The following is a case study of Shelley Kim Hall, a Clinical Psychologist based in Empangeni, KwaZulu-Natal, South Africa.
What is a clinical psychologist?
It’s, a little bit of a difficult question to answer at the moment, there has been some disagreements around scopes of practice. And so it’s really based on competency, what you’ve done in your training, and what sort of supervision you’ve had.
But traditionally, in the way I was trained, and most people of my age group, I believe, you as a clinical psychologist, you have to spend at least six months of your internship, where you’re working in a mental hospital. So our focus is mostly on actual mental illness, working in hospitals or working in private practices, with that focus on mental illnesses, if that makes sense.
What made you decide to become a psychologist?
Pure fascination, I come from a family of teachers and I didn’t quite know what I wanted to do, but I knew I didn’t really want to be a teacher. So I went off to university started doing psychology in my undergrad, and I just wanted more. And then I was fortunate enough to be accepted into masters program, and then into clinical psychology because in those days, they took very few people into the clinical programs. So it was just yeah, fascination that really, really grew. And it’s definitely a passion.
Were there any role models/ mentors that you had growing up that shaped you to be a clinical psychologist?
My life was quite impacted from a young age, I lost my father when I was about nine, just very, very suddenly, he had an aneurysm of the aorta so it was just a sudden death that knocked all of us. And I think I wouldn’t really say I’ve had any role models, I’ve always had to be quite independent from a young age. So I think that just sort of drew me to the profession, and just wanting to be able to support other people who go through major traumas in their life, because it is it’s completely life changing. So I think it did pretty much grow from that.
How long have you been in private practice
It’s a little bit of a story again, because I actually I finished my training and went into private practice for a year. Because, us clinical psychologists, we have to work for the government for a year for community service. So I did mine at Ngwelezana Hospital in KwaZulu-Natal, which is a local hospital.
And then I was in private practice with a colleague for I think, two years. My husband, and I then decided we wanted out of South Africa and wanted a different worldview. So we actually went to Jamaica, based on his qualifications as a farmer. So we were over there for about almost 10 years. And then we moved back to South Africa. So we’ve been back for about six years now. So I had to start my practice over from from scratch.
Were you still able to practice as a psychologist in Jamaica?
I had stamped my passport that I was not allowed to be employed, but what I did to keep myself current is I actually joined their board, because at that stage, anybody could call themself a psychologist to work in the fields in Jamaica. You can imagine the horrors we were seeing.
So I joined the psychology board as their secretary for a few years and we managed just after I left, to get it through with the government that you had actually had to have specific qualifications to practice psychology. And then I did some voluntary work with mustard seed organizations, actually a Catholic organization. And I ended up teaching, I ended up teaching at a school as well, the thing I did not want to do as a child, but I’m glad it’s helped me alot. When I’ve got to assess children and things like that, having a teachers perspective as well has actually really helped, its been quite a journey.
Coming back to South Africa, after being in Jamaica, and having to rebuild again, were there any challenges that you faced having to literally start from ground up again?
Yes, it was quite difficult, you know, trying to get my head back around things like medical aids and ICD 10 codes. And just getting your name out again, was quite hard, I can remember I printed a bunch of business cards, and I went around to all the doctors, and very few referrals came in.
So it’s been very, very much realizing it’s actually word of mouth and having good collegial relationships, and just running a business, because that’s something that our training does not cover and essentially, you’re actually running a small business.
So all of these things kind of thrown at me and trying to figure out the best ways, the most cost efficient ways of running things, and finding office space and all of that. But it’s actually it’s been really exciting. I’ve really enjoyed it.
Do you have an assistant helping you? Or did you get eventually get in an assistant when you started your practice?
Initially, I didn’t, I did everything myself, which I think is very valuable, because you really they learn and get to know your business from from all aspects.
So last year, I had somebody join me just before lock down, I took on a lovely young lady, who had no experience at all, and she’s had to learn all the ropes with me, and we slowly slowly getting there. That’s been a big, big help, because I do also have two young girls of my own. So it’s just not having to come at home in the evening and still have to do your billing and follow up with the business side of things. It’s so nice.
Also we can’t answer our phone when we with the clients and some people don’t seem to understand that and they get quite irate. So it’s lovely to have somebody who can do all of those things or if you’re in a zoom session, and somebody calls Get on to the session that your receptionist can assist you with that and help your client.
When would you kind of start suggesting that person maybe takes that first step to go and maybe I just need to have a chat to somebody?
Often people come when things are very, very broken, and it’s much harder to fix. You know, we’re not all happy all the time. That’s impossible. We do all go through moments of sadness. When a trauma, something happens, whether it’s a loss or something like a hijacking, you do expect a few nights of disturbed sleep, feeling unsafe, all of that is normal.
But when things start to persist, like if you’ve had a sad mood, or if you had a trauma, and those symptoms are increasing after say, two weeks, then it’s worthwhile just checking in. Even if it’s just for one session, just to find out, what can I expect? How should this progress? What are some things I can try to see if I can relieve these symptoms on my own. And it’s usually a good idea if you’ve been trying for two weeks, and things are just not getting any better?
And of course, the minute you start feeling, actually don’t want to be here anymore. I wouldn’t mind if tomorrow morning, I just didn’t wake up. That’s a massive red flag, then, you know, then it’s, I wouldn’t even wait the two weeks, then, you know, you need to really try and see somebody quite urgently.
If I start seeing a therapist, is it going to be years in therapy?
I think in most psychologists, we don’t want to keep our patients sick, trapped in therapy forever. We’re all very, very well aware of financial constraints. So most of us when you come for the first time, we’re going to sit there people always go, why must I go back into the history, but we must because we like to conceptualize, we like to see where you’ve come from where you are the moment get really good concept of watching needing.
So we can say to you, it’s very hard to say where there’s gonna be two sessions or ten sessions, because things can organically kind of come out in therapy. But generally, we want to keep you there get you well, again, as quickly as possible give you the skills, so you can get on with it. If we need to refer refer you to psychiatrist, we’re not allowed to prescribe for some medication, if we feel is a diagnosis and a reason or neurologist if we feel it could be an underlying condition causing something.
But our aim is to get you one against get you back out there. We don’t want to have you lying on the couch for years and years and years of possible.
I think we should also just qualify that, you know, if you had something like a bipolar disorder, or a really, really severe depression, then it might be that you would be checking in more often. And then we do start spacing it out so that you are coming in like say once a month and then every three months and then every six months. And with those sort of disorders you do kind of go backwards and forwards especially if you’re not well maintained on your medications, then you might need to come for a period of more intensive therapy again. But generally that is the aim to try and get somebody stable to give them the skills. So they rely on us less and less.
Anything else that you would like to let people know from a clinical psychologists perspective?
I think just on their points, actually wrote an article on my LinkedIn profile a little while ago, is people tend to come when they are in crisis. And I find quite interesting, you know, we want to exercise you want to do mindfulness, you want to do all of these things.
And then people will say, Oh, you know, I’m writing exams, or I’m so pressurized at the moment, I can’t come to the exercise class, so I can’t make my therapy this month. That’s really interesting. Why would you drop the healthy habits that are maintaining your physical and mental health, when you’re under more stress? Put down the running shoes to increase your stress time. Doesn’t make sense, but we all tend to do that. That is when we should actually increase those habits really not decrease them? And I think that’s something I’d really like everybody to think about.
Contact Details for Shelley Kim Hall
Mobile Number :: 0630552172
Practice Address :: 5 Addison St, Empangeni Central, Empangeni, 3880
Email :: [email protected]