Experiences of a Trainee Counselling Psychologist – The End of the First Semester
From the Unconscious to the Conscious
For a first-year trainee studying a Doctorate in Counselling Psychology, the feeling of being overwhelmed can be a familiar one.
People are often drawn to the profession of psychology due to their core character traits resonating with the skills required to become a good psychologist, such as empathy or warmth. However, it can be these very character traits that lead untrained professionals to become too heavily involved in the emotions of their patients, and struggle to establish boundaries in the therapeutic dynamic. Armed with some experience in the field of mental health together with a degree in Psychology, students can lead themselves to believe that they already have the skills necessary to becoming a counselling psychologist.
The term ‘unconscious incompetence’ was originally coined by Abraham Maslow, and has sometimes been attributed to those students who are somewhat unaware of the journey they are about to embark upon. ‘Conscious incompetence’ is the more assuring stance of students’ realisation of the vast world of psychological knowledge they are now in amidst of.
This happened to me when I stood in the library at Regent’s College in London, looking at a whole wall of books written by Freud and hundreds of texts dedicated to counselling and psychotherapy. I felt completely overwhelmed, as I turned to my friend and said ‘I really don’t know anything’.
Clinical Exposure – Problems with Empathy
Students studying on a Professional Doctorate in Counselling Psychology are required to secure a placement in a counselling/clinical setting to gain 50 hours of 1:1 client time by the end of the first year. I was fortunate to have had experience at a private hospital as a psychology assistant before embarking on the Doctorate this September. This meant undertaking challenging work keyworking patients with eating disorders and personality disorders, in high intensity environments.
Given the nature of this work, I led myself to believe that I must have some ‘expertise’ to deal with such complex cases. However, when I reflected on the anxiety that I had experienced to do my job, I realised that I was as much using my character traits and personal experiences as well as my limited counselling skills training to work as effectively as possible. The experience was gold dust in acquiring knowledge and gaining exposure to different aspects of mental health, and patients were responding well – but was I looking after myself?
Further reflection led me to look at the anxiety of working with patients suffering with mental health problems. As a person who is naturally empathetic, I was a ‘sponge’ to the needs and emotions of patients. I would feel this tension as soon as I stepped on the wards of the hospital. This character trait gave me a lot of information about the feelings of the patients I was helping, but my own internal world was feeling unbalanced.
I realised quickly that I needed help in wrapping myself up – being able to draw the line between my patients’ feelings and my own, and developing myself to be able to build reparative relationships with them. On the Doctorate, it is suggested that trainees begin in a placement dealing with clients with mild-moderate problems, to fully embed core counselling skills and lower the risk of high levels of anxiety associated with complex client groups.
Getting the Right Support
Supervision and reflective practice form a core element of psychology training, and both are paramount in helping students grow, develop and learn. Supervision led me to talking about one case in particular, where I had felt a patient wanting to befriend me. I knew this was important information for the patient to know, but I was feeling under pressure and did not know how to reflect this information back in a therapeutic way.
Supervision helped me to unpick the relationship and look at elements ‘transference’ and ‘counter-transference’, terms which were originally established by Freud. It helped identify which elements formed part of the patient’s feelings and experience, and which emotions were my material. More recently, Petruska Clarkson (2003) has developed a model for building therapeutic relationships – theory which has been very helpful in underpinning my experiences of feeling like a ‘sponge’ for emotions and how to give back the right material to help the client.
Attending personal therapy is also a requirement of a Counselling Psychology Doctorate, where trainee counselling psychologist students will see their therapist for a minimum of 10 sessions in the first year, increasing in the final years of the course. It is in personal therapy that the past experiences and emotions of the trainee can be worked through, and can then be more readily identified in the therapy room with clients. I realised that my strong reactions to certain patients were as much a reflection of my own material, which could be worked through with my personal therapist. This work can be painful or anxiety provoking, but it is a continual learning curve for a counselling trainee with the aim of becoming a well-rounded professional.
Balancing the Course and a Lifestyle
Most trainees find themselves in the predicament of securing funding. For this reason, I opted for a part-time Doctorate, which takes place just one day a week at University. This meant one essay of 3500 words in the first term and an assessed group presentation.
During the first semester, we revisited counselling skills which were videoed and critiqued, as well as attending research methods lectures. This had the amazing effect of ‘deskilling’ most trainees, as we began to realise the enormity of the task at hand when faced with a client. Unpicking the dynamic of the therapeutic relationship and looking at all the possible interventions and models was quite daunting!
With the NHS currently working more with CBT approaches, we focussed on this aspect and were supervised in trying to implement the model. Trainees were also tasked with finding a placement to gain their 1:1 client hours, which required a lot of forward planning and paperwork, to take up one day per week.
I spent the summer prior to the Doctorate planning my working lifestyle. I handed in my notice to my full-time employment and realised that I needed a job that was flexible with minimal stress. I was lucky to put previous office work as a PA into play, and secured a 3-day a week contract . This left one day for a placement and one day for lectures at University, with occasional weekend shifts at the private hospital for clinical exposure. Having completed the first semester working predominantly 6-day weeks, suffice to say I am exhausted and cannot wait for the Christmas break!
However, the satisfaction gained from spending such a productive and challenging few months is immense. A career in psychology is a huge commitment but it definitely pays off – I have thoroughly enjoyed meeting the people that are part of this world and feel excited about what that can bring in the future. As a BPS member (trainees apply to become members of the Division of Counselling Psychology), invites to lectures and conferences are available, bringing students into the fold with other trained psychologists and their specialisms.
A training in psychology is a commitment on many levels, which people should feel they are ready to embark upon. One of the many tensions for trainees is acknowledging and dealing with anxiety provoking situations for which they need appropriate support. Gaining access to this support and using it effectively is paramount in ensuring people are ‘wrapped up’ and are using their experiences to learn more about their clients and themselves.
I have been fortunate to have fantastic support in supervision and good teaching at university to self-reflect and use psychological theory to underpin my experiences. An awareness among untrained professionals could help in more collaborative ways of working to support each other though these challenges. According to the model, the third stage in the journey is to reach ‘unconscious competence’, which hopefully will come about after much exposure and practice of using the skills. Placement experience, together with a focus on research methods and putting together a thesis proposal by the end of year 1, stands students in good stead for reaching the final stage in the process and becoming ‘consciously competent’.
Clarkson, P. (2003). The Therapeutic Relationship. Whurr Publications Ltd. London.