How does the role of a psychologist differ from CBT counsellors etc?

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sorvio
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How does the role of a psychologist differ from CBT counsellors etc?

Post by sorvio » Wed Oct 30, 2019 3:16 am

Forgive me if this is the wrong place to ask this, but I'm considering a career in mental health and not sure which to go for. If I literally google 'nhs psychologist' it brings me to a page on how to access CBT. CBT seems to be the main (or only) thing the NHS does nowadays for mental health. So how does the role of a psychologist differ, day to day, from NHS CBT counsellors, psychotherapists or PWPs and whatnot if they all deliver the same type of therapy? What sort of patients does a psychologist see in comparison? And how does one gain access to an NHS psychologist for treatment? I've never seen it mentioned on the NHS website or anything like that, it's almost like they don't exist.

Thanks.

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miriam
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Re: How does the role of a psychologist differ from CBT counsellors etc?

Post by miriam » Tue Nov 05, 2019 7:38 pm

Perhaps it would help to look up "clinical psychologist" rather than the rather vague and meaningless "psychologist"? I don't do any therapy at all, and plenty of clinical psychologists use models other than cbt. But those who use cbt use it at a much more skilled level than PWPs in IAPT. That's just the frontline service for mild to moderate mental health need in the nhs nowadays. There are many posts on the site about what CPs do in various services and hope they differ from other roles. I'd suggest you start with the wiki.
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Re: How does the role of a psychologist differ from CBT counsellors etc?

Post by Spatch » Tue Nov 05, 2019 10:23 pm

CBT seems to be the main (or only) thing the NHS does nowadays for mental health.
Regardless of what the website says, this isn't true. While CBT is possibly the most widely available formal psychotherapy, depending on the service and locality, you can get a range of different therapies on the NHS ranging from person centered counselling at some GP practices through to systemic/family therapy and some psychodynamic therapies in complex psychological services.
So how does the role of a psychologist differ, day to day, from NHS CBT counsellors, psychotherapists or PWPs and whatnot if they all deliver the same type of therapy?
They don't. As Miriam says CBT is actually a very broad church and can emcompass a range of different approaches and skill levels.IAPT PWPs trained to deliver manualised protocol driven CBT informed packages for mild anxiety are completely different to say someone delivering Enhanced CBT for Eating disorders or Schema Focussed CBT. It would be like saying your five year old daughter and Shakespeare both can write English, so really what's the difference?

Also some of them may not deliver therapy at all, especially in neuro-rehab or research settings or in senior management roles. I would really advise you read "What is Clinical Psychology?" by Llewelyn and Murphy to get more of an understanding of the role. I am sympathetic, as the information beyond a few websites around the nature of what we do is extremly poor (beyond Psychologist= therapy), and people have a far clearer understanding of the role of CPNs or GPs in comparison.
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sorvio
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Re: How does the role of a psychologist differ from CBT counsellors etc?

Post by sorvio » Fri Nov 08, 2019 10:52 pm

Thanks for the responses.
miriam wrote:
Tue Nov 05, 2019 7:38 pm
I don't do any therapy at all
Did you ever do therapy? Have you written anywhere about your career experiences and day-to-day life/schedule in the past?

Spatch wrote:
Tue Nov 05, 2019 10:23 pm
CBT seems to be the main (or only) thing the NHS does nowadays for mental health.
so some of them may not deliver therapy at all, especially in neuro-rehab or research settings or in senior management roles. I would really advise you read "What is Clinical Psychology?" by Llewelyn and Murphy to get more of an understanding of the role. I am sympathetic, as the information beyond a few websites around the nature of what we do is extremly poor (beyond Psychologist= therapy), and people have a far clearer understanding of the role of CPNs or GPs in comparison.
I see. Other than that book, would you recommend any sites, videos or books etc that go into what the day to day schedule of a clinical psychologist might look like? I see you have a book about being an assistant psychologist, maybe I'll give that a go. The general gist I'm getting is that clinical psychologists are similar to the roles I mentioned but offer more advanced therapy for people with more serious mental health problems beyond mild depression.

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Re: How does the role of a psychologist differ from CBT counsellors etc?

Post by miriam » Sat Nov 09, 2019 5:13 pm

sorvio wrote:
Fri Nov 08, 2019 10:52 pm
miriam wrote:
Tue Nov 05, 2019 7:38 pm
I don't do any therapy at all
Did you ever do therapy? Have you written anywhere about your career experiences and day-to-day life/schedule in the past?
My blog is linked from my signature in every post, and there is an article that is called "I am not a therapist".
But in answer, I have done therapy in the past. Both as a trainee, and as a small strand of both my NHS and private work. I'd say maybe 1/10th of my NHS time, and less since I've left the NHS. I'm usually tempted when there is a client nobody else can engage, or where there is something I can specifically bring to the table that a cheaper or more patient therapist might not. I generally work with very complex cases - normally in a time-limited way. I think I've only had two clients where I've been involved personally for more than 12 sessions in my whole career. But I can do it competently, and I've supervised a lot of trainees and more junior CPs in delivering therapy. I just choose not to because I have other priorities.

Generally, in terms of using my own expertise, I've always been skewed towards very thorough assessments and giving advice to the individual and their network, and letting other professionals do the long-term work. So I've worked a lot in neurodevelopmental services where I've been primarily involved in the assessment and diagnosis elements rather than post-diagnostic support (though I've designed information leaflets, psychoeducational groups for other professionals to deliver, and been involved in research and both local and national policy for this client group). Likewise I've worked a lot with children's social care, where I've done consultations and training for caregivers and professionals, designed groups and written a book, contributed to lots of policy work, and have been involved in service design and development. I've also done lots of assessments (or supervised APs and more junior CPs to do so), and given advice about care planning and whether therapy would be beneficial and of what sort. Finally, I've done loads of specialist assessments to help the family courts make decisions about cases, and again made recommendations about care plans and whether therapy would be beneficial, and if so, for whom and what type and for how long.
Miriam

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Re: How does the role of a psychologist differ from CBT counsellors etc?

Post by miriam » Sat Nov 09, 2019 5:22 pm

sorvio wrote:
Fri Nov 08, 2019 10:52 pm
Other than that book, would you recommend any sites, videos or books etc that go into what the day to day schedule of a clinical psychologist might look like? I see you have a book about being an assistant psychologist, maybe I'll give that a go. The general gist I'm getting is that clinical psychologists are similar to the roles I mentioned but offer more advanced therapy for people with more serious mental health problems beyond mild depression.
This website has loads of information, including wiki pages about a typical week for many different professional roles, and our Aspire e-magazine that you can download. There are also several books about what it is to be a clinical psychologist in the UK.

Spatch's book is a funny fictional take on the life of an AP. It is well worth reading, but I don't think it will tell you what a CP does. Tanya Byron wrote about her experiences in the Skeleton Cupboard, which is another novel-like take on the topic. There is also the book "what is clinical psychology?" and the youtube channel clinpsyexplained where Ian talks about his experience as a CP. There also seems to be a talk here from Susan Llewelyn which is likely to be good too.
Miriam

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