One on one with Systemic Psychotherapist Lydia Guthrie

Can you tell me a bit about your background and what inspired you to pursue a career in mental health?

While I was an undergraduate, studying Politics, Philosophy and Economics, I volunteered with a student charity called "Bridge". I used to spend a day a week accompanying a social worker on visits to young people living in the housing estates around Oxford, to see whether they wanted to get involved with our charity. The contrast between the affluence and privilege of the city centre and the poverty and exclusion which I saw on nearby housing estates hit me hard, and I became passionate about inequality and social justice. 

I then trained as a social worker, and worked in the criminal justice system as a Probation Officer for 12 years. I specialised in working with men who had committed sexual offences, and ran and supervised sex offender treatment programmes. While listening to the men's narratives, I became interested in how their early experiences influenced their development. I also worked with the victims of serious crimes, and with women whose partners had committed sexual offences against children. After leaving the Probation Service, I spend ten years as a self-employed trainer and supervisor, delivering training in criminal justice, mental health and social work settings.  I also studied for an MSc in Attachment Theory, and wrote books to support practitioners in social work and criminal justice settings. Although I loved this work, I found that I missed clinical work very much. I was drawn to family therapy/systemic psychotherapy, as it seemed to combine two things I love – attachment theory and working with groups. I've had a very rich set of trainings and experiences, and I've always followed my intuition about the next step in my career, rather than having a grand plan!

What does training as a systemic psychotherapist entail?

Most systemic psychotherapy students already have a professional qualification, such as social work or nursing. The systemic psychotherapy course takes four years, and most people fund themselves. The training is a combination of academic work and supervised clinical practice. In the final two years, there is a compulsory 200 hours of supervised practice, plus a research dissertation. I was very lucky, and was able to organise a placement in a CAMHS team, where I learned a huge amount. I had studied at MSc level before, but the systemic psychotherapy course was without a doubt the most challenging course I've ever done. I was lucky to be part of an incredibly supportive cohort of students, and we pulled each other through. The course leads to an MSc, plus full registration with the United Kingdom Council of Psychotherapists (UKCP).

What does a typical day at work look like for you?

My work in an NHS trust involves care coordination, assessments, and offering family therapy to families and young people. We are a very busy team, and, like my colleagues, I often work more hours than I should just to try to keep up. 

What do you enjoy most about your role?

I enjoy most aspects of my role, and the weekly family therapy clinic is a highlight. I also offer clinical supervision to several colleagues, which I enjoy very much. I'm very interested in how clinicians stay healthy in environments that are dominated by risk, and being a good supervisor is important to me.

What do you find most challenging about your role?

Like most teams in the NHS, we are struggling with issues of staff recruitment and retention. Demand for our services is very high, which affects workload, and it's difficult when we can't meet the expectations of families. The pace of work is so fast that it's often difficult to find space to reflect on wider issues. 

You're a trustee of Circles South East – tell me more about this role?

Circles South East is a charity that aims to reduce the harm caused in society by sexual abuse. We offer support services to individuals and families who are survivors of sexual abuse. We also recruit and train community volunteers to support people who have committed sexual offences. They form a Circle of Support and Accountability around the person with the aim of reducing reoffending by promoting safe community integration. There is robust research that suggests that Circles of Support are effective interventions to reduce the risk of reoffending. I'm very proud to be a Trustee.

You recently co-authored a book entitled 'Attachment-based Practice with Children, Adolescents and Families: Understanding Strategies and Promoting Positive Change; tell me about this?

I am passionate about Crittenden's Dynamic Maturational Model of Attachment and Adaptation, which is the underpinning theory of this book. We are a very diverse group of authors, from different professions and different cultural and racial backgrounds. The core of the book is a collection of case studies of young people and their families or carers, exploring how attachment theory can be useful in formulation and intervention. The book is informed by many different approaches, and contains a really good introduction to attachment theory and how it can be practically useful when working with families. And there are fabulous illustrations which bring it to life!

Can you share a piece of work that has really changed or shaped your practice?

The experience which has most shaped my practice is having personal therapy. The experience of seeking help, and being truly vulnerable with another human being, was a very powerful one. I re-authored my account of my early years experiences, and became more aware of ways I'd coped with adversity as a child through developing self-protective coping strategies. Some of the coping strategies were still useful, but some less so. I believe that all mental health professionals should have the experience of seeking their own therapy, but I appreciate that there are lots of barriers in the way of this.

What would you advise others that are interested in training as a systemic psychotherapist?

It's a wonderful way of working with families, but the course is incredibly hard work, so make sure you have enough support from own your networks.

Fauzia Khan is an Assistant Psychologist currently working within the NHS, whilst completing her Doctorate in Counselling Psychology.