Clinical Psychologist questions

[Birdsongsinging]

I am a Clinical Psychologist in the NHS and wondered if anyone wondered about anything that I could try and answer?

Some accurate data for training places here:

https://www.clearing-house.org.uk/about-us/number-places

It is still very hard to get a place albeit slightly easier due to an increase in places.

What do you think of psychiatrist's ?

Do you think enough is being done to diversify the intake into clinical psychology of young white middle class women?

As a mid life career changer, with caring responsibilities, and lived experience, I keep hearing so much about how welcome candidates like me are into psychology roles, and on the DClin Psych, but that’s not been my experience so far.

This is a fascinating and helpful thread: thank you.

A few more Qs:

1. Are counselling psychologists being trained by the NHS?

1. How long is their training compared to clinical psychologists? And in the NHS what is the difference in the work they do?

1. Do many psychologists trained by the NHS leave immediately or soon after?

1. In your experience, are many in-patient MH nurses bank-nurses?

Thanks again!

@scarecrow22
I’m a MH nurse and can answer your question 4.

IME, it really depends on the ward. Wards tend go through phases where pretty much everyone is permanent and then, little by little, people move on and suddenly there’s a lot more bank. Usually this then leads to wards becoming a little less stable/safe as bank staff don’t know the patients as well. Eventually there’s a round of recruitment with golden hellos/ preceptorships/ development posts and then there’s lots more permanent staff again. It can take years for a ward to go round this cycle, and, of course, it doesn’t apply to all wards-some wards are wonderful places to work and have very few vacancies/bank staff.

A trust will generally try and fill as many vacancies with permanent staff as possible even if that means recruiting many NQNs. Add on students, and this means that there are many wards run almost entirely by students and NQNs with bank staff for support and a few harassed senior staff in the background. As you probably know, there’s something of a recruitment crisis in MH nursing in particular. As a student I was told I would walk into pretty much any band 5 job I applied for and this has been pretty much true.

I hope this helps. Why do you ask?

When you are treating people, how much information do you gather about that person? Do you ask their relatives and friends in order to get as full a picture as possible?

Or do you entirely rely on the patient?

I only ask because my ex is a rabid liar and minimises his abuse of me and our dcs to his psychiatrist as "out of character" and as "exchanges" and accuses me of abuse.

@JennieTheZebra

That was fascinating, thank you.

I was curious bec I was in two different wards and in one almost all the staff were bank nurses. (The other was a dystopian nightmare which I barely remember.) At times the bank nurses would sit in the observation room with their backs to the patients, apparently chatting to colleagues who, though standing facing them, could also not see the public' area of the ward. At least one man handled the female patients inappropriately; another regularly burst into anger and could be physically intimidating, even to female patients. Two or three men dominated the TV, and there was generally a very uncomfortable atmosphere. In addition almost all therapy session and activities were cancelled (ironically the CQC report praised them for their fabulous timetable of stiff). Nurses did not spot patients not eating. One patient tore strips off their bedsheet; when discovered (by a private therapist who visited), they initiated a regular check of the sheets, which did not happen once. There were also several electrical items with leads left lying about. You get the picture.

I was curious whether my experience was typical or not.

Thanks again for the info. It's a great thread.

Like everyone, some are nicer than others and some are better than others but I respect them and have good relationships with many psychiatry colleagues.

Sorry @BlastedPimples I was away and then ill and forgot to come back again.

Regarding how much information we get from others, usually we only get information from the person we are seeing unless they are under guardianship for whatever reason.

If there are things that we think it would be helpful to get an external view on we might ask for the persons permission to ask a relative but without their consent we would go no further.

Occasionally people phone to try and provide us with additional info but I would tell them that they really need to speak to the person themselves about contacting me, again, gaining their consent.

It does make it tricky though when people dont tell the truth.

Hi @scarecrow22

Sorry to take so long to answer but at least you got an answer to No 4!

1 - I dont know of any being trained by NHS. As far as I know in Scotland they pay for Doctoral Clinical Psychology training, CAAP's (Associates) and more recently Assistant Psychologists have been able to do additional training to become guaranteed Band 5's (I cant remember the name right now).
2 - Sorry but I dont know how long their training is - I think a lot do it part-time though so it may vary a lot.
3 - not many psychologists trained by NHS leave very early in their career but it is becoming more common. A few years ago I met a work force planner and they said Clinical Psychologists were really good for work force planning as they stayed for a long time and didnt move around that much. I suspect that has changed a lot now.

Sorry for delay @Thisisabsolutelyfine

I know many courses are trying to look at how the applications / those accepted can become more diverse and also the ACP (Association of Clinical Psychologists) has been looking at this. In the past there were quite a few honorary appointments which meant that only those who could afford to work for nothing could benefit.

There has also been talk of mentoring schemes although I haven't seen this in reality.

It really does need addressed but not sure the solutions, I suspect there are many professions with similar issues. There is a whole society issue about advantage / deprivation / access / education etc. It is quite depressing when you stop and think about it.

Hi @TheQueensCousin

Sorry for delay, we all have (or are meant to have) different job plans which set what tasks we should be doing and how much time we should be spending and that includes consultants. So for example we might be expected to see 18 people per week and the Consultant might only be expected to see 12, depending what is agreed. In some services there are a number of Consultants but someone who is the professional lead and so they will have more managerial responsibility.

It also depends on the size of the service and the managerial structure as to who is expected to do what.

The British Psychological Society did set guidelines as to how many people should be seen clinically per week and this varies by band. Consultants tend to be Band 8C and 8D whereas now 8B's are usually expected to have some management responsibilities.

Sorry, I realise my answer is pretty unclear!

I've met some lovely clinical psychologists when my children were being diagnosed with autism but why do you all look so young 🤔😂

"t does make it tricky though when people dont tell the truth."

Doesn't it render all treatments useless and a waste of time?

Yes but you dont know that and how can you? There is no way round that. and it is an unusual scenario.

If only I looked young!