|"My feelings at the end of the day will be almost entirely dependent on how the sessions went. When I feel I could have done more for someone it is amazing how strongly my own sense of self-worth can become momentarily entangled in the day’s therapy"
On paper, the structure of my day as a clinical psychologist is reliable enough that I rarely write it down. In reality, though, it’s highly unpredictable; its true nature dependent on the lives, experiences, ambitions-realised and challenges faced by my clients since I last saw them. I travel to work hoping that the people I am due to see have had positive weeks.
I provide psychological therapy for people with psychosis. I work mainly within the early intervention branch of the service, seeing young people experiencing a first episode of psychosis.
Appointments are weekly, for six to nine months and I generally see four clients per day. Afternoon slots are popular so I might spend part of the morning catching up on notes and correspondence, planning sessions, or in discussion with other team members: psychiatrists, nurses, social workers and vocational workers.
I provide evidence-based cognitive behavioural therapy for psychosis (CBTP). When I meet a client for a therapy session we will review their week, recap on our last meeting and decide together how to use the hour. This might be to continue an ongoing piece of work, for example helping the person to develop strategies and confidence in managing commanding voices while taking steps forward in their lives. If they have had a particularly difficult week we will make space for what is present.
The unpredictability of a psychologist’s day is bound up in the challenge of being with the person as they are in that hour, on that day, in that week, but in tying this to a principle that the person can take with them into their week ahead, and ultimately beyond a time-limited course of therapy.
On busy afternoons, the minutes between each session are important. I try to ground myself before seeing each person in the commitment and care that each person is deserving of and in the effort they have made to attend. The hope is that each client can feel as though my working week centres around their appointment.
During gaps in the afternoon I will complete my therapy notes. I prefer not to write much during sessions – unless the person and I are mapping something together – so it is important to write up a summary while things are still fresh in my mind.
I was fortunate to come into clinical psychology at a time when the idea of psychosis as an understandable and human psychological reaction to adversity is more widely accepted and respected by those providing care, and interventions are more consistently driven by clients’ own goals, values and personal models of recovery. Nevertheless, these recognitions are ongoing – when I hear stories of bullying, victimisation and stigmatisation it can feel like a long road to changing public perception.
My feelings at the end of the day will be almost entirely dependent on how the sessions went. When I feel I could have done more for someone it is amazing how strongly my own sense of self-worth can become momentarily entangled in the day’s therapy. When I feel that I have played a part in helping someone move closer to the life they value and deserve, it is the most rewarding work I can imagine.
Before leaving I will text or call the people I am due to see the next day, to catch up briefly or just to give a reminder. I quite enjoy these more informal contacts. It is lovely to hear if a person is out with friends, has had a good day at college, or has put a piece of our work into practice, and I am immediately struck by the efforts and energies that must have gone into facing such challenges.
I work with people able to draw from a seemingly unending well of courage and resilience. I genuinely have no idea what makes such strength possible, but I learn an enormous amount from my clients about what it is to be human.Read the full article here. www.theguardian.com 30/1/15