The most common historical association with psychology has to be Sigmund Freud and the terms Freudian slip and the Oedipus complex. If you don’t know about the latter, it’s probably best not to Google as it may just put you off psychology altogether. Freud did go on to break the mould with less toe-curling theories, by focussing on the idea that mentally distressed folk could be helped, not through medical intervention, but through talking alone. His idea of a ‘talking’ cure laid the foundation of modern psychology, allowing a plethora of talking interventions to cultivate over time.
Clinical psychologists play crucial roles in delivering such therapies however, despite the first clinical psychology clinic opening in 1896 and the number of clinical psychology training places growing exponentially since the 1950s, there still remains an air of mystery around what a clinical psychologist actually does. Primarily, clinical psychologists are trained to doctorate level to help implement therapeutic interventions. The bestowed title of doctor can lend itself to bewilderment and raised eyebrows given that medical training is not a part of the core training of a clinical psychologist. With the apparent confusion about the role, the true value placed on clinical psychologists within the NHS is questionable, and it can only be hoped that clinical psychologists are not likened to the Friends character Ross, who frequently got laughed at by his ‘friends’ when he claimed to be a doctor.
Thankfully, at its 70th year the NHS has somewhat recognised the utility of psychology creating posts in innovative and diverse clinical settings such as intensive care units, neuropsychiatry, gender identity clinics and so forth. This may be due to a recognition of the core skills clinical psychologists hold. Primary, focus on high quality thorough assessments, relying on the integration and interpretation of complex data to formulate ideas about the development and maintenance of difficulties, helps to direct patients and teams to the most useful treatment interventions ensuring resources are fully utilised and supporting cost-effective provision. Assessment skills can also be applied to teams, providing an extremely useful medium through which discussions can be held. Reflective groups, supervision and even off-the-cuff discussions with clinical psychologists often provide a safe forum for teams to air their concerns, discuss difficult cases, learn how to formulate their work with clients and feel heard and understood. Without the space to think reflectively and assess practices, teams run the risk of becoming disjointed and disheartened in the current economic climate governing NHS practice.
Trained in research, audit and evaluation, clinical psychologists are also able to use their knowledge to effectively evaluate a range of issues. Audits can capture data on frequency of use or adherence to diagnostic specific interventions or referral routes to psychology for example. Research can evaluate the impact of organisational changes on staff morale or productivity. The scope is vast enough to allow research to be meaningful to its service.
Clinical Psychologists have access to eager young trainee clinical psychologists who are ready and willing to conduct small and large-scale research on a range of questions or issues which are pertinent to the NHS. With this assistance, there is an opportunity to conduct research in a systematic and evidence based way. Managers would benefit from seizing this prospect to allow psychologists to utilise their skills and raise the profile of services upon research dissemination. Not doing this simply leads to wasted opportunities and over time, a loss of an important skill base.
It is highly unlikely that Clinical Psychologists will ever master the much sought-after skill of mind reading, however the profession will continue to develop its core competencies in assessment, formulation and intervention, research and evaluation, supervision and consultation and perhaps most importantly leadership. NHS senior level staff must pay heed to the fact that an increasing number of clinical psychologists are side stepping into private practice and to then question how services can continue to meet the needs of Clinical psychologists.
The focus for clinical psychologists within the NHS will not necessarily be to change their role, but to showcase their skills in leadership and management. With the unity of resource, support and opportunity, clinical psychologists in high-performing roles can help bridge gaps in communication between frontline and senior level staff, aid transformations, provide forums for reflective practice and continue to disseminate psychological knowledge and interventions to assist therapeutic and organisational change. One might say that the core role of clinical psychology hasn’t really changed and like Freud, its founder, the profession will continue to break the mould, even if it has to be against the odds.