Unhappy with clinical work

[Physionerd]

Hi everyone,So I've having a major problem I'm hoping I could get some advice on. I'm currently in a pretty strong Clinical program. I've always wanted to go into research/academia, never had any desire to practice. I applied to both clinical and experimental programs, but went with clinical because it was the best research match and I felt like having a clinical background would be helpful for doing research. Here's the problem....I love my program, but I absolutely hate clinical work. I knew it wasn't going to be my favorite, but it absolutely drives me up a wall. I find it interesting from an academic standpoint, but the actual day-to-day client interaction is making me absolutely miserable. Even only having a few cases a week I find painful. I can switch into the experimental program, but I'm not sure its a good idea. I like the idea of having experience as a therapist, and I'm not sure I'd be as competitive on the job market with the experimental degree given my research line. Of course, I'm also not sure I could make it through internship. Emotionally I mean...I'm able to put aside my feelings and I think I'm at least competent in therapy (though it will never be a strong point). Doing it full-time sounds horrifying though.Has anyone else gone through something similar? Is there any reason not to do the experimental degree? Is it worth fighting through this if I don't want to be a therapist?

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[JockNerd]

Where are you doing clinical work now? If it's at a Student Counseling Center, things can be harder there than in, say, hospitals, for different reasons.

At most schools, you can get experience doing assessment work in your second year of clinical work onward. And you can get internships that focus on assessment. It's definitely not completely removed from therapy, but you might enjoy it more.

I have a really similar experience, although I think my program might be more supportive; among faculty, everyone is pretty openly academically oriented and wants to help produce good researchers. I also went where I am for the research match, but I've had some really awesome supervision and don't have the low self-efficacy for clinical stuff that I was experiencing in September, although it's still definitely not my goal.

 

[Physionerd]

I've done it in a few different settings now - it really doesn't make a whole lot of difference. People irritate me. I hate having to attend to "body language" and sit uncomfortably for an hour because crossing your legs means something more than you like sitting with your legs crossed. I'm interested in the process, mechanisms of change, etc. The cerebral stuff I love - reading about therapy is great. Its the actual interpersonal stuff that drives me crazy. Assessment is slightly better, but still not something I enjoy. The report-writing component is fun...if I could just have other people conduct the assessments, sit in a room and write reports and conceptualize treatment plans all day without actually interacting with clients, I'd probably like "clinical" work alot moreI didn't mean to make it sound like my program wasn't supportive. They're also very openly research-oriented. The reality is that its still a clinical program though so obviously we're set on a path to get licensed. The issue is that I feel like even that much clinical work might be too much for me. If its beneficial in the long-term, I might be willing to sacrifice the short-term for it. If its not beneficial in the long-term, it would make me much happier to not have to deal with it. I just don't want to make a stupid career move that will affect the next 30 years because I wasn't willing to spend 1 year on internship.

 

[erg923]

I'm not gonna tell you to switch or anything, but these are great issues to bring up with your supervisor(s) at your site. Also would be good to bring this up with faculty you may be be close to. If they are academically oriented, you might as them how they made it through clincial work and the strategies they used to make it more bearable. Also inquire about the setting(s) they did enjoy (if any at all).

Also, do you dislike interacting with patients in clinical research settings (such as doing SCIDs and highly structured assessment measures)? Do you simply dislike the therapeutic hour, or do you dislike all clinically related interactions with patients? I ask this because I know many people who love interacting with patients in a highly structured setting where there is little therapy, but you still get to interact, help the patient, and learn clinical skill (i.e., clincial trials research). They simply dislike psychotherapy, and the ongoing duty and responsibility for care inherent to that activity.

Do you like neuropsych? During training you would have to spend alot of time in clincial work, but after you get out, many neuropsychs have a psychometrist to all the testing and you simply write reports all day. You do have to do a clinical interview though, so you couldn't avoid patients all together. There is no such thing as totally blind interpretation of test results in a clincial setting.......I wish there was sometime though...lol

 

[Physionerd]

The closest thing to clinical work I enjoy is training research assistantsReally, pretty much any interaction with clients or research participants is not my thing. I realize that makes me sound like I'm brooding in a dark basement somewhere, shunning all human contact. I like to think I'm friendly and social for the most part. I don't think anyone would know I felt this way if I didn't say so. I'm not trying to avoid any and all human contact. I just very much prefer to be behind-the-scenes. Always have, probably always will. I'm hugely into biological processes, so I obviously enjoy that aspect of neuro. My research interests don't exactly match up with neuro, but if I were to do something clinically, neuro is probably the least unpleasant. However, the prototypical "neuro" disorders hold no interest for me so its kind of a trade-off. I just feel like I'm in a pretty impossible situation here - I really do love studying psycopathology but I feel any direction I go has some element that I absolutely cannot stand.

 

[erg923]

You sound like the prototypic candidate for those "experimental psychopathology" programs at Minnesota and Stanford.

 

[deleted176373]

I just don't want to make a stupid career move that will affect the next 30 years because I wasn't willing to spend 1 year on internship.

I think it's a small price to pay for the long term career flexibility. A year is nothing, it will fly by and you will move on to your post-doc where you can do the kind of work you really envision yourself doing. I would argue that to be a clinical psychologist, all the components are important... What makes the field unique is the blend of all the skills we are forced to cultivate during our training. Not always pleasant, but the end result is worth it I think.

If offered a year of misery to obtain a life filled with happiness, would you take it? Some wouldn't, others would. It really sounds like you know what you want to do and how to get there, but you just don't like the how to get there part.

Mark

 

[edieb]

I think where you do your clnical work has a HUGE impact on how much you like or dislike it. During internship, most of my patients are very low functioning and, as a result, are much harder to assess and treat. For me, dealing with these patients is painful. However, I do have a few higher functioning ones who are interesting to talk to and I notice that they hour flies by with these

 

[psychanon]

That's a really tough one. Perhaps you can figure out what it is you hate about clinical work and try to find a clinical position/ internship where that is minimized. Maybe you could talk to your DCT, since it sounds like your program is sympathetic to clinical work haters, and see if there's a way you can structure your time to minimize the stuff you hate.

There are some internships where you spend most of your clinical hours doing assessments for research studies, and you have a day of protected research time. Maybe that wouldn't be so miserable for you?

If it were me, I would stick it out. The rewards of having a clinical degree in terms of getting faculty positions are too high. But I'm not you, and I can't feel how miserable you are. If it helps, there have been a couple of people in my program who have switched to experimental for similar reasons, and I think they've ended up happier.

 

[Physionerd]

Thanks everyone, I appreciate the advice. Psychanon, could you elaborate on what you mean by rewards of having the degree for getting faculty positions?This is the main reason I haven't switched over yet - is it that there are more openings for clinical professors? I realize clinical programs may want professors who can supervise - is that the main reason or are there other advantages too?
I'm not opposed to sucking it up if it will be helpful in the long-term. I've just never gotten a clear answer for whether it would be helpful in the long-term. I realize clinical programs may want faculty to supervise students in the clinic, but I think its pretty clear I wouldn't be good at it regardless of whether I get a clinical degree or not. If it helps when you're on the job market to have the background in clinical work, then I'll probably stick with it. Unless having that clinical background means I'll be getting pressure to do "clinically-oriented" things for the rest of my career....

 

[WaitingKills]

I think it's a small price to pay for the long term career flexibility. A year is nothing, it will fly by and you will move on to your post-doc where you can do the kind of work you really envision yourself doing. I would argue that to be a clinical psychologist, all the components are important... What makes the field unique is the blend of all the skills we are forced to cultivate during our training. Not always pleasant, but the end result is worth it I think.

If offered a year of misery to obtain a life filled with happiness, would you take it? Some wouldn't, others would. It really sounds like you know what you want to do and how to get there, but you just don't like the how to get there part.

Mark

I fully agree.

I'm thinking of the OP's situation in relation to mine. I hate research. Hate it hate it hate it. But I also know that a clinical degree, rather than a PsyD will give me career advantages here in Canada (we don't have PsyD's therefore it's hard to have them recognized... not starting a debate people) as well as career diversity. So all the research I slugged through for my Master's and all the research I am having to do now for my Ph.D (5 years worth all together of something I absolutely hate) will be worth it in the long run. I don't think a couple practicums and an internship will be that bad in the long run, especially if you get something more in neuro or assessment based. It's one of those things that you have to grin and bear it to get what you want.

As for your last question regarding whether having the clinical rather than pure research Ph.D will be any benefit for you, from my point of view, it will. Keeping in mind that I'm obviously partial to the Clinical Ph.D, it allows you to do both clinical and research work. There may be a time in your life that your clinical experience will really help you out, or there will be a research job at a hospital or something that requires a clinical background (most do, at least up here). You never know what's in your future, so best not to limit yourself. And if you get a clinical degree, you won't be pigeon holed into doing only clinical related jobs at the university. Several prof's at mine have clinical degrees but do absolutely no clinical work.

Good luck with your decision.
Just remember to take your time choosing so you don't regret it later.

 

[Yalebound13]

Physionerd-- I get the notion of doing research rather than the clinical day-to-day work but I am just curious; perhaps working through the boring clinical work is actually taking you through an intense process of which you haven't wanted to explore. In other words, maybe this process is igniting some transference and you are avoidant of your own issues??? If so, I have read this is a common issue for all interested in clinical work at some point. Just food for thought???

 

[psychanon]

Thanks everyone, I appreciate the advice. Psychanon, could you elaborate on what you mean by rewards of having the degree for getting faculty positions?This is the main reason I haven't switched over yet - is it that there are more openings for clinical professors? I realize clinical programs may want professors who can supervise - is that the main reason or are there other advantages too?
I'm not opposed to sucking it up if it will be helpful in the long-term. I've just never gotten a clear answer for whether it would be helpful in the long-term. I realize clinical programs may want faculty to supervise students in the clinic, but I think its pretty clear I wouldn't be good at it regardless of whether I get a clinical degree or not. If it helps when you're on the job market to have the background in clinical work, then I'll probably stick with it. Unless having that clinical background means I'll be getting pressure to do "clinically-oriented" things for the rest of my career....

You know, I'm still a grad student, not on the market yet, so it'd really be better if you got the advice of someone who has been on the job market. But my sense is that a clinical degree would be more valuable. This is perhaps especially because of the supervision factor, but there are also other faculty duties that clinical people are more able to do, such as teaching assessment and intervention classes, mentoring clinical grad students, etc.

One thing that it depends a little on is your research area. If your research area is very much in the clinical area (e.g., depression), then you're probably going to have to apply to clinical areas within departments. I would think that clinical areas would see a non-clinical degree as a liability, or at least they might see it as somewhat odd--- in academia, it seems like the beaten path is what gets you the job. If your research has a non-clinical bend to it-- physio, developmental, social, health, etc.-- maybe you could end up working in a non-clinical area. They wouldn't care so much about your lack of clinical training. But even in that scenario, you're limiting your options, and as competitive as academia is, you really want no limitations.

If this is something you're seriously considering, I would definitely talk it over with someone who knows what the consequences will be.

 

[PsyDr]

there is nothing wrong with disliking clinical stuff.


go with what you are interested in. If you are looking for money, simply take an honest inventory of your specific skill sets, then research what unique market demand you could fill with these skills.

 

[JockNerd]

Physionerd-- I get the notion of doing research rather than the clinical day-to-day work but I am just curious; perhaps working through the boring clinical work is actually taking you through an intense process of which you haven't wanted to explore. In other words, maybe this process is igniting some transference and you are avoidant of your own issues??? If so, I have read this is a common issue for all interested in clinical work at some point. Just food for thought???

Seeing tranference in an internet forum post gets you one of these from me:



It's hard for me to see really abhorring clinical work to the degree that you'd want to ditch a program you're apparently well into. But keep in mind that there's that whole year of internship to do after it's all done, too. I guess I'd just put out that I know people who love pretty singular aspects of clinical work; crisis stuff, assessment, group work, individual work. Unless you've seen it all and it all stinks, it seems like a big loss to me to drop it at this point, and still continue on in Psych.

 

[Physionerd]

It's hard for me to see really abhorring clinical work to the degree that you'd want to ditch a program you're apparently well into. But keep in mind that there's that whole year of internship to do after it's all done, too. I guess I'd just put out that I know people who love pretty singular aspects of clinical work; crisis stuff, assessment, group work, individual work. Unless you've seen it all and it all stinks, it seems like a big loss to me to drop it at this point, and still continue on in Psych.

Well, we're not talking about ditching and starting over. We're talking about me having the option of basically stopping clinical work and not doing an internship. Nothing else changes other than the words on my diploma. Really I'm just trying to get a sense of how much "easier" it is to get a job with a clinical degree relative to other fields. It sounds like the answer is substantially even if just by opening more doors. psychanon - My interests are in clinical disorders, but very much on the biological side (genetics and neuroscience). I've never seen anyone in this area not have a clinical degree before, so it would definitely be out of the ordinary. Yalebound - Not to blow off what you said completely, but I really doubt there's any validity to it. Its been across a variety of settings, with a variety of different patients and issues. As I've mentioned, its not really the subjects that come up that bug me (I enjoy the theory and find much of it fascinating), its just the actual song and dance of client-therapist interactions that I can't stand. There's nothing "intense" about my experiences with it, I just find it unbelievably boring and definitely the part of my day I end up dreading. Everyone - Thank you all for the advice. I did talk to some folks about this and betwee them and you, you've all made a convincing argument for me to suck it up and finish the clinical work, as distasteful as I may find it. I'm just hoping I'm putting on a good enough face when I'm actually in therapy - I don't like it, but I'd feel terrible if it actually came across that way in a session and a client took it personally.

 

[Cosmo75]

I'd target the research heavy internships out there, like UIC for example. You only do 2 days of clinical work, the rest is spent in the lab. That way you get the clinical degree but with less pain