Clinical Psychology

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Clinical Psychology

• Dr Eleanor Strain
• Sussex Partnership NHS Trust

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What is Clinical Psychology?

• Clinical Psychologists draw on psychological
  theory and research evidence to try and improve
  peoples quality of life and reduce suffering.
• Interpersonal skills- e.g. empathy and good
  communication skills, and compassion for others
  are important.
• They work in specialisms with adults or children
  with mental or physical health problems, and
  their families and carers.
• Also work with people with learning disabilities
  and people with acquired brain injuries.
• E.g. chronic pain, cancer, depression, anxiety,
  psychosis.

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Different approaches used

• Cognitive behaviour therapy-helping clients
  identify automatic thoughts, core beliefs and
  behaviour- links with emotion
• Systemic-how interactions between parts of a
  system (e.e. family) can be changed to achieve
  goals. (Social constructionist).
• Psychodynamic-patterns of relating and
  attachments to significant others often arising
  in childhood.
• Solution focussed approaches-look at someones
  strengths and resources to help them improve
  quality of life.
• Humanistic- more general supportive counselling
  skills
• Different philosophical underpinnings but similar
  in practice.

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How do Clinical Psychologists work?

• Assessment-information gathering, perhaps using
  standardised tools or questionnaires.
• Formulation-Shared understanding of clients
  situation, problems, strengths and goals.
• Intervention/treatment-using psychological
  approaches to bring about change and achieve
  goals.
• Evaluation-using questionnaires etc.
• Other aspects The relationship and sensitivity
  to power issues around difference.

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Other roles

• Consultation, supervision and teaching-to other
  professionals e.g. nurses.
• Research and audit-but time available for this is
  often limited.
• Helping with team and organisational
  issues-clinical psychologists often involved in
  helping to facilitate change and team processes
  within organisations.

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How do you become a Clinical Psychologist?

• Undergraduate degree in psychology on a course
  accredited by the British Psychological Society
  as conferring Graduate Basis for Registration.
• A paid postgraduate training course which is
  currently a tree year vocational doctorate degree
  organised by a university but sponsored by the
  NHS (current salary approx. 20-23k).
• In order to get onto a training course, a 2.1 or
  1st is usually required, and a masters or pH.D.
  are looked upon very favourably.
• In addition, clinical and/or research experience
  is usually required to get onto a training
  course.

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What counts as relevant clinical experience?

• The most sought after experience is being
  employed as an assistant psychologist (usually in
  the NHS).
• But other experience is very relevant- both to
  getting an assistant post and getting on a
  training course.
• For example, Nursing assistant jobs, Care
  assistant jobs, Occupational therapy, voluntary
  work (Samaritans, Childline, Youth Groups etc.).
  In fact any kind of caring work- whether paid or
  voluntary is very helpful. Often the variety of
  work is important- so even a couple of weeks can
  be put on an application form and talked about at
  interview.
• Many people think it is almost impossible to get
  onto a training course but training places have
  expanded by 3-4 times over the last 10 years.

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What counts as relevant research experience?

• Any postgraduate course or further qualification
  even if not directly related to psychology will
  provide evidence of commitment to study.
• E.g. Masters, pH.D., diploma etc. or counselling
  skills course.
• Work as a research assistant for a University or
  within the NHS.

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My own career path

• Undergraduate degree in Neurobiology at Sussex
  1991-1994.
• pH.D. in Neurobiology at Sussex researching
  vision in Crustacea 1994-1998.
• Working for the audit commission as an auditor
  and the NHS as a trainee accountant 1998-2000.
• In 2001 worked voluntarily in sheltered workshop.
  Then worked as a nursing assistant, OT assistant
  and then in 2002 as an assistant psychologist
  working in chronic pain.
• 2003-2006 Trainee Clinical Psychologist at
  Salomons, Canterbury Christ Church University.
• 2006-current working for Sussex Partnership Trust
  in assertive outreach team and inpatient
  rehabilitation unit.

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Dispelling myths

• Perhaps more difficult to get an assistant
  psychologist job than to get onto a training
  course (because fewer of these jobs than training
  places). Treated as one of the profession when
  you do.
• Guaranteed job!- often highly competitive for
  jobs once qualified. Many now fixed term.
• In future more of the job is likely to involve
  consultation and supervision to other
  professional. Less focus on direct contact with
  clients as many nurses or assistants can do this
  work (for less cost).

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What I enjoy about being a clinical psychologist

• Every day different and lots of variety.
• Challenge of trying to understand how someone
  else experiences the world.
• Having to think on ones feet and use ones own
  experiences rather than sticking to some
  formulaic response.
• Collaboration with colleagues and clients.
• Creativity involved and underlying philosophy of
  the work means that the work involves respecting
  and validating others experiences, rather than
  labelling them.

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Drawbacks/frustrations

• Limited resources in the NHS which means can only
  offer limited sessions at times, after a long
  waiting time.
• Juggling admin work and research and audit with
  clinical work (although I enjoy the variety).
• Sometimes it feels difficult to help clients
  because practical issues many linked to poverty
  mean that psychological help is a luxury not able
  to benefit from fully.

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References and online resources

• Marzillier, J., and Hall, J. (1999) What is
  clinical psychology? (3rd edn.) Oxford Uni Press.
• www.prospects.ac.uk/ details of different jobs,
  inc. clinical psychology.
• www.forum.psyclick.org.uk online resource for
  prospective clinical psychologists
• www.bps.org.uk website of the British
  psychological society which can give details of
  approved courses etc. and how to apply for
  training and useful links.