Clinical psychology training placements in London

With the national expansion in training numbers for clinical psychology, London's training courses require more placements than ever. This is the third in a series of articles where trainees and their supervisors describe a clinical psychology placement from their different perspectives. 

The aim of the series is to illustrate some novel and specialist placements which clinical psychologists in London may not be aware of and remind those qualified colleagues who don't regularly supervise what a rewarding and important professional activity this can be.

This interview involves supervisor Jenny Cove and her trainee Rhiannon Storrie talking to Keith Miller about working together in a specialist placement as part of the psycho-oncology service at North Middlesex Hospital in London.

The service consists of a small psychology team and has an establishment of a half-time 8c and a full-time 8a post. The aim of the service is to provide emotional and psychological support for people with cancer as part of a four-stage model of professional psychosocial support provided across the cancer pathway.

• Level 1 support is provided by all staff responsible for the care of people with cancer
• Level 2 is enhanced support provided by professionals with additional training, typically clinical nurse specialists (CNPs)
• Level 3 and 4 is specialist support provided by trained professionals, including CPs and CPs in training

Jenny spoke about the unique nature of the placement experience for trainees.

There is a wide range of work within a health psychology setting and trainees have the opportunity to develop their health psychology expertise working with a supportive multi-disciplinary team, as well as using and developing a wider range of transferable skills.

The focus on clinical work is on supporting patients to adjust to challenging and potentially life-changing health situations. Trainees have the opportunity to deliver direct clinical work (inpatient and outpatient) for people with cancer and their families using a range of different psychological approaches including ACT, Mindfulness, CBT and CFT, with referrals coming mostly from the CNPs. They also provide psychological skills training to members of the MDT, support and supervise CNSs through clinical discussion groups, provide consultation to the MDT and support service development projects.

During the pandemic, trainees have been physically present in the hospital, enabling them to remain directly involved in the service and feel connected. This has been an important contrast to the virtual teaching which has been necessarily part of the pandemic.

Jenny emphasised the benefits to supervisors whereby trainees bring new perspectives on clinical work and service developments, as well as updates about new developments in other areas of clinical psychology. She described offering placements as an enriching experience for the clinical psychologists, along with other members of the team, and is enthusiastic about continuing to offer placements in the future.

Rhiannon was also very positive about her experience of the placement and found that it was unlike any other placement experience she had been involved in.

She particularly enjoyed being part of a supportive multi-disciplinary team working across the hospital with a wide range of staff. Rhiannon discovered that she had several sets of transferrable skills since patients who used the service often required help with issues which pre-existed their cancer diagnosis including anxiety, depression and substance misuse. 

Most importantly, the members of the team were very receptive to her input which included running training sessions on managing self-harm and assessing suicide risk.

Being in the hospital helped her understand the system and made the placement a much more effective and valuable experience than if she was only involved virtually.

She had decided to take up the placement following a presentation by another trainee about a health psychology placement. She wanted to get involved in this work prior to finishing her training and as the placement developed, her confidence grew, leaving her with a richer perspective on this important and expanding role for clinical psychology within healthcare.