‘Surely there’s room for more diverse approaches in our discipline’

Where did it all start? 'I was born in London. Much of my family lived in Pakistan; I started travelling there when I was one. I went to school there up till my A-levels for family reasons – my roots are in Pakistan.

'My family were and are very education-focused; they expected me to continue in further education and have a career. But at 18 I had a choice of going to university in the UK where my mother lived, or joining my aunt in the US. I chose the latter, studying at Rutgers State University, New Jersey – one of the top 10 universities in the States.'  

Saniya's bachelor's degree was in psychology. 'At that time, a US degree/qualification was based on the number of credits needed to achieve a specific degree. I did the introduction to psychology course amongst other medical-related courses and got fascinated by it, particularly in the structure of the brain, which linked to my medical interests. One professor was immensely supportive and gave me encouragement. Following this course, I focused on psychology courses. In Pakistan I'd really wanted to follow in my aunt's footsteps and become a medical doctor, but my family discouraged me. As a good Asian girl, I had listened to my family and dropped the idea of going into medicine. When I found psychology and decided I wanted to be a psychologist I resisted another round of family objections! After completing my bachelor's degree in 1991, I came back to live in the UK.'

Given your own interest in medicine, it seems surprising you have specialised in counselling psychology. 'In the US you don't decide on a specialism too early, and your initial training doesn't include practical experience – it's more an academic subject. My focus was therefore on achieving academic qualifications rather than appreciating differences between professional roles.'

Saniya says that in the UK at that time, the choices were either clinical or health psychology if you wanted to work in the NHS. 'Health had a strong research aspect, whereas clinical psychology was more about clinical work – research was optional. Clinical seemed the obvious choice as I was keen to work with people and not be an academic or researcher. It's not an unusual situation for students, but the process of trying to get on a clinical course was hugely frustrating – in fact I tried to get on one for five years and failed each time. I applied for everything I could, thinking this was the only option I had.

'When I came back to the UK, the British Psychological Society hadn't yet sorted out equivalency with US degrees, so I had to obtain a graduate diploma in psychology as a conversion course to get GBR [Graduate Basis of Registration with the BPS]. I thought that would be the door into further education and then into practice as a psychologist. But many universities still didn't understand American degrees, and in addition I needed to gather practical experience before being accepted. I started looking for jobs, especially in the mental health area. One was to become a counsellor, which resulted in a Certificate in Basic Skills in Counselling awarded by University of Westminster.'

It's obvious from Saniya's tone and careful choice of words that this was a dark period for her. 'By that stage I felt I did not fit. But I had gathered a lot of life lessons from various roles – I did some agency nursing work for about a year, then was a nursing assistant at Broadmoor Hospital for four years, working in several different wards.'

Saniya has been a volunteer for St John Ambulance for 21 years. 'It provided really important experiences and skills around diagnosis and treatment. I've been involved in first aid, radio communications and ambulance work, as well as having held area and county roles in personnel. I was also Trauma Risk Management (TRiM) team leader and a trainer in mental health. In the end, it's these experiences that have helped me in my work as a counselling psychologist. I suspect that students drawn to the area need to experience many different aspects of life before they can really start studying.'

Saniya took her Postgraduate Practitioner Diploma in Counselling Psychology at what is now London Metropolitan University. 'It was luck that someone suggested studying the subject, as it was a new and upcoming field in the NHS.' By that stage she'd given up on the clinical route. 'Counselling psychology tapped into my curiosity around the individual subjective experiences of people with the same diagnosis. By working collaboratively, individuals could be empowered towards their recovery.' Since that time she's become a positive enthusiast for, and defender of, counselling psychology. 'I feel protective towards the area. It irritates me when people imply it's not as good as clinical psychology or less valuable or somehow easier. Are there differences? Yes, in philosophy and in the training; less so in the actual work/job roles. Now there are more similarities than differences, but there are still differences. For example, all clinical psychologists can administer neuropsychological tests, whereas now only those counselling psychologists who have done further training can administer them. But even this is changing – more counselling psychology doctorates include this in their course. Clinical psychology trainee placements are agreed between the local NHS Trust and the university, whereas counselling psychology trainees must find their own year-long placements. They must demonstrate experience in three theoretical models.'

According to Saniya, there is still a stigma around whether one is a clinical or a counselling psychologist. 'Some recruiters are more focused on "titles" rather than the skills and experiences that would enable the applicant to do the role. Most counselling psychologists have come across instances where a clinical psychologist with less relevant experience gets a job they feel better qualified for!'

Saniya stresses she has 'huge respect' for clinical psychologists: 'I just think that the focus needs to be on the care and service we provide to the communities we serve, rather than whether the psychologist is clinical or counselling. Surely there's room for more diverse approaches in our discipline.'

'I like challenges!'

Saniya arrived at psychology late but 'perhaps my experiences and maturity prepared me for working in the NHS where there are difficult, challenging and ever-changing conditions; for dealing with complex presentations with minimal resources and career challenges. I was determined to be a psychologist and, when I was applying for courses, wasn't prepared to do anything else.'

The counselling psychology course she attended was a trial run for BPS accreditation. 'We had to organise all our placements ourselves. Eventually a very helpful senior clinical psychologist offered me a placement within Farnham Community Mental Health Team (CMHT) in Surrey. At qualification, this led to a permanent position. Both as a trainee and then as a qualified psychologist, I often had two roles, working in both primary and secondary care. After several years of both roles, I chose to stay with secondary care and started working full time in CMHTs, changing teams from Farnham to Guildford to Aldershot, to Farnborough.'

Saniya's tasks within CMHTs ranged over a huge area. A sample would include: providing psychological assessment and therapies to clients with severe, enduring and complex mental health difficulties; facilitating group work; managing waiting lists and engaging in service developments; supervising trainees and junior psychologists; representing her local area in projects for compliance in NICE guidelines and recovery work. One of her achievements was writing, developing and training an NHS Trust- wide project to support staff following a traumatic incident and then becoming one of the team leaders.

'At that time, I felt settled and was enjoying my role. But very specific circumstances at work led me to begin to doubt my abilities as a psychologist. I nearly reached the point of giving up. However, I was fortunate that my support network reminded me of the challenges I had faced and what it meant to me to be a practising NHS psychologist. (I also did not have an answer to my husband's question of "what will you do if you gave up psychology?")' Recovery from the consequent depression, led to a more fundamental change in her career. 'I'd worked as a locum in the health psychology department within my NHS Trust, and this developed into an interest in physical health. I was fortunate to be offered a permanent post in a different NHS Trust's clinical health psychology service. Currently l am leading services in the areas of diabetes and chronic fatigue syndrome. This involves working with medical consultants, specialist registrars, specialist nurses and physiotherapists, among others.'

Saniya's career path has not been a conventional one. 'I like challenges and tend not to be good at interviewing but seem to impress people more by what I do on the job. So, a lot of my career openings have resulted from people seeing me work and then inviting me into locum, part-time or full-time roles. If you're considering this sort of career, grab opportunities to show your skills and stay in touch with people.'

When researching this interview, I discovered Saniya had been a Foundation Trust governor. 'I was a staff governor for therapies in Surrey and Borders Partnership NHS Foundation Trust. I had been searching for a different challenge. One of my mentors had fulfilled the role prior to my election and suggested it to me. Psychologists can use their analytical and research skills, their commitment to an evidence-base for monitoring and questioning actions and decisions involved in this role. It gave me an overall view of the Trust and the NHS, which in turn gave me a context for understanding how frontline and administrative staff work. The NHS is a fascinating organisation for anyone considering a career in it. When I joined, it was difficult to get into, but it was a job for life. Now the demands are higher, there are fewer resources, less career progression and no pay progression. Because of views about counselling psychology I discussed earlier, we find it difficult to position ourselves in the NHS… the same is true outside it. We're still fighting a battle to be distinguished.'

You say that your interests include military psychology and PTSD. 'I became interested in PTSD in St John Ambulance and then later at Broadmoor. I was very involved in staff incident support in several of my roles. My master's thesis was in staff support following an incident at Broadmoor Hospital. I guess the interest grew as I became more fascinated by trauma and PTSD, and I was fortunate that my various roles helped me gain valuable experiences in this area. When I started working in Aldershot, we had a few veterans' referrals and I would receive these. I became interested in treatment of veterans, attended several courses as well as all the military conferences organised by BPS. So, my dream job would be running a military/veterans' psychology trauma service!'

And your goals now? 'I'm interested in developing my leadership and management skills as I am keen to challenge myself as a senior manager. Besides I am not aware of many counselling psychologists in senior managerial positions! In the meantime, I have been asked by BPS Wessex Branch to coordinate the Surrey Hub, and that is one challenge I am looking forward to.'

We didn't have time to touch on Saniya's involvement in aikido or her interest in trekking and reading science fiction. But I hope the interview has proved once again that every psychologist has a special story to tell.