Psychology

Now a little bit about me. I have a long job title. I'm a forensic clinical neuropsychologist specializing in health and medical psychology. The "forensic" part means that my reports end up in the legal system usually before administrative law judges. The "neuropsychology" part means that I have specialized training in brain functioning. Health and medical psychology means I work with psychological functioning as it relates to health and wellness and medical illness. The "clinical" part means I work with people and not just do research or work with animals. It also means I follow specific diagnostic procedures and that most of the people I evaluate would be considered ill, although not necessarily mentally ill.

My job involves psychological and neuropsychological evaluations including testing and report writing. I have a doctor of philosophy degree in clinical psychology specializing in health and medical psychology and my training included two post doctoral fellowships-one in psychology and law, and one in neuropsychology. I get asked a lot about the difference between a psychiatrist and a psychologist and a therapist. A psychiatrist is a medical doctor who has taken coursework on psychology and mental illness. Following medical school a psychiatrist spends a year of residency and a year or two of fellowship learning about mental illness. A psychologist spends a minimum of four years learning about mental illness and therapy and, before being allowed to practice independently, must complete about 1000 to 3000 hours of clinically supervised practice depending on the State where they practice. A therapist generally completes two to three years learning about how to do therapy and completes around 1000 to 3000 hours of clinically supervised practice. In most States, psychiatrists can prescribe medications, although some psychologists in some States with special training are being allowed to prescribe.

Psychologists can have one of two degrees. A Doctor of Philosophy Degree or PhD, or a Doctorate in Psychology or PsyD. The PhD degree is a research based degree. Holders of that degree wrote a published book in a field of research known as a doctoral dissertation. The PsyD degree is a clinical degree. Holders of that degree wrote an extensive paper similar to a dissertation but it was about treatment not research. There is a Doctor of Philosophy Degree in medicine, but most of the physicians who hold the degree do research as their main occupation.

About 10 years ago I switched from clinical practice to an evaluation practice. I no longer do clinical treatment except under very rare circumstances. I have always liked psychological testing and psychological evaluations give me the opportunity to do a lot of testing.

There are a lot of types of tests and new tests are being created all the time. I've taught psychological assessment to graduate students. They are often surprised to find out that there's a lot of math involved in testing and assessment. Psychologists can assess everything people can think, feel, or do. We can infer internal states based on reported thoughts and behavior. Psychologists can also explain what is normal or abnormal based on population statistics and professional consensus about what constitutes normal and abnormal behavior. We can compare what people say they like and dislike and give them an idea about how well they would be suited to a job, a career, an area of study, or even someone to date.

When I was in clinical practice as a health and medical psychologist my work involved working with physicians and patients to ensure compliance with treatment, understanding of medical conditions and options for treatment, and to ensure that physicians understood the impact of the patient's strengths and weaknesses on their treatment plans. In some cases I helped patients document their medical conditions and provided research on possible diagnoses and treatment options for their physicians. With an average psychological consultation being 50 minutes and an average medical visit being 20 minutes, it's not a shock that things get lost in translation between doctor and patient.

In addition, people of different ages, genders, cultures, educational background and income level all communicate slightly differently. That also contributes to important information getting lost or not understood. So for all the people who "don't believe in psychology" then I explain that what I do is translate what they tell me into medical language and back up what they say with objective test data to support their complaints. That's something most people can understand and get involved with cooperatively.

I do the same thing currently, but I generally am evaluating people who are reporting disabilities. I translate what they tell me into medical language and back up their complaints with objective test data to make their complaints clear and understandable. Sometimes the complaints don't translate well. The person is vague or has a limited way to express how they think and feel. The data then is invaluable. Sometimes the data suggests that the complaints are either too much for the situation or too little for the situation. Then psychological factors can be factored into what is going on. Some people complain easily. Some people never complain unless things are dire. Just listening to complaints alone won't tell me if this is someone from either of those groups. The testing will tell me what is going on. That's why I like doing testing. It helps people get the correct treatment, services and resources they require.