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Sarah Swan: My Working Life as a Clinical Psychologist

Published on: 15 May 2024

Andrew Nisbet: My Working LifeCan you describe what you do in 1 sentence?

I use psychological theories and expertise to help individuals and organisations understand their psychological makeup, improve their mental wellbeing and enhance their functioning.

What qualities do you think you need to do your job well?

You need to be curious about people, reflective and empathetic.  You also need to be willing to reflect on yourself and have good strategies for self-care.  It is important to be flexible while also able to hold boundaries.  

What did you want to be when you were at school? 

I didn’t really know what I wanted to be but my parents told me I would be on the phone for hours, providing a listening ear and giving advice to friends, as well as their boyfriends! So, I think there was always a desire to help people through talking.  

How did you end up in psychology?

When I went to university, I studied behavioural sciences as I still wasn’t that sure what I wanted to do and this enabled me to study a broad range of topics.  I soon found that I enjoyed the psychology courses the most so I chose those options in my final year so I could graduate with a degree that was recognised by the British Psychological Society.

What do you enjoy most about your current role?

After spending more than 20 years working in the NHS, I now work independently and love the variety of work.  I find the therapy work, as well as the coaching and supervision I offer to other psychologists, really rewarding.  

Why did you leave the NHS?

The reason I left the NHS was that I increasingly found I was unable to work in a way that fitted my values. It was frustrating to only be able to offer support to people with very complex and chronic difficulties within secondary health care, rather than being able to work with people to prevent their difficulties getting to that stage.  It was also difficult to work within a constantly changing structure, leading on service redesign programmes without significant investment in mental health.  I found it increasingly difficult to manage the tension between wanting staff to deliver more and looking after employee wellbeing.

Would you recommend your career to a young person? 

Yes. It is a privilege to have others share their stories with you and open up about their traumatic histories and/or most difficult personal struggles. Clinical Psychology also enables you to work in a diverse range of settings and with different populations.  And it never feels boring as people are so interesting!

What has been your biggest career challenge and how did you overcome it?

Realising that I had become unhappy and unfulfilled working in the NHS was really challenging for me – it had always been a core part of my professional identity.  But I made the choice to leave so I could prioritise my own wellbeing.  

Getting involved in our professional body, the Association of Clinical Psychologists UK, enabled me to continue to work more strategically alongside my therapy work.  Since then I have also broadened out into other areas of work such as expert witness work and consulting for organisations. All of this has given me a high level of work satisfaction alongside a better work-life balance where I can control and minimise stress.

What was your best career move?

Apart from moving into independent practice, the most important career move for me was when I moved from working in addiction services back into mental health services.  I had been fortunate to work my way up to consultant level within addiction services, but I then stagnated in my career as there were few options available to me.  When I moved back into mental health, and to an NHS Trust where clinical psychologists often took on leadership roles, I was able to get involved in Trust-wide projects. This not only helped me improve my leadership skills and experience but also opened other doors to progress my career.

What 3 words would your colleagues use to describe you?

I hope they would say I am supportive, helpful and hard-working.

What’s the best advice you’ve ever had from a patient or work colleague?

To take leave!  It is really important to have time where you completely switch off from work.

If you could go back in time and give one piece of career advice to your younger self, what would it be?

To be more confident and assertive in networking.  It can feel like a bit of a dirty word in the public sector, but so often great opportunities have come from talking to people and making use of my connections.  And people are usually more than happy to help.

Typically where do you spend your lunch break and what do you eat?

Now I am based at home, my lunches are more variable.  I often batch cook soups in the winter or have interesting salads in the summer.  My lunch break can range from 15 minutes to an hour or more, depending on my day’s activities.  

What do you do to relax/de-stress?

I have a dog and live in the countryside, so walking is a really helpful way to de-stress.  I also use the mindfulness and relaxation strategies I recommend to my patients!  I love socialising with friends and family.  When I was diagnosed with breast cancer in 2019 I was lucky to find out what a great support network I have.

What do you regard as a great career achievement?

Writing and publishing my book ‘Coping with Breast Cancer: How to navigate the emotional impact throughout your journey’ and also supporting the other writers in the series, as the Series Editor.  All the books are written by clinical psychologists who have themselves experienced a life challenge, sharing their personal as well as professional knowledge to help others.

What do you hope will be your legacy to your profession and colleagues?

I hope that by sharing my experience in my book of how I coped with the emotional impact of breast cancer, it will show others in the helping professions that it is ok for us to struggle with our emotions too. In the past, we were not encouraged to be open about this, but we are not immune to life challenges and emotional difficulties.  I hope that by being honest about my own struggles it will help others, both within the profession and outside it, and encourage them to seek help where necessary.

Is the thought of retirement a dream or a nightmare - and why?

Although I work hard and love what I do, I also look forward to retirement.  I enjoy playing the piano but never seem to find the time now, so I would love to do that more.  I would also like to travel more frequently and visit places I have yet to see.

Where are you happiest and why?

At home with my husband, sons and dog.   During my illness I realised the importance of spending time with the ones you love.  I often over-fill my time which leaves little time for relaxation so just having an afternoon free to relax at home is always so enjoyable and leads to a sense of contentment.

Do you have any regrets about becoming a psychologist?

Not at all.  If I were to live my life over again, I would still train as a clinical psychologist.  It is a profession I am proud of and I feel lucky to have found a career that I find so fulfilling.


Sarah Swan is a consultant clinical psychologist at The Swan Consultancy

She graduated with a BSc in behavioural sciences from the University of Huddersfield in 1993 and, after gaining relevant experience, went on to complete a doctorate at the Royal Holloway, University of London in September 2000. 

She began working as a clinical psychologist for the NHS in 2000, taking various positions in Surrey and London before becoming a consultant in 2006 at Central & North West London NHS Trust. In 2012 she moved to Surrey and Borders NHS Foundation Trust where she implemented a trust wide strategy to transform services for people with personality disorders and their carers. She subsequently set up her own consultancy practice taking on private therapy clients and also delivering staff support interventions for businesses and organisations.

In January 2019 Sarah became Head of Psychology at the South London and Maudsley NHS Trust, providing clinical and professional leadership for psychology and psychotherapy services for adults within the Croydon borough. She also became the director (England) at the Association of Clinical Psychologists, helping formulate the strategic development of the profession.

She finally left the NHS at the end of 2019 to build her consultancy business and now offers a range of services to individuals (psychological therapy), other psychologists (supervision and coaching), the courts (expert witness work) and businesses (staff emotional wellbeing).