What is Clinical Psychology?
Strickly speaking, Clinical Psychology is not a specific type of therapy, but rather a branch of applied psychology.
Compared to other groups (e.g. doctors, nurses) it is a relatively small profession, numbering about 10,000. It is also quite a young profession, only about 50 years old.
The role of a clinical psychologist is to promote psychological well-being and reduce psychological distress. Clinical Psychologists usually work in hospitals in both medical and mental health in-patient settings, in community mental health teams, private clinics, universities and sometimes in the not-for-profit sector.
Work in these areas can involve the provision of a variety of psychological interventions, also research, development of treatment approaches and/or treatment evaluation, service delivery, training and supervision.
An experienced clinical psychologist working in the NHS will have gained exposure to many different client groups in a variety of mental health settings. This exposure provides them with a broad skill-set, equipping them to work at a high level with diverse populations and problems.
Clinical Psychology Training
Clinical Psychology training is funded by and takes place within the National Health Service. Before someone can use the title of Clinical Psychologist, they must be registered with the British Psychological Society (BPS) and have gained a specialist postgraduate qualification.
The postgraduate qualification is full-time and takes place over three years. The profession of Clinical Psychology is regulated by the Health and Care Professions Council (HCPC) and the British Psychological Society (BPS).
Training takes place in both university and a combination of NHS settings that offer services to the following populations: children/adolescents; adults; those in later life and people with learning difficulties.
Clinical psychologists will have an ‘eclectic’ training consisting of several different therapeutic modalities. Although the modalities studied and practised will depend in part on the combination of university and clinical placements, they will usually include Cognitive Behavioural Therapy (CBT), Systemic and Psychodynamic approaches.
These trainings will often be incorporated into an Integrative approach and many clinical psychologists (in a similar way to therapists from other trainings) would describe themselves as Integrative Practitioners. Following on from initial training and clinical work, psychologists may undertake training in an additional therapy or therapies.
As with other therapists, a commitment to continued professional development is expected by the professional bodies regulating clinical psychology (BPS, HPCP). This is for the purpose of remaining up to date with developments in therapy and research.
Aspects of Treatment
Creating a ‘formulation’ with the client is a cornerstone of the way many clinical psychologists work. A formulation is usually a written document compiled during the early meetings between client and psychologist.
Using an Integrative approach, a clinical psychologist will be able to collaborate with their client to produce a coherent, holistic formulation that takes into account the following factors: Problem description, – creating a clear, agreed-upon outline of the problem; predisposing factors that contributed to the problem (e.g. loss of a parent as a child, childhood trauma); precipitating factors in terms of events that are close in time to the development of the problem (e.g. loss of job, divorce); perpetuating factors are those aspects of a problem that help to maintain it (e.g. allowing others do help in a way that disables, rather than enables the person with the problem); protective factors refers to positive attributes of the person that can be utilised to help with their problem (e.g. a sense of humour, abilities and skills).
The formulation, in turn, informs the subsequent therapeutic work that takes place. Therapy can be focussed, time-limited with identified appropriate goals. Or it can be more explorative, open-ended and less goal-focussed.
Whatever the framework, agreed-upon change of some order would be an expected outcome. Throughout therapy, most clinical psychologists take an open, curious stance, adopting a reflexive position that implies self- awareness of their own assumptions, motives, cultural attitudes, and interpretive lenses.
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