More Than a Listening Ear

 More Than a Listening Ear

Aarya Godse

When you imagine a psychologist, what do you see? Someone sitting in a chair, listening to people talk about their problems? Well, I did too. Before talking with Alexandra DeMarco, a licensed clinical psychologist at Kaiser Permanente, I thought I had a pretty good idea of what psychologists did: listen, ask questions, and help people work through difficult situations. But the more I learned about Alexandra’s career, the more I realized how much I had been missing.

From working with children, teens, and adults to conducting assessments and making difficult decisions, her experiences revealed a side of psychology I had never really considered. Our conversation showed me that being a psychologist isn’t just about understanding the mind but helping people understand themselves.

I want to thank Alexandra DeMarco for taking the time to speak with me!

Road to Psychology

My conversation with Alexandra helped me understand that psychology is not just about listening to people talk through their problems. There is a lot of thought and structure behind how psychologists approach treatment, especially when working with people experiencing serious mental health challenges. 

Her own path into psychology was relatively long, involving years of education, internships, and licensing exams. While her journey showed me how much preparation the profession requires, what interested me more was what happens once psychologists actually begin working with patients. Her experiences at Kaiser Permanente gave me a closer look at the different ways psychological treatment can support people.

Not Just Therapy

One of the biggest things I learned was that therapy can look very different depending on the person and their needs. During her residency at Kaiser Permanente, Alexandra worked with children while also spending part of her time in the Teen IOP, or Intensive Outpatient Therapy, program. The program worked with teens transitioning from inpatient units after serious mental health concerns or 5150 holds.

 Hearing about this made me realize that psychologists can play an important role at different points in someone's mental health journey. Treatment does not necessarily end once someone leaves intensive care. Instead, psychologists can help people develop skills that allow them to manage their emotions, thoughts, and behaviors as they transition back into their everyday lives.

Today, she is a part of the Uplift Program which is structured around specific treatment goals rather than completely open therapy sessions. Patients may work on coping skills, emotion regulation, overthinking, and rumination. Toward the end of treatment, they may also begin addressing situations they have been avoiding through gradual exposure. The idea of gradual exposure especially stood out to me. Someone experiencing social anxiety, for example, might feel overwhelmed by the idea of leaving their home or entering a crowded place. Instead of immediately facing the most difficult situation, treatment can start with smaller, more manageable steps and gradually build from there.

This helped me see how psychological treatment can turn something that feels overwhelming into a series of achievable steps. Rather than simply telling someone to “stop being anxious,” a psychologist can help them understand their patterns, develop coping strategies, and slowly work toward situations that once felt impossible. It showed me that psychology is not only about understanding the mind but also about finding practical ways to help people change how they respond to challenges.

Do Psychologists Have to Go to Medical School?

One question I had going into the interview was whether psychologists who work in hospitals have to attend medical school. And the answer surprised me.

Alexandra explained that she has a PsyD, or Doctor of Psychology, rather than a medical degree. People who want to become psychologists can pursue either a PhD or a PsyD, meaning medical school is not required. At the same time, psychologists can still work closely with medical professionals and patients in hospital settings.

As part of her work at Kaiser, she is also sometimes on call to conduct 5150 assessments in the hospital. A 5150 is a California law that allows someone to be involuntarily detained for up to 72 hours when, because of a mental health disorder, they are considered a danger to themselves, a danger to others, or gravely disabled. These situations can be emotionally difficult for many people. Psychologists do not want someone to reach a point where this type of intervention becomes necessary. Her role can involve evaluating a patient's situation and determining whether inpatient treatment is necessary or whether the patient can safely return home with an appropriate safety plan.

The Impact of Psychology on Mental Health

As our conversation continued, I asked about the impact she believes psychology is making in today's world. Her answer focused on something that sounds simple, but is incredibly important: helping people understand that it is okay to ask for help. 

Alexandra explained that people can suppress their emotions because of cultural expectations, their environment, or concerns about safety and resources. Psychology can give people tools to process those emotions instead of continuing to push them down.

The Importance of Early Diagnosis

Today, one area that deserves more attention is the early identification of ADHD and childhood trauma. She explained that some children struggle in school for years without understanding why. Some may not receive an ADHD assessment until they are much older, meaning they can spend years believing that their difficulties are their own fault.

This stood out to me because students spend such a large portion of their lives in school. When a student is struggling academically or behaviorally, it can be easy to assume that they simply are not trying hard enough. This reminded me that there can be many different reasons behind someone's behavior or academic struggles.

The ‘Aha’ Moments

When I asked Alexandra what she finds most rewarding about her work, she talked about something I found especially interesting: the “aha” moments.These are the moments when patients begin to understand why they think, feel, or behave in certain ways. Once patients develop that awareness, they can begin making changes to their mindset and behaviors.

Advice for Someone Who Wants to Become a Psychologist

Toward the end of our conversation, I asked what advice she would give to teenagers who are interested in psychology. Her first piece of advice was to make sure the motivation comes from genuinely caring about helping people grow, rather than choosing the field primarily for financial reasons. She also emphasized that students do not need to know immediately whether they want to pursue research psychology or clinical psychology. There is plenty of time to explore different areas of the field before deciding exactly where they want to go.

Her own experience also showed her the importance of having a strong support system. She described needing a “village” behind her throughout her education and career.

Advice for Teens Today

Near the end of our conversation, Alexandra shared a message that went beyond careers and psychology. She told me that teenagers should not be afraid to ask for help when they need it. She explained that many therapists, including herself, have their own therapists. In fact, her doctorate program required her to complete 50 hours of personal therapy so that students could understand what it feels like to be on the other side of therapy.

That detail stood out to me because it challenged the idea that asking for help is somehow a weakness. Even people whose careers revolve around helping others can need support themselves. When I first started this interview, I wanted to learn what it takes to become a psychologist. I did learn that: years of college and graduate school, internships, residency, licensing exams, and a great deal of persistence.

Final Takeaways

I learned that psychology is not just about diagnosing disorders or understanding how the mind works. It is also about empathy, self-awareness, patience, and helping people understand themselves. Her experiences working with children, teenagers, and adults also showed me how many different paths psychology can take. A psychologist might work in a therapy program, collaborate with medical professionals, conduct assessments, or help someone recognize patterns in their own thoughts and behaviors.

Most importantly, our conversation reminded me that struggles are not always seen. Whether it is a student having difficulty in school, someone dealing with anxiety, or a person who has simply become used to pushing their emotions aside, there can be much more happening beneath the surface than we realize. And sometimes, one of the most important steps someone can take is simply recognizing that they do not have to handle everything alone.

Thank you so much again to Alexandra DeMarco for taking the time to be a part of my project and for sharing her experiences with me.