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A Graduate Student Perspective of Professional Identity Development

Posted By Jeffrey Ellison, Thursday, May 16, 2013
Developing a Professional Identity
Jeff's post is the 3rd installment in this series. Click here to read the first and second posts.

The comments of Dr. Reitz and Dr. Bishop in this series to date bring to mind a recent conversation with several of my fellow graduate students. In this conversation, my peers suggested that: 1) integrated practice is less complex and thus less effective than traditional methods of clinical practice, and 2) mental health providers with sub-doctoral training are qualified to provide collaborative care services, so why would a psychologist want/need to do it?

When I first began writing this post, I had planned to formally rebut my peers’ "misconceptions” of integrated primary care (Had they actually read the research?); to finally set-the-record-straight about integrated primary care (What about psychotherapy? There are plenty of very qualified and competent sub-doctoral level providers with expertise in traditional psychotherapies!); and to prove to everyone that the practice of integrated primary care is actually a worthwhile endeavor (Even for a psychologist!). As I read through the other blog contributors’ posts, however, I began to sense that the conversation that I had with my peers was not about the "facts” of integrated care at all. Instead, this conversation may have been a representation of our divergent professional identities.

But how do students 3, 4, or 5 years into their respective programs develop such different professional identities? In the initial post in this series, Dr. Reitz discussed how trainees pass through Chickering’s seven "vectors” multiple times throughout their educational journeys. In the first years of graduate training, the "identity” that all trainees develop (Chickering’s 4th vector), though broad and rudimentary, is likely fairly uniform across trainees. As trainees undertake more clinical experiences they pass through Chickering’s vectors again and again (e.g., during beginning practicum, advanced practicum, and internship, etc.).
Trainees are particularly
vulnerable to identifying
with the first thing
(i.e. model, theory, etc.)
with which they become
confident and competent.

Through this process, students hone and focus their professional identities based on many factors including personalities, interests, and specific experiences. Inevitably, as a result of this process, students will conclude their training with unique and personally tailored professional identities. Increased job satisfaction, career investment, and productivity are all likely positive side-effects of this process. Additionally, this process promotes variety within our respective fields, thus allowing our fields to remain flexible and adaptive even in this ever-evolving healthcare environment.

Unfortunately, there are also downsides to our increasingly divergent professional identities. In the conversation I described above, neither my peers nor I were able or willing to stray from our narrowly defined professional identities. We took the same classes, participated in the same clinical experiences, worked with the same supervisors, and progressed though the same clinical psychology program, but we seemed to have nothing in common! How could this be? In reading again through the previous posts, I realized that the reason that it may have seemed that we had nothing in common was that, though we had well developed individual professional identities, we had poorly developed group professional identities (e.g., we had only vaguely and narrowly defined concepts regarding what it really to be a clinical psychologist or mental health provider). In other words, we had become so focused on "the trees” that we could not see "the forest.”

I recognize this as a problem specifically within the clinical psychology training process, however, I would bet that the same problem occurs within other fields as well. I hypothesize that this hyper-focus on specialization (i.e., sole focus on developing an individual professional identity) has its roots in the first years of training. When trainees enter graduate school, they typically come from a undergraduate programs where they were likely considered highly competent and top-of-the-class. When they enter graduate school, however, they are again inexperienced "newbies,” who have to prove themselves in a new program. Because of this, trainees are particularly vulnerable to identifying with the first thing (i.e., model, theory, etc.) with which they become confident and competent. Students become fixed on domains in which they are competent instead of continuing to explore new things (i.e., models, theories, etc.) and struggling with incompetence again. Granted not all trainees are seduced in this way, but in my case, it certainly makes sense. My initial practicum experiences occurred in integrated primary care, a setting where I am still exclusively practicing today.

In writing this, I am not trying to suggest that it is not okay to specialize or that it is a necessarily a mistake to become enamored with the first experiences in which you taste confidence and competence.I am suggesting, however, that it is important for trainees to carefully analyze their motivations.I also think that it may be important to rethink the structure of training programs so that they may have introductory experiences (i.e. not just book work) in a wide range of clinical models and theories prior to specialization.As such, I completely agree with Dr. Bishop’s assertion that providing students with inter-professional and collaborative experiences very early in their training may help facilitate the development of a more broadly defined professional group identity.


Jeff Ellison

Jeff Ellison is an advanced student in the clinical psychology Ph.D. program at East Tennessee State University. In his current externship placement he provides behavioral health services to patients presenting in primary care and community health settings across the state of Tennessee via videoconferencing. His research interests include: the integration of primary care and mental health; the use of technology (e.g., videoconferencing) in expanding access to behavioral health care; rural mental health care; and dissemination, implementation, and quality improvement for primary care and mental health settings. In his free time, he enjoys running, hiking, biking, and exploring the outdoors with his family.

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Megan Miranda says...
Posted Monday, June 17, 2013
I agree with you regarding the "missing the forest for the trees" type individualistic focus on professional identity and not a cohesive professional identity as a group. I am a doctoral student in the Counselor Education & Supervision: MFT track program at The University of Akron and although there is a seminar class focused on professional identity and advocacy, there is still a lot of vagueness regarding the professional identity of an MFT versus a PC. As we get even more specialized in our training focusing on MedFT that group professional identity as an MFT gets even more muggy and vague.
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Katie Wootton says...
Posted Thursday, June 27, 2013
Hi Jeff, I really enjoyed reading your discussion on professional identity. I am currently also in the Counselor Education & Supervision: MFT track program at The University of Akron. I feel as I have developed more of my own professional identify, I have become critical of others who have not. I am realizing though from your post, that those who I have been critical of for not developing some sort of professional identify, have not had those experiences (" inter-professional and collaborative "). Which is a learning experience for me as a future educator when working with students. -Katie
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