Reflections on Diverse Pathways to a Paid Assistant Psychologist Role

Megan McGinley, Niamh Davoren, Amy Walsh, Siobhán Clifford and Sarah Summerville

AP Reflective Pic

Abstract

In the current paper, we as five Assistant Psychologists (APs) working in paid posts, reflect on our experiences thus far along our psychology careers. Within, we identify many areas of commonality and contrast woven across our journeys through education, relevant experience, personal development, and our current role. In Ireland, a paid AP post is often anecdotally referred to as the gold standard of experience when applying for the Doctorate in Clinical Psychology. With this in mind, we reflected on and compared our journeys to this point. Each of our pathways have been significantly different and perhaps not straightforward. However, our experiences have afforded us with a breath of competencies and skills, which we benefit from both personally and professionally. The current paper examines these similarities and differences in order to provide an insight into the experiences of APs through a reflective lens.

 

Introduction

Looking at our education, relevant experience and our personal development, we found areas of both commonality and contrast. We chose to focus on these areas as they were themes that reoccurred in our discussions and underpin our career progression. As we reflected on each area, we found that our experiences so far have afforded us with the competencies and skills required for our current AP post and while different, each of our paths have led us to this point on our clinical psychology journey. Reflection is an essential skill when practicing clinical psychology, as outlined in the British Psychological Society practice guidelines1 and Psychological Society of Ireland’s supervision guidelines2. Reflective practice brings a number of benefits to practitioners such as awareness and management of biases. It enables practitioners to be open to feedback and facilitates eagerness to improve1. According to research, reflection improves decision making3 and aids psychologists in maintaining ethical and professional standards4. Reflective practice is a competency which we are actively focusing on to develop. Our focus on reflective practice, together with the commencement of our current AP posts inspired this reflective piece, detailing our journey thus far within the realm of clinical psychology. Having simultaneously taken up employment in these paid AP posts, we now have the opportunity to reflect on each of our pathways to date.

 

Education: Opportunities and Frustrations

Previous research, which has profiled APs and those pursuing clinical psychology in Ireland, has found that an overwhelming percentage hold a master’s degree5, 6. Collectively, we have completed six masters across the Republic and North of Ireland. Yet, in discussing our routes to becoming APs, we found that a lack of clear guidance from secondary level through to university level was a recurring theme. At secondary level, psychology was not a career that was promoted or clearly explained. At university level, there was an overwhelming pressure to choose a relevant master’s that would ultimately prepare us to pursue a Doctorate in Clinical Psychology. Conducting our own research into what pathway to follow was essential in choosing an educational path as adequate guidance was not always provided (e.g. searching for a course accredited by the Psychological Society of Ireland).

 

Each of us had recognised in our undergraduate degrees that we would most likely be required to complete the minimum of a master’s level degree. Bearing this in mind, we have all found ourselves frustrated on occasion with the length of time we have spent in academia. A common frustration stemmed from comparisons to other peers’ career paths and how they appeared to progress at a quicker pace than our own; specifically, securing relevant work with an undergraduate degree. Intrinsic to this is both our own and society’s expectations of holding a master’s degree and gaining employment. In many careers, a masters’ degree is not essential and is only required if an individual wishes to become more specialised in their field of work. However, on the path to clinical psychology, it feels as essential as an undergraduate degree. We have found that this can be difficult to explain to family and friends, as well as trying to shake the image of ‘the perpetual student’. Our progress seemed minimal then, although reflecting on these experiences with hindsight, we can see that we were on the same trajectory as other aspiring psychologists. However, this was overshadowed at the time by the lack of results for our efforts; such as graduate entry paid employment.

 

It is widely recognised that the path to clinical psychology is competitive and the pressure experienced to excel relative to our psychology undergraduate peers can be overwhelming. We felt this was reflected in differing ways during our postgraduate degrees. Some of us experienced this competitiveness almost to an isolating degree and felt little camaraderie among classmates. Contrastingly, some of us experienced a nurturing and supportive environment of classmates and unsurprisingly reported more positively on our postgraduate experiences. Upon reflection, we feel the courses that were more supportive, tended to be smaller and had a more diverse student population. The absence and presence of a supportive peer group has guided our own interactions with each other as a group of APs within a clinical psychology service. We recognise the value of peer support and how it is more beneficial to help each other towards a career in clinical psychology rather than perpetuate a competitive environment.

 

Reflecting on our experiences throughout our educational careers, we are now able to recognise the benefits of these challenges as they prepared us for our roles as APs and have given us a solid foundation for our potential careers as clinical psychologists. These formal and informal teachings during our educational careers, so far, have become skills that are integrated into our daily practice as APs.

 

Clinically Relevant Experience

Due to continuing development of the AP position, the disconnect between study and postgraduate employment can feel like a large jump into the abyss. The established culture of unpaid AP roles within the Republic of Ireland6 requires many aspiring psychologists to seek paid employment in other clinically relevant roles, following study. Despite this challenge, combined with the limited amount of AP positions, we all secured psychologically relevant roles , such as support worker or research assistant posts. Indirect clinical experience was gained through voluntary roles and for some of us, through clinical research. Our involvement in a range of divergent research projects has led to an assortment of differing interpersonal and research strengths that we each now bring to the role as a team of APs.

 

Equally, all of us have been fortunate to experience a rich variety of clinical work with both general and clinical populations throughout the lifespan. However, acquiring this experience was not as straightforward as simply gaining an AP role. Instead, we chose to take on available caring roles in order to develop our skill sets, which often meant taking a detour from the idealist’s direct route to clinical psychology. For many of us, this required  welcoming new challenges, which has since afforded us a wealth of knowledge and a colourful source of individual learning that we may not have otherwise gained. Some of us have worked with vulnerable populations for the purpose of research (e.g. homeless populations), with others working in more specialised settings (e.g. tutoring children with an autism diagnosis informed by Applied Behaviour Analysis). Working directly with clients has fostered applied skills, which we use as part of our practice today. Volunteering (e.g. Samaritans) has also been a valuable outlet to learn and apply clinical skills. Openness to experience in meeting our individual learning needs has been a necessity for all of us and may partly explain why we have worked with multiple agencies of diverse purpose and ethos. Having experienced many different organisations ranging from clinical and addiction settings to various disability and mental health services, we each have a broad baseline to contrast our current role. This has also fostered a broader understanding of healthcare provision.

 

At times, the sense of competition to progress along the clinical path has imposed feelings of urgency and haste towards gaining experience. With our current knowledge and experience, we recognise the limits to our competencies and appreciate that earlier frustrations with workloads and clinical exposure may have been borne out of this urgency. As time has passed, having worked in a number of roles between differing organisations, an understanding has developed that workloads were devised differently and mostly tailored according to acquired skill set and limits to competency. This has been a key learning point that we have all taken into our current role and use to manage our expectations.

 

Despite our varying experiences, a commonality has been the inconsistent value placed upon training across different organisations. This resulted in the absence of training being generally reported as a barrier to professional development. Looking back, efficacious training has informed and prepared us for our current roles e.g. ‘Children First’. Training nurtures a sense of capability and readiness, which acts as a medium to remove some of the unknown that can maintain anxieties in new settings.

Personal Growth and Development

Personal development is arguably one of the most significant aspects of growth we have experienced in our journeys towards clinical psychology. It is a lifelong process, which we continue to maintain, while also recognising the extent to which we have already personally developed through embarking on our individual paths. We acknowledge how our experiences to date on this journey have been crucial in making us more informed versions of ourselves today, both as APs and as individuals.

The concept of self-worth, or lack thereof, was a theme that was prominent in our reflections of our own personal development. In pursuing a career in psychology, questioning our self-worth has manifested as considerations of changing academic paths and invariably questioning our abilities and competencies. These feelings may well be attributable to the challenging nature of pursuing psychology as a sustainable career. We concurred that there is a profound lack of opportunities to demonstrate skills and competencies while completing a degree in psychology. The work that we engaged in to maintain our financial independence (e.g. retail work) both during and after our studies, generated feelings of inadequacy which we felt negatively impacted on our self-worth. We felt that this arose from questioning our skills as early-career psychologists, rather than recognising the lack of availability of AP roles. This may have been compounded by taking on the expectations of others. However, we all agreed on the necessity of completing and balancing various employments, which ultimately led to a significant amount of our personal development; including an opportunity to take a break from psychology and the enhancement of competencies, such as organisational, teamwork, and communication skills. These are essential competencies we continue to apply in our current role as APs.

 

We explored the relationship between questioning one’s self-worth and the inevitable crossover with experiencing “Imposter Phenomenon”7. This concept is well-established within psychology and denotes an internal barrier to empowerment and achievement through internalised self-doubt that one will be exposed as a fraud7. All of us at various points have experienced this phenomenon, and continue to experience it at times. Central to this widespread feeling across our group, is the fact that we are now paid for roles which we would have previously held in a voluntary capacity. Although challenging at times, feeling inadequate or incompetent is something, which may have hugely helped our personal development. Feelings of anxiety or inadequacy have helped fuel efforts that have made us ensure that we are always striving to reach our full potential. Simultaneously, realising our own limits of competency relative to the stage we were at individually, remains important. Personal development and reflective practice has allowed us to become cognisant of our own limits of competency while also acknowledging our abilities.

 

Self-care is a practice deemed necessary in a vast range of caregiving positions, including psychology8,9. Although we were all aware of its importance and necessity, we discovered upon reflection that we were not always practicing what we were preaching. Balancing the demands of pursuing a career, financial stability, and attempting to maintain interpersonal relationships made the task of engaging in self-care seem extremely difficult. Now that we are receiving stable finances, relevant experience, and regular working hours, most of us agree that it has become significantly easier to practice self-care. It was also gleaned that many of us experienced feelings of guilt initially when considering self-care. We were suddenly exposed to regular hours with free weekends without requiring extra work or study. Initially, filling free time with self-care activities felt like a foreign concept for many of us. Having this opportunity to reflect has allowed us to recognise our limits and the signs of becoming burnt out, which is essential in our current roles. Each of us acknowledges that to be fully present and deliver the most optimal service and skills we have to offer to our clients, we must first look after ourselves, listen to our bodies, and practice self-care. Therefore, we now recognise self-care as more of an achievable priority than we may have previously. It is worth noting that some reflections discerned amongst us reported that engaging in self-care is still something we struggle with. This is a commonly reported issue amongst caring professionals, in which one’s own self-care is disregarded as a means of focusing on the client’s care9.

 

Our Current Role

In our current role as APs, we are working together on paid fixed-term contracts as part of a team with other clinicians. Since beginning in this role, we have been granted numerous opportunities for training and have had the fortunate experience of being able to access much needed practical resources and support. We receive weekly individual supervision with a clinical psychologist and have the opportunity to engage in bi-monthly peer supervision with other APs based in similar services. While working directly with clients, each of us have had differing experiences from past roles which highlighted a range of supervision formats and how clinical supervision has been delivered. Supervisors have played a paramount role in the growth and support of our learning, which has developed from both clinical observation and supervision. For some of us who received structured, regular supervision, this is where much of our learning was consolidated. For others, supervision was less frequent and often informal. This was reported as a barrier to reflective practice. Through this experience, we have learned the merits of quality supervision practice in our role today.

 

Aspects of this role are both similar and contrasting to previous psychological work we have experienced. Gaining paid employment brought a sense of relief and comfort as we could now focus all of our working energy on developing within a field we enjoy and are passionate about, without needing to add an extra source of income. As previously mentioned, self-care was an aspect that we had all struggled with. However, our new positions have afforded us with time and means to truly invest in self-care at a higher level on Maslow’s hierarchy of needs10. Although we have been experiencing a sense of career stability that has been uncommon for us all up until this point, our contracts still include an end date; which brings with it an element of uncertainty for the future. To date, nothing along any of our varying paths has signalled a definite arrival at the positions we now hold. Similarly, these positions do not guarantee a place on the Doctorate of Clinical Psychology as our next stop. They do, however, guarantee an enrichment of our careers in the world of psychology.

 

Working alongside four other APs has been a new experience for us all. This peer environment has allowed for informal and formal peer supervision, an opportunity to build upon teamwork competencies, and the chance to foster an environment in which we can learn from each other’s journeys and gained perspectives. All humans have the ability to uniquely perceive one same situation or event11. Likewise, although in practical terms all five of us are experiencing the same role within the same setting, all of our takings from this role will be unique.  In the context of the broader team, this was the first time some of us were provided with the opportunity to work under the guidance of a clinical psychologist. For others, it was another opportunity to gain a real sense of the diverse nature and ways of working within this profession. Being part of this broader team has allowed us to experience great levels of both professional and personal support. Experiencing this nurturing and supportive culture has fortified our careers and it is something that we can now take into our future working lives and endeavours.

 

An important aspect, which has remained a central thread along all of our individual paths, is an appreciation for the opportunity to engage in meaningful work with those in our communities. Having the privilege of being a part of individuals’ intimate psychological journeys has afforded us perspective on the reasons why we are endeavouring to become clinical psychologists. Reflecting on the human impact of this type of work has also inspired us to continue our learning within this broad field and renew our motivation for career progression.

 

Conclusion

The experiences of questioning self-worth, enduring “Imposter Phenomenon”, navigating education, tolerating social sacrifices, and engaging in self-care, while extremely challenging, have also led to the personal development which we deem to be hugely beneficial for who we are as individuals and clinicians today. However, we experienced none of these elements within a vacuum, but rather surrounded by the immense support, guidance and reassurance, which we each received in our personal lives, something that we cannot ignore. Throughout our discussions, we realised that each of us have followed different paths to arrive at the same destination. This realisation instilled huge personal reassurance for us; the recognition that some individuals will have done more, some will have done less, all will most likely have done differently, and that is okay. The pressure to gain experience and secure, paid, relevant employment often obscured our abilities to fully acknowledge the value of our experiences. However, now that we each have had an opportunity to look back, and collectively reflect on previous experiences, we can identify the value of these and acknowledge their contribution to our practice today. Having said this, we are aware of the limitations and barriers to reflection, namely that it is both anecdotal and coloured by our personal experience. Also, we acknowledge that the current paper is not without bias. Our views are not representative of all AP experiences and are subjective to our own personal recall.

 

Comparing our journeys has also allowed us to appreciate the variety of experience we each bring to our team and how this provides our clients with a more enriched service provision. We now embrace our learning role and realise that developing competencies is a process, which takes time. Ultimately, we hope to continue along the path of clinical psychology through completion of the Doctorate in Clinical Psychology. The contrast between the path now and before, however, is the realisation that hopefully, the positions that we are in will allow us to further develop our reflective practice and be mindfully appreciative of the value in our experiences. The path seems less intimidating without thorns and darkness; now it is just a journey that we are each progressing along and will arrive at our destination when we are ready. Reflecting on where we are today has helped us acknowledge our strengths and achievements to travel along an enlightened path that is more illuminated and less daunting.

Authors

Megan McGinley, Niamh Davoren, Amy Walsh, Siobhán Clifford and Sarah Summerville, Child and Family Psychology, Primary Care, HSE.

Corresponding Author: Megan McGinley Contact: megan.mcginley@hse.ie

References

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  2. Psychological Society of Ireland. Supervision Guidelines. 2017. Available from:https://www.psychologicalsociety.ie/footer-2/PSI-Guidelines-Policies–Papers. [Accessed 25th October 2018].
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