- Written by May Chi, Psychologist, Supervisor at PsychLab.
I’m taking a moment to remind everyone, myself included, that it’s been an interesting two years, and models of private practice need to take into account that our clinics are staffed by humans. Squishy, fallible, aging humans. Before I add my two cents, I would like to highlight some great points from The Highly Efficient Psychologist, an article from the InPsych magazine, of which I am an avid reader.
“The highly productive private-practice psychologist has clear goals and a long-term focus, and understands their practice evolves over time.”
This is personally true for me. I’ve been at my most engaged in practice when I can see how the things I am doing today align with my continued professional development. My professional goals have evolved over time, from job search, to creating opportunities for others.
“Wavering non-attendance fees, agreeing to bulk-bill and reduce fees, writing unpaid or highly discounted reports might be the easy option – and may even make us feel good – but resentment can build.”
I have been fortunate enough to have private practice mentors, successful group practice psychologists and business owners, to who I owe all the business acumen I possess. The gap between what the government is willing to fund in terms of health services, and what these services cost when delivered by awesome humans, widens every year. I have seen too many good psychologists burn out or sliding down that slippery slope trying to bridge this impossible gap.
“The productive psychologist embraces technology and works towards technological excellence.”
Can I admit that it was my mother who talked me into a smart phone (by putting one in my hand while telling me I had to keep up with the times), and introduced me to YouTube and Facebook? Knowing my technology inertia, I make an extra effort to surround myself with techies, learning by osmosis, because it is true – efficient use of technology saves time and trees, and increases reach.
To add to these excellent points, I would just like to remind readers that you don’t get a highly efficient psychologist without being a healthy human psychologist first. So my two cents:
“Do one thing at a time.”
The sheer amount of tips and ‘have tos’ about business and practice makes for the biggest FOMO. While you can read six ideas in an article, your body can only slowly, effortfully implement one of these ideas at a time. So it’s not even a tip really, or a choice, it’s a wonderful feature of the human condition.
This is my trademark secret to not only healthy, but high-performance psychologist. Anyone who has brought a pillow and blanket to their full-on job and spent part of their lunch break curled up on a comfy couch in the staff area, knows what I’m talking about. Having a nap in the workday happens across all cultures. It even works for babies, and they always seem like healthier humans afterwards (not saying a psychologist is like a baby, but… maybe we’re not that different).
My experience is that psychologists have no problem being highly efficiently eager to meet unrelenting standards, it’s the transition back into the mere human form that is problematic. Going home means leaving your psychologist hat at the door, and spending time doing things any healthy normal human would do.
Until we invent and widely disseminate robots that can be better, more efficient, and errorless versions of psychologists, rendering us all obsolete, please continue to prioritise your own health and vitality.
Ben's student project with PsychLab was to compile a list of services on the Fraser Coast that may have experience working with veterans and the Department of Veteran Affairs. The digital copy is available here:
- Written by Ben Reed, on student placement towards Certificate IV in Mental Health Peer Support.
1. As far as healthcare in Australia is concerned, quality and standards of care is of a high quality compared to some other countries. However, there is an oft true sense of the healthcare system failing for veterans and their families.
2. Despite the increased funding and subsequent improvements in non/clinical services around veterans, it is obvious that clinicians/practitioners and GPs are not familiar with the complexities of veteran healthcare – especially in the area of mental health.
3. It is often that veterans feel let down, as even though Defence provides “In-Service” mental health support – it is often out-sourced through to civilian health professionals. With this in mind, veterans seemingly feel they are nothing more than another statistic because they are currently serving at that point in time. This has led to mostly falsely raised hopes that when they discharge from Defence (either at Own Request or Medical Discharge), the quality of healthcare will be of higher standards (both clinically and skillsets of practitioners).
4. Many veterans have had to change GPs on multiple occasions which not only causes severe anxiety, but also raises the negative attitudes of veterans towards healthcare. This is mainly due to the lack of corporate knowledge among GPs with regard to Department of Veterans Affairs (DVA) policies and guidelines regarding health and support of veterans.
5. The trend regarding the lack of formal training of mental health clinicians is that there are many who have to submit reports to DVA, who have absolutely no military exposure/experience, or understand what the veteran goes through during deployments, and throughout the discharge process. The only form of training clinicians have is the online learning suite through DVA. The bad part about this is that in essence, clinicians have no incentive to complete the courses. This, in the end puts veterans at a disadvantage as there is no trust that clinicians will provide the proper support veterans need.
6. Also, clinicians refuse to take on veterans as clients because they feel unprepared and under skilled in providing the proper support needed. This also limits the number of clinicians that veterans are able to utilise.
7. Another factor concerning veteran mental health (and suicides) has been pointed out in The Constant Battle: Suicide by Veterans Report is that there is a severe shortage (paras 3.66-3.76) of clinicians who actually have a significant amount of experience working with the military and its veterans. Further to this it was sighted that there is no formal training provided to mental health clinicians. This has led to the estrangement of veterans when they leave the military and trying to access services in the civilian community.
8. As a veteran myself, I too have found dealing with civilian practitioners who do not understand veterans’ needs and the complexities of DVA’s policies and guidelines. I tend to agree that there is a small percentage of DVA-cognisant practitioners that exist in the system though. The issue is that we need more practitioners who are (or wanting to become) familiar DVA’s policies and guidelines.
9. This will not only benefit the veteran, but it is also beneficial to the practitioner as they themselves will become subject matter experts in veterans’ support. The more practitioners with this knowledge that are in the system, the easier it becomes for veterans to seek quality healthcare more often.
10. Although through SME assistance, quality of care and high standards can be achieved. However, the biggest limitation is the time taken for practitioners to become conversant with DVA’s policies and guidelines through various means. These means may include online facilitation of training courses, presentations at conferences or via distribution of the literature.
- Written by May Chi, Psychologist, Supervisor at PsychLab.
Yesterday marked the fourth and final session of a focused psychological strategies training that I helped facilitate for General Practitioners. I won't lie. Occupying the same virtual space for over twelve hours, with a group that some of my colleagues refer to as 'the gatekeepers of our profession', was definitely an exposure task and a half. It was also an amazing experience and I hope more psychologists in our community get involved in training other health professionals, including medical practitioners. I now have a better appreciation of the following:
A GP perspective matters when training GPs.
Even though the content of the program was on focused psychological strategies (psychological being the psychologist's domain), I would not presume to understand what these strategies look like in GP practice. A GP understands the practicalities of their profession and can explain these strategies in a way that brings them to life. Co-facilitating with Dr Rebecca Lock was an absolute pleasure and gave me an insight into the world of general practice.
Many GPs are concerned about the mental health of their patients.
The overwhelming impression that I got from this group was that GPs are concerned about the struggles of their patients. They recognise the impact of a patient's thoughts, feelings and behaviours, not just on the trajectory of mental illness, but also the impact on other health outcomes such as in chronic pain, diabetes, and substance use. GPs know they are faced with untangling the web of symptoms, and they care deeply about their patients wellbeing.
GPs can and do apply psychological strategies.
In the Wide Bay Burnett area, it can be difficult to see a psychologist. We're not some sort of endangered species (yet), it's just that there's such a high need for psychological services. GPs who can and do apply psychological strategies change the health trajectory of their patients. I found that bite-sized activities that also integrated into other parts of general practice were most likely to be applied.
You don't need to know the theory, but it certainly helps your agility.
This training allowed GPs to follow a cook book, but that's certainly different from being a chef. I would urge all GPs who have an interest in predicting and influencing health behaviours to do the deep dive into psychotherapy. Heck, if it worked for Russ Harris, who says it can't work for you?
But seriously, to those who are studying undergraduate psychology at the moment, stop rolling your eyes.
Running this training reaffirmed for me that a thorough understanding of psychological principles is what makes psychologists so good at working with human behaviour. Theory sharpens and broadens our focus, helping us to pivot and adapt to the client's needs in practice. Understanding the why helps you adapt the how to suit the situation.
In a month's time, I will do a follow-up session with the lovely cohort of GPs to find out how their foray into focused psychological strategies is going. I am looking forward to it.