Moving outside the clinic

The interview with Jenny Taylor (January issue) got me thinking. She talks clearly and excitingly about the benefit of 'doing psychology' differently, stepping away from the traditional one-to-one therapeutic frame, and towards a more systemic and nuanced understanding of how best to support young people. She describes providing support for the people who are already supporting young people, rather than striving to develop a new therapeutic relationship. She talks about moving outside of a clinic setting, and thinking differently about who our clients are, and what they need.

I currently work from a community psychology framework, which acknowledges that many of the systemic challenges young people face contribute to their wellbeing, and their distress. In supporting young people, community psychologists strive to step away from an expert position, and instead support the strengths and resilience in communities. As a newly qualified clinical psychologist, I work with young men who have been affected by serious youth violence in London. The work draws upon a range of psychological theories including attachment and narrative, to provide holistic support for these young men. My interest in this work grew out of my experiences as a trainee clinical psychologist, as I noticed that many marginalised young people were excluded from traditional mental health services. I wanted to explore how psychologists could work flexibly and innovatively to support the young people for whom psychologists are often hard to reach. It was lovely to read about Taylor's application of a similar approach.

There has undeniably been increasing interest in this way of working. Organisations such as Mac UK and Owls work alongside young people, often with lived experience of serious youth violence, to promote wellbeing. Many services, both NHS and third sector, use coproduction to develop and evaluate their services.

However, the majority of psychologists still work in traditional mental health settings, providing one to one therapy for people who are able to access these services. Jenny described the safety and effectiveness of adapting psychological approaches, which left me wondering why psychologists don't work in this way more often. I wondered if psychologists often feel confused about what community psychologist do, and whether it feels like a big leap into the unknown. I know it did for me when I began my journey from clinic to community settings.

To help demystify community psychology, I wanted to share some of the things I've learnt. I've learnt the need to work flexibly, adapting what we know works to different settings and locations. While it can be difficult to take a less powerful position than the traditional therapist-client relationship affords us, I've learnt the benefit of retaining a curious and unknowing stance. I've learnt that hanging out and building trust is the key to supporting young people who have so often been mistrusted by services. Read more about my work at https://thepsychologist.bps.org.uk/you-dont-have-have-all-answers.

Dr Hannah Alghali
Clinical Psychologist
Royal Holloway, University of London