Psychological professional

Introduction to being a psychological professional on the neonatal unit

Psychological professionals working in the neonatal unit have specialist expertise to support the emotional and psychological wellbeing of infants, their families and staff during a baby’s neonatal stay. Psychological professionals work in partnership with families to understand and explore their emotional wellbeing and develop a plan which supports them. Psychological support can be offered individually to parents, with their baby by the cot-side or in a group with other parents on the unit. Psychological professionals are part of the multidisciplinary team and are available to support the team with consultation and advice on the mental health and wellbeing of families on the unit, as well as providing support directly to staff themselves.

Psychological professionals support junior psychological therapists and unit staff wishing to promote the wellbeing of neonatal families through consultation, supervision, debriefs, teaching and training. They also offer specialist advice to strengthen parent-infant relationships and bonding; neurodevelopmental needs of the baby and additional resources or referrals for the family when they leave the unit. Psychological professionals have specialist skill and training in building relationships in complex situations and can support when there are differences in opinion between families and medical staff about care plans and needs of infant.

How do you become a psychological professional on the neonatal unit?

Most psychological professionals working on the neonatal unit will come from either a clinical psychology; child and adolescent/adult psychotherapy or counselling background. Psychological professionals working on the unit will typically have advanced training and experience of working with children and families in hospital settings, supporting parental wellbeing, parent-infant relationships and/or working with families with health or neurodevelopmental needs.

Clinical Psychologists

Clinical Psychologists bring together a wealth of knowledge and skills in clinical and developmental psychology to support the wellbeing of children, families and staff. Their training includes a foundation degree in psychology, relevant experience and/or advanced study e.g. MSc in psychological knowledge and practice; as well as a 3-year doctoral training in Clinical Psychology. Clinical psychologists are trained to support mental health across the whole lifespan, enabling them to support parents, infants and the wider family. They are trained in a variety of therapeutic skills, techniques and approaches which enable them to select psychological interventions in line with best evidence, understanding and research. Clinical psychologists are able to assess, formulate and offer psychological support to promote parent and infant wellbeing, family relationships and neurodevelopmental outcomes. Clinical psychologists also have advanced skills in research which they use to support evaluation, audit and service development. Their training also encompasses approaches to staff support, teaching and training.

Child and Adolescent Psychotherapists

Child and adolescent psychotherapists are trained in observation, assessment and developing formulations that inform the care plan in partnership with the family. Child and adolescent psychotherapists acknowledge the impact of complex emotional experiences which can influence across generations and operate at an unconscious level through behaviour, play and relationships. Child and Adolescent psychotherapists have specialist skills to work with and understand pre-verbal communication and behaviour and appreciate that previous difficulties can be triggered during times of high stress and emotional need. Psychotherapists also have specialist skills to work with individuals and groups in distress when there are differences linked to clinical decisions. Many psychotherapists are trained to doctoral level. Their training in research methodology can be used to support clinical evaluation and research within a service.

Counsellors

Counsellors are trained to provide emotional support to children, adolescents or adults. Counsellors are trained to work with psychological distress, to listen to the impact of this distress and to work with the person to develop goals and solutions for a better future. Their training and is often at a post graduate or Masters level, lasting from 12 months to 2 years although many have done courses of shorter duration.

Progression opportunities

Supporting the emotional experience of the family during their neonatal stay is a key priority to optimise psychological, emotional, neurodevelopmental outcomes for the infant, parental as well as family mental health and relationships at a crucial stage in the family journey.

Working on the neonatal unit as a psychological professional is a developing area of psychological practice. There are several new posts for psychological professionals across the banding structure. These posts are typically at an 8a and 8b level to reflect the level of clinical skill and leadership needed to develop the specialism and work with complex emotional dynamics in neonatal settings. It is anticipated that there will be an increase in placements for psychological professionals in training attached to the new roles.

To work as psychological practitioner on the unit, psychologists and psychotherapists will typically have a clinical interest and understanding of work with parents and infants in critical care settings. Psychological professionals have a range of transferrable skills, developed through their degree, pre-clinical and clinical trainings in infant/clinical observation; child development; clinical work and knowledge of child, adolescent, and family mental health; paediatric and neurodevelopmental services; work with Under 5s and/or with new parents in perinatal teams.

There are education and training opportunities to support psychological professionals transitioning to roles in the neonatal units. A competency framework for psychological professionals is in development which will guide learning, practice, training and supervision needs to develop skills and specialism within neonatal care.

It is an exciting time to work as a psychological professional on the neonatal unit. There are opportunities to develop advanced clinical skills; shape and develop services, contribute to research, policy and practice for neonatal families. There are opportunities to contribute to unit culture, support compassionate practice and positively influence the trajectories for neonatal families who have until recently received little or no psychological support or intervention.

In brief, for a Clinical Psychologists, a typical week may involve:

Working with the baby:

Providing intervention sessions to support the parent-infant relationship using a variety of models and interventions, such as
- Brazelton NBO or NBAS
- Watch, Wait and Wonder (WWW) – with adaptation
- Video Interactive Guidance (VIG)
Working with the staff team to think about the babies needs and the importance of providing neuroprotective care.

Working with parents and families

Providing psychological assessment and evidenced based therapy for parents (individually or together), to help support them with the multiple adjustments, fluctuations and the associated emotions they experience as a result of their baby’s neonatal journey
Facilitating or co-facilitating parent groups on the unit
Providing support sessions to siblings and wider family members that may be impacted by a baby’s admission.
To support in situations where difficult decisions need to be made
Liaising with a wide range of community and hospital-based services, including:
- Community mental health services
- Social care and safeguarding teams
- Schools and nurseries

Working with staff

Taking part in multi-disciplinary team (MDT) meetings – sharing thoughts and formulations on families’ experiences.
Undertaking psychological pre-briefs and debriefs, prior to or following difficult situations.
Providing case consultation to medical teams
Providing reflective practice sessions to different staff teams
Providing teaching and training on staff inductions, nurse courses and grand rounds
Providing support sessions for staff who may be finding things difficult and ensuring they are sign posted to appropriate support where necessary.

Child Psychotherapist – A day in the life

A day in the life of a Neonatal Psychological Professional My role As a child psychotherapist on a NICU I…

The help we received from the NICU psychologist was pivotal for us. I’m not sure how I would have got through it all without having them there to talk to. Having someone who understood NICU, rather than just perinatal was key. Things are tough on NICU but you’re in fight-or-flight mode, when you get home it all hits you and you need someone who understands. I might not be here today without the support I received from the psychology team.”

(Mum)

To be able to receive the help so quickly after he was born was invaluable really. I don’t know where I’d be now without it, I’d be in a much worse place.”