EP58 Exploring the Journey to becoming a Clinical Psychologist. A conversation with Oliver

In this episode of 'Pondering Play and Therapy,' host Philippa welcomes Oliver, a trainee clinical psychologist. They discuss the extensive and multifaceted training path for clinical psychologists in the UK, which includes clinical placements, research, and academic work. Oliver explains the importance of evidence-based practice, the variety of therapeutic approaches like CBT, DBT, and CFT, and the practical challenges faced during training. He shares his diverse experiences working in acute and urgent care, CAMHS, and other settings. The conversation also highlights the competitive nature of gaining entry to doctoral programs and the ongoing efforts to diversify the field of clinical psychology.

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Transcript

Exploring the Journey to Becoming a Clinical Psychologist. A conversation with Oliver

[00:00:00] 

Philippa: Welcome to this week's episode of Pondering Play and Therapy with me Philippa. And this week my guest is Oliver, who is a trainee clinical psychologist, and he has worked in acute and urgent care settings. Cams and eating disorders. So it's got quite a wide variety of experiences Oliver. So thank you so much for coming onto our podcast and welcome.

Oliver: Thank you, Bella. It's good to be here. 

Philippa: Okay, so my first question, Oliver, is what is a trainee clinical psychologist? What does that actually mean? 

Oliver: Yeah. It's quite a broad thing actually, to be honest. So a trainee clinical psychologist. In terms of a UK context specifically, is somebody who is completing a doctoral level training program to qualify as a clinical psychologist.

There [00:01:00] are lots of different elements to training. So part of it is the actual clinical working in real world clinical settings on different placements. And that can be working with people across the lifespan. So from. Young children all the way up to older adults. Then there is the kind of research element of it.

So as a doctoral student, you have to complete research and learn how to be a researcher. So clinical psychology is an what we call like evidence-based practice profession. So you have to use evidence and research in your actual applied practice. And to be able to do that, you have to learn. How to, A, conduct research, but then b, also read, understand, disseminate, share research with other people.

In whatever settings you're working in. So that's a big part of the training. And then I guess the other part is the academic side [00:02:00] alongside that. So that's doing what you would imagine any university student might do. So attending lectures learning about different things within clinical psychology, different models, different therapy approaches.

And then completing university assignments to evidence you are learning in that. So I often describe it to people. It's having three jobs in one. You are constantly spinning all of these plates. So like some days of the week. I'm on my clinical placement, working basically as a psychologist in whatever clinical setting I'm in at the moment.

Then another day I'm at university all day listening to clinical psychologists or people within that sphere talking about their expertise. And then other days I'm working on my research and getting my research thesis project done. So there's lots of different elements to it. But yeah, the ultimate goal is that you do that typically over three years, full time.

To then qualify as a clinical [00:03:00] psychologist. 

Philippa: Okay. So I have some questions about that. The first one is, when you say doctoral, that means that you will be a doctor when you finish. So you get to be Dr. Oliver. 

Oliver: Yes. 

Philippa: Once you, you finished? Yes. Okay. And then when when you talk about clinical psychology 

It's quite a big. Subject. Do you? So can you just for people who are listening that maybe don't know what psychologists do or clinical psychology do, can you just explain a little bit about that? 

Oliver: Yeah, of course. So typically how I explain it's, I go back to what is psychology, and so I would split like the science of psychology, which is the science of human nature and the way human beings are and think and behave.

I split that into two broad camps. So you've got the kind of academic side of psychology and then the more [00:04:00] sort of applied real world side of psychology. So the academic side is, so tho those would be psychologists working in say, universities or research settings, developing the science itself.

So looking at thinking up theories, looking at theories and carrying out research. To prove or evidence things. And that's them creating this evidence base of the science of psychology. And then the other side is the applied real world side of being a psychologist. So these are psychologists who essentially take that science, take that understanding of, human nature, that's being developed.

And apply it to the real world and to real people in various different settings. So there are different types of applied psychologists, so that would be things like forensic psychologists, health psychologists. Educational psychologists, and then clinical psychologists are a type of applied psychologist.

So [00:05:00] specifically clinical psychologists. What we do is we take that science the understanding the evidence base. We apply it to real world settings and in quite broad ways. But I guess a real simplified way of explaining it would be we take that evidence and we apply it to the real world to help people with their distress.

So that might be helping people alleviate their distress or just manage their distress. But, and I appreciate that's quite broad. So you might find clinical psychologists working in all sorts of different areas and settings. So the more traditional, what you might think of as a, psychologist working in like mental health settings where we're helping people with, their mental health and different types of, mental health presentations.

But then especially now it's, increasingly more common to find clinical psychologists in other areas. In the sort of general health settings. So it's not uncommon now to find, clinical [00:06:00] psychologists working in general hospitals on, ward. So working in things like oncology or palliative care helping in that physical health space.

Clinical psychologists might also now, again, increasingly start working in forensic settings in judicial, the judicial system or working in educational settings. So there's a lot of Blurred lines, I think of where you might find us working. But essentially, I think if you were to drill down to the, bedrock of it, the foundation of it, it is essentially we use that science, that evidence to help people presenting with distress in whatever context that might be.

Philippa: Okay, so and so really. W it's thinking about what works 

For people, whether they're children, babies, adults, elder, elderly people. So what [00:07:00] works and how do you know it works? So you've got some people who are working on, actually, we think this might work. So an example, an easy example. I'm gonna ask you a little bit more about the research bit.

So an easy example is cognitive behavior therapy. So we've had people on here talk about that. CBT. You can measure that if we do this intervention in this way, we start at A and we end at B, and we can see that there's been. Positive change for the person and that the person's reporting it. It's not about you saying, no, I can think this is something different.

This is about the person or the child, the A, the adult saying, yes, I can see that there's been a positive change for me. The change that I wanted. And we can attribute it to that intervention that, that CBT. So you've got the people that are gathering all that information and saying, this is working.

And then maybe adapting things [00:08:00] when there's, gaps and thinking, actually, let's try this and see if this might give a better outcome. And then you've got people like yourself who are. Taking that. So thinking, okay, so ZCBT delivered in this way for this amount of time with these people should be 

The best. The gold standard for that person. So, things like, I suppose my next question is CBT something that's got a beginning, middle, and end 

Is quite easy? To, to, get outcomes for on here. We often talk about trauma and attachment. 

I'm guessing there's, that's not quite so easy to, measure. 

Oliver: Yeah, you're exactly right. So things like CBT, for example, are often treated, are often thought of [00:09:00] as like the gold standard. For a lot of, if we're talking about mental health, specifically mental health presentations but there's a big debate of is that just because, A, it's really easy to evidence the efficacy of CBT because of the way that it can be tested in research and then b it's quite easy.

To do short term as well. So that means from like a funding perspective if we're thinking about like in, in an NHS setting for example it's quite straightforward, especially at lower levels with what we would call lower level presentations. So this would be things like mild to moderate anxiety or depression.

You can quite effectively target that. With CBT, which is an intervention that you can do relatively short compared to a lot of other therapies. So you've got CBT, there a type of therapy that is really quite easy to evidence, causality [00:10:00] within research. So does this specific thing, the CBT, cause this specific outcome.

So you can show that it works. And then b, like I say, it's quite easy. To do in a relatively short period of time. And then also with CBTA, a big part of CBT as is the case with a lot of therapy. But a core sort of tenant of it is you are teaching the client ways to help themself going forwards.

So they often say that once you've had that CBT for that particular problem, you don't always necessarily need more CBT for it down the line. You've learned what you need. You've developed those tools there and then to help you target that problem. So should it arise or should it continue to be a problem in the future?

You've already been skilled in, dealing with it. So there's lots of reasons why CBT is treat it as this gold standard, and it's not without its issues as is anything. And a big part of being [00:11:00] a clinical psychologist is being able to identify when things are appropriate, but also being really critical about things all the time.

So yes, that is the gold standard, but there are issues and I have to be aware of those issues and when best to apply it and how to adapt it for my particular client, depending on them and their presentation. So then coming onto thinking about trauma and and treating trauma or helping somebody with trauma, that typically lends itself, I think, a bit better to what we would call more sort of relational therapies. Not always, but I, would be thinking of going down that sort of route. But the problem then with these sort of more relational therapies is that they're a lot harder to show cause and effect.

Again, that idea that this specific element has caused this specific outcome. And that's not to say these therapies aren't effective. They are effective a lot of the [00:12:00] time. But it's just a lot harder to evidence that and these relational therapies as well. You tend to have to engage somebody for a much longer period of time to see positive change.

Which again is not necessarily a bad thing, but if we're coming back to thinking about funding and providing a service that spends its money wisely. You think about these funders where are they gonna put that funding and that money? Are they gonna put it in the thing that, that they, that can cause a positive change over 12, 16, 20 odd weeks?

Or are they going to put it in the thing that realistically to see the same kind of change you would expect a much longer period of time? So yeah big, sort of debate there, 

Philippa: and that, and I guess then as a psychologist, I wonder when you're on your, courses, how are they taught? Do you get equal?

This is just, yeah. I'm curious [00:13:00] about this. Do you get e, is the course given equal attention to those equal therapies or is it weighted more to the ones with the much more robust evidence base? 

Oliver: So the thing with clinical psychologists is we're often described as like the jack of all trades, but the master of none in terms of therapies.

So if you do your clinical psychology doctorate, you aren't typically trained in one therapy modality. So it's not like becoming a CBT therapist, for example. Where on that training, that's all you're doing day and night is CBT, and you become an expert in that. We don't get that sort of level of detail of training on any one particular therapy.

It's more we get given insight and opportunity to practice with the appropriate level of supervision with lots of different things and develop a kind of toolbox of different. Things that we might use [00:14:00] depending again on the particular client and presentation or scenario we're working with. So yeah we're not necessarily experts in any one thing that, that's not to say though, that we don't spend more time focused on certain things.

So pretty much most courses, clinical psychology courses in the UK are very ccbt dominated. And there will be a lot of that. Taught and, you're encouraged to practice a lot of that, but it's never just that solely. So for my course specifically, I guess the big main three that we tend to think about is the more sort of CBT esque therapies.

That would be CBT, but then that would be a lot of the sort of what we call third wave therapeutic approaches. So things like DBT Act, cap, all of these things that kind of come. So 

Philippa: can you explain though, so if people haven't heard of them, what are DBT ACT cap? 

Oliver: Yeah, of course. All, of these kind of therapies, we call them the third wave therapies 'cause they come from [00:15:00] CBT.

So they're all very heavily CBT informed. So it's the same sort of theoretical underpinning of what's informing the therapy, but it's just different focuses and different approaches within that. So with CFT, for example, which is compassion focused therapy, very heavily informed by CBT, but it's much more focused on developing compassion for oneself and developing compassion for others.

So it would be used for specific presentations. So typically if someone's coming and they're quite self-critical, got quite low self-esteem that kind of presentation. A CFT approach might be most appropriate. 

Philippa: Yeah. And that's got some attachment stuff running through it, hasn't it? CFT it does.

Compassion focus therapy does try and blend a little bit this relational element doesn't it, into that. I know CBT, one of my closest friends is a [00:16:00] CBT therapist and they would say it takes into account trauma and that. I would maybe have a different view of that, but I think compassion focused therapy really does try to blend the relational more, more than, the others.

I don't know what your views of that are. 

Oliver: Yeah I, definitely agree with that. A lot of these third way therapies developed because people were like, these people that developed them when using CBT or were quite knowledgeable on it, but we're finding that. For specific people or specific presentations.

It just wasn't effective in its raw form and so that they've taken it and developed it. And added things in to make it more specific for different things. So with CFT it would be that more sort of people that are quite self-critical, that aren't responding to that traditional CBT approach. You bring in these different unique elements of CFT that might help that with DBT, which is dialectical behavior Therapy that was developed by a psychologist called Marsha [00:17:00] Linnehan who.

Her, she herself had been diagnosed at the time it was, called Borderline Personality Disorder. But there are different labels we might give to that. And she found that for her, and for a lot of her clients with this diagnosis, traditional CBT just wasn't for, whatever reason, wasn't helping.

And so then she found, she carried out the research and she looked into what elements of it aren't useful or aren't applicable here, and how can we adapt and change that? And from that came DBT. And that's the same with all of these different third wave approaches. They're basically ccbt plus, 

Philippa: yeah. 

Oliver: Or whatever it is that they need to be almost.

So we, so on training, on, on clinical psychology training, we start with the CBT and then we, as we go along throughout our training, we can then branch off and try different things and experience these different therapies and approaches that fall under that umbrella for, the [00:18:00] different things we need them for.

Philippa: And you get to go on placements, don't you? And work. Like you said at the beginning, you do three days a week within. And do, you do different placements throughout your three years? 

Oliver: Yeah. So it can differ from course to course. Different courses take different approaches.

It's not just a standardized thing, but there are underlying competencies that we have to meet regardless of where we're training. And most forces, I think now do subscribe to what we would call this competency model where there are essentially these nine categories that we have to prove we can tick these off.

So those would be things like psychological formulation. Can we do that? Can we assess people? Can we do intervention? Can we evaluate interventions? There are these nine things that we have to prove over our three years of training. And, we do that through going on placements. So my course specifically, we [00:19:00] do six placements across the three years.

So two in each year. They're typically about six months at a time, which is a good chunk of time to be able to go in somewhere and. Build a bit of a foundation and get to know colleagues and other people in the set, in the setting, and then get on with some work, some clinical work for a good, portion of time.

Traditionally a lot of courses took a more sort of lifespan approach where you had to do. Placements in each different area, like area of the lifespan. So a child placement, a working adult age placement, an older adult placement, a learning disability placement. But nowadays with more people coming into training, so the training courses are taking on more people, which is great, but there are less placements available for trainees.

So it's not the case now, at least on my course, that everyone's gonna be able to do those. Different lifespan [00:20:00] placements, it's much more Now, can you demonstrate these nine competencies? Yeah. In different settings. And ideally that would be with diff people across the lifespan. So for myself, so far, I've done an adult placement.

I've done an older adult placement. I'm currently doing a child and young person's placement, so I'm able to tick those, but it's not as defined in that way anymore. 

So like for my next placement, I'm going into a forensic setting. Working with people with, severe and enduring mental health presentations that have been through the judicial system.

So yeah that's, the general approach that my course at least takes. 

Philippa: And is it easy to get onto the doctorate? 

Oliver: It really isn't, if I'm being honest. So no is the answer. And there, there's various reasons for that so traditionally courses were quite [00:21:00] small in terms of how many people they would take, and that is changing slowly.

I think now roughly every year they take on just, I think over a thousand people across the country across different courses. Which still it could be more but it's a lot more than it used to be. So some courses they can have. I think now I think the biggest cohort I've heard of in recent times was about 80 people in one year taken on at that particular course.

But that's not the norm. So my course, for example, has about 25 people taken on each year, which would be more in line with traditionally what you would expect. There are course is that. Take on less than that still. I, know some courses are more around like the 15 people a year mark, so you've got not many spaces, but lots of people that want to do it.

And you've got this funnel of all of these people wanting to get to this place. And then it, as you get further [00:22:00] down, it gets more and more competitive until you get to that sort of entry onto the course. Yeah it can be really difficult. It's really quite competitive. And I can speak more to the process of what that actually might look like, if that 

Philippa: Yeah, I think, yeah, just telling is, how did you get to get on there?

What, why did you want to be a clinical psychologist as well? What, is that? 

Oliver: Yeah, so I can, speak to why first. So for me. There was never any real sort of undying wish from a young age to be a clinical psychologist. I'd be lying if I said there were I very much accidentally fell into first the world of psychology and then more specifically clinical psychology.

So for me, up until about the age of 16, I'd never really heard of this psychology thing other than in films and tv. Had no interest in it whatsoever. Then when I came to do my A Levels I, basically turned up for my first day of sixth [00:23:00] form and was told, I was called into the head of sixth form's office.

So I thought, oh God, what have I done? It's day one. And she sat me down and she said, you can't do the options that you've chosen, unfortunately. 'cause they clash in terms of timetabling. So you're gonna have to drop one of your A level options and pick something else up instead. And she said, your options are, I think it was either a level geography or a level psychology.

And I had to make a split decision there. And then in that moment, what am I gonna do for the next two years? And I just chose psychology on a whim. And then skipped two years later, I'm finishing my A Levels and I'd completely fallen in love with this. The subject of psychology and learning about people and the human mind and how we interact with other people and, everything that comes with that.

To the point that I then made the decision, this is what I want to go and study at university which I did. So then I, went and did my undergraduate [00:24:00] in psychology over, over three years, as most people do. And yeah, I just fell more and more in love with I, think for me with initially with psychology, it was the breadth of it.

There was just so much to it. One day you could be learning about the actual sort of physiological mechanisms within the human brain, and then the next day you are learning about attachment and development, and then the next day you are learning about cognition, and then the next day you are learning about mental health and mental illness.

There's just so much variety in it. And for someone that's always liked to have this I've always liked to have my finger in lots of different pies. Like I've never focused on one particular thing. It was nice to have this breath, but then I came to the end of that, undergraduate course, and I had to make a decision where am I gonna go next?

Even then, I wasn't a hundred percent sure. I had a couple of ideas in mind and I [00:25:00] actually chose to do a master's degree straight away. And I did my master's in health psychology, which is a bit different from clinical psychology. 

And there were various reasons why I chose to do that. And I really enjoyed that course.

But there was just something missing. It just wasn't. The area I wanted to work in going forward. And I learned a lot from my master's and I, would do it again, but I think the one thing it taught me was that I don't want to be a health psychologist to be honest. And then I spent a period of reflecting and thinking about what, is it that I'm being drawn to in terms of like my values and what matters to me.

And I just kept coming across clinical psychology. I couldn't really shake it. And I think for a long time I denied that almost because I knew how competitive it was. I knew how difficult a journey it was going to be to get to that point. But I 

Philippa: So can I just ask you, once you finished your Master's 

Are you [00:26:00] not a psychologist then what does that mean? Because if, once you've done your degree in social work 

You are a social worker. Once you've done your degree in lots of things, you are then that play therapist, you're a play therapist. But once you've done a psychology degree 

You are not a psychologist, 

Oliver: not in the uk. So there's a big debate going on about this actually currently. So the, just the word psychologist is not a protected title, so anyone could technically call themselves a psychologist, but there are a lot of moral and ethical issues with that if you don't have the appropriate training.

However, specific titles are protected, so like clinical Psychologist is a protected title and you cannot call yourself that legally in the uk if you have not done that training and are not subscribed to the appropriate sort of board. But yeah, so once you finish your undergraduate or your master's, [00:27:00] depending on, what it was if you haven't done the specific training to become whatever type of psychologist it is.

You can't really call yourself a psychologist. So 

Philippa: what does that give you? Then? What does, why would you do the degree in psychology? What, would be the purpose of that? 

Oliver: Yeah. Yeah. So there are lots of different routes that psychology can actually lead into, which aren't being an applied psychologist.

So again, it might be you go and work in a research or academic space. So a lot of people do their undergraduate. And then go on to do further study and might do a PhD, which would be a research doctorate typically to specialize in an area of psychology, but researching that and, developing the evidence base on that.

So that might be one, but. There are lots of different job route that people might then follow following, having a psychology degree anything working with people. A lot of people might go on and [00:28:00] work in education settings, trained to become teachers maybe, or people might go and work in like HR settings or in that kind of occupational role.

Can be quite difficult I think, actually for people to figure out where they go next. 'cause I think people do go into it perhaps with that misconception of, I'm gonna do my three years at undergrad and I'm gonna be a psychologist. And unfortunately that's not the case. And I think you can 

Philippa: be an assistant psychologist, so can't you, which is one of 

Oliver: Yes.

One 

Philippa: of the ways into the next level. Is that right? 

Oliver: Yeah. So that would be like gold standard route into. Then going on to train as an applied psychologist in whatever area. So within clinical psychology, it's really common for people to do their undergraduate degree, perhaps do a master's that is becoming increasingly common now.

And then you, before you can get. A place on a doctorate [00:29:00] course, you have to prove that you have some level of clinical experience prior to applying. And it's different for different courses. Most courses. Now it's a bare minimum of a year. But I would argue that. The a year because of the competitive, like how many people apply, you're gonna need more than that realistically to, to have your application considered.

And so there are various roles you might do in that span between university undergraduate level and applying for the doctorate. And that might be, yeah. 

Philippa: Yeah. 

I was just gonna say, and also from, I suppose from seeing assistant psychologists come in to to, our service and then be applying for the, doctorate and trying to move on it, it's also seems, it's also that lots of courses want a variety of experiences.

So it's, I'm just thinking about people listening to this who think actually I can go and do a, degree and a Master's and then do a [00:30:00] year and then in an ideal world, that might be the case. The reality is that it seems to me watching clinical psychology supply assistant psychology supply is that the feedback is, yeah, you might have enough years experience, but you haven't got enough variety.

So go and try in, in a different setting, go and try with a different client group. So the more experience as a assistant psychologist you've got. I guess is helpful. I suppose it's not necess it's not deemed that you've got to have it, but it is gonna be much more helpful.

Is that right? 

Oliver: Yeah, definitely. I think that's one of the biggest issues with the process of becoming a clinical psychologist is there's no one sort of route. To get there. There's no one particular formula. Whereas if I compare myself to my, like medical colleagues or counterparts, so [00:31:00] psychiatry for example, it's a bit more set in stone the steps that you take to get there.

I'm not an expert in that, but I know that, yeah. You would go to med medical school and then you. You do these various stages, but is it it's spelled out for you in advance, whereas with the clinical psychology route, there is no one particular way of doing that. And even in my own cohort of trainees that I'm currently training with in my year, we all have so much different varied experiences.

Our journeys to get to where we, are is so different and diverse, which I think is great 'cause it brings so much diversity in terms of experience. But it can be really tricky for that newly graduated undergraduate psychology graduate to know where to go, where to start and, unfortunately there isn't one particular answer that I can give to that.

But I would definitely advise what you've just mentioned the variety, try and get as much varied [00:32:00] experience. And that doesn't necessarily have to be mean, moving from role to role constantly. It can mean that, but think about within whatever role you are working in. So if you're in an assistant psychologist role, how can you work in different ways?

How can you get varied experience within that particular role? I know people that have got onto clinical. Doctorate level training that only had one AP role, but they might have had that over the course of many years. But they were able to evidence when they applied and when they were interviewed that one role, it might have been one role, but it gave them a lot of different experiences.

Yeah, so it's not necessarily the quantity of the experience, I would say. Yeah. It's more about the quality and how you evidence. 

Philippa: And I guess volunteering with volunteering if you're volunteering with different people or doing different bits you're working with a community, aren't you?

You're working with people, you're working within in settings or that, I guess is evidence [00:33:00] of, that work. 

Oliver: It can be a good foot in the door. There again, there is an ongoing debate about voluntary work though, because there are questions about whether that. Creates a bit of an imbalance in terms of people that can and cannot access doctoral training down the line.

So for me, for example, I, when I graduated, I worked as a healthcare assistant on psychiatric wards for about two years, and that was my first job out of university. And I did that to get my foot in the door and start getting experience working in a clinical setting with real people with real problems.

And that was great. And that was a paid post. But then I managed to secure what we would call an honorary assistant psychologist post, which is essentially voluntary, unpaid working in that same hospital. And I did that for about six months part-time. But I was only able to do that because I was in a [00:34:00] privilege enough position to be financially secure and be able to do that.

So I was still living with my parents and my, family at the time, and. I was privileged to, to be in that position. Yeah. And not everyone is, and so there's this big debate now, should we be operating out these honorary assistant psychologist roles because certain people just might not be able to take them because they're not in a position to be able to take them.

And then that closes the door for them for developing on. Yeah. So I think as somebody that accessed that, and that was my way in, I can't say. Wholeheartedly that I don't think it should be an option, but I think it's very nuanced and I think we have to think about how that, might not be fair for everybody.

Philippa: And is I guess that was my other, one of my questions is that you often think about psychiatrists as. Middle class [00:35:00] affluent that there's a type. Is that true or is that that is there more diversity to it than that? 

Oliver: I think traditionally the world of clinical psychology has been very specific demographic.

I think there is truth to that. So traditionally you would think of a clinical psychologist as a middle class white woman. Yeah. And there is, there are big movements now and there's a lot of push to really kind open doors and diversify the profession. And I'm very much all for that. And my stance is I think we need to create a workforce of clinical psychologists that best represents the communities we serve.

And our communities are. Immensely diverse in all different ways across all different aspects of identity. And we need to have representation of all of that within the [00:36:00] workforce. And there are big pushes towards that. It's not happening quick enough, unfortunately. And there are still barriers to that lots of nuance to it.

But moves are being made to really try and diversify that profession and like I say, create a workforce that best represents the communities we serve. 

Philippa: Yeah, I ju and, that would be great. I could have a conversation about that in great detail, Oliver. But I just want to, just to talk about, your experience really about that acute and urgent care and, those sorts of things.

What was that like working in, those areas with adults? Often on here we talk about children, so it'll be interesting to think about, adults. 

Oliver: Yeah. Yeah. So like I say, I very first started out. Straight after my master's working on adult psychiatric wards. And that was initially in a support worker role, so less of a traditional psychology therapy sort of role.

It was more [00:37:00] hands-on helping on the wards but completely such, valuable experience. Yeah, it was really challenging, especially as somebody that was very new to that not really knowing what to expect. So I actually started out, so the hospital I worked in, it was a private hospital.

It was in an NHS hospital had various wards. So they had an eating disorders ward, which is where I started. They had acute adult mental health wards. They had an addictions ward, they had children's wards. They had. Pq, so a psychiatric intensive care unit. So lots of different wards for different presentations and, different things.

And I was able, like I say, I started out on the eating disorder ward. But I was able then to kind of transition and move and, work in all of these different settings, which I was very much for. 'cause like I say, I was trying to get as [00:38:00] much varied experience as I could. But yeah it was, a lot to adapt to and, Change and I learned an awful lot from it and I would highly recommend it to anyone who is at that point of wanting to become a clinical psychologist or wanting to work in any helping professional with people. I think doing care work or support work or whatever it is a, great way to get your foot in the door 'cause they're crying out for people.

But also such invaluable experience. It really teaches you a lot about the basics of human connection. Yeah, I'd highly recommend it. 

Philippa: And you say you then got the assistant psychologist post there. How did that differ from the healthcare? 

Oliver: That was very different and very difficult to acclimatize to I think as well.

So essentially it was a, an honorary post, so it was voluntary and it was part-time. So it was just the one day [00:39:00] a week in this AP post on the eating disorders ward. Then I obviously I did that one day a week, but I still needed to earn an actual living alongside that. So I kept my support worker role alongside that.

So I would do two or three shifts as a support worker. So they were 12 hour shifts a week, and then I would do my eight hours, I think it was on a Thursday every week as the assistant psychologist on the eating disorder ward. But then that meant that I couldn't then work on the eating disorder ward as a support worker.

Because those are two very different roles. So as a support worker, you are there with people in their most vulnerable state constantly. And, you have to get involved in things quite personal things. Whereas as an assistant psychologist, you're in that more kind of therapeutic role, and there are therapeutic boundaries that need to be kept in place.

So when I was in that AP role, my [00:40:00] supervisor, who was the psychologist for the ward was very adamant that unless you are working with someone, so you're in a session, for example. You shouldn't be on the ward. 

Philippa: Yeah. 

Oliver: You need to come off and you need to go to the therapy office in the hospital and be based there.

And you come onto the ward to do your sessions with people or run your psychology groups, which I used to do a lot of. And then you come off, whereas a support worker, I would be on that ward 12 hours a day. I'd be sat with people and know some people, especially on eating disorder wards, they would often be on bed rest 'cause they'd be so physically frail.

They'd be sat in bed all day. You'd be sat there in their room with them as a support worker. A massive shift. A massive difference. Yeah. Yeah. And for me, 

Philippa: yeah. And then you, did you go from there into the, doctorate or did you do some other, roles? 

Oliver: Yeah, so I had a few more years of pre-training experience to get in the bag.

First so I was there for, at that hospital for [00:41:00] about two years, all in all, including the ap honorary ap one day a week. And then having done that for only six months, one day a week, that was enough experience for me to then start getting interviews for actual paid full-time assistant psychologist posts, which were pretty much all in the NHS.

So I started interviewing for those and I got quite lucky, I think that I only interviewed for a handful before being offered one. I know some people go to an insane amount of interviews and, Get rejection after rejection until they finally do get that opportunity. But I was quite fortunate that after only doing that part-time post for about six months, I got my first full-time paid post.

And that was working in cams. And that was working in the Cams service where I used to live in the single point of access team, which is essentially like the front door of the child and adolescent mental health service. [00:42:00] For the area to every referral that was made to cams, wherever that's come from has to go through that single point of access team.

And our job in that team is essentially to triage all of those referrals. So why are they being referred? What's the presenting concerns? Where's best to put them? Can we even help them? Do we even have a service for them or do we need to signpost elsewhere or refer on elsewhere? So that. It was predominantly my job.

So as an assistant psychologist in that team, it was a lot of screening referrals and then contacting people. So either the young person or young person's parent or carer. And some cases if it was a school referral, it might be contacting teachers. On rare occasions, if it was a GP referral, we might contact them for further information.

So lots of liaising with different people. To get as much information as we could to come to a decision then as a clinical team. [00:43:00] Of what do we do with this referral? How best, if at all, can we help this young person? 

Philippa: So you are the person that we all get frustrated with and you're the one that's like, why haven't you taken my referral?

Yeah. 

Oliver: It's a really, it's a really difficult position 

Philippa: to be, I can imagine. I honestly, I can I've worked in Cams myself. 

So I so I have an understanding from a Cams perspective of just how many referrals come through the door. And that you have to have a way of gatekeeping because you, there isn't just no way that service which whichever candidate is, can take all the referrals on. So I absolutely get it, but from my perspective, referring in when you think yours is the one that should get through and then doesn't, you just, it can be so frustrating. So I can imagine that was. Quite a tricky job, really. And [00:44:00] then not just dealing with the, clients and the young people and, reading their stories and, thinking actually these really do need some support, but we can't do it.

So you've got that sadness of rejecting them, but then professionals like me where you have to then be saying yes, but, and we are saying yes but that's quite tricky. 

Oliver: Yeah. It's a lot to balance. It's, not a, post that I was able to do for that long because of those reasons. I think I was there for about 10 months before I was ready to move on because it, it was quite exhausting work.

Especially when you are being hit with this never ending wave of referrals. Like it never ends. And, you do have to be quite firm and boundaried and that's not necessarily coming from you as an individual that's coming from higher up of what you can and cannot. Allow through that door.

And that really takes a toll on a person. [00:45:00] But again, I learned a lot from it. I do it again. I because I, learned an awful lot about not just working with young people, but I guess assessing people and really getting to the bottom of what is the main presenting concern and what can be done about that, and being quite pragmatic about that.

Yeah, lot, lots of really valuable skills from it. Definitely. 

Philippa: Absolutely. And do you, what year are you in now, Oliver? Are you in your third year? 

Oliver: No, so I'm in my second of three years, so I'm about coming up to halfway through, through my second year, which was, is also halfway through my training. So yeah, after this I've got another three placements.

And then I, everything being well should hopefully be in a position to qualify and then start practicing as a qualified clinical psychologist. 

Philippa: Do you have an [00:46:00] idea of where you want to go or are you're still very much open and thinking, I'm just gonna have all these different experiences and then decide?

Oliver: I think that is the beauty of training is that it's kinda being a kid in a sweet shop, that you get all of these amazing experiences and you get to try all these different things. And yet the thing that you think you want to do next changes, sometimes week on week, depending on what you're doing.

So, to answer that question, no I dunno a hundred percent where I'm gonna go once I do qualify. I do have some ideas. So like I say, I spent a lot of time working in acute and urgent care settings, pre-training. So once I left that Cams AP post, I did various. More roles inside inpatient and like community crisis care sort of settings.

And that whole area of work really appeals to me. So that's a [00:47:00] potential. But like I say I'm, very much open to. To trying different things and not getting too stuck and, too hyperfocused on one particular thing until I do reach the end of my training. 'cause I don't, I dunno what's around the corner.

Philippa: No. And the thing is really true. When I did my training, the one thing that I was not gonna do was work with children ever. I didn't go to any of the you get options sometimes, don't you? That there'll be three. Three lectures on older adults, learning disabilities, children, and you can choose which one the, I never went to any children ones because that I was just adamant that I was never gonna work in children and families.

It was gonna be too difficult, all that sort of stuff. I. And it is literally the only thing I've ever done is work with children and families. I've never done anything else. So I think you just, it's good to have all those experiences be open and Yeah. Also you've gotta see when you get out the end, what jobs are there, aren't you?

Oliver: Yeah. That is also the thing, but it is interesting, I think things you think you are [00:48:00] going to perhaps not be drawn to or particularly enjoy, you often do get surprised. I'm quite similar in that. I never thought I'd be interested in working with young people, and yet I'm on my child and young person's placement currently, and it is by far and away one of the most enjoyable experiences I've ever had on training and, from before.

And so it has really surprised me and it does throw a bit of a curve ball at you of, hang on, is this what I want to do? That's another thing to potentially consider. So yeah, like I say, it's about keeping your options open. 

Philippa: Absolutely. Absolutely. We are coming to the end of our time, Oliver, thank you so much for sharing that with us.

And it would be really interesting maybe in 18 months time for you to come back and let us know where you've ended up what you chose to do, how you've done. And we can call you Dr. Oliver on our, podcast. But thank you so much for your time. It's been amazing. [00:49:00] 

Oliver: Thank you so much for having me, Philippa.

It's been lovely to have the space to reflect on it all as well, so thank you.