Psychotherapist career in the UK

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!

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.

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?

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

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?

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.

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.

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

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.