Testing Experience and VA Internships

[futurepsydoc]

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I was hoping that current VA interns and VA internship applicants could provide some perspective on the importance of psychological testing with respect to getting an interview and/or securing an internship placement within the VA system.

I have heard from multiple peers, professors, and supervisors that a premium is placed on testing experience in the VA system. Yet, at the same time, I get the sense that testing experience following internship is not all that useful unless you plan on specializing in testing, have a career in neuropsychology, or work with specific populations in which testing is heavily utilized (i.e., children, adolescents, elderly, developmentally disabled, forensic, etc).

Maybe I am naive in some sense, but if my goal is to work with veterans and focus on the treatment of PTSD, substance abuse, and adjustment/reintegration related problems, I am not sure how psychological testing experience will better prepare me for this endeavor than additional training in psychotherapy. Yet, if I can't get my foot in the door because I am weak in testing, my ultimate goals may be much more difficult to attain.
Hence the original question.

Any insight fellow members could offer would be greatly appreciated.

 

[Therapist4Chnge]

I was hoping that current VA interns and VA internship applicants could provide some perspective on the importance of psychological testing with respect to getting an interview and/or securing an internship placement within the VA system.

It depends on the VA....some really value assessment experience, while others may not care as much. I know assessment was one of the core competency areas during my training, though I'm not sure if that was a VA requirement, APA requirement, or both. We had to show proficiency in IQ assessment, personality assessment, and demonstrate that our assessment choices were appropriate for our cases. Our cohort came in with a wide range of assessment experience, so don't think you need to have seen hundreds of cases to get an interview. A number of the VAs I interviewed at were open to providing additional assessment training if sought out/warranted.

I have heard from multiple peers, professors, and supervisors that a premium is placed on testing experience in the VA system. Yet, at the same time, I get the sense that testing experience following internship is not all that useful unless you plan on specializing in testing, have a career in neuropsychology, or work with specific populations in which testing is heavily utilized (i.e., children, adolescents, elderly, developmentally disabled, forensic, etc).

I think the biggest mistake people make about assessment work is that it is somehow "in addition" to talk therapy and other interventions. It is very much a core component of our the intervention work because it brings objectivity to our clinical judgments. Unfortunately assessment work has taken some hits in the past 10-15 years because of declining reimbursements, but now it is on the upswing with the focus on EBTs and outcome research. I don't think most psychologists get enough assessment training during their university years, at least not in a format that is truly applicable to "real world" challenges.

I am somewhat biased because I am a neuropsychologist, but I also provide talk therapy (reluctantly ) and consultation as part of my day to day work, and assessment plays a central role in my talk therapy work. I think your typical private practice will be less likely to give anything more than a BDI-II, BAI, etc...but a job in the VA will require at least some basic assessment work. For instance, as interns we had to do monthly C&Ps (with the core staff required to do more). A C&P consisted of a clinical interview and then administration of various screeners, at least one personality assessment, and a few other measures. It wasn't an extensive battery, and thankfully portions were computerized, but we still had to interpret the data and write reports based on our findings.

Maybe I am naive in some sense, but if my goal is to work with veterans and focus on the treatment of PTSD, substance abuse, and adjustment/reintegration related problems, I am not sure how psychological testing experience will better prepare me for this endeavor than additional training in psychotherapy. Yet, if I can't get my foot in the door because I am weak in testing, my ultimate goals may be much more difficult to attain.

Assessment experience will enhance you ability to provide empirically based treatments. Differential Dx will dictate treatment interventions, and going off of clinical judgment is often not enough. Prolonged Exposure Therapy, one of the leading EBTs for PTSD in the VA setting, requires frequent administration of PCLs, BDIs, etc. It isn't rocket science, but it at least it is something. In the substance abuse area they often do pre/post assessments for outcome research.

At the end of the day I am sure you can carve out a niche where you have minimal interactions with assessment work, but it will definitely be around the VA system. Some people in private practice refer out all of their assessment work, but I think they are losing out on one of the most valuable things our training has provided us as clinicians.