Showing posts with label academic. Show all posts
Showing posts with label academic. Show all posts

Monday, May 2, 2011

25 pages...

means I have just finished writing the longest paper of my life.

I am happy to say I have come a long ways in paper-writing since I first started this blog.  No, I do not have many blog posts to show for the paper I just finished.  But I understand the process a lot better.  Or rather, I've developed a process that's starting to work for me.

For this paper I knew I had to start more than a month in advance for several reasons: 1) I had never written a paper longer than 16 pages and didn't even know if I was capable of writing 25 pages of double-spaced text; 2) my prof straight up required us to have 20 sources; 3) I decided based on previous paper-writing experiences that familiarity with sources definitely helps the medicine go down; 4) reading 20 sources takes a very long time.

Well, I didn't end up reading 20 sources, but I did read significant parts of at least 13 sources.  In fact, out of all the time I spent on this paper, probably about half of it was spent reading and taking notes on sources.  I hadn't written anything aside from a single blog entry (on the medical model) until less than a week before my paper was due.

For the sake of drama, let me chronicle the last few days of the process leading up to the Monday 12:30pm due date:

Thursday.  Usually I'd be busy seeing clients all day, but I had half the day off, so I finished reading a source I had started and was able to write the first 2 pages of my paper.

Friday. After working two hours at my job in the morning I come home and send out a call to prayer by email to faithful friends letting them know I'm feeling quite overwhelmed at the prospect of writing 23 more pages by Monday.  I work until my meeting at 5pm, and still have only written 2 more pages.  The girls I meet with from 5-6:15pm encourage me that God will help me write my paper.  I go home and write another 4 pages, and also add in the blog about the medical model, which puts me up to 9 pages.  I am not feeling very happy with the pace of my writing and estimate that if I continue at the same pace I will not finish on time.

Saturday.  I wake up and read my Bible and ask Jesus to help me with my paper.  While I am praying, I get the idea that instead of writing sections of the paper in order, section by section, I should try writing source by source, and just plug in the information from each source into the appropriate section.  I apply this strategy and work until a bridal shower that night, with a brief break to choreograph some of my new rap parody.  By the time I leave for the shower I have 17 pages, which has me feeling very pleased.  I come home and am able to add only 1 more page, putting my total up to 18.  I have finished adding the information from all my source notes, and I go to bed.

Sunday. It's my Sabbath, so I don't work on my paper at all.  Now maybe you understand why I was afraid of not finishing.

Monday.  I wake up at 6am and work straight until 11:45am.  I had been sleeping a little fitfully the night before and woke up ready to start working.  I had been worried about what I would add to my paper, not knowing how I would get another 7 pages since I had already used the information from my sources.  But I just start working through the paper and adding transitions and explanations between all the information from my sources, and the paper keeps growing.  At 11:45 I had three lines on the 25th page.  Done.  I emailed it in and left the house within ten minutes to catch the bus.  I even made it to class on time.  I feel AWESOME!  I think I am smiling super huge and dancing in my seat the whole bus ride.  I try not to smile to big at my classmates who all look dead tired, but I feel FULL of energy and enthusiasm.

What did I learn? 
  1. Source by source writing is TONS easier than section by section writing.  Before I wasted so much time looking for the facts I needed and wondering if I was missing anything.  This way it was all included and I just put it in whatever section needed it most.  I'm really thankful God shared that secret with me :)
  2. Jesus provides for me!  And that's why I take a Sabbath, to remember that Jesus can provide for me and does provide for me despite my best efforts.
  3. Reading sources and taking notes on them is worth it.
  4. I can write 9 pages in one day.
  5. Starting to actually write more than a week in advance would probably be a great idea next time.
  6. Finishing a task that seemed overwhelming and impossible well and on time is a completely exhilarating feeling!
Oh, and the paper was about evidence-based practice in psychology, but who cares?

Saturday, April 9, 2011

The Medical Model

The medical model has long been the dominant model of our time for providing health services.  It has the most power, the most money, and the largest following.  Essentially it has these core components: a disorder, a scientific explanation for that disorder, a mechanism of change, healing actions, and specificity.  The disorder is whatever the problem or complaint is that puts the patient in need of services.  The scientific explanation is the etiology of that problem according to relevant research or theory.  The mechanism of change is whatever strategy will be used to solve the problem.  Healing actions are the specific interventions applied to the patient.  Specificity is the inference that the healing actions are what cures the patient.  These comprise the core of the medical model.

In the realm of medicine the strategy used is applying medical knowledge, and the healing actions are the actual treatments given, but in psychology the strategy is the theoretical approach of a given counselor, and the healing actions are the specific interventions used.  In medicine the interventions are physiochemical, but in psychology the interventions are psychological.  Both have incidental, or placebo, effects that are psychological.  This poses somewhat of a problem for psychology as both the specific interventions and the incidental effects are psychological.  Perhaps the medical model is not the best framework for psychology.

Nevertheless, psychology has adopted the medical model, which means it has had to fight for turf in the medical arena.  In the 1990s psychopharmacology started to assert that its treatments were more effective and more proven.  In response, psychology had to prove the effectiveness of its own treatments, which led to manualized treatments and contributed greatly to the thrust now known as evidence-based practice.

In the medical model everything must be proven, and since psychology has professionally fallen into this model, it leads to specific treatments having to be documented and then proven through research, as if they were a new drug being tested.

Tuesday, March 22, 2011

Counseling in the Chinese World Consultation: Diamond in the Rough

…or in the jungles of Thailand, as it were.

This consultation was not well known outside of certain circles, nor was it advertised beyond a few notifications.  It was arranged by humble people doing significant work, and attended by the same.  I did not have much idea of what to expect in coming here, but what I found was valued relationships, insightful discussions, rest for the weary, and vulnerable stories.

What made the conference so beautiful was the people who came.  We had counselors, professors, community leaders, counselor-trainers, students, spouses, nonprofit workers, and supervisors.  And they came from a variety of backgrounds, some from Chinese backgrounds, some from Western backgrounds, and some from a mix, and current living situations in all parts of China (Beijing, Chengdu, Sichuan, Kunming), Hong Kong, Taiwan, Thailand, Malaysia, and America.  Some came as teams, some as individuals, some as couples, and even some as families.  Many already knew some others, and many new connections were made.

Our backgrounds greatly enriched the conference but also posed some challenges.  The greatest challenge revolved around the truly bilingual composure of our group.  A little more than half of our 28 participants spoke Chinese as their heart language, and the remaining spoke English.  Of course, the vast majority of the group spoke both languages, enough to benefit from proceedings in either language, but a few speakers did not understand much at all of the other language.  So even though the least bilingual among us spoke at least some of the other language, it was not enough to understand a session.  This meant that a burden of translation fell onto the small portion of our members who spoke both languages well enough to translate.

Translation was a struggle throughout the conference, and taxed our most fluent members heavily.  We tried several different strategies, most often choosing to have simultaneous translation for small groups of people at a time so as not to slow down our meetings.  This language divide also permeated our informal interactions, with participants of the same heart language more likely to connect with each other than primary speakers of opposite languages.  However, I was impressed to see bilingual meal tables and a lot of code-switching (e.g. switching between English and Chinese), and plenty of persistent participants making connections with speakers of opposite languages as well.

Personally, I found the bilingual nature of this conference delightful yet stretching.  I was a little nervous when, as a primary English speaker, I was placed in a small group with three primary Chinese speakers.  I thought our small group would probably have to operate completely in Chinese, and worried that this might keep me from fully participating.  Our small group did operate mostly in Chinese, but I was absolutely delighted to discover that I could understand almost everything that my group members were saying.  Of course I didn’t understand every single word, but I understood their stories and what they were communicating.  And I even learned new words, and was reminded of old words I had forgotten, just from context.  This is extremely exciting to me because my cross-cultural growing up experience has made language a crucial issue for me.  One of my greatest longings is to have more language ability.  It is always disappointing when I realize how much more there is to learn, or compare my Chinese ability to my English ability and find them so disparate.  Conversely, it is always a great joy when I discover that I have succeeded in a new way or have made significant progress in learning Chinese.  The new success that I delighted in this time was that of understanding Chinese spoken on a vulnerable heart level.  Never before had I had Chinese friends communicate with me on the heart level in Chinese.  I felt I was opening new doors of potential for vulnerability in cross-cultural friendships.  I still cannot communicate in Chinese on that heart level, so thankfully my group was able to find a happy medium in that it was completely acceptable for me to talk in English, since they all understood it well enough to understand what I was saying.  So we had a small group in which each of us spoke in our heart language, and all of us understood.  This was truly precious to me.

It was stretching too in that I also got tired.  I can understand a lot, but it takes more work to understand Chinese than it does to just listen in English.  Listening in English is like breathing.  Listening in Chinese is like treading water.  My mother would add that listening to both simultaneously is like running uphill.  I sincerely admire international students who have learned English as a second language and now attend classes in that language.  If I was already feeling tired, I had to force myself to keep paying attention and understanding instead of just tuning out.  There are also other levels of understanding that I have not yet reached.  When in our meeting we watched four group members have an academic-level discussion on major issues that arise in doing counseling in the Chinese Christian world, there was too much that I could not understand, so I had to listen to someone else translate.  I dream of the day when I will be able to not only understand that level of discussion, but also communicate well enough to participate.

This conference also produced the treasure of rich discussions built on our diverse backgrounds, and facilitated by our flexible schedule.  When attending a conference, one usually expects to be given a schedule of specifically what will happen when, accompanied by appropriate descriptions.  The schedules that we were given upon arrival had very little detail, as well as very little correspondence to what actually happened during our conference.  I suppose fewer numbers of people all staying in the same place and eating the same meals does allow for easy rescheduling with just one announcement.  What really happened is that we would start one session and everyone got so involved that it went overtime.  Also, we took long breaks.  The breaks were supposed to be only 30 minutes long, but they turned out to be more like an hour long.  However, no one seemed to mind, because what was happening during the breaks was the same as what was happening in the sessions, people were sharing stories and learning from each other and encouraging each other.  In fact, this is what happened the whole week no matter what we were doing.  Whether we were in a session, in small groups, eating, walking, or just standing around talking, the stories and learning continued.

We had two “fishbowl” discussions that were particularly interesting.  Four or five people were chosen to discuss a certain topic while everyone else watched.  For the first we had a professor, a community leader, a counselor-trainer/director, and a former community leader who is now a counselor.  All were native Chinese with experience working in China.  They discussed tricky issues involved in doing counseling in the Chinese world.  It seems there are a complicated set of expectations that clients have for counselors and community leaders in China.  For example, community leaders are often expected to do counseling for free for members of their community.  At the same time, the members may not really be serious about doing the necessary work of counseling, and use the community leader’s lack of counseling qualifications as an excuse not to engage.  Some community leaders are really not qualified, and most are overburdened with other responsibilities.  Others actually are qualified, and for them it can be helpful to let clients know their qualifications.  Clients in China respect qualifications and will be more likely to engage if they know they are working with a professional.  On the other hand, there are not many counselors at all in China, so people in certain communities are being trained to do the work of counseling without going through a formal program, by other counselors.  It was also suggested that any clients be asked to pay at least a small sum of money so that they would take counseling more seriously and be willing to engage in the work.

The second fishbowl had a Chinese couple who had worked in the aftermath of the Sichuan earthquake for three years, and three other people to listen and reflect with them.  Their stories were incredible and heartbreaking.  Since they were living in the earthquake zone, they too experienced the aftershocks and trauma.  They would visit a small town and return later to find it completely wiped out by an aftershock.  People disappeared as quakes continued to shake.  All day long they listened to other people’s stories and grief.  They were so full themselves that this put a lot of tension on their marriage.  The husband wanted to be alone after hearing other people’s stories all day, but the wife wanted someone to talk to.  And in some cases, the grief they were dealing with was so intense, that the wife described feeling like an idiot and not knowing anything to do.  So she just sat for three days with children who had lost both their parents because their father killed their mother in his trauma, not saying anything.  She realized the children were talking to the dog, and that was the only time they would talk.  So she talked to the dog too.  She was able to bond with them by just being there for three days, feeling their pain and talking to the dog.  Slowly this couple is being restored and renewed.  They have left the earthquake zone and are learning to laugh again.  They have more time to be together as a couple, but this is a burden that leaves slowly.

We also had several case consultations, where a member would share about a client, and the rest of us would listen and give feedback.  One psychotherapist was working in a Malaysian city that did not have many other therapists.  She was the only one with her level of qualifications, working at a local hospital.  A man with schizophrenia came to see her, but became explosive and threatening when she confronted him about sending her long emails that he expected her to read in between sessions (and in smaller communities it is much more difficult to limit access to your email address).  She struggled with on one hand feeling compassionate toward him and wanting to help him but on the other hand feeling extremely threatened by him.  His psychiatrist had already told him that he could only be seen for prescribing medicine and not for psychotherapy. In situations like these it seems best for the counselor to become a mobilizer of resources.  She cannot continue to see him, but what she can do is recommend other resources to him.  Also, confidentiality became a different story after she found out he was her next door neighbor.  People in the complex need to know, since he is in danger of harming her.  Other stories were shared and this was a valuable venue for discussing some of the challenges of providing care within a smaller community where the counselor may also be part of the community.  It becomes essential for the community as a whole to take on some burdens of caring for hurting individuals in their midst.  Again, confidentiality becomes a different issue and the counselor needs to help clients become part of community.

None of these were planned or scheduled before the conference started, but anything that happened became a platform for rich interactions full of insight.

More vulnerable stories were shared during small group times and saturated our informal interactions.  These went hand in hand with rest for the weary, because part of the soul is restored when it has a chance to share its burdens with a kindred spirit.  I had my own story unpacked when I realized through conversation with my TCK roommate for the conference that I had “more issues than I thought” when it comes to crossing cultures.  There were painful aspects of my experience that I had ignored and thought I had skipped over.  But I realized I hadn’t skipped over them, I merely failed to recognize them.  It felt so relieving to be with someone who understood because she had experienced the same, and it was good to hear her insights.

The other aspect of rest was just getting away from our normal routines and schedules, escaping to the beautiful mountains of Thailand, just up the road from an elephant training camp.  I heard people exclaiming how they were so grateful to come to this conference because it was giving them rest for their minds, souls, and bodies.  The flexible schedule also made the conference more restful, because it gave a feel of doing whatever was needed, instead of pressure to get things done or obey a schedule.

This conference was incredibly valuable to me and others who attended.  It gave us the opportunity to connect with like-minded people and care for each other.  Some participants previously felt very isolated in their work and ministry, but now feel they have support accessible through a quick email or phone call.  It gave us a chance to listen to and learn from each others’ experiences.  It gave us a chance to rest.  It enriched our perspectives on counseling in the Chinese world.  This conference was truly a blessing.
----
So were the elephants down the road...








PS. See more pictures here
https://picasaweb.google.com/sarspin/ThailandElephantsAndOrchids?authkey=Gv1sRgCPr0yt609v3bqwE&feat=directlink


Wednesday, February 23, 2011

Certification Above and Beyond: Options for Overachievers

Some of you have received a license to practice as a psychologist in your state of choice, and you are not satisfied.  You want another credential to back up your training.  It turns out you have the grand opportunity of getting another credential, primarily through three organizations.  The first is the ASPPB (the progenitors of the EPPP).  The second is the National Register of Health Service Providers (NR).  The third is the American Board of Professional Psychology (ABPP).  Now I know the rest of you are thinking, "Oh, but I was completely satisfied when I got licensed.  What could induce me to go to the trouble of obtaining another credential when I just spent the past seven to ten years getting my doctoral degree and getting licensed?!"  That is a great question.

The ASPPB, NR, and ABPP each offer their own credential, with their own qualifying process, and of course, the accompanying fees.  Each of these beneficent organizations additionally offers you the opportunity to start banking your credentials with them before you graduate with your doctoral degree.  Maybe you haven't heard of credential banking: sending all of your credentials and qualifying documentation to one of these organizations, having them verify each credential and archive it in a file for you.  Later when you apply for licensure in one or multiple states, you can have that organization send all your qualifying credentials directly to the licensing board of your choice.  This would save you the hassle of collecting all the official documentation and having it sent to a licensing board yourself, each time you apply for licensure in a new state.  As for the credential that is offered by each organization, and obtained by meeting specific requirements, it is like that organization's seal of approval.  The hope is that some states will recognize the credential as satisfactory and grant you a license without needing to see all your original documentation, and many states do recognize some or all of these credentials.  In some cases a state licensing board may still require you to take a jurisprudence exam or waive only some of the requirements for licensure.

I am too bored at the moment to go into the specific requirements for each credential, but rest assured that whether you seek a credential or just a credential bank you will always have to pay an annual fee to maintain your credentials with one of these organizations.  Really, this is an enterprise that stems from the original monster of different requirements for licensure in each state and the increased mobility of today's world.  If all states had the same requirements for licensure, then all states could be part of one big agreement of reciprocity, and instead of resending credentials to each new state you would only have to show them a current license and take that state's jurisprudence exam.  How simple that would be!  Not to mention much cheaper!

Mobility remains the number one struggle in licensure.  Let's say you originally get licensed in a state with very few requirements for supervised hours.  After practicing for 15 years, you decide to move to Florida, which requires 4000 hours of supervised experience.  You didn't have an accredited internship and only had 1500 hours of postdoctoral supervision.  Even though you have been practicing for 15 years, you still won't be able to get licensed in Florida until you make up the rest of your supervised hours.  And who is going to supervise you?  Another psychologist, possibly one who has only been practicing for five years.  Does this make sense?

Tuesday, January 25, 2011

Hoops to Licensure Cont.

As promised...
.......................
Also known as the Examination for Professional Practice in Psychology, the EPPP is required for licensure in all states and provinces.  It is a computerized written examination designed to test 8 major content areas (each comprising 8-15% of the entire exam) that are seen by the Association of State and Provincial Psychology Boards (ASPPB) as "foundational to the competent practice of psychology."  The exam has 225 multiple choice questions with four answers each and no penalty for incorrect answers.  As of Aug 2011, only 175 of those questions will contribute to your score (previously 200 of those items were scored).  The rest are pretest items for validity testing.  The scores for this test are scaled from 200-800 just like all the other major scholastic tests of life, i.e. the SAT and GRE.  In most jurisdictions a score of 500 or more is passing, and that is also the ASPPB recommended passing score.

But wait there's more!  In addition to passing the EPPP, all states require a certain amount of supervised experience.  Frankly, I'm still quite confused about how many states allow for some of these hours to be before your doctoral degree is conferred.  In general, I am under the impression that most states only allow you to count hours after you have received your doctorate, which would mean not counting any of your hundreds of practicum hours during graduate school, nor your thousand or more hours during internship.  The general standard for supervised experience seems to be around 1500 to 2000, though some jurisdictions may require up to 4000-6000 hours.  However, things in this arena may be changing, as the Commission on Education and Training Leading to Licensure recently recommended two years of experience (equivalent to around 2000 hours) as sufficient preparation for licensure, allowing for one or possibly both of those years to be before receiving a doctoral degree.

Furthermore, many states require additional exams.  The possibilities include an oral exam, a jurisprudence exam, and ethics or other exams.  These vary widely by jurisdiction, and anyone seeking licensure would be well advised to look up the specific requirements per state of choice.

After all of these requirements have been successfully navigated, you will apply for licensure in a given state.  This process entails filling out an application and having credentials and transcripts and records of hours all sent to the licensing board of said state, as well as an application fee, of course.  Then you will be a Psychologist.  Not a clinical psychologist or a counseling psychologist or an industrial organizational psychologist, everyone gets the same title: Psychologist.
...........................
Coming soon: Certification Above and Beyond: Options for Overachievers

Monday, January 24, 2011

Hoops to Licensure

The only reason I'm writing right now is because I have accountability, and I have not written anything academic yet, nor have I written anything at all in several days.  I haven't read many sources yet, but I have read a few, so here goes...a rough, rough draft putting together some thoughts from my readings so far.
.....................................
Licensure as a psychologist is about jumping through a series of hoops, in order.  According to one source, the proportion of time that it takes to become licensed as a psychologist, compared to the median amount of money a psychologist makes, is significantly less than other professions, being a doctor for example.  So the hoops must completed in order, and there may be some slight variations based on your state of residence or choice.  First, you must apply to and enroll in an APA accredited program.  Check, that's the only thing on the list that I've accomplished so far.  Next, you must complete your doctoral degree.  Read, you must pass a number of classes, accumulate debt as a graduate student, spend hundreds of hours in practicum training, and write a dissertation.  Not only that, but in completion of your doctoral degree you must apply for internship sites and go through the match process to determine where you will be located for a year of your existence, likely uprooting you from the support networks you formed in graduate school and potentially causing relationship strife with any significant others (at least that's what I've heard).  After a successful supervised internship year at an APA accredited site, if you have finished your dissertation, then your doctoral degree will be conferred upon you.  Next hoop: the EPPP.  Also known as the...
................
to be continued, I've met my 15 min quota for the night ;)