A day in the life as an Assistant Psychologist in the NHS

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First and foremost, it may be expected to see a title like this as a ‘VLOG’ but for now, I thought it would be useful to share this article with The Psych Journey – here goes! May I say that this is ‘my day’ in the life as an Assistant Psychologist (AP) and will not representative of everyone. AP’s work in many different environments and fulfil various roles. I am very lucky to love my role as an AP (working in acute mental health), I love the environment and I accentuate all of my skills. It is also not the same every day, some days can be extremely busy or filled with meetings and/ or training and some can be more calm and steady (unlikely in a hospital).

My job as an AP is hospital based, I work in a mental health hospital across different acute wards. To give context, the professionals that make up the MDT (Multi-disciplinary team) are Clinical Psychologists (Trainee to Consultant level), Assistant Psychologists, Occupational Therapists, Psychiatry doctors (trainee to Consultant level), Junior Doctors, Nurses, Healthcare Assistants, Pharmacists, Social Workers, Dieticians, Physiotherapists and all the other wonderful staff, including non-clinical such as housekeeping, administrative staff, cleaning staff, other hospital staff and chefs. So here goes, a day in the life of an AP.

6:30am: GET UP!

Typical irritating iPhone alarm starts dinging, it’s time to get up, make my bed and prepare for a day in the unknown. First things first, brush my teeth, training clothes on and time to get the morning run in (This doesn’t happen every morning).

Not my morning run view, obvs.

After this, I engage with morning meditation, using the HEADSPACE app which is my personal favourite.

Whether engaging with Mindfulness or being ‘mindful’, spend parts of your day engaging with it – try your best to be present at the moment.

Shower time, shirt on, hair done, check my bag, ensuring my work laptop, MacBook and AirPod Pro’s are packed too – seriously, they’re all important. I’m genuinely not fixed to certain times and get bored of a rigid routine so I do change my routines around to what suits me and how I’m feeling.

8:30-45am: Arrive to work.

Arrive into the Clinical Psychology Department at the hospital and see my colleagues including fellow AP’s, Trainee Clinical Psychologist and the Clinical Psychologists and Lead Consultant Clinical Psychologist (usually not around – too busy). Hopefully, we have a spare minute to see how everyone is. Sometimes, I catch other colleagues for a quick brew, junior doctors, nurses etc.

09:00am: Board Review.

A board review is a short discussion about the patients on the ward at the current time. It flows along with at least one from each profession in the MDT but doesn’t quite work out like this. Important points are made about current care plans, challenges and treatments and interventions. It can be a difficult meeting when many conflicting views are flying round but as an AP, I would be consolidating this information, formulating and working as a team and sharing knowledge.

09:30am – 11:30am: Ward Round
This is what we hope for everyone, not just the people we see in hospital.

The very busy two hours which involves being as time constrained as possible (not typically ideal for clinical psychology) to see around half of the ward capacity. Thus, meaning a select number of patients are seen one day per week and some are seen twice per week by the MDT. A ward round generally includes reviewing the patients medication, understanding their presenting difficulties, worries and concerns. In addition, what has been going well for them. This is a time to establish what the person might need in their care, do they need to see Clinical Psychology? (I believe (as does my supervisor) that all people on an Acute ward can benefit from Clinical Psychology). Do they need Occupational Therapy? Do they need Physiotherapy? These are all important questions that need to be answered in a short space of time whilst considering that the person in front of us is in hospital because their mental health is not in the best place. They can be very emotionally distressed and constrained time is not helpful. Ward round generally swifts by quickly and most of the time, it is enjoyable; sometimes, it requires every ounce of your energy but this is where you start to think about why – what has happened to this person in front of you? – reflection begins. Ward round is over.

11:30am -12:30pm: Catchup with Trainee Clinical Psychologist
P S Y C H O L O G Y

It is always helpful to spend time with Trainee Clinical Psychologists. You’re able to understand and see how they practice and think about your own practice and development. The question you may ask yourself is, how do I progress as a better clinician and get onto the Doctorate in Clinical Psychology. Time with the Trainee Clinical Psychologist is invaluable – it’s an added layer of supervision. This is a time to discuss your current challenges and concerns and also a time to reflect on the work you have been doing with their support, whether shadowing them or working on a joint piece of work.

12:30pm -13:00pm: Lunch / time to read or write

Have lunch – generally something bland but healthy – tuna, pasta and sweetcorn – making you hungry?

I tend to spend this time reading / writing articles relative to content creating or learning. I find it difficult to  switch off from doing something productive and I think that we can spend this half an hour (2.5 hours per week) doing something that can help us progress with a learning process/ creating something new. However, I have recently realised this contradicts ‘well-being breaks’ and ‘being mindful’ so have taken more breaks to switch off.

13:00pm – 15:00pm

Individual sessions with patients/ service users – I always ask what the person would prefer to be identified as – hospitals create terminology that does not suit everyone. This is generally very interesting, whether I am shadowing the Lead Clinical Psychologist or working with the Trainee Clinical Psychologist or working with one-to-one with a ‘patient’. I’m constantly thinking about what is being said to me / us and formulating the presenting problems/ difficulties. All of which will be used in a clinical formulation, a valuable piece of work that will help guide the psychological interventions adopted by the Clinical Psychologist, Trainee Clinical Psychologist or Assistant Psychologist. There will be more on clinical formulation / formulation in a further article. Ultimately, this is one of my favourite periods of the day, it offers me the time to think about the Clinical Psychologist that I want to be.

15:00pm: COFFEE

A very important part of the day to keep me pushing through.

Here is a picture of a coffee I wish I was drinking.

15:00pm – 16:00pm: Clinical Notes

Time to do the part that takes (sometimes) a lot of time. I feel as though I tend to write a draft, read over the notes, re-read and then my supervisor will always check them and give me feedback. Clinical notes are not simplistic and as an AP, it is important to know that we are not qualified clinicians and our terminology should not impose clinically significant content and make inferences that we are not qualified to make. All of this is taught and delivered in supervision, hence, the value of supervision – it’s partly the process by which we become ‘to be’ Clinical Psychologists. 

16:00pm – 17:00pm: Supervision

Supervision – one of my favourite parts of the week. The tactic I take with supervision is to use a notebook throughout the week and note down points that are important for me to visit with my supervisor. I carry my notebook around with me, always – I never want to lose a thought/ idea that’s useful for supervision/ my development.  This usually involves challenges in and throughout the week, work with patients and positive/ rewarding moments in the week and a variety of other things. Also, challenging moments in the week where I need to uncover my thoughts about the scenario. Another article will be posted regarding supervision and reflection and the critical importance of their use in your practice as an Assistant Psychologist. Overall, supervision is one of the most valuable tools in preparing us for the Clinical Psychology Doctorate but also helping us enjoy our experiences as AP’s and becoming better AP’s.

17:00pm: Home Time!

It’s definitely not always bang on 17:00pm but the variance is something I enjoy.

There we have it! A typical, exciting and jam packed day in the life as an AP working in an acute mental health hospital. Of course, this will differ by day and the service, and it may not happen exactly like this. As mentioned, I work in an acute mental health hospital and it is well-known for being busy and changeable but, it’s exciting and I am well supported by the most fantastic Lead Clinical Psychologist and team.

I hope you enjoyed this article, gained some insight and feel excited by what you may be able to do/ are exposed to as an AP in an acute mental health hospital. Being an AP is brilliant and I’m often feeling intellectually stimulated and emotionally challenged, I feel incredibly grateful for such an opportunity and I am learning every day.

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Author: George (Creator of The Psych Journey and NHS Assistant Psychologist)

My book recommendation of the week for all who are interested in mental health – A wonderful book by the most down to human, Matt Haig:

You can also listen to this book for FREE! if you do not want to buy the book above/ prefer to listen to the audio version/ or finances are tight. Please find it here: https://www.bbc.co.uk/sounds/series/p08jkjbl

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