Part 1 the Role of the Clinical Psychologist

FAQs

PART 1 – THE ROLE OF THE CLINICAL PSYCHOLOGIST

(1)What is a clinical psychologist?

Clinical psychologists are trained to understand the human mind, people’s behaviour and their emotions. This helps them to understand how complex mental health problems are and how they can develop so often. Clinical psychologists also help to reduce distress and to improve psychological wellbeing.

(2) Where do clinical psychologists work?

In Scotland, the majority of clinical psychologists work for the NHS but some work privately or with community organisations. A smaller number of clinical psychologists work in Universities focussing on teaching, training or research.

Clinical psychologists may work in many different settings, including:

Adult Mental Health
Older Adults
Child, Family and Adolescents
Forensic
Learning Disability
Neuropsychology and Brain Injury Rehabilitation (eg: stroke, head injury and dementia)
Clinical Health Psychology (eg: cardiac, plastic surgery, pain)
Rehabilitation of Long Term Mental Health Conditions

(3) How does a clinical psychologist work?

Clinical psychologists mainly work on a 1 to 1 basis with people, but family members and carers may be involved.For example clinical psychologists might help children experiencing distress by working with their parents. They may also help in preventing psychological problems developing and in improving NHS services, or by providing advice, supervision and training to other professionals.

Clinical psychologists assesspeopleto developformulations and treatmentplans using evidence based practice. They thenevaluatepeople’s difficulties, to make sure that their approaches are really helping clients to make helpful changes in their lives.

An ‘Assessment’ involves gathering information to understandaperson’s problems.It is completed in a variety of ways, such as by speaking to the person and their carers, through questionnaires, and by making observations of the person.
‘Formulation’ is an on-going process carried out by clinical psychologists using information gathered during assessment and treatment. It involves working out with the client a summary of how their psychological problems have developed and which factors have kept them going.For example unhelpful thinking patterns and behaviours can cause problems to remain.
Clinical psychologists treat people using ‘Evidence based practice’. This means that they use the best available research evidence to guide what they do. For example, several psychological therapies have been proven scientifically to help people with various different kinds of psychological problems.
‘Evaluation’ is when the clinical psychologist reviews whether the psychological treatment for the person has been effective. This could involve asking them whether they feel their difficulties have improved, or by repeating questionnaires or observations. These findings can then be compared to information gathered when the personfirst came to see the clinical psychologist.

(4) What training does a clinical psychologist have?

Training usually takes between 7 and 9 years. Usually, staff complete an undergraduate psychology degree and then work as assistant or research psychologists for at least one to two years before applying for clinical training. This now involves a 3-year doctoral course (a higher degree - usually a Doctorate of Clinical Psychology), which includes clinical placements in adult mental health, children and families, learning disabilities, older adults, neuropsychological assessment, and specialist placements.

Once trained, clinical psychologists continue their training through continuing professional development to allow them to further develop their skills.

The Division of Clinical Psychology in Scotland (DCP-S)is the professional body of clinical psychologists and part of the British Psychological Society.

(5) How can I check if a clinical psychologist is legally allowed to practise?

The law requires clinical psychologists to be registered with the Health & Care Professions Council (HCPC) if they wish to practise (to work in clinical psychology). You can check whether a psychologist is legally registered on the HCPC website.

The HCPC was set up to protect the public. Professionals who register with the HCPC meet agreed standards for their training, professional skills and behaviour. The HCPC can take action against health professionals who fall below these standards and can prosecute those who pretend to be registered. Complaints can be made to the HCPC.

(6) What's the difference between a clinical psychologist and other mental health professionals?

The main difference between clinical psychologists and other staff working with mental health problems is that clinical psychologists usually have a wider range of training. They can therefore work the widest range of clients and work with all severities of mental health problems from the mildest difficulties to the most severe problems.

A clinical psychologist typically has a degree in psychology, and additional postgraduate professional training in clinical psychology (usually a Doctorate of Clinical Psychology). They may also have additional qualifications such as a Masters or PhD. Clinical psychologists do not have a medical qualification (although many have the title ‘Doctor’) and they cannot prescribe medication. They have extensive training in a range of psychological assessments and talking therapies, such as Cognitive Behavioural Therapy, Interpersonal Therapy or Psychodynamic Psychotherapy. Their training also involves working with people across the lifespan from children to older adults.
A counsellor, therapist or psychotherapist differs from a clinical psychologist because they are usually trained to use one specific psychological approach and often only to work with one client group e.g. children and adolescents. They may or may not have a degree, and their therapy training can vary from a few weeks to doctoral training over several years. Registered psychotherapists usually have extensive training. Counsellors and therapists are usually only trained to work with less severe difficulties. Psychotherapists can work with more complex problems but tend to use a single approach instead of a combination of approaches.
A Psychiatrist is a qualified medical doctor who has specialist training in working medically and often psychologically with mental health problems. They sometimes work in the same team as the clinical psychologists and may see a person over the same time period. They focus more on the medical aspects of psychiatric illness, and they are able to prescribe anti-depressants and other medications. However, some psychiatrists also train to become psychotherapists after completing their psychiatry training.

(7)How do patients see a clinical psychologist?

In Scotland, patients are usually referred to a clinical psychologist by their GP. If a patient is seen in a community mental health or hospital team, staff within that team (for example: a Psychiatrist or Community Psychiatric Nurse) may be able to refer to Clinical Psychology. People with physical health difficulties can also be referred by others in a hospital team, such as a general doctor,depending on their condition.

It is also possible to see a clinical psychologist privately either through your GP or by contacting the clinical psychologist directly. It is recommended that you check their professional qualifications before you contact them (see Question 5. How can I check if a clinical psychologist is legally allowed to practise?).

(8) There is a long waiting list for this service but I need to see someone now – what should I do?

It is recommended that you speak to your GP about getting alternative help if you become very distressed or concerned while you are on the waiting list to see a clinical psychologist. They may be able to provide you with alternative options for helping you with your difficulties whilst you are waiting to be seen.The Scottish Government has set a target that by 2014 all individuals referred to see a clinical psychologist will have been offered treatment within 18 weeks, if this is suitable.

(9) I am afraid to use psychology services in case I am ‘sectioned’ – is this likely?

Being ‘sectioned’ is another word for being detained under the Mental Health (Care and Treatment) (Scotland) Act 2003. In rare circumstances, if a psychologist considers that a person is a danger to themselves or to others they may contact psychiatric services who have legal powers to require individuals to remain in psychiatric hospital so that effective treatment may be provided for them. However, clinical psychologists more typically work with a variety of other services to reduce the likelihood of people needing to be taken into hospital.

(10) I have heard about CBT – What is this?

‘Cognitive Behavioural Therapy’ is a talking therapy that explores cognitive (thought processes) and behavioural (what you do) aspects of a wide range of mental health problems (for example: anxiety; depression; eating disorders, bipolar disorder, and schizophrenia). CBT enables you to find more helpful ways of thinking and behaving, to help improve mental wellbeing. This approach is often used by clinical psychologists because lots of research has been completed to prove that it helps with a very wide range of difficulties. For more details about CBT including a video explanation of it by Professor of Psychology David Clark visit the nhs.uk website.

(11) What can I expect if I see a clinical psychologist?

How many sessions am I likely to need? Sometimes a clinical psychologist will only see you once and then refer on to other healthcare professionals if this seems to be the most helpful plan. Otherwise the number of sessions you need depends on the problem you present with. As well as using their own judgement, clinical psychologists are guided by published standards about how many sessions are usually needed to treat certain psychological problems. Sessions are usually weekly or fortnightly.
How long do the sessions last? Health Boards vary but assessment sessions usually last 30-60 minutes and therapy sessions usually last 50-90 minutes.
Will I be prescribed medicine? Clinical psychologists are not allowed to prescribe medication as they are not medically trained. Your GP or psychiatrist will discuss with you about whether they feel medication is medically appropriate for you. However, a clinical psychologist can help you to consider whether medication is ‘right’ for you personally. Often a combination of medication and therapy works best.
Can anyone else attend with me? Talk to the clinical psychologist about whether or not they feel it would be helpful for you to have somebody to attend the sessions with you. There are certain cases where it would be more helpful for you to be seen alone. The clinical psychologist will often ask about options for involving significant others and carers. If an interpreter is required this can be arranged for you.

(11) If I'm not happy with thepsychologist allocated to me what can I do about it?

If you are not happy with a clinical psychologist try to talk to either them or someone in the service about it. Take someone with you if you feel this would help you to put your point across. If you want to make a formal complaint follow your local NHS guidelines or seek advice through the Patient Advice and Support Service (PASS) via your localCitizens Advice Bureau. You can also complain to the Health and Care Professions Council.

(12) Where can I get details of local self-help groups, other supportsetc.?

Support and self-help for clients and carers varies across Scotland. Your GP, clinical psychologist or a professional involved in your care may be able to tell you what is available. The following national organisationsoffer good starting points:

The Princess Royal Trust for Carers
Patient Advice and Support Service (PASS) via your local Citizens Advice Bureau.
The Scottish Independent Advocacy Alliance can help you find advocacy organisations in your area.
SAMH is the Scottish Association for Mental Health and provides advice and support.
The majority of Long Term Conditions have a national charity. This can be a good way to find local groups.
The Samaritans
Breathing Space
VoX is the Scottish national mental health user network
The NHS Inform website is designed to be a single source of quality assured health information for the public in Scotland.

The Royal College of Psychiatrists is the professional and educational body for psychiatrists in the United Kingdom and the Republic of Ireland. This web site offers access to many self-help guides for a range of mental health conditions.

Compiled by Dr Mairi Albiston, Clinical Psychologist, and Jude Clarke, Service User and Carer Rep, both of the DCP-Scotland, with contributions from Dr Stephen Marks, Clinical Psychologist, NHS Greater Glasgow & Clyde, North East Glasgow and East Dunbartonshire.