The Doctor is IN.

Recently, the edublog world has been talking about how teacher accountability might be measured in much the same way doctors are measured—by professional standards, not client outcomes (such as test scores). The argument has been made that doctors are not punished for undesired outcomes; they are accountable for doing what professionals should do given their client’s circumstances. Eduwonkette summarized the position nicely.

Ok, so if teachers are the doctors who do the best they can under the circumstances with all the professional tools and data-based decision making skills, what would that make school psychologists?

I’d argue in the medical model, we would like to be the Wellness Coordinators or Early Childhood Primary Care Physicians who focus on prevention. At least in the world of urban education, I think we are more like Emergency Room Psychological Triage Doctors. Whose life is in danger? Who is in the most pain? Who is a danger to others? Who is quietly suffering in the waiting room? Go! Go! Go! Oh, and we are also understaffed, don’t have phones or offices, have to share our equipment with 40 other doctors, and drive between 3-5 different “hospitals” in a given week. As one dear reader and fellow school psychologist wrote me the other day, “The pure lack of space and resources makes for sometimes disabling inefficiency. Do I have to go to private practice to get a working phone and a door that closes?” And she’s in a fancy school district.

It is difficult to sustain one’s self in such an environment. The burnout rate for school psychologists is alarming. Half of the profession sees themselves leaving within 5 years. I see people coming to my blog with search terms like, “Hate my Job and School Psychologist.” It’s sad. The problem with the current system of service delivery is that it is set up to wait until the child is so “ill” that they have to be tested to see if they have suffered enough to be called “disabled” and get some services. I don’t usually get to work with kids until they have failed out enough to possibly warrant special education. And if they are only minor learning injuries, you’ll have to just wait. Come back in a year when there’s a statistically significant drop in your academic performance though!

The rewards of this job are intangible. Once your students are stable and feeling better, they go away and the next 5 traumas are there waiting for you. You are left with, “Huh. Wonder how much I helped that kid?” and you have to move on. By and large, you work intensely with a child for a few months and then are left to wonder what interventions or words of encouragement “stuck.” Did they end up taking their prescription? Did they change their behavior? They left feeling better and didn’t come back, so is that good news? Did the parents and teachers leave the IEP meeting or counseling conference thinking about the child’s needs in a different way? Did their behavior change to help the child? Does the child feel better about his/her learning?

Before you get out the Kleenex box for me, I still love my job. There are days that I am so encouraged and empowered after seeing a kid I’ve been working with finally make a break through. There are days where I am Debbie Downer and am angry at the inequities. It is a job of extremes.* You have no choice but to hold yourself to the standards of best practice and do your best every day. You may not have a working phone, but you have kindness, knowledge, research, and clinical experience, and hope you have made a difference.** You take the small victories. Every so often you get a student come back to you and say things like, “You made me feel smart for the first time!” or “I miss our talent group!” and it makes it worth it. Somehow I think a standardized test about their feelings wouldn’t quite capture that.

It would be so much better if school psychologists could be Wellness Coordinators or at least Primary Care Physicians who follow children through their development to prevent school failure and provide anticipatory guidance. Instead, we put on our best psychological bandage, give our prescription for learning, and hope that healing occurs.

Oh, and can someone tell Lucy to talk to the school board about increasing our time at our school sites to do prevention work? It may cost slightly more than 5 cents, but I think we’re worth it.

*It might be so extreme I’d leave out the “e,” make spelling errors, and create a recruitment poster for the neXt generation that said: “R U Ready to be Xtreme!?! Think of a career where U get Skooled every day! School Psychology!” We would have competitions about who could last the longest in an urban school with no resources. Kind of like Survivor. Only you could vote yourself off when you couldn’t take it anymore.

**Hope. So hot right now.

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Comments on The Doctor is IN.

  1. Anonymous says:

    The ending to this was hilarious. This was all really well done!!!
    -Current school psychology intern

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