The Aspiring Psychologist Podcast - From NHS to Private Practice: A Psychologist's Journey
Episode Date: March 3, 2025In this episode of The Aspiring Psychologist Podcast, Dr. Marianne Trent is joined by Dr. Rosie Gilderthorpe to discuss her journey from working in the NHS to establishing a thriving private practice.... They explore the challenges, rewards, and mindset shifts required to make the transition, as well as the opportunities that private practice can offer for both clinicians and clients.Key TakeawaysUnconventional Paths – Dr. Rosie shares her non-traditional route into psychology and how it shaped her career.The Reality of Private Practice – Insights into why private practice isn’t just about financial gain but about flexibility, work-life balance, and filling service gaps.Overcoming Imposter Syndrome – How self-doubt plays a role in transitioning from the NHS to private work and ways to navigate it.Finding Your Niche – Why personal and professional experiences can help shape a meaningful and sustainable career.Giving Back Creatively – Alternative ways to support those who can’t afford private services while maintaining a sustainable business.Timestamps00:00 - Introduction01:41 - Meet Dr. Rosie Gilderthorpe03:10 - Taking an Unconventional Route into Psychology07:05 - Working in the Prison Service10:30 - Navigating NHS Training & Culture17:49 - Transitioning to Private Practice26:09 - Overcoming Imposter Syndrome in Business30:58 - Finding Purpose Beyond Therapy35:36 - Using Private Practice to Fill Service Gaps41:13 - Career Progression in Psychology45:35 - Final Thoughts & Where to Find Dr. RosieLinks:📲 Connect with Dr Rosie Website: www.psychologybusinessschool.com LinkedIn: https://www.linkedin.com/in/rosanna-gilderthorp-0346b115b/🫶 To support me by donating to help cover my costs for the free resources I provide click here: https://the-aspiring-psychologist.captivate.fm/support📚 To check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0 📖 To check out The Aspiring Psychologist Collective Book: https://amzn.to/3CP2N97 💡 To check out or join the aspiring psychologist membership for just £30 per month head to: https://www.goodthinkingpsychology.co.uk/membership-interested🖥️ Check out my brand new short courses for aspiring psychologists and mental health professionals here: https://www.goodthinkingpsychology.co.uk/short-courses✍️ Get your Supervision Shaping Tool now: https://www.goodthinkingpsychology.co.uk/supervision📱Connect socially with Marianne and check out ways to work with her, including the Aspiring Psychologist Book, Clinical Psychologist book and The Aspiring Psychologist Membership on her Link tree: https://linktr.ee/drmariannetrent💬 To join my free Facebook group and discuss your thoughts on this episode and more:
Transcript
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Hi there, it's Marianne here. Just before we get started, I wanted to quickly let you
know about an incredible free masterclass happening this Monday, the 3rd of March at
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you will unlock some exclusive bonuses worth over £800, which includes one-to-one coaching,
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or just drop me a DM.
Right, let's get on with today's episode.
Do certain types of psychologists
feel more drawn to private practice?
And how does imposter syndrome
play into the decision to take the leap?
In today's episode, I am joined by Dr. Rosie Gilderthorpe,
and together we'll explore her journey from NHS into private practice, the kind of clinician she was, and the challenges
and rewards of building a psychology business.
Whether you're wondering what private practice is or curious about whether it could be a
good step for you, stay tuned for insights that might just change your perspective. Hi, 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 practice 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. I hope
you'll find today's episode a really useful look into what private practice
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 there 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 MP3, please do share this episode, please do subscribe,
follow the show and if you're on Spotify you
can ask me questions on there too. And on Apple podcast 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.
Hello, it's lovely to be here. Thank you for having me on.
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. Yes you both got so
much to say about private practice haven't we? We 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.
Yeah well I kind of hope that some of the aspiring psychologists listening 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 realized 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. So I applied for it, not having a clue
that psychology was this hyper competitive world
where everybody was like, you know,
trying to take the best steps to get on the clinical course
and 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 mouldable. And 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 have 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. They would pay for your masters 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 think there's 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 have definitely stayed there. But when they changed
the rules and you then had to go away and study on your own for a masters, I thought,
my God, £3,000 for a masters? 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 kind of you know 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 kind of on a grapevine from a friend. 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 Salamands and I guess the rest is
history but yeah 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 honoree, 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 and I didn't even know about the hoops and I
got there eventually so I just wanted to kind of share that bit of the story.
Thank you, that is so important and I think you almost ended up as a forensic psychologist
really. They would have been training you to be a forensic psychologist in the prison service I would
assume. Yeah that's right and I would have loved it. I love clinical but I would have loved
forensic as well, I think it's fascinating. Yeah, 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 and essential criteria. Yeah, 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, you
know, I don't think my application would have 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. Like I was doing a 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 learnt and seeing
how it would map onto the competencies for a clinical psychologist, which I just got
off the BPS website. 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 interviews. So yeah, I think often
you need more confidence in your experience than you might feel if you haven't come that traditional
route. Absolutely, I think from some of the kind of reading I've done into gender differences in
job searches, the data suggested men will have a tendency of applying for jobs where they fulfill 30% or whatever of the essential criteria,
whereas women would only apply when they kind of fulfill 90%.
And it feels like you've kind of taken a more holistic view, actually, than many people would have done.
And it worked, you know, because you got that job.
Yeah, and it was partly. I think it would have been different, a
different story if I'd really known how competitive it was. I'd
never met a clinical psychologist when I went to
Salomon. So there was nobody to tell me that it was really
cutthroat and that people would have been applying for like 10
years. And when I got there, and I saw those people, and it was
everything to them, you know, 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 like 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. You know 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. 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.
Oh, hugely, because the culture in the prison service could not be more different to the
culture of clinical psychology. And, you know, we'll probably talk a bit today about the
problems in the culture of clinical psychology, but you know, neither of them are, you know,
a perfect example of a healthy or a 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 Salamand and picked up very quickly. I was like, oh, okay, we have to say I'm wandering 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. You
know, I never want to sound like I think one is better than the other, I actually don't.
I think in both streams of psychology,
we need to find a middle ground.
Yeah, 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 like they were being 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 a year.
We then, a couple of years in, won a court case to get that raised up to about £17,000, I think £14,000 a year. We then a couple of years in won a court
case to get that raised up to about £17,000 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. I'd always from day one been like this is a low paid job
considering what we're doing here and in the prison service it's really stark
because 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, you know, unsupervised contact with prisoners as part
of our role, which is, yeah, 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 couldn't, 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.
And 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.
And I think that comes from applying for a job
that you're good for, you know,
five times before they let you do it.
I don't think that's good for you psychologically. And I don't think going, you know, five times before they let you do it. I don't think that's good for you psychologically. And I don't think going, you know, 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're not worthy
of having a comfortable life, you know, basically comfortable life, which I think is really sad.
Mm, totally agree. We've had a whole episode on the ethics of honorary assistant psychologist posts,
and yeah, like you say, like people begin to think, well, I can't apply for something qualified
because I wouldn't, I'm not, 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, you know, those neuro-psychs
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 honorees psychs.
But so it sounds like you are really broadly experienced and naturally, of course, very
reflective, but you've honed your craft since kind of 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 practice, Rosie?
Yes, it was never really my intention to go into private practice, which is
interesting because I think I am quite entrepreneurial but I didn't recognise
that in myself as a younger person. Private practice 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.
You know, I really love psychology, much as I didn't have a long-term game plan like 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.
I just love everything about it.
So I was like, right, OK, I'm going gonna 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 like eight till four or nine till five
every day. And so private practice was the only option for me really. And I think it did help
that I'd had a, you know, slightly different journey into private practice,
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. Like all of those imposter thoughts really came up. But actually, when you kind of
find yourself with a client in private practice that has a complicated life history and you
realize gosh you've mentioned something in this assessment session which touches
on my experience from every part of training then you realize what an 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, like 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. 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
practice, I was still a little bit narrow about it. And I'd really encourage anybody that's
thinking about going to private practice to recognize 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 practice I didn't have like role models that I could ask I
didn't really know anybody that had done
it before me who wasn't mega super experienced and so clients just came to them because everybody
in that area already knew who they were. 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 practice. And also because
I'd had a terrible personal experience of hyper-emesis gravadarum in pregnancy, and
hadn't been able to find any psychological support. So I had, you know, 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 realized. And I'd like anybody else, you know,
thinking about their career and their private work to know you can do that you
can make any specialism work. Sorry,
No, that's okay. I think, 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 kind of navigate the world with
people being really, really rubbish at talking about grief. And yeah, and obviously what
we know from your experiences and then Dr. Cara Davey as
well who unfortunately experienced a very sad sterile birth of her daughter and now
really supports people in that as well. And then, you know, 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. I think so. And I think knowing what people actually need as
well. And 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 you know,
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 a perinatal psychologist to ask me what is
hyperemesis gravidarum which should be shocking. It is really scary to me
because it affects two to three percent of pregnancies. That's the lowest
estimate. It could be as much as 10 percent and yet you know the knowledge is not really there
that these people are you know in desperate need of support. I believe it's impossible to
experience hyperemesis gravadarum which for anybody that doesn't know it's severe completely severe, completely intractable nausea and usually vomiting as well that occurs
you know 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 socialize, 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 in 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.
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?
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, mine wasn't maybe mine wasn't HG because I never had a drip.
I never had, you know, 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 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.
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. So that can be really useful.
But also there's a ton 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 but you know 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 gravidarum and the fact that therapy helps from day one of
my independent practice and I'm still shouting about it a lot now and I do feel we're getting
somewhere. 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're not commissioned to talk about hyperemesis gravidarum 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.
And you didn't just start a private practice, you decided you were going to help support
others to start their private practice as well.
And there's a lot of shame out there, isn't there, about should I? Shouldn't I? What would
other people say? You know, 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 practice, isn't there?
Oh, 100%. And, you know, as I've already mentioned, I didn't have a very much choice about it.
So I really I felt the weight of that shame. I, you know, I really struggled. I didn't
want to go into private practice. At Salamans,
where I trained, the discourse around private practice was extremely negative. I hadn't
imagined it for myself until maybe I was in my late 50s or something. I think I'd had
a little vision that I might retire into private practice 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.
People often ask me like 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 know, 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.
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. You know, 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. I've done that from very
early on in my practice. 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 for their charity or their CIC. You can set up your own CIC.
I ran one for a few years alongside my private practice. And so there's tons 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 realized
I was making a really positive impact in people's lives. But it was very big for me at the beginning.
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, you know, 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 practice, 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 kind of 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
practice out there.
There was one good book that I found the Rob Bore 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 practice?
How do I do a good private practice?
And I'm a clinical psychologist.
Like all those things I put into Google had never returned any UK-based results and I didn't find the US results
very helpful because it's such a different system over there. And so when I started to kind of 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 practice to come on and talk to me about the
exciting stuff they do and just get some positive narratives out there that private practice can be
inspiring and exciting and it doesn't have to be shameful 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 like, should I be a limited
company? And those kinds of common questions that come up at the beginning. And yeah, 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 sector.
I, 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.
Oh, that is so powerful. And yeah, that's your that's your why. But it sounds like we're
kind of quite similar in that we like we like to spread our time over a kind of variety of things in the week and across the month.
Yeah, it sounds like you've got two podcasts on the go.
Yeah.
Is that right?
Well, hats off to you.
One is a lot to manage, I find.
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 like 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 have helped me so much while I was going through it,
then I'll put an episode out. But it kind of sits on my sub stack. It's there for people that need
it. It's not designed as a like week in week out podcast. I couldn't manage that at all.
I 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.
People will just hit subscribe, hit follow and it will ping into them when it's there.
Yeah, exactly. And like I recommend it to people. So if I, 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've got like, I can't remember how many
episodes it is now, like six or eight, which give you most of the psychoeducation 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 because it allows me to do that, but kind of bracket it off. And then
in the rest of my Substack, I talk about, you know, parenting children with additional needs and, you
know, running a business around that, and lots of much broader issues
that touch a lot of people that I work with.
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 practitioners,
psychologists in private practice.
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. Kara, because it was really down to Dr. Kara and my
husband that I started a business. You know, 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 Kara was always like, come on, do it. Like you're gonna find it, it's
gonna be easier than you think it is. Like you would be brilliant at this. And
I was like, Oh, no, I'm not enough. I'm not enough. I'm not enough. And then my
youngest was starting preschool and I was in the NHS three days a week. So I was
going to have two mornings off a week when he was in preschool. 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
practice. 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 practice.
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 like feeling, I'm not enough.
I'm gonna not know the answers.
I'm gonna be not good enough.
I'm not worth the money that I'm gonna 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, yeah, that imposter syndrome not being enough.
And you know, I managed to pull myself together and get to through my first, you know, 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.
That doesn't, I don't mean to sound that dismissive
of the work I was doing, but you know,
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 surprised. Yeah I recognise that feeling
when I first got positive feedback from somebody in private practice I was
literally blindsided by it. I was like what I did well but you know 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 because 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.
Yeah, and in the whole of my doctorate, I qualified in 2011. My first private practice
client was 2019. So that's eight years later. But in the whole of my training, private practice
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 yeah, most were working in the NHS. And yeah, like we had
one specialist workshop in the third year that you could opt into about private practice.
That ended up being so massively oversubscribed. But that was it, you know, one day talking
about private practice. But, you know, 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 an end result of the recession from 2008.
Oh my goodness.
So I think 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.
They can't, because they can't guarantee you a job.
You know, I actually, the trust that trained me
didn't have any jobs when I qualified.
I ended up in a children's trust, you know,
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,
you know, 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, you know?
stay in their end of that bargain that was never written down, you know?
Yes, and I do think that's important. And I think, you know, for different reasons. So when I qualified, there were plenty, I think, of band seven jobs available.
And I think, you know, 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 another thing, like the NHS
doesn't look after your career progression at all. And actually, you know, 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. 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're refusing to have experienced psychologists
who are leading teams their full time,
you are not allowing that to happen,
then how important is psychology to you really?
I just, 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, 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, I've coached people that are running their own services, who are accepting, you know, 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, like 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 have 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're 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 sort of ground yourself in what's important to your practice
and use that as your North Star rather thaning yourself off from thinking about any options.
Oh, Rosie, I could honestly talk to you for ages,
and I feel like we're only just, you know, 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, you know, about ways people can learn more about you, perhaps how they can follow you on social media, how to follow your sub stack, for example?
So if you're thinking about going into private practice, we've got everything you need,
including a free checklist over at psychologybusinessschool.com. So for
private practice stuff, hop over there. I am also quite active on my sub stack 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 Rosanna Guilderthorpe and I'm on Instagram as at Rosie Guilderthorpe 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.
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.
Thanks so much for having me. It's been a real pleasure.
Oh, likewise. Thanks, Rosie.
much for having me it's been a real pleasure. 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.
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