Issue 19

Becoming a Clinical Psychologist

The route to becoming a clinical psychologist, like many other professions, involves years of study combined with practical experience in a variety of settings. Whilst the training pathway is broadly similar for most people pursuing this career, the experiences gained prior to training can differ considerably. Some of the individuals I trained with came from different factions of the NHS, for example nurses, NHS managers and psychology PhD students.

For others, like myself, the decision to return to psychology represented a complete change of career. I worked as an outdoor pursuits instructor for several years and it was this job that sparked my initial interest in psychology. I enjoyed seeing the positive change in children and adults who achieved a goal during an activity or overcame a fear partly as a result of the support and encouragement from their peer group and instructors.

For me, helping and supporting those individuals with mental health problems seemed an important and rewarding job. After all, one in four of us will develop a mental health problem during the course of our lives. After obtaining an under-graduate degree in psychology, aspiring clinical psychologists usually spend several years working as assistant psychologists, research assistants or support assistants in various mental health settings, prior to gaining a place on a Clinical Psychology Doctorate training course

These training courses are structured so that trainees must successfully complete five placements in adult mental health, child and family mental health, learning disabilities, older adults and finally an elective placement. I decided that once qualified I would like to continue to work within adult mental health and this decision led me to choose an elective placement at the Caswell Clinic. Initially, I wasn′t sure if I would like to continue working in a forensic service once I became fully qualified. However, during the time I spent at Caswell I had an opportunity to meet and work with several patients, gaining new experiences and a clearer understanding of the role of the psychologist in this setting. I thoroughly enjoyed working at Caswell and when two clinical psychology posts were advertised I decided to apply.

What do Clinical Psychologists do?

Generally, the role of a clinical psychologist involves working collaboratively with patients, their carers, their family and/or their support team. Usually this involves undertaking a comprehensive assessment, which can include the use of questionnaires and neuropsychological assessments, in addition to information shared in a clinical interview. This helps us to develop a formulation of the patient′s difficulties.

The formulation can then be used to devise the best intervention or approach for the patient and usually this is done collaboratively with the patient. On some occasions this means the psychologist will continue to work directly with the patient, or on other occasions they may feedback to the support team and have no further direct contact with the patient. When the psychologist continues to work directly with the patient, sessions may focus on a specific issue of mental health depending on the patient′s difficulties. For example, helping patients to overcome anxiety or depression, and/or supporting them in changing the way they think and feel in relationships.

Clinical Psychology at the Caswell Clinic

Clinical Psychologists at the Caswell Clinic work in the way described above but are also able to offer specific, specialised assessments that are not usually carried out by generic adult mental health psychologists. These include detailed personality, neuropsychological, and formal risk assessments that are aided by our specific training in a number of psychometric tools that generic psychologists may not have. We also have a good deal of experience in assessing more severe personality disturbance and adult manifestations of developmental disorders such as Aspergers Syndrome and ADHD. Although we sometimes work therapeutically either individually or in a group setting with patients much of our work is focused on the appraisal of risk and offending behaviours. These specific skills enable us to develop a comprehensive formulation that helps the patient and clinical team to move collaboratively towards a positive outcome. In addition, we collaborate in identifying the goals and future treatment needs for the patient as part of their longer-term rehabilitation. This might include working with the patient and nursing team to stabilise and improve patient′s mental health, develop reliable relapse indicators and help patients to manage and cope with on going mental health difficulties and previous traumatic life events.

Although some patients may experience relapses in their mental health on occasions, we hope that the support and input that patients receive from staff, including clinical psychologists will support patients to make steady progress enabling them to move forward with their lives.

AndreaC. Clinical PsychologistAn Experience of Ramadan.

Chat Issue Winter 2007

In August Kamal H, who many of you probably know, started to tell me that Ramadan was coming. As excited as he was about it he was expecting it to be more difficult to attend his occupational therapy groups and would hope for some understanding with his difficulties in getting up at that time. I asked him what it was and he described a holy month when Muslims fast between dawn and dusk and prayers carry more potency.

That basically nothing can pass the lips during the daylight hours. I thought it sounded hard and asked what would make it easier? He said that the support of other Muslims who were also fasting was a great help but here it was a bit harder as there were not any other Muslims. I did a quick calculation in my head, more of a snap decision really and tried to look at my toes that were invisible past my belly and said, "I don′t mind fasting with you. "

As the days approached I did not really think much about it, figuring it would be a crash diet, good for me and one of life′s varied experiences. Then a date was given September twelfth to October twelfth as set by a lunar calendar and announced in the Holy city of Mecca. So what was Ramadan going to be like? Kamal told me so much more the week before than he had in that first conversation.

When I thought of nothing passing the lips I thought about food. I did not think about drinks, cigarettes, sweets, chewing gum cups of tea. Nothing meant nothing. So when were you supposed to get all these things in? Easy before you prayed at around five in the morning and at night around half past eight.

Praying in the morning I had not done that since school assembly. On the first day in hind sight I think I should have told my family what I was doing. They are used to my odd hours due to shift work, but my apparent lack of appetite and ravenous devouring of milk and dates to break the fast was something new. Dates are out of interest a naturally Halal food I learned and they are used by many to break the fast.

Day one rolled into week one and I started to think less about my bodily needs and wondered what is Islam? Five things are fundamental to the religion but I was finding out more things of interest than:-

There is one god, the testament of faith, the Shahada.

Prayer, five times a day, a direct communication with the one god.

The giving of support to the needy, Zakat.

Fasting, the month of Ramadan and an appreciation of what it is to want but to grow spiritually.

Pilgrimage or Hajj to Mecca, performed once in a lifetime and only if fit or financially able.

I was finding out that knowledge is allied to faith and the sciences and learning are very important. I discovered a list of prophets going back to Adam and including Moses and Abraham. I found a belief in the Immaculate Conception of Jesus. That when you shake hands with people minor sins are forgiven. A belief in the creation and a word Salaam.

Salaam means peace and is a greeting, it is a great word and I have used it often since September twelfth. It has always met with goodwill and friendliness.

( I also found out that if you are going to face south east and pray to Mecca in a traditional Muslim way in your bedroom. Tell you′re wife.)

Iestyn W. Staff nurse Cardigan Ward.