Y'all were right--kinda

[PsychNLife]

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So, just this October, at the beginning of my 4th year of my PsyD, I withdrew.

Mind you, academically, I was a strong student and got primarily A's. I was in the middle of a dissertation I was excited and passionate about. However, clinically, I did not have enough support in place from the program and my last two practicum placements for my disabilities.

MY first two years and practicum placements were great, but the third, in my 3rd year, I should have been wary about. In the interview, I had asked what issues past students have struggled with, and they said past students have struggled with executive functioning (which I do too sometimes--due to my ADHD-- but I didn't even disclose that at first). I did not want to go with that placement, but it was the only site during that round to give me an offer, so I felt pressure to accept it. Not very surprisingly, I began to struggle significantly at that extremely busy and high-output community-hospital site. I thought to myself "I just need to get through the year, and then I will be good. I had even gotten to the next years acceptance at a consortium site at a well known college--I JUST had to get through the year and I would have been at a very good site.

I struggled with documentation in the EHR. I was able to write notes quickly but navigating the system, having the right tags, provider numbers, making sure the dates were all correct, somewhat silly ADHD mistakes such as that built up (which was my fault and I couldnt get a handle on managing my medication regimen to help fix it). Their scheduling system was difficult for me and it help changing. There was longer documentation such as paperwork for CPS that I couldn't handle well.

In session, utilized my skills, I think decently. Sometimes I had patients drop, but when my supervisor shadowed one of my sessions she said I did very well. So, at least with some patients, we had a pretty good rapport and treatment plan. Some patients I found more difficult, but I don't necessarily think I lack clinical acumen.


Unfortunately, I became so stressed about trying to fix it that I became tearful in one or two staff meetings (never with patients).

Then, after trying my best to fix things but being unable to-- the busy community hospital site fires me. I was devastated. I lost the next years consortium site which I had an acceptance to. I finish out the rest of that year at one of my old (better) practicum sites.

Since in year 3 I lost my year 4 acceptance at the consortium, and it was already past the cycle, I was stuck with a truly terrible bottom of the barrel site come August (the beginning of year #4). I try to stick with it, but it was getting so unethical-- asking me to do things way beyond my scheduled time- demanding I answer emails when I was SLEEPING and IN CLASS and NOT ON CALL and reporting me to my advisor about it. She was sketchy with letting interns bill things-- and generally a poorly run private practice. This unethical supervisor then reports a CAN (Corrective Action Notice) on me. I was told I could either withdraw or risk dismissal. So I withdrew.

I withdrew in October of 2024, so this most recent October.

I spent several months extremely devastated. Then , I applied to a ton of programs, mostly MSW and also MPP-- so that I could branch out beyond just clinical work if I wanted to. I got accepted into both (MSW and MPP), I started at one and deferred the other as a backup in case something happens.

I know that PsyDs get a bad reputation. And most of my cohort is going to graduate, but the lack of true support was terrible. They did not support me when I was struggling with my disabilities (at least, not enough, mostly just shaming me and asking me how I can make sure it won't happen again). The second time, they REALLY did not support me and allowed her to be unethical.

I just wanted to share my story of my unfortunate experience with this PsyD program.

PS: I left with an en route masters from the PsyD, but its not licensable unfortunately.

 

[futureapppsy2]

Sorry to hear about this! Unless we're missing something, it sounds like your faculty dropped the ball without doing proper mediation and due diligence. I've had supervisees who have had concerns about and concerns from their practicum sites, and we've always run a lot of due diligence--meeting separately and together, getting, documentation, remediation plans if needed, etc. It's odd that your faculty would jump to dismissal, especially if you reported the concerns prior and had documentation,

They did not support me when I was struggling with my disabilities (at least, not enough, mostly just shaming me and asking me how I can make sure it won't happen again)

This is, unfortunately, the common experience of a lot of disabled trainees--did you ask for accommodations? If so, at what point and were they granted?

 

[PsychNLife]

Sorry to hear about this! Unless we're missing something, it sounds like your faculty dropped the ball without doing proper mediation and due diligence. I've had supervisees who have had concerns about and concerns from their practicum sites, and we've always run a lot of due diligence--meeting separately and together, getting, documentation, remediation plans if needed, etc. It's odd that your faculty would jump to dismissal, especially if you reported the concerns prior and had documentation,

I forgot to add, we did do a remediation plan. They had me explain to them what happened, and they basically just gave me an extra hour of supervision per week. A lot of it was just me telling them that I am in fact disabled and that one extra hour of supervision wasn't going to fix my executive functioning or the fact that they weren't direct with communicating with me (because I am also autistic). I think they dropped my caseload down by like 2 people as well, and then didn't tell me that I was also responsible for making up those hours somehow. These things just did not help very much.

I think a lot of it had to do with the high speed nature of the site and the way it was managed. Also, for what it was worth, the supervisor for the initial bad one was a kinda anti-disability ABA guy. He also told me it was an issue that occasionally in supervision, I didn't make eye contact with him--after knowing I was autistic.

I did not withdraw until the secondary bad site, this recent October.

 

[PsychNLife]

Sorry to hear about this! Unless we're missing something, it sounds like your faculty dropped the ball without doing proper mediation and due diligence. I've had supervisees who have had concerns about and concerns from their practicum sites, and we've always run a lot of due diligence--meeting separately and together, getting, documentation, remediation plans if needed, etc. It's odd that your faculty would jump to dismissal, especially if you reported the concerns prior and had documentation,



This is, unfortunately, the common experience of a lot of disabled trainees--did you ask for accommodations? If so, at what point and were they granted?

I tried to, but it was a messy process. I tried to get some WFH time in a distraction free environment, i was allowed to use empty rooms, but by the point this came around my relationship with the supervising team was kinda tense and non friendly, and with the stress I was under from this process--it didn't really help. It was also partly on me to get my **** together with my meds but also keep in mind, I had only done group therapy before in a minimal documentation type of site (well in my first 2 pracs it was group and low documentation), and then this hospital was like ALL documentation for the very first time and 12 individual clients.

They gave me like one hour a week of extra supervision and reduced my case load by like 2. But it didn't really help. Their EHR system and scheduling system were very complex, and I think it was a poor match for both myself and the site (and my final site as well---though they were much more unethical.

 

[smalltownpsych]

The PsyD program I went to was very supportive of a diversity of students from different backgrounds with different abilities and needs. I am sorry that you experienced something quite different. We also had a wide range of choices for sites so finding a good fit when things didn’t work out was feasible. I am sorry that you didn’t receive that type of experience. My program was university based which might have been part of it but it was also just well run and where ever I run into graduates of weaker programs, it makes me realize how fortunate I was. Good luck with your career and learning what types of environment works for you and your specific neurological makeup and how to maximize your strengths and mitigate weaknesses is the key.

One final point is that I want to emphasize environment. There is an optimal range of stress and the brain doesn’t do well when it is in a chronic state of overload and half of the time what we call disorders are just different brains that have different types of stimuli that they work well with. As someone who has run treatment programs for young people with varying cognitive and psychological profiles, this is one of the most important aspects of helping someone to improve, heal, grow, and thrive. Yet it is often neglected as we try to force people at various ends of the standard distribution to function as though they are in the middle. The example of stupid supervisor trying to increase eye contact is a great example of that. I have supervised some very socially awkward and diagnosed with autism therapists and I have found that they can be very effective with patients and the two that come to my mind had the most difficulty with certain types of socially adept jerks. Even though I’m better at handling that type, who wants to?

 

[PsychNLife]

The PsyD program I went to was very supportive of a diversity of students from different backgrounds with different abilities and needs. I am sorry that you experienced something quite different. We also had a wide range of choices for sites so finding a good fit when things didn’t work out was feasible. I am sorry that you didn’t receive that type of experience. My program was university based which might have been part of it but it was also just well run and where ever I run into graduates of weaker programs, it makes me realize how fortunate I was. Good luck with your career and learning what types of environment works for you and your specific neurological makeup and how to maximize your strengths and mitigate weaknesses is the key.

One final point is that I want to emphasize environment. There is an optimal range of stress and the brain doesn’t do well when it is in a chronic state of overload and half of the time what we call disorders are just different brains that have different types of stimuli that they work well with. As someone who has run treatment programs for young people with varying cognitive and psychological profiles, this is one of the most important aspects of helping someone to improve, heal, grow, and thrive. Yet it is often neglected as we try to force people at various ends of the standard distribution to function as though they are in the middle. The example of stupid supervisor trying to increase eye contact is a great example of that. I have supervised some very socially awkward and diagnosed with autism therapists and I have found that they can be very effective with patients and the two that come to my mind had the most difficulty with certain types of socially adept jerks. Even though I’m better at handling that type, who wants to?

I really appreciate this. It has always been difficult navigating this aspect of the work as someone who is disabled, specifically on the spectrum. It was so terrible, it made me question if I should continue to pursue clinical work (And the dean of the program essentially said "you should think hard about if this kind of work is something you want to continue to do") . Not that I was even specifically bad at clinical work, just some aspects of it are less manageable for me, like aspects of documentation or working with certain subsets of patients (I think I have decided working with young kids and their parents might not be for me). I had some patients I clicked very well with and I have had roleplays and supervised sessions that have gone very well (And I have been told and gotten feedback that they went well). Of course, we all have some types of patients that we don't click well with or we struggle more with and ultimately transfer them. I perhaps might be a bit more niche in who I work well with compared to other clinicians.

If I continue to do clinical work, I need something slower paced, with very accommodating supervisors. The reason I am now looking into MSW and MPP is that some kinda combo within that world would allow me to still potentially do clinical work if I wanted but also branch out to advocacy and policy as well, in case this kinda crumbles on me. I am trying to be creative and look into things like advocacy, policy, science communication for psychology, and a lot of things I could do potentially with out without some clinical work involvement. I still do really enjoy some aspects of clinical work.

As many people with my kind of profile feel, it just seems like nowhere is meant for us.

And, this is all on top of being massively in debt for the amount of time I spent there.

I still wonder where I would be at right now if I had gotten my **** together in time, got more solidly into my medication regimen.

 

[smalltownpsych]

I love reframes so I would say figuring out what strategies and environments work best for me as opposed to getting my stuff together. I think it is actually more useful language and self-talk. I do think your statement that we all have populations we work well with and those we don’t and maybe yours is narrower sounds like a helpful way of conceptualizing. I personally have a broad range of people I work well with and that is a benefit but I also know that one of my former supervisees who was more narrowly focused ended up being very skilled at delivering ERP for OCD and I have not developed that skill. It became kind of a self reinforcing loop (I’m not sure if that is what I really mean to say or a correct description). Nevertheless, the more I saw the skill she had, then the more patients I shuffled that way that needed it and the better she got at working with them. If I had just focused on her social deficits, then that would not have been useful to anyone.