Specializing in eating disorders

[Kelly75]

Hi everyone. I’ve known for a long time I wanted to specialize in EDs and have worked in the field with a masters before coming back to get a doctorate. Anyone else wanting to specialize get pushback from professors or supervisors that they shouldn’t specialize in EDs because they’ll get burnt out, won’t make any money, won’t know how to treat anything else, etc? Just curious if this is a common experience.

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[foreverbull]

I did not hear the same information from others about this track, although certainly informally some areas are known for being "high burnout" such as DBT specialists, PTSD specialists, etc., and ED tends make the list. Not sure if research bears this out as higher burnout for ED than generalists? Something you might want to look into. And I'd suggest chatting with an ED specialist who works in a hospital or private practice setting to see what it's like.

What I did find in grad school and beyond was that it is really hard to get into this area without a solid practicum, internship, or postdoc with in-depth training. In many settings I've worked in, only one or two clinicians would have competence to treat eating disorders, so the earlier you can get the experience, the better. After postdoc, you're largely shut out of this specialty because jobs will require extensive experience, at least from the job offerings I saw a few years back. Ideally, if you are still early in your doctoral training, you could try to make sure you get specialist ED training and some generalist training via practica/externships.

A former supervisor of mine largely saw folks with ED in her private practice, but also worked with clients with other concerns (anxiety, depression, etc.), so she never got "stuck" working only with ED. If you have experience in generalist areas, you can always fall back on it as part of your core competence, so I would argue no, you're not necessarily shut out of generalist practice.

 

[deleted760483]

Actually yes I heard almost this exact same feedback, except for the money part. My therapy practicum was about 50% ED focused and about half of the internship sites I applied to were strongly ED focused. I distinctly remember my advisor saying "don't pigeon hole yourself" several times throughout the process. He also expressed concern about my gender (I am a male) which helped me realize he was completely ignorant about the world of ED treatment.

Currently, I am the only psychologist in my entire county who specializes in eating disorders. I love what I do, make a very good amount of money, and have a wait list for therapy. Being a specialist will really never be a bad thing, unless you want to live in a VERY rural area where there simply may not be a high enough concentration of the population you wish to work with to make a living.

 

[PsyDr]

So I'm not really a huge treating person.

IMO, treatment of children are one of the things that people are willing to pay for. Paying for the treatment of a disorder that threatens the life of your child is almost a no brainer. Just guessing: the mean eating disorder pt comes from a higher SES than average.

 

[Sanman]

Are any of the people that are giving you pushback doing what you envision yourself doing in the future? If not, take their advice with a grain of salt. IMO, it is easier to go backwards and be a generalist at work after you have specialty experience than it is to get a specialty job with less experience.

 

[cara susanna]

I know a lot of eating disorder specialists (my program had strong ED faculty) and they seem to be doing pretty well.

 

[Kelly75]

Thanks for your thoughts everyone. The pushback has not been coming from anyone who is in the field of eating disorders. The only person in my program who is in the field of eating disorders has encouraged me to continue with specializing. The thought to take others’ advice with a grain of salt is especially helpful. I think the professors who are pushing back are coming from the perspective that our program is a generalist program and that I shouldn’t be specializing this early. I already worked in eating disorders for several years before I came back to school and really enjoyed it, so it’s hard to break away from that when it’s what I know I want to do. I also have a lot more to learn in terms of eating disorders, so I got an ED externship where I’ll be doing a type of therapy I’ve never done, and I’ve gotten a lot of pushback for that as well since some people thought I should’ve gotten an externship that was not ED related. I’m trying to balance listening to the perspectives of professors/supervisors who have a lot of experience and getting the best training in order to go into a field that I’m confident is what I want to be doing.

 

[Sanman]

What year of the program are you in and how many externship you going to have before you finish? With the additional info, I see where they are coming from. Nothing wrong with your choice of externship, but try to get a few other experiences along the way as well.

Something like a college counseling setting may dovetail with your interests, but not be quite as specialized. Remember, specializing does not mean only doing one thing. Having research in the area and some clinical rotations is enough prior to internship and post-doc. It doesn't mean ONLY doing one that for all of your doctoral training.

 

[Kelly75]

Thanks, that’s a good point. I’m going into my third year. For the first two years of the program I worked in a community mental health setting. Both third and fourth years I’ll be doing externships. I was close to choosing a college counseling center for third year, so maybe for fourth year.

 

[Sanman]

Something to consider, where would you like to do internship? Take a look at placements you would like and next year is a time to round out your experiences to fit with those of some internships. It might be college counseling or academic medical center.