Another route to Health Psychology: via the Scottish Highlands

Hi everyone and welcome to our next blog entry. We have the pleasure of learning from Hannah Proudfoot, Health Psychologist. Hannah offers an excellent example of working with change and uncertainty across her journey to becoming a Practitioner Psychologist, but also and experience of leaning into the change and letting it form part of her decisions. We hope you will find Hannah's journey an inspiration, as much as we do!

Another route to Health Psychology: via the Scottish Highlands

I completed my Psychology undergraduate degree at Durham university in 2014, and unlike many of my peers, I didn’t have a grad scheme or internship lined up straight away. I had been taking the approach of “focus on the current hurdle in front of you” and had actively decided not to rush into anything right away to allow myself time to figure out what I wanted to do next. I knew I wanted to continue pursuing Psychology in some way, I just wasn’t sure what that looked like yet. I decided to sign up for a voluntary mental health placement in Sri Lanka where I could gain hands-on experience in psychiatric wards while immersing myself in a beautiful country that was still recovering from a harrowing, not-so-distant past. 

With this upcoming venture and some form of Master’s degree in my future, I needed to start saving and luckily landed a job in marketing whilst living at home with my parents in Cumbria. I enjoyed being in the working world and could have very easily stayed in this comfortable situation but the world of Psychology was calling me and I owed it to myself to listen. 

I started looking for Master’s courses and I recall the moment that “Health Psychology MSc” popped up on my screen – I was intrigued – and lost myself in a rabbit hole of reading and research (a very interesting one, might I add). I hadn’t heard of Health Psychology before but it sounded right up my street, especially “psychosocial factors in health and illness”. I’d always had an interest in health and having gone through my own struggles with Irritable Bowel Syndrome for the last couple of years without much support or guidance, I felt strongly about the need for developing psychological support for health conditions. 

In September 2016, I embarked upon the Health Psychology MSc at King’s College London and had the best year learning and laughing with a close-knit cohort and lecturers who were experts in the field. I was so pleased that I hadn’t gone straight into a course from undergrad and took the time to explore my options because otherwise, I might have missed out on this relatively new branch of Psychology. 

For my MSc placement, I joined a research team at the Faculty of Nursing and Midwifery at King’s who were developing psychological interventions for Inflammatory Bowel Disease (IBD). Although I was disappointed not to work directly with patients during this time, I realised the importance of clinical research in improving the lives of those with long-term conditions and felt proud to be a part of this work. 

I was fortunate to continue working with this team for 3 months after finishing the MSc where I undertook a thorough systematic review on targets for interventions for faecal incontinence in IBD. This review contributed to the development of a multifaceted management intervention to improve the well-being of people with IBD, known as IBD-BOOST. Ideally, I’d have loved to stay working in this area and be involved in the delivery and evaluation of this intervention, alas, with limited funding available, this wasn’t possible at the time. 

From there, I joined UCL’s Tobacco and Alcohol Research Group as a Research Assistant / Co-ordinator. In truth, it took me a while to feel settled here – possibly because I was still trying to find a balance between being professional and being my true self (often described as “wonderfully weird” – think Phoebe Buffay from Friends). This often made me sink into myself and seem shy – when really, there was a voice inside wanting to be heard. Six months in, I moved into a shared office with others in my team with whom I quickly became friends and felt like an established member of the team, which in turn made me feel more empowered and confident in my role. Here, I was managing the day-to-day tasks of a research project (investigating the health effects of potentially harm-reducing tobacco products); meeting with participants; co-supervising MSc students; co-ordinating meetings, events and conferences; and collaborating with colleagues on the occasional research paper. I loved the variety of the role and truly felt awe-struck being in the presence of such talented and knowledgeable researchers (whose statistical skills blew me away). But it was working with participants that really interested me. I was having daily conversations with members of the general public who would talk to me about their smoking behaviour – why they continued to smoke, what they had tried in an attempt to quit, and sometimes, would ask for my advice. That wasn’t my role at the time, however, it did make me think that I would like to be having these kinds of conversations with people and be in the position to support others to improve their health. 

That’s when I came across the advert for a funded Trainee Health Psychologist post with NHS Education for Scotland (another route to the Stage 2 Qualification in Health Psychology). I didn’t think I stood a chance at getting onto the programme – I knew how competitive it was – but what did I have to lose? I applied and 3 months later, I was moving to Inverness on my own. There were only 2 of us in the cohort that year, and my peer (and soon-to-be-friend) was placed in Dundee – so we really were going it alone in some regards. Being a trainee Health Psychologist in a health board where Health Psychology was still finding its feet was tricky at times. My intervention work was being supervised by a Clinical Psychologist and I think we were both hesitant for me to be “let loose” with clients, given my lack of previous experience. In order to be given the opportunities I needed to develop clinically, I signed up for as many training courses as I could find; Motivational Interviewing, Cognitive Behavioural Therapy, and Acceptance and Commitment Therapy, to name a few. These courses made me feel more confident in delivering interventions and helped me realise the breadth of health-related psychological interventions (i.e., it is more than behaviour change).

Ten months into the programme, the COVID-19 pandemic hit. With any training course, there are likely to be ups and downs along the way, but the pandemic brought a new level of turbulence. I recall feeling so helpless as I saw and heard about the situation in the local Hospital and what my colleagues were facing every day. Similarly, the Diabetes Service where I was working with clients had reduced its service provision at this time, and my intervention work was halted. This brought feelings of guilt and stress that I couldn’t be of service to my clients. In response to this, I worked with clients to co-produce an interactive digital workbook to support people with Diabetes to cope during the changing phases of the COVID-19 pandemic. This experience taught me the importance of service user involvement in the planning and delivery of healthcare services.

Alongside this, I got involved in developing and facilitating support groups for hospital staff working in COVID-19 wards. My original training plan was out the window but this gave me a real taste of what it was like to work in the NHS – where flexibility and initiative is needed in the face of unprecedented situations. As someone who had always required structure and plans – I was able to cope with this change surprisingly well and found a new layer of resilience that I didn’t know I had. I found my learnings from psychological interventions invaluable during this time and welcomed a refreshing sense of vulnerability by sharing how I was truly feeling with colleagues and supervisors. In this vulnerability, I found strength – and this is something I have taken forward with me in my post-qualified career.

These unplanned experiences were probably what helped me secure my first qualified post as a Practitioner Psychologist in a Staff Psychological Wellbeing service at Northampton General Hospital. This role gave me a breadth of experience, from supporting individuals and groups of staff with complex difficulties to contributing to service development within a small and hardworking team. I learned so much under the wings of Dr Claire Hallas, the service lead, who helped me believe in myself and develop autonomy in my practice, and I really felt part of a family in the team. 

Sadly, and somewhat ironically, whilst I was co-facilitating a countywide support group for staff with Long Covid, I developed health problems myself after having COVID-19. I was experiencing brain fog, fatigue, speech difficulties and unexplained seizures. I took some time off work (about a month) which is now a bit of a blur that I don’t fully remember. When I returned to work, I returned to lighter duties (non-clinical work) as I focused on my health recovery. My team was very supportive, allowing me to work flexibly from home as I figured out my next steps. During this time, I still managed to achieve a substantial amount – I developed service materials, teaching and training resources, intervention materials, and completed many CPD courses. However, without the clinical work – I wasn’t really fulfilling the requirements of the role, nor was I sure when I would feel ready and able to do so. I made the difficult decision not to extend my fixed term contract with the team, as I knew I needed to be closer to friends and family as I focused on my health.

For the first time ever, I was allowing myself to take a break from employment without knowing what my next move would be. This was a very unusual and daunting experience but I knew it was the right decision for me.

I took a couple of months to rest and was working on building up my strength and confidence again. This whole experience had really knocked me and I felt like a shadow of my former self – I felt as though it had taken me so many years to build up my confidence and now, I was starting from scratch. In the face of these doubts, I persevered and continue to do so every day. I started looking for jobs again and shortly after, I was approached about a research position in the Health Psychology section at King’s College London. 

I am pleased to say that I secured the role as a Researcher / Psychologist on a research programme: REFUEL-MS, led by Professor Rona Moss-Morris, which aims to develop a digital intervention to support people living with fatigue in Multiple Sclerosis. The intervention will be based on exercise interventions and Cognitive Behavioural Therapy, and I’ll be heavily involved in co-developing the intervention content. Two weeks into the role and I’m really enjoying it and glad to be back to a regular routine after a much-needed break. As for my health, it still presents its challenges, and is something that I’m working on and managing every day. But I don’t want to let it keep me from my passion for Psychology. I am better able to recognise when to take a step back and prioritise my self-care, which is why I know I’m ready to take on this role. 

My take-home message from my journey thus far is that we can try to plan and map out our ideal career or life ahead but we cannot control what will happen along the way and the different directions it can take us. My advice is to go with it, trust the process and the uncertainty, and you never know what opportunities you might find. 

As Padesky (1993, p3) said, “if you are too confident of where you are going, you only look ahead and miss detours that can lead you to a better place.”

Thank you Hannah, it was great to learn more about you and how you overcame very many obstacles, to being the successful Health Psychologist you are today. It was also lovely to read about the variety in your daily employ, including research components and clinical practice and the very many other facets your role as a Health Psychologist include. 

We hope reading about Hannah has been interesting and stimulating and made you curious to find out more about Health Psychology and Practitioner Psychology roles in general. Let us know if you would like to share your own journey in a blog entry.

Kind regards, 

The Pathways team.