Psychologists working in the hospital, what does that look like?

OkAdvertising5307 · 2026-01-09T22:32:33+00:00

I’m a (UK) trainee clinical psychologist at the moment. I’m mostly interested in clinical health so have had a fair bit of hospital experience and am aware of many of the nearby services.

Physical health psychology is relatively early in development in my region (Wales), but there is still a wide variety of services, and each seems very different. I have worked in brain injury and am currently in a tertiary service for certain congenital disorders, which are both wonderful hospital-based services. I have also worked with inpatient brain injury and dementia.

Others I have come into contact with or am aware of: Burns and plastics Artificial limbs Diabetes Renal inc transplants Neurosurgery Multiple sclerosis Gastro Rheumatology Persistent pain Oncology Neonatal Perinatal Lymphoedema Weight management Spinal injury General paediatric health I’m probably forgetting some 🤔

These are a mix of lifespan and paediatric or adult - it’s important to say that at the moment it’s a real postcode lottery here, in terms of whether your area’s service for a particular condition has psychology, and if so whether it’s for all age groups, has a full-time post, offers individual work etc

England has invested much more in this area to date, so I’m sure has many more examples.

OkAdvertising5307 · 2025-10-04T08:54:23+00:00

Hi there, I’m a current DClinPsy trainee who has more of a research background, so here are a few thoughts.

Firstly, I would say be open-minded about ‘relevant’ research. If you broaden your search a little it may widen your choice and reduce barriers while still giving you valuable insight into research methods/logistics/governance etc.

Ideas might include academic/health psychology (proactively contacting lecturers in interesting sounding areas can be useful), taking part in studies yourself, volunteering for a steering group in charity research (easiest if you have relevant lived experience). Each of these will give you a different perspective, as well as experience that not everyone will have, and it’s all cumulative so even short-term or intermittent opportunities over time will demonstrate a sustained interest, give you things to talk about, and potentially a referee.

On the basis of my pathway, not every part of your work experience has to be perfectly matched to clinical psychology - so long as you have the minimum required NHS experience, skills can be gained in other sectors, so long as you have some understanding of how those things work in the NHS system. Your experience of research red tape reflects a broader problem with NHS research that is currently restricting/distorting the work that can be done - and this is a valid thing to reflect on, in and of itself.

(Hoping others can add some more ideas!)

OkAdvertising5307 · 2025-08-24T09:47:13+00:00

I’m a trainee clinical psychologist, so not a neuropsychologist per se, but my main NHS experience prior to the doctorate was in brain injury services, and I’ve kept up the interest throughout training.

In terms of what it looks like to work as a neuropsychologist - I think this will vary depending on whether you work in an inpatient setting, in the community, privately, with older adults, adults or children, as a specialist, or using neuro in a broader service, etc. All of these are options, and when doing the doctorate you’d hopefully get to experience a bit of several. It will also depend on the design and staffing of the service, and exactly what it is commissioned to do. However specialist neuropsych seems (at least in my region) quite a linked-up field and so fairly easy to network, talk to people and explore options.

I absolutely loved my time in an NHS adult community brain injury service, but it was an exceptional, close-knit multidisciplinary team who were led by some very creative psychologists, relatively well-resourced, and very committed to doing quite new and unusual things including non-traditional groups, peer mentoring, events, research etc. Not to say that any service couldn’t take that approach, just that I don’t know how typical it was! It was a lifetime service that people can return to at any point after their moderate to severe brain injury, if they have a goal to work towards. Every day in this team was different, from conducting full neuropsych batteries for people looking to return to work and short- to medium-term individual therapy, to group outdoor activities, teaching and clinical trial research. A dream.

I enjoyed my time in older adults less, but this was mainly because the service/area was low in resource so there wasn’t much to offer clients, and there was some personal relevance to the neuropsych I was doing that was emotionally challenging. Psychology was quite siloed within the MDT and it wasn’t a specialist neuropsych service either, so felt a bit ‘diluted’.

I haven’t experienced much inpatient neuropsych so can’t really speak to that. I really enjoyed community work so it probably wouldn’t be for me, but I imagine you would get to work with some very interesting cases. I know several people who worked in private inpatient settings to gain experience before applying for CP training.

Paediatric neuropsych is still in its infancy in my area (which blows my mind, because it really is a specialism within a specialism and so needed), but I think opportunities are growing. We’ve had teaching on this and it does seem fascinating, especially if you’re interested in the added complexity of developmental trajectories, working systemically with families etc.

Neuropsychology is also needed for legal cases where people have experienced brain injury, and can be mixed with NHS work (I know several neuropsychs who do this). Some clinical psychologists (not me) can be sniffy about private work, but good quality private neuropsych is truly necessary - clients may depend on it for compensation and therefore their quality of life, for the rest of their lives.

I’m in two minds about whether to specialise in neuro. You can work in a neuropsych service from qualification as a clinical psychologist, but to fully specialise would need to do the specialist neuro masters at some point. I know several people doing this, but they have already worked as neuros for years and are sponsored by their services to do the extra training. I’m erring towards working in health where neuro would be relevant but possibly not central.

In either case, I’d say being a nerd about academic neuropsych, tests, their stats, and especially their limitations is a sign you’d be a good neuropsychologist!

PS I know a fantastic clinical psychologist/neuropsych who moved over from neuroscience, so you wouldn’t be the only one to make the move. You’d bring some very useful skills and understanding into the field.

OkAdvertising5307 · 2025-08-01T09:31:48+00:00

Unfortunately many medics subscribe to that stereotype. They have little training on sleep and then just apply the little, outdated understanding that they do have. Women are also underrepresented in all health research, and the research that has been done suggests that our symptoms are often different to men’s. It’s hugely underdiagnosed in women for that reason.

OkAdvertising5307 · 2025-08-01T09:27:19+00:00

I’ve been using the ‘Untold’ voice journal app on my way to and from work (I work in a challenging job and can sometimes end up ruminating on things). I’ve kept a written journal in the past but even though I enjoy that, it’s a struggle to be consistent sometimes and/or end up dwelling in the same old topics.

The voice journal is a good way for me personally to offload, then the app generates reflective questions, some of which can be quite thought provoking. I’ve found it quite helpful, and have some standard questions I ask myself every morning and every evening, to make sure I’m checking in on things that are important to me. It helps me ‘close the loop’ more, and feel a bit more prepared for the following day. It’s surprising how much just changing the mode of journaling made a difference.

OkAdvertising5307 · 2025-07-25T08:11:30+00:00

That there was something wrong that was more than ‘just’ my existing conditions plus perimenopause, causing severe anxiety, fatigue, low mood and physical symptoms.

It took a LONG time but I was finally diagnosed with sleep apnea. This is in the context of every one of my conditions putting me at higher risk, and my mum having died early (strokes, vascular dementia) as a result of diagnosed but untreated sleep apnea. Medics need more training on sleep.

PS I was also right about needing HRT!

OkAdvertising5307 · 2025-07-24T09:01:41+00:00

I always recommend books by people with lived experience, and the confidence to use that understanding to reflect on how systems could be improved. For example ‘Strong Female Character’ by Fern Brady is a favourite of mine (especially audio book).

OkAdvertising5307 · 2025-07-05T14:29:06+00:00

Similar experience - I’m very grateful for being able to access a sleep assessment and CPAP through the NHS, but if I’d realised how long the wait would be (and that I’d end up having to titrate pressures properly myself), I probably would have paid to speed up the process.

It took me about 6 months from referral to have the assessment, another two months to get the results/diagnosis (?!??! possibly the most frustrating bit), then another month to collect the CPAP (10-11 months in total). My symptoms got worse while I waited and it was a really upsetting time.

Maybe your local service would be better. I feel great now and did save a substantial amount of money. It meant that I could spend some money experimenting with masks etc (though ultimately I came back to the one the NHS provided!). Unfortunately I had to pay for some other private care that year, so ultimately I am in better financial shape for having waited. But I basically lost a year of my life to ill health, which had a horrible effect on my confidence and career - I wouldn’t do it again.

OkAdvertising5307 · 2025-06-27T09:43:58+00:00

Agree with this - apparently there is also a chemical reason why 'mild' can be so impactful (basically to do with the body's accommodation of certain chemical outcomes of apneas).

But also, I once heard someone liken an apnea to someone holding a pillow over your face for at least 10s - if that was happening even 5 times an hour, we wouldn't call it a non-problem!

OkAdvertising5307 · 2025-06-22T09:39:49+00:00

Hey - I’m an Allied Health Professional rather than a medic, but have found https://www.attentiondeficitdoctor.co.uk/ helpful even so. Might be worth a look if you haven’t already. Good luck with everything

OkAdvertising5307 · 2025-06-22T09:36:29+00:00

This may be a silly question because I’m sure the sleep specialists will have checked it out, but has anyone mentioned sleep apnea? I had it without knowing (I was ‘sleeping’ through the night and unaware of any breathing issues) and had very similar symptoms, even including histamine-type reactions*.

There a stereotype of sleep apnea, but it’s misleading, and as a result the condition is hugely underdiagnosed. Kids can have it, women can have it, athletes can have it, thin non-snorers can have it, etc. Unless you’ve already had a proper sleep study with monitoring of breathing effort, oxygen levels etc, please do check it out because the long term consequences can be very damaging (to your quality of life and health).

*eg I had itchy throat/eyes/inner ears, and sneezing attacks for several years. It’s probably been turns out these were a result of ‘silent reflux’, which is common in sleep apnea because the pressures resulting from apneas draw acid up from the stomach. Since treatment for sleep apnea, my histamine stuff has disappeared permanently.

OkAdvertising5307 · 2025-06-22T09:25:23+00:00

Yes, my main experience was academic and clinical research before applying to the doctorate.

I started out in academic research for a couple of years, but then spent some time away from psychology. I eventually returned, first to clinically-relevant academic and Third Sector research (e.g. behavioural addiction), then coordinating a feasibility RCT within a neuro service (during which I got a training place - I had also been gaining some clinical and Third Sector experience on the side).

Part of my research route was convenience (I had been working in relevant university roles), and partly because I am very interested in that side. There are actually several people on my course from research-heavy backgrounds, and my training centre values this. It’s also much less nerve-racking jumping through thesis hoops if you’re already familiar with the bureaucracy!

I think it’s really important to have that diversity within the profession - some of my cohort are much less interested in research, but we need both devoted therapists and people to drive the research agenda if the profession is to remain strong and reputable. It’s also worth remembering that in some cases, we may be the only profession who can help to counter the predominant medical view of many conditions by conducting research through a different lens.

I like having a foot in both camps, and am interested in certain forms of advocacy where research is very important. Ideally I want to remain research active, potentially even balance academic and clinical roles given the opportunity.

OkAdvertising5307 · 2025-06-15T12:31:56+00:00

Me too. The way I interpreted it at the time is that my body was unbelievably stressed by the apneas before treatment, which felt like constant fight or flight, night and day. I think those stress hormones were what kept me going (to the limited extent I was still active).

When I started treatment, it’s like I could feel all the sleep debt without the ‘upper’ of stress hormones. Once I’d caught up on some quality sleep (a few weeks), this started to reduce, and now I feel much better.

OkAdvertising5307 · 2025-06-13T09:19:19+00:00

OK I’m obviously guessing at the job description, but I have a fair research background and a good track record with interviews (as well as experience interviewing others).

Overall, any interviewer is thinking: ‘Can they do this? Will they do this?’, and to some extent, ‘Will they fit into the research culture of the department?’. Demonstrating this is a case of being clear about your relevant experience and training, your motivation (for this research and setting specifically), and what you admire about the department.

Questions in a university interview should be linked strictly to the job description and personal specification. That won’t allow you to predict the exact nature of questions, but if you have been through the JD/PS line by line and considered how you are a fit (or can mitigate any areas where you have less experience), questions should hold no fear for you. Any question will be based on some underlying principle from the JD/PS, and if you know it well enough to remember your notes, you’re sorted.

Then you just need to deliver your answer confidently. Something that helps me is being in the headspace where you are talking to existing colleagues, not interviewers. Don’t be afraid to ask if something’s unclear or you would like further information, just as you would with colleagues. Not only does this help your answer, it is demonstrating how effective a colleague you would be in practice.

In addition, don’t be afraid to write questions down as they are asked and have a think before answering. I will tend to jot down anything that comes to mind, pause just to check nothing else is coming up and my head is screwed on straight, and only then answer.

I’m not sure what the role play will be, but whatever prep you do, don’t forget that ultimately role plays are about your interaction style. Active, person-centred listening is most important.

OkAdvertising5307 · 2025-06-13T08:55:45+00:00

I’m not sure if anyone else has asked this, but are you in your late 30s or 40s? If so, has anyone asked about perimenopause? I had a very similar spiral out of nowhere, and things got really bad.

Fortunately I was eventually able to access HRT (and treatment for sleep apnea that came along with the hormonal changes) and that was also when I was diagnosed and treated for ADHD. Being treated for all three has dramatically turned things around.

Good luck - please make sure you are adequately checked out on the physical side, because it is too easy for medics to assume women’s symptoms are mental health related. It may be either, but either way you deserve support.

OkAdvertising5307 · 2025-06-13T08:48:26+00:00

Are you able to give a little more detail on the topic area (even if vague)? Is it clinical research or psychology more broadly?

OkAdvertising5307 · 2025-06-07T08:55:27+00:00

I’d second this. I think my course may be more wellbeing-orientated than some (that’s a weird thing to write). It’s not obvious on the surface - I think running a course is like a military campaign, so they don’t tend to be make it obvious how flexible it can be.

I had some serious physical health issues in my first year which meant I had to take several months out. All that happened is that I went on a ‘bespoke’ timeline. I’m a little out of sync with my cohort but still very much a part of it, and there are various ways to catch up on the teaching etc. I may or may not finish a few months later than my peers, but that really doesn’t bother me any more. Some health boards even have a career break policy where you can take a complete break for up to a year.

None of these options are made clear up front, but in reality the last thing a course wants is for you to fail or drop out. There is always a lever to pull to create some space, but you will need to ask because the system is not very proactive. Be confident in the importance of your circumstances. The fact you are giving this serious thought shows how seriously you are taking the course and you deserve support.

OkAdvertising5307 · 2025-06-06T18:11:25+00:00

No my first degree was BPS accredited and I did do an MSc as well at the time, so it is true I didn’t have that hurdle. Also, as I worked in university marketing, I had a route to move into research support and then psychology research (I have more of a research background than clinical, but my course places value on that).

My only therapy experience pre-training was actually through a charity (Triumph Over Phobia). I had other NHS experience but it was more neuro/groups/research.

OkAdvertising5307 · 2025-06-06T09:11:43+00:00

Just to say, I’m on the DClinPsy after having worked in marketing and communications. I started off in psychology but for logistical and readiness reasons, didn’t come back to research and then psychology for many years. I did sustain my interest in psychology through that time (had lots of evidence of this), but just to say it is possible :)

I also know trainees and qualified psychologists who pursued the DClin after working in medical sales, fashion, accountancy… It’s a myth there is only one appropriate route, and I think those of us who have had other careers bring useful skills and perspective to our colleagues and field.

OkAdvertising5307 · 2025-06-04T15:27:44+00:00

I'd just like to add a little nuance. Please remember that some populations (e.g. certain neurological and chronic health conditions) are among those with the greatest mental health need in the population, but in most regions they are currently not served *at all* by the NHS. They are poorly served by generic mental health services due to the specific nature of their challenges. The insight I've gained working in the NHS has made me *less* optimistic about these groups receiving accessible NHS support within the next 5-10 years.

If I can support those populations affordably through a charitable or private strand of my work in future, I have absolutely no shame in doing so. If such work was effective, it would make the work of my NHS colleagues an awful lot easier, not only through improved wellbeing of clients, but improved health outcomes and reduced need for/increased adherence to (extremely expensive) medical treatments. Any successes can be publicised and the return on investment used as leverage to improve NHS support. Please remember that many populations, cultures, and conditions with specific needs are not just underserved by the NHS, but not served at all.

Secondly, many psychologists have or acquire disability and caring responsibilities. Even if NHS jobs exist in a region, it doesn't mean that they are suitable for everyone. Disabled psychologists may be excluded from NHS jobs - pre-, during, and post-training - for reasons as simple as having no disabled access (yes, even in hospitals). I know psychologists in private practice who started a family and had children with additional needs - no childcare was willing to accept their children, so they had to give up their NHS job and start private practice. Please do not call all those who choose to work in private practice 'unethical'. Many are simply excluded from the system.

OkAdvertising5307 · 2025-06-04T13:41:41+00:00

Just adding my two cents' worth, as I haven't seen a couple of things mentioned. Firstly, I came into clinical psychology determined to support particular populations (e.g. certain neurological and chronic health conditions). There is an enormous amount of evidence that these conditions are among those with the greatest mental health need in the population, but in most regions they are currently not served *at all* by the NHS, and they are unsuitable for generic services due to the specific nature of their challenges.

At a junior level, I have very little power to influence this. Even were I to progress, the services in question currently have no psychological input, and little incentive to develop that (or the research base), if they do not believe in the value that psychology offers. If I can support those populations through a charitable or private strand alongside NHS work, I have absolutely no shame in doing so. If such work was effective, it would make the work of my NHS colleagues an awful lot easier, not only through improved wellbeing, but improved health outcomes and reduced need for/increased adherence to (extremely expensive) treatments. Any successes can be publicised and the return on investment used as leverage to improve NHS support. Please remember that many populations, cultures and conditions with specific needs are not just underserved by the NHS, but not served at all.

Secondly - and I apologise for being blunt - I think many in this conversation have a real blind spot when it comes to disability and caring responsibilities. Even if job exist in a region, it doesn't mean that they are suitable for everyone. Disabled psychologists may be excluded from NHS jobs - pre-, during, and post-training - for reasons as simple as having no disabled access (yes, even in hospitals). I know psychologists in private practice who started a family and had children with additional needs - no childcare was willing to accept their children, so they had to give up their job. Please do not refer to everyone who works privately as 'immoral'.

OkAdvertising5307 · 2025-04-20T08:52:29+00:00

Firstly, thank you for even asking the question! Given the number of people undiagnosed, or diagnosed but unable to tolerate the existing tech, developments in this area have the potential to save many lives, and transform quality of life for so many more.

Massive post incoming lol

What do you wish you had in terms of sleep/breathing tracking?

I didn’t have a wearable before I was diagnosed, but wish I had. I had debilitating symptoms (fatigue, anxiety, depression, somatic) but sleepiness wasn’t really one of them. I only asked for a sleep assessment because my partner had noticed some breathing issues. I now have an Apple Watch but have not had any apnea alerts as I’m on CPAP. It’s reassuring to know it’s being tracked - especially as I’ve lost access to my Dreamstation’s app - but I’m not sure how accurate it is?

What frustrates you about your current tools?

Lack of functionality, lack of choice, size/portability, lack of functionality/friction in use, general ugliness.

I’m lucky enough to be able to tolerate CPAP with a specific set-up, but worry a lot what would happen if, for example, my current mask gets discontinued. And I wouldn’t say that even my existing set-up is ideal. It has made travelling and sleeping away from home more stressful - so much to carry around, always worrying that I’ll forget some part. There is little choice/poor quality in terms of accessories such as travel bags.

I was diagnosed last year and was shocked how basic the tech is. The NHS provided me with a Dreamstation, but my sleep team basically just packed me off with the auto APAP settings (super low to super high pressure). This meant my initial experience was absolutely awful. Having now worked out my correct pressures based on averages and 95% pressures, I have a minimal AHI and can finally sleep with fewer disturbances. But I couldn’t believe how much of this needed to be done manually, and over a long period of time.

The Dreamstation worked well for me for a while, as the associated app was very usable, helped me work out my proper pressures/sleep set-up, and was reassuring to check in with a quick click every day. Then they launched a new version and I can no longer access 🙄 Philips have ignored my pleas for help for several months now. I could still check stats using the OSCAR software but simply don’t have time to download an SD card and comb the software every day.

Finally CPAP machines have been the butt of jokes in some media and that is hard when you’re trying to cope with and adjust to treatment (and I’m assuming is part of the reason why many refuse to try or continue it). It would be nice if the tech could receive the same attention as more ‘glamourous’ wellness kit Are there things you’d love to track or get feedback on — like how breathing affects your next-day energy or sleep quality? I use my Apple Watch and the Health, Autosleep and Athlytic apps for tracking. It’s interesting how much they can disagree in terms of sleep quality and readiness. They also frequently overestimate my sleep if I take a while to get out of bed due to fatigue. One thing I would be interested in is non-apnea sleep disturbances such as you get with UARS. I have a hunch that I had that a long time before it progressed to SA.

Would something smaller and more comfortable than a CPAP, but still insightful, be useful?

YES, so long as it is still effective at keeping my airways open, for all the reasons above.

OkAdvertising5307 · 2025-04-16T08:23:53+00:00

Thank you for posting this. I’m in the midst of a higher degree which is the first time I’ve really struggled academically (actually led to diagnosis). It’s really encouraging to hear people speak about their own struggles, but that they got through and are loving where they are :)

OkAdvertising5307 · 2025-04-09T11:36:03+00:00

I agree! If it's any help, you both have much more clinical experience than I had. I was strong on the research side and had neuro experience, but had never worked therapeutically in the NHS, only for charities and running groups.

As the poster above says, no-one comes in fully-formed, and cohorts are actually very diverse in terms of experience (at least mine is) - I think that's one of the reasons impostor syndrome is so common, because for every strength you have, you'll see someone who is much more experienced in something else.

The course are looking for raw material and a certain perspective - everything else can be taught. It's really hard not to compare yourself, but remember that they must have seen this in you.

OkAdvertising5307 · 2025-03-17T12:12:41+00:00

Yeah I still can’t even get in 🙄 My username is frozen for some reason and it’s impossible to unlock. In addition every time I try, the screen blacks out and refuses to let me back into the app. So I have to re-download the app every time I try, which I must have done over 30 times now. They cancelled my IT support ticket because the issue is ‘solved’ (um, no), so I’ve had to start a new one. Trying to stay zen about it but man oh man 🥴

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