I just stumbled on a website created by Dr. Raymond Lloyd Richmond, a fellow psychologist here in the Bay Area. It’s pretty comprehensive, and seems good for both clinicians and clients. I think the most noteworthy section is on how to become a psychologist.

Yesterday I got my letter from the EPPP and I passed! Wa-hoo!

Now that I passed, I’m comfortable writing about it. It was really challenging and I didn’t confident that I passed either while i was taking the exam or when I left. Many of the questions I had never seen before and I had to just use deductive reasoning to try and find the best answer. I also changed probably 10% of my answers when I went back through the exam. Thank god I took many practice exams and studied through a study guide. Probably 10% of the material on the test I only knew because of the study guide. I’m also really surprised that the scores came back so quick. Supposedly they only report scores twice a month. I must have gotten lucky and ended up on the right side of the mid-month cutoff.

Next up is the California Psychology Supplemental Examination (CPSE)

This looks like it might be helpful in studying for it:
http://www.quia.com/pages/cpsepretest.html

I’m really trying to avoid spending a few hundred on a course, but that may be necessary. Although the information is all very relevant to practicing psychotherapy (unlike the EPPP), the questions are pretty tricky.

I can’t wait for all this to be over with.

Yesterday I finally took the Examination for Professional Practice in Psychology (EPPP). I’d been studying since October (with a 3 month break for traveling) and am crossing my fingers that I passed and can move towards the next step towards getting license.

To everyone who is curious how I did, my only reply is that it is so difficult to tell. There are 225 questions on the exam, 25 of them don’t count (they are test questions) and I need to get about 150 of the remaining 200 correct to pass (the questions are weighted). When I went into studying for the exam, I was totally amazed about the amount of material that I was needing to teach myself for the first time. Over the past few months I ended up mastering all that information (this test is on ALL of Clinical Psychology, not just therapy which in my opinion is ridiculous). But when I went into yesterday’s examination, I was once again surprised about how many questions contained terms and theories that I had never come across in my schooling, in my study manual or in the practice exams I had taken.

So fingers are crossed. Scores get reported twice a month, so I’ll know pretty soon what my next steps are. In the meantime, I’m reviewing what hoops still remain. Below are two great articles from the APA that are a godsend on how to stay organized with all this stuff.

http://www.apa.org/monitor/julaug06/license.html
http://gradpsych.apags.org/sep07/internship.html

The Bay Area is a small place, sometimes resembling a small town. Its virtually impossible to go anywhere and not run into someone you know or at least recognizes you as a friend of a friend. So being a Clinical Psychologist here isn’t easy when trying to avoid dual relationships with clients. One reason why this blog is anonymous is to prevent myself from having a dual relationship here with current or potential clients. Having professional boundaries is one of the keys to a healthy therapeutic relationship in which most growth can happen for the client.

Awareness of the challenges of maintaining a professional stance when encountering dual relationships are very present here. The networking process is often through friends or social/professional networking sites, and colleagues who easily become friends outside of the workplace. Therefore as a clinician, you’re lucky if you clients are more than two degrees of separation away from your personal life. And the more social you and our clients are, the closer they are going to be to entering your social circle.

For example, one of my private practice clients and I got connected through a online networking site that my friends and I use mostly for social purposes. I never met this person before, nor did it seem like any of my friends were connected to him through the site. But knowing very well of how quickly circles begin to overlap here, our second session was completely devoted to discussing the inevitable time when we will run into each other in the park, at a concert or festival. How will it go down when it happens? We’re not quite sure, however, I believe having this conversation before we’re caught off guard in an awkward encounter, will strengthen our relationship and allow the client to grow through the process.

building a private practice isn’t the only way to have a self determined career in clinical psychology. i’m finding that there are opportunities for creating employment opportunities where one wouldn’t think they exist. this requires the same mentality as creating one’s own practice - i am of value to people and organizations.

one thing that i’ve learned is that my cover letter really needs to be about me. not about how great of a clinical psychologist i am, but how great of a person i am in relation to this thing that i do called clinical psychology. my hope is that these communications to prospective employers and organizations will at least catch their attention. it also gives me the belief that if they are interested in who i am, then there is likely to be a better match, than if i just pitched myself in a generic way and they chose to hire me.

so as a (partial) result of these tactics, i find myself part time employed at my old organization. i proposed to my old program manager, that i was looking for work and perhaps could offer my services to the organization, on a part time, temporary, flexible hour, assistant manager type basis. lucky for me, i have a set of skills that they need desperately (i’m the veteran member of the team by a longshot) and he accepted. so happily, i have a stronger resume and plenty of choice in this new position. i’ll not only be seeing clients for therapy, but also training new hires and building the program up so that there’s a structure to support it when i choose to move on.

the next step is create the next opportunity that will replace this one, that will excite me enough to move on.

networking might be my biggest challenge when it comes to my professional practice. most of my class in my Psy.D. program moved back east after coming to the Bay Area to get their degree. so that leaves me without a strong connection to any group of clinicians in which to build a referral network.

so i find myself building my practice based on my colleagues over the years and through my peer group. approaching people i know personally isn’t the hard part. approaching professionals that are one degree removed is a little trickier, because i have someone speaking on my behalf, endorsing me as a clinician worth getting to know. so i’ve created a networking letter based on mutual need for making a receiving referrals. we’ll see how it goes.

Dear _____,
This letter is being sent to you through [name of colleague, friend, etc]. I am writing to connect with you as a colleague and potential source of referrals for our respective practices. [A little about me and my practice and need for someone to refer to]. I would like to connect with you to see if it would be possible for me to refer these clients to your practice in these circumstances.

In turn, [a little more about me and the type of clients I work with and my ability to take on new clients]. [something about my resume]

[Making the personal connection, setting up a phone call, casual meeting, etc]
Sincerely,
[your name here]

and then there’s the idea of approaching people that i have no network connection to. here i haven’t found a way to comfortably broach the subject…

building a private practice is as difficult as i always imagined. it began with feelings of “i will never get a client” and continues, despite the initial success to include thoughts like “i will never get enough clients.” i’m a psychologist, so i know all about negative thinking and unproductive thoughts, by i definitely have to utilize some of my CBT skills in order to stay positive during this journey.

i have found no useful information online about building a private practice in clinical psychology. i’m surprised that there isn’t a wealth of information out there; mentors anonymously sharing their experience with recent graduates and newly licensed clinicians. despite this frustration, i’m finding it quite rewarding to be forced into a situation in which i need to make personal contact with peers and colleagues, asking for advice. its is humbling, while also providing a means of broadening my professional network. more on this in an upcoming post.

i’m also finding myself internally battling over ideas of being very business-like or very personal in my efforts to make my practice grow. the folks over at tiny gigantic have some good advice on this matter of self branding. its hard finding this balance. i’ve been taught a certain business model through the years - i’m in a competitive market and that i must strategize, brainstorm and carve out a niche market for whatever endeavor i’m taking on in order to achieve. however, these wise words from tiny gigantic make sense, especially considering what field i’m in. it doesn’t make sense to be trying to brand and sell myself as a psychologist. what i’m offering is my authentic self. the more i can be true to that idea, and be genuine, the more i show people what role i can play in their healing.

i find this an incredibly useful reflection. an exercise in truly believing that i am worth something.

I didn’t expect this one at all. I’m back from traveling and dying to get back to work. That’s not to say that I’m not really enjoying waking up late and having coffee at noon and playing in the park, but seriously, I’m ready. A little life re-evaluation while taking in some foreign cultures for three months really did it for me. I’m incredibly motivated.

I feel blessed to have been given this confirmation of life path. However, one of the things I was hoping ot discover while exploring the other side of the world was to see what I wanted to focus my energy on within the field. But that didn’t happen. So I’ve been hitting the regular channels such as the mental health agencies I know in the Bay Area, scanning craigslist and the good old PsyCarreers looking for inspiration. I have told myself over and over again that this next position I take should be a long term one. My goal is to find an agency, hospital, etc that will feel like home for a few years while I can simultaneously start to build my private practice.

I try and balance this future tripping goal setting with staying practical and taking one day at a time. For now my anxiety is low about needing to find work asap (my savings will tide me over to July 1) so I feel I can fully explore what options there are out there. This has led me to look back on some of my previous declarations of what I am not interested in doing (again), like working with children, in a hospital, etc. I haven’t come up with any solutions yet, but I’m exploring what it might be like for me to try something new or even put on a hat that I haven’t worn in a while.

And now, back to writing cover letters…

So, I’m back from my wonderful travels and hitting the ground running. Despite all that’s happening in my personal life, I’ve got this EPPP thing that I’m ready to be over with. So I’ve sent in what I call my “application to apply.” In other words, the paperwork to get my Authorization to Test letter is in the mail, so I can actually schedule my test (why do they make this process so convoluted?).

So now its the waiting and restudying game. After taking a few practice tests, I’ve decided that I haven’t really retained any of the difficult information that I had to study for the first time (mostly Stats stuff) in the last round of studying this Winter. That means hitting the books hard, taking practice tests every other day and studying my mistakes on the between days. Then, back to those lovely flash cards I made back in January.

It feels good to not be back at square one, as I’m now relearning, but I have to say, this isn’t quite enjoyable yet.

Two years ago at my internship at a community mental health center I had the fortunate experience of having such an amazing clinical supervisor, who provided such a supportive atmosphere mixing both acceptance and challenge, that I was truly transformed after working with her. As my 2006 internship grew to a close, she opened my eyes to a new way of being with people that made saying goodbye a beautiful and rewarding experience.

Goodbyes have never been easy for me. Learning my way around ending a relationship as complex as one with a client has been one of the most challenging and rewarding experiences of my career. Through a combination of the wisdom passed down to me and my own intuition, I have learned to work with clients to create personalized rituals that allow the expression of sorrow, frustration, happiness or whatever other emotions come up as we close a deeply emotional relationship.

I’m not interested in getting into the clinical theories around ending therapy relationships because that’s a lot to get into here. This comes up today because I am resigning from my current psychologist position tomorrow. This means not only am I ending my relationships with my clients, but also my supervisor, my colleagues and the organization that has become like family over the past three years. I do this with great sadness in my heart. I will miss them all dearly.

However, at the same time, we are able to part with gratitude and joy for having known each other. By acknowledging the bond and knowing that we will take a little bit of the other person with us as we continue down our paths, we can gracefully say our goodbyes.