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Clinical, Counselling and psychotherapy

‘Psychologists have essential transferable skills’

Ian Florance talks to Joan Baxter about providing therapy, being the patient, schools, and more.

02 September 2010

Joan Baxter had only been in the role of CEO at WPF Therapy ‘for a week last Monday’ when we talked in the charity’s new offices at London Bridge. ‘The City is just over the river. One of my aims is to build up contacts and sources of support there.’

Previously the Westminster Pastoral Foundation and wpf Counselling and Therapy, WPF Therapy (www.wpf.org.uk) celebrated its 40th anniversary in 2009. ‘It was founded by a Methodist minister, Bill Kyle, who had identified a need for “synthesis between social case work and pastoral counselling”. We were based in a Catholic convent in Kensington for many years, but we no longer have a religious affiliation. What has remained from those early days is a strong psychodynamic and psychoanalytic tradition. We provide a range of training, from introductory courses and post-qualified CBT training to master’s degrees and postgraduate diplomas in psychodynamic, group analytic and psychoanalytic psychotherapy.’

WPF also see over 500 clients a week at London Bridge and over 15,000 across the national network of centres for one-to-one and group sessions. Many clients self-refer and pay for themselves. ‘We offer lower price clinics for full-time students and those on jobseekers allowance. Our contract and partnership work will become more important in difficult financial times. We’ve been working with Wandsworth PCT to reduce waiting lists under the IAPT initiative, for instance, with Kensington and Chelsea to support carers, and we’re developing groups for older people. We’re building links with Community Action Southwark and with commissioners in local areas.’

Joan says she is particularly keen to strengthen a third strand of activity: research and development. ‘We need more robust evidence of the effectiveness of our interventions. Impact analysis was an integral component of a recent grant from the Department of Health to develop CBT services.’

New government emphasis on third sector involvement, funding for IAPT and personalised budgets means that there is real scope for WPF to grow and develop. I can understand why Joan saw the job as a fascinating challenge, but I can’t see how she got here, since she trained as an educational psychologist and, in recent years, worked for the Audit Commission.

‘I wasn’t sure what to study at university. My father wanted me to study medicine. I did hard science A-levels. I was drawn to psychology but no one from my school had studied it before. So I played safe and went to Reading University, where the first year allowed me to sample psychology alongside physiology and biochemistry and zoology. By the end of my first degree, I knew I wanted to be a psychologist. At the time clinical psychology was very much aimed at adults with mental illness, and I decided to become an educational psychologist. There’s something hopeful about educational psychology: you’re in at the beginning. I followed a fairly standard route: I did my PGCE at the Froebel Institute, taught for two years in Hackney and then trained as an educational psychologist at North East London Polytechnic.’

Joan came out of her training with a ‘full set of behaviourist assumptions, but in the real world there was not enough in that toolbox. My first job brought me into contact with the Tavistock Clinic, which had a huge influence on my work… I became interested in emotional aspects of learning and became much more systemic. I soon realised that the emotional culture and power relations within a school have a significant impact on children’s well-being. There was a real tension in the work. Educational psychology embraces a social model of disability. The SEN framework has encouraged schools to locate difficulties within the child. The growing autonomy of schools encouraged a view that it was the institution and not the child or parent who was the real client, with an emphasis on keeping the headteacher happy with the services received from the local authority.’

Driven by her insights, Joan applied for a job with the charity theplace2Be. ‘I was Head of Service Delivery and spent five years helping design a model of practice to support children’s emotional well-being in schools. This was my escape from being a resource guardian, to focus on the child in context.’

Joan moved on to become Assistant Chief Educational Psychologist in Buckinghamshire. ‘I enjoyed the work but found the political dimension very frustrating and a major restructuring placed my job at risk. Whilst there, I was extremely impressed by the Audit Commission’s review of our services for behavioural needs. Their report helped us focus on priorities. So I applied for a position there and learnt a lot about finance and governance while working with hugely varied clients. I also led on the development of web-based tools to help schools and children’s trusts improve value for money in provision for special educational needs.‘

All of this seems a big jump, but as Joan says: ‘Psychologists have transferable skills which are essential in any job – assessment and analysis, generating trust, testing hypotheses. Communication matched to audience is another skill I used in giving evidence to parliamentary committees and drafting responses to policy consultations. People with psychological training can make effective organisational leaders. I used all these skills when I had to review governance arrangements at a primary care trust recovering from a £25 million deficit, within ten days!’

Some years ago Joan had some Kleinian analysis herself, an experience she describes as ‘extraordinarily valuable. It’s a shame that psychologists, unlike psychotherapists, are not required to have an experience of being “the patient”. Don’t get me wrong: Psychology offers a really valuable scientific approach, which gives a more certain basis for action than some other approaches. But scientific method has been necessarily slow in providing a full toolkit, and, meanwhile, people need help. People’s fundamental strategies for dealing with the world are formed when they’re very immature and totally dependent on others for their care. Psychoanalysis relies on gaining an understanding of these habitual ways of managing ourselves, using evidence drawn from the relationship which develops between the therapist and the patient. Ultimately I hope that the disciplines of psychoanalysis and psychology can properly inform each other to build a much richer profession of psychotherapy. ’

And this, among many other experiences, led to Joan’s present role at WPF. ‘I felt I was ready for a CEO role having had plenty of experience as number two. I wanted a fulfilling job back in the charity sector, focused on supporting people’s emotional lives. All my training and experience has pointed me in this direction. As a newcomer to the business you have to identify how best to add value and what are the real priorities – at the moment, making sure we are well positioned to benefit from a new policy context, bringing in new contracts and capturing and reporting the impact of the work. It’s not all rocket science, but it is very worthwhile challenge.’