It’s a very interesting discussion that has been stirred up, by Dr Russel Ayling and Emily Brookes, around the essence of the Counselling Psychologist: a discussion that seems to be lurking underneath the surface of most modules that I have attended as part of my Doctorate course, discussions with colleagues, conference material and even the pub after all this. I don’t have a concrete answer myself; what I do have, however, is a different viewpoint, since I was introduced to this search for identity after I had already chosen to emigrate for this particular field. What I will try to do is to describe what Counselling Psychology means in a country not so far from here, and even more than that, what Counselling Psychology in the UK looks like when being advertised overseas.
I finished my undergraduate degree in Psychology in Greece, a country where higher education is largely free, and the few private colleges and universities that do exist, are not recognised at the same rank. This limits the need to brand different branches of Psychology and gives a solution to who is being called a Psychologist straight away: as long as you have graduated from one of the four (public) Psychology departments of the country, whose courses are four years long and include a clinical placement and a research project, you are a general Psychologist and eligible to be a member of the Greek Psychologists Association, with the accompanying license to practice. Graduates from private universities are Psychologists too, but have a much harder time getting licensed and usually require additional studies. I won’t go into the problems and shortcomings of this system, I’m just painting the picture.
It is at the point that you have graduated and are now a Psychologist, that the time comes to think about specialising. It’s not necessary, you could go on and practice as you are, but thankfully most graduates are looking for at least a Master’s degree, in order to gain further insight into the area of Psychology they are interested in. The options within the country are embarrassingly limited. Clinical Psychology is generally considered to be the applied branch of Psychology, where Psychopathology is discussed, you get to know what a Psychiatric hospital looks like and you are introduced to the almighty Psychiatrist. Psychology of Addictions is a big thing, and then you have Cognitive Psychology, almost synonymous with research, and Developmental/Educational Psychology where, even though there are no psychologist positions in schools in Greece, you learn all about why you would be quite useful there. Master’s degrees are again public and free, you pass exams to get in and courses last for two years, usually. Counselling Psychology has appearedin the last decade or so, and there is a Master’s degree for it, which surprisingly has fees. There seems to be an international theme around Counselling Psychologists having to pay for a lot of things, but I’ll get back to that a bit later on.
The reason that I was initially drawn to Counselling Psychology was because of my experience of an introductory module in my last year of my degree. It was the only module that was practical and touched upon how Psychologists actually make a living and what day to day life as a Psychologist looks like. It discussed the different theories around the length of the session, private practice and boundaries; it introduced the notion of theory integration, and that it is OK – things tend to get quite purist in Greece. It felt like a fresh breath of air to my slightly suffocated mind, which was having a hard time imagining a future as only one thing and working in only one place. I was drawn to Clinical Psychology, I wanted to work with people, not with numbers on a page, not in schools (children are great but their teachers and parents… I don’t know), I had already been volunteering in drug addiction services for three years and was quickly getting over that too. But Clinical Psychology was too close to a rigid medical paradigm; medication is questionable in the best of cases in my opinion, and the infrastructure of mental health care in Greece is so limited that it felt like I would be sentencing myself to a path where I could bring very little change. I wanted options! And this is the point in my journey where the UK came into the picture.
I have always wanted to leave Greece, at least for some time, to live somewhere else, study somewhere else, and broaden my horizons. I had caught the Counselling psychology bug now, so I started research. From where I was, with the resources available to me at the time, it seemed like Counselling Psychology was an American concept: nice, neat and practical, and very focused on career evolution. The courses advertised and the articles I could find spoke about how Counselling Psychologists have all the things I admired: a focus on the client, a deep understanding of theory, a direct focus on practice and work with people, plus a multitude of employment opportunities. It really seemed like a unicorn for me; through one field you could have the option of teaching, doing research, private practice, work in mental health care, specialise in children, and so on. Since the US was too much of a reach, geographically and financially, I started looking at options in Europe.
I researched France, Spain and the UK, going by the languages that I already spoke, since I felt that starting a post-graduate degree without some comfort with the language would make things unnecessarily difficult. In France I found very little, most courses that would accept me were psychoanalytic in nature, which I loved, but it did not give the array of options I was craving. The system in Spain felt quite similar to the Greek one, and again, Counselling Psychology was not directly mentioned anywhere. I diverted my attention solely to the UK since I could find courses specifically named Counselling Psychology, plus I could see myself staying on, living and working there.
I emailed many institutions directly trying to gather information and found out that ‘Psychologist’ is a protected title in the UK and that not all people who deliver therapy are Psychologists. I also learned that a Masters won’t do me any good if I want to practice and that I need to try for a Doctorate if I want to be qualified. That was a bit of a blow, although to me it made much more sense than being qualified, as I was, after only four years and minimal practice. In most course descriptions, the focus on the therapeutic relationship was highlighted, as well as the applied nature of this specialisation. Clinical Psychology, to the eyes of an outsider, seemed to be synonymous with the NHS and reserved only for British citizens and outstanding, already experienced practitioners. One Clinical course rejected me, saying I was very young as well. Counselling Psychology courses seemed much more eager to take me on, and I ended up choosing City University in London over another Counseling Psychology doctorate because of the emphasis on integration and inclusion of Psychoanalytic modules.
I will skip through the part of applying, interviewing and moving to the UK and will finish this train of thought by describing what I learned about Counselling Psychology in the UK that was different from what I thought it was.
1. Counselling (and Clinical) Psychologists are not the only ones who can have private practice or generally work directly with clients. Although this was very explicitly said to me when inquiring about which level of education to go into, the reality is far from it.
2. Counselling Psychologist trainees need to pay for a lot of things that other breeds don’t have to. I won’t include therapy, because I believe everyone should pay for therapy while in training; I will include HCPC supervision though (some placements offer HCPC supervision, however most trainees will need to pay for it at some point) and travel expenses, and all placements being voluntary. This creates questions around the worth of Counselling Psychologists, both amongst other Psychologists and other professions as well.
3. The reason why there is so much discussion around identity and description of different roles in the UK is closely connected to the existence of different accreditation and regulation bodies, ssuch as HCPC, BACP, etc. This makes it necessary to define who does what and how someone can judge if what is being done is done properly.
4. Closely connected to the previous point, the education system in the UK is private, which means competitive. This fuels the need to advertise courses and to assure students that they will pay to become something that will give them work. To my eyes, the comparison between Clinical and Counselling Psychologists stems from the comparison of the equivalent training programmes and the fact that these two branches of psychology lead to a protected Psychologist title. Whilst in Greece you would become a Clinical Psychologist if you like Psychopathology, or a Counselling Psychologist if you like a bit of everything and want a well informed private practice; in the UK it has more to do with which course you were able to get into and how much you could afford to pay for your training.
I am very grateful to the London Counselling Psychologists blog, which inspired me to organise these thoughts that I’ve been having for a long time, even though I have over-simplified some concepts in my attempt to bring them together. I don’t know if my reflections will be useful to anyone else; I hope they will be, but I am now intrigued to figure things out for myself, read, think, discuss, enquire and be more aware. To be continued…
Cornelia Givissi is a final year Trainee Counselling Psychologist at City University