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