Surviving Clinical Psychology

Navigating Personal, Professional and Political Selves on the Journey to Qualification

James Randall, James Randall

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429768552
• Edition: 1
• Topic: Psicologia
• Subtopic: Psicologia clinica

This vital new book navigates the personal, professional and political selves on the journey to training in clinical psychology. Readers will be able to explore a range of ways to enrich their practice through a focus on identities and differences, relationships and power within organisations, supervisory contexts, therapeutic conventions and community approaches.

This book includes a rich exploration of how we make sense of personal experiences as practitioners, including chapters on self-formulation, personal therapy, and using services. Through critical discussion, practice examples, shared accounts and exercises, individuals are invited to reflect on a range of topical issues in clinical psychology. Voices often marginalised within the profession write side-by-side with those more established in the field, offering a unique perspective on the issues faced in navigating clinical training and the profession more broadly. In coming together, the authors of this book explore what clinical psychology can become.

Surviving Clinical Psychology invites those early on in their careers to link 'the political' to personal and professional development in a way that is creative, critical and values-based, and will be of interest to pre-qualified psychologists and researchers, and those mentoring early-career practitioners.

Part I
The context of clinical psychology

Chapter 1
What clinical psychology can become

An introduction

James Randall

This book is an invitation. Within these pages, the authors welcome you to different stories about training and practice within clinical psychology. We invite you to consider not only what clinical psychology currently offers society, but encourage you to explore what could be offered. By recognising the fact that you, as pre-qualified clinicians, are the people who shape our profession and are at the core of its future – we hope to invite you to use these pages to challenge us all; to tell us what clinical psychology should be offering to our communities and society as a whole.

Surviving Clinical Psychology holds very seriously the fact that the words on these pages can only go so far, and it is through what you do next that change can be fostered for the people we meet within our work and expand the possibilities of what clinical psychology can do for society. The pages that follow do not hold any ‘moulds’ for you to squeeze into, and do not detail any professional-sounding, award-winning scripts to impart upon those around us. The pages that follow look to remind you of why personal, professional and political differences are at the heart of clinical psychology’s future – but it is this, that can connect us.

Whilst this book may help guide your next steps, it will not necessarily pave the way to any predetermined destinations. It simply offers a reshuffling of priorities; a rethinking of what matters most when we are navigating our ways through prequalified roles and clinical training. This book redefines these notions of ‘becoming’ anything else, other than you – a person with a repertoire of experiences that clinical psychology would be lucky to welcome into the fold. This book offers a seat in an overly distracted and often damaging world. From here, you might uncover clinical psychology’s greatest swindle that to achieve more, you must do more. This only serves to perpetuate the individualising cogs that disentangle you from the web of support and community that is within an arm’s reach. This book calls on you to reach out to one another and to support one another – to create a sense of community throughout these turbulent times and testing terrains.

What Surviving Clinical Psychology invites you to do differently then, is do less, in a way. It raises the question of how much more we can achieve through disengaging with compulsive pulls to compete and instead, build platforms for one another in order to focus on doing what matters most to those who need our support. This book recognises that in order to do this, we must embrace our differences and support one another to survive within imperfect and sometimes, toxic systems. At the heart of this text is an invitation to reconnect with your values, your hopes and your passions, and to realise the potential of what you have to offer to clinical psychology – not necessarily what clinical psychology has to offer you.

Navigating the book: sections and chapters

Surviving Clinical Psychology is divided into four sections to enable you to navigate your way through as usefully as possible. Each section concludes with a shorter, reflective chapter, capturing a range of personal perspectives on the topics addressed throughout.

The context of clinical psychology

This section of the book invites you to consider some of the core practices of clinical psychology, what it means to be a supervisee and considers the ways in which pre-qualified journeys tend to be storied. This section of the book then concludes with a reflective discussion exploring the limits of ‘reflective-practice’.

The personal: the selves as human

This section of the book invites you to truly consider the ‘personal’ in personal and professional development, through a focus on personal experiences of distress, integrating values and principles of social justice into our relationships with others, and experiences of using personal therapy. This section of the book concludes with a chapter by two practitioners with lived experience of distress, reflecting on working within psychiatric settings.

The professional: the use of self in clinical psychology

This section of the book explores the significance of personal identities and differences within professional development, through a focus on diversity and the ‘Social GgRRAAAACCEEESSSS’, using psychological formulation to make sense of our own experiences, and considering the ways in which we can sustain ourselves throughout the journey, particularly training. This section of the book concludes with a reflective paper exploring the experiences of a teacher and student, considering their own experiences of psychological distress, identity and selfhood.

The political: selves and politics in practice

This section of the book invites you to consider a range of topics in which the personal and professional becomes the political. In doing so, we address issues relating to experiences of psychiatric diagnoses, power in organisations, and question ideas around therapy itself. This section concludes with a reflective conversation between trainee clinical psychologists as they navigate the political dilemmas faced within their training and practice.

Navigating the book: boxes

Surviving Clinical Psychology also invites readers to engage with the text and explore their own role in creating clinical psychology’s future. In supporting readers to do this, the chapters incorporate three different styles of boxes throughout the book:

Thinking space

These boxes provide a series of questions designed to encourage you to not only extend your thinking, but to consider ways to change and improve your practice. These boxes may for example, include particular material or statements for you to consider in greater depth.

In focus

These boxes provide accounts of lived experience, dialogues and reflections on practice, summaries of services, and examples of innovative initiatives. These In focus boxes are also used to bring examples of practice to life, through providing further details about particular concepts or models.

Reflective activity

These boxes provide you with short exercises to support you in developing the ideas from within the text, on the one hand to consolidate the information and questions within the text, but on the other, to actively engage with and challenge the material presented. At times, these activities may invite you to connect with others in order to extend the invitation beyond these pages and to open up dialogues with your peers and broader communities.

The values at the heart of Surviving Clinical Psychology

Too many books answer the questions of what is clinical psychology? And How do I become a clinical psychologist? Whilst these questions are important, and no doubt helpful aids on the journey to qualification, what these texts tend to omit is the much more complex, yet richer question of what can clinical psychology become? This latter focus is what lies at the heart of this text and within its pulse – a number of shared values and principles:

Inclusion and collaboration: only us

Surviving Clinical Psychology addresses a range of experiences throughout its chapters and includes many examples of adversity, psychological distress and health difficulties more broadly. In editing this book, it was very important for me to challenge multiple falsehoods of clinical psychology (and the helping professions more broadly). One such notion was the idea that individuals experiencing any form of psychological distress are in some way different to the likes of you and I. When working in an in-patient unit as a health-care assistant, I recall a person asking me: “How on earth do you do this?” I recall their surprise, when my answer was simply, “I just start from the point in which this could be myself or any one of my family in here, and I start from there”.

Surviving Clinical Psychology welcomes many authors who just like those who access our support, identify as having their own lived experiences of psychiatric services, mental health difficulties, and/or societal adversities. Key to this is a rejection of the discursive divides of us and them, and an opening up of dialogues around what it means to sit on both sides of the proverbial therapy chair – to be practitioner and someone with lived experience of distress. As such, Surviving Clinical Psychology resigns ‘case studies’ to a clinical psychology that has pathology rather than social justice at its core, and invites readers instead, to think about psychological distress as defined by those who have experienced it themselves. After all, “the ultimate power is the power to define. We have that power. Let’s define our experiences… for ourselves. Let’s define the world” (Kinouani, 2017).

Surviving Clinical Psychology thus sets out a new vision for clinical psychology that draws its lessons from the lived experience and accounts of the people themselves. Similarly, then, in writing about pre-qualified practice within clinical psychology, this book acknowledges that we must create contexts for individuals and communities to be heard. This book aims to be one such platform. Within these pages, individuals from minoritised groups and those traditionally margin-alised from the profession, share their accounts and highlight their vision for what clinical psychology can become. Writing in collaboration with those from across all stages of their career, the authors within this book have contributed to a larger story of advocacy, mentorship and support in process and practice – through coming together, sharing, collaborating, challenging one another, writing, and consulting far and wide. For “omission is a powerful statement” (Starr & Weiner, 1981) and in some ways, this book offers a counter-statement to the profession – inclusion is a powerful action.

Reflective activity: joining the conversation

As this book is about and for you, it would be short-sighted to not have you involved in some way, shape or form. As such, we invite you to contribute to the topics discussed in this book. Perhaps you would like to share your reflections about some of the activities included, to add to the debates, or to share your own experiences. Importantly, this is about clinical psychology welcoming your perspective to the fold. This is a clinical psychology that reaches out.

Join the conversation at #SurvivingClinicalPsychology

Social justice and community psychology

This book celebrates what clinical psychology can become with you on its side, acknowledging a need for something to change. This is a profession whose history is rooted in disconnecting individuals from their social context. A profession that has secured status and a powerful standing within the professional market, through predominantly placing the impetus for change on the individual. Clearly, “we’re working hard, and working harder isn’t working. The sense of a particularly individual incompetence [creeps] in. This is the dirty work of isolation” (Reynolds, 2019, p. 7).

From within the walls of clinical psychology itself, Surviving Clinical Psychology tries to disentangle clinical psychology from this purely self-centred point of view. The connotations here are purposeful. On the one hand, clinical psychology needs to look beyond the individual and to address the needs of communities. In doing so, the profession has to take very seriously that we are already well aware of the key determinants for psychological distress and poor health (e.g., poverty, homelessness).

Surviving Clinical Psychology then, attempts to invite you to (re)consider your personal and professional development, with the political very much at the fore-front throughout. As understandable as it is to aspire for a sanitised and ‘clear-cut’ science, this book cannot accept a clinical psychology without politics. A clinical psychology without politics at its heart would only be reputable in as far as it is farfetched and unintelligible; dangerously decontextualised from the lived reality of hardship and distress and the potential of such an approach to do harm itself.

Surviving Clinical Psychology opens up a dialogue that invites you to join others already addressing the social and material conditions that lead to poor health and psychological distress. The third-sector, charities, grassroot groups, and service-user organisations, among many others, have been leading the way on much of this work for decades, and it is time we started to seriously listen to them and take action together.

In focus: the context and language of survival

In naming this book, I chose to use the language that resonated for those within the pre-qualification community. Through years of consultation and representation, the message was clear: for individuals hoping to one day train as a clinical psychologist, the journey is often experienced as turbulent and something to survive. The message has uncomfortable undertones, particularly in relation to the relative privileges aspiring psychologists are often afforded. Also uncomfortable in light that something so hoped for and aspired for – could also warrant a survival of sorts. This on the one hand, reflects the unclear routes to training and structural uncertainties embedded in a hugely popular, yet under-resourced career path. On the other, unqualified practitioners often find themselves in services overstretched, under-funded and facing financial cuts – fostering and perpetuating the very conditions that increase a demand upon our services in the first instance. And so, prequalified practitioners find themselves seriously considering ways in which to survive such detrimental conditions and the negative impact such conditions have on their own mental and physical wellbeing. Secondly, they find themselves considering ways to sustain themselves during difficult times, in order to ...