Work experience

I'm a third-year undergraduate studying psychology and cognitive neuroscience at the University of Nottingham. I wanted to obtain work experience in clinical psychology so that I could gain a better understanding of what this career would entail, and whether I would enjoy it. I e-mailed 11 clinical psychologists based near to where I live in Cambridge, whose details I found on the BPS website. Out of these, one offered me work experience.

The work experience that I obtained was with Susanne Vosmer, a clinical psychologist at a low-secure psychiatric unit where half the patients were forensic patients. All the patients were sectioned under the Mental Health Act.

The experience I gained was invaluable; rather than spending all my time running errands and getting the tea (as I had suspected might be likely from the stories I had heard from other students), I found myself immersed in the day-to-day work of front-line clinical psychology. Shadowing Susanne, I sat in on sessions that she conducted with individual patients, attended many of the meetings that are involved with the job (e.g. ward rounds, where each patient is discussed, with care and so on being evaluated), and helped run a group session. I was even given the opportunity to help write up a study.

Sessions were fascinating to attend; by meeting the patients, I encountered the mental disorders that we had learned about, and saw for myself how they manifest in people. The most common diagnoses at the unit were schizophrenia, depression and anxiety disorders. The common psychological treatment at the unit was cognitive behavioural therapy, and it was really useful to watch this therapy in practice, again having only read about it. The experience was made even better when, after each session, I was able to discuss the patient we had just seen, and give my thoughts on them and how the session had gone. I was even given the opportunity to help to run one group session on anxiety, in which I presented some relaxation techniques and exercises. 

I was taken aback – and delighted – when on the first day of my placement Susanne offered me the opportunity to help write up a study that she had conducted in her own time. I performed the data analysis (a little more complicated than those we have done in lab classes), and then wrote up the journal article. This was a very valuable experience because – unlike on our course, where we get feedback only once the work is complete – she gave me feedback on each section as the first draft was completed, and then again for each successive version, thus enabling me to improve my writing technique.

This work experience gave me a great insight into the work of a clinical psychologist – both the positives and the downsides. Watching patients responding to treatment and improving is very rewarding; every day holds something different; and the job appears to be one that challenges, whether it be through working out how best to treat a patient, or conducting new research.

However, the experience also showed me that clinical psychology can be very demanding; as well as working the nine-to-five job, research is vital to progress within the profession, and unless the job itself entails research then this often must be conducted in the psychologist's own time. It also demonstrated some of the undoubted frustrations involved in the job. One of the difficulties of working effectively in the secure unit was that patients often refused to take part in treatment. The Mental Health Commission had recently visited the unit and informed patients that they had a free choice whether or not to attend sessions (e.g. with the psychologists, occupational therapists or other staff). Where patients are sectioned they are often unwilling to take part in sessions, despite the fact that these are aimed at addressing and improving patients' conditions so that, in time, they can be released. Having seen the frustration caused when patients making progress stop turning up, I have to ask the question:  If we are willing to section people, taking away their freedom, then why give them freedom to decide whether they attend their sessions once they are sectioned, when these are the very things that may help them to get better?

Some of my fellow students  see work experience as fodder to bolster a CV, rather than something of intrinsic value. They assume that they will be either left languishing in a corner to watch but not participate, or treated as cheap (i.e. free) labour to perform menial tasks. This doesn't have to be the case – a good work experience placement can put life into the lecture-room theory, and give you a real insight into what it would be like to pursue a career in clinical psychology. 

Of course, I can't pretend that everyone's placement will be as stimulating and useful as mine was. It seems clear to me the success and benefit of a work experience placement ultimately depends on the person who is offering it to the student. Those who do provide work experience – and, as I found out, they are a minority – should really try to make it just that… an experience.  

- Anna Rosselli

Frequently, students are taught 'mental disorders', how they manifest in individuals and how they are treated. Learning about individuals who have unusual experiences (commonly referred to as 'schizophrenia') may provoke anxiety and fear. So working in psychiatric inpatient and, particularly, forensic secure settings, may not automatically come to mind when considering a career in clinical psychology. In my experience, this is a real shame because I have learnt as much from this client group as they have, hopefully, learnt from me. Primarily, I took on a student to offer her the opportunity to not only gain insight into my work but also provide her with an experience of this client group.

Commonly, this population is portrayed in the media as either 'mad' or 'bad' (dangerous), or both, and wider society expects staff in secure forensic inpatient units to take care of and care for this population, which is frequently ostracised, hated and feared. Admittedly, since this client group can provoke strong feelings in staff, it is perhaps not the easiest of environments to work in or to gain work experience in clinical psychology. And it can only provide limited insight in the many facets of clinical psychology. At the same time, the current setting is genuine and honest because we are confronted with raw emotions, which are inherent in all of us. The distinction between them (the 'insane') and us (the 'sane') becomes, at times, more blurred due to projections and projective identification. The current work setting offers the opportunity to connect to people rather than work with 'schizophrenics'. My decision to take on a student was motivated by the hope that this experience could enable her to become a bit more critical of diagnostic systems, realising perhaps that 'mental disorders' are diagnostic entities and not the 'real' thing, and more importantly, less fearful of working with this client group.

As clinical psychologists we do many different things, and exposing students to the many different aspects of clinical psychology is important so that they can make a more informed decision about wanting to join our profession or not. Carrying out research is vital to evidence-based practice, but resources in the NHS are extremely limited. So having students on placement, who can contribute to this process, can be very helpful. It is important, however, to provide students with experiences which are in their 'zone of proximal development', thereby encouraging and advancing their individual learning. It should not be exploitative and students should be neither regarded nor treated as 'cheap labour'. In my experience, our profession does perhaps rely a bit too much on an unpaid workforce. Possibly this is because many psychologists are overworked and overloaded with demands. This may also explain why not everybody is able to offer work experience. However, a realisation that we all can be 'rejecting', at times, may help to deal with the inevitable disappointment which may arise when a request for work experience is being declined, and encourage students to keep on trying.

- Susanne Vosmer