Steve Holliday, PhD, ABPP-CN
Dr. Holliday is a board certified clinical neuropsychologist and the Chief Mental Health Officer for four Veterans Affairs (VA) healthcare systems within the Veterans Integrated Service Network (VISN) 17, which serves about half of Texas. He did not search for or expect a career in the VA, but shortly after receiving his PhD in clinical psychology from the University of Arizona in the late 1970s, he was offered a position in the psychiatric day hospital program at a VA hospital in San Antonio. With the guidance of Rod Baker who was the chief of the VA hospital at the time, Dr. Holliday began his career in the VA system. Now he is responsible for mental health services and research at four VA health care systems, and spends additional time volunteering in his areas of interest as he has always done throughout his career. He encourages others to volunteer, become active in local and national organizations, attend training programs and workgroups, and develop a “professional hobby” in order to become a leader and a valuable asset to one's organization.
You suggest psychologists get their foot in the door at the VA in any way they can and stated, “I cannot imagine a better place for psychologists to work.” What is particularly special about working at a VA?
1) Their mission is serving those who serve the country and I enjoy working with a veteran population. 2) There is flexibility in moving around the VA system. When a new position opens, we look to psychologists who already work there first, so there are plenty of opportunities to change positions and move up. 3) There are more opportunities for leadership in VAs compared to other organizations and most VAs are used to seeing psychologists in these leadership positions. For example, when the new Texas Valley Coastal Healthcare System opened a few years ago, I selected a neuropsychology resident to work there and she became their mental health associate chief of staff only two years out of postdoc. So you can get leadership experience quickly, especially if you are willing to move. This is a little bit more difficult in a big city because there is not as much turnover. If you remain in a position at one clinic your whole career, you don't have the opportunity to move up. Also, the vacancy rate in mental health in the VA system is 8-10%, so the outlook for early career psychologist jobs is really good right now. 4) You can receive a wide range of experiences. My goal was to receive as diverse an experience as possible and not remain stuck in only neuropsychology. Through the VA, I held a variety of positions, such as psychiatric director of a day hospital program and program director of an inpatient substance abuse unit. You can get a significant amount of exposure to different levels of treatment and get the opportunity to work with a wide range of other professionals. If you are willing to relocate geographically, that opens up even more opportunities. 5) They let you do research! This is my “professional hobby,” which is something I enjoy doing but is not part of my required duties. Conducting research allows me to work in neuropsychology, publish, and attend meetings. I was also able to create an APA accredited neuropsychology postdoctoral program using grant money.
If students and early career psychologists are interested in a career in the VA system, how do you suggest they could prepare for that and get their foot in the door?
The more experience you have, the more competitive you'll be for being selected for a VA job. If you know you want to work in a VA, then go for it early. That means applying for internships and postdoctoral fellowships at a VA. If you are unsure if you want to build a career in the VA, the predoctoral practicum or internship will help you decide if that is what you want to do. Additionally, a person will benefit from having letters of reference from VA psychologists. After 30 years of reading letters of reference, they all say the same thing. However, if I receive one from a VA psychologist, I'm more likely to pick up the phone and discuss the applicant with them. If I know the psychologist, I'm more likely to believe the letter.
Also, a person can stand out by volunteering to do the jobs that no one else wants to do and performing them well. Psychologists bring something to the table that is particularly good for leadership and management positions. We have a skill set in changing, convincing, and motivating people's behavior. A typical trajectory for a psychologist would be program director à training director for psychology program à assistant chief of staff à chief of staff and that is where it usually ended. However, that has changed in the last five years. Now, psychologists can work regionally or nationally in Central Office positions. Therefore, the more you can develop leadership skills, the more likely you will be able to thrive in the VA system.
You began your career in the VA after the chief of the VA hospital in San Antonio, Rod Baker, offered you a position as a psychologist in their psychiatric day hospital program. Since then, Dr. Baker has been a great mentor who encouraged you to join the local and state psychological associations and to volunteer for work groups within them, helped you establish a local neuropsychological society and develop an APA accredited postdoctoral program in the VA, sent you to national leadership meetings, and even encouraged you to apply for your current chief psychologist position. What unique advice has he given you?
Rob baker encouraged me to have a professional hobby. This is something that you enjoy doing and something that your hospital/medical center sees as useful. It should show what you can do and demonstrate leadership potential. For me, my professional hobbies were research and training. To begin developing your professional hobby, reach out to someone and let them know your interests. For example, you can state, “I'm full time clinical, but I'm willing to put in extra time for this particular area that interests me.” Market yourself!
I mentored an early career psychologist who had an interest in gay/lesbian/bisexual issues. She reached out to other professionals and let them know she was willing to lead workshops, participate in community outreach, etc. This individual pursued these volunteer activities and became known for it. Then, six months later, she was selected to be the Women's Veteran Program Director. If you want to rise in leadership, you have to know that it requires more than a 40-hour week.
What would you like to say about the recent media coverage on the long wait times to get an appointment at a VA hospital?
Bad press is a self-inflicted wound. Also, almost no one meets that target. We meet it about 70% of the time. Even if you had good insurance, you would be lucky to get an appointment in four to six weeks. If this “crisis” gets us more providers, then that's a good thing!