneasy... I know I have CBT experience even though I haven't done it the past few years, but I have no experience with cog rehab outside of the classroom.

If you have CBT experience, and adequate neuropsych training, you'll be able to pick up cog rehab more easily than some other protocols. Is there any additional training or supervision that you can get in the early going?

 

[LETSGONYR]

If you have CBT experience, and adequate neuropsych training, you'll be able to pick up cog rehab more easily than some other protocols. Is there any additional training or supervision that you can get in the early going?

I actually find this pretty interesting, as I also have limited exposure to cognitive rehab (other than some readings by people like Barbara Wilson, and just generally hearing, "well there is such limited research on the efficacy of cog rehab, since the population is so variable and it's not conducive to an RCT...").

Are there particular books/readings/therapy protocols that you (or others) have found effective or helpful?

 

[WisNeuro]

Are there particular books/readings/therapy protocols that you (or others) have found effective or helpful?

I have a couple of therapy protocols, but they're specific to the study that I've worked/am working on regarding the Cog Rehab piece. Off the top of my head, you could start with some of Elizabeth Twamley's work with cog rehab. She does quite a bit, although I think a lot of her recent stuff has centered on cog rehab in individuals with schizophrenia. I'll look through my stuff when I have time and see if I can pull some citations for other work.