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20 Questions: Eva Markham, Ed.D. [Child and Adolescent Psychology]

Created 09.12.07 by Lee
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Eva R. Markham, Ed.D. is a psychologist with the Weisskopf Child Evaluation Center of the University of Louisville in Louisville, KY. Dr. Markham is also assistant professor of pediatrics in the University of Louisville School of Medicine. She earned her undergraduate degree from the University of Louisville and her Masters degree from the University of Evansville. In 2000, she completed her doctorate from the University of Louisville. Dr. Markham is also an ordained minister and assistant rector of Resurrection Episcopal Church in Louisville.

1. What is your primary area of practice?

I now primarily work with children and adolescents and their families. The focus of our center is on individuals with developmental disabilities such as autism and tourette’s disorder, but much of our practice also deals with complex emotional and behavioral disorders. I provide diagnostic services, treatment, and consultation, and I am involved with educating medical students, residents, and psychology graduate students. I am able to work with providers from across many disciplines and in a variety of locations, which makes for a very stimulating job.

2. Describe a typical day at work.

I might arrive at the office and perform a series of clinical services, such as psychological evaluations, feedback sessions with families, or treatment sessions with young persons and/or their caregivers. On other days, I might go to a school in a remote location in KY and consult with school staff about addressing some particular issue that has arisen. I sometimes provide professional development activities. I lecture residents on a monthly basis regarding psychological data and learning-related problems. I serve as faculty for ethical training within the introductory clinical medicine course. I provide supervision for graduate practica students in psychology and for post-doctoral psychologists. My days are rarely typical!

3. How many hours per week do you work? Does your work involve much travel?

My work week is 37.5 hours although I tend to be at the office a bit more. I sometimes travel around my home state and also work in near-by states occasionally. I am able to present papers at conferences and attain continuing education experiences in many places.

4. What are the characteristics of your primary patient population?

My clients are most commonly between 2 and 12 years of age, although both younger and older persons are seen. Many have problem behaviors. Sometimes that is the primary diagnosis. Other times, the behavior problems are secondary to some other condition, such as a language disorder, autism, ADHD, or mental retardation. I see persons from all socio-economic strata, representing many ethnic and racial groups. Working at a university affiliated clinical program tends to increase the diversity of our referral base.

5. What is the most challenging aspect of working with this patient population?

One of the greatest challenges we face is the lack of access to services that many people experience when they need mental health services. Many people do not have health insurance. Second, many who do have insurance cannot find providers who are covered by their particular plan with the needed expertise. Finally, there are many barriers to accessing services, such as lack of transportation or lack of child care. That is very frustrating for clients as well as providers.

6. Does your job involve teaching responsibilities? If so, please describe.

My teaching duties are diverse. I do trainings/continuing education programs for psychologists as well as educators and mental health and medical professionals. I do a monthly lecture for residents in pediatrics and internal medicine/pediatrics about psychological data and learning problems. I serve as a faculty facilitator for second year medical students studying ethical issues as part of the introductory course in clinical medicine. I supervise psychologists and students, providing training for them. I sometimes teach a traditional graduate course in developmental disabilities for psychology students. I often provide guest lectures for courses in the School of Social Work. Teaching is perhaps about a tenth of my total job activity.

7. What is it like being a non physician working in an academic department of a college of medicine?

For the most part, I find it very comfortable being a non-physician within the medical school faculty. My colleagues are respectful of my expertise and do not seem to view non-physicians as a lesser species! Many of our most successful researchers within the medical school are not physicians, which I think has contributed greatly to the physician faculty’s positive attitude toward those of us who are not M.D.’s.

8. How long have you been in your current position? What did you do before?

I have been working at my current site since 1995. I was away from the Center, doing my pre-doctoral internship for one year during that time, but I continued to work part-time even while on internship. Before that, I practiced within a large multi-specialty medical group in a small town.

9. Do you do any outside consulting or other professional activities?

At present, I do almost all my work in the context of our Center. From time to time, I present workshops on the weekend or take on an outside project if there is no conflict with my role at the university.

10. Do you participate in research, conferences or presentations?

My research participation has been very limited to date. I have begun to collaborate with a student on a large data set which we hope will lead to publications. I provide many conference presentations ranging from brief local events to more extensive presentations at national conferences.

11. What do you like best about your specialty? What do you like least?

I like psychology’s many tools and the potential they offer for making the lives of children and families better. As we recognize the value of early intervention and address issues near their inception, there is much potential benefit for the individual, as well as society!

12. Are you satisfied with your income and opportunities for career satisfaction?

Like most people, I really feel compensation for psychologists should be better. However, I do feel that my salary is certainly adequate. Our culture values some things more than others. Human services are not high on the totem pole of priorities.

13. What do you tell parents who ask you about the hypothetical link between autism and childhood vaccines?

I tell parents that major scientific organizations have repeatedly concluded that childhood immunizations are safe and cannot be linked with increased rates of autism. There is excellent data from multiple sources to support that. I want my grandchildren immunized, as there is more risk from some of these preventable diseases than from the immunizations.

14. What is the future of autism treatment? What hope can we offer families with affected children?

In the years to come, I expect autism treatment to improve in quality and in availability. As more and more people become aware of this diagnosis, sometimes less than ethical individuals invent a “treatment” and market it effectively. Over time, people will become more aware of what is supported by solid data and what is simply a well-marketed hoax. Many investigators are currently trying to establish the most efficacious treatment protocols for the variety of presentations that one sees among persons diagnosed with autism. Their work will have great value in years to come.

15. If you have a family of your own, does your career leave you enough time to spend with them?

If I had young children, I am sure that I would feel some pressure in juggling work, family and personal interests. Since my children are grown and I am, in fact, a grandmother, I am in a different place with regard to work-family conflict.

16. Do you have any hobbies?

I enjoy reading. Swimming and walking are other activities that I enjoy. I also enjoy working with refugees from the Sudanese civil war who live in my community. I am active in church work. I live in a neighborhood that often gathers to socialize, so my life is rich and full!

17. What types of volunteer activities or community service are you involved in?

I am involved with the Tourette Syndrome Association. I serve on a regional advisory council for that group, and I am the support group leader for our local affiliate group. I serve as a non-stipendiary clergyperson of the Episcopal Church and have several committee roles in governance on the diocesan level. I work with international refugees, particularly the Sudanese, as time allows and try to assist them in furthering their educational goals (attaining U.S. citizenship, etc.). I am an active member of several professional organizations, including the American Psychological Association and our state association.

18. Where do you see yourself in 10 years?

It is exciting to think that I see myself retired in 10 years. I do not expect to retire to the rocking chair. Rather, I see myself “retiring” to travel, as well as consulting and training professionals on an occasional basis. I am developing competency in parenting coordination, divorce mediation, etc., and I hope to do some work in that area after I “retire” from my university position.

19. If you could do it over again (become a clinical psychologist), would you?

Actually, I probably would. With psychologists likely to gain the ability to prescribe medication in most jurisdictions over the next 10-15 years, I think the discipline will have wonderful opportunities for practitioners. Psychologists are ideally trained as scientist-practitioners with unique capacity for serving people with a variety of needs. All of our training is focused on human development. We have wonderful gifts to offer society.

20. What advice do you have for students desiring to pursue a career in clinical psychology?

Students should do their very best to avoid incurring a large amount of debt in getting their training. For those individuals who find themselves unable to get what they need without loans, I would strongly encourage them to explore options for practice which qualify them for loan forgiveness or repayment. Salaries in the field simply are not high enough to let us graduate, repay our loans, and get on with the business of buying homes, establishing families, etc. It is a wonderful field, but one that is not compensated as well as it should be.

 

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Comments

  1. Therapist4Chnge says:

    Would you recommend practicing in a smaller city like Louisville and/or in the surrounding area? I’ve heard great things about places like Nashville, Louisville, and Charlston. Are there opportunities for up and coming clinicians in a place like Louisville?

  2. anonymous says:

    how can you have a clear conscious about prescribing drugs when you don’t have the education to prescribe. why should you be excited about the future for psychcologists? would this not endanger patients?

  3. zipmedic says:

    The debate about psychologists prescribing medication has been contentious and continues to rage on.

    Think about how it is set up right now — you meet with a psychologist and discuss your concerns/issues. The psychologist feels you would benefit from medication. The psychologist sends you to a psychiatrist (who also charges you, of course) who meets with you maybe once a month for about 30 minutes just to verify you’re not having any negative side effects and refill your script.

    Certainly, patients could benefit both financially and emotionally by having to share their confidential issues with only one person. I would not advocate blindly grandfathering all psychologists in to prescribing medicine. With some continuing education on the relevant psychiatric medications, I don’t see how this could be a bad thing. Just MHO, though.

  4. a doctor says:

    you need to remember psychotropic medications have some of the worst side effects in all of medicine. “some CE courses” will not cut it. thus the inherent risks would not benefit patients “financially or emotionally”, and could be potentially deadly. However, I believe the risks can be ascertained through a complete medical knowledge of the human body as learned through medical school and further residency training.(7 years!)not 2-3 yrs of nonmedical courses.

  5. zipmedic says:

    I remember quite a lot. I also suspect that this is going to happen within the next 10 years. Whether it manifests as “CE” or a 1+ year track as part of a clinical PhD, I can’t say.

  6. Anonymous says:

    I would recommend practice in an area such as Louisville. It is large enough to offer diverse work settings for a psychologist, and fairly sophisticated arts, recreation, etc. Yet the city is small enough to not make commuting too difficult. There is a great need for competent clincians in more rural areas as well.

  7. sarah says:

    I think it will be implemented as part of a collaborative practice agreement with psychiatrists, which should address some of the concerns raised about screening for medical conditions, drug interactions and adverse reactions. Psychologists already prescribe in the military, the VA and the IHS.

  8. Anonymous says:

    On the subject of prescribing psychologists, the current standard is coursework which is essentially a master’s degree(2 yr.)program which is taken by psychologists licensed to practice psychology independently for not less than 5 years. It also requires a fairly significant amount of supervised patient contact. Testing for mastery of academic content is also part of the process. The model is based on the Dept. of Defense process for training prescribing psychologists. I believe this is the standard endorsed by APA, and law in NM, LA and a couple other jurisdictions which have statutes allowing prescribing by credentialed psychologists. There is not and has never been any move to “grandfather” people. There are several other non-physician disciplines which have prescritpive authority in many jurisdictions. Data does not suggest any higher rate of medication related problems for these disciplines although that has consistently been the argument used to advocate against extending the right to prescribe. I say, the time has come for appropriately trained licensed psychologists to manage their clients medications!

  9. a doctor says:

    it will never work

  10. Anonymous says:

    As already mentioned, it’s already working.

  11. Anonymous says:

    I think the fear is that people who are actually MORE qualified than medical doctors to treat psychological pathology might be allowed to prescribe medications as well which would make psychiatrists potentially obsolete. After all, why can’t a clinical psychologist with medical training just collaborate as needed with primary care providers just like psychiatrists do?

  12. Anonymous says:

    What is the typical timeline of training for a psychologist? How many years does it typically take for one to be licensed and what are you doing during these training years? Thanks

  13. Anonymous says:

    Psychologists typically spend 4-6 years in their graduate program, and have both pre and post-doctoral years to be eligible for licensed, independent practice. Depending on the particular field of psychology, a student has a mix of classroom, clinical and research experiences. In some programs there is more or less research emphasis. With the pre-doctoral internship process being highly competetive, students often spend a great deal of time doing practica above and beyond what is required for their program. So to answer the question, it can take 6 years, or more, to be licensed for independent practice as a health service provider.

  14. autismexpertsnot says:

    Looking for information on autism or behavioral disorders? You sure you know about autism? ALL side? Go to you tube: Search for video titled: “Behaviorally Fragile Autistics” and “Looking Back at Severe Autism”. This will take you to channels that show a case of severe autism with self injury that has baffled experts over the years. Yet, surprisingly, the family has come up with some good ideas how to deal with the behavior.

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