Iapt versus clinical psychology training

Discuss the content and style of the different clinical psychology doctoral training courses, the differences between them, placements, teaching, chat to other trainees and connect with other people who have places on the same course
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DHE2020
Posts: 2
Joined: Mon Apr 26, 2021 2:24 pm

Iapt versus clinical psychology training

Post by DHE2020 »

Hi there,
Just looking for some honest opinions.
I am a pwp who has just gone on sick leave (phew!) and handed in my notice due to being forced to increase our caseloads further (without being payed extra of course) after a gruelling year working at home in the pandemic with severely distressed humans. I am unsure whether this has burned my enthusiasm for my own endeavours with therapeutic practice but I wanted to know what those who have done IAPT feel it’s like compared to the DClin? Is it any less intense in terms of demand? Is vicarious trauma properly acknowledged and supported when on placement as this is something completely ignored by my iapt service and contributed to my burn out.
Just reaching out to see if it’s still worth pursuing or if I did get it are the expectations/environment while training similar?
Thank you!
hawke
Posts: 154
Joined: Tue Feb 07, 2017 11:10 am

Re: Iapt versus clinical psychology training

Post by hawke »

I worked as a PWP for four-ish years before training, and am now due to qualify later this year.

Training for me has generally been a lighter absolute workload compared to IAPT. As a general rule of thumb, adult and child mental health service placements tend to be quite busy, while older adults and learning disability placements are much quieter. The academic workload has ebbed and flowed, as you might expect from a university course - I had a lot of free time for following my interests in the first half of the course, but the second half has been dominated by thinking more pragmatically about completing a thesis. In particular, the job is much more varied than working in IAPT, so time spent in direct contact with clients is much much lower. The course is incredibly intensive in terms of learning - I remember feeling bored towards the end of my time in IAPT, but now I cannot wait to just tread water for a little bit in my first post-qualified job! As well as learning skills, you also change placement every 6 months, so there is the additional demand of your working life changing regularly, so there is definitely no settling into a comfort zone or routine. You spend three years being constantly evaluated, which is also absolutely draining by the end of it. Psychology also has a much greater expectation for using yourself within the job and therapeutic relationship, so there is a huge amount of personal learning and reflection to be done, which can at times be uncomfortable - half my cohort at least have ended up in therapy themselves. So absolute workload is not at IAPT-levels, but don't underestimate the other practical and emotional demands of training.

I think psychologists tend to have a better understanding of the personal impact of the work (e.g. vicarious trauma), but I think services vary in how supported practitioners are. I think there is much more variability in supervision as well - my best and worst experiences of supervision have been on training. As a psychologist, the expectation actually shifts, so you're expected to be the one containing and supporting other staff. So I do think psychology training equips you to better manage the personal impact of therapy, but the expectations placed on you grow to match. So personally, training has been harder for me than working in IAPT, even though I've been 'doing' less for most of it.
DHE2020
Posts: 2
Joined: Mon Apr 26, 2021 2:24 pm

Re: Iapt versus clinical psychology training

Post by DHE2020 »

Thank you for your helpful and thorough response hawke. I find self-practice/reflection is massively lacking in PWP work and is something though uncomfortable I do tend to enjoy. The problem for me has been the production line element of therapy with no time to learn new things but just to plough on with what limited amount you know.

The client contact element being less appeals to me as I feel I’m often working with clients at step 2 who have severe enduring mental health difficulties without adequate training. I feel a definite lack of experience and knowledge compared to the expectations held of me as a PWP.

That sounds challenging as a psychologist to be always seen as the supervisor or ‘knower of answers’. Do you feel you have been adequately supported by your supervisors and do you have a choice in your placements at all?

So it sounds like the intensity/relentlessness is somewhat less comparatively but the mental and (goes without saying) academic challenges and expectations are significantly higher?
Thanks for your help with this just thinking a loud!
hawke
Posts: 154
Joined: Tue Feb 07, 2017 11:10 am

Re: Iapt versus clinical psychology training

Post by hawke »

It sounds like you're in a very similar place to where I was as a PWP - craving the personal and professional learning. At times I do regret not doing HI training, as I think that would have scratched the learning itch for a while and equipped me better for CBT in the long-term, but generally I'm happy I made the jump to psychology.

Again, one thing to caution is that feeling of lacking the experience and knowledge also doesn't leave you as a trainee - if anything, that's been a lot worse as I've been expected to jump in at a band 6 in services with client groups I have no experience with. Supervisors are generally quite mixed, as courses are desperate for placements so supervisor match is less important than availability. My course has been pretty good at matching me with desired placements though, and offers us a choice of model specialisations. So while I know geography is one of the most important factors for most people training, it is definitely worth considering your fit to the course specialities if possible.

Psychologists are generally working in the space beyond the evidence base, using formulation to try to understand complex presentations, but generally I think the training helps with managing the anxiety that comes with that uncertainty. I think training equips us very well for assessing, formulating and evaluating - but the interventions part requires even further training once you qualify, so it's definitely no magic bullet for feeling ill-equipped to deal with the problems that people bring!
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