Our voices heard: aspiring psychologists’ accounts on announced changes in HEE funding
Health Education England (HEE) has recently released a statement about the eligibility of candidates to apply for funding in psychological professions. The statement was initially published through the Clearing House website and it immediately gained public attention from the online psychology community resulting in various responses. 1,2,3, 4, 5, 6 Following the reactions from those impacted and advocates in the field , the statement was reviewed by HEE, leading to a 3-years delay in the changes of the eligibility criteria for aspiring psychologists.
Although we appreciate the rapid responsiveness of HEE, we feel that it is appropriate for aspiring psychologists’ voices to be heard. As such, we decided to write this article, which was inspired by Surviving Clinical Psychology, edited by James Randall.
This piece of work presents two personal accounts of applicants, who would like to remain anonymous, using the theory of social GRACES as a framework. The social GRACES is a concept for self-reflection highlighting aspects of our identity. The experiences illustrated in this article will allow us to highlight how people’s decisions (e.g. to join a funded training) are not only influenced by personal choice, but are also influenced by the multiple identities they may hold, which are shaped by their context, and how these intersect.
Below, you can find a conversation-type of article, which aims to invite people who have been impacted by this announcement and subsequent changes to share their feelings and take part in the discussion by answering the same questions discussed here. If you wish to be part of the conversation, the website provides the opportunity to post your narratives and feelings in the comments area either by using your name or anonymously.
We hope that we will keep the conversation alive by showcasing people’s experiences and life circumstances in order to better inform HEE on how to address existing issues (e.g. staff retention) not only by restricting people’s choice, but by addressing wider inequalities.
- Would the decision from HEE regarding funding psychological professions have impacted you in applying for the DClinPsy? If yes, why?
First personal account
I am not originally from the UK, so I have no family in the country. I am a first-generation migrant here. Fun fact: I actually first moved to the UK specifically because where I am from we don’t have the profession defined in the same way (i.e. leadership, scientist-practitioner); the focus is more on psychotherapy. Once I moved here, I needed to find a job fairly soon as my family did not have the financial means to support me with rent or living expenses. I hold a BSc in Psychology (2:1), so I tried applying to Assistant Psychologist (AP) and Research Assistant (RA) posts, but was not offered any interviews. Thus my clinical journey took a different direction and I started working as a Support Worker. After one year and half of me unsuccessfully applying to AP, RA posts and to the DClinPsy, I was feeling reasonably discouraged. It is important to mention that some AP/RA posts appeared on the NHS and other websites and within a few hours they no longer were available online. So, if I was seeing the post in the morning but was at work, I was not able to review my cover letter and apply on time as most likely the post was already gone. I decided I needed to gain more clinical experience, so I looked into Psychological Wellbeing Practitioner (PWP) training. It seemed a good option as I could gain clinical experience and hopefully pursue my dream of becoming a Clinical Psychologist. Hence, to answer the question, yes it would have impacted me, I would have needed to wait two years after qualification. And, let’s assume I waited two more years but I wasn’t successful. What then? Still in this country without a family, I know I am not able to afford buying a house with a PWP salary. I would not be able to have my dream job and not enough money to settle down.
Second personal account
Like many, I could not afford to do an MSc or apply for honorary positions as I have a family to support, as well as other expenses. Therefore, getting the required experiences has been difficult. Assistant Psychologist roles only appear to go to those with the above. Fortunately, at the time IAPT and the PWP training offered me a fantastic alternative. Over the years, I have been working in IAPT and recently completed my HICBT training. I purposely avoided applying last year so that I could spend a year working as a qualified CBT therapist in IAPT. My peers, however, did apply and get on. The lack of awareness meant that I would have not been able to apply this year.
2. Do you have any ideas on how HEE could deal with staff retention for funded courses?
First personal account
I have been working as a PWP. As such, I have experienced the high caseload and the amount of complexity that we face as PWPs — most of which is not taught how to deal with at university. For example, I was asked to screen people for ADHD and autism and often dealt with people that were at immediate risk to self. Hence, not appropriate for primary care services. I believe to facilitate staff retention for PWPs, caseload, efficient screening and complexity should be reconsidered.
Second personal account
The issue is with both the training and the services. With the training, it is incredibly short and does not reflect the reality of the role. My PWP training forced me to memorise a script and made it clear I was not a therapist. However in reality I was treated as a therapist by the service and clients. Using a script does not work, because everyone is different. When I qualified as a PWP, I realised that I had learned almost nothing that I could use as a qualified PWP. The HICBT has been better in this regard. However, 9 months of active teaching is not nearly enough. Some courses offer 12, 16 and 24 months. I believe 12–16 months is better and all courses should be standardised in terms of length.
Regarding the services; targets are ever growing, there is a clear lack of staffing which forces many of us to work harder and harder. This is impacting the quality of the therapy offered and preventing us from engaging with specialisms to not only further develop the service but also offer something different and development. As a result of constantly seeing clients, many are feeling burnt out. This is why people are leaving, not because of the DClinPsy, but because we burn out. I recommend putting a national cap on all targets and force local CCGs to increase staffing numbers IF they want to increase the targets.
Finally, the way many services work is not within the evidence-base. NICE guidelines make it clear that 20-sessions of CBT are needed. However many services restrict this to 12-sessions, which means that as therapists we cannot do a full course of therapy leaving people needing further therapy causing them to re-refer.
We invite everyone to reflect on your experiences and take part in the conversation:
- Would the decision from HEE regarding funding psychological professions have impacted you in applying for the DClinPsy? If yes, why?
- Do you have any ideas on how HEE could deal with staff retention for funded courses?
For an easy read of the social GRACES framework look here. Please feel free to share on social media and with your peers.
