A Dual Perspective: Reflections on Working with Two Specialist Teams in the Private Sector

Main Theme: How balancing work across two specialised teams has deepened my clinical

understanding, refined transferable skills, and shaped my perspective on psychological assessments.

I'm Isabel Castelow, an aspiring clinical psychologist with two degrees in Psychology and experience in both research and mental health settings. While I knew that securing an assistant psychologist position would be the ideal next step, I recognised the challenge of landing that first assistant role given its competitiveness. When I secured the role to work at a private psychological service, I was intrigued by the opportunity to experience the dynamic, pace and structure of a private service.

Private psychological services provide mental health support outside of publicly funded systems, and the services are typically paid for by clients, through insurance, as part of NHS waiting list initiatives or specific funding sources, such as local authorities or the Adoption and Special Guardianship Support Fund (ASGSF). My role within the private sector offered a unique opportunity to work across two specialist teams, and this blog aims to reflect on the distinct learning experiences and challenges involved in managing this dual role.

I was involved in both the Socrates Multidisciplinary Assessment and Review Team (SMART) and the Socrates Developmental Assessment and Relational Trauma Service (DARTS). The SMART team screens and assesses young people for autism and Attention Deficit Hyperactivity Disorder (ADHD). The assessment process for this team utilises standardised tools, such as the Autism Diagnostic Observation Schedule (ADOS), and involves information gathering from caregivers, schools and one-to-one sessions. The team is highly multidisciplinary, drawing on the expertise of a range of professionals. Within this team, I assisted with assessments by liaising with schools, administering neuropsychological assessments, performing observations of the young person, and writing reports. Following the completion of the assessment process. I also contributed to multidisciplinary diagnostic discussions with the team.

Alongside this role, I contributed equally to the DARTS team, which specialises in assessing and providing therapy to children and young people with complex presentations related to developmental trauma, as well as providing support to parents and carers through Dyadic Developmental Psychotherapy. Similarly to my work in the SMART team, I took an active role in assessments and report writing. Since much of the work is funded by the ASGSF, I also coordinated closely with therapists and social workers to ensure the most appropriate package of care is in place within the constraints of the available funding.

As I reflect on the unique learning experiences and challenges this dual role brought, I’ll explore the key differences between the two teams. One difference lies in the dynamics of professional collaboration within the teams. Although both utilise the expertise of a range of professionals working together to achieve a common goal, one functions as an individual unit, while the other operates through more independent roles across various branches.

Within the SMART team, there is continuous collaboration and discussion, and when a professional works individually with the young person, the information is integrated and shared within the team. Due to the diagnostic nature of the assessments, it is important that all information is shared to create a holistic picture of the individual and rule out any alternative explanations for their presentation.

In DARTS, due to the nature of therapy the work naturally divides the team into separate yet connected branches. A therapist works individually with the young person, and during assessments, a consultant clinical psychologist leads each case, and other professionals are invited when their expertise is required. This means daily team meetings are replaced by targeted discussions, ensuring collaboration is shaped by the specific clinical needs of each case. This contrast in the teams' dynamics underlines the need to adopt the collaboration technique that most effectively serves the psychological team’s aims, ensuring that communication and teamwork are optimised for the best possible outcomes. Crucially, it shows that both the extent and the form of communication and collaboration must stem from the clinical question at hand.

Another distinction highlighted through parallel working is how the structure and flexibility differ across the teams. As the SMART team undertakes diagnostic assessments, the process is systematic to meet guidelines and criteria. This means the assessments, although adapted to the individual's needs, have a defined workflow requiring the young person to complete specific sessions for a valid assessment. In contrast, due to the formulation-driven nature of the DARTS assessments, more flexibility is required. The young people we work with have faced developmental trauma, such as abuse, neglect and/or other adversity, so each child we meet ranges in presentation and complexity. It is therefore important that the assessment matches the pace of the young person. While some children complete a cognitive assessment and a series of psychometrics, others respond better to a play-based assessment. When meeting the child, the clinician gauges this and adapts to best suit the young person and their situation, so more flexibility is required within the DARTS team.

This demonstrates that one size does not fit all when it comes to Psychological Assessments. Working across both teams emphasised that assessments are not about the instruments we use, but the clinical questions we are asking. A measure can feel too rigid or fluid depending on our aim -clarity or depth? Hence, adapting between structured and flexible approaches has enhanced my critical analysis. I have learnt that within psychology, it is not just about following processes, but it’s about knowing when to stay structured and when to be client-led. In some circumstances, an overly structured assessment may fail to grasp the complexity, and in others, an overly flexible approach could risk ambiguity and invalid results in standardised assessments. It is vital that the assessment aligns with the clinical question.

As the differences have been established, I will explore how working across two teams has refined my skills. Whilst working in the SMART team, I've developed the ability to notice subtle behaviours and mannerisms, such as eye contact, intonation, and small physical movements, that can provide insight and evidence for an assessment. When starting this role, it felt like an impossible task to keep track of all these behaviours whilst interacting with the young person, but by observing and learning from other professionals, this skill has greatly developed. With this, I have also learnt the importance of critically observing behaviour without actively searching for specific traits. I recognise that it could be easy to fall into the trap of seeing what you expect to see. To avoid this, I’ve become mindful of evaluating the context as a whole rather than isolating individual behaviours. For example, rather than noting 'eye contact was fleeting,' I now ask myself reflective questions such as “was the young person anxious?” or “Could there be another explanation?” This approach enables me to thoughtfully interpret what I observe. This skill has also proven valuable and transferable to trauma-based work, where, despite not assessing against specific criteria, it has enabled me to detect subtle changes in a young person’s behaviour or language. For example, when a young person reacts largely to small sounds or movements, I may infer that they are hypervigilant and adapt communication or the session plan to be more suitable.

Another skill which has been developed through working across two specialist teams is pacing, by this I mean the ability to manage two workloads simultaneously, whilst managing expectations. A major positive of working within a private psychological service is autonomy; although I am a novice to the working world, I was given the freedom to manage how I split my time between the two teams. However, managing my time and setting realistic expectations was a challenge initially, particularly because I tended to want to complete tasks immediately after they were requested. I soon realised that it was not the most efficient way to work or feasible in the long term. I therefore had to develop a system that ensured I focused on priorities and managed expectations, without overwhelming myself.

I learnt the importance of setting clear boundaries with myself by being honest about what I could realistically complete and communicating this openly within the teams. This ensured my supervisors were aware of the workload I could manage that week, and then able to delegate tasks within theteam to ensure we stayed on track.

I have also learnt the importance of professional detachment and compartmentalising whilst working in an emotionally demanding setting. My role as an assistant psychologist was one of the first occasions where I had to compartmentalise my emotions from my professional work, away from my home life. Although at university I often worked with case studies, it was easy to view them purely from an academic perspective, rather than relating to the fact that they represent real individuals. Working face-to-face with individuals who have experienced significant trauma provides an emotionally demanding situation. On one occasion, I worked with a young girl over multiple sessions and developed a rapport with her before becoming aware of her background. Upon learning about her history, I felt a mix of emotions, frustration and sadness at what these young people experience, passion around this field of work, and some uncertainty. I was surprised by how conflicted I felt. On one hand, I felt motivated to make a difference; on the other, I wondered how I’d manage the emotional toll. It made me reflect on how to stay engaged and empathetic without letting the weight of these stories affect my personal life. This is where the value of clinical supervision became apparent. I discussed this situation and the mixture of emotions with my supervisor and learnt the importance of professional detachment and compartmentalising. I learnt how to be compassionate and present while not becoming overwhelmed or personally entangled in the young person’s experiences. This balance allows me to offer effective support while protecting my emotional wellbeing, which is a skill I will carry forward as my career progresses.

Navigating two teams in parallel has not only broadened my experience and skill set but has also required adaptability, critical thinking, and a growing sense of self-awareness. This experience has taught me that one size does not fit all when it comes to psychological assessment, and each approach must be tailored to the clinical question. Above all, I’ve come to value the clarity that supervision, professional boundaries, and reflective practice brings to clinical work.

This dual role continues to stretch me, not only professionally, but personally, inviting ongoing reflection about the kind of psychologist I hope to become. How might our early clinical experiences influence the values and approaches we bring into training and beyond?