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Improving access to Psychological Therapies

A clinical psychologist shares her experience of supporting the team providing the Redbridge Improving Access to Psychological Therapies (IAPT) service in North East London:

I have worked in Improving Access to Psychological Therapies (IAPT) since 2011 and my role has changed from working as a trainee high intensity cognitive behavioural therapist to becoming a qualified cognitive behavioural therapy (CBT) therapist.

I currently work as a senior high intensity clinician and have done so since 2015.

Prior to joining the IAPT workforce, I qualified as a clinical psychologist in 2010 and upon completion of this core training, I worked as a clinician in community recovery teams providing assessments and therapy to individuals who needed support from secondary mental health services.

My move to Redbridge IAPT service in 2011 happened when, as a parent of a young child at the time, I had practical priorities in mind such as being able to work flexibly, having a short and affordable commute and access to affordable housing.

Being from a minority background and coming from a different country, I also wanted to ensure that I worked in a service with colleagues and clients from diverse backgrounds as I find this provides a fascinating working context as well as a sense of belonging.

Over the years, being a clinician from a minority background, has enabled me to deeply understand issues, such as racism, discrimination, prejudice and cultural differences that both clinicians and clients from black and minority ethnic (BME) backgrounds can face. This in turn enables me to support and empathise with both colleagues and clients in a way that I believe would not be possible if I had not experienced these issues myself.

As a high intensity therapist, my role entails three distinct areas of work which keep my professional practice interesting and evolving.

I have a small clinical caseload offering CBT to individuals as well as couples’ therapy for depression. I supervise CBT therapists and therapists who have completed couples’ therapy for depression training.  Moreover, I facilitate a CBT pathway placement in our service, which offers a one year placement to a 1st year clinical psychology trainee, who I supervise.

The more specific managerial and leadership aspects of my role involve line managing several clinicians and leading the high intensity team. We support the clinical lead and the service team in providing a high-quality service, identifying and managing clinical risk as well as supporting the team to continue developing as therapists.

I believe that by completing a thorough and demanding doctoral level academic and clinical training programme in clinical psychology, I comprehensively understand the psychology of human development and mental, psychological and emotional functioning throughout the lifespan.

This enables me to support the team in complex decision making to meet the needs of a wide range of service users who access our service without any level of screening prior to their initial triage. During triage supervision, I support my colleagues to focus on the main presenting issues while considering a web of factors that will be part of clients’ lives such as their cultural, socioeconomic and life experiences and life stage. Having a thorough and a broad understanding of mental health and lifespan issues means I can provide structure, knowledge and understanding to help decide on the best course of action for supporting our service users.

The more challenging aspects of working in IAPT are well-known: large caseloads, a fast-paced working environment and targets to meet. These challenges require continuous work to overcome them, including finding ways to maintain my and the team’s focus on our professional core values such as delivering ethical and high-quality professional care as mental health specialists in primary care.

These challenges, however, are outweighed by the immense satisfaction that comes with seeing someone reach recovery.

One of the advantages of working in IAPT and being a senior clinician and manager has been the many opportunities to engage in continuous professional development, including learning from an inspiring clinical lead. Over the years, I have attended many high-quality training sessions on topics such as mindfulness based cognitive therapy, couples’ therapy for depression, supervision training, CBT for long term conditions, amongst others. This has kept my practice up-to-date and interesting and has equipped me to clinically support our team.

As a manager, the NHS trust provides relevant and helpful line management training, which has enabled me to support the staff I manage. I am particularly keen on supporting staff in achieving the work/life balance they need whilst striving to support the needs of our clinical population.

Moving forwards, I hope that IAPT services will provide a wide range of professional developmental opportunities, such as research activities and training/teaching of other professionals, as this may help to respond to the challenge of growing and developing the IAPT workforce and maintaining their enthusiasm and interest in working in primary care.

Gisele Marinho

Gisele Marinho is a clinical psychologist with the Redbridge IAPT service in North East London where she has worked since 2011.

She hails from Portugal, but was born in Beira, Mozambique and is of Indian Goan descent, coming to the UK in 1994 and living in London ever since.

Gisele started working in mental health in the NHS as a Nursing Assistant in an acute psychiatric ward in 2003. From 2003 – 2004 she was an assistant psychologist in a rehabilitation unit for people with severe and enduring mental health problems, before becoming a graduate primary care mental health worker. From 2007 she worked for three years as a trainee clinical psychologist before becoming a clinical psychologist. She worked as a clinical psychologist in 2010-11 in two community recovery teams in Redbridge providing psychological assessments and therapy to clients with severe and complex mental health difficulties and working in a multidisciplinary team.

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  1. Kassander says:

    “I believe that by completing a thorough and demanding doctoral level academic and clinical training programme in clinical psychology, **I comprehensively understand the psychology of human development and mental, psychological and emotional functioning throughout the lifespan.”**
    ———-
    ** = Then you are unique.
    .