Psychology Hierarchy

[ThatPsyGuy]

I recently just gone done catching up with a friend of mine who's also in a Psychology program and they told me how their cohort had a discussion regarding the perception of the field from within and outside.

They mentioned an interesting point in how they believed that there was a "hierarchy" in Psychology.

For example, in their discussion it was touched on that clinical psychologists may be perceived as higher on the totem pole than counseling psychologists, that vocational psychologists' research and practice are perceived as bottom rung, and that people will look up to clinical psychologists & I/O psychologists more because it's perceived that they make more money from the public eye, and etc etc etc.

The point of it is that they believe that there is a hierarchy in the psychology field. I wanted to see you all's opinions on this.

In my opinion, I believe that the public opinion of psychologists will generally be overlooked in terms of counseling/therapy. A clinical psychologist and a counseling psychologist are able to provide the same quality of care and honestly, they probably don't even know the difference between the two fields of psychology. They probably won't even differentiate between a MA and Ph.D. level practitioner.

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[Sanman]

I recently just gone done catching up with a friend of mine who's also in a Psychology program and they told me how their cohort had a discussion regarding the perception of the field from within and outside.

They mentioned an interesting point in how they believed that there was a "hierarchy" in Psychology.

For example, in their discussion it was touched on that clinical psychologists may be perceived as higher on the totem pole than counseling psychologists, that vocational psychologists' research and practice are perceived as bottom rung, and that people will look up to clinical psychologists & I/O psychologists more because it's perceived that they make more money from the public eye, and etc etc etc.

The point of it is that they believe that there is a hierarchy in the psychology field. I wanted to see you all's opinions on this.

In my opinion, I believe that the public opinion of psychologists will generally be overlooked in terms of counseling/therapy. A clinical psychologist and a counseling psychologist are able to provide the same quality of care and honestly, they probably don't even know the difference between the two fields of psychology. They probably won't even differentiate between a MA and Ph.D. level practitioner.

This is true in society at large, not just in psychology. Not that long ago, we elected a president to run this country based on the perception that he made a lot of money. People look up to money and power.

 

[AcronymAllergy]

I don't think the average patient (or person outside of psychology) will know or recognize a difference between a clinical or counseling psychologist. I don't know that the average person would have any idea what an I/O psychologist is or does. If they're going to notice anything, it might be where your degree is from or how long you've been practicing. But the average mental health consumer in upcoming generations may also have a bit more understanding of, and experience with, the mental health system, and may be more aware of some of those things than past generations.

At least in my experience, the possible hierarchy of clinical psychologists "at the top" so to speak is largely restricted to trainees, and maybe a small number of professors, in psychology graduate programs. I've not come across that outside of graduate programs, to include internship and fellowship training programs. I don't know that I could tell you whether the psychologists I worked with in previous clinics had gotten their degrees in counseling or clinical psych, and wouldn't have known whether they had a Ph.D. or Psy.D. if not for email signatures or door name plates.

I suspect patients who've received therapy may recognize/assume a difference between a psychologist and a masters-level counselor. They initially may or may not understand/appreciate the difference between a psychologist and psychiatrist.

 

[PsyDr]

“What kind of nerd is the best nerd?”

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[foreverbull]

For example, in their discussion it was touched on that clinical psychologists may be perceived as higher on the totem pole than counseling psychologists, that vocational psychologists' research and practice are perceived as bottom rung, and that people will look up to clinical psychologists & I/O psychologists more because it's perceived that they make more money from the public eye, and etc etc etc.

The point of it is that they believe that there is a hierarchy in the psychology field. I wanted to see you all's opinions on this.

In my opinion, I believe that the public opinion of psychologists will generally be overlooked in terms of counseling/therapy. A clinical psychologist and a counseling psychologist are able to provide the same quality of care and honestly, they probably don't even know the difference between the two fields of psychology. They probably won't even differentiate between a MA and Ph.D. level practitioner.

Some sites actually exclude counseling psychologists for no other reason than bias. A colleague tried to apply on internship to a clinical only site on the East Coast and reached out to the training director and said it was a great fit for her and asked if they’d make an exception. The answer was no—clinical only.

So there is bias against counseling psychology here and there, probably because it has a different history than clinical and there are far fewer counseling psychs in the country. One state even required counseling psychologists to meet a higher standard for documentation for licensure to prove their “equivalence” if I recall a colleague there saying when he tried to get licensed. This was 7 years ago.

So yes, some clinical and medical-based sites especially put the clinical psychs at the top of the chain and think less of counseling, and some BOPs even have bias, or at least have in the past. Completely unfair, in my opinion, given the equivalent training and practice required by APA.

I’d agree that your hierarchy sounds about right in some psychology circles, and those who know nothing about counseling psych and its training are more likely to place it lower on the hierarchy than clinical. In my experience, this bias has come largely from clinical psychs.

 

[ClinicalABA]

We have five licensed psychologists in my organization- 2 clinical phds, 1 clinical psyd, 1 school phd., and one combined counseling and school phd. We all do the same thing, and I dont think that any of the non-psych folks we interact with- both within and outside our agency- even know that we have different training/degrees, let alone an hierarchy. Families we see certainly don't know. End of the day, we all have the same licence (i.e., Mass. Psychologist- Health Services Provider). When we sit around the table ourselves and discuss things, the differences in training/experiences can sometimes be apparent, but are also relatively subtle (though we do give the psyd some good-natured crap about not doing a dissertation and how much they had to pay for grad school). While I might show a little in-group bias towards the Clinical PhD ,I find that the differences between us- if any- are more a result of the specific programs we went to, vs. the degrees we earned.

 

[quickpsych]

We have five licensed psychologists in my organization- 2 clinical phds, 1 clinical psyd, 1 school phd., and one combined counseling and school phd. We all do the same thing, and I dont think that any of the non-psych folks we interact with- both within and outside our agency- even know that we have different training/degrees, let alone an hierarchy. Families we see certainly don't know. End of the day, we all have the same licence (i.e., Mass. Psychologist- Health Services Provider). When we sit around the table ourselves and discuss things, the differences in training/experiences can sometimes be apparent, but are also relatively subtle (though we do give the psyd some good-natured crap about not doing a dissertation and how much they had to pay for grad school). While I might show a little in-group bias towards the Clinical PhD ,I find that the differences between us- if any- are more a result of the specific programs we went to, vs. the degrees we earned.

Agreed most differences between seem to be programs and such. Which makes me curious, how come the PsyD didn't do a dissertation? Spent years working on one in grad school, with full defense and all. I just assumed all APA accredited programs PhD or PsyD require a dissertation.

The school psychologist is an interesting one depending on state or country. In some jurisdictions masters level "school psychology program graduates" can call themselves "school psychologists" with just a Masters, which has become a topic, and legal debate in states where actual psychologists have taken issue with them calling themselves psychologists after a 2 year masters program.

 

[smalltownpsych]

Clinical psychologists with PsyDs who just started a private practice are at the top of my hierarchy 😜 and the rest of you all can sort out where you are below that. Maybe the neuropsych folk who are doing forensic work could be on the next rung or they could fight it out with the ABA folks or the academic people. Erg used to be up there but then he went and got some kind of weird administrative job so not sure where that fits.
Seriously though, I am impressed by what we all do and bring to the table with our unique skill sets. Other than that, I think our patients and clients are impressed even when they don’t always understand what we do and why. In general, people know psychologists are pretty cool even if they don’t always know what the title means or entails.

 

[borne_before]

The general public does not have the skills to differentiate the various kinds of psychologists. They do know we're higher on the rung than a counselor, though.

If counseling homies feel excluded for no other reason than bias, school psych PhD's have it the hardest. And that's just not my victim complex speaking.

 

[singasongofjoy]

I agree w/ @borne_before that the gen public perhaps differentiates between master's level vs something with a D at the end, and also tends to get confused about the difference (or that there is a difference) between psychologist / psychiatrist. Within the field, I think it's downright stupid that some places exclude some degrees (e.g., school psych) - my internship site's posting still says it excludes school psych folks and yet I think some of the grad students i supervise for practicum (many have been school psych from a great local program) would be great candidates that I'd be proud to write rec letter for for that site. (note to self to contact TD about this - I think I did like 5 years ago but can't recall for sure now)...

In my current AMC outpatient clinic setting, I don't perceive any kind of hierarchy of prestige or whatever (caveat in my state master's level school folks aren't referred to as school psych). Our school psych folks bring different things to the table that us clinical folks seek them out for (we have 1 school psych out of 4 psychologists, and many school psych students - often with experience working in schools before going to grad school - that have taught us a great deal about their areas of interest / experience). Our program has had school psych interns and postdocs probably about as often as clinical. I would love for a counseling psych to enter the picture and have tried to recruit some for other centers in our program that have openings; our master's level counseling psych person (i know titles change across states) is def recognized for her own expertise compared to the psychologists who are more involved w/ diagnostics w some specific SMI therapy exceptions based on interest).

all that to say i think the areas of bias are pretty narrowly relegated to specific training programs, school psych doctoral programs are in those settings under-appreciated, and the general public doesn't know one from the other.

 

[Justanothergrad]

There are a few issues here as best as I can tell:
Issue 1: From a public perception, counseling psych sounds a lot like 'counseling' and so many think that they are the same, whereas clinical sounds 'different'. This isn't about training, but naming and brand. In my opinion, this is the long term greatest issue of bias that will be faced by counseling.

Issue 2: For some reason, the history that counseling came out of is held tightly as a reason that it remains different in outcomes. The outcome differences are minimal, with perhaps about the only difference relating to employment settings in a few job types (but not competency in job duties - I can speak explictly about assessment practices here). This is generally most true for AMC, counseling centers, and neuropsych practice. Change is hard so some people opt not to consider evidence of the need to change their opinions. When I was applying to internship, I recall some sites telling me they don't accept counseling folks because they dont know how to do psychological assessment. As someone who is highly visible in the field of psych assessment at a national/international level, I had to laugh.

Within the field, I don't find nearly the same level of discrimination. National organizations, for instance, dont have any issue having me involved as a stake holder for decisions intended for "clinical psychology" despite my counseling training. Most other professionals dont know (and thus can't care) in settings unless you talk about training or have to testify about your education.

 

[borne_before]

As a bit of a tangent - I think the all the pissin' on a post about clinical/school/counseling is one of the most kneecapping things we do to each other. I think it's mostly a legacy of academia masturbating about "which ivory tower is best." The latest example is the psychological science folks. The smariness about gatekeeping psychological science is rather ironic- as many of those departments crank out thousands of indebted psych BAs per year.

We all bring different skills to the table and in a world that is ever increasing in diversity - it's needed to best serve.

 

[WisNeuro]

As a bit of a tangent - I think the all the pissin' on a post about clinical/school/counseling is one of the most kneecapping things we do to each other. I think it's mostly a legacy of academia masturbating about "which ivory tower is best." The latest example is the psychological science folks. The smariness about gatekeeping psychological science is rather ironic- as many of those departments crank out thousands of indebted psych BAs per year.

We all bring different skills to the table and in a world that is ever increasing in diversity - it's needed to best serve.

Eh, if anything, I'd argue that we don't do enough gatekeeping when it comes to scientific rigor in training. The number of people embracing pseudoscientific treatments is ever growing, and it tends to occur more strongly in programs that do not require much research exposure, or only a surface level scratching of it. I'd argue that the relaxing of that rigor is the worst thing happening to us, as it lowers our training standards to essentially midlevel providers who paid way too much for a degree.

 

[ClinicalABA]

Agreed most differences between seem to be programs and such. Which makes me curious, how come the PsyD didn't do a dissertation? Spent years working on one in grad school, with full defense and all. I just assumed all APA accredited programs PhD or PsyD require a dissertation.

The school psychologist is an interesting one depending on state or country. In some jurisdictions masters level "school psychology program graduates" can call themselves "school psychologists" with just a Masters, which has become a topic, and legal debate in states where actual psychologists have taken issue with them calling themselves psychologists after a 2 year masters program.

Dissertation wasn't required at the time in her PsyD program (though they have since starting requiring what they call a "dissertation"). Mass does have a master's level school psychologist licensure, and you can only call yourself that if you are licensed as such. It causes a bit of confusion, but not much (probably moreso for those who are "licensed psychologists"- e.g. doctoral level, did an internship, etc.- and work in schools where there is this other person called a "school psychologist").

 

[borne_before]

Eh, if anything, I'd argue that we don't do enough gatekeeping when it comes to scientific rigor in training. The number of people embracing pseudoscientific treatments is ever growing, and it tends to occur more strongly in programs that do not require much research exposure, or only a surface level scratching of it. I'd argue that the relaxing of that rigor is the worst thing happening to us, as it lowers our training standards to essentially midlevel providers who paid way too much for a degree.

I don't entirely disagree. But, many of these problems could have been avoided if the ivory tower clinical folk were more inclusive and kept up with demand. Academics were too busy doing dumb academic games and the market came up with a compelling alternative. Now it's a bit of a runaway train and academics are doing what academics do best - complain and do nothing to address the issue from the ivory tower.

 

[AcronymAllergy]

I think there are some academics, such as those who see patients clinically themselves (e.g., in their own private practices), who are very aware of the practice issues facing psychology. But I agree that psychologists of eras past, including academics and those practicing, let important practice issues pass them by.

 

[WisNeuro]

I don't entirely disagree. But, many of these problems could have been avoided if the ivory tower clinical folk were more inclusive and kept up with demand. Academics were too busy doing dumb academic games and the market came up with a compelling alternative. Now it's a bit of a runaway train and academics are doing what academics do best - complain and do nothing to address the issue from the ivory tower.

I don't buy that there is an issue with demand. There are plenty of MH providers, but there is an access issue in terms of access to providers who accept insurance and such.

 

[AcronymAllergy]

I don't buy that there is an issue with demand. There are plenty of MH providers, but there is an access issue in terms of access to providers who accept insurance and such.

Definitely agree that there's a huge access issue relating to providers who accept insurance. But I also think in some areas, there's just a dearth of mental health providers and resources altogether.

 

[borne_before]

I don't buy that there is an issue with demand. There are plenty of MH providers, but there is an access issue in terms of access to providers who accept insurance and such.

I'm sorry - I was talking about the demand to become a mental health provider. The academy's model of psychology never made any attempt to keep up for the people who wanted to become psychologists. As an example of a field that did is physical therapy.

 

[WisNeuro]

I'm sorry - I was talking about the demand to become a mental health provider. The academy's model of psychology never made any attempt to keep up for the people who wanted to become psychologists. As an example of a field that did is physical therapy.

Why should legitimate institutions keep up with a demand when there is no supply issue on the other end? Are you saying that if state universities somehow found exorbitant funding streams to increase classes sizes 10X-fold and hire a huge amount of tenure-track professors who don't exist, we wouldn't have diploma mills?

 

[WisNeuro]

Definitely agree that there's a huge access issue relating to providers who accept insurance. But I also think in some areas, there's just a dearth of mental health providers and resources altogether.

In rural areas, sure, but increasing supply in other professions have shown us that it will almost always be an issue. Increasing supply only leads to more people saturating metro markets, very few of those people move to rural areas enough to make a significant difference.

 

[borne_before]

Why should legitimate institutions keep up with a demand when there is no supply issue on the other end? Are you saying that if state universities somehow found exorbitant funding streams to increase classes sizes 10X-fold and hire a huge amount of tenure-track professors who don't exist, we wouldn't have diploma mills?

They already have exhorbitant funding streams - the BA in psychology. I do think if the field increased cohorts, back in the day, we could have avoided diploma mills. But the professors of these programs were too lazy and more focused on creating good researchers than walking the line between research and clinical skills. FFS you can't get into a clinical program without talking about how all you want to do is be in the academy.

 

[Sanman]

They already have exhorbitant funding streams - the BA in psychology. I do think if the field increased cohorts, back in the day, we could have avoided diploma mills. But the professors of these programs were too lazy and more focused on creating good researchers than walking the line between research and clinical skills. FFS you can't get into a clinical program without talking about how all you want to do is be in the academy.

The last sentence is just plain untrue. I never had academic aspirations and neither did most of my classmates and we were accepted just fine. Same for my undergrad institution. IMO, the avoidance of diploma mills could have been avoided completely had APA taken an early role in accrediting a licensable masters degree. Most folks just want a masters with good clinical training to be a therapist and no such avenue really exists. Think about the school psychology route, the SW route, etc., how many opt for masters vs doctorate?

 

[WisNeuro]

They already have exhorbitant funding streams - the BA in psychology. I do think if the field increased cohorts, back in the day, we could have avoided diploma mills. But the professors of these programs were too lazy and more focused on creating good researchers than walking the line between research and clinical skills. FFS you can't get into a clinical program without talking about how all you want to do is be in the academy.

This is patently untrue. The amount of money that state universities have received from federal and state governments has decreased drastically over the years. So, while tuition has gone up, it is not exactly as if departments are now flush with cash, they are generally not even making up for the shortfall in loss of funding. I also agree with Sanman about the last statement, not true in any program I have been affiliated with, R1's included.

 

[borne_before]

Things have changed at universities since y’all were admitted - like two people telling me how wrong I am were prolly in grad school before the iPhone was invented.

Also, apa is an extension of the academy. The only losers who have time for leadership are childless professors (meaning that they don’t have worry about time/money) who don’t touch an ounce of clinical work. Same for psych boards.

And yes I am bitter. I’m also done with this subject.

 

[Sanman]

Things have changed at universities since y’all were admitted - like two people telling me how wrong I am were prolly in grad school before the iPhone was invented.

I think someone is jealous some us were young adults having fun before cell phone video was a thing. Yes, being stupid was better then.

 

[smalltownpsych]

I think it’s a good argument you guys are having in some ways but I think it’s missing the point a bit. I think that the error has not been in the diploma mills vs traditional as much as in our inability to strengthen our own ability to remain strong leaders in the field of mental health. I think we squabble too much and miss opportunities. Why are so many clinical directors MA level folks? Why do counseling programs now have non-psychologist Counseling PhDs teaching? I outperform the myriad of MA level folk in my area and I attribute much of this to the APA accredited doctoral education that I acquired enroute to attaining licensure. I don’t need to compete with other psychologists, I need to work with them to ensure we maintain our rightful position in the hierarchy of mental health as the leaders that we have been historically and should hopefully continue to be.

 

[futureapppsy2]

Things have changed at universities since y’all were admitted - like two people telling me how wrong I am were prolly in grad school before the iPhone was invented.

Also, apa is an extension of the academy. The only losers who have time for leadership are childless professors (meaning that they don’t have worry about time/money) who don’t touch an ounce of clinical work. Same for psych boards.

And yes I am bitter. I’m also done with this subject.

Nah, this isn't remotely true--off the top of my head, I can think of many people I know in APA goverance who a) clinicians, b) parents, or both.

 

[futureapppsy2]

Why do counseling programs now have non-psychologist Counseling PhDs teaching?

This is actually a CACREP-accreditation requirement--they require that faculty in accredited MA Counseling programs either have CACREP-accredited PhDs or have taught in CACREP-accredited programs for X years before 2013. On one hand, I think CACREP's "Counseling has nothing to do with psychology" bit is a tad delusional; otoh, I can see why a profession would want to protect its turf (something psychology has been historically bad at, to its detriment).

 

[futureapppsy2]

In rural areas, sure, but increasing supply in other professions have shown us that it will almost always be an issue. Increasing supply only leads to more people saturating metro markets, very few of those people move to rural areas enough to make a significant difference.

We see this so much in medicine when schools open up "rural primary care" tracks and like 75%+ of the students in those tracks match to non-primary care specialties.

 

[smalltownpsych]

This is actually a CACREP-accreditation requirement--they requiire that faculty in accredited MA Counseling programs either have CACREP-accredited PhDs or have taught in CACREP-accredited programs for X years before 2013. On one hand, I think CACREP's "Counseling has nothing to do with psychology" bit is a tad delusional; otoh, I can see why a profession would want to protect its terf (something psychology has been historically bad at, to its detriment).

I get that, but I wonder if we could have been more involved in this process as opposed to adversarial especially since we had counseling psychologists. I am pretty sure that we were the teachers at the schools at one time.

 

[WisNeuro]

Nah, this isn't remotely true--off the top of my head, I can think of many people I know in APA goverance who a) clinicians, b) parents, or both.

Ditto for state and board of psych members.

 

[WisNeuro]

Things have changed at universities since y’all were admitted - like two people telling me how wrong I am were prolly in grad school before the iPhone was invented.

Also, apa is an extension of the academy. The only losers who have time for leadership are childless professors (meaning that they don’t have worry about time/money) who don’t touch an ounce of clinical work. Same for psych boards.

And yes I am bitter. I’m also done with this subject.

Indeed they have, but the pattern of funding decreases sadly, has not. This is all also public information. I'm all for trying to find solutions to these problems, but those solution shave to consider the practical reality of the situations.

 

[Sanman]

I get that, but I wonder if we could have been more involved in this process as opposed to adversarial especially since we had counseling psychologists. I am pretty sure that we were the teachers at the schools at one time.

The irony is that out response was to argue, disagree and form the PsyD. You should read about NIcholas Cummings and his role in all of that back in the day.

 

[smalltownpsych]

The irony is that out response was to argue, disagree and form the PsyD. You should read about NIcholas Cummings and his role in all of that back in the day.

Not surprising. It seems like infighting might be one of our less beneficial core competencies.

 

[Justanothergrad]

This is patently untrue. The amount of money that state universities have received from federal and state governments has decreased drastically over the years. So, while tuition has gone up, it is not exactly as if departments are now flush with cash, they are generally not even making up for the shortfall in loss of funding. I also agree with Sanman about the last statement, not true in any program I have been affiliated with, R1's included.

Not us, we (like most every other public univ psych department I'm aware of) wake up daily and think "lets stay in an old building with crusty pipes, maintenance issues, and not enough space or support to manage our needs". Last year everyone got a free plane as a bonus. This year, we will probably get our own personal islands.

All of the crap in here about departments being flush with money, leadership not having children and being "losers", and grad school not being possible without wanting to be an academic is junk. It is fair to say that I favor people who help me do research and I seek that out in admission, but thats 40% of my job and that 40% is weighed like 90% so why wouldn't that be something I want help with? And why wouldn't I want students not to have that training since it makes better practice. I swear, people keep conflating "you have to want to be in the academy" with "be part of research while in school so we can make sure to look good to universities and keep getting stipends for you, even if they suck some"

 

[futureapppsy2]

Not us, we (like most every other public univ psych department I'm aware of) wake up daily and think "lets stay in an old building with crusty pipes, maintenance issues, and not enough space or support to manage our needs". Last year everyone got a free plane as a bonus. This year, we will probably get our own personal islands.

All of the crap in here about departments being flush with money, leadership not having children and being "losers", and grad school not being possible without wanting to be an academic is junk. It is fair to say that I favor people who help me do research and I seek that out in admission, but thats 40% of my job and that 40% is weighed like 90% so why wouldn't that be something I want help with? And why wouldn't I want students not to have that training since it makes better practice. I swear, people keep conflating "you have to want to be in the academy" with "be part of research while in school so we can make sure to look good to universities and keep getting stipends for you, even if they suck some"

That, and knowing research is essential to being a good clinician! Otherwise, we get people unironically promoting brainspotting and the like because it sounds “biological.”

 

[WisNeuro]

That, and knowing research is essential to being a good clinician! Otherwise, we get people unironically promoting brainspotting and the like because it sounds “biological.”

This just caused an uproar on some of our listervs when some of us questioned the data and called it pseudoscience. Luckily not my neuro listserv, that one is pretty rational and reality-based.

 

[Justanothergrad]

I can see that I really poked the nest. I’m OK with that, to be honest. This is a convo we need to have.

Let’s just not pretend that most people on psych boards, leading departments, etc. aren’t people who have “balanced” lives. Examples of that include: having one partner who does all the housework and child rearing (if they’ve had kids), gray hairs who have an empty nest, white males, are wealthy for other means than psychology, etc.

Not that having kids is the end all and be all - it’s just and example of how time is limited if you do other things. JFC I thought this board would have found that statement in my above post the most controversial rather than the other stuff I said. Perhaps that means something too.

I do see a trend where people just out of grad school- with all that piss and vinegar school - try ascend the hierarchy, by joining organizations, committees, work groups, etc. but that usually goes away after their life gets more balanced. Usually they have a realization that it’s just “group homework.” But to count these people, often diverse, and discount where the real power lies because of a few token members is missing the point.

Next you’ll be telling me that ABPP isn’t just a club for crusty old white dudes, or those aspiring to be one someday.

it's not "stirring the nest". More, its that your facts don't fit reality or hust fit a reality of a subgroup/older generation. It makes me wonder where you got all your insider info on admissions, or attitudes of Faculty. Or why your opinions are more valid than those of individuals making those decisions or playing roles in boards who are openly telling you 'this is junk'.. These aren't all white men telling you this. Nor is it all people who graduated before cell phones. I believe there is an old WAIS winter analogy that may be appropriate to quote here.

Frankly, we need to stop talking about balanced lives. I don't know what that is. People never have balance because there isn't a right answer. People have choices that make them happy.

 

[WisNeuro]

I can see that I really poked the nest. I’m OK with that, to be honest. This is a convo we need to have.

Let’s just not pretend that most people on psych boards, leading departments, etc. aren’t people who have “balanced” lives. Examples of that include: having one partner who does all the housework and child rearing (if they’ve had kids), gray hairs who have an empty nest, white males, are wealthy for other means than psychology, etc.

Not that having kids is the end all and be all - it’s just and example of how time is limited if you do other things. JFC I thought this board would have found that statement in my above post the most controversial rather than the other stuff I said. Perhaps that means something too.

I do see a trend where people just out of grad school- with all that piss and vinegar school - try ascend the hierarchy, by joining organizations, committees, work groups, etc. but that usually goes away after their life gets more balanced. Usually they have a realization that it’s just “group homework.” But to count these people, often diverse, and discount where the real power lies because of a few token members is missing the point.

Next you’ll be telling me that ABPP isn’t just a club for crusty old white dudes, or those aspiring to be one someday.

Not my experience at all. Most of the people I know in these positions are two professional households who happen to care very much about advocacy. I agree with @Justanothergrad in that it's a mismatch of your perception and the reality that most of us in these areas actually see in real life. As for ABPP, if anything, at least for neuro, as far as the past several years, it's definitely skewed much more in the direction of women in recent years, commensurate with the actual demo of people graduating with graduate psych degrees.

 

[borne_before]

I’ll admit I may be wrong. Thank y’all. You’ve given me some things to consider.

 

[Pragma]

I’ll admit I may be wrong. Thank y’all. You’ve given me some things to consider.

There are definitely serial advocacy types out there that do it for the glory/power and other wrong reasons. I think it is sad when the same people hold positions across different organizations - spread it out instead of getting title-hungry, folks. Do one or two things well instead of trying to take everything over. But there are also those of us that do these things because we care about the field for the small wins, even if it means sacrifices for our own families. It's never a good thing to generalize too much, in my experience it has been a mixed bag. I think you took the feedback here effectively and I also don't think that the essence of some of your posts is wrong.

For ABPP, in neuro it has been becoming standard for a very long time but I get why people don't want to do it in other specialties if it doesn't feel like it is useful. But still, it's not THAT hard to do, the question is how relevant is it for your career?

 

[borne_before]

There are definitely serial advocacy types out there that do it for the glory/power and other wrong reasons. I think it is sad when the same people hold positions across different organizations - spread it out instead of getting title-hungry, folks. Do one or two things well instead of trying to take everything over. But there are also those of us that do these things because we care about the field for the small wins, even if it means sacrifices for our own families. It's never a good thing to generalize too much, in my experience it has been a mixed bag. I think you took the feedback here effectively and I also don't think that the essence of some of your posts is wrong.

For ABPP, in neuro it has been becoming standard for a very long time but I get why people don't want to do it in other specialties if it doesn't feel like it is useful. But still, it's not THAT hard to do, the question is how relevant is it for your career?

Y’all are kinda inspiring me to look for leadership ops.

 

[Pragma]

Y’all are kinda inspiring me to look for leadership ops.

APA might suck, but it’s the only org out there fighting on the hill. Take those opps, give your time, have an influence. It’s been a common theme on these boards over the years.

I’ll temper that with the fact that Divisional stuff is much more cutthroat and probably what you are observing. I hate Divisional politics and that’s what a lot of people feel. But we can’t leave APA bc of a ****ty Division - our profession depends on it.

 

[ThatPsyGuy]

Kinda reviving this because the same friend talked about a similar hierarchy but in Integrated care settings.
To be honest, I don't know too much about integrated care, but I imagine that the Psych/Behavioral Health positions are uh, not too high up.

 

[Sanman]

Kinda reviving this because the same friend talked about a similar hierarchy but in Integrated care settings.
To be honest, I don't know too much about integrated care, but I imagine that the Psych/Behavioral Health positions are uh, not too high up.

That one is easy:

Hospital/Program Administrator

Physician/NP - Team Leader

Everyone else

 

[AcronymAllergy]

Kinda reviving this because the same friend talked about a similar hierarchy but in Integrated care settings.
To be honest, I don't know too much about integrated care, but I imagine that the Psych/Behavioral Health positions are uh, not too high up.

If you're talking about some sort of hierarchy of the various healthcare specialties, there might be one, but I'm not sure if there's enough consistency to have a rule of thumb about it. A lot will be clinic-specific. In the last clinic where I worked, for example, mental health was generally viewed pretty highly (in no small part probably because MH managed the patients or conditions other specialties had trouble dealing with/didn't want to deal with).

At the end of the day, I don't usually think it's worth worrying about. Show up, do good work, advocate for yourself and your profession, and if someone wants to judge you based on where in the building you work or what initials follow your name, that's on them.