Clinical training - how hard is it?

Information about qualifications, experience and the typical career path

Clinical training - how hard is it?

Postby choirgirl » Wed Aug 06, 2008 10:08 am

Clinical training - how hard is it?

With ‘hot topic’ issues such as perceived elitism and the difference between achieving a ‘high’ and ‘low’ 2.1, as well as the stress of going through the mill of experience-gathering and applications, it is very easy to focus on the holy grail of just getting on to a clinical training course without actually thinking about how hard the work might be. While the drop-out rate for UK D.Clin.Psy. courses is actually very low, clinical training is a demanding 3 years combining clinical placements, academic study and research culminating in a thesis. This Wiki topic has been contributed to by current and recent trainees to illustrate the reality of day-to-day study and dealing with the demands placed on the average trainee.

There’s no getting away from the fact that the D.Clin.Psy. provides a high workload, and expects equally high standards to be achieved and maintained. How each individual trainee addresses and copes with that understanding will probably depend as much, if not more, on their life circumstances at the time than how they fared academically on their undergraduate course. It might seem like stating the obvious, but if you struggle academically then the D.Clin.Psy. will be tough - the course involves a lot more independent study than an undergraduate course and culminates in a thesis which is typically 100,000 words, so most people find it a big step up. However, if you've done well on your first degree, it seems probable that you have a better idea how to study efficiently and present work to a high standard. It may be helpful to have a read of your previous assignments, projects, reports etc and reflect on the strengths and weaknesses of each, and any feedback from supervisors along these lines.

Previous study/work experience: Completing a Masters and/or PhD before training can make the academic work less daunting, especially the thesis; however, you may find the clinical work more challenging, especially at the start of the course when, if you have comparatively less in the way of clinical experience, actually being in a room with people and engaging in therapy may be very new to you. Conversely, if you've had a lot of AP or GMHW experience you will have some good basic clinical skills to get you through placements a little easier, but may find the academic rigours of the course more of a challenge.

After all the competition to prove yourself and secure a place on training, trainees often have raised expectations of what is 'good enough' and stress themselves through perfectionism. It helps to know how common these feelings are (which may be part of 'imposter syndrome') and to actively challenge them. Some courses are better than others at addressing this issue, for example by making assignments pass-fail and stressing the importance of accepting being 'good enough' rather than perfect.

Most trainees – and qualified clinical psychologists - aren't geniuses, but they are decent, intelligent and bright clinicians who can do a clinical job well. In short, the practitioner – and hence also the clinical trainee - needs to be well-organised and able to apply his or her academic knowledge through the medium of their clinical skills.
Having said that, many trainees do not find the course too academically taxing. The learning is more of techniques and ideas than of facts and figures, but there are often essays, case reports and presentations to complete as well as the research. Yes, it’s tougher than an undergraduate degree, but it’s nowhere near as intellectually draining as some other training paths in other professions. It is, though, very demanding with regard to multi-tasking and handling uncertainty. It also requires considerable person skills and the ability to think flexibly. If you can't handle pressure, time management and self-organisation, it is going to be extremely difficult to stay on top of things and maintain those exacting standards, if not impossible. Adaptability is also key – bear in mind that the work organisation strategies you have honed to perfection up to now might be great for essays, reports and short assignments, but may not be tenable for that major research project.

This comment from one ClinPsy member on a training course reflects the experiences of many trainees: “I don't find the work especially difficult in and of itself - it's just getting it done when you have placements, reading to do in relation to clients, other assignments, ongoing research etc, not to mention my attempts to maintain a personal life!”
The challenge to maintain different roles - one role as student for the academic parts, one role as clinician-in-training for the clinical placements, one role as partner-friend-private individual, is one which may not come easily at first. And don't underestimate the emotional and psychological impact of training; on some days (those great days when everything ‘goes right’), you may want to skip round feeling on top of the world; on others, you might want to march into the department and scream abuse at the whole world of psychology, or burst into tears in front of supervisors, even quitting may be your uppermost inclination at times. It helps to find people you can trust with those feelings, and to have a good knowledge of ways and means you can identify and address such extremities of emotions, both professionally and in your personal/social life.

Clinical training is a challenge, but at the same time, you won't get on the course if you're not capable. That’s precisely why the selection procedure is so rigorous and tests both the academic, the clinical and in many cases the personal. But remember, at the other end of those 3 years are ordinary people with mental health problems for us to work with – course providers don’t want an entire discipline of super-high-flying Nobel Prize-winning over-achievers (although a few with the capabilities and aptitudes to be future professors, innovators and field leaders will probably naturally emerge most years). But training isn't the end of the journey. You don't leave the course a prototype perfect psychologist. Think of the steps you have taken in your personal and professional development from the point that you graduated to the point of applying for the course. That is the scale of change that happens again over the duration of the course. But our learning doesn't end at the end of the course. Many qualified psychologists say that the course is just the first step, and that in fact they learn more in the years after the course, and continue to learn throughout their career.

Some trainees say the real challenge is towards communication: finding creative and idiosyncratic ways towards a shared understanding of complex problems with clients, using simple, non-jargonistic language. Others say that the biggest growth in training is in recognising what each of us brings of ourself into our professional role, and where our own strengths and weaknesses lie. Other people say that part of the challenge is learning how to survive and work productively within the system of NHS psychology services, in the context of constant change and where the quality and quantity of services is limited by budgets and waiting lists.

And remember too that plenty of people can and do manage 3 years’ work to emerge as qualified and competent practitioners!

With many thanks to Charlotte, astra, Ruthie, Spatch, BlueCat, chixta, katyboo and miriam for their contributions.

Note: If you have a suggestion about how to improve or add to this wiki please post it here. If you want to discuss this post please post a new thread in the forum. There is information about the structure, rules and copyright of the wiki here.

Content checked by qualified Clinical Psychologist on 20 May 2016
Last modified on 20 May 2016
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