Clinical Training

As we are getting ready for the fall semester to begin, one of the administrators in our department asked the returning grad students for "wisdom" to pass on to the new students. My advice was this:

"Real" life doesn't stop because you're in grad school. Travel to somewhere new... climb a mountain... cultivate relationships outside of school... learn how to brew beer... have a baby... whatever it is that makes you happy. These are the things that will keep you going when grad school starts to drive you crazy and will make you a better psychologist in the long run.

Fortunately, our department encourages us to practice self-care on a regular basis, which has given me "permission" to take a break from work every now-and-then and enjoy the beautiful Colorado scenery. I recently hiked Quandary Peak, elevation 14,265 feet (see the photo taken at the summit), my third "14er." Very few experiences take me away from school, both physically and mentally, like standing on top of the world!

At the end of May, I completed a practicum rotation in a long term care facility (aka nursing home). I discovered that I love working in that setting and its something that I hope to gain more experience with while I'm on internship.

Dr. Eleanor Feldman Barbara is a psychologist who works in long term care and writes a blog about her experiences. She recently wrote an interesting guest post on the role of psychology in treating mental illness in nursing home residents for McKnight's Long Term Care News.

Another great resource for those interested in the topic of mental illness in long term care is the group Psychologists in Long Term Care (PLTC). 

Most of the time when we hear about Autism, we think about children. Surprisingly, or not, children with Autism grow up to be adults with Autism. I recently began a practicum rotation at The Resource Exchange (TRE) where I will be working with adults with developmental disabilities (DD). It has opened up a whole new world to me; the families of adults with DD face a lot of challenges that I've never considered before. This article in Time Magazine illustrates some of these challenges, written from the perspective of a sibling.

I've gotten a few questions recently on how one becomes a geropsychologist. While there are many paths leading to a career in geropsychology, here is one of the most efficient routes:

1) Get a bachelor's degree in Psychology: if not Psychology, another social science (e.g., Sociology) or physical science (e.g., Biology) is also helpful, as long as you take enough Psychology classes to get a basic, broad understanding of the field.

2) Get a doctorate degree in Psychology: if you'd like to go into clinical work, you'll need to complete a program in Clinical or Counseling Psychology. With a bachelor's degree, these programs usually take 5 - 6 years to take classes, write a dissertation, and complete one year of internship. The internship year is typically the last year of one's program and involves full-time clinical work.

3) Get a post-doctoral ("post-doc") position: In order to gain enough supervised clinical experience to be eligible for licensure or additional research experience (and rack up publications), many people choose to do a post-doc. Depending on what your goals are, this could take 1 - 3 years to complete.

Some people (myself included) decide to work or get a master's degree before entering a PhD program. This can add several years to the process, but is often very valuable experience.

Division 12 II of the American Psychological Association (APA) has a lot of useful information for students in geropsychology. APA Division 20 has a comprehensive list of graduate programs that provide specialization in adult development and aging.

The Council of Professional Geropsychology Training Programs (CoPGTP) has created an evaluation tool using the Pikes Peak Geropsychology competencies. The purpose of the tool is twofold: (1) for psychologists to evaluate their on-going training needs and (2) for supervisors to evaluate geropsych graduate students' development during a training program.

The 16-page list of competencies is daunting, for geropsych professionals at any level. However, when we discussed the document in my Clinical Geropsychology II class, my classmates and I were pleasantly surprised at how much knowledge and experience we are gaining through our program.

One of programs I was involved in at the CU Aging Center this year was the At Home Mental Health Service program. We partner with a local social service agency for seniors to provide therapy for clients in their homes. These individuals typically have a number of physical or emotional problems that make it difficult for them to leave their homes to obtain services.

Some things I learned through my work in this program:

1) It's OK to set boundaries: For example, asking clients to put pets in another room or not to smoke during the session is not selfish or too demanding, rather it's a way for me to take care of myself in order to give my full attention to the needs of my clients.

2) Therapy goals can never be too clear: This is particularly relevant with older clients who are dealing with loneliness. Sometimes I was seen as a "visitor" coming for social reasons. While increased social contact may be helpful in and of itself this may not be the best use of a therapist's skills.

3) Good supervision is essential: Of course supervision is always necessary, but it's especially important when dealing with complex clients. It was extremely helpful to have a team of peers and more experienced clinicians to discuss cases with and a place where I could admit I had no idea of what I was doing!

4) A lot of older adults who could benefit from therapy are out of the "reach" of traditional services: Several of the clients who I worked with through this program probably would have never engaged in therapy if it meant weekly trips to a clinic to meet with a therapist.

Though challenging, my participation in the At Home program was a valuable experience in helping me to develop as a therapist.

One of my clinical rotations at the CU Aging Center this year was in the Memory Clinic. The Memory Clinic provides brief cognitive screening for individuals who may be experiencing problems with their memory. This type of testing is less extensive than a standard neuropsychological assessment and can determine whether an individual's cognitive abilities are within a "normal" range for their age, if clear cognitive impairment is present, or if further testing is indicated.

As it turns out, most of the clients who I've assessed this year have had emotional problems that were contributing to their memory difficulties, rather than dementia. This is good news in the sense that depression, anxiety, and sleep problems are potentially treatable. Other individuals were having no memory problems, but wanted a baseline measure of their functioning in case they experience a decline in the future (a current fear of thousands of baby-boomers).

If you are in the vicinity of Colorado Springs and are interested in a memory assessment, you can contact the CU Aging Center at 719-471-4884 to schedule an appointment.

A lot of people who know me now probably wouldn't believe it, but I used to be an expert pessimist. I could ruminate on the worst aspects of any situation with the best of them. I've made several changes in my life in order to shift to a "glass half full" orientation; one of the things that helped me the most was to begin a "gratitude journal."

For the past few years, I've kept a notebook that contains lists of whatever I'm grateful for at that moment, however large ("I'm grateful for being able to visit my family at Christmas") or small ("I'm grateful for my flannel sheets"). I decided recently that I needed a practicum gratitude list. As any graduate student knows, many aspects of the practicum experience can be frustrating and annoying, but there are also many that can be appreciated. So, here's my current gratitude list for working at my practicum site:

- I'm grateful for being able to work almost exclusively with older adults and their families.

- I'm grateful for not having to search and interview for a new practicum placement every year.

- I'm grateful for having the opportunity to be involved in so many different rotations.

- I'm grateful for having a five-minute commute.

- I'm grateful for having my own desk and computer.

- I'm grateful for being able to work with bright, interesting, motivated colleagues who have similar professional interests.

We received news this week that our Ph.D. program is accredited by the American Psychological Association. UCCS now has the first official Clinical Psychology doctoral program with a curricular emphasis in geropsychology!