Providing peace of mind

The hardest part of psychology is getting into it. But when qualified, the chance to help others is stimulating and satisfying, writes Nick Jackson

What makes people tick? It's a question we ask ourselves everyday. Or, more often, what on earth does he/she think they're doing? And that simple curiosity is the first thing you need to become a psychologist.

What makes people tick? It's a question we ask ourselves everyday. Or, more often, what on earth does he/she think they're doing? And that simple curiosity is the first thing you need to become a psychologist.

The utopia of a republic of reason - the shared vision that makes us normal - will always have its outlaws. And, as with many a real republic, its outlaws help to define it. But life beyond the norm is a hard and lonely place. It's the work of a psychologist to make it easier, to help people understand the rules of normal behaviour, and to see themselves and others in a helpful, healthy way. Of course, it's not that easy.

The most common route into such a career is by completing a psychology degree, followed by work experience, research, or work as an assistant psychologist, and then a privately or NHS funded three-year postgraduate course - now a DClinPsych. But other options are available. Anne Cooke, 42, started a career in television after graduating in linguistics, which included some elements of psychology. After completing a conversion course and postgraduate training, she works as a consultant clinical psychologist. "In psychology, there's a good career structure, unlike in the media where it seems to hang on a lucky break," she says. "And it's a good balance. It's useful and helpful, as well as being intellectually stimulating." Ms Cooke worked in community mental health until recently. She sees the role of a psychologist in the mental health system as balancing doctors' medicinal solutions with a focus on how patients see their world. It's a difficult job, but a rewarding one. "The best and worst parts of the job are very similar," she says. "You're talking to people in great distress, so you have a relationship with them. People sometimes kill themselves, which is very hard. But the good thing is that you're often able to help."

Psychologists who specialise in adult mental health, like Cooke, are often faced with problems that reach back many years. Ruth Coppard, 64, is a child psychologist and well aware of how important it is to address these problems early to prevent them ruining a patient's life. "You can make a lot of difference," she says. "You can prevent later difficulties by giving children a different perspective and allowing them to reframe, so their problems don't become embedded in their psyche." Coppard, too, did not follow the most common path into psychology. A significant minority of clinical psychologists - a term which covers several disciplines, including child, adult, and elderly mental health, and forensic, counselling and neuropsychology - do not undertake the postgraduate training programme. Competition is tough to get on the courses, and three years more study does not appeal to everyone. By starting in branches of psychology such as educational, occupational, and industrial psychology that don't require postgraduate training, psychologists can train on the job. Coppard worked for many years as an educational psychologist before moving into child psychology in the 1990s. She says her approach has given her a more eclectic experience of working with children.

Dr Olwen Wilson, 53, also works as a consultant clinical child psychologist. She understands how daunting the training can seem. "The hardest bit about psychology is getting into it," she says. "You're 30 before you get your own job." But she also believes it's worth it, fascinating and rewarding. "We help children get back on track, and you can see them shifting back into a normal, happy life," she says. "Making kids happy is my job." Like many psychologists working in the NHS, she also loves the environment. "The teamwork's great," she says. "Working in a private practice isn't the same at all - it can be very lonely. In the NHS, you're all pulling together; everyone's very dedicated and caring; really good people."

Many psychologists work part time in the NHS and part time in private practice. Nadine Field, 47, describes herself as consultant psychologist and entrepreneur. As well as her work in adult mental health at Milton Keynes Hospital, she is an expert witness for the Law Society, and has set up a website, www.psychologyonline.co.uk, providing psychological consultation via the web. She says she owes much of her flexibility to her postgraduate course in counselling psychology - similar to the clinical course, but with a greater freedom in your choice of core subjects - which allowed Field to study forensic psychology as part of her course. "If you want more flexibility, counselling psychology is probably the best way forward," she says. The title counselling psychologist can be misleading. "None of the counselling psychologists I know does counselling," she says, "and we don't sit there in knitted jackets making cups of tea."

It is possible to move into newer branches of psychology while undertaking the clinical postgraduate course, but as forensic and neuropsychology are not among the core subjects, it requires a greater commitment and often a six-month elective placement on top of your core studies. Dr Julia Heller, 48, is a consultant forensic clinical psychologist at the Shaftesbury Medium Secure Clinic in Springfield University Hospital, London. Dr Heller spends some of her time in the courts, and the rest working with female offenders at the clinic. Forensic psychology is any psychology with some legal element, so you can find yourself working in the prison system, secure psychiatric hospitals or with the courts and the police. "I became interested in forensic psychology because I have an interest in the legal process," says Heller, "and I'm interested in the whole area of why people commit offences and criminality." At the clinic, she works with patients to help prevent them reoffending by finding out how best to treat their psychological needs using psychometric testing. There is only so much she can do and the complexity of the problems her patients have to deal with means that many do reoffend. It can be frustrating, but it's also interesting. "It's a very buzzy atmosphere - it's always changing," she says. "Patients can deteriorate quickly and there's an intense quality in that environment."

Another newer and fast developing field of psychology is neuropsychology. This is the study of the impact of brain injury on psychological processes. Patients who have been in accidents, or suffered aneurysms, strokes, or tumours, which have injured their brain, can suffer a wide range of problems, including changes in personality and thinking function. Living a normal life can become very challenging, as tasks like driving a car become more difficult and changes in personality can confuse and distress families and carers. Patients are sometimes unaware of how serious their injuries are and psychological help is needed to prevent them harming themselves. Neuropsychologists need to disentangle the symptoms of alterations in brain functions - the neuropsychology - from the psychological reaction to trauma. "It is complex," admits Dr Colin Wilson, 36, a consultant clinical neuropsychologist in Belfast. "It's an intellectual, practical and personal challenge. But that's why it's so good." In common with all psychologists, the greatest job satisfaction for Colin Wilson is to be had from helping people recover from their problems and go on to live a normal life.

It is this satisfaction in helping others that binds the various disciplines in psychology together and is a shared vision. Considering the training and experience necessary, the remuneration is not considerable. Your starting salary after qualifying will be about £17,000, rising to £36,000 for experienced psychologists, and topping £60,000 for the best and most experienced. But Olwen Wilson says this should not discourage anyone: "You do it to help, not for a lot of money. You do it for love."

'PSYCHOLOGY IS A VERY REWARDING PROFESSION, WHATEVER THE FIELD I'VE WORKED IN'

Dr Sarah Newton, 50, is head of clinical psychology services, Plymouth Teaching Primary Care Trust (TPCT)

I started by doing a London University degree, which I did externally at Oxford Polytechnic in anthropology, law, and psychology. Then I made my decisions about what I wanted to do. It is an advantage to study something other than straight psychology, as there's a lot of useful crossover information. I felt my degree was a particularly good combination and elements from the other disciplines come in handy. I then did my conversion course as an MSc in experimental psychology at Sussex University. Getting through that meant I was able to register as a graduate with the British Psychological Society and start applying for clinical psychology training. I followed this up with some research on adolescents with learning difficulties at the Hester Adrian Research Centre at Manchester University, which lead to a PhD. While I was doing that, I started my clinical psychology training at Birmingham University. Then it was a Masters course; now it's a DClinPsych. After finishing my training, I worked with adolescents and children. In one job, I worked in the burns unit, and helped them with the psychological trauma that they experienced as a result of their injuries.

I now head clinical psychology services for the Plymouth TPCT, which has four speciality areas covering a range of services, so I do a fair bit of management. But I still do some clinical work. I've found psychology a very rewarding profession, whatever field I've worked in and whatever age group.

For more information see the British Psychological Society website at www.bps.org.uk/