A week in the life of a newly qualified clinical psychologist (adult)

Newly Qualified CP in Adult Psychological Therapies Service - A Week In the Life:-
Well, like many people in this department, I only work part-time, I do 3 days a week – Tuesday, Wednesday and Thursday. It suits me as a parent to work part-time and have some semblance of work-life balance

Tuesday
First thing on Tuesday mornings I usually spend an hour or two catching up with e-mails and telephone messages from Friday and Monday. For example this morning I finally got to speak to a psychiatrist I’ve been chasing for two weeks about a client. It’s not the psychiatrist’s fault, it’s just that we keep missing each other. Not surprisingly, once we had got hold of each other on the phone we had a lot to discuss and the call was quite long. I procrastinated over making another similar call to another psychiatrist about another client – I’ll do it tomorrow.

I also booked myself onto a PQT (Post Qualification Training) event in a few weeks time and then spent half an hour looking blankly at my KSF stuff, still unsure what I’m supposed to actually do with it! Gave up on KSF and made a couple of phone calls to a CMHT and Day Treatment Services about the client I’d been discussing earlier – again, leaving messages which get returned when I’m at lunch, and so it goes on.

After lunch I have 2 regular therapy clients (separately) with whom I’m making very slow in-roads. Between clients I usually have a bit of time to do any admin I need to do and this afternoon I did finally get to speak to an OT in Day Treatment who did some lengthy work with the client I was discussing earlier.

For the last hour and a half of the day I’m in a newly-qualified peer-supervision group which meets monthly and gives us a chance to air our “newly qualified angst” in a safe supportive environment. I’m hoping we’ll continue into a “not-so-newly-qualified-peer-support-group” in the future as I find it really beneficial to have that forum.

Wednesday
On a Wednesday morning there is usually a business/clinical meeting at least every other week. I report on the state of the post-assessment waiting list to the meeting, i.e. how many waiting, how long and who’s on the priority list. There’s usually some discussion around the priority cases and who might take them and when. The problem is we are a secondary care service and we don’t get simple cases so the priority ones are the worst of the worst really, usually very complex, long-standing issues. So once someone has a full caseload they can be log-jammed for ages and unable to take anyone new on.

I often have a line management meeting on a Wednesday too, I have my line management separate from supervision and with a different person, which is better than having the same person for both, I find.

Later on Wednesday I usually see one or two more clients.

Thursday
Thursday mornings I usually see a client before having supervision. Supervision provides a welcome oasis of calm and support before I see another client who really needs lots of services that aren’t available, so they get me instead!! And then, after lunch, I see another couple of clients. I try to make sure all my notes and computer input are up to date before I leave on a Thursday.

My current caseload in three days is seven people, all of whom have long-standing, entrenched difficulties such as OCD, depression or personality disorder. Every single one has been particularly hard to engage and two of them have involved a lot of systemic work that our department doesn’t really do and isn’t set up for. Most of my clients are exhausting to see and, with some, it’s hard to contain their overflowing emotion in the room. With some it is also hard to find a focus for the work and I think some clients end up in Psychology because no-one else can cope with them and they get passed from pillar to post around services.

With some clients I might think about taking more of a consultancy/supervisory role so that the bulk of the work can be done through the CMHT. it's not really how our service is set up so it's not so easy to do, but at times I feel like I’m trying to do psychology in a vacuum and it won’t make a blind bit of difference, so I often feel the need to engage with the CMHT and the psychiatrist and work through them more. One of the drawbacks of working in a discrete Psychological Therapies Service is that we are not very well joined up with other services so when people need a more systemic, multi-disciplinary approach it is very hard to manage it from our somewhat isolated position.

I am really enjoying the challenges and using supervision to the full to cope with what I’ve taken on. I’ve only been here a couple of months but I have had some glimmers of progress with one or two people already. It’s actually a really tough job but I love it.

Astra

Just thought I'd add a little update a year on. Not much has changed really, the first batch of clients have gradually moved on and I have taken on new ones over time. I feel a little more confident and have learnt loads since starting this job. My service may be about to be re-engineered which may mean a lot more working into teams, which I think will be a good thing as long as we can keep the sense of belonging to a psychology department too, I hope it will be better for clients too. I have just started a 2-year CAT Practitioner course with ACAT North and am hoping that this will arm me with some additional therapy and formulation skills. I'm still feeling well supported although the peer supervision group has recenlty fizzled due to a few people moving on to new jobs and such like, I guess there's only so long you can call yourself newly qualified anyway!! I was lucky in that my job was set up as an 7/8a to start with and I will soon progress onto 8a as I have achieved all the necessary requirements. I know people in other trusts have had huge difficulties arguing for rebanding to 8a after the 18 month-2 year mark post qualifying. It's definitely worth arguing for in interviews if it's not clear in the job advert that you'll have that progression. All in all it's going pretty well!

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