Becoming a Clinical Psychologist &
Psychotherapist - an experiential account
Gitanjali Goyal Khanna
Clinical Psychologist, National University
Hospital, NUH
Adjunct Lecturer, Department of Psychology,
NUS
The Guest House ~ Rumi ~
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they're a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.
Be grateful for whoever comes,
because each has been sent
as a guide from beyond.
Time for Reflection
What next after our
Psychology Degree?
Why are we here?
Who we are and what we do?
Getting Started..
Basic question- What are my preferences
Do I want to do therapy?
Do I want to conduct assessments?
Do I want to do research?
Do I want to teach?
Where do I want to work?
As demonstrated by what?
Overarching importance of faculty advising and
mentoring
World of Choices
Sub Fields in Psychology
Clinical Psychology
Neuropsychology
Developmental Psychology
Educational Psychology
Health Psychology
Sports Psychology
Industrial Psychology
What is Clinical Psychology?
Largest subfield
Different from other fields
Involves knowledge of the different
diagnostic systems for mental health
disorders (ICD-10 & DSM-IV)
Specialized treatments for specific
conditions
What do Clinical Psychologists do?
Therapy
Assessment
Research
Teaching and Supervision
Program Development and Evaluation
Administration
Consultation
Public Policy
What is Psychotherapy
An art…
A bond..
A conversation..
A dance..
A relationship with a difference
Not just techniques
Its more than the sum of its parts..
What is Psychological Assessment
Analysis & Synthesis
- as per needs of the client
- to understand strength & weaknesses of the client
Goal follows from referral question
Sources : interviews, observations, standardized
tests & projective tests.
Technician vs. Clinician!
Research in Clinical Psychology
Research in etiology of major mental disorders:
Schizophrenia, Depression etc
Research in Etiology: Biological/Psychological
Research on Assessment
Research on Treatment
A Typical Day of a Clinical Psychologist
Hard to describe- since the work is so varied. Some
commonalities are:
Diagnostic interviews (detailed work up & mental
status examination)
Psychotherapy in outpatient clinics & inpatient ward
Psychological assessment- IQ, Neuropsychological,
Personality, Diagnostic Clarification
Appropriate recording, report writing and transcripts
for therapy.
Range of Types of Problems
Minor mental health problems
Major mental health problems
Acute Physical
Chronic Physical
Substance Abuse
Sexual Problems
Personality Disorders
Where do Clinical Psychologist Work?
Private Practice and Counseling Centers
Individual and/or group therapy
Colleges and universities
Hospitals
- inpatient ward
- day hospital
Industries / Business
Legal & Governmental Agencies
Military
Managed Healthcare Organizations
Community Healthcare Centre
Range of Client Groups
Adults
Children
- Autism
- with Learning Disability
Older Adults
Brain Injured Clients
Forensic Clients
Working in a Multidisciplinary Team
The „Care team‟ for any client should usually
collaborate with other professionals
„The Psy Complex‟(Rose, 1985): word „complex‟
refers to a complex of Professions such as-
-Psychiatrist
-Clinical Psychologist (CP)
-Advanced Practicing Nurse (APN)
-Psychiatric Social Worker (PSW)
-Occupational Therapist (OT)
-Speech Therapist
Boundaries within this „psy complex‟ are murky
Range of Types of Interventions
One-to one Therapy
Marital Therapy
Family Therapy
Group Therapy
Carer & Nurse training or Intervention
Organizational Intervention
Attitude to be a Clinical Psychologist
Own attitudes and beliefs towards Mental
health issues
Ability to recognize our own limitations
Tolerance to stress
True Empathy
Good listener
Clinician or Technician ?!
Pros & Cons of a career in Clinical
Psychology
Positives Negatives
Personal fulfillment Long Hours
Making a difference High Risk of
Changing burnout
Environment Unchanging Clients
Learning Intensive
Experience
Internship opportunity in Department of
Psychological Medicine, NUH
Psychology Observation Programme (POP)
Intake: once a year
Details are available at
http://www.med.nus.edu.sg/pcm/
Career opportunities at NUH
For graduate students with degree in
Psychology: research opportunities with
the GRP programme is available.
More details at:
http://www.med.nus.edu.sg/pcm/grp.htm
Career opportunities at NUH
For graduate students with Bachelors
Degree in Psychology: opportunities with
REACH programme is also available.
More details at
Making the Right choice is
as important as the
hardwork you need to put
in to Realize that GOAL
…and ensure that a career
to you doesn’t happen by
chance but purely by
CHOICE
Masters versus Doctorate?
Trap of seeking letters rather than appropriate
amount of training
Breadth of training and issues of flexibility and
autonomy
Terminal versus non-terminal masters?
Back to initial questions
Desire to teach? Where?
Investment analogy: Careful planning,
preparation, and diversification
On a Personal Note…
I entered the field of Clinical Psychology with a lot of interest
and passion but also some apprehension about what to expect.
My journey in the last 10 years has been most engaging and
fulfilling. The science of Clinical Psychology enables me to
understand my clients in a manner that helps me help them
best. There have been times when I felt that my work left me
emotionally drained due to the intense nature of the work. But
there have also been umpteen opportunities for personal
growth and development both from academic pursuits as well as
experiential learning on the job to make it a satisfying career. It
is also heartening to see that the field is making progress and
getting more organized and recognized.
Reshmi K.K. (Sr. Psychologist)
NUHS
Ethics in Clinical Psychology
Ethics is defined as “The moral principles that govern a
person‟s behavior or how an activity is conducted”.
For CPs it implies an understanding of the moral
principles underlying psychological thought and activity.
Some of the ethics based on the APA code are:
Professional competence in services
Referrals
Client welfare
Confidentiality
Interesting Reads
Man‟s Search for Meaning- Victor Frankl
On Becoming a Psychotherapist- Windy Dryden &
Laurence Spurling
Dibs in search of Self- Virginia Axline
The Piggle- D.W. Winnicott
The man who mistook his wife for a hat – Oliver Sack
When Nietzsche wept – Irvin D Yalom
Games People Play- Eric Berne
Flow: The Psychology of Optimal experience – Mihaly
Csikszentmihalyi
Questions
Remember to Follow your
heart
...and the very best of luck
