What’s a clinical psychologist?

One of the most common misconceptions in mental health is what a clinical psychologist is and what they do. Very often, people have no idea what distinguishes us from psychiatrists, except that they associate us with having a chat over a cup of tea and a biscuit. Here then, is my quick and dirty guide to the distinction.

A psychiatrist is a medical doctor who chooses to specialise in mental health. They may work with adults, children, offenders, people with learning disability or brain injury. They are licensed to prescribe medication and some will also do some kind of psychological therapy. A medical degree takes five or six years and then speciality training takes another six or seven. You can probably make it to consultant by 31 or 32 but most people take a bit longer than that.

A clinical psychologist is not required to have a medical degree. They will have an undergraduate degree in psychology and experience of working with people with mental health problems, learning disability, autism or brain injury. To qualify as a clinical psychologist you have to do a doctoral degree (thus both psychiatrists and psychologists are ‘Dr’, but different types of Dr) which includes research as well as clinical work with a range of different groups (children, adults, older people, people with learning disability, at the very least). A person doing this course is referred to as a ‘trainee clinical psychologist’ and despite the fact they’re not qualified, they usually have several years’ experience. Because of the nature of clinical psychology training, trainees tend to be quite varied in terms of age – on my course, there was probably ten years between the youngest and the oldest, and we were known for being a remarkably ‘young’ cohort. It is not unusual for people to begin training in their thirties, forties or fifties. Because we are not medically qualified we do not prescribe drugs, but we do an awful lot of other stuff. We do therapy, of course, whether that is for individuals or families. We run groups for people who may have similar difficulties. We do research and teaching and we often do staff training to help them work with the people they see more effectively. We do assessments of cognitive functioning, such as when we receive a referral for someone with suspected dementia (in fact, only psychologists are allowed to do this). We also do work with staff groups if they are finding particular patients or residents difficult to understand or work with. This is especially common when working with people who have dementia or a learning disability – often people who have these problems find it difficult to communicate what they want or need, so they don’t get it. They can become frustrated and sometimes they behave in ways which others find challenging, such as hitting or kicking. Psychologists are trained to see behaviours as a means of communication and to look for patterns which might give us some idea of why someone is acting in a particular way. Once we know why we can do something to change the behaviour, perhaps by changing their environment or ensuring they have access to the things they want. That sounds relatively straightforward; in reality, it takes quite some to get a good understanding of the problem and the underlying cause; not to mention trying to think of possible solutions. On top of all that, we are used to dealing with risk of harm (to self or others) and are often included in crisis planning.

So we do a lot aside from having a chat. But if I’m honest, whatever we’re doing, we’re usually happiest if we’re doing it in the company of a cup of tea and a biscuit.

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