Clinical psychology jobs and training explained

A clinical psychologist talking to a client
What do clinical psychologists do and how do you become one? TARGETcareers and psychologist Dr Sonia Bues outline the job and the qualifications you’ll need.

Careers in clinical psychology offer intellectual challenge, the chance to help people and – eventually – a good salary. However, it takes a long time to qualify – potentially around ten years from starting university – and you’ll probably need to do some low-paid or unpaid, unglamorous jobs after you graduate as a first step towards getting a place on the highly competitive clinical psychology doctorate training programme. For example, you might spend your first year or two after university working as a care assistant helping elderly people with their basic needs on not much more than the minimum wage while coursemates start well paid graduate jobs in business or finance. Will you be OK with this?

If we haven’t managed to put you off, read on to discover what clinical psychologists do and how to become one. We’ve included lots of insights and advice from clinical psychologist Dr Sonia Bues, who works for the NHS Eating Disorders Service, to give you an insider’s view.

What do clinical psychologists do?

Psychology is the study of brain and behaviour. Psychologists are professionals who use this knowledge in their jobs; there are a number of different types, including clinical psychologists.

Clinical psychologists work with people who are experiencing mental health problems, emotional difficulties, behavioural issues, or physical health problems that have a knock-on effect on mental wellbeing. They can also work with people who have learning disabilities. For example, they could help people who suffer from anxiety, have an addiction or an eating disorder, or suffer a lot of pain due to illness or injury.

The work involves assessing the nature of individuals’ difficulties, so as to understand them properly, and putting together appropriate treatment plans. Often they’re also involved in delivering these – for example, they might provide a ‘talking therapy’, such as cognitive behavioural therapy, which aims to uncover and challenge negative thought patterns that are contributing to a problem.

Most clinical psychologists are employed by the NHS. They typically work closely with other health professionals, such as doctors (including psychiatrists) and nurses, and sometimes also social workers and teachers. Clinical psychologists can’t prescribe medications themselves, but the doctors they work with can.

How to become a clinical psychologist

To become a clinical psychologist you need to:

  1. Take either an undergraduate (first) degree in psychology, or an undergraduate degree in a different subject followed by a psychology conversion course. Make sure that your psychology degree or conversion course is accredited by the British Psychological Society (BPS).
  2. Get a lot of experience that relates to clinical psychology (usually several years’ worth).
  3. Take a clinical psychology doctorate (a higher level degree), which again needs to be accredited by the BPS. This combines university study with actual work.

Psychology degrees

Undergraduate psychology degrees typically last three years in England and Wales, and four years in Scotland. Some include an extra year, known as a sandwich year or placement year, which you will spend away from university gaining experience in a psychology-related workplace. You can find out more about studying psychology at university, including what to expect and the different careers it can lead to, in our psychology degrees guide.

How to get onto a clinical psychology doctorate – the experience you’ll need

Getting a place on a clinical psychology doctorate is very competitive. Sonia comments: ‘There were almost 4,000 applicants for 600 places in 2017 so that’s a 15% acceptance rate.’

It’s ideal to have directly relevant experience such as working as an assistant psychologist (which typically involves assisting a clinical psychologist) or research assistant (which typically involves assisting in academic psychological research at a university). However, it’s also competitive to get these positions so you’ll usually need other experience first, for example as a:

  • care assistant (providing assistance with tasks such as washing, dressing and meal preparation to people who would struggle to do so by themselves, typically in their own homes)
  • healthcare assistant (can involve assisting hospital patients with tasks such as washing and dressing, going to the toilet and eating meals, or conducting routine tasks in a GP surgery)
  • social worker (graduates whose degrees aren’t in social work usually need to do a two-year masters degree before starting work, though there are two fast-track schemes – Frontline and Think Ahead – that combine paid work with a part-time social work masters degree that is paid for for you)

Sonia explains: ‘All postgraduate courses require some degree of work experience and typically people will spend one to seven years gaining experience before they are successful. I think the average is three to four years. It helps to get as much varied experience as possible as well as having a reference from a clinical psychologist.

‘Degree courses that include a sandwich year can be a really good way to get that all-important first experience. Lots of people start off initially doing voluntary work. I volunteered for a bit as a Samaritan, then spent four years in paid work as a support worker for adults with learning disabilities, as a graduate mental health worker in primary care and as an assistant psychologist. I was successful on my second application.’

What the clinical psychology doctorate involves

As regards the doctorate itself, Sonia says: ‘The doctorate course lasts three years and includes teaching, five or six clinical placements, coursework/essays and a doctoral dissertation. It is very full on but drop-out rates are very low.’

When will I start getting paid and what salaries do clinical psychologists earn?

With luck, the majority of experience you gain while trying to get onto the clinical psychology doctorate will be paid. For example, assistant psychologist, research assistant, nursing assistant, care assistant, support worker and graduate mental health worker are normally all paid jobs. However, Sonia cautions: ‘I was quite fortunate; I only volunteered for a bit, but it’s not unusual for people to have a mix of paid and unpaid employment to gain experience.’

You will also get paid during your clinical psychology doctorate, as you’ll be working as well as studying.

In terms of salaries, psychologists in the NHS are paid according to salary bands on a pay scale known as the Agenda for Change. The salaries themselves can change a bit from year to year, though which jobs are in which bands is less likely to change. Salaries as of 1 April 2018 are:

  • Assistant psychologist – band 4 (starts at £20,150) or possibly band 5 (starts at £23,023)
  • Clinical psychology trainee (those on the doctorate) – band 6 (starts at £28,050)
  • Newly qualified clinical psychologist (those who’ve just finished the doctorate) – band 7 (starts at £33,222)

Experienced psychologists tend to sit somewhere in bands 8a to 8d (which start at £42,414 and go up to £85,333 at the very top end). A few roles are in band 9 (which starts at £84,507).

Sonia’s career as a clinical psychologist specialising in eating disorders

Sonia explained her own job to us in more detail. She says: ‘Clinical psychologists work across the lifespan with clients with complex difficulties. I currently work as a clinical psychologist in an eating disorders service for children and adolescents. I assess the young person and their family when they first come into our service and offer treatment, support and guidance with reference to their eating disorder and any other mental health problem they might have.

‘I typically work with young people and their families for nine to twelve months and see them quite frequently. I also supervise more junior colleagues, provide teaching to colleagues or other teams and coordinate service evaluations and some research. My job is very varied and busy!’

What are the best and worst aspects of being a clinical psychologist?

Clinical psychology is a good career if you want to be directly involved in helping other people. Sonia comments: ‘I like being able to be part of someone’s journey towards recovery and hopefully making a difference to their lives. The downside is that mental health services are often overstretched and there is not enough capacity to meet the demand.’

What skills do psychologists need?

Unsurprisingly, clinical psychologists need to be good at interacting with other people. Sonia expands: ‘In order to be a good psychologist you need to be a good listener, non-judgemental and empathic. You need to be able to make relationships with people from all walks of life. Change can often be slow so you need to have patience and resilience, as sometimes the work can be upsetting (supervision from a more experienced psychologist helps with this though!).’

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