The Enterprising Psychologist

When I was in graduate school, it was common to hear professors intoning that "private practice is dead" thanks to the rise of managed care. Now that I have been in private practice for more than a decade, I can confidently assert that they were dead wrong. In fact, I will go further, and suggest that, as a general rule, it is probably a good idea to ignore the sage advice of people who don't "have skin in the game." It is one thing to make wise pronouncements from an ivory tower; it is quite another to admit that you don't know much about what is actually taking place in the real world.

I suspect that one reason professors try to steer graduate students away from full-time clinical work is that such work is, in many cases, not something that they had ever undertaken themselves or, if they had, not something that they were terribly successful at. It is a bizarre fact that many professors of future clinical psychologists do not maintain active clinical practices. They teach, but they do not practice. In this post, I am going to refer to the very useful O*NET Interest Profiler from the U.S. Department of Labor to possibly address why there is a divide between clinical researchers/academicians and clinicians and, further, why there seems to be a divide between private practice clinicians and agency-employed clinicians. [You can take the O*NET Interest Profiler here.]

One reason that I like the O*NET Interest Profiler is that it is brief (60 items) and practical. Rather than just describing your personality or attributes, it provides you with a list of jobs that you might be interested in pursuing. Among the jobs listed on my profile are my two actual jobs, clinical psychologist and psychology teacher–postsecondary. The Interest Profiler also suggests a number of jobs that I could see myself, in a different life, having ended up doing. I think that the test is best used not to eliminate certain jobs from your list of potential careers, but to expand your list into fields that you might never have considered, or even heard of.

How did O*NET do such a great job of matching me to these jobs that I already do and enjoy? It asks you to rate a variety of job tasks on how much you think would enjoy doing them. The job tasks are eclectic, from tap dancing to filing. Each task is assigned to a certain Interest category: Realistic, Investigative, Artistic, Social, Enterprising, or Conventional (RIASEC is the acronym). Realistic types like doing work with their hands, fixing things, installing things, etc. Investigative types like solving problems, finding solutions, discovering things, analyzing data. Artistic types like being creative, imaginative, and spontaneous. Social types like working with people, particularly in a teaching or helping role. Enterprising types don't mind taking risks, accepting responsibility, and going where no one has gone before. Conventional types prefer the tried and true, are fans of systems and procedures, and are careful with details. Your scores are likely to reflect a preferred combination of multiple interests.

The job of clinical psychologist is coded in the O*NET system as an ISA job: Investigative, Social, and Artistic. We explore problems and seek solutions, and we try to help people by forming intimate relationships with them. We have to be okay with not knowing where things will take us, and be comfortable not having all the answers. As the great psychiatrist Irvin Yalom has said, we have to create a new therapy for each patient.

Certainly, professors in clinical psychology programs are strongly Investigative, and, if they are passionate teachers, also strongly Social. But I wonder if they might be missing a bit of the Artistic, and maybe have a bit too much of the Conventional. Writing the grant proposals necessary to fund research (and graduate students) is detail-oriented work, and it requires following a strict set of rules. So too does programming software, analyzing data, preparing articles for publication, submitting them to journals, and addressing the concerns of peer reviewers. The Conventional strengths that enable them to do, and even to enjoy, that sort of work, might mean that the far messier and less structured work of actual psychotherapy would be less pleasing to them. And because it is less pleasing to them, they might not value psychotherapy or other clinical work as a career activity and therefore steer their students away from it.

Psychologists who actually do prefer the messy and creative work of clinical practice might also be limited in some ways if they are high only in Investigative, Social, and Artistic interests. The addition of the Enterprising interest might be needed for them to give up the perceived security offered by taking a job in clinical psychology and to venture out on their own. Without the Enterprising interest, psychologists might self-limit their potential earnings and sacrifice much of their autonomy. And, as I pointed out in my previous post, they might be less able to pay off the student loan debt from their graduate training.