Plunging into Psychotherapy

The Practical Site

1 Military Hospital is a medical facility located in Thaba Tshwane, Pretoria. It is part of three military hospitals that are located across the country and provides quality healthcare to the South African National Defence Force as well as their dependants. As trainee clinical psychology students, we are placed in the Psychology Department of the hospital, taking care of the mental health of military personnel and their families. This department is home to registered clinical psychologists, intern psychologists, student psychologists and other staff members. The services found in this department include psychometric assessments, psychotherapeutic treatments, and a family clinic. Psychologists in this department form part of a multidisciplinary team with other health care practitioners in the hospital to provide holistic care to both in-and-out patients.

Engagement with the military community

Our practical work at 1 Military Hospital began expeditiously. Not long after our orientation at the University, we travelled to the hospital to meet our on-site supervisors and for orientation on what the practicum component of our training would entail. In that same week in the latter half of February, our practical exposure began, and we saw our first patients. Since then, we have continually engaged with our patients on a weekly basis, conducting psychotherapy at the hospital for two hours once a week. Back at the university, we also engage in an hour of supervision with our individual supervisors every week. Supervision is an opportunity to discuss our patient work and receive guidance to ensure that our patients receive appropriate psychological treatment to alleviate their presenting symptoms. It is also within the supervision space that our personal and professional development is cultivated and continuously monitored.

The Process

The first step in our engagement process begins when we receive a referral. The patients referred to us present with a wide range of concerns, ranging from interpersonal problems to complex psychopathology. The second step is the intake interview, where we gather information about the patient’s history, symptoms, and other relevant details. The third step is formulating and conceptualising a treatment or assessment plan. The fourth step comprises either psychotherapeutic intervention, psychometric assessments, or both depending on the needs of the patient. Termination is the last step of the process, which can occur after 10 to 12 sessions of psychotherapy. Moreover, we collaborate with a multi-disciplinary team and refer to other departments such as psychiatry and occupational therapy when required.

The Academic Component

Our engagement with patients at 1 Military Hospital is grounded on an integrative application of what we learn in class, that is, our coursework. This includes, among others, theories from which we can understand and formulate our patients, interventions we can draw from in our patient work, along with clinical diagnostics, psychometric assessments, and report-writing. We are exposed to modules such as Clinical Interventions and Therapeutics, Clinical Psychopathology in Context, and Clinical Assessment and Patient Management, which guide how we approach working with our patients at the practical site. To advance our cultural awareness and sensitivity to matters of diversity, including race, gender/sexuality, age, and class, we also have lectures that focus on developing this aspect of our academic and professional development.

The Experience

Initially, this experience was one that we had all found to be daunting and challenging, as we were still adjusting to this new process and establishing ways in which to bring our theoretical knowledge into the therapeutic space. However, the staff members that we have been exposed to at the Psychology Department at 1 Military Hospital have been immensely supportive. They are always willing to offer a helping hand or advice on patient work and as a result, we soon found our footing and the practical training component of our degree started to run more smoothly. Although this experience has presented us with challenges, it has been a rewarding one as we have been given the opportunity to see the growth in both our patients and ourselves. Through this experience, we have learned more about the field of clinical psychology and different ways to engage with a diverse population of patients.