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What is a Clinical Psychologist?

Hannah Sugarman

If you aren't sure, you are not alone. I'm pretty sure most people (including my own family and friends) don't really know what being a clinical psychologist actually involves. So let's get started with what people think we do:


A graphic with the title "psychologists" showing six different images each with its own caption. "What my friends think I do", with an image of Derren Brown, the illusionist. "What my parents think I do", with an image of some false teeth chattering. "What society thinks I do", with an image of Sigmund Freud. "What clients think I do", with an image of a doctor in a white coat with a clipboard. "What I think I do", with an image of Tony Soprano in a session with his psychologist. "What i actually do", showing a woman in front of a computer screen with an expression of despair, sitting next to a pile of paperwork.
Image retrieved from a 2016 article by Carolyn Anderson on LinkedIn

From my conversations with people over the years, I've found the above image to be pretty accurate! Most people don't have a clear understanding of what a psychologist is and what we do...and why would they? A lot of the time, peoples' jobs are a mystery to everyone except them! Here, I want to offer an explanation of what a psychologist is, so that people can know to seek one out if they reach a point of poor mental health that they cannot overcome without professional support.


What is a clinical psychologist?


We work with people who are experiencing mental or physical health problems, using proven treatments to help people to overcome symptoms of poor mental health. Clinical psychologists typically work in "clinical" settings - that is, in healthcare settings (this can mean services for physical or mental health, or both). We are trained to work with people who are experiencing "clinically significant" distress. This means that they might meet criteria for a diagnosable mental health problem. That said, many of the people we work with have not been diagnosed with a mental health problem, but are experiencing symptoms of poor mental health. The principle I tend to stick to is: Clinical psychologists support people when their mental health is getting in the way of their lives in a significant way.


Our work requires us to check the evidence regarding what works best for someone's presenting problem. This is how we decide which treatment to offer; we use recommendations like NICE to select an evidence-based approach to support our clients.


But what do clinical psychologists actually do?


A man sitting on a sofa with his hands clasped together

The short answer is: We do our best to help people to understand and manage mental health problems and/or other changes that affect how you think and behave. This is often done via psychological therapy.


Of course, the long answer is a bit more complicated than this (feel free to scroll past if you aren't interested in the long answer!). Clinical psychologists work across a huge range of settings, and what we do day to day is quite different according to where we work. Some of us work with individuals, some with couples, some with families, some with only adults or only children...each clinical psychology role is slightly different. For example:


  • Psychologists working in adult mental health services (such as NHS talking therapies) may do a lot of one-to-one work with individual clients, offering assessments and psychological therapy to help people to overcome difficulties by making changes to how they understand and cope with their problems.

  • Psychologists who work with children and young people will do a few different types of work alongside direct work with the client. They may do some work with the child's parents and other people in their "system", such as siblings or teachers. For very young children, a psychologist might not work with the child directly very much at all, but try to make changes by working with the child's parents and the people around them.

  • Psychologists who work with older adults might work both with individual older people and the people they come into contact with, such as a spouse, other family members and care workers. In these settings, psychologists may work with mental health problems such as panic disorder or depression. They might find themselves supporting people with issues that are sadly fairly common in older people; for example, managing bereavement, or anxiety about increasing frailty. Psychologists in these settings may also help to assess someone's cognition (thinking skills like memory, attention and processing speed) to help to determine whether they are experiencing dementia.

  • Psychologists working with people who have experienced strokes or other neurological conditions may spend quite a bit of their time considering how someone's cognitive abilities were affected by the damage to their brain. They might undertake detailed assessments of this using sensitive tests that help them to identify exactly which parts of someone's thinking have been affected. They will often work closely with other professionals (like physiotherapists, speech and language therapists, occupational therapists, doctors and nurses) as well as the person and their family to bring together information about someone's mental health and cognition to help to make sense of what is happening for them as they learn to live with any changes they have experienced.


So, you can see how varied the clinical psychologist roles are. And this is just a few examples: you'll find clinical psychologists across a wide range of settings in the public, private and charity sectors.


How is a clinical psychologist different from a counsellor or a psychotherapist?


There is a lot of confusion about this, quite understandably! The role of a clinical psychologist can seem pretty similar to other professionals, and in part, it is. Like counsellors and psychotherapists, we offer talking therapy for people going through periods of stress or poor mental health. However, the length and nature of our training and the wider scope of our role looks quite different. The main things that set clinical psychologists apart from other professionals in the field are:


  • We have to complete an undergraduate degree in Psychology (some people go on to also complete a Masters degree)

  • We then have to complete a Doctorate in Clinical Psychology at one of 38 approved universities in the UK. This training takes 3 years, and applications are competitive, so most trainees have quite a bit of experience under their belt by the time they start the course. By the time they qualify, most clinical psychologists have been working in the field for between 8 and 10 years;

  • As part of our training, we have to pass training placements in adult settings, with children, with older people or people with learning disabilities, and two specialist placements. We have to pass a number of competencies that confirm we are able to work with a diverse range of clients, across the full range of severity and complexity;

  • We undertake a research project as part of our doctoral training (here's mine!); this is a substantial part of our training and we are expected to become experts in research methodology and the critical appraisal of research;

  • We must train in a range of different models, allowing us to use different approaches to best meet the needs of our clients;

  • In order to practise in the UK, we have to be registered as a "practitioner psychologist" with the Health and Care Professionals Council;

  • In addition to delivering psychotherapy, clinical psychologists are expected to undertake detailed assessments, offer consultation, training/education and be engaged in research and service development initiatives;

  • We tend not to rely on diagnoses; instead, we use our training to develop a formulation of someone's problems that helps to explain why they are having a particular issue at a particular time, and what they can do to overcome it.


In summary:


The role of a psychologist is varied, and goes beyond providing therapy.

Although some parts of our role can look very similar to other professionals such as counsellors and psychotherapists, the route to training and wider activities we undertake are quite different.


I hope this provides a useful overview of what a clinical psychologist is! Want to know more? Get in touch!




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