DBH at ASU

[Pragma]

I wish psychology would change the lingo on the word "internship." It has too many other connotations. We should just make up a word, like practitionership.

Or "matchitionership"

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[PHD12]

I wish psychology would change the lingo on the word "internship." It has too many other connotations. We should just make up a word, like practitionership.

I was confused for a college student intern by a patient I was trying to encourage to go to detox. He definitely had his "beer goggles" on

 

[tpizza01]

Internship isn't an "arrange your own" thing in clinical psych doctoral programs. You go through a match system. Having connections helps, but it isn't guaranteed to get you one. Coming from an online program will be a huge liability for your chances of matching to an accredited internship (which, as others have said, you would need for a VA psychologist job).

Yes, I understand the match system. I do have a good network, but as I mentioned in another post, I am certainly not going to rely on it as a "guarantee" - heck - I'm not even in a program yet The VA is not my only option either. I have never, and will never put all of my eggs in one basket - I wouldn't be where I am professionally if I did.

As far as the getting an internship with an online program, I understand that matching will be tough, I've talked with a few others around the area that are in programs from Walden and Capella (not that I want to attend these programs) and they claimed that it is indeed difficult - however, they DID find something and are happy with what they have.

Thanks for the response

 

[bmedclinic]

however, they DID find something and are happy with what they have.

Are they happy, or have they settled? Here's why I'm saying this: I've accepted where I matched for internship, but it was my 8th place. It's the only place that is APPIC and not APA. I regret it. And I'm from a B&M PhD program-- in that sense those things are clearly in my favor. Now, I must have royally screwed up somthing at my interviews to have not matched, and that sucks, but is an aside (I was also really sick for the majority of the time I was interviewing, which really really sucked). Anyways, all I'm saying is that finding "something" likely isnt what you want. I'm already scrambling, knowing that my internship wont set me up for post-doc like I'd like.

You said you're not even in the program yet.
Think about this: At every step, all the odds will be stacked against you. If you match "somewhere" and it's not APA approved, all the odds for many jobs will continue to be stacked against you. Now consider this: your competition is not a bunch of slouches- they're people getting doctorates in an overly competative field with an internship crisis. If you knowingly choose to go to a school that's going to set you a few steps back, that's your call-- but just know it wont stop. Everyone applying for internship is indeed, not on equal footing. Not trying to be a buzzkill, sorry if I am. It's a HUGE decision, though.

 

[Therapist4Chnge]

Doing everything "right" provides nothing but a chance at ending up okay. You still need to keep the debt down, attend an APA-acred. program & internship, complete a post-doc/fellowship (ideally in a speciality area), and pass the EPPP. At this point they now have an opportunity to make a decent living, have some flexibility, and have a shot at a nice career. Falling outside of this path will add hurdles, some of which are easier to navigate than others. The vast majority of posters on here are trying to watch out for prospective students because many don't know what they don't know.

 

[PHD12]

Yes, I understand the match system. I do have a good network, but as I mentioned in another post, I am certainly not going to rely on it as a "guarantee" - heck - I'm not even in a program yet The VA is not my only option either. I have never, and will never put all of my eggs in one basket - I wouldn't be where I am professionally if I did.

)

Tpizza: Do you know the difference between APA, APPIC and unaccredited internships? Those folks at walden get unpaid, unaccredited ones generally speaking. Do you know about the employment limitations of taking on an APPIC or unaccredited internship? What about the specific employment/licensure limitations from an unaccredited doctoral program? Do you know the specific requirements that every VA requires to land a predoctoral internship? Did you know that you can't work while completing the predoctoral internship and that many unaccredited positions are also unpaid (there are very few accredited ones that are part-time)?

You keep talking about the VA and having connections there. However, if you went to any online program (incl. walden, capella, etc), you would not even be able to apply there for a predoctoral internship because these programs are not accredited. If you graduated from either program, you would not be able to work there as a psychologist either. This is a national regulation at every VA. Again, this is a fact that others have pointed out. I am not trying to argue with you either, I am just hoping that you do more research, especially regarding the different internships.

Here is the VA national training website for psychologists where you can read about eligibility: http://www.psychologytraining.va.gov/eligibility.asp

 

[Sanman]

Doing everything "right" provides nothing but a chance at ending up okay. You still need to keep the debt down, attend an APA-acred. program & internship, complete a post-doc/fellowship (ideally in a speciality area), and pass the EPPP. At this point they now have an opportunity to make a decent living, have some flexibility, and have a shot at a nice career. Falling outside of this path will add hurdles, some of which are easier to navigate than others. The vast majority of posters on here are trying to watch out for prospective students because many don't know what they don't know.

This pretty much sums up what most people are trying to say nicely and is very true. The other thing to keep in mind is that VA positions are very competitive. I had a friend apply for a VA job (smaller suburban VA) that externed at that particular VA and knew the staff. She did not even interview. She asked her old supervisor the reason why and the answer was that there were 400 applications for 1 spot.

 

[PHD12]

This pretty much sums up what most people are trying to say nicely and is very true. The other thing to keep in mind is that VA positions are very competitive. I had a friend apply for a VA job (smaller suburban VA) that externed at that particular VA and knew the staff. She did not even interview. She asked her old supervisor the reason why and the answer was that there were 400 applications for 1 spot.

Very similar to what i've heard. Even the VA postdocs out here cannot get a VA psychologist position. I know many previous VA interns and VA postdocs who could not get into the VA system afterwards as psychologists because the competition is so keen (most are near cities). The VA psychologists I know got into the VA system about 5 years post-degree or worked in a "less desirable" location first.

Anyhow, it's disturbing to hear people on this forum talk about how they will take out 200K in debt because they will just work for the federal government afterwards.

 

[erg923]

Tpizza: Do you know the difference between APA, APPIC and unaccredited internships? Those folks at walden get unpaid, unaccredited ones generally speaking. Do you know about the employment limitations of taking on an APPIC or unaccredited internship? What about the specific employment/licensure limitations from an unaccredited doctoral program? Do you know the specific requirements that every VA requires to land a predoctoral internship? Did you know that you can't work while completing the predoctoral internship and that many unaccredited positions are also unpaid (there are very few accredited ones that are part-time)?

You keep talking about the VA and having connections there. However, if you went to any online program (incl. walden, capella, etc), you would not even be able to apply there for a predoctoral internship because these programs are not accredited. If you graduated from either program, you would not be able to work there as a psychologist either. This is a national regulation at every VA. Again, this is a fact that others have pointed out. I am not trying to argue with you either, I am just hoping that you do more research, especially regarding the different internships.

Here is the VA national training website for psychologists where you can read about eligibility: http://www.psychologytraining.va.gov/eligibility.asp

I jept thinking the same thing. These programs are not APA accredited, thus you are NOT even eligible for 90% of internships.

I have always jokingly said that the best test of EF is to ask the patient to put the Wisconsin cards back in order after the administration. Can't one criteria for critical thought be the weighing of financial reward vs financial risk and pros and cons....

 

[edieb]

Very similar to what i've heard. Even the VA postdocs out here cannot get a VA psychologist position. I know many previous VA interns and VA postdocs who could not get into the VA system afterwards as psychologists because the competition is so keen (most are near cities). The VA psychologists I know got into the VA system about 5 years post-degree or worked in a "less desirable" location first.

Anyhow, it's disturbing to hear people on this forum talk about how they will take out 200K in debt because they will just work for the federal government afterwards.

The high level of competition for a VA psychologist position was not what I experienced at all 2 years ago. Thus, I think it depends where you apply. A good strategy is to apply to a less desirable VA and then once you're in, wait the requisite year and get the inside track on a VA job in a more desirable location.

 

[futureapppsy2]

I'm already scrambling, knowing that my internship wont set me up for post-doc like I'd like.

Just out of curiosity, why did you decide to rank a non-APA site? I'm not judging at all (G-d knows the imbalance is awful all-around!), just wondering how you weighed the pros and cons and if you'd make that same choice in retrospect.

 

[AcronymAllergy]

Just out of curiosity, why did you decide to rank a non-APA site? I'm not judging at all (G-d knows the imbalance is awful all-around!), just wondering how you weighed the pros and cons and if you'd make that same choice in retrospect.

Unfortunately, I think bmed has previously said they wouldn't do the same again. But I can speak first-hand to the intense pressure you're under during those few days when you're really focusing on your rank-order list, all the while with the possibility of not matching weighing very heavily on your mind. I'm not a particularly anxious individual, but that whole situation even had me dealing with physiological symptoms.

Looking back on my own experience, there were probably 1 or 2 sites that, while accredited, I probably shouldn't have ranked owing to a variety of factors. But hindsight is particularly brutal when it comes to the internship process.

 

[Pragma]

I have always jokingly said that the best test of EF is to ask the patient to put the Wisconsin cards back in order after the administration. Can't one criteria for critical thought be the weighing of financial reward vs financial risk and pros and cons....

Well - many of these folks, I'm guessing, have a lot of subjective "pros" that they are fixated on beyond any financial considerations. (e.g., "They will call me Doctor")

 

[tpizza01]

Tpizza: Do you know the difference between APA, APPIC and unaccredited internships? Those folks at walden get unpaid, unaccredited ones generally speaking. Do you know about the employment limitations of taking on an APPIC or unaccredited internship? What about the specific employment/licensure limitations from an unaccredited doctoral program? Do you know the specific requirements that every VA requires to land a predoctoral internship? Did you know that you can't work while completing the predoctoral internship and that many unaccredited positions are also unpaid (there are very few accredited ones that are part-time)?

You keep talking about the VA and having connections there. However, if you went to any online program (incl. walden, capella, etc), you would not even be able to apply there for a predoctoral internship because these programs are not accredited. If you graduated from either program, you would not be able to work there as a psychologist either. This is a national regulation at every VA. Again, this is a fact that others have pointed out. I am not trying to argue with you either, I am just hoping that you do more research, especially regarding the different internships.

Here is the VA national training website for psychologists where you can read about eligibility: http://www.psychologytraining.va.gov/eligibility.asp

Ok, Let's forget the VA altogether because I am obviously not being heard. You even quoted me saying that it is an option, and "option". But again, let's just forget it. You mentioned Walden folks getting unpaid internships "generally", and while I agree, and I am sure you can prove it, I can say that there is one that works in my counseling center that is getting paid - and yes, @bmedclinic , they are happy.

Difference between APA and APPIC varies, but I guess the best way to put it would be the difference in availability of jobs in the end. Not sure what is greater, and I am sure it will vary depending on what field or area of specialization you are in. However, I also would like to throw this out there from the Virginia Board o Psych.:
"1. Candidates for clinical psychologist licensure shall have successfully completed an internship that is either accredited by APA, APPIC or the National Register of Health Service Providers in Psychology, or one that meets equivalent standards."
It is stated very similar in their requirements for education, simply put, APA or equivalent education course load.

Look, all, I realize that the internship is probably one of the biggest things to consider before going for any doc, but I think this is getting way deeper than it should. Keep in mind, that I am not saying that it is unimportant, I know it is. I am also sure that getting one is a difficult process - not denying it. I realize that I may not get one right away - got that ...

@therapist4change, you said:

Doing everything "right" provides nothing but a chance at ending up okay. You still need to keep the debt down, attend an APA-acred. program & internship, complete a post-doc/fellowship (ideally in a speciality area), and pass the EPPP. At this point they now have an opportunity to make a decent living, have some flexibility, and have a shot at a nice career. Falling outside of this path will add hurdles, some of which are easier to navigate than others. The vast majority of posters on here are trying to watch out for prospective students because many don't know what they don't know.

Very well put, but I would say that I am willing to take a chance at all of this, knowing that in the end, license or none, I will have gained more knowledge and be able to provide a better service for my clients. In the end, that's what it's all about for me. With licensing, I am hoping to provide MORE services, but all in all, I want to increase my knowledge, while still having at least a "shot" at licensure. (I will be an LPC also though).

I came on this site looking for answers, information, others' experience, and I feel in a way that this has gone to the level of a 'youtube' comment section. It's discouraging. I feel misunderstood, judged, you name it - I feel like I entered a playground to play and got sand thrown in my face for bringing up a new idea of how to cross the monkey bars. I realize there are some realities in this field, and traditional methods of getting to where we want to be, but not all of us want to be where each other wants to be. Some of us are not afraid to to take chances and try something different. You see, we are all going to die one day, and the pieces of paper that we hold really don't mean a thing. It's the path we take, the work we put in, the value that WE ourselves place on each of those that matters. While some are afraid of death, some of dying, some afraid of living, I remain afraid of not living and experiencing things. It's not a matter of whether or not my experience is accredited by an organization, it's a matter of whether or not my experience was valued by me and was I able to do good with that experience. Call it hokey and old fashioned, but it's how I feel. I do fine financially right now, and I am not about looking for a bigger check, in fact I will be taking a loss once I fully transition into this field. But I am doing it anyway. Because I believe that is where I belong.

So, maybe a little help here? Because all I am getting so far it seems, is what not to do, or discouragement of entering an online program. Trust me - the minute I can afford to leave that job and still take care of my family, I will be applying to the b&m schools, but for right now, I am looking at other options.

Thanks

 

[Pragma]

I do fine financially right now, and I am not about looking for a bigger check, in fact I will be taking a loss once I fully transition into this field. But I am doing it anyway. Because I believe that is where I belong.

That's a great position to be in. It must be nice.

So, maybe a little help here? Because all I am getting so far it seems, is what not to do, or discouragement of entering an online program. Trust me - the minute I can afford to leave that job and still take care of my family, I will be applying to the b&m schools, but for right now, I am looking at other options.

My advice would be to wait for that minute you mentioned here.

I am sorry that you are feeling like people are throwing sand in your eyes. But I would also offer that sometimes people come to these forums with a loaded question. If they don't get the response that they were looking for, they get upset. Personally, I would advise anyone against attending an online program. That is my opinion. I am not going to sugarcoat it.

You ultimately have to make the best decision for you, as you alluded to. But at least you have information about a) outcomes for the program, b) cost compared to other options, and c) how people in the field perceive these programs (very negatively). If all of that is okay with you, then so be it.

 

[tpizza01]

That's a great position to be in. It must be nice.



My advice would be to wait for that minute you mentioned here.

I am sorry that you are feeling like people are throwing sand in your eyes. But I would also offer that sometimes people come to these forums with a loaded question. If they don't get the response that they were looking for, they get upset. Personally, I would advise anyone against attending an online program. That is my opinion. I am not going to sugarcoat it.

You ultimately have to make the best decision for you, as you alluded to. But at least you have information about a) outcomes for the program, b) cost compared to other options, and c) how people in the field perceive these programs (very negatively). If all of that is okay with you, then so be it.

Thank you for your honest opinion.

Trust me, I did not come here with a loaded q. But I was expecting to hear from some of the positives as well. It was hard enough for me to come here knowing that I was going to be bombarded with negatives right off the bat. Does that make any sense?

Sand: Maybe a little exaggerated, but still, lol. I am looking for help, and all I seem to have gotten is a feeling (my feelings) of judgment for even 'thinking' of online.

Regarding "must be nice". I can say, that yes, it is - and I don't' mean that to be mean. I worked hard to get where I am, but in the end, I am not happy. I want to change, and since money isn't everything, I am willing to take a loss - but I still need to take care of my family.

Thanks again

 

[cara susanna]

Please understand that we're not trying to be mean. The people responding to you in this thread are mostly students and young professionals in psychology who have seen this process play out. I understand wanting to get into a clinical psych program so badly, I really do. I was in that place myself once. However, we're often so focused on getting in that we don't think about what lies on the other side. I'm speaking as an incoming fifth year who will be applying for internship for the first time. And I am so completely anxious about it, even though my program has a good APA-accred match rate. I can't imagine how I would feel if I were in a program where the statistical odds of matching were completely against my favor.

 

[tpizza01]

Please understand that we're not trying to be mean. The people responding to you in this thread are mostly students and young professionals in psychology who have seen this process play out. I understand wanting to get into a clinical psych program so badly, I really do. I was in that place myself once. However, we're often so focused on getting in that we don't think about what lies on the other side. I'm speaking as an incoming fifth year who will be applying for internship for the first time. And I am so completely anxious about it, even though my program has a good APA-accred match rate. I can't imagine how I would feel if I were in a program where the statistical odds of matching were completely against my favor.

Thank you for the response.

It just seems like I am getting a lot of opinions that are not really supported, and really geared toward just the end placements. I want to know abotu experience in the different environments - or can anyone provide me a case in which the graduate was completely clueless because of the education they received from an online program. Also, one of the programs I am looking into is Fielding - a blended program. Their residencies and face to face time is fairly extensive and provides plenty of class time.

Good luck with internship I'm sure you will be fine.

 

[PHD12]

HI Tpizza:

I commend you for trying to increase your knowledge base and wanting to help your patients. I am pretty confident that you would learn more by attending workshops by experts in the field (The VA will even cover some of these) and also paying for supervision if necessary, than by attending an online program. It will also be significantly less costly than 100K tuition. For example, you can attend a 10-day intensive DBT workshop with Marsha Linehan et al. (the person who created the treatment), and I believe get ongoing supervision afterwards and join a free consultation group in DBT in your location. That is just one example. You will never get this type of quality and depth of training via online program.

Secondly, if licensure is even a secondary goal, you will face an uphill battle with both an unaccredited program + unaccredited internship (which is almost a sure bet when you attend an unaccredited program). You know this stuff already. For what it's worth, I have never met a licensed psychologist in PP or in any setting who got licensed with an online degree. Maybe others have? I have one distant relative who completed a distance education PhD program in psychology approximately 15 years ago. She is still not licensed and is not able to work in the field (fortunately, spouse is supporting her).

Unfortunately, we can't give you an exact percentage of how much risk you are taking since Walden/Capella DO NOT report any licensure rates on their websites. I would presume that the licensure rate is very low otherwise they would report it (like all programs do). Anyhow, if you are willing to take the risk, go ahead.

Here are some online reviews from walden students. Sometimes positive reviews online are also written by the program though: http://www.onlinedegreereviews.org/college/walden-university-reviews/psychology-1331/reviews/

 

[tpizza01]

HI Tpizza:

I commend you for trying to increase your knowledge base and wanting to help your patients. I am pretty confident that you would learn more by attending workshops by experts in the field (The VA will even cover some of these) and also paying for supervision if necessary, than by attending an online program. It will also be significantly less costly than 100K tuition. For example, you can attend a 10-day intensive DBT workshop with Marsha Linehan et al. (the person who created the treatment), and I believe get ongoing supervision afterwards and join a free consultation group in DBT in your location. That is just one example. You will never get this type of quality and depth of training via online program.

Secondly, if licensure is even a secondary goal, you will face an uphill battle with both an unaccredited program + unaccredited internship (which is almost a sure bet when you attend an unaccredited program). You know this stuff already. For what it's worth, I have never met a licensed psychologist in PP or in any setting who got licensed with an online degree. Maybe others have? I have one distant relative who completed a distance education PhD program in psychology approximately 15 years ago. She is still not licensed and is not able to work in the field (fortunately, spouse is supporting her).

Unfortunately, we can't give you an exact percentage of how much risk you are taking since Walden/Capella DO NOT report any licensure rates on their websites. I would presume that the licensure rate is very low otherwise they would report it (like all programs do). Anyhow, if you are willing to take the risk, go ahead.

Here are some online reviews from walden students. Sometimes positive reviews online are also written by the program though: http://www.onlinedegreereviews.org/college/walden-university-reviews/psychology-1331/reviews/

Thank you for your response - it was very constructive and helpful.

For the record - I am steering way clear of Capella and Walden.

 

[razo001]

Sorry for the late response. This program is definitely a scam and should be avoided at all costs. If you're looking to add a quick Dr. to your name then please do so. I'm glad I'm out of the program.

I loved the part where one of our professors stated "We're not a cut throat program, the competitiveness is during the application process. We look for well rounded people, not for people who do very well on closed book tests". If you've went to a legitimate school with a solid education this isn't what you want to hear from your doctorate program.

Although they are expanding to China....

 

[bmedclinic]

Just out of curiosity, why did you decide to rank a non-APA site? I'm not judging at all (G-d knows the imbalance is awful all-around!), just wondering how you weighed the pros and cons and if you'd make that same choice in retrospect.

No, I aboslultely regret it. This year was my second year applying, and I didnt want to go at the APPIC match a 3rd year. Last year I was really limited due to my program and having just been married (and my wife being 1 year into her MA program). I looked at places within 6 hours. This year, my application was much stronger, but I (early on) wanted a fall back.. just becuase I couldnt imagine not matching again. I thought "no biggie- I'll match at one ofthe 7 VA spots I ranked above that" at the end. You can even see my posts about exactly this-- and my anxiety over this in the APPIC thread. I weighed it out, and in my mind thought "I'll match at a VA, but just in case." Quite frankly, I didnt really think long and hard about what it would mean if I didnt match at the VA/non APA spots I was ranking. I would absolutely not do it again. I wish very, very, very much I could go back. No offense to the FSPS types-- but basically- now my degree is limited just like theirs, and that makes me sick to my stomach considering all my work. I feel very much on the outside, looking in.

So, while on internship, I'm going to have work very hard because I recognize no post doc will be "handed" to me, like was alluded to at many of the VA sites I interviewed at. In addition to that, many post docs just wont accept a non-apa internship. And why should they? It's an easy way to eliminate presumably the lower half of the applicants.

 

[docma]

many post docs just wont accept a non-apa internship. And why should they? It's an easy way to eliminate presumably the lower half of the applicants.

While your disappointment at not going to a VA makes sense, I hope you will not let despair wreck what might be good in your internship year. And (maybe under a different thread) you should solicit data on what folks from non-APA internships go on to do in post-docs (or, gasp!, an actual JOB after internship). It does happen. It is more work to find those positions. But they happen. I even know folks who are working in university-affiliated VA systems where the university side will consider qualified folks who came through APPIC, non-APA internships, Yes, it is a steeper climb but if you network well based on your actual clinical skills you will find that the larger world is not quite as rigid and Kafka-esque as the pre-doc internship hunt can make it seem.

At a minimum, you could start learning where the graduates of APPIC, non-APA internships find their post-docs and jobs. There are a lot of them out there who go onto licensure and careers beyond the VA.

 

[bmedclinic]

Thanks docma. Didnt mean to come off the way I probably did, but mostly I'm just worried about networking. Truth be told, I'm looking to do behavioral sleep medicine most likely (though I'd also gladly do something more health psych/primary care oriented as well). I think at this point, for me, the biggest hurdle is just networking.

 

[docma]

If you go into internship with a goal to build that network you will find your way. And the Affordable Care Act is going to inevitably generate more primary care jobs. And everyone needs to sleep. Current work on bipolar disorder, for example, puts a lot of emphasis on this and you could start networking through university and med center sites that treat these conditions (Cal and Stanford are the ones I know but they have to have similar programs across the country). Health care systems like Kaiser do not require APA internship for post-docs. Your experience and attitude are the key factors in what comes next.

 

[PHD12]

If you go into internship with a goal to build that network you will find your way. And the Affordable Care Act is going to inevitably generate more primary care jobs. And everyone needs to sleep. Current work on bipolar disorder, for example, puts a lot of emphasis on this and you could start networking through university and med center sites that treat these conditions (Cal and Stanford are the ones I know but they have to have similar programs across the country). Health care systems like Kaiser do not require APA internship for post-docs. Your experience and attitude are the key factors in what comes next.

I agree with your overall suggestions. However, Kaiser strongly prefers APA internships and on my interviews applicants we were all from APA sites. They don't require it per se, but pretty much all their postdocs are from APA internships (unless they did a kaiser internship) I applied to pretty much all the locations recently and they are getting 100-300 apps per location. They even snag people from VA internships because it's become so competitive. Anyhow, that is just one example. Stanford also requires APA internships for all their research and clinical post-docs so maybe you are referring to another type of position? I'm sure there are exceptions to this rule, and I agree that Bmed has some good options for primary care jobs. However, I would recommend expanding his search outside of California as well.

 

[docma]

I actually don't think the poster is looking in California. And I know at least a dozen interns within the last 5 years who went to Kaiser post-docs from an APPIC, non-APA internship and not from a Kaiser pre-doc. They are at least open minded enough to consider APPIC applicants from programs that cannot yet afford APA accreditation costs.

The reference to the university programs was not for post-docs but as places to network and learn about clinical settings where research or expertise on sleep is being done, as potential employment sites. Sometimes a real job is preferable to a post-doc.

 

[DreadyCat]

I was reading this thread because I too am considering getting a DBH from ASU. I decided to respond in this thread due to my positive experiences with online education, specifically Capella University's Masters of Science in Mental Health Counseling, I will graduate 6/14/13 and after finishing my first field work course Practicum, I was offered a paid internship from the same site, and more recently offered a salaried position which will start 7/1/13 if I accept it. I have an interview with another agency in my area, have also been working with a local psychologist and the board of directors of a new hospital in my area on developing a mental health unit at their facility, and discussed the possibility of private practice with a MD and Nurse Practitioner after I complete the required hours for my LPC.

Currently I am part of an interdisciplinary treatment team which works with individual's with intellectual disabilities in a state ran federally funded residential facility. The psychiatrists' who visit our facility are contracted and make the majority of their psychiatric medication decision based on the feedback and suggestions of the mental health staff. In order to be the director of the facility an individual must hold a doctoral level degree in a relevant field. The state board informed the current director they would recognize ASU's DBH as long as the applicant had significant experience dealing with the population entrusted in the facilities care. I do not want to be a psychologist, but believe the DBH would make me a more rounded behavioral health care provider due to the exposure it potentially provides on the medical side of health care. I also think the DBH would provide me with beneficial information if I decided to go the private practice route!

I am 35 years old and started investing in real estate 12 years ago with no money of my own and my family was poor will I was growing up. I currently do not reside in California but the real estate bubble had no impact on my investments there which will pay themselves off in the next 13 years. Therefore, the cost of an educational program will not influence my decision. Successful people have drive, determination, dedication, and motivation and will not allow the negativity of others who fear change stand in their way! Any comments, suggestions, or concerns will be greatly appreciated and my sole mission is to provide the best services for the clients I work with. P.S. I may not be able to practice at a VA by using "Dr." at the beginning of my name if I tried to obtain employment there, but the LPC-MH would do the trick!

 

[silverheart]

I was reading this thread because I too am considering getting a DBH from ASU. I decided to respond in this thread due to my positive experiences with online education, specifically Capella University's Masters of Science in Mental Health Counseling, I will graduate 6/14/13 and after finishing my first field work course Practicum, I was offered a paid internship from the same site, and more recently offered a salaried position which will start 7/1/13 if I accept it. I have an interview with another agency in my area, have also been working with a local psychologist and the board of directors of a new hospital in my area on developing a mental health unit at their facility, and discussed the possibility of private practice with a MD and Nurse Practitioner after I complete the required hours for my LPC.

Currently I am part of an interdisciplinary treatment team which works with individual's with intellectual disabilities in a state ran federally funded residential facility. The psychiatrists' who visit our facility are contracted and make the majority of their psychiatric medication decision based on the feedback and suggestions of the mental health staff. In order to be the director of the facility an individual must hold a doctoral level degree in a relevant field. The state board informed the current director they would recognize ASU's DBH as long as the applicant had significant experience dealing with the population entrusted in the facilities care. I do not want to be a psychologist, but believe the DBH would make me a more rounded behavioral health care provider due to the exposure it potentially provides on the medical side of health care. I also think the DBH would provide me with beneficial information if I decided to go the private practice route!

I am 35 years old and started investing in real estate 12 years ago with no money of my own and my family was poor will I was growing up. I currently do not reside in California but the real estate bubble had no impact on my investments there which will pay themselves off in the next 13 years. Therefore, the cost of an educational program will not influence my decision. Successful people have drive, determination, dedication, and motivation and will not allow the negativity of others who fear change stand in their way! Any comments, suggestions, or concerns will be greatly appreciated and my sole mission is to provide the best services for the clients I work with. P.S. I may not be able to practice at a VA by using "Dr." at the beginning of my name if I tried to obtain employment there, but the LPC-MH would do the trick!

As a MSW that had to network his ass off, fight tooth and nail for a good job in the DC area, and is one of the few offered positions in private practice directly out of graduate school, I can assure you that this is all false. Story too good to be true? Check. One post? Check. Someone is TROLLING. May I cross your bridge?

Now back to the DBH... I do have experience with someone that has graduated this program. He was the CEO of a nonprofit drug treatment facility that I worked for. The company was around for 40 years and did a lot of good...but only because of the clinicians. The administration kept us in the dark and there were many times we didn't have PAPER to complete documentation. He told the staff that the whole company was closing on a Friday on the Tuesday before. THAT is the caliber of individual that is in this program AND graduates.

 

[NotTheHoff]

I wish psychology would change the lingo on the word "internship." It has too many other connotations. We should just make up a word, like practitionership.

A few places refer to it as residency. I am referred to as a psychology resident, not an intern, right now. For people from other disciplines, it seems to be a more highly regarded label. I find nurses, psychiatrists, etc. are quicker to understand my experience level and qualifications when they see me as a resident instead of an intern.

 

[cara susanna]

Resident is usually the term I see for people who don't have their license yet but have completed their PhD.

 

[erg923]

I was reading this thread because I too am considering getting a DBH from ASU. I decided to respond in this thread due to my positive experiences with online education, specifically Capella University's Masters of Science in Mental Health Counseling, I will graduate 6/14/13 and after finishing my first field work course Practicum, I was offered a paid internship from the same site, and more recently offered a salaried position which will start 7/1/13 if I accept it. I have an interview with another agency in my area, have also been working with a local psychologist and the board of directors of a new hospital in my area on developing a mental health unit at their facility, and discussed the possibility of private practice with a MD and Nurse Practitioner after I complete the required hours for my LPC.

Currently I am part of an interdisciplinary treatment team which works with individual's with intellectual disabilities in a state ran federally funded residential facility. The psychiatrists' who visit our facility are contracted and make the majority of their psychiatric medication decision based on the feedback and suggestions of the mental health staff. In order to be the director of the facility an individual must hold a doctoral level degree in a relevant field. The state board informed the current director they would recognize ASU's DBH as long as the applicant had significant experience dealing with the population entrusted in the facilities care. I do not want to be a psychologist, but believe the DBH would make me a more rounded behavioral health care provider due to the exposure it potentially provides on the medical side of health care. I also think the DBH would provide me with beneficial information if I decided to go the private practice route!

I am 35 years old and started investing in real estate 12 years ago with no money of my own and my family was poor will I was growing up. I currently do not reside in California but the real estate bubble had no impact on my investments there which will pay themselves off in the next 13 years. Therefore, the cost of an educational program will not influence my decision. Successful people have drive, determination, dedication, and motivation and will not allow the negativity of others who fear change stand in their way! Any comments, suggestions, or concerns will be greatly appreciated and my sole mission is to provide the best services for the clients I work with. P.S. I may not be able to practice at a VA by using "Dr." at the beginning of my name if I tried to obtain employment there, but the LPC-MH would do the trick!

1. That's scary and seems like an abrogation of their ethics/duties.

2. Your view of doctoral education via this DBH prpgram is exactly what many of us here are trying to prevent from taking hold. Namely, that its either a.) a piece of paper that qualifies one for a specific job title b) is a trade school. Personally, I would like the doctorate to mean much more than simply preparing one to do one specific managerial job.

 

[AcronymAllergy]

...Also, many psychologists (and other psychotherapists) know little about chronic physical illness and how this affects their mental health, or know of very little effective interventions to help their mental health while coping with such physical illness....

I would actually disagree with this statement, given that at the very least, all clinical/counseling folks are going to have had classes in things like the biological bases of behavior. Additionally, with the growth currently occurring in health psychology and behavioral medicine, many trainees will have had practicum and/or internship experiences in primary care settings (heck, there are postdocs devoted solely to gaining specialty expertise in the area, such as in primary care mental health, HIV/hepatitis C, etc.). Thus, in my view, the DBH is attempting to fill a role for which many psychologists are currently (or for which they soon will be) trained.

That's just my opinion, though. I do agree that, particularly with ACA, the role of essentially all healthcare providers and/or the provision of healthcare in general is going to change to at least some degree.

 

[Therapist4Chnge]

Like many here on this forum I'm a masters level clinician graduated from a CACREP program and seeking a next step in academics. There are really only two choices that make sense to me. PhD in counseling, or something similar to this DBH program. I doubt I'll be seeking tenure as a professor and don't wish to spend 4-5 years with several doing research.

There are at least two more options:

1. Attend additional training seminars, workshops, etc. Continuing Education is meant for this pursuit.
2. Find mentorship in another area of practice (within the scope of your licensure) and broaden your training that way.

Also, many psychologists (and other psychotherapists) know little about chronic physical illness and how this affects their mental health, or know of very little effective interventions to help their mental health while coping with such physical illness.

This is incorrect. There is an entire sub-field of psychology (Health Psychology) that trains in these exactly areas, and there are multiple related sub-fields (e.g. Rehab Psych, Gero Psych, Neuropsych, etc) that also get training in some of these topics. I regularly lecture on these types of topics for my hospital's residency program, as well as present at Grand Rounds and also do in-service trainings for auxiliary staff (e.g. nurses, aides, PTs, OTs, etc) on related topics. My next presentation is actually on the neurologic underpinnings of depression (and related mood disorders) following neurologic injury.

Likewise, MD's know very little about effective phsychotherapeutic interventions to help their patients to evoke the behavioral changes necessary to reduce their patient's symptoms of chronic illness; pain management, diabetes, heart disease, obesity all have complicated lifestyle components.

This is also incorrect. Many physicians are pursuing additional training to learn more about these areas. They aren't going to be the primary providers of these services, but they are being trained to identify red flags and get a referral to someone who can provide the interventions.

...if a client has a breakdown in the exam room they can be walked down the hall to an in-house therapist (consider mental health parity).

This is already done in the current healthcare setting with pre-existing mental health resources.

This degree program is attempting to create a market where one does not currently exist. There are better options already out there, so trying to carve out a new area is not going to be very helpful to the public nor the students completing the additional training. There is no need to re-invent the wheel by creating a program with no track record that requires less training and is not recognized as equivalent in the eyes of the states (or licensure would be available for the specific type of program.)

 

[PurpleRain769]

I am not having the same experience at all, so I thought I would put in my 2 cents for anyone who would like to know another perspective.

It is no different than other fields offering professional doctoral degrees, such as DrPH. And the program is going away from the Biodyne Model as Cummings is no longer affiliated with the program as of December 2014. The program will ASUs alone and the curriculum is strong on integrating knowledge and training in behavioral health and behavioral medicine.

I was considering other programs, notably the PhD, but as I wanted more applied clinical training in primary care (where I did half of my Master's internship), I chose this program over other research based programs. I cannot express how much I have learned. It is online, but the internship is obviously in the clinic. We also have to implement a behavioral health program on a population and test its effects on patients. All of my classes have weekly skype-like real time lecutres and then recorded lectures that run anywhere from 3-6 hours per week, in addition to other assignments (recorded patient sessions, papers, etc.). Tests are open book, obviously, but are timed and are not merely recall... We have to apply what we have learned in a way that shows we are integrating the material in a clinical manner.

Why is the degree important when we can practice under our Master's level licensure? Why is a PsyD? You can practice under the Masters, so why invest in further doctoral studies with any degree? Because we are learning our specific field in depth. I could work in integrated care with my masters, but I would not be able to do it well and at the level I will now be able perform after my advanced training. Mental health psychologists and counselors rarely learn anything medically related, but we do. We have classes similar to behavioral medicine programs that teach medical disease and etiology, in addition to the behavioral health treatments for those diseases (diabetes, hypertension, cancer, obesity, etc.).

Just because it is new, does not make it a joke or bad. Just my opinion, and I understand yours. I had the same concerns when considering this program. But then again, the PsyD was once brand new (and that was pioneered by Cummings as well). The DrPH was brand new once. Even the M.D. is fairly new considering the legitimacy and respect given to medical doctors only began in the last century.

 

[erg923]

I am not having the same experience at all, so I thought I would put in my 2 cents for anyone who would like to know another perspective.

It is no different than other fields offering professional doctoral degrees, such as DrPH. And the program is going away from the Biodyne Model as Cummings is no longer affiliated with the program as of December 2014. The program will ASUs alone and the curriculum is strong on integrating knowledge and training in behavioral health and behavioral medicine.

I was considering other programs, notably the PhD, but as I wanted more applied clinical training in primary care (where I did half of my Master's internship), I chose this program over other research based programs. I cannot express how much I have learned. It is online, but the internship is obviously in the clinic. We also have to implement a behavioral health program on a population and test its effects on patients. All of my classes have weekly skype-like real time lecutres and then recorded lectures that run anywhere from 3-6 hours per week, in addition to other assignments (recorded patient sessions, papers, etc.). Tests are open book, obviously, but are timed and are not merely recall... We have to apply what we have learned in a way that shows we are integrating the material in a clinical manner.

Why is the degree important when we can practice under our Master's level licensure? Why is a PsyD? You can practice under the Masters, so why invest in further doctoral studies with any degree? Because we are learning our specific field in depth. I could work in integrated care with my masters, but I would not be able to do it well and at the level I will now be able perform after my advanced training. Mental health psychologists and counselors rarely learn anything medically related, but we do. We have classes similar to behavioral medicine programs that teach medical disease and etiology, in addition to the behavioral health treatments for those diseases (diabetes, hypertension, cancer, obesity, etc.).

Just because it is new, does not make it a joke or bad. Just my opinion, and I understand yours. I had the same concerns when considering this program. But then again, the PsyD was once brand new (and that was pioneered by Cummings as well). The DrPH was brand new once. Even the M.D. is fairly new considering the legitimacy and respect given to medical doctors only began in the last century.

So your Ph.D. enables you to work as a masters-level clincian.... for masters level pay I would assume, right? Uh, Congratulations?

PS: I have a phd in clinical and obviously learned a thing or two about medical/health psychology and work in primary care. All my labs grants were devoted to health psychology topics, in fact. There is a whole APA divison voted to what you are describing. Division 38. So dont come on here touting that your training is rare snowflake. Its not.

 

[AcronymAllergy]

I am not having the same experience at all, so I thought I would put in my 2 cents for anyone who would like to know another perspective.

It is no different than other fields offering professional doctoral degrees, such as DrPH. And the program is going away from the Biodyne Model as Cummings is no longer affiliated with the program as of December 2014. The program will ASUs alone and the curriculum is strong on integrating knowledge and training in behavioral health and behavioral medicine.

I was considering other programs, notably the PhD, but as I wanted more applied clinical training in primary care (where I did half of my Master's internship), I chose this program over other research based programs. I cannot express how much I have learned. It is online, but the internship is obviously in the clinic. We also have to implement a behavioral health program on a population and test its effects on patients. All of my classes have weekly skype-like real time lecutres and then recorded lectures that run anywhere from 3-6 hours per week, in addition to other assignments (recorded patient sessions, papers, etc.). Tests are open book, obviously, but are timed and are not merely recall... We have to apply what we have learned in a way that shows we are integrating the material in a clinical manner.

Why is the degree important when we can practice under our Master's level licensure? Why is a PsyD? You can practice under the Masters, so why invest in further doctoral studies with any degree? Because we are learning our specific field in depth. I could work in integrated care with my masters, but I would not be able to do it well and at the level I will now be able perform after my advanced training. Mental health psychologists and counselors rarely learn anything medically related, but we do. We have classes similar to behavioral medicine programs that teach medical disease and etiology, in addition to the behavioral health treatments for those diseases (diabetes, hypertension, cancer, obesity, etc.).

Just because it is new, does not make it a joke or bad. Just my opinion, and I understand yours. I had the same concerns when considering this program. But then again, the PsyD was once brand new (and that was pioneered by Cummings as well). The DrPH was brand new once. Even the M.D. is fairly new considering the legitimacy and respect given to medical doctors only began in the last century.

I can't speak for counselors, but as erg mentioned, I can say that it seems to be the rule rather than the exception for folks in clinical (and I would imaging counseling) psych programs to learn medically-relevant information and practice in medical settings (e.g., primary care). This would be supported by the increasing numbers of doctoral programs I'm seeing with a focus on medical/health psych (e.g., UAB, UNT, UTSW, Southern Miss.), the increasing number of primary care and other health-related (e.g., HIV/Hep C) postdocs, and the increasing numbers of psychologists working in primary care mental health integrated roles.

Also, it's long been discussed on this board that the perhaps formerly-true stereotype of the PhD being almost entirely research-oriented is false, as many/most programs nowadays are balanced, and subsequently the average Ph.D. internship applicant has as much clinical experience as the average Psy.D. internship applicant. Additionally, the majority of folks graduating with Ph.D.'s go on to primarily or solely clinical careers. However, I would agree that Ph.D. programs are very research-based in that they require direct participation in the scientific/research process for the purposes of directly informing future professional activities (including clinical work).

 

[DynamicDidactic]

And the program is going away from the Biodyne Model as Cummings is no longer affiliated with the program as of December 2014.

I am curious why Cummings will no longer be affiliated with the program.

 

[erg923]

Cummings .

 

[PurpleRain769]

So your Ph.D. enables you to work as a masters-level clincian.... for masters level pay I would assume, right? Uh, Congratulations?

PS: I have a phd in clinical and obviously learned a thing or two about medical/health psychology and work in primary care. All my labs grants were devoted to health psychology topics, in fact. There is a whole APA divison voted to what you are describing. Division 38. So dont come on here touting that your training is rare snowflake. Its not.

For a psychologist, you're kind of an dingus... sweet pea. I was just sharing my experience. I am sure you are a psychological genius, but I doubt you know all there is to know about integrated care. There are a lot of choices out there, a lot to learn, and apparently, current programs are not meeting the need. Which I am sure you already know, as you probably keep up on the research. But if it makes you feel better to tear others down because they do not subscribe to your beliefs on what is needed or worthy, then maybe you should seek some counseling of your own.

As the saying goes... If we both belief and think exactly the same, one of us is not needed.

 

[erg923]

For a psychologist, you're kind of an dingus... sweet pea. I was just sharing my experience. I am sure you are a psychological genius, but I doubt you know all there is to know about integrated care. There are a lot of choices out there, a lot to learn, and apparently, current programs are not meeting the need. Which I am sure you already know, as you probably keep up on the research. But if it makes you feel better to tear others down because they do not subscribe to your beliefs on what is needed or worthy, then maybe you should seek some counseling of your own.

As the saying goes... If we both belief and think exactly the same, one of us is not needed.

Dingus is not something you hear everyday. Good one.

This has nothing to do with "beliefs" about anything, darlin...

Your program gives you a doctorate in something that does not exist. You went into the program as an LCSW or MFT or LPC and you will hired as the same. Thats not belief, its a fact. Why? Cause nobody knows what the **** a "doctor of behavioral health" is? Thats a psychologist to most employers. But, no, you're not a psychologist. The prorgam isn' t filling a "need." Its marketing.

I dont know everything about integrated care, no, but I don't think we need to sell as this grand and wondferful thing that requires a whole new degree. I am still a psychologist. And thats what my clinic wants. That what my clinic needs, first a foremost. Yes, to be maximally effective, I must tailor my practice to the setting, and must be well informed on medical conditions and their psycholgical sequela. But most of all, I just need to be a good psychologist and clinician. Assessment (whether quick and dirty or organ transplant psychological evaluations), diagnpostics, AD/HD evals/screens, brief interventions, traige, consultation. Thats what they need. Fitting into the culture and model of primary care isn't all that hard. It takes some mentoring and getting used to, but a doctorate in "integrated care?" Paaaa-lease.

 

[PurpleRain769]

I can't speak for counselors, but as erg mentioned, I can say that it seems to be the rule rather than the exception for folks in clinical (and I would imaging counseling) psych programs to learn medically-relevant information and practice in medical settings (e.g., primary care). This would be supported by the increasing numbers of doctoral programs I'm seeing with a focus on medical/health psych (e.g., UAB, UNT, UTSW, Southern Miss.), the increasing number of primary care and other health-related (e.g., HIV/Hep C) postdocs, and the increasing numbers of psychologists working in primary care mental health integrated roles.

Also, it's long been discussed on this board that the perhaps formerly-true stereotype of the PhD being almost entirely research-oriented is false, as many/most programs nowadays are balanced, and subsequently the average Ph.D. internship applicant has as much clinical experience as the average Psy.D. internship applicant. Additionally, the majority of folks graduating with Ph.D.'s go on to primarily or solely clinical careers. However, I would agree that Ph.D. programs are very research-based in that they require direct participation in the scientific/research process for the purposes of directly informing future professional activities (including clinical work).

I generalize when I make my statements... I understand there will be some PhDs and PsyDs who have medical knowledge, but from my experience it was because they specialized in medical health and took extra or elective coursework in that area. I do feel that PhDs are more research heavy, which is not to say they are not clinical. And PsyDs are more clinical, which is not to say they are not research. Just the focus is more heavy on one for the other.

Could I get into Primary Care with just a masters in counseling? Technically, yes with a license. But in this job market, people need to have specialty training to have the edge. I did not get medical training with my masters as it was 100% counseling and psychology, so the odds are that I would search high and low and not be a strong contender. Or I can get a doctoral for advanced training in my specific field... My choices are a PhD, PsyD, or a professional doctorate. I chose the latter for many reasons. PhDs are the superior, end all/be all degrees in psychology. No one is disputing that, at least not me... But I do not want a degree for the title or prestige. I want a degree for the advanced learning and training, and with a professional doctorate, I do not have to spend 4-8 years to get there. A few years, intense specialized training, and viola.

This was my choice. My response was my opinion, my experience, and my choices that I wanted to share to give this thread a balanced view in case someone out there was curious whether others had anything positive to say. My peers in the program are all very established, experienced, licensed professionals who are eager to learn more. Money is important, but it is not the only thing... Expanding options is a huge deal in our field.

 

[PurpleRain769]

Dingus is not something you hear everyday. Good one.

This has nothing to do with "beliefs" about anything, darlin...

Your program gives you a doctorate in something that does not exist. You went into the program as an LCSW or MFT or LPC and you will hired as the same. Thats not belief, its a fact. Why? Cause nobody knows what the **** a "doctor of behavioral health" is? Thats a psychologist to most employers. But, no, you're not a psychologist. The prorgam isn' t filling a "need." Its marketing.

I posted a$$hole... It must have been corrected for me.

 

[PurpleRain769]

Dingus is not something you hear everyday. Good one.

This has nothing to do with "beliefs" about anything, darlin...

Your program gives you a doctorate in something that does not exist. You went into the program as an LCSW or MFT or LPC and you will hired as the same. Thats not belief, its a fact. Why? Cause nobody knows what the **** a "doctor of behavioral health" is? Thats a psychologist to most employers. But, no, you're not a psychologist. The prorgam isn' t filling a "need." Its marketing.

And please do not address me as "darlin"... You sound like an immature, sexist, narcissist.

 

[PurpleRain769]

Dingus is not something you hear everyday. Good one.

This has nothing to do with "beliefs" about anything, darlin...

Your program gives you a doctorate in something that does not exist. You went into the program as an LCSW or MFT or LPC and you will hired as the same. Thats not belief, its a fact. Why? Cause nobody knows what the **** a "doctor of behavioral health" is? Thats a psychologist to most employers. But, no, you're not a psychologist. The prorgam isn' t filling a "need." Its marketing.

My program does not claim to make psychologists. And it does exists... Know how I know? I am actually in it right now! Unless I am hallucinating?? Hmm... Thanks anyway. Your posts reek of entitlement with a slight whiff of low self-esteem... covered with arrogance like a cheap cologne.

 

[KillerDiller]

And please do not address me as "darlin"... You sound like an immature, sexist, narcissist.

To be fair, you did call him "sweet pea" first. Both terms of endearment sounded pretty belittling to me.

 

[erg923]

My program does not claim to make psychologists. And it does exists... Know how I know? I am actually in it right now! Unless I am hallucinating?? Hmm... Thanks anyway. Your posts reek of entitlement with a slight whiff of low self-esteem... covered with arrogance like a cheap cologne.

I dont know everything about integrated care, no, but I don't think we need to sell as this grand and wondferful thing that requires a whole new degree. I am still a psychologist. And thats what my clinic wants. That what my clinic needs, first a foremost. Yes, to be maximally effective, I must tailor my practice to the setting, and must be well informed on medical conditions and their psycholgical sequela. But most of all, I just need to be a good psychologist and clinician. Assessment (whether quick and dirties or organ transplant psychological evaluations), diagnostics, AD/HD evals/screens, brief interventions, traige, consultation. Thats what they need. Fitting into the culture and model of primary care isn't all that hard. It takes some mentoring and getting used to, but a doctorate in "integrated care?" Paaaa-lease.

 

[PurpleRain769]

To be fair, you did call him "sweet pea" first. Both terms of endearment sounded pretty belittling to me.

In response to his "snowflake"... I stooped and responded with sweat pea... I admit it.

 

[erg923]

Darlin is "southern thing..." Dont be such a drama queen about it.

 

[PurpleRain769]

I dont know everything about integrated care, no, but I don't think we need to sell as this grand and wondferful thing that requires a whole new degree. I am still a psychologist. And thats what my clinic wants. That what my clinic needs, first a foremost. Yes, to be maximally effective, I must tailor my practice to the setting, and must be well informed on medical conditions and their psycholgical sequela. But most of all, I just need to be a good psychologist and clinician. Assessment (whether quick and dirties or organ transplant psychological evaluations), diagnostics, AD/HD evals/screens, brief interventions, traige, consultation. Thats what they need. Fitting into the culture and model of primary care isn't all that hard. It takes some mentoring and getting used to, but a doctorate in "integrated care?" Paaaa-lease.

OMG, then do not get one... Kinda simple!

Oh wait... I just noticed you are VA psychologist. Nevermind. It all makes sense now! lmao.