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Hey, everyone. Welcome back to another episode in the Out-There Assessment series, a series where I’m talking with practitioners who work in unorthodox or unique settings or specialties.
Today, my guest is Dr. Brie Pillegi. Brie is a board-certified forensic psychologist in Minnesota where she works for the state and has a [00:01:00] private practice. She completes a variety of evaluations, primarily for criminal and civil cases in Minnesota and for the federal government. Her work includes competency, criminal responsibility, civil commitment, risk assessment, mitigation, independent medical examinations, and repeat sex offender evals.
Dr. Pileggi has experience working in correctional facilities, both as a sheriff’s detention deputy and in mental health. She’s also bilingual and completes forensic evaluations in both English and Spanish.
We talk about… I think the theme for this episode is flexibility. You’ll get to hear all about the different work settings that Brie gets to work in and the flexibility that’s required to adapt to each of these settings. So very enjoyable. As with all of these out there assessment episodes, I could talk forever about many nuances of her practice, but we try to keep it as [00:02:00] tight and compact as we could hit the high points. I think you’ll enjoy it.
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All right. Without further ado, let’s get to my conversation with Dr. Brie Pileggi.[00:03:09] Brie. Hey, welcome to the podcast.
Dr. Brie: Hi. Good morning. Thanks for having me.
Dr. Sharp: I am glad to have you. Yes. Another guest for what I’m calling the Out-There Assessment Series for relatively unique or unorthodox work environments. I think you fit the bill for both of those terms. I’m excited to chat with you. So, let’s dig into it. Just start and tell me about your work setting these days. What do you do from day to day and week to week?
Dr. Brie: I’m a forensic psychologist. I work full-time for the state of Minnesota. I also have a private practice, which I do one day a week. There’s a lot of overlap between those two positions, but then I do some different [00:04:00] work in my private.
Essentially, my job typically is to complete court-ordered forensic evaluations. So I do a lot of competency, criminal responsibilities, civil commitment, and risk assessment. That requires that I review a whole lot of records. And then I will often travel to wherever the individual is located. Sometimes, especially after COVID, we’re able to do those evaluations remotely, but there’s still a fair amount of travel involved. And so I’ll interview the individual, do testing if needed, and then I write a report and send that off to the court. And then I’m the expert witness if that goes to the hearing.
Dr. Sharp: Okay. There’s a lot wrapped up in that.
Dr. Brie: Yes.
Dr. Sharp: That was a nice summary. We’re going to dig in.
Dr. Brie: Thank you.
Dr. Sharp: Yeah. I think there’s lots to check out there. I want to hit on several aspects [00:05:00] of your work because there are many different facets it sounds like. You mentioned the travel and going to different settings. Maybe we just start there and tell me about where you’re working, what environments you’re working in, and what the travel looks like between those environments.
Dr. Brie: Absolutely. Prior to COVID, we did a lot more travel. It’s less now, but it’s starting to open up again. I see individuals in a huge variety of settings. I would say most frequently jails all across Minnesota. It could be any kind of jail, a metropolitan jail, or a tiny little rural jail in the middle of nowhere. Occasionally I’ll go to one of the state prisons.
And then we also see individuals in hospitals. We have some locked mental hospitals here in Minnesota. And then sometimes individuals are in the community and hospitals on a mental health [00:06:00] ward. And then we have a campus in Minnesota where all of our individuals who are civilly committed as much as we know and dangerous are, and I do a fair amount of work there. So quite a few different types of environments.
Dr. Sharp: Sure.
Dr. Brie: I should add, and then in my private practice, I have an office where I see individuals in the community as well on occasion. It’s in an office setting or say an attorney’s office, a group home, or a courthouse. So really a lot of different places.
Dr. Sharp: Right. Well, I think a consequence of working in so many different environments is the need to be flexible. I would love to talk a little bit about, well, maybe a lot about that because people hear like, Hey, I go into the jails and do evals, right? That sounds like a relatively [00:07:00] consistent, predictable thing. But in my experience, at least, jails are very different, right? And I’ve limited experience, but I’ve done evals in let’s say 3 or 4, or 5 jails here in the northern Colorado area, and they all have a different vibe. I’m curious if that is the case for you as well.
Dr. Brie: It’s absolutely the case. Jails are run by the sheriff of the county. I’ve noticed huge differences between the very large metropolitan jails in the Twin Cities, and then those that are rural. I started as a corrections officer myself in one of the large counties here and it was very strict. It was very regulated. It was very supervised. It was almost paramilitary in terms of the rules, the uniform, the way that we were allowed to wear our hair and dress, and it was formal. The inmates weren’t [00:08:00] allowed to have paper clips or staples.
And then now I find myself in these tiny little rural counties. Just for comparison sake, our count at the jail I used to work at could be 900 some days, and these little jails that I go into now, they may have 16 people there, 8 people there. So it’s first name basis. There’s no security. They are not concerned about what materials are brought in. The inmates have access to a lot more than I’m comfortable with and experience with.
And so navigating, I mean, I could be in one of the bigger jails on Monday and then the tiny little jail on Tuesday and it could be a jail I’ve never, ever stepped foot in. And so, really interesting to see how different they are. And you have to very quickly figure out either the culture and the environment, and adapt. Flexibility- I think you hit the nail on the head. I have to be flexible in all [00:09:00] aspects. You show up and have to figure it out and you don’t have a lot of time to do it.
Dr. Sharp: This was hard for me again, speaking super limited experience in these environments, but it hit on two things that are challenging for me.
1. I like predictability and being able to prepare for things and know what to expect, right? So it definitely hit on that.
2. The other, I don’t know if you experience this, we could talk about this, but there’s something about the jail or correction setting where I feel like any mistakes or gap in my knowledge or not knowing the rules was totally amplified and I just felt so dumb. They’d be like, oh, go put your stuff over there and oh, you can’t bring that in. Maybe it was all in my head. So I’ll throw all of that out there and see what you want [00:10:00] to do with it.
Dr. Brie: I’m also an individual that loves predictability and control. I like to be very scheduled, very detailed, but this is a job where you have to be flexible. You have to roll with the punches. You have to adapt. And I think I’ve over time learned to, I call it act as if, like, act as if I know, act as if I’ve been here, act as if I’m the one in charge, and that works pretty well. I think a lot of times, people may be looking to you to see how comfortable you are, how confident you are, and if you know what you’re talking about.
I, for right or wrong, when I walk in with an official badge from the state and it says doctor, most of the time I’m able to get the answers that I need, the information that I need, people are willing to help, people are very respectful and deferential, and so that helps. But [00:11:00] you show up and the person’s having a bad day and they don’t want to talk to you, or you show up and things are going great and then all of a sudden you say something that triggers them and you have to decide in the moment, what do I do? I need to keep myself safe but do I end the evaluation, do I try to calm them down and continue? What are my options? You have to think on your feet.
I feel uncomfortable all the time, but it’s part of the job. I don’t know, I guess I expect the unexpected. I try to prepare for my cases, but one thing I’ve also learned is they’re never the way that I expect them to be. I’ll read a chart on an individual and think I know what I’m walking into and then it’s almost always the opposite.
Another thing that I’ve learned is always, and because I was a corrections officer, I have a lot of respect for them and their roles. I have a different perspective than I think other forensic psychologists do going into that environment, and so I [00:12:00] always check in with the staff. So I always will say, what have your interactions with this individual been like? Are they any different today? Is there anything I should be aware of? I always defer to them. That builds rapport with the staff and that helps me have a little bit more data about what I’m walking into and what I can expect. I don’t know if that answered your question. Kind of all over the map there.
Dr. Sharp: Yeah. No, it does. I’m curious if you went through any kind of deliberate process for yourself to get more comfortable with that or if you learned it over time to get more comfortable with being flexible and rolling with it and so forth.
Dr. Brie: I think it’s a few things. When I started at the jail as a corrections officer, I was quite young. There were many inmates there who knew the jail [00:13:00] and the rules far better than I did when I started, but I had to pretend like I knew what I was doing and command authority. And that was really hard.
So I think just being thrown in the deep end, so to speak in that environment and trying to figure out a way to survive or be successful, I think starting so young, so early in that type of setting, and then I went on from there to work in three state prisons, two federal prisons. And eventually, for me, it was just my spot. I liked being in that environment.
I also think that for me personally… I was assaulted at one point in time, and that made things difficult for me to have that sense of confidence. And so I actually started doing jiu-jitsu. And that was something that for me was [00:14:00] to prepare mentally, physically, personally, to be able to go into these environments and feel like if something were to happen, I have the training to fall back onto, and I feel a little bit better about my ability to handle myself. But no matter how much you prepare and no matter how much experience you have, there are always elements that are out of your control and you just have to think on your feet and figure it out.
And the flexibility is something where it’s just like. Oh, well, I can be upset about it or frustrated about it, or I can just reschedule and find something else to do. This is the nature of the work. You have to go with it.
Dr. Sharp: Yeah, that seems to be a theme with all the forensic folks I’ve talked with is you have to roll with it. You can show up and think you’re going to spend all day somewhere and you’re out in a half hour any number of reasons.
Dr. Brie: That is the job. I just saw somebody… to give an example, I had an evaluation I was trying to [00:15:00] schedule. Normally, it’s two weeks’ notice, we schedule 2 to 3 hours, and we confirm ahead of time. There’s all this preparation involved. In this particular case, I was notified on a Saturday that this individual was in the hospital and she was about to be released on Monday morning. And so I had to go Sunday evening to go see her. I showed up at the hospital. It was a huge hospital. I had to download a 16-page PDF to give me directions through the hallways to find the psych ward. I showed up. I spoke to the staff. I found the room. I set the room up. I did the collateral consult. I did all these things and then I get in the room and the woman, I may have spent five minutes with her and she walked out.
I was like, oh, okay. Well, that didn’t go as expected. But on the other hand, I got my evening back at least. I thought it would be here for three hours and now I get to go home. So it’s like, I don’t know, what’s the sense in being upset about that? It is what it is. [00:16:00] So just move on. But that’s a typical scenario.
Dr. Sharp: Yes. You just got to be adaptable.
Dr. Brie: Right.
Dr. Sharp: Well, let’s talk a little bit about the details of this work because there are some nuances that most of us don’t deal with day to day for testing kids and adolescents and young adults out in private practice. So I’m particularly curious about certainly the security aspect to it, bringing materials in, how to get materials underneath the glass window, or what if you can’t get it underneath the glass window- the actual ins and outs of testing in jails particularly.
Dr. Brie: It’s tricky. Again, you never know what you’re going to be up against. Even if it’s a jail that I’ve been to many times, it depends on who’s working that day and depends on that particular inmate and it depends on their mood that day.
So what I [00:17:00] do… Well, first of all, the materials that I have are materials that I’ve used for years. And so I feel fairly confident that they’re ones that are okay to be bringing in like their paper, forms, and a pencil, for example. I don’t even give them a pencil. I have them answer verbally and I write it down. I have a test kit. So all of the things that I think I could possibly need.
Back to what I was saying before, sometimes people see the doctor badge and they’re just like, okay, go ahead. And they don’t know what’s in that bag. And to me, that’s stalking. It’s like, you should open that up. You should look through it. I should go through security, like a metal detector. That’s what I’m used to. And I feel they should be doing that. Most of the time they just let me on through. Sometimes though, they do want to look through it. Sometimes they do limit what’s allowed in. And then in those cases, I have to just use what I have available to me.
I try to see people in [00:18:00] person. They call them contact visits, meaning we’re in the same room together, even though they’re in jail, even though they’re acutely psychotic or whatever it may be, even if they have a history of violence. Again, I check in with the staff and I say, how are they doing today? Are there any concerns? Sometimes the staff will want to sit in with me if at all possible. I avoid that and I’ll ask them to sit outside the door or to be monitoring visually, either by a camera or by walking by and doing checks.
I set the room up before I have them bring the person in so that I know where the cameras are, where the intercom buttons are, where the duress buttons are, so that should I have an emergency and need help, I know how to contact them. But I try as much as possible not to have other individuals in there so that they’re not seeing the test materials. It’s not distracting. A lot of the individuals I work with are quite paranoid, so they don’t want anyone from the government, [00:19:00] aside from me. Sometimes I’m even a problem. They don’t want other people in there, and that’s understandable. So I try to limit that while balancing safety concerns.
If they recommend that I see the person non-contact, meaning there’s glass between us and we have to use a phone to communicate, that’s more tricky, obviously. They can’t manipulate things like on a WAIS with the block design, for example, but we can do other verbal administrations of different kinds of measures.
Honestly, these days, the measures that I do most frequently are malingering measures. So it would be the TOMM, the M-FAST, the SIRS, things of that nature. And those are things that I can show them the paper and have them respond and I’ll mark it off, or I can read it to them and then mark it off.
Some of the [00:20:00] other things that are tricky are the environment itself and the lack of control that we have over that. For example, if you are testing a person, did it recall a memory when you’re reading them a list of items and you’re asking that they repeat them back to you? Inevitably, there’s a commotion or some keys jangling or a door that’s slamming. And so that makes it really hard.
I guess the underlying message here is that you adapt, you do the best that you can with what you have, and then you have to make note of whatever the limitations are. I think it’s so important that I think, especially young career psychologists might feel this pressure to do everything so perfectly and they might want to minimize certain distractions that occurred or problems that came up.
My philosophy is that [00:21:00] you put that out there, front and center so if anything happens that disrupts the testing or makes it complicated or it’s not ideal or it was a problem, you put that in your report and you say what happened and you explain why that wasn’t standard procedure or administration and how that may or may not have impacted the results in your opinion. You have to own it.
Dr. Sharp: Right. I don’t know what the alternative is, even though we’d be tempted, I think, to try to make it look as perfect as possible and standardized as possible. But otherwise, you’re just lying and that’s doesn’t seem like a good thing to do.
Dr. Brie: I think, too, in this profession, I’m writing these reports for other forensic psychologists, maybe they’re doing a second opinion, maybe they’re doing a subsequent report years later, attorneys, judges, for the most part, those [00:22:00] individuals have an understanding of this population and these settings.
And so for me, it really hasn’t been too much of an issue after the fact, if that makes sense. No one ever questions. They easily could, but that hasn’t been the problem. The challenge is more in the moment. What are you going to do to get the information you need that’s valid and reliable? And that can be tricky. And that’s something that’s ever-changing that you have to be making decisions and adapting on the fly to.
Dr. Sharp: Right. That seems like a skill set that’s really necessary for this work environment. Well, do you feel like that’s something that you can learn or does it have to be innate?
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Dr. Brie: That’s a really good question. I do think it’s both. I really do. That might sound like a cop-out. For me, again, I value my years working in other jails, state prisons, and federal prisons. I think that that experience helped me learn [00:24:00] techniques or ideas, watching supervisors, how they navigate those kinds of things, just having experience while in there. All of that I think is so helpful, so valuable.
But then, on the other hand, if you are very rigid and you struggle to juggle multiple factors and considerations, think on your feet, be flexible, be quick, and handle your own internal thought process of like, what is it that I need to gather? How much time do I have? Do I need to expedite this? How’s this person doing in front of me? That’s challenging. Plus, the environment around you. I think some of that’s innate. I think some of that either you do well with that or you struggle with that. And I think that certain people are better suited for the environment, the population [00:25:00], and the work than others. Some people are pretty natural at it and other people struggle.
Dr. Sharp: Yeah, I can get on board with that. I want to ask you one last question before we transition to bigger-picture stuff. One thing that I’ve struggled with, I think, in working with forensic psychologists in private practice doing consulting work is, I put such an emphasis on predictability, scheduling, titrating your referrals, knowing when you’re going to write reports, when you’re going to be testing and the balance of all of those things.
What I found is that that’s really tough. We can set a weekly schedule and say, I’m testing on Tuesdays and Thursdays, I’m writing reports on Fridays, but it runs into this problem that we’ve talked about, which is you might show up on Tuesday and that person can’t test. So now what? And there seemed to be shifting deadlines in terms [00:26:00] of when courts want reports. So I’m just curious from a practice management standpoint or time management standpoint, how do you negotiate so much movement in your schedule and deadlines and so forth with getting the work done?
Dr. Brie: That’s an excellent question. There are a few things that I do. One is, if I’m doing competency, that’s an issue of how the person is functioning currently, I don’t want to see the person two months prior to their hearing because so much can change. I also don’t want to see the person with such a limited time frame left that I don’t have time to get collateral information. I don’t have time to request records. I don’t have time to reschedule if the person doesn’t show up. I don’t have time to write the report. So, a good window for me is about two weeks. That means they’re fairly close to the hearing, but I also have a little bit of leeway. I also have a little bit of flexibility.[00:27:00] If a person doesn’t show up or I have to reschedule for whatever reason, then typically there’s a little bit of time, a little bit of buffer where I can reschedule and it’s fine.
A lot of times I have people in the community that are homeless, quite frankly, and we can’t find them or we can’t get them in. They don’t have transportation. They don’t have a way of doing a remote evaluation. And that’s another challenge. And so, it’s a pretty frequent occurrence that we can’t track someone down and get them scheduled. We’ll put in an effort to try and eventually, we might just say, I’m sorry, we don’t have the time to complete this. Therefore, we’re closing this case. If you are able to locate this individual and get good contact information, we’re happy to take this as a new referral.
I’ve also learned to put in boundaries for myself and just say, I will do my due diligence. I will [00:28:00] make every effort to get this person scheduled. But at some point, you have to draw a line as an individual and as a business owner and just say, this isn’t feasible any longer, but we’re happy to work with you in the future if we’re able to get this person in.
I always have something to do. It’s not always convenient. Like, last week I was asked to testify and I sat there for an hour and a half until the judge said, well, we see you’ve done three evaluations with this individual. No one’s contesting it, so we’re just going to adopt your findings. And then I had to sit there even longer and I’m thinking, I don’t know why I was even called here. That just killed my whole morning because I had to cancel a whole bunch of appointments and commitments in order to fit that in and then they didn’t even need me, but it is what it is.
So I don’t have any hard and fast days of like, this is what I’m doing. I try generally to [00:29:00] make my appointments either in the morning or in the afternoon. I find that too early, you’re going to get a lot more people that aren’t willing to cooperate; lunchtime, they don’t want to cooperate; too late, they’re thinking about their evening and dinner. So I try to accommodate and try to make it as easy as possible for people to cooperate and show up. I try to be considerate of their lives and their schedules.
I had one individual who I knew took the entire day off work to come to see me and then accidentally drove an hour in the wrong direction. By the time he was going to make it to me, I couldn’t stay that long. I knew the situation he was in where he needed to be working, and he took the day off, and he was trying, and I agreed to go in on a whole […]. I try to be accommodating. I try to work with people.
I try to make things [00:30:00] fit best for my schedule, but at the end of the day, if you have to clear your schedule for testimony or an evaluation and it doesn’t pan out, then I always have a report I can write. I always have records I can review. So, I don’t have like this day, I’m doing this that day I’m doing that. Not too much because it never works out. I tried some, like Tuesdays are an administrative day, and Fridays are evaluation days, but always knowing this could change at any moment.
Dr. Sharp: Fair enough. Flexibility is the name of the game it seems. I would love to pivot to some big-picture questions and ask, first off, what do you love most about this kind of work?
Dr. Brie: There are a few things that have attracted me to this work. One is, I see the cases as like puzzles. [00:31:00] I love getting all of the separate pieces of data, the records, the testing, the interviews, the collaterals, and putting it all together and trying to make sense of it. To me, that’s fascinating.
I also enjoy being in the role of an educator to the trier of fact and the attorneys. I enjoy trying to help figure out complex psychological issues and help individuals involved in the cases make sense of what’s going on and what would be maybe a good direction forward.
Also, it’s just never really a dull moment. The cases are so interesting. They’re fascinating to me. And so there are, obviously a lot of individuals in my life that are always interested in hearing the stories. I always say, [00:32:00] truth is stranger than fiction. There are a lot of very interesting cases. I enjoy not having the mundane routine, repetition day in and day out. I really enjoy sinking my teeth into something new, fresh, and interesting.
Dr. Sharp: Sure. Yes. All of those make sense. What about things that you do not love? Is there anything that you could do without in this whole work setting?
Dr. Brie: I sure could. This is an easy one. The one thing about my job I dislike is testifying. It causes me no end of anxiety. Fortunately, in my experience, it’s never as bad as I expect it will be. The idea I have in my head of [00:33:00] how horrible it could be and how I don’t know what I’m doing. I don’t know what to say. I made a mistake and they’re going to criticize me and attack my credibility. All of those things are never as bad as I imagined them to be. But I think that’s the problem is you never know what you’re going to get.
A lot of times the attorneys, and this is no knock on them, it’s not their area, but a lot of times they don’t actually understand the issues well enough to ask questions about the things that I’m most insecure about or that I find to be the most glaring issues in my work, and so instead the questions I get feel sometimes it’s very out of the left field and then I feel like I can’t prepare. So I prepare for testimony for sure, but then I’m never really asked the questions that I anticipate. And so to me, that’s super anxiety provoking and [00:34:00] I don’t enjoy it.
Dr. Sharp: That’s fair. Well, it sounds like you’re a normal human being, which is helpful.
Dr. Brie: That is good news.
Dr. Sharp: Nice. If there were any recommendations, ideas, or thoughts for folks who are listening and they’re like, I want to go down this path as well, what would you suggest to these individuals?
Dr. Brie: That’s a question I’m asked quite often, and I have a few suggestions. One is, what I was always told was you have to be, first and foremost, a very strong clinician. So I think it’s important that individuals interested in this field don’t get blinders on and focus just on the forensic aspect. You have to get a good education and training in the fundamentals.[00:35:00] You have to be good at interviewing. You have to be good at building rapport with an individual who doesn’t want to be there, doesn’t trust you, doesn’t want to answer your questions, and you don’t have a lot of time. You have to be strong diagnostically with your skills figuring out what’s going on and making an accurate diagnosis. You have to be strong with assessment. I think that’s less glamorous, but that’s what makes you a good forensic psychologist. So I think it’s really important that people focus on the basics first and get good at that.
I also think that any and all experience that someone can get in any type of related forensic setting or population is really valuable. It’s a niche area. It’s a specialization, yet within our specialization, there are so many different [00:36:00] places that you can get experience and types of evaluations that you can do. So I would recommend work with adults and juveniles, work with men and women, work in outpatient and inpatient, get experience with chemical dependency, with sex offending, with severe persistent mental illness. You need to get exposed to as much of it as possible but that’ll also help you focus on what it is that you feel is the best fit for you.
And then I think the last recommendation I have is to do a postdoctoral fellowship. By the time you finish, for me, a bachelor’s degree, a master’s degree, or your doctorate, you’re constantly agreeing to 9-month or 1-year commitments to do your training. It’s exhausting and you just want to be done.
And so I was wondering… At the end of my [00:37:00] internship, I was like, I don’t need this. I don’t have the energy for this. I want to start working, have a career, and be stable. I don’t want to do another year and prolong my ability to get going. I applied to one Postdoctoral Fellowship and got it and was like, okay, well, I guess I’m doing this and it was the best thing I have ever done for myself in my career. It’s that old thing you don’t know what you don’t know. And it was the most valuable year of training I’ve ever had.
So, if people are on the fence or they’re not sure if it’s worth it, I would suggest you give it some serious consideration because I think it’s the single thing that prepared me and helped me.
Dr. Sharp: That’s great advice and very easy to [00:38:00] to pursue. Super concrete. Thank you.
Dr. Brie: Absolutely.
Dr. Sharp: This has been a great conversation. I feel like I could talk to you for a long time about all the ins and outs of everything you do. I know we didn’t even touch on some of the other aspects that are very worth talking about. It’s been tough to cut these conversations a little bit short for this Out-There series, but I appreciate you coming by.
Dr. Brie: Absolutely. Thank you so much for having me.
Dr. Sharp: Absolutely. Thanks for being here.
All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and your life. Any resources that we mentioned during the episode will be listed in the show notes. So make sure to check those out.
If you like what you hear on the podcast, I would be so grateful if you left a review on [00:39:00] iTunes, Spotify, or wherever you listen to your podcasts.
And if you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have mastermind groups at every stage of practice development, beginner, intermediate, and advanced. We have homework, we have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much
The information [00:40:00] contained in this podcast and on The Testing Psychologist website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis, or treatment.
Please note that no doctor-patient relationship is formed here and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.