From NHS to Private Practice: A Psychologist's Journey

Dr Marianne Trent (: 00:00

Do certain types of psychologists feel more drawn to private practise? And how does imposter syndrome play into the decision to take the leap? In today's episode, I am joined by Dr. Rosie Gilder Thorpe, and together we'll explore her journey from NHS into private practise, the kind of clinician she was and the challenges and rewards of building a psychology business. Whether you are wondering what private practise is or curious about, whether it could be a good step for you, stay tuned for insights that might just change your perspective. I welcome along to the Aspiring Psychologist Podcast. I am Dr. Marianne and it's my pleasure to be here for you. As a qualified clinical psychologist, I say it's my pleasure to be here because of course, being in private practise gives me more options to be able to choose how I use my time. This is definitely something that gave me many headaches when I was in the NHS.

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I hope you'll find today's episode a really useful look into what private practise is and what fantastic opportunities it creates for you to be the kind of clinician you want to be, and one that creates opportunities for services where you know that ought to be a better provision. If you do find this content helpful and you're watching on YouTube, please do like, please do subscribe. Please do drop me a comment, consider sharing it with people in your network too. If you are listening as an MP three, please do share this episode. Please do subscribe, follow the show, and if you are on Spotify, you can ask me questions on there too. And on Apple Podcasts, please do rate and review. Hope you find this useful and I'll catch up with you on the other side. Hi, I just want to welcome along our guest for today, Dr. Rosie Gilderthorpe. Hi Rosie.

Dr Rosie (: 01:46

Hello. It's lovely to be here. Thank you for having me on.

Dr Marianne Trent (: 01:48

Well, thank you for being here, and it was lovely to meet you in person recently as well, which is where the idea for this episode came from.

Dr Rosie (: 01:57

Yes. We've both got so much to say about private practise. We

Dr Marianne Trent (: 02:02

Really have. We really have. So let's have a think just before we dive into that just a little bit as a potted history really about your journey to becoming a clinical psychologist and to where you are now, if that's okay.

Dr Rosie (: 02:15

Yeah. Well, I kind of hope that some of the aspiring psychologists listen to this might find it reassuring to know that when I was 21 and I graduated with an English degree, I didn't even know what a psychologist did or what one was really, I had a sort of vague interest in psychology and how people worked. But the reason I didn't study it at university was that I didn't think there were jobs in it. So I did English thinking I'd probably be a teacher or something like that. Then realised that I really didn't want to be a teacher. And so started working in a gym, mostly cleaning, doing a bit of fitness instruction work, that kind of thing. And then because I am old, I saw an advert in the paper for a psych assistant job in the prison service, and I thought, oh, that'd be interesting getting to work in a prison and hear interesting stories that are different to mine.

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So I applied for it not having a clue that psychology was this hyper competitive world where everybody was trying to take the best steps to get on the clinical course and had been dreaming of it since they were 12. And I had no idea of any of that. I didn't know what CBT was. I just literally chanced my arm and went for an interview and they gave me the job, I think as an experiment to see what would happen if they had somebody entirely moldable. So I did that job in the prison service for about four years in total. And while I was there, I studied for an open university degree in psychology. I absolutely loved it. I loved every minute of that job and I probably would've stayed there if it hadn't been for the fact that they changed the route to chartership. So when I started in the prison service, it was the best employer in the whole wide world.

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They would pay for your master's and take you right the way through to chartership without you ever having to take a break from paid employment. And that was something that it just didn't feel like an option to me. I didn't so much interesting stuff we could go into around that. But essentially, my parents are culturally working class, never found it acceptable. The idea of unpaid internships, that kind of thing. For young people, it was you're an adult, you stand on your own two feet, you pay your way. And so it never occurred to me to move back in with my parents or do any of those things, which I know now lots of people had to do to get onto clinical training. So I feel grateful that I managed to come through the route that I did, but that's why I was really attracted to the prison service would've definitely stayed there.

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But when they changed the rules and you then had to go away and study on your own for a master's, I thought, my god, 3000 pounds for a master's. I'm not paying that, which I'm laughing because it's so tragic that young people have to pay so much more than that now. But yes, so I at that point turned my attention to the NHS and the route into clinical training. And again, I knew nothing about it. I was really ignorant of the fact that it was really competitive and there were people literally changing their whole lives to try and fit around this really narrow definition of what a clinical psychologist should look like. Thank God I didn't know any of that. But what I did know was that my open university qualification wasn't viewed in the same way that the red brick ones were. I'd heard that on a grapevine from a friend.

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And so I applied to universities that did a test because I knew arrogantly that I would do well on a test and I did. So that got me an interview at Solomon's, and I guess the rest is history, but I just wanted to share that because I think it seems for a lot of young people that I talk to now that they feel like if they don't follow this very rigid pathway that involves a lot of honorary disgusting that they're called that in my view posts where you don't get paid and you get treated really badly. They think you have to jump through every hoop perfectly. And I didn't, didn't even know about the hoops. And I got there eventually. So I just wanted to share that bit of the story.

Dr Marianne Trent (: 06:34

Thank you. That is so important. And I think you almost ended up as a forensic psychologist, really, they would've been training you to be a forensic psychologist in the prison service, I would assume.

Dr Rosie (: 06:44

Yeah, that's right. And I would've loved it. I love clinical, but I would've loved forensic as well. I think it's fascinating

Dr Marianne Trent (: 06:53

And I too miss the job papers because I think what I loved about the job papers is you didn't need to know search terms to search for. You could end up with something really interesting that really lit you up, but you wouldn't necessarily have searched for, and I love that. But it's interesting that you were employed as a psychology assistant because actually, of course what we know is if it was called an assistant psychologist, you likely would have needed the BPS approved degree. But often psychology assistant jobs don't quite have the same person spec an essential criteria.

Dr Rosie (: 07:26

And it's really interesting actually because for that reason, they are not looked at in the same way on an application for clinical psychology, which is another reason that people, I don't think my application would've got through if I hadn't gone for a course that did a test. But the experience that I got there was so much richer than I think a lot of my colleagues that came through the assistant psychology route. So it really is about understanding what is relevant about the experience you've had. I was doing PCLR interviews. I was doing a lot of cognitive testing, screening people for learning disabilities, and just got really good at motivational interviewing, delivering CBT interventions coaching as well. I did a lot of coaching in that role. And so what I think I was good at was extracting what I'd learned and seeing how it would map onto the competencies for a clinical psychologist, which I just got off the VPS website.

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Whereas what I think a lot of people do is they have so much imposter syndrome that they don't see how their maybe not quite perfect experience might actually give them some of the competencies that they're looking for because they're so busy telling themselves it wasn't perfect. Whereas I think something I had as a young person was just this ability to go, oh, yeah, well, I think that sort of maps across and to communicate that hopefully quite well at interview. So yeah, I think you need more confidence in your experience than you might feel if you haven't come that traditional route.

Dr Marianne Trent (: 09:01

Absolutely. I think from some of the reading I've done into gender differences in job searches, the data suggested men will have a tendency of applying for jobs where they fulfil 30% or whatever of the essential criteria, whereas women would only apply when they fulfil 90%. And it feels like you've taken a more holistic view actually than many people would've done. And it worked because you got that job.

Dr Rosie (: 09:31

And it was partly, I think it would've been a different story if I'd really known how competitive it was. I'd never met a clinical psychologist when I went toson, so there was nobody to tell me that it was really cutthroat and that people would've been applying for 10 years. And when I got there and I saw those people and it was everything to them, that shook me a bit. And I think if I'd met them before I'd done the interview, I probably wouldn't have gotten through it. But I kind of sailed through with a bit of ignorance about all of that. And then it hit me a sledgehammer on day one of training, and I just thought, I don't deserve to be here. And it was tricky after that point, but thankfully no one in my life knew that clinical psychology was a big deal. My parents, my dad said to me, what they'll pay you to do that? And I was like, yeah. So yeah, nobody had really got in my head about it being a massive deal before I got there.

Dr Marianne Trent (: 10:30

Yeah, well, sometimes that helps. But yeah, I guess my next question was going to be what was it like when you started training? But it sounds like it was a very steep learning curve.

Dr Rosie (: 10:37

Oh, hugely. Because the culture in the prison service could not be more different to the culture of clinical psychology. And we'll probably talk a bit today about the problems in the culture of clinical psychology, but neither of them are a perfect example of a healthy or useful culture by a long stretch. But the culture in the prison service was very straight talking. They were very suspicious of people that used overly tentative and perhaps overly compassionate language. Whereas I landed in Solomon and picked up very quickly. I was like, oh, okay. We have to say, I'm wondering a thousand times before we're allowed to make a point here. And I just couldn't believe the amount of circles that people talked in. But I picked it up and I learned how to adapt to the new culture, and I see the benefits of both. I never want to sound like I think one is better than the other.

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I actually don't. I think in both streams of psychology, we need to find a middle ground. It was a very steep learning curve. And I think also there was a lot of, and we're going to talk loads about this today I'm sure, but a lot of people felt kind of guilty to be there, and they were paid loads for something that they didn't deserve to be paid loads for. And the prison service pays a lot less than the NHS in the lower level. So when I was a psychological assistant, we were actually being paid, I think 14,000 pounds a year. We then a couple of years in, won a court case to get that raised up to about 17, I think. But it was very, very low paid. And our NHS equivalents were always on a little bit more, but I'd always seen the injustice in it.

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I'd always, from day one being like, this is a low paid job considering what we're doing here. And in the prison service, it's really stark. You would have male colleagues with no qualifications coming in on day one, earning more than you in a job, which was mostly sort of manual handling and not even people that had contact with prisoners. Whereas we would have unsupervised contact with prisoners as part of our role, which is why we won that court case eventually. But I'd never considered that we were overpaid ever. And I landed in clinical psychology training and everyone's talking about us being overpaid, and I really couldn't wrap my head around it to be honest. And what there wasn't much recognition of was reflection on why you would feel that way. I felt at the time, and I still feel that it came from trauma. I felt these people have had their brains washed into believing that they're not worth anything. I think that comes from applying for a job that you are good for five times before they let you do it. I don't think that's good for you psychologically, and I don't think doing a difficult job and not being paid at all for it as we do in the honorary psych jobs, I don't think that that's good for you. I think it leaves you with this idea that you are not worthy of having a comfortable life, basically comfortable life, which I think is really sad.

Dr Marianne Trent (: 13:57

Totally agree. We've had a whole episode on the ethics of honorary assistant psychologist posts, and yeah, like you say, people begin to think, well, I can't apply for something qualified because I'm not doing good enough stuff here. It's actually, yes you are, because actually they ought to have advertised that as a substantive post because they cannot run that therapy group without you. They can't do those neuropsychs without you being the extra ratio of numbers. You are an essential part of the workforce, so it's not fair. So please, if anyone's interested in that, please do check out the episode on honoree psychs. So it sounds like you are really broadly experienced and naturally of course very reflective, but you've honed your craft since becoming closer to qualified and you've been qualified for some time now. Do you think having that broad experience helped you to springboard into private practise? Rosie?

Dr Rosie (: 14:55

Yes. It was never really my intention to go into private practise, which is interesting because I think I am quite entrepreneurial, but I didn't recognise that in myself as a younger person. Private practise became the only route available to me to continue being a psychologist. My kids have additional needs. We're a military family. And so with all the moving and lack of support network and the fact that my children couldn't really manage things like nursery, it just wasn't possible for me to continue in the NHS, but we needed my income. And so I didn't want to work as anything else. I really love psychology much as I didn't have a long-term game plan a lot of people do. When I arrived in it, I really felt it ticked all of my boxes. I love the academic side, I love the applied bit. I love being in a room with people.

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I just love everything about it. So I was like, right, okay, I'm going to have to find a way to be a psychologist that doesn't require me to be in an office far away from my home from eight till four or nine till five every day. And so private practise was the only option for me really. And I think it did help that I'd had a slightly different journey into private practise because I suppose it meant that I'd been used to thinking quite widely about how psychology can be used and looking for different opportunities to use my skills. But I also think clinical psychology training does give us that anyway. I think you have a broad training which is really, really useful to you. And sometimes I think we underestimate that. I came out of training thinking like, oh my God, I'm a jack of all trades and a master of none.

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Like all of those imposter thoughts really came up. But actually when you kind of find yourself with a client in private practise that has a complicated life history and you realise, gosh, you've mentioned something in this assessment session which touches on my experience from every part of training, then you realise one asset that is because your formulations are that much richer for it. But I did find, and I still find that I use my forensic training all the time. It comes up in really unusual settings. And it definitely springboarded my doctoral research because in my time in the prison service, I must have done hundreds, way more than I'd ever be able to account of learning disability screenings. And so when it came to learning how to do a full scale neurodevelopmental assessment, I was already confident with all that stuff, which is quite tricky, like reversing and block design, which goes against everything that I am naturally good at.

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I didn't have to learn all of that at that point. I just really was learning the nuance of interpretation. So yeah, I think it helped me immensely through training and then going into qualified work that I'd had that foundation, which was a bit broader. But weirdly, when I went into private practise, I was still a little bit narrow about it. And I'd really encourage anybody that's thinking about going to private practise to recognise that you can do any specialism independently. You have different methods of marketing and you have a different business model, but all of them are possible. Whereas when I went into independent practise, I didn't have role models that I could ask. I didn't really know anybody that had done it before me who wasn't like mega super experienced. And so clients just came to them because everybody in that area already knew who they were.

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So there was nobody like me who had done it that I knew the story of. So I stepped away from my specialism in learning disability, which is what I was doing in my first qualified job, and went into perinatal partially because I didn't know how learning disability work would work in private practise. And also because I'd had a terrible personal experience of hyperemesis GR in pregnancy and hadn't been able to find any psychological support. So I was passionate about it and I'm really glad that I did go that route. But I'm also aware that I had more options available to me than I realised, and I'd like anybody else thinking about their career and their private work to know you can do that. You can make any specialism work. Sorry, I

Dr Marianne Trent (: 19:35

Went off on a tangent.

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No, that's okay. I think what I've learned really from getting to know other private psychologists is many of us do start to really find our passion when we've had some similar life experience to that ourselves. Because you begin, like you say, to notice the gaps in that. So I started to begin to speak about grief when my dad died, and my experience of navigate the world with people being really, really rubbish at talking about grief and obviously what we know from your experiences. And then Dr. Cara Dvy as well, who unfortunately experienced the very sad sterile birth of her daughter and now really supports people in that as well. And then I just think it really, you don't have to be hit by a bus, as they say to know it hurts, but it sure does help with your empathy.

Dr Rosie (: 20:33

I think so. And I think knowing what people actually need as well. What I love about independent work is that you can see a gap in provision and design something that fills it. And that's not always therapy. Sometimes it is. And for hyperemesis, I know that there are very effective therapies that can really help people, but those are not routinely offered in the NHS. It's not unheard of for even the perinatal psychologist to ask me, what is hyperemesis gr? Which should be shocking. It is really scary to me because it affects two to 3% of pregnancies. That's the lowest estimate. It could be as much as 10%, and yet the knowledge is not really there, that these people are in desperate need of support. I believe it's impossible to experience hyperemesis grim, which for anybody that doesn't know, it's severe, completely intractable nausea and usually vomiting as well that occurs outside of the typical window for nausea and vomiting in pregnancy. So the way that I define it, and I'd encourage anybody to define it, is that if it's interfering with you living a good life, so you can't go to work, you can't socialise, you can't do the things that make your life worth living, then it's HG get help for it because normal nausea and vomiting it pregnancy, you should be able to live your life around it. Whereas people with HG can't, it's like you lose all of those building blocks of good mental wellbeing.

Dr Marianne Trent (: 22:10

I think one of the most high profile cases was Princess Catherine Duchess of Cambridge. She had it with George, I think, didn't she? And so that kind of started more of a conversation and then has maybe, hopefully stuck did and didn't. No,

Dr Rosie (: 22:25

Yeah, it did and it didn't. So it did. But obviously she accesses private healthcare and will have received treatment extremely promptly. And it's like a weird chicken and egg scenario. So I speak to many people in my clinic that say, oh, well, maybe mine wasn't HG because I never had a drip, I never had vitamin injections or any of the stuff that Princess Catherine had. So mine must have not been as bad. No, I'm afraid care in this country is just really poor for hg. I've just recorded an episode of my podcast, pregnant and Sick with a doctor who specialises in hyperemesis, and we don't get the help that we need here. We don't get the drugs that we need. We don't get the nutrition that we need. We don't get IV drip when we need it, and that means that we have much worse outcomes.

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So people are using the fact that they didn't get help to tell themselves that their condition was not severe, when actually, unfortunately, you can have very severe HG in this country and not receive any help for it unless you know what to ask for. So a lot of what I do on substack is talk about what you can ask for and what you should be advocating for and the reasons that it can help you as well. So obviously on the psychological side, we've got all the stuff from the acceptance and commitment therapy literature, which is really helpful for managing symptoms and helping you to get through it psychologically. We can also see that EMDR is quite helpful for lots of people, and I use that a lot in my clinic. Really, really helpful for managing the trauma, but also for breaking some of those associations that make you just vomit all the time.

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So that can be really useful. But also there's a tonne of medications, loads of medical options that are safe that you can ask for and try and they don't normally get offered to people. And nutritional support should be available way before it is to most people. But again, if you ask, there are specialist services you can be referred to, so always ask. But anyway, as you can tell Marianne, it absolutely drove me bonkers that this information wasn't out there for people and that there weren't social media accounts giving people this information that people go through this and they don't even look for therapy because they don't know that it can help them. So I set out early doors to shout about hyperemesis grava and the fact that therapy helps from day one of my independent practise, and I'm still shouting about it a lot now, and I do feel we're getting somewhere.

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There's an amazing charity, pregnancy Sickness Support who have put some really good stuff out there, and it's making a bit of a splash. But to come back to why is independent work so important, it's for this reason. Because if you are not commissioned to talk about hyperemesis GraBar in the NHS, you can't do it. And if they haven't yet recognised that this is a problem, you can't research it, you can't see patients for it, you can't do anything with it, you can't put your opinions out publicly about it. Whereas because I'm independent, I'm working on research in this area, I'm writing on this area, I'm on social media, I'm on substack, and I'm seeing clients for this condition, and I don't know, but I don't think I'd be able to see most of the people that come to me if I was working in a perinatal service because they are so overwhelmed with the people that more easily meet their criteria. So yeah, it's a bit of a rant, but I do love working independently because you get to pursue your interests,

Dr Marianne Trent (: 26:09

And you didn't just start a private practise. You decided you were going to help support others to start their private practise as well. And there's a lot of shame out there, isn't there? About should I I, what would other people say? What does it say about me if I've been trained by the NHS to then leave? There's a load of hurdles to overcome before we even begin to see our first client in private practise, isn't there?

Dr Rosie (: 26:38

Oh, a hundred percent. And as I've already mentioned, I didn't have very much choice about it, so I felt the weight of that shame. I really struggled. I didn't want to go into private practise at Solomon's where I trained. The discourse around private practise was extremely negative. I hadn't imagined it for myself until maybe I was in my late fifties or something. I think I'd had a little vision that I might retire into private practise at some stage, but it hadn't been part of the game plan for me. And so yeah, I had all of the big feelings, but at the end of the day, my children needed something. And so I fought through the big feelings and made it happen. And it was extremely painful. I mean, I literally had an upset stomach every day for a year. I felt so ill about it for that whole year.

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People often ask me how I'm so confident or how I find it so easy to do business and marketing. I did not find it like that in the first year at all. But what happened for me, and I believe what happened to most people is you start to help people and you start to help people that weren't getting help from the NHS. And sadly, that's an awful lot of people who you imagine when you're working in the NHS, you imagine the people using private services are all mega privileged and they don't really need very much. That is not the case. I found there were just huge sections of society that weren't meeting criteria for one reason or another, and were being refused a service. And so I've never felt guilty really since that first year because I can see the work that I'm doing that these people can't get any other way.

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I've also found there are loads of different business models and loads of ways of giving back to people that can't afford your full fee. So I talk a lot in psychology business school about never discounting your fees. You work out what your fee needs to be and you charge that fee because otherwise you're going to end up working for less than you did in the NHS very quickly. If you've never worked privately, you won't believe me, but you just have to trust me on this one. I've supported hundreds of people through this process, and you can very easily end up on minimum wage quickly if you start discounting your services. So you leave that fee where it needs to be, and then you get creative about the other ways that you can give back. So the simplest way is you offer some pro bono hours through a charity.

(: 29:17

I've done that from very early on in my practise. But you can do other things, like you can work on research. It doesn't necessarily have funding behind it yet. You can join in with projects that local community interest companies are running. You can provide supervision that people can't afford to pay for their charity or their CIC, you can set up your own CICI ran for a few years alongside my private practise. And so there's tonnes of things that you can do to give back and provide something again that is not being provided and that independence allows you to be really creative about how you do that. Yeah, I think the guilt and the shame kind of lifted when I discovered all those different ways of working. And I realised that I was making a really positive impact in people's lives, but it was very big for me at the beginning.

(: 30:10

So yeah, I don't want people to think that it's just a mindset that you can switch on and off. I don't think it is for a lot of us, you have to get out there and start doing it, and then your feelings will start changing as a result of your actions rather than, for me anyway, I couldn't do it as a thought experiment really. But yeah, so you asked why I set up psychology business school to support other people, and that was because two years into my practise, I'd found my feet with it. I wasn't feeling sick anymore. I'd found these other business models, which had made my income a lot more stable. I'd worked my way through a lot of that shame and a lot of those problems. And I looked around me and there really wasn't anybody teaching about private practise out there.

(: 30:58

There was one good book that I found the Rob Ball book, and that had been really helpful to me. But I'd spent hours at the beginning googling, how do I set up a psychology private practise? How do I do a good private practise? I'm a clinical psychologist. All those things I'd put into Google had never returned any UK-based results, and I didn't find the US results very helpful, such a different system over there. And so when I started to feel a bit more confident, and I met a couple of other psychologists in Plymouth who were really supportive of me and made me feel a bit more confident about myself, I thought, well, let's put a podcast together where I get people that have done well in private practise to come on and talk to me about the exciting stuff they do, and just get some positive narratives out there that private practise can be inspiring and exciting, and it doesn't have to be shameful.

(: 31:50

And then we can infuse that with some tips and tricks for people as well, so they at least know how to get their foundation sorted and just feel a bit less alone with it. So that was the intention of the Business of Psychology podcast, which is still going now, I'm proud to say. But very quickly, people started to ask me for specific stuff. And so I'd get experts in to do a masterclass on things, should I be a limited company? And those kinds of common questions that come up at the beginning and before I knew it really, that had spiralled into a course and then coaching. And yeah, it's just gone from there really. And I love it. I love any part I can play in getting more independent work out there so that we can start evidencing the gaps that exist in public. Yeah, I'm so excited about that. I love every one of my coaching clients inspires me, and every single one of them is meeting a need that the public sector doesn't meet. And if we all collect our evidence, we can show what needs are not being met and advocate for those people to the public sector. And ultimately, that is my goal.

Dr Marianne Trent (: 33:02

Oh, that is so powerful. And yeah, that's your why. But it sounds like we are kind of quite similar in that we like to spread our time over kind of a variety of things in the week and across the month. It sounds like you've got two podcasts on the go. Is that, well, hat's off to you. One is a lot to manage, I find.

Dr Rosie (: 33:28

So pregnant and sick is a bit different. So I set that up a couple of years ago and I use it basically as a resource for people who are going through hyperemesis or trying to recover from it. So it's not like I'm trying to do an episode every week when I have an idea of, oh, okay, this exercise worked really well with the last client I worked with. Or I met this person that shared a perspective that would've helped me so much while I was going through it, then I'll put an episode out. But it kind of sits on my substack. It's there for people that need it. It's not designed as a week in week out podcast. I couldn't manage that at all. I

Dr Marianne Trent (: 34:10

Love it. Okay, so it sounds like it's almost like a spoken blog almost. So things when it comes to you, when it strikes inspiration, that's when you record and people will just hit subscribe, hit follow, and it'll ping into them when it's there.

Dr Rosie (: 34:27

Yeah, exactly. And I recommend it to people. So it's another way of working with people that can't necessarily afford therapy with me. If I get an inquiry and they can't afford the therapy, but I know that they need psychological help for hg, then I know, okay, I can't remember how many episodes it is now, six or eight, which give you most of the psychoeducation that I would give you in therapy. It's not the same as the relationship obviously, but it's got that information about how you advocate for yourself. It's got some mindfulness based exercises that people find really helpful. And crucially, it kind of helps people understand that their mind plays a role. It's not the cause of hg, but it can make it a lot worse. So for me, it's really important that everybody's empowered with that knowledge and it's there for them whenever they need it. So I love that and I love substack as a platform. It allows me to do that, but kind of bracket it off. And then in the rest of my substack, I talk about parenting children with additional needs and running a business around that and lots of much broader issues that touch a lot of people that I work with.

Dr Marianne Trent (: 35:36

Thank you. I think it's worth thinking about the people that we surround ourselves with. So there's a Facebook group that you and I are both part of which accepts qualified practitioner psychologists in private practise. And I was part of that Facebook group for, I kind of watched for a while before I probably for a couple of years really. And then it's funny that I've already mentioned Dr. Cara because it was really down to Dr. Cara and my husband that I started a business. I can now say it's a business. At the time I was a bit embarrassed and ashamed to call myself a business woman, but that is where I am now. But Cara was always like, come on, do it. You're going to find it. It's going to be easier than you think it is. You would be brilliant at this. And I was like, oh, no, I'm not enough.

(: 36:26

I'm not enough, I'm not enough. And then my youngest was starting preschool and I was in the NH S3 days a week, so I was going to have two mornings off a week when he was in preschool. And my husband was like, well, what are you going to do with your time then? And I was like, no, clean the house. Have a massage, have a nap. And he was like, I don't think so. You could start your private practise, you could start that business. And I was like, I suppose I could, but I probably preferred my ideas. But it was those two spare, spare spare mornings a week. That was the start of my private practise. And interestingly, on the first ever morning when I was going off to clinic, I was standing at my kitchen sink crying. And that probably doesn't surprise you because of the amount of people that you've coached through this, but I was feeling I'm not enough.

(: 37:19

I'm going to not know the answers. I'm going to be not good enough. I'm not worth the money that I'm going to be paid for this because I was so used to being paid such a lower wage in the NHS comparatively hour by hour. And so I just had this massive sense of just that imposter syndrome not being enough. And I managed to pull myself together and get to through my first clinic, which was two people, and then I had to race back and get my youngest from school, but it was so much less than I'd been used to working in the NHS actually, I don't mean to sound that dismissive of the work I was doing, but they wouldn't have met the criteria for the NHS. But they were still suffering. They were still distressed. And the skills I needed came to me readily and I did a good job. And I was really

Dr Rosie (: 38:18

Surprised I recognised that feeling when I first got positive feedback from somebody in private practise. I was literally blindsided by it. I was like, what? I did well. But I think that's part of what our training does to us. I think it really does make you think less of your skills. I think there's a prevailing culture that everything we know is just common sense and we don't really know anything. And actually you should be proud of the skills that you have and the qualifications that you hold. And actually other people do respect those enough to pay for them as well. And I think it's important that we try and infuse that in the younger people coming up behind us. And whenever I talk to people, whenever I have the opportunity to talk to trainees or assistants or aspiring assistants, I'm always really trying to talk them up. They naturally already are talking themselves down. I think it's a big problem. So I'm not surprised by that at all. No, but I am saddened by it.

Dr Marianne Trent (: 39:16

And in the whole of my doctorate, I qualified in 2011. My first private practise client was 2019, so that's eight years later. But in the whole of my training, private practise wasn't really mentioned at all. Most of the people coming to teach us were working in the NHS. Some maybe had a side hustle, but most were working in the NHS. And yeah, we had one specialist workshop in the third year that you could opt into about private practise, and that ended up being so massively oversubscribed. But that was it one day talking about private practise. But I think times probably have changed quite a lot since then, especially when I graduated. There were no jobs of my cohort of 16 people that graduated at that time. Three people had jobs to go to because of the recession at that time, three people. And it took me until the start of December to start my first qualified job because there was just no jobs as a end result of the recession from 2008. Oh my

Dr Rosie (: 40:20

Goodness.

Dr Marianne Trent (: 40:21

Yeah. So that changed. That probably changed the narrative around that stage really, because the NHS is certainly for training doctorates for the clinical psychology route. They have no expectation currently of you having to stay in the NHS after you qualify because they can't guarantee you a job. Actually, the trust that trained me didn't have any jobs when I qualified. I ended up in a children's trust 26 miles up the road, so you don't owe any allegiances. And I think that was kind of quite important to me at that stage to think, well, I was ready to be an NHS employee in the trust that had trained me, but they couldn't sustain their end of that bargain that was never written down.

Dr Rosie (: 41:13

And I do think that's important and I think for different reasons. So when I qualified, there were plenty, I think of band seven jobs available, and I think looking around there probably are at the moment, but there's nothing if you wanted to go above that really. And I think that's thing the NHS doesn't look after your career progression at all. Actually, I'm not an expert on any of this stuff at all, but I know that there are people that they get promoted and they end up being told they have to work less hours or their pension contributions go up to the point where they're paying lots back in extra tax, which means that they're never really getting any progression in terms of financial pay or really in career satisfaction. It always really shocked me in the NHS that I never met somebody in a consultant post who was allowed to work full time.

(: 42:17

It just didn't happen. So it's like, oh, so you can actually never earn above about 50 grand in the NHS because as soon as you get to a grade where they would have to pay you that they slush your hours down. And I think that's terrible for two reasons. First, it's terrible for the individuals. I think we all need progress in our careers in order to feel like we've got that sense of achievement that kind of keeps us growing as people and as professionals. But I also am really concerned about what it says about the way that we view mental health. If you are refusing to have experienced psychologists who are leading teams there, you are not allowing that to happen. Then how important is psychology to you really? I think it is very, very indicative of how psychology is actually viewed in the mental health system that we have in the public sector.

(: 43:12

And it must change and we must be advocating for that change. And I think the only way we can do that is by showing a better example. And some of my coaching clients are doing an amazing job of this. I've coached people that are running their own services, who are accepting local authority and even NHS funded clients into their psychology led services and showing what a blooming good job psychologists can do when they're allowed to properly run a service full-time, be in charge of that service. So yeah, I think there's so much wrong with how the public sector is run at the moment that being blindly loyal to it isn't probably helping anybody. But that's not to say I would've liked to have done longer in the NHS, and I might go back to it one day if life allows me. I don't think we need to see it as this big divide, but I think what you do need to do is think about your values and what you need right now and make sure that your needs are met and that you are able to live your values through your work. And that might look like a hybrid for you. It might look like working only in hs. It might look like working only independently. Just be open, be open-minded and ground yourself in what's important to your practise and use that as your North star rather than cussing yourself off from thinking about any options.

Dr Marianne Trent (: 44:35

Oh, Rosie, I could honestly talk to you for ages and I feel like we are only just scraping the surface of this, so I might well have to invite you back on later in the year to have this as the introduction to this. But we'll perhaps go straight in on a deep dive for some of this stuff later in the year. Thank you. Could you let us know about ways people can learn more about you, perhaps how they can follow you on social media, how to follow your substack, for example.

Dr Rosie (: 45:04

So if you're thinking about going into private practise, we've got everything you need, including a free checklist over@psychologybusinessschool.com. So for private practise stuff, hop over there. I am also quite active on my substack at the moment, which is just Dr. Rosie. The publications called Know Your Mind, so you should be able to find me quite easily there on that. I talk about the more personal side of business and parenting, and that's also where you'll find my pregnant and sick stuff around hyperemesis. So that's kind of my social media home if you like, but I'm also on LinkedIn as Dr. Roanna Gilda Thorpe, and I'm on Instagram as at Rosie Gilder Thorpe, which is like my businessy stuff around psychology, business school, and at the pregnancy psychologist for more of the hyperemesis stuff. So yeah, I'm lots of places, but Substack is probably the home.

Dr Marianne Trent (: 46:00

Thank you so much for your time, and thank you for turning up, even though you've got a cold, you've done amazingly well. So thank you very much.

Dr Rosie (: 46:07

Thanks so much for having me. It's been a real pleasure.

Dr Marianne Trent (: 46:11

Oh, likewise. Thanks, Rosie. Wow, what an engaging and inspiring powerhouse Dr. Rosie is even when she has a cold. Thank you for your time, Rosie. Please do go and follow Rosie on all of her social channels, which have been on screen and are in the show notes. And if you'd like to access the checklist, she mentioned, please do head to her website. Do you think it would be useful for me to chat with Dr. Rosie again and if so, what questions would you like me to answer or what would you like us to cover? Please do let me know in the comments or drop me a message on social media where I am Dr. Marianne Trent everywhere. If you'd like to help by buying me a cup of herbal tea to say thank you for the content that I create on this podcast, please do.

(: 46:56

There are links in my show notes and in all of my social media channels where my Link Tree Bio will take you right there. If you would like to check out my masterclass on thinking about going all in into private practise, which you can access by going to my website, www.aspiringpsychologist.co.uk, and then going to the Learn with Me tab. If you are an aspiring psychologist or for that matter, a qualified psychologist, you might well love reading the Clinical Psychologist Collective, which gives lots of lovely real life accounts for people that are practitioner psychologists or trainee psychologists at the time of writing. There's also the Aspiring Psychologist Collective, which gets wonderful reviews, and if you or someone you care about is autistic and wondering how you could begin to go about forging a career in mental health, then an autistic anthology is the most brilliant book for you.

(: 47:50

If you would welcome some more support, care, guidance, and advice for nurturing your development in psychology, please do consider the Aspiring Psychologist membership, which you can join from just 30 pounds a month. We have all of our bases covered in terms of research, in terms of CBT skills and formulation, in terms of professional issues and models, approaches, theories, confidence, interview tips, skills and practise, and so much more. Head to my website, www.aspiringpsychologist.co.uk, and click membership. You can also head to that same website and get your free Psychology success guide, which also gets great feedback. Thank you so much for being part of my world. If you're looking to become a psychologist,

Jingle Guy (: 48:40

Then this podcast.