Seizing the day

As Claire Halsey tells it, training to become a psychologist sounds like the plot for an adventure film. Her adventure started in Gatley, Greater Manchester.

'My mum was a ceramicist, my dad  a mining engineer. I went to Cheadle County Grammar School for Girls where  I did OK, but, if truth be told, my brain didn't really wake up till I went to Sheffield University. I chose geography, sociology and psychology as my three subjects for the first year but fell in love with psychology. I'd never thought deeply about how people interact and how society works. I remember being particularly immersed in environmental psychology where I was influenced by Chris Spencer, an inspiring mentor. I also enjoyed social psychology. Immediately after graduating I went straight into the clinical psychology MSc at Surrey University. That wasn't so uncommon in those days.'

The jobs she did while studying sparked Claire's interest in learning difficulties. 'Between my second and third year I worked as a nursing assistant at St Lawrence's in Caterham.' The hospital was built in the 1870s and regularly appears in lists of the lost hospitals of London and as a site for exploration by urban explorers. 'It was an old-style asylum with 2000 beds. Some patients had been there for 50 to 60 years after being committed for "moral turpitude".' After graduation Claire worked at Normansfield Hospital, a similar old-style asylum, shortly after the inquiry into mistreatment there. 'I wanted to specialise in learning difficulties after that, but like many who go into clinical psychology with set aims and interests I came out with a wider view of what I might do. Part of the joy of studying the subject is its multi-theoretical nature, giving experience of different ways of working and different environments.'

Towards the end of clinical training Claire undertook a specialist placement in an adolescent inpatient unit near Brighton 'This introduced me to working with teenagers, something which has borne fruit in my later career. It also gave me a very practical introduction to systemic theory.' Nevertheless after graduating as a clinical psychologist Claire returned to her interest in learning disability and took up a post at another large specialist hospital: The Manor in Epsom, which was built in 1899. After a short period working on the 'locked wards' for adults with learning difficulties a period of travel and broader experience seemed like a good move.

From close to heaven to burnout
There seem to be more opportunities for people to travel pre-, post- and during university courses nowadays. Claire had gone straight from school to a degree course, to postgraduate studies, to a job 'and it felt like a treadmill so I set off round the world with my then partner. Our plan was to drive across America, travel to Australia then come home to the UK across Asia. But we never got to Asia. After the US, Canada and Hawaii we arrived in Sydney with next to no money. I got a job as a clinical psychologist with learning disabled patients in locked wards as I had in Epsom'. Despite this I get the impression that Claire was not someone who planned ahead or mulled over strategy. 'No, I tended to seize the day then worry about the implications afterwards.' And did travelling abroad change your point of view? 'Certainly. I gained more understanding of how psychology affected people's everyday lives. More things seemed possible.'

'It was a great time. Travelling and then living in Sydney was close to heaven. Underlying all this, though, was a real dissatisfaction: I'd started working again in locked environments and it didn't sit well. This was around 1983, but it felt like I'd moved back to early 20th century practices. A locked environment certainly doesn't help psychological interventions. So, with a bad case of burnout I gave up work and set out travelling again, eventually taking up a new career as  a camel handler .'

Enter the camels
Claire and her partner decided to treat themselves to a fortnight's camel trek across the central Simpson Desert and ended up staying out there for three months before moving on to Alice Springs. 'There I got a job on a camel farm, raced in the Alice Springs camel cup and eventually set off to walk to Western Australia with a friend and her camels.' What was the attraction? 'I loved riding horses as a child… camels are lovely creatures, and I just enjoyed being in the Australian bush.' Claire returned to Alice Springs before moving on to Cairns, the tropical city in the North of Queensland. 'And, surprise, surprise, I was out of money again. I went into the job centre and there was a role for a social services child care officer. I got it and worked in the Queensland Service for over three years in areas from psychology, fostering, adoption and court work to child protection. I was lucky enough to provide services to Torres Strait Islanders and remote aboriginal communities, always working hand in hand with local people. It was fascinating and challenging to do this. It's never entirely possible, coming from a very different cultural heritage, to be aware of all the nuances of working with a different group of people, showing the correct respect and fully understanding another perspective. However, I truly appreciated working closely with a diverse group of local staff who brought an approach of cultural mindfulness to my work.'

'An annoying downside of the work was the discovery that I was very prone to seasickness, and travelling by motorboat from island to island was the least enjoyable element of the work! On a serious note, being educated and supported to work cross-culturally was vital learning for my clinical practice.'

Claire's time in Queensland gave her a new enthusiasm. 'In Children's Services I found my niche and lifelong friends among my colleagues. However, after a few years it was time to move on. Cairns felt too small and I couldn't see the next step in my career. Jobs like this, especially where safeguarding is part and parcel of daily work, mean you do have to take care of your own well-being too. I began practising t'ai chi, which helped me greatly, and I would recommend activities like this to anyone in a stressful role.'

On leaving Cairns Claire drove round the outback on her own ('I suppose my idea of heaven is taking to the road in a VW Combi ') taking in such experiences as canoeing and horseriding. 'The plan was to meet my friend and her camels in Western Australia and I did work on her camel farm in Geraldton, WA for a while. Eventually I returned to familiar work and took up a role as a clinical psychologist in social services again. Once in Perth I started to write and that's now a major part of what I do now.'

Writing, and moving to the UK

'Western Australia Social Services had a very strong public information remit in the 1990s, and it was there that I met Chris O'Neill who I now work with in Stoke. She'd written the first of a series of leaflets to support parents of teenagers, and as the series grew I got involved. First writing tip sheets, leaflets and pieces for newspapers then moving on to public health DVDs on subjects that included Living with Babies, Toddlers and Step Families.'

I learnt huge amounts about writing from being really well edited. I work now primarily with Dorling Kindersley and for magazines such as Prima and Mother and Baby, and they're great at providing a really detailed brief and giving useful feedback to keep the text succinct. Being able to write for different audiences is invaluable, it gives the opportunity to make psychological ideas accessible.'

Claire ended her time in WA managing the psychological services element of Social Services for Western Australia before making a personal choice to return to the UK. 'I'm a dual citizen and I still feel 50 per cent Australian. We moved back in '99 for family reasons, to be near close relatives, especially our parents who forged strong relationships with our children. Once in the UK it was thanks to an advert in The Psychologist that I picked up a job in the NHS with North Staffordshire Combined Healthcare and I've been there ever since.

'Since arriving back in the UK I finally found time to complete the post-qualification doctorate at Sheffield, receiving it in 2008 after five years' work and with the help of my previous mentor Chris Spencer and Simon Eltringham. It was quite a stretch getting this finished alongside working full time and having a busy family life. The biggest sign of how much psychological careers have changed was when a younger student asked me "Are you really allowed to practise as a clinical psychologist without the PhD?" After I'd been in the job for over 20 years!' Did you feel the need to get a PhD? 'It was definitely an aspiration of mine as well as a way to stay sharp. As with any profession when you're practising day to day there is a real need to refresh your skills and knowledge which can become out of date. That's why CPD is so important.''

It's inspiring to work with inspiring people'
What do you do now? 'I work for the NHS as a Consultant Clinical Psychologist supporting families, children and young people in Stoke and North Staffordshire. l also have a small private practice, which includes both writing and broadcasting.

'Since being back in the UK being a practitioner and trainer in the Triple P positive parenting programme has been a major part of my life. This approach was created by Professor Matt Saunders, who became a huge influence on my thinking. My initial training in 2002 has led on to delivering Triple P to a group of parents in the ITV1 programme Driving Mum and Dad Mad and being involved in the launch of the parenting early intervention programme by the national government, including a visit to Tony Blair at No 10 as the initiative was launched.'

Media is obviously a big part of your work. 'Well, it's one part of my work. You have to get used to it, be careful, cautious and clear. For example it's important to settle issues like editorial control in advance, whether it's television or written media. I found the Society's media training useful in that regard. We as a profession have a lot to offer society and we shouldn't be scared of putting our message across.'

You can't have much spare time, I say. 'No! Within my NHS job we've just become involved in children and young person's Improving Access to Psychological Therapies, which is both exciting and time-consuming. Over the past few years I've also been busy writing or co-writing books in the areas of parenting and child development suchas Ask a Parenting Expert, and I continue to contribute to magazines and provide occasional comment on radio regarding issues of the day.'In my NHS role I always enjoy working with children and young people, and I'm extending an interest in children's sleep into the world of teen and adult insomnia at present. I don't want to stop developing as a psychologist, and value every chance to learn more. It's inspiring to be with inspiring people.'

See www.clairehalsey.com.

Self-publishing without illusions 

Mike Bender wrote a comprehensive self-help handbook for older adults worried they might have dementia 

Having previously never had any difficulty finding a publisher, I never intended to self-publish. This is an account of how I ended up doing so.

I have had the idea for You're Worried You Might Have Alzheimer's for some ten years. As a consultant clinical psychologist, I valued creativity and the notion that the practising clinical psychologist was in a good position to develop innovations in both practice and theoretical understanding. Around that time, I realised that the NHS was no longer a supportive environment. So, having the luxury (as it now seems) of mental health officer status, I got out. I spent a year writing up two books that I had been commissioned to write: the theoretical Explorations in Dementia (Jessica Kingsley, 2003); and Therapeutic Groupwork for People with Cognitive Losses (Speechmark, 2004); and I worked with Professor Richard Hallam editing the moving diaries of a young man diagnosed with schizophrenia (David's Box, Polpresa Press, 2011). With Gilly Constance and Joy Williams I set up a long-term support group for people with dementia in Wadebridge, North Cornwall, which is still running nearly a decade later. And then feeling at a bit of an identity loss, I enrolled for an MA and then a PhD in English at Exeter University.

All through these years of study, I could see the need for a self-help manual for older people with memory difficulties. All the available books were for professionals or for carers/relatives. Memory clinics were being set up all over the country, but at the same time, the resources these people needed – individual and family therapy, occupational therapy advice, day care and respite care – were being cut back. So, if they wanted to do something about their condition, the sufferers would have to do it themselves; and I believed, that they could benefit from suitable advice and encouragement. Throughout my PhD years, I thought somebody would write such a book but they didn't, so I started keeping notes on potential chapters. I made sure I kept a university presence to give me access to the library and a respectable e-mail address.

I asked four experts in the field of the elderly to form my support group: Gilly Constance, Richard Warrell, Alison Bender and Kay Harding. They also were chosen as being able to talk to me straight about what they were being asked to advise on. If I did one thing right, it was that.

When you get old, you are faced with a wide range of problems – not just psychological, but also loss of income, loss of mobility, diminution of friendship networks etc. – so the manual would have to be wide-ranging and would encompass areas I knew little about, for example, keeping healthy and legal matters.

I drafted each chapter, sometime with great gaps, and then sought out one, or if possible two, experts in each field. I must have contacted some 20 people and all gave me feedback, usually way beyond the quick e-mail; and then looked at the next draft.

I had no great desire to self-publish, but I found that I could not get a publisher without an agent, and I couldn't get an agent without a publisher being interested. After a while, I gave up trying and this had the advantage that I made all the production decisions – A4, font size 14, wide spacing, use of bold, spiral bounding, divides etc. – all aimed at making the book user-friendly for a person of 75 or so.

Some 15 months later, I was again fortunate to call on people with expertise on layout and computer preparation. It was vital to find an expert to create a professional-quality cover, and a willing and helpful printer.

I have found gaining publicity for the book the most difficult part of the process, as I am poor at self-promotion. As I was writing the book, services for older people were being cut back still further, which gave me even more motivation to get a self-help manual out. I priced it – over 300 A4 pages on quality paper – at under £20 to make it as affordable as possible. So, although I don't think I'll ever get my money back, I'm glad my book is 'out there' and proud that
I wrote it; and I'll always be grateful for all the people whose advice and support made it possible.

So, would I recommend self-publishing? The ability to make all/most of the decisions about the production is enjoyable, but there are a lot of questions you need to answer first (see box), of which the most important are: Is there something you feel really strongly about and only you can say? Do the people who matter to you agree?

Dr Bender's self-help manual and handbook, You're Worried You Might Have Alzheimer's: What YOU Can Do About It is available from www.beeswing.biz

If you're thinking of self-publishing

Before you start
I    Does your household back the project and think it valuable? If not, the time and money involved will cause severe tensions.
I    Can you afford it? Estimate the development costs (paper, toner, visits, etc.). In my case, they were greater than my printing costs.
I    Set up a separate account for the project,
so that you can realistically assess ongoing costs.
I    You are unlikely to get your money back.
At best, it will be over a long period
I    Have you got the time? What will have to go?
I    If you are at work, could there be conflicts about your private interest?

During the writing/production
I    Always keep in mind who you're writing for.
I found it useful to imagine an older person reading the book.
I    Allocate regular writing times and stick to them.
I    If possible, have a prestigious e-mail address.
I    Who will support and advise you during the writing phrase?
I    Never copy and paste previous material. You need to be totally focused on the potential users.
I    As you write, think of how you want the book to look and feel, as this affects your style and presentation of material.
I    Get as much feedback on drafts of individual chapters as possible.
I    Keep people and organisations who could be interested in your product in the loop about your progress. They may well give you useful advice on presentation.
I    What fitness regime have you got to counter sitting at the computer for hours?

After publication
I    Keep your support system going. The lack of interest can feel very hurtful and demoralising.
I    Allocate regular times when you will work on furthering the book's success.

My journey to becoming an assistant psychologist

Edward Howard, an assistant psychologist at Royal Bolton Hospital, tells us about his experiences getting there

I was just one of many psychology graduates wanting to be an assistant psychologist. Clinical psychology is a competitive area with so many psychology graduates and so few assistant psychologist posts. I achieved my degree in 2010 and finally secured my first assistant psychologist post a few months ago. It was challenging, but I got there in the end.

I began getting relevant experience soon after I graduated. It was easy securing some voluntary work as many mental health charities seek out volunteers, and it's a great way to gain experience of mental health. I did apply for a few assistant psychologist posts, but unsuccessfully. When I rang up for feedback they said I needed to get more experience, recommending that I apply for nursing assistant jobs.

So I spent six months applying for nursing assistant jobs, in both the private and public sectors. It was very demoralising because I put so much effort into the applications but heard nothing back from anyone. I kept myself motivated by knowing that I was slowly building experience within mental health and that I would secure something eventually.

I was finally offered my first job as an activities coordinator on an older adult mental health ward in the NHS. With my foot in the door, I then focused on preparing myself to become an assistant psychologist. I downloaded various versions of person specifications for an assistant psychologist and compared the requirements with what I had to offer. It all seemed overwhelming and confusing! I also felt hopeless faced with the fact that the majority of assistant psychologist jobs require you to have previous experience as an assistant psychologist! I found help from the clinical psychologist who was supervising the assistant psychologist on my ward. She broke down each element of the person specification and suggested what I could do to achieve them.

It was then I began to take on additional work to fulfil these criteria. I became the 'Life Story Work Officer', where I ensured all patients were approached to begin a life story book, and I also read a few CBT books out of interest. I then applied this CBT knowledge by helping patients explore their thoughts, feelings and behaviours. I was involved in conducting neuropsychological assessments and spent time with the assistant psychologist to learn more about her job role. Finally, I e-mailed clinical psychologists around the Trust and secured a voluntary assistant psychologist post for a few hours a week.

I continually applied for assistant psychologist jobs and developed my covering letters Then after about a year I began to be offered interviews. So next I had to learn how to do well at interview, and after seven interviews I was offered my current post.

Looking back, I feel I may have taken too much on and not allowed myself enough time to relax. I worked part-time during the week as an activities coordinator, a volunteer assistant psychologist and at weekends as a waiter.

I became very tired and distant from my friends and colleagues, possibly damaging my relationships with them. I also lacked assertiveness and feel I was taken advantage of a few times. With so much work I found it difficult to cope on occasions. But I persevered and that's now all in the past.

I currently work across two mental health wards for older adults, doing cognitive assessments and formulations, organising psychology groups and providing psychological therapies under heavy supervision. The job is challenging but rewarding at the same time. I've become more reflective about my work and now have a deeper understanding of the role of psychology in health care. I enjoy this role a lot as it is varied and I'm learning so much along the way. Even though it felt like a long and tiring journey to get here, I definitely think it was worth it in the end.