Why do you want to be a clinical psychologist?

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miriam
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Why do you want to be a clinical psychologist?

Post by miriam » Tue Apr 10, 2007 7:18 pm

For me, it just seemed interesting and the CPs I knew seemed to enjoy their job and be intrigued by it, even after 20 years working in the field. I enjoyed academic and science A-levels and there were plenty who thought I should do medicine, but as I often said "I want to talk to people about what is going on in their heads, not cut them open and find out!" And enjoying the process is the key to not becoming frustrated and disheartened, even when the goal seems a long way off.

I'm 15 years down the line now, three degrees and much work on, but I still love my job. It has great variety, humanity and purpose. Every day makes me stretch my understanding a little more, and admire the diversity and resilience of the kids I work with a little more. I think its a well paid job, and more importantly one that gives me a great deal of satisfaction. And I completely recommend it ) I never really gave anything else any serious thought.

I think in some ways, I've always been a sucker for needy people who want help, particularly those who will take on board new ideas and put in effort themselves, rather than relying on others to make change for them. I may have initially chosen clinical psychology for the idea that it feels good to help people. Actually on reflection now one of the things I like about my career is the fact that in my personal life I don't have to feel obligated to help people as I have partitioned it with nice healthy boundaries into my professional role. This means I can make much more objective judgements in my personal life (just as giving to charity by direct debit allows me to ignore other charitable appeals with less guilt). It therefore fits with my need to be helpful and caring to others (something I think that is part of the identity of many females and may explain the bias towards women in the profession since it has evolved from an academic/medical profession into a "caring profession").

I do feel there is a very strong drive to do something worthy as a profession, and that we can get rather smug about it, or fail to admit that its what we get from it that makes us want to give. I chose a job that fits well with my personality - I like variety, I like dealing with people, I like feeling I stretch my intellect, I like feeling that I do something that is helpful towards others (particularly children), I like the responsibility, I like being able to make a difference, I like the pay, I like the terms and conditions, I like my colleagues. I feel totally overwhelmingly lucky to be in a position that I can do something I love to earn my living, when so many people can't (I guess that is why I see the half full glass and don't like it when people dwell in the negatives). So, relative to that, the difficult cases, the sense of never being able to do enough, the defensive service boundaries, the odd awkward professional, the conflicting demands, the politics are all really tiny things.
Miriam

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Post by chixta » Thu Apr 19, 2007 10:11 am

Money and power!!! :lol: :lol: :lol: :wink:

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Post by Bella » Thu Apr 19, 2007 12:34 pm

Good NHS holiday allowance! :wink:

(although TBH I work for a Uni and my holiday allowance is better!)

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Post by miriam » Sun Sep 20, 2009 3:52 pm

Gosh, wasn't I enthusiastic back then! I think its mostly still true, but I guess the process of organisational change, and the move to more management responsibility has made it feel a bit different, and maternity leave has brought new perspective...
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Post by Gilly » Mon Sep 21, 2009 11:04 am

its nice to see that most of what you believed and cared for back then still applies :) although the tone of your post implies that it isnt quite what you want of it, if thats the case, may i ask why? (as a budding hopeful future CNP)

Ill have a quick go at this:

for me, its the combination of the science and caring about people.

Ive always been "the one to go to" for advice, for a chat when people are down and have problems, and since A level ive enjoyed (most of) psychology, i found it a fascinating subject with lots of unanswered questions and interesting bits to explore. This combined with the fact i want to work in the NHS, helping people suggested CP as a profession i would enjoy and flourish in (also, my love of clinical psychology/brains/mental health pointed me towards it)

And of course, the money, women and power.

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Post by miriam » Mon Sep 21, 2009 2:28 pm

Gilly. wrote:its nice to see that most of what you believed and cared for back then still applies :) although the tone of your post implies that it isnt quite what you want of it, if thats the case, may i ask why?
I think that the more the NHS moves towards a business model, the more it loses sight of the purpose we all joined up for - to provide the best possible care for the people referred to us. So, for me the process of being involved in a competitive tender process, then our trust losing and being transferred to another trust who are much more business-like has been quite hard. It made me realise that to a business manager, not only are the families we see just numbers, but so are the staff! So, I continue to love the work I do with families, and to enjoy the variety of the role, and the colleagues I work with, but the business side has encroached more. As you'd see in my blog about organisational change, it is hard to maintain morale when told that your job is at risk, and when it seems that some managers above the clinical service level can't see the difference between CPs and cheaper professionals and therefore view us as too expensive.
Miriam

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Post by missm » Mon Sep 21, 2009 3:52 pm

That's an interesting view Miriam. This is something I've been thinking about for a few weeks now actually. That is, the NHS becoming more "business-minded" and private companies tendering out their services to GP's surgeries and so on. I was reading some snippets from the Liberal Democrat's conference yesterday and, along with Labor and Conservatives, they pledge that spending cuts WILL NOT affect "front-line services" as they put it. We all know the absolute mess the country is in at the moment and the mind-boggling debts that the government has run-up. How do others see this affecting the way we offer services on a day-to-day basis, if it will affect us at all? It strikes me that perhaps we will have to become more adept at marketing our profession!! Would people be willing to essentially "sell" themselves and their skills to privately-paying individuals? What about selling your services to the government itself (that is, if a qualified CP becomes self-employed and they then tender out their services to local GP's surgeries or whatever)? Do others think will become more commonplace? I think seeing myself as offering a "service" does tend to go against my beliefs (I am after all, not a business-woman and I chose not to go into business), but perhaps this is the way things are going? What are others' thought and opinions on this?

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Post by baa » Mon Sep 21, 2009 4:05 pm

I wanted to be a CP as I love lots of face to face therapeutic work with patients, so now I'm not a CP, I'm in IAPT :))

I think we should start seeing the NHS in a more business orientated way, there is a finite amount of money, a large number of holes in most Trusts and a need to get good enough care for the largest number of people out of the services.

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Post by Gilly » Tue Sep 22, 2009 9:31 am

but the issue is baa, that if we start seeing the NHS in a truly business model, run simply by cost - then CP's get priced out of the market.

From what ive managed to pick up around here/my AP position, the main issue is that because CBT is the most effective treatment for some (and a good one for other) disorders and problems, this is the one thats implimented. Coupled with the fact its probably cheaper and has a quicker turn around then say...psychodynamic therapy, its a win win.

However, if this is the only thing you look at, why would you hire a clinical psychologist when you can get two Cognitive behavioural therapists?

Thinking about it....I dont think i would oppose the move to a "GP style" house office of clinical psychologists if it came to it, (with a little room of magazines and some kids toys!)

...but its a bit disheartening to read stuff like this as someone who is still many years away from even getting to a course.

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Post by baa » Tue Sep 22, 2009 9:48 am

I don't think it should all go completely businessey as the patients can get lost in it.

But! I don't mind that CPs won't be the only option, they won't get completely priced out as they do hold skills specific to their profession that other's can't provide, but for the day to day mild-moderate mental health problems that can be sorted by someone cheaper, I think it's good that there will be more diversity in mental health. The LIW/HIW in my team have counselling, asst psych, enduring mh charity, clinical psychology, drugs and alcohol, careers advisor and OT backgrounds. This is a nice place to work.
Gilly. wrote:
Thinking about it....I dont think i would oppose the move to a "GP style" house office of clinical psychologists if it came to it, (with a little room of magazines and some kids toys!)

...but its a bit disheartening to read stuff like this as someone who is still many years away from even getting to a course.
I have waiting rooms and magazines, they make me feel terribly grown up and responsible, I'm the person who appears in waiting rooms and says "mrs X?". For some reason this delights me :lol:

Don't be disheartened, there's more opportunitites for you now than just the CP course without having to go off and retrain as a nurse/OT/counsellor.

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Post by Spatch » Tue Sep 22, 2009 10:41 am

Ahem.

You do realise that clinical psychology is an international field, and thrives quite nicely everywhere else on earth. Where there is no NHS. There are far more areas even within the UK that a CP can work outside the NHS and Counselling psychologists tend to be far better and more foresightful than clinical ones at doing this.

Reading about the history of CP will show you that these fears have been around since the start of the profession, and helps put things in some perspective. Read David Pilgrim's and Katherine Cheshire's book, or check out the resources at the BPS website for more info.

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Post by miriam » Tue Sep 22, 2009 12:53 pm

To me worrying CPs will get priced out the market is like saying strawberries will get priced out the market because apples cost less per pound! I think there is a place in the market for CPs and we offer brilliant value for money, just not in delivering therapies at the milder end of presenting problems, we have to use our other skills.
Miriam

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Post by h2eau » Tue Sep 22, 2009 2:42 pm

When I was last working down in England as an AP just over a year ago, they were talking about the implications of Payment by Results and how this would affect how services would be provided in the child clinical psychology service I was working for. It does seem that the NHS is increasingly becoming more business-oriented, seeing people as numbers and figures as miriam said. But on the other hand, as baa points out - the NHS has a finite set of resources so they have to find some way to cut the cake. I do think that a number of initiatives such as PBR have been 'lifted' from acute care contexts when they may not be entirely appropriate to the work we do. After all, a hip replacement operation is a discrete package of care, psychological interventions often involve a number of variables that aren't so easily packaged up. I guess stepped care was an approach taken from acute settings, but there a limitations to the 'one size fits all' approach.

Another point that sprung to mind when reading this was that up in Scotland, Agenda for Change has only just gone through and people are still wrangling over bandings for posts. AfC made a point that many qualified CP posts working in adult mental health/primary care are not specialised enough to fulfil the criteria for Band 8, therefore I think that in NHS primary care services, we are going to see fewer CPs. However, higher up the steps there is still clearly a role for people working with complex/severe/longstanding difficulties and also in supervising those working lower down the steps. This is in addition to the many varied roles in child and family work, LD, clinical health psychology, early intervention....the list goes on. So as Spatch pointed out, its not all doom and gloom! And of course we should all be doing research looking at what works and how we can improve our clinical practice to produce the best outcomes.

I think the key is adapting to the ever-changing NHS and playing to the strengths of whichever particular role we are in, whether that's as a CP, LIT, HIT....

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Post by baa » Tue Sep 22, 2009 4:59 pm

oh! I had a thought! We shouldn't be all businessy, we should be efficient yet patient centred. That sounds better. My manager has proposed tesco style BOGOF inpatient double beds though :D She isn't good at taking the BigWigs seriously.

We have targets to meet otherwise Bad Things happen, that might or might not be linked to payment by results. Mind you, the targets are amusingly low, and in the first quarter I met the Trust's "getting people back to work" target all by myself :lol:

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