Psychotherapist career in the UK

Watch
faithinpopcorn
Badges: 3
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#1
Report Thread starter 1 year ago
#1
Hi everyone,

I'm considering a career switch to the field of psychotherapy but I am quite worried about choosing the right modality in regards to employment opportunities.

Since in my current profession I'm self-employed, I would prefer to be employed in the future by the NHS or clinics/hospitals/universities/schools (although I'm happy to be doing private practice alongside). From the research I've done so far, the NHS seems to be employing mainly CBT, Systemic Family or CAMHS psychotherapists (as far as I understand these are more solution-focused, evidence-based, short, and therefore cheaper types). There's also some demand for psychodynamic psychotherapists but not nearly as much it seems.

I was originally thinking to train in psychodynamic psychotherapy at Birkbeck (Certificate of Higher Education in Psychodynamic
Psychotherapy, leading to the MSc in Psychodynamic Counselling and Psychotherapy). From what I can understand this is usually long-term therapy focusing more on complex trauma and depression, rather than phobias/anxiety/PTSD.

I like that it's not time-limited and that you get to know the patient better rather than working in 6-12 sessions, but I also think I would be interested in working with people who suffer from postnatal depression, addictions, and PTSD. Though I've read therapists often use a mixed approach, the underlying theories of psychodynamic therapy and CBT are conflicting.

I'm slightly stuck in making a clear decision as to which modality would suit me best. Could anyone share their training experiences and employment experiences after graduating?

Thank you so much!
1
reply
Incidentaloma
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#2
Report 1 year ago
#2
Doing a counselling course is very unlikely to get you employment in the NHS. These courses are very popular and that has led to a saturated market, not eased by the fact that the NHS overwhelmingly prefers its therapists to have done their training on top of a recognised 'core' mental health profession (social work, occupational therapy, mental health nursing, etc). The easiest way to become an NHS clinician would be to train in a core profession, or to apply right away for trainee psychological wellbeing practitioner (PWP) roles in IAPT. A counselling MSc gives you no real advantage.

I have a psychodynamic/psychoanalytic background. I completed a preclinical MA with the Tavistock and Portman that makes me eligible for NHS training as a psychoanalytic child psychotherapist. If you'd be happy to work exclusively with children and young people, this is one option you could look into - child psychotherapists do more long-term work with patients who have very complex presentations, often trauma-related. You'd need to complete a preclinical course approved by the Tavi to be eligible to train and have substantial work experience with young people of different age groups. I have decided to apply for medicine instead, for a variety of reasons, but I thoroughly recommend their courses and approach.
4
reply
Nerol
Badges: 21
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#3
Report 1 year ago
#3
(Original post by faithinpopcorn)
Hi everyone,

I'm considering a career switch to the field of psychotherapy but I am quite worried about choosing the right modality in regards to employment opportunities.

Since in my current profession I'm self-employed, I would prefer to be employed in the future by the NHS or clinics/hospitals/universities/schools (although I'm happy to be doing private practice alongside). From the research I've done so far, the NHS seems to be employing mainly CBT, Systemic Family or CAMHS psychotherapists (as far as I understand these are more solution-focused, evidence-based, short, and therefore cheaper types). There's also some demand for psychodynamic psychotherapists but not nearly as much it seems.

I was originally thinking to train in psychodynamic psychotherapy at Birkbeck (Certificate of Higher Education in Psychodynamic
Psychotherapy, leading to the MSc in Psychodynamic Counselling and Psychotherapy). From what I can understand this is usually long-term therapy focusing more on complex trauma and depression, rather than phobias/anxiety/PTSD.

I like that it's not time-limited and that you get to know the patient better rather than working in 6-12 sessions, but I also think I would be interested in working with people who suffer from postnatal depression, addictions, and PTSD. Though I've read therapists often use a mixed approach, the underlying theories of psychodynamic therapy and CBT are conflicting.

I'm slightly stuck in making a clear decision as to which modality would suit me best. Could anyone share their training experiences and employment experiences after graduating?

Thank you so much!
Hi!

I, too, am on a psychotherapy route. I am currently doing a level 4 qualification in therapeutic counselling and doing my placement where I work at a drug and alcohol service. You're right, brief interventions are most definitely favoured by the NHS, in particular CBT. With regards to employability, especially within the NHS, CBT training would be the way to go. There are paid trainee posts for this that occasionally pop up, but you need to be in a core professions, such as counselling, mental health nursing, PWP etc.

There are so many modalities, and many therapists will train in more than one and use an integrated approach where possible/ necessary. This is probably a good way as it opens more doors, however, of course it will be costly and take a decent amount of time.

My plan is to get my counselling qualification and hopefully continue to work within the company I currently work for as a counsellor, then either go onto a Counselling Psychology doctorate or high intensity therapies training - not decided yet!
1
reply
Lord Asriel
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#4
Report 1 year ago
#4
(Original post by Incidentaloma)
Doing a counselling course is very unlikely to get you employment in the NHS. These courses are very popular and that has led to a saturated market, not eased by the fact that the NHS overwhelmingly prefers its therapists to have done their training on top of a recognised 'core' mental health profession (social work, occupational therapy, mental health nursing, etc). The easiest way to become an NHS clinician would be to train in a core profession, or to apply right away for trainee psychological wellbeing practitioner (PWP) roles in IAPT. A counselling MSc gives you no real advantage.

I have a psychodynamic/psychoanalytic background. I completed a preclinical MA with the Tavistock and Portman that makes me eligible for NHS training as a psychoanalytic child psychotherapist. If you'd be happy to work exclusively with children and young people, this is one option you could look into - child psychotherapists do more long-term work with patients who have very complex presentations, often trauma-related. You'd need to complete a preclinical course approved by the Tavi to be eligible to train and have substantial work experience with young people of different age groups. I have decided to apply for medicine instead, for a variety of reasons, but I thoroughly recommend their courses and approach.
This comment is absolutely spot on, and should be considered by anyone signing up with expectations around counselling courses.

@Incidentaloma: If you are going down the medicine route have you considered becoming a medical psychotherapist? One of my therapy supervisors is a Psychiatrist/ Medical Psychotherapist and is brilliant, and some of my fave NHS clinicians I have worked with are medical psychotherapists.
0
reply
giella
Badges: 15
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#5
Report 1 year ago
#5
The majority of people offering therapy in the NHS that I’ve encountered? Psychiatric nurses who’ve completed additional training and IAPT workers who’ve come from backgrounds like social work, midwifery or nursing. These are the people the NHS are likely to invest in because they’ve already got extensive experience working within the client groups most likely to access or benefit from that kind of therapy.
It’s really not something you can usually just qualify your way into if you want to work in the NHS. Counselling may be an unregulated profession but the NHS itself is going to be quite conservative and selective about the people they hire and they value experience and commitment more than just about anything else.
I’m going to be a little un-PC here and say that counselling tends to attract some specific types of people (I’ve been among them). You’ve got the people who’ve had counselling themselves who think, this is amazing. I’d love to spend all day doing this (guilty)! You’ve got the people who’ve got a bit of a penchant for telling people what to do (you can’t make me admit anything!). You’ve got the people also who are wanting to avoid doing anything that doesn’t directly lead to them doing and only and exclusively counselling. A subgroup within all three of those are the people who think that looks and sounds like a cushy job, I’ll do that but only if I don’t have to face any barriers or hurdles or trials to get into it.
I’m not saying you’re necessarily any of those, but remember that the people who often make it are the people who’ve already put in hard time in other roles first and they’ve earned their stripes there. They’re not doing it on a whim or with the bare minimum of entry qualifications to their name but as a culmination of a career’s worth of skills development and experience which make them very well placed to work with particular client groups or in particular settings?
Ask yourself this: who would be better placed to help provide therapy to new mothers with PTSD or PND? Someone who decided after their own experience of counselling that they were ready to help others achieve the same turn around or perhaps a health visitor or a midwife of five years’ experience who knows the complexities of biological, psychological and social problems that affect women of all backgrounds in the postnatal period who understands the multidisciplinary aspects of working with vulnerable women and who has the other clinical skills that go with it? Or maybe some who, after her own experience, set up a group for women undergoing the same thing, volunteered her time to facilitate it every week, got guest speakers in, completed CPD and training to support herself, set up parallel groups to support feeding difficulties, secured funding bids to get in extra support, knew how to signpost women to other services, and who completed a relevant professional training course in her own time etc etc. Who would the NHS be hiring?
2
reply
Incidentaloma
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#6
Report 1 year ago
#6
(Original post by Lord Asriel)
This comment is absolutely spot on, and should be considered by anyone signing up with expectations around counselling courses.

@Incidentaloma: If you are going down the medicine route have you considered becoming a medical psychotherapist? One of my therapy supervisors is a Psychiatrist/ Medical Psychotherapist and is brilliant, and some of my fave NHS clinicians I have worked with are medical psychotherapists.
It was a couple of former psychiatry colleagues who gave me the final nudge I needed to apply for medicine, one of whom is a medical psychotherapist. I suspect that's what I'll end up doing, but quite a few doctors have told me that they went into medical school with their hearts set on one specialty and ended up doing something they'd never dreamed of, so I'm trying to keep an open mind.
0
reply
faithinpopcorn
Badges: 3
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#7
Report Thread starter 1 year ago
#7
(Original post by Nerol)
Hi!

I, too, am on a psychotherapy route. I am currently doing a level 4 qualification in therapeutic counselling and doing my placement where I work at a drug and alcohol service. You're right, brief interventions are most definitely favoured by the NHS, in particular CBT. With regards to employability, especially within the NHS, CBT training would be the way to go. There are paid trainee posts for this that occasionally pop up, but you need to be in a core professions, such as counselling, mental health nursing, PWP etc.

There are so many modalities, and many therapists will train in more than one and use an integrated approach where possible/ necessary. This is probably a good way as it opens more doors, however, of course it will be costly and take a decent amount of time.

My plan is to get my counselling qualification and hopefully continue to work within the company I currently work for as a counsellor, then either go onto a Counselling Psychology doctorate or high intensity therapies training - not decided yet!
Hi,

Thanks for your reply!

Was jus curious about the placement you mentioned - was it difficult to get one? Do training institutions help with that?
0
reply
Nerol
Badges: 21
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#8
Report 1 year ago
#8
(Original post by faithinpopcorn)
Hi,

Thanks for your reply!

Was jus curious about the placement you mentioned - was it difficult to get one? Do training institutions help with that?
Hey!

This year, placements have been very hard to get because a lot have been cancelled. Generally, colleges don't help with finding a placement, you have to contact places yourself. I'm just lucky because I happen to already work somewhere that offers counselling placements!
0
reply
psarmento
Badges: 1
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#9
Report 10 months ago
#9
(Original post by Incidentaloma)
Doing a counselling course is very unlikely to get you employment in the NHS. These courses are very popular and that has led to a saturated market, not eased by the fact that the NHS overwhelmingly prefers its therapists to have done their training on top of a recognised 'core' mental health profession (social work, occupational therapy, mental health nursing, etc). The easiest way to become an NHS clinician would be to train in a core profession, or to apply right away for trainee psychological wellbeing practitioner (PWP) roles in IAPT. A counselling MSc gives you no real advantage.

I have a psychodynamic/psychoanalytic background. I completed a preclinical MA with the Tavistock and Portman that makes me eligible for NHS training as a psychoanalytic child psychotherapist. If you'd be happy to work exclusively with children and young people, this is one option you could look into - child psychotherapists do more long-term work with patients who have very complex presentations, often trauma-related. You'd need to complete a preclinical course approved by the Tavi to be eligible to train and have substantial work experience with young people of different age groups. I have decided to apply for medicine instead, for a variety of reasons, but I thoroughly recommend their courses and approach.
Hi, Sorry to jump in but just seen what you said about your MA. I have applied for the same preclinical MA and was wondering if you could give me some information on what to expect
0
reply
Incidentaloma
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#10
Report 10 months ago
#10
(Original post by psarmento)
Hi, Sorry to jump in but just seen what you said about your MA. I have applied for the same preclinical MA and was wondering if you could give me some information on what to expect
Will you be studying in London or at one of the Tavi-affiliated centres elsewhere in the country? They are pretty much identical in terms of content but each centre seems to have its own particular 'feel' and atmosphere.

In a nutshell, this is probably the most rewarding course I've ever done. There is a mixture of theoretical study, where you get to grips with key psychoanalytic concepts and read the foundational texts; and more experiential learning, such as the infant observation that is at the heart of the course. Teaching is all delivered in small-group seminars. This can be a bit unnerving if you're not used to it, but it's a really stimulating way to learn. Some aspects of the course are emotionally quite challenging, particularly the work observation module, where you take it in turns to present a vignette from your work and discuss it as a group. As you're meant to bring a scenario you found challenging or thought-provoking, It can be hard not to feel judged or defensive with everyone scrutinising it. But this is also an important part of the learning. You're encouraged to reflect on your own feelings and responses throughout the course, to develop a good level of self-awareness and the capacity to understand and tolerate those aspects of your own self that you find difficult. Developing observational skills is also paramount - I would never have believed that a drowsy newborn could communicate so much or raise so many questions until I spent an hour a week giving one my full attention!

Lots of students in my cohort enrolled hoping to progress to the clinical training. Most of them changed their minds or become doubtful about it (including me). There were a variety of reasons for this. However, the course is still worth doing in its own right, even if you don't end up pursuing the training - it's incredibly useful for anyone working with children in any capacity.
0
reply
HorrificSausage
Badges: 4
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#11
Report 9 months ago
#11
(Original post by Incidentaloma)
Doing a counselling course is very unlikely to get you employment in the NHS. These courses are very popular and that has led to a saturated market, not eased by the fact that the NHS overwhelmingly prefers its therapists to have done their training on top of a recognised 'core' mental health profession (social work, occupational therapy, mental health nursing, etc). The easiest way to become an NHS clinician would be to train in a core profession, or to apply right away for trainee psychological wellbeing practitioner (PWP) roles in IAPT. A counselling MSc gives you no real advantage.

I have a psychodynamic/psychoanalytic background. I completed a preclinical MA with the Tavistock and Portman that makes me eligible for NHS training as a psychoanalytic child psychotherapist. If you'd be happy to work exclusively with children and young people, this is one option you could look into - child psychotherapists do more long-term work with patients who have very complex presentations, often trauma-related. You'd need to complete a preclinical course approved by the Tavi to be eligible to train and have substantial work experience with young people of different age groups. I have decided to apply for medicine instead, for a variety of reasons, but I thoroughly recommend their courses and approach.
If I'm planning to get an MSc in Psychology, what jobs am I likely to get in NHS?
0
reply
giella
Badges: 15
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#12
Report 9 months ago
#12
(Original post by HorrificSausage)
If I'm planning to get an MSc in Psychology, what jobs am I likely to get in NHS?
Unlikely anything above a band 4 at entry level. Maybe the NHS scientist training scheme.
0
reply
eduorclinpsych
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#13
Report 9 months ago
#13
(Original post by Incidentaloma)
Doing a counselling course is very unlikely to get you employment in the NHS. These courses are very popular and that has led to a saturated market, not eased by the fact that the NHS overwhelmingly prefers its therapists to have done their training on top of a recognised 'core' mental health profession (social work, occupational therapy, mental health nursing, etc). The easiest way to become an NHS clinician would be to train in a core profession, or to apply right away for trainee psychological wellbeing practitioner (PWP) roles in IAPT. A counselling MSc gives you no real advantage.

I have a psychodynamic/psychoanalytic background. I completed a preclinical MA with the Tavistock and Portman that makes me eligible for NHS training as a psychoanalytic child psychotherapist. If you'd be happy to work exclusively with children and young people, this is one option you could look into - child psychotherapists do more long-term work with patients who have very complex presentations, often trauma-related. You'd need to complete a preclinical course approved by the Tavi to be eligible to train and have substantial work experience with young people of different age groups. I have decided to apply for medicine instead, for a variety of reasons, but I thoroughly recommend their courses and approach.
Do you mind my asking the structure of the pre-clinical Master's/PG study with Tavistock and Portman? I've been looking into this route, and I'm a tad confused by their wording on the site. You can attend the M70 course where attendance is all day Wednesday.... is this just for the theoretical-based work or will this incorporate observations that need to be undertaken?

I popped them an email to ask time requirements etc. (as in, do I need to leave my current full-time job or not?) and they didn't really respond with a clear answer.

Would love to hear more. I'm currently torn between Educational Psychology and Child and Adolescent Psychotherapy. I know both are very different but have a genuine interest and passion for both.
0
reply
Incidentaloma
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#14
Report 9 months ago
#14
(Original post by eduorclinpsych)
Do you mind my asking the structure of the pre-clinical Master's/PG study with Tavistock and Portman? I've been looking into this route, and I'm a tad confused by their wording on the site. You can attend the M70 course where attendance is all day Wednesday.... is this just for the theoretical-based work or will this incorporate observations that need to be undertaken?

I popped them an email to ask time requirements etc. (as in, do I need to leave my current full-time job or not?) and they didn't really respond with a clear answer.

Would love to hear more. I'm currently torn between Educational Psychology and Child and Adolescent Psychotherapy. I know both are very different but have a genuine interest and passion for both.
The teaching day is just for seminars. You organise your observations at a time that's convenient for you and the family. You will observe an infant from birth to two years for an hour each week, and later on in the course you will observe a nursery-aged child in their nursery, again for an hour per week. This is a shorter commitment of one year. (Breaks are allowed and expected.)

You are required to be working with children and young people in some capacity. This is because one of the core seminars is the Work Discussion group, where you will write up, present, and explore vignettes from your job. So your employer needs to be willing to accommodate the teaching days. This was probably my favourite seminar - I got so much out of it. I was a special school teacher when I did the course and it transformed my whole approach. (If you spread the course over three years rather than two, you can do the theory modules in first year and then pick up the obs modules in second, and you don't necessarily have to be working with children for the pure theory. They do prefer it though.)

I would strongly recommend you take the course even if you're more inclined towards EP, because it's phenomenal teaching and really increases your capacity to think quickly yet deeply under pressure. These days I work in A&E, which is often chaotic and full of distressing scenes, and I draw on what I learned at the Tavi all the time. It would stand you in good stead on an EP doctorate too, and it's definitely time well invested.
Last edited by Incidentaloma; 9 months ago
0
reply
eduorclinpsych
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#15
Report 9 months ago
#15
(Original post by Incidentaloma)
The teaching day is just for seminars. You organise your observations at a time that's convenient for you and the family. You will observe an infant from birth to two years for an hour each week, and later on in the course you will observe a nursery-aged child in their nursery, again for an hour per week. This is a shorter commitment of one year. (Breaks are allowed and expected.)

You are required to be working with children and young people in some capacity. This is because one of the core seminars is the Work Discussion group, where you will write up, present, and explore vignettes from your job. So your employer needs to be willing to accommodate the teaching days. This was probably my favourite seminar - I got so much out of it. I was a special school teacher when I did the course and it transformed my whole approach. (If you spread the course over three years rather than two, you can do the theory modules in first year and then pick up the obs modules in second, and you don't necessarily have to be working with children for the pure theory. They do prefer it though.)

I would strongly recommend you take the course even if you're more inclined towards EP, because it's phenomenal teaching and really increases your capacity to think quickly yet deeply under pressure. These days I work in A&E, which is often chaotic and full of distressing scenes, and I draw on what I learned at the Tavi all the time. It would stand you in good stead on an EP doctorate too, and it's definitely time well invested.
Hi there, thank you so much for your very detailed and helpful response. It's greatly appreciated and it's clear you're very fond of your experience having studied the course.
0
reply
~Tara~
Badges: 16
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#16
Report 9 months ago
#16
The employment issue within the nhs is not because of there being "too many counsellors". There is a MASSIVE culture of exploitation within counselling and psychotherapy. Counsellors/psychotherapists are expected to volunteer for YEARS after they are qualified. There is also a move from one of the biggest proponents of that exploitation to make it so that people are even more unemployable. Ridiculously and shockingly, there is a document in the nhs - from iapt - that states qualified counsellors are *unsafe* to do 1-2-1 work with patients. They have yet to retract this.

I would say that atm it is not worth doing a diploma until you know whether youll only have to repeat all your learning on a degree or above. The training for a counsellor is not stepped up like the other professions. You are equally qualified with a level 4 diploma as having a masters. Very little opportunity to "top up" core training and cpd is unregulated. I've been qualified for 5 years and im choosing to go down the psychologist route
Last edited by ~Tara~; 9 months ago
2
reply
Lord Asriel
Badges: 11
Rep:
? You'll earn badges for being active around the site. Rep gems come when your posts are rated by other community members.
#17
Report 9 months ago
#17
(Original post by ~Tara~)
The employment issue within the nhs is not because of there being "too many counsellors". There is a MASSIVE culture of exploitation within counselling and psychotherapy. Counsellors/psychotherapists are expected to volunteer for YEARS after they are qualified. There is also a move from one of the biggest proponents of that exploitation to make it so that people are even more unemployable. Ridiculously and shockingly, there is a document in the nhs - from iapt - that states qualified counsellors are *unsafe* to do 1-2-1 work with patients. They have yet to retract this.

I would say that atm it is not worth doing a diploma until you know whether youll only have to repeat all your learning on a degree or above. The training for a counsellor is not stepped up like the other professions. You are equally qualified with a level 4 diploma as having a masters. Very little opportunity to "top up" core training and cpd is unregulated. I've been qualified for 5 years and im choosing to go down the psychologist route
I agree with this, and it is frightening how much free labour early career counsellors are supposed to offer, as well as the way that nearly half counsellors end up working for free.

There has been a lot written about why, but from my understanding some of this is due to the way that some disciplines (like medicine or psychology) have started from a place of professionalisation; very high barriers of entry, requiring very specific qualifications, NHS integration and a standardised curriculum so all practitioners have a standardised skillset. However, disciplines such as counselling have come from a very different background; of lay skills, non professionalisation, often voluntary or charitable origins. As a result it is quite a different experience to be working in these different roles even if you are in the same team.

The other 'myth' is also that all counsellors make no money. In reality there is huge variation. From my observations, monetary success in counselling is probably more about the individual's skill as a business person more than how good they are at counselling. If they can master the skills of marketing, networking, building up a client base and offering in demand services they can easily make more money than an NHS medic and with far, far better working conditions (plus are removed from some of the bullying that can happen in the NHS).
0
reply
X

Quick Reply

Attached files
Write a reply...
Reply
new posts
Back
to top
Latest
My Feed

See more of what you like on
The Student Room

You can personalise what you see on TSR. Tell us a little about yourself to get started.

Personalise

What is your favourite revision method?

Taking notes manually (78)
20.69%
Note taking apps (7)
1.86%
Flashcards (86)
22.81%
Revision guides (19)
5.04%
Past papers (172)
45.62%
Something else (let us know in the thread) (15)
3.98%

Watched Threads

View All