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Race, Leadership and the changing face of Clinical Psychology

26 Jan 21

Dr Margo Ononaiye talks to Adrian Whittington about her career in clinical psychology...

Race, Leadership and the changing face of Clinical Psychology

Race, Leadership and the changing face of Clinical Psychology

Dr Margo Ononaiye talks to Adrian Whittington about her career in clinical psychology and what it means to be the first Black woman to become a Clinical Psychology Doctorate Programme Director in the UK.

Adrian:             Margo, I'm delighted to hear of your recent promotion to the role of Programme Director at the University of Southampton Doctorate in Clinical Psychology. I really enjoyed our time working together earlier in our careers, and know how hard you have worked to achieve this, and the gifts that you will bring to it as a clinician, educator and academic. I am also struck by the symbolic importance of your appointment, as the first Black woman to occupy such a role in the UK.

Margo:             Thank you, I'm really pleased to have taken up the role. This is what I have always wanted, and I hope that it also shows that whatever your background, you can rise to the top of your field, whatever you want to do.

Adrian:             What was your journey into the field of Psychology?

Margo:             In terms of my heritage, my Dad is Black Nigerian and my Mum is white British.  I grew up in quite a poor one parent household with my Mum, Grandmother and two sisters, in a small village in Somerset. We were one of the only families in the village who were not solely white which unfortunately meant we experienced racism from a young age.  Also, having seen my Mum struggle financially, I knew that I wanted to not struggle in this way and felt that I needed to earn.  This meant that when I left school, I took up a post as part of the youth training scheme (similar to apprenticeships now) in a travel agency as it was also a passion of mine to travel as I had only been on one holiday (a very rainy week in the UK in a caravan) during my childhood. My boss told me she thought long and hard about whether to hire me, because of my colour. Mum had always taught me to embrace difference, but this is when I first realised that my heritage could be a barrier.  I stayed in the travel industry for over 13 years and worked my way up to being a Senior Shop Manager who took lots of overseas holidays!!!

There was however a part of me that always wanted to learn, so when I got the chance to do a teaching certificate to teach travel and tourism, I grabbed the opportunity. I thoroughly enjoyed this training and wanted to continue learning.  The course gave me enough academic points to be able to apply for university as I did not have A levels. I took a chance and called the University of East London psychology department, and was successful in getting in to do my degree there. I had to work throughout my degree doing some lecturing and also working part-time in travel agents to make ends meet. Despite this, I worked hard and managed to get a first class degree and an award – which felt amazing.

Adrian:             Wow, it's striking how you had to really go after your opportunities. What happened next?

Margo:             I loved learning, and after my degree I decided to go on to do my PhD in Sheffield, in a clinical area. In the first year, I funded the whole thing myself by working as a lecturer alongside my studies. My supervisor helped me to apply for funding and I received a small grant and free tuition from the second year onwards which was incredibly helpful.   One of the participants in my research had a profound effect on me, and I knew I wanted to train to know how I could help him with the anxiety he was experiencing. I wanted to use both my academic side, and my naturally caring nature. My PhD supervisor, Professor Graham Turpin, suggested that a career in clinical psychology may be the ideal next step. It hadn't really crossed my mind before, but I took a punt and went for it! I was surprised to find that lots of others in the interview process seemed to know each other (the Assistants network) and knew a lot about what was expected. I really felt in the dark and alone during the interview process, but I was offered a place on the Sheffield programme and took it.

Adrian:             What was it like for you as a Black woman becoming a clinical psychology trainee?

Margo:             I enjoyed the training and Sheffield was an excellent programme, but I was horrified by how much my ethnicity was highlighted and discussed. I had experienced horrific racism in the past, and occasionally at work in the travel industry, but in clinical psychology there was this new concept of 'polite' as well as implicit/explicit racism. Some of my experiences in training were unacceptable and I was lucky to always be able to discuss it with one of my training cohort – Dr Chris Irons (thanks Chris!). For example, I was asked by one supervisor very politely to check with all of my clients if they were happy to be seen by me. I didn't understand this suggestion - but she clarified that it was because I was Black. Thankfully, I discussed this with Chris and then my Tutor who was appalled and dealt with it immediately. At other times, my supervision didn't meet my needs fully - such as when I was dealing with racist language in my placement from clients. My supervisor dodged the issue rather than discussing it despite me saying how upset I was.  I know that other BAME trainees have experienced similar difficulties and sadly it is still happening today. 

Adrian:             The quiet, polite racism sounds in a way harder to pin down and deal with than when it is in plain sight. Is this something that continued once you qualified?

Margo:             Upon qualifying, the workplace was usually very white, and when I went to conferences, that also felt very white, there were a few of us with dreadlocks who always acknowledged one another.  When I moved to Salomons and we worked together, we had more diverse IAPT training cohorts. Black trainees tended to come to me and talk about racist experiences at work. I tried to give them the sort of help I hadn’t always had. My next job was at the University of East Anglia on the Clinical Psychology Doctorate. When I went up to visit Norwich with my partner, he asked a taxi driver what it was like to live there. His answer was that "it is 98% white"! I was not going to allow this attitude to impact upon my career and I settled in and was soon promoted to Clinical Director. I seemed to attract a lot of raised eyebrows from clinical psychology colleagues about how I had achieved this after X number of years since I qualified. I found people didn't readily recognise the fact that I had experience in a previous career, a PHD, and had come in from a different route to many. The training community seemed difficult to break into, and I couldn't work out why.  I am pleased to say that I now feel very much part of this group but it took time and energy to get to this point.

Adrian:             Do you think these are the sorts of experiences that people sometimes describe as "microagressions". On their own they may seem small, but they add up and create a picture of discrimination?

Margo:             I do think so. It was really important for me to have informal chats with a colleague who has mixed heritage, to check things out. This helped to see things for what they were. I decided to make myself feel comfortable and welcome, so I put myself forward to lead the project on BABCP accreditation of courses. This did lead to me feeling more included and part of the training community. I had something to offer and I was enjoying my role. Then Liverpool happened [The Liverpool Group of Trainers in Clinical Psychology Conference]!

Adrian:             Ah, you were there?

Margo:             Yes I was.  It was very upsetting for me. The mock slave auction was personally horrendous for me to watch – it felt like I was watching a member of my family being sold. Lots of Black people got up and left but I went into shock and just stayed there. The social media afterwards blew up, and in itself included implicit racism and microagressions. It didn’t feel like a community, but an atmosphere of blame which felt so unhelpful – for me this was an opportunity to learn and make change. As part of this discussion on social media, people made reference to there being no Black course staff present - even though I was there! I found it very odd that no one reached out to me.  I knew things had to change, but couldn't see how they could.

Adrian:             How did this experience shape what you did next?

Margo:             I realised that I wanted to become a Programme Director, partly to show that you can be Black and female and make it in the clinical psychology training profession. I had moved courses in 2016 to Southampton as I needed to be nearer to my Mum, who was very ill. I took a demotion to move to Southampton and became Deputy Clinical Director, which was painful (from a professional perspective). I was then promoted to Clinical Director and then promoted once again to Programme Director when the post became available in 2020. I was delighted to be offered the post because I knew this was based totally on merit. I knew it wasn’t driven by positive action but that they knew what I was capable of – I have met my career ambition!

Adrian:             Congratulations again Margo, it’s great news. Having been through this journey, what reflections do you have about how we now need to tackle racism in the profession?

Margo:             From my perspective, it feels that the issue of racism in clinical psychology is multi-layered and extremely complex. Firstly, we need to acknowledge that there is a problem and recognise our own micro-aggressions and ‘polite’ racism. Those in leadership roles within the profession must work towards ensuring opportunities are offered to everyone no matter what their backgrounds.  In consideration of the training community, we need to target courses and hold them to account to ensure that people from diverse backgrounds can train to become clinical psychologists. Secondly, we must recognise that Black, Asian and Minority Ethnic candidates may need to come to clinical psychology from unconventional routes, like I did and often will make sacrifices along the way. We need to think outside of the box and recognise a whole range of experience and transferrable skills. IAPT has provided a paid route for gaining a foot on the career ladder for a more diverse group, and we need to celebrate this and support career progression through all the professions. We need to stop recruiting so heavily on academic attainment but draw out the individual qualities and potential that people bring through our recruitment processes. Thirdly, we need to provide real support for people of colour who become trainees. It is not an easy path, and people need to be welcomed at every step of the way and have support for the racism and discrimination they will no doubt experience. Finally, everyone needs to look to themselves and understand the part that they may play in maintaining the problem.

Adrian:             So we can all be part of the solution, whether we are white, Black or Brown?

Margo:             Yes definitely, we need to find safe spaces to learn how to talk about race and racism, spaces where it is safe to explore, and occasionally to get it wrong. Now is the time - everyone is talking about this and there seems to be momentum for change within the profession – which feels great. I am encouraged by the targeted initiatives coming out, such as from Health Education England, and that there is some money behind them. But now we need to work together so that people know what to do in practical terms to change, with clear outcomes that are monitored and achieved.  Let’s work together rather than in little pockets – to speak for the profession as a whole. We could hold showcase events aimed at minority communities each year, for example, to really amplify our message of welcome. There are so many groups working on similar things, let’s join them up and focus on the same plan with a common language.

Adrian:             And finally, Margo, what would be your message for people of colour considering a career in clinical psychology?

Margo:             Go for it! As my mum used to say – it is important to ask, because if you don’t ask you don’t get. Don’t be afraid to create your own opportunities such as seeking out others in the field who can offer you support and guidance along the way.  Finally, never ever let who you are limit your career choices and who you want to become.