Hello!
Gosh, feels a bit weird to return to this blog pretty much a full year on from my last. I’ve not written for ages, but that’s okay – this was never going to be a big project, but I hope once I’m done training it will at least offer a bit of perspective on what life looks like from pre-training and beyond.
So my first year is basically DONE. I have one week left before I go on a well-deserved break and that takes me up to the end of my first year placement and hand-ins. So what have I learned?
- Primary care is not for me.
Oh man. IAPT is a beast, isn’t it? It is the biggest provision of evidence-based psychological therapies basically anywhere in the world. It’s meant like, a bajillion people have been able to access therapies where before they would have been left basically unsupported. It’s created a whole new psychology workforce and meant that more people than ever before are trained in evidence-based psychological therapies or self-help. Excellent. Good! Wow.
I have been in IAPT for a whole year. I have learned loads. I consider myself now to be something of a whizz at some of the disorder-specific CBT models, and find them deeply satisfying to work within when the person’s difficulties match with them. I have been lucky to have a good supervisor who has helped me think as flexibly as one can within the IAPT model. But overall, I’ve really hated it. This is not a bash on IAPT as a whole – more my reflections on why I don’t think I’m well-suited to it:
a. The data – look, I just don’t care about the data. I use measures with my clients and they can sometimes find them useful, I understand the need for some systematised way of collecting data. But I don’t give a teeny tiny shit about manipulating how I record my contacts to help with the recovery data, I don’t care about recording my client’s benefit status every single fucking session, and I find it really hard to get on board with discharging people because they’re now ‘subclinical’. Nope. No thank you. This is in violation of my own values and morals. Goodbye.
b. CBT – CBT works for some people, some of the time. I have seen some absolutely amazing transformations with mine and other’s clients using CBT and I love that people are now able to access this pretty routinely without much fuss (though with a v long waiting list…). But for some people, it doesn’t seem to stick. One of my biggest frustrations is when people’s problems don’t really fit with any one disorder-specific model. This, in my experience, is where IAPT starts to struggle to accomodate people. It’s also difficult as a trainee psychologist, I think – I am not training to be a CBT therapist, and yet all I am doing is very standardised CBT, and when this doesn’t fit I have to push o with it anyway. I’ve definitely gained a strong CBT foundation that will be so useful for me in placements and jobs to come, but it’s been at the expense of any broader thinking, which is a shame.
- Your cohort will get you through.
I am lucky to be on a relatively big course, so the pool of new people has been a bit wider than perhaps in other courses. I’m pleased about this, as I’m not from the traditional trainee demographic mould, and was a bit worried about finding people on my wavelength. But I absolutely have. It’s weird – I would liken making cohort friends to a holiday romance. It’s so intense and you’re in this weird bubble all going through the same exciting thing at the same time; bonds form fast. I can’t believe I haven’t known these people for even a year yet. We had exams (who thought revising for exams while working full time and still learning new content at uni was a good idea, honestly!?) and it was tough. But we got through, pooled resources, shared flashcards and library dates, and then all collapsed in a delerious drunken haze at the post-exam night out. The same practical support happens for placement too – got a stupid question about a CBT thing you should definitely know now that you don’t want to ask your supervisor? Hit up the group chat. 22 messages and a gif or so later, you’ve got your answer and prevented yourself from looking like a knob in front of your supervisor. Winner.
- You are going to feel like you have no idea what you are doing the vast majority of the time and you need to start feeling okay with that.
Not sure really what to add to the above. Remember that sweet, sweet assistant life? Where everyone banged on about how great you were all the time? Where you and your spreadsheets were totally in order and you had a very organised to do list? Where you felt pretty competent in your role, and just all shiny and pleased to be getting to do assistant-things in your shiny new assistant-job? Ha. Yeah, that disappears rapidly. I have never felt more incompetent in my life as I have this year. I am starting to feel okay about it; starting to feel comfortable saying ‘no, I’m sorry, I have no idea what I need to do – can you help explain again?’ I still quite frequently sit in sessions thinking ‘ummmmm’. I have it on good authority that this feeling never goes away, so buckle up.
- It really is just a course.
The DClinPsy is put on a mighty high pedestal. I am so priviledged to get to do the course, don’t get me wrong. It gives me access to a career I will be proud to do, and have wanted to do for years. Don’t even get me started on the fact we get paid to do this! But it is also… just a course, like any other.
You will have days of lectures where you have to mainline an espresso in every break to keep you going through the next 33985 badly formatted powerpoint slides. You will have days on placement where you feel so frustrated with the system/government/team/world that you just wanna quit and open a bakery (my plan B career). You will have pointless paperwork and buerocratic nonsense that infuriates you perhaps more than it should, and you will have essays, coursework, case reports, and exams that bore you half to death and leave you led on your bed staring at a wall as it’s the preferable, more interesting option. This is okay, it’s all part of the process, but it’s one that doesn’t get spoken about all that much. The DClinPsy, with all its highs and lows, is a means to an end and elevating it to this impossibly high esteem helps nobody.
That’ll do, I reckon. Maybe see you next year?







