In the last couple of years I have completely changed my working world from being a Cognitive Behavioural Therapist working with individuals to a Commissioner working on system change. Whilst I have chosen to leave my Psychological Therapy role behind the skills, development and experience I gained there are never far from the surface.
My working journey has frequently surprised people, having trained and worked as a Pharmacist for several years, before training as an Integrative Counsellor. In 2009 I started as a Psychological Therapy trainee for the new IAPT service in West Sussex, starting University again at the same time as my youngest son.
I loved the learning that Cognitive Behavioural Therapy brought, although not always the way that “complex patients were supposed to fit into neat therapeutic models”. I never met a patient who looked anything like the examples in the textbooks! In 2014 I was seconded to work in a new pilot as a CBT therapist in a multidisciplinary Proactive Care team working with complex patients with long term conditions aiming to keep them out of hospital or long-term residential placements. The challenge now became how to translate all the counselling and CBT knowledge I had to work with anxiety, low mood, grief and acceptance in a patient’s home when their greatest difficulty was frequently a severe and significantly limiting physical health problem or social care need.
Working in an MDT was a great and rewarding experience and I learnt so much here about the wider health and social care system and how staff can work well in integrated teams even if the infrastructure, location, computer systems, red tape, history and organisational culture make it hard. I wanted to be able to make a difference to that bigger system but I didn’t know how beyond the team I was in. At the same time my husband had had his own long-term health problems for a number of years that had placed me in a carer role and I was struggling to have the emotional energy for my therapy clients as well as my personal life.
So what does an on the edge of burnout Therapist, who can spot problems, work with and analyse data and likes to see the bigger picture do without experience or specific qualifications in this area? The answer fell in my lap when I saw an advert for a Darzi Fellowship - it seemed the ideal opportunity to step out into the unknown.
Again I was fortunate to be in the first cohort of Darzi fellows for Kent, Surrey and Sussex and took on a project far away from anxiety, low mood and long term health problems. As well as studying for a Post Graduate Certificate in Leadership in Health at LSBU, I worked with Care without Carbon Team at Sussex Community NHS Foundation team trying to answer the question of ‘How do you embed environmental sustainability in the clinical care strategy?’
Just over a year on after the fellowship ended, I am now far away from individual patients. I thought long and hard before I gave up my Therapy role. I concluded that I was an enabler at heart and as long as any new role allowed me to do that I knew I would be satisfied. Most Leadership development courses cover things like self-development, collaborative working, relationship building, trying out new thinking, finding the common ground – is this not the work of every session with every patient for Psychological Therapists? Now my patient is a local health and care system and I am learning how to listen to this stressed system and identity the interventions that will help it manage its own psychological distress.
Lead Manager, Commissioning Community Services in Sussex