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Section 32 - Sources of Support

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While training is usually an exciting and stimulating experience, it can also be challenging and sometimes stressful. It is not at all unusual for trainees to go through periods when they feel overwhelmed or upset. Making a judgment about when to seek support is not always easy; especially because these periods of stress can be fairly transient, and in some ways learning to manage them is part of the learning process. Equally, even mental health professionals can be reluctant to seek help because they somehow feel that they should be able to cope by themselves, even when they know that they are finding this a challenge.

Making a judgment about when a problem needs to be addressed is not easy, but the course aims to ensure that trainees can seek advice and support in a reasonably timely manner. We also hope that the ethos of the course counters any sense of stigma attached to mental health problems in trainees or in staff – after all, if we are true to the values of our own profession we should accept our own potential vulnerability, and be open to taking appropriate steps when  we know that we are not managing as well as we might.

Seeking psychological therapy and psychiatric support while on the course

There are two broad reasons for seeking therapy while on the course. 

Some trainees feel  personal therapy would help them to understand themselves better, and hence be more effective as psychologists. Their aim is not to resolve specific problems or symptoms but to have the opportunity to reflect at a more general level.

Some trainees on the course experience psychological difficulties which interfere with their personal or professional functioning. For these individuals the motivation for seeking therapy (alone or in conjunction with more medically-based interventions) is because their problems are impacting on their lives in a significant manner.

Whatever the motivation for therapy, the course will try to help put trainees in touch with relevant individuals or organisations.

Trainees who are experiencing a mental health problem which impacts on their capacity to undertake the course, and especially their capacity to undertake clinical work, are encouraged to talk to a member of the course team - hopefully their Course Tutor. Although we understand the reluctance of trainees to reveal problems to members of the course, we can use our professional contacts to try to locate the most appropriate therapist - not always an easy task for individual trainees, especially if they are already feeling distressed.

Sometimes trainees might be best served by a standard NHS mental health referral through their GP. This will certainly be the case if their problem is more appropriately addressed by a combination of psychological therapy and medication, or by medication alone.

This section includes information about support systems:

a) offered by the course;

b) offered by UCL, and

c) offered by external organisations.

SUPPORT SYSTEMS WITHIN THE COURSE

Course Tutor

Each trainee is assigned a Course Tutor. The tutor’s role is holistic – not only to support and advise on academic and clinical matters, but also to monitor and support personal/professional development.

The course is keen that trainees maintain regular contact with their tutor, and that they see their relationship with the tutor as supportive. For this reason there are timetabled ‘tutor slots’ throughout the year which ensure that trainees meet with their tutor on a regular basis. The content of these meetings varies according to need, but usually includes discussion of academic progress and forthcoming work, experience of clinical placements and supervision, progress with research, and issues related to personal/professional development. Our intent is that the relationship between tutor and trainee is such that these meetings can also include discussion of any personal matters that are impacting on the trainee’s experience of the course.

In addition to timetabled tutor slots, there is more formal discussion of progress and development at the ‘developmental review’, which takes place annually.

Trainees are free to contact their Course Tutor at any time, especially if there are any pressing matters that are causing concern. Access is not restricted to timetabled slots.

Mid Placement Review (MPR) visitor

Each trainee is assigned an MPR placement visitor who visits their placement and undertakes the Mid Placement Review. Often - but not always – the MPR visitor is the trainee’s course tutor.

The role of the MPR visitor is to review progress in the placement and trainee development within it, and to help supervisors and trainees problem-solve if any there are any difficulties with the placement. More details of the MPR process can be found in the relevant sections of this handbook.

Research Co-ordinators

Each year group has a Research Co-ordinator who assists trainees in choosing the area for the Major Research Project, finding a supervisor, and so on (more details can be found in the section of this handbook which gives details of the Major Research Project).

PERSONAL ADVISOR SCHEMES

Background

At the beginning of the course trainees are given the name of an experienced clinician from the north London Region, with the intention that this person will act as their personal advisor throughout the course.

The primary role of the advisor is to provide a stable and continuous external professional focus for the trainee throughout the three years of training. Hopefully advisors will help support their trainee’s professional development by acting as an independent ‘sounding board’, offering a regular opportunity to discuss and review their experiences on the course and to place these into a broader perspective. The advisor will develop knowledge and understanding of the trainee's background, ongoing experience of the course, and aspirations for the future.  They also offer more general support, and (if the trainee wishes) can act an advocate, supporting the trainee in managing problems which arise in relation to academic or clinical aspects of the course. However, meetings are not ‘therapy’ and advisors are not therapists; although it is very likely that personal issues will be discussed in meetings, the emphasis should be on professional matters.

Details of a parallel scheme for black and ethnic minority trainees, and for gay, lesbian and bisexual trainees can be found at the end of this section.

Procedure

Trainees are asked to arrange an initial meeting with their advisor; hopefully this will form the basis for further contacts. However, if (for any reason) a trainee is unhappy with the person to whom they have been allocated, they can contact their Course Tutor (or any other member of staff) and request reallocation. Trainees are not under an obligation to justify this request – the priority of the course is simply to make sure that trainees feel comfortable with their advisor and that they experience them as being of benefit.  

The plan is for meetings to continue throughout training. How frequently visits take place is for the trainee and advisor to decide, though for the contact to be meaningful at least two visits a year seems sensible.

Meetings are confidential; the advisor will not be involved at any stage in the trainee's supervision, and there is no direct feedback between advisors and the course. If an advisor acted as an advocate for the trainee, this would only take place at the trainee’s request.

Practical Arrangements

The timing and venue for meetings are left to the trainee and advisor to negotiate. For convenience, some pairs have met at the advisor's home, while others meet in the workplace. Meetings may be from 1-2 hours duration. Trainees are entitled to take time from their placements or study time to meet with their personal advisors.

It can be useful to discuss mutual conceptions of the personal advisor relationship at the outset, how the trainee would like to use the contact and where boundaries will be drawn.

Policy
  1. The scheme should operate in a way that ensures continuity, confidentiality and impartiality.
  2. The personal advisor for any particular trainee will not act as a clinical supervisor to that trainee at any time.
  3. Advisors should meet at least two times per year. Regular contact should be scheduled, rather than waiting for problems to arise.
  4. The clinical trainee may additionally request to see their advisor at any time, and advisors should attempt to respond to such a request within a short period of time.
  5. Contact between the advisor and the trainee will remain entirely confidential, including details of the time and content of meetings.
  6. Trainees or advisors who consider that the pairing is unsatisfactory and wish to change should approach the co-ordinator of the scheme. The trainee will be assigned a new advisor.
  7. Where an issue appears to have reached an impasse, and all attempts to settle the matter directly with the trainee have failed, clinical and academic supervisors may approach a trainee's advisor in order to request or prompt some help in mediating the problem.  Such an approach can only be made on the understanding that the advisor acts primarily as an advocate for the trainee, and can only be involved with the trainee's consent.
Involving the advisor in appeals and disputes

Where a trainee feels that he/she has been dealt with unfairly by the course in any respect, the trainee may request that the advisor becomes involved as an advocate.

This policy is not intended to replace, or in any way alter, any policies currently operated in University College London, or in specific Health Authorities, regarding disciplinary or appeals procedures. Disputes will normally be dealt with in the first instance by the trainee directly. The advisor will only become involved at the trainee's request and after appropriate attempts by the trainee to resolve the problem.

PERSONAL ADVISOR SCHEME FOR LESBIAN, GAY ANDBISEXUAL TRAINEES

PERSONAL ADVISOR SCHEME FOR BLACK AND ETHNIC MINORITY TRAINEES

Background

We value diversity within our trainee cohort, but we recognise that sometimes ‘difference’ can be an important issue during training, and can impact on the training experience. This isn’t inevitable, but we think it is better to recognise the possibility that some trainees might want support around their difference (and to offer this) than to deny this possibility and offer nothing.

The schemes are additional resources for trainees who may wish to address particular issues relating to sexuality or to ethnicity in relation to their training. Although they are similar to the personal advisor scheme, they are best seen as parallel, rather than an alternative, systems.

Both aim to offer a private space to reflect on any issues relating to sexuality or ethnicity which may be impacting on trainees. Although trainees may want to discuss issues of concern, it would be a shame if advisors were purely seen in a ‘troubleshooting’ role. Trainees should also feel free to use the experience and expertise of advisors more widely to help with personal and professional development. The role of personal advisors is to offer support, advice and advocacy as appropriate; not to provide personal therapy.

Useful areas of discussion might include:

  • Negotiating the overlap between personal and professional lives;
  • Feeling unique within a training peer group and making decisions about how much or how little to say about one’s sexuality or ethnicity;
  • Feelings of isolation within peer group, placement setting and the profession of clinical psychology;
  • The impact of working with clients and staff within a predominantly white or European culture, or a culture of assumed heterosexuality;
  • Working in systems and with colleagues who may have conflicting personal values and theoretical frameworks for thinking about ethnicity or homosexuality;
  • The importance of hearing the experiences of qualified clinical psychologists who come from black and ethnic minority backgrounds, or are lesbian, gay and bisexual.
Accessing an advisor

The way these two schemes operate is somewhat different.

Lesbian, gay and bisexual trainees

Access to an advisor is through a directory, which currently has the names of 21 psychologists. They are mixed in gender, sexuality and ethnicity, and work in a wide variety of clinical settings.

It is hoped that trainees can feel free to approach their course Tutor or other course staff about access to the directory, but the course acknowledges that not all trainees may want to do this. Trainees have the option of accessing the scheme independently by contacting:

Deepti Shah 01895 207777 deepti.shah-armon@thh.nhs.uk
Robert Watson 0207 601 7827 robert.watson@bartsandthelondon.nhs.uk

Deepti or Robert can be contacted in order to discuss whether the scheme seems appropriate, or simply to ask for directory details (which can be sent or emailed). The directory holds quite detailed information about advisors (that trainees are requested to keep for their own use), which will enable trainees to make a choice about which advisor to approach. Whether a trainee continues to meet this advisor and how frequently can then be negotiated between the two parties. Trainees can change their advisor at any time, though this should be discussed with the person initially approached when accessing the scheme.

Black and ethnic minority trainees

A number of personal advisors have indicated an interest and willingness to make themselves available for black and ethnic minority trainees who may wish to discuss the sort of issues noted above.

Access to an advisor is through the Course Tutor or a member of staff.

PARENTS AND CARERS SUPPORT SCHEME

Trainees who are parents or carers may experience training rather differently from their peers, particularly because it can be hard to balance the demands of training with the demands of these roles. For this reason it is helpful for trainees to have access to a forum for sharing experiences.

Accessing the Parents and Carers support Scheme

This is a peer support scheme that includes trainees from all three North London courses. If trainees are parents and/or carers and would like to get in touch with other trainees in similar circumstances, they should forward an email and telephone contact details to Kristina Soon (Clinical Tutor) who will forward details to the other trainees who have joined the scheme. The list of names and contact details of the trainees who are already a part of the scheme can also be sent to individuals.

Queries about support for trainees should be directed either to  the trainee's Course Tutor or to Kristina Soon (Clinical Tutor).

SUPPORT SYSTEMS OFFERED BY UCL

Student counselling services

The induction programme always includes a talk from a representative of the student counselling service, which is based in Taviton Street. The service offers a range of interventions, including brief CBT. Recognising the fact that trainees are full-time employees the service tries to be flexible when offering appointments (for example, by scheduling these early in the day or in the evening). 

Details of the service can be found at www.ucl.ac.uk/student-counselling

Online support

There is an online mutual support group for UCL students at www.ucl.ac.uk/support-pages

Support for trainees with disabilities and/or special needs

UCL and Departmental policy is to offer appropriate support to trainees who have disabilities or special needs. This usually means finding the best way to adapt working conditions or the working environment to meet the trainee’s needs. 

The term ‘special needs’ covers a wide range of difficulties – for example, those which relate to academic work (such as dyslexia), or disabilities which restrict travel, or which make it important that placements include appropriate access and working conditions. Trainees should feel free to discuss any special needs with Course Tutors early in the course so that (where applicable) special provision can be considered and arranged.

UCL Disability Services offers a range of services – more information can be found at: www.ucl.ac.uk/disability

Careers information and guidance

Careers advice is given throughout the course. Each trainee follows a mix of compulsory and elective placements, and their ‘training plan’ will usually relate to their plans for post‑qualification employment. Emerging ideas about employment are usually discussed with the Course Tutor (and especially at development reviews). In the third year there is one session of formal teaching, which covers the process of applying for jobs (making applications, writing CV's and interviewing technique).

Because there is such a close link between training and employment most careers advice is given on an individual basis by Course Tutors. However, trainees can make use of facilities offered by the Career Advisory Service (www.ucl.ac.uk/careers).

Graduate School

Details of support offered by the Graduate School (including Faculty Office, Dean of Students, and Advisors to Women) can be found on the website:

www.ucl.ac.uk/admission/gsp/current/facility/index.html

POTENTIAL SOURCES OF THERAPY FOR TRAINEES

Trainees seeking a consultation for personal therapy

We have a long-standing arrangement with Noel Hess (a Clinical Psychologist and Psychoanalytic Psychotherapist based at University College Hospital), who offers initial consultations to help trainees explore any aspect of seeking personal therapy, and can make referrals for consultations and therapy.  Trainees do not need to go through a tutor before making contact, but it sometimes helps speed-up the consultation process if a member of the course talks to Noel first. Noel is happy for trainees to contact him directly (Noel.Hess@candi.nhs.uk). His colleague, Gabriella Rubino, is also offering consultations, and she can also be contacted directly (GRubino@tavi-port.nhs.uk).

What follows is a list of potential therapy resources. Trainees should bear in mind that making the information/contacts available is not  an explicit endorsement of them. UCL is unable to vet the quality of these services and it is the responsibility of the individual seeking help to ensure that the service they choose meets regulatory standards that they are happy with.   

Psychodynamic therapies

There are a number of organisations that offer reduced fee schemes for people on relatively low incomes - for example:

British Association of Psychotherapists (BAP)

www.bap-psychotherapy.org/

Provides 3 times a week psychotherapy, usually with a trainee; a commitment of a   minimum of two years is required.

London Centre for Psychotherapy

www.lcp-psychotherapy.org.uk/clinic.htm

Provides 3 times a week psychotherapy, usually with a trainee; a commitment of a   minimum of two years is required.

The Lincoln Centre and Institute for Psychotherapy

Look on their website for details:

www.lincoln-psychotherapy.org.uk/

The Westminster Pastoral Foundation

www.wpf.org.uk/

Intake Office: 020 7361 4803

There are a number of mainstream psychoanalytic organisations that may be able to offer therapy - though some will charge a more standard fee:

The Anna Freud Clinic

12/14/21 Maresfield Gardens, London NW3 5SH    

Tel: 020 7794 2313

Have limited vacancies for full analysis (5 times a week) for young adults from 18-25.  Fees are means related.

The CJ Jung Clinic of the Society of Analytical Psychology

1 Daleham Gardens, London NW3 5BY     

Tel: 020 7435 7696

Offer a full analysis mainly with trainees 4 times a week for at least 2 years. There is a sliding scale for payment of fees.

The Camden Psychotherapy Unit

293-299 Kentish Town Road, London NW5 2T

Tel: 020 7284 6558

Offer individual psychotherapy once a week for 2 years to those people who are unable to pay for it privately.  A contribution is expected from those who can afford to pay something.  For Camden residents only.

The Institute of Group Analysis

1 Daleham Gardens, London NW3 5BY        

Tel: 020 7431 2693

Will provide a list of members through which group therapy can be organised.

The London Clinic of the Institute of Psychoanalysis

http://www.psychoanalysis.org.uk/clinic.htm

112a Shirland Road, London W9 2EQ          

Tel: 020 7563 5002

Offer a full analysis (5 times a week) with trainees and a commitment is required for 2 to 3 years.  Fees are means related. 

CBT

The British Association of Cognitive and Behavioural Psychotherapy maintain a list of accredited CBT therapists on their website (www.babcp.org.uk).

Guy Moss (Clinical Psychologist) offers a reduced fee rate negotiable for trainees.  As he takes referrals though insurance companies trainees may be able to get their therapy covered through this route. (07951 468 168; Guy.Moss@royalfree.nhs.uk)

Cognitive Analytic Therapy (CAT)

The Association for Cognitive Analytic Therapy maintain a list of CAT therapists (see www.acat.me.uk). The Munro Clinic can also be contacted for a list of private therapists (020 7955 4822)

CAT therapists in North London include:

Shirley Akgun 07989 130 229 works through a GP practice in Tottenham
Annie Nehmad 07957 232 906 works in Stoke Newington East London
Maureen Ryan 0208 539 5496 works in Leytonstone

CAT therapists in West London include:

Miranda Buckley 0207598 9799 works in Kensington

CAT therapists in South London include:

Virginia West 0208 673 5508 works in Balham
AnnaLee Curran 0208 761 2836 works in West Norwood
Services for sexual minorities

For information and contacts:

Robert Watson 0207 601 7827 Robert.Watson@bartsandthelondon.nhs.uk
Deepti Shah 01895 207 777 Deepti.shah-armon@thh.nhs.uk
Pink Therapy 0207 434 0367 www.pinktherapy.com

(fees are negotiable, with a number of therapists working across London)