‘I realised I should put more trust in myself’

Georgia Dunning with her personal reflections on an undergraduate professional placement in a Clinical Neuropsychology Service.

My first individual session as a Psychological Wellbeing Assistant (PWA) in a Neuropsychology Department was with an elderly woman who had suffered a stroke and needed to stay in hospital for rehabilitation. The stroke had left her with an expressive aphasia, which meant she was unable to communicate verbally, and she also had visual difficulties. I found out that she loved to read prior to her stroke. I noticed that she had some books on her bedside, and so I asked if she would like me to read to her. All through, I was thinking to myself ‘Am I good enough for this role? Am I doing this right? Am I friendly?’ 

I lacked confidence. I was an undergraduate student, and this was a new experience. I was finding it hard to remember to use closed questions and doing so also meant it took longer for me to understand what the lady wanted to convey. I felt out of my comfort zone, but this was also an important stepping stone. It made me realise I needed this learning curve in order to grow and change through experiencing new opportunities. I had to trust my skills and apply them to a new scenario.  

How did I get here?

Within the UK, various degree programmes offer students the opportunity to undertake a professional placement year, undertaken in their penultimate year of study. Courses offering placement years can be found on the UCAS website. The reported benefits of completing a placement year for the student include increasing employability after graduation (The Graduate Market, 2019), and they are more likely to obtain higher paid graduate jobs (Brooks & Youngson, 2016). Across various degree programmes, including Psychology, students who complete a placement year are more likely to obtain a higher degree class compared to those who do not (Huws et al., 2006; Mansfield, 2011; Brooks & Youngson, 2016; Jones et al., 2017). 

So during my undergraduate psychology degree at the University of Manchester, I sought out a professional placement year within a Clinical Neuropsychology service. I was hoping for a deeper understanding of working in Clinical Psychology, as well as the opportunity to put the theory I had learned into clinical practice. With the competitiveness of Assistant Psychologists posts on the rise, I also felt that a placement year was a good opportunity to obtain work experience in the field as early as I could. 

During my studies, I had developed an interest in cognition, so when I found the role of Psychological Wellbeing Assistant (PWA) in a Neuropsychology Department I felt this was perfectly suited to my interests.

It’s ok to feel like this

That first session helped me grow as a PWA. I was able to see how I could help people whilst they were in hospital. In the moment, it may have felt uncomfortable, but I realised that I should put more trust in myself. My thought process, and the way I felt, at least showed that I wanted to do as well as I could, as I was aware of how I was coming across. 

I talked about this in clinical supervision (my supervisor was a Consultant Clinical Neuropsychologist) and we spoke about how these feelings of inadequacy often arise in clinical practice. Now that I have finished the placement, looking back, I think this may have been my first encounter with ‘imposter syndrome’ (Clance & Imes, 1978), which refers to an individual believing that they do not deserve the success they have, or that they are a ‘fraud’ in the position they are in. My supervisor told me this phenomenon is common within the field of Psychology. I realised this might be something I have to face throughout my career, and that it is ok to feel like this. 

Working with distress

In another session, on a brain injury ward, a young woman became emotional and tearful. Before, she had been quite closed with what she shared, rather ‘flat’ in emotion. We had built a strong rapport by spending an hour a week together for six months, talking about her interests and just being there for her. In this particular session, she became extremely teary, which was something nobody on the ward had seen before. This made me feel a bit uncomfortable, and afterwards I sought out my supervisor to discuss what had happened. 

We spoke about how, on face value, it might have appeared like a ‘bad’ thing that they were upset, but we also talked about how it potentially representing a positive step in therapy, as they were beginning to open up about their thoughts and feelings. It showed that she was starting to process what had happened to her, and felt more able to talk about it. I realised my empathic traits are evident when I see somebody upset, and at the time I can assume the worst, but supervision allowed me to take a step back and reflect on difficult situations. And I was being exposed to those situations earlier in my career than I would have been ordinarily. 

Endings

During my placement, I started to use therapeutic ending letters with clients (Turpin, 2011). These were something my supervisor suggested I could use when sessions were coming to an end, such as when a person’s discharge from hospital was getting closer. The ending letters seemed to be powerful, both for the client and for myself. One person I spent time with said that it would, “…remind me of my achievements” and it seemed to provide a positive perspective on the end of our work together. I think that this paralleled some of the things I took from the writing the letters and they also seemed to provide me with a way of reflecting positively on the role I played whilst also thinking, “What did I learn from this experience?” 

Looking back, endings letters were also a way for me to manage 'goodbyes', with someone I had spent long periods of time with someone, as I had not realised how difficult this might be when I first started out. They are definitely something I would want to use in future roles.

Looking back and looking forward

The more the year went on, I realised how mature I had become, and I was able to apply my knowledge from my university degree to real life situations. When starting the placement, I felt too ‘immature’ to be stepping into the world of work, and scared of what I was getting myself into. But my self-confidence increased, and I found a real interest for Clinical Psychology. I now have a far better understanding of what to expect if I pursue a career in the area. The placement year also helped me to become more time efficient, as whilst working on my placement year I kept a part-time job. 

To anybody thinking about doing a placement year, I would definitely recommend it. The lessons I have learnt have been beneficial for both my professional and personal development. In Berofsky’s terms, I have increased personal autonomy – I do not feel as dependent on others when completing a task. Next steps: following discussions with my supervisor, I have decided to apply for a Masters course.

Georgia Dunning is at the University of Manchester.

References

Berofsky, B. (1995). Liberation from self: A theory of personal autonomy. Cambridge University Press.

Brooks, R., & Youngson, P. L. (2016). Undergraduate work placements: an analysis of the effects on career progression. Studies in Higher Education41(9), 1563-1578. https://doi.org/10.1080/03075079.2014.988702

Clance, R. R., & Imes, S. (1978). The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy Theory, Research and Practice, 15(3), 1–9.

Huws, N., Reddy, P., & Talcott, J. (2006). Predicting university success in psychology: are subject-specific skills important?. Psychology Learning & Teaching5(2), 133-140 https://doi.org/10.2304/plat.2005.5.2.133

Jones, C. M., Green, J. P., & Higson, H. E. (2017). Do work placements improve final year academic performance or do high-calibre students choose to do work placements? Studies in Higher Education42(6), 976-992. https://doi.org/10.1080/03075079.2015.1073249

Mansfield, R. (2011). The effect of placement experience upon final-year results for surveying degree programmes. Studies in Higher Education36(8), 939-952. https://doi.org/10.1080/03075079.2010.486073

The Graduate Market. (2019). Annual review of graduate vacancies & starting salaries at the UK’s leading employers [pdf]. Retrieved from: https://www.highfliers.co.uk/download/2019/graduate_market/GMReport19.pdf

Turpin, C., Adu-White, D., Barnes, P., Chalmers-Woods, R., Delisser, C., Dudley, J. and Mesbahi, M., (2011). What are the important ingredients of a CAT goodbye letter?. Reformulation, Winter, pp.30-31.

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