This past year has really made me think about my professional identity and future career. I always used to say "I never want to be a therapist! I can't imagine having to listen to people's problems all day." But now, as I enter my third year of supervised clinical work, my perspective is completely different.
My first year of clinical work was not very fun. I worked at an outpatient community health facility that serves low-income people. Supervision was less than ideal, student interns were very under-valued, and client turnover was huge. This first year basically reinforced my idea that clinical work was not for me.
My second year of clinical work was completely different. I worked at a state hospital in a long-term psychiatric unit. The majority of the people on my unit had schizophrenia and are often treatment-resistant (meaning they do not respond well to anti-psychotic medication). I did both group and individual therapy. All my individual therapy clients were diagnosed with schizophrenia. I was supervised by a psychology intern weekly as well as informal supervision from the unit psychologist.
This year really changed my view of clinical work. First of all, it was the first time I really experienced formal, individual therapy with people diagnosed with schizophrenia. It was very challenging, eye-opening, and rewarding at the same time. As I continued to gain experience, I realized my own strengths as a clinician and my ability to effectively work with individuals with schizophrenia. I feel that working directly with this population is not something every clinician is good at, or even wants to do. Second, I learned how much progress can happen in a full year of consistent therapy. When it got closer to my year as a practicum student ending, I knew I couldn't leave. So, I spoke to my supervisor and figured out a way to stay and continue seeing a few of my clients. I decided to do this because all of the clients I started therapy with were still hospitalized. I figured I could continue to build the progress I had seen while learning clinical skills along the way. The course of recovery from schizophrenia can be a long one, and I feel very grateful that I can continue to help a few people I started with to build their growth.
I think I enjoyed it so much because of the clinical presentation of the clients and the setting. I had experience with schizophrenia in the past, but this was in psychiatric rehabilitation programs, which can be pretty different than formal therapy. Also, I really enjoyed the inpatient setting. It helps maintain consistency with sessions and rapport-building with clients. And I enjoy collaborating with professionals at the hospital. Some of the nurses are really amazing and I love getting their perspective on clients. The psychiatrists are really good and the chair of psychiatry is doing a great job building the department. And there are several psychologists who are amazing and really care about the clients. Finally, there are some great techs who have their own views of the clients and welcome collaboration daily.
The culture of the hospital is different than other places, too. A few of the clients (sadly) have lived there a long time. Some of them between 5-10 years. Most of them want to get out, but sometimes people want to stay there forever. While you are there, you really get to know the clients well. Certainly the people I have met with for therapy, but many others through groups and informal interactions. It is amazing to get to know people there and really experience how amazing people are underneath their shells. I have had such a great experience here that I am seriously thinking of being a full-time clinician. I hope to do this and still be involved with research. I think staying in touch with research is so important to be an effective clinician.
Well, those are my thoughts for now...
