Ask me anything- You asked, I answered

Author: Dr Hannah Osborne, Consultant Clinical Psychologist and EMDR UK Accreditated practitioner providing therapy & EMDR in Berkhamsted, Tring & Hertfordshire

These are some of the questions I’m most often asked about being a psychologist — both in and out of the therapy room.

Even though therapy is talked about more openly now, there’s still a lot of uncertainty about what psychologists actually do (and sometimes what we don’t). So, here are some honest answers.

1. What is the difference between a psychiatrist and a psychologist?

This is probably the question I’m asked the most.

In simple terms, psychiatrists are medical doctors, whereas psychologists are not. This means psychiatrists can prescribe medication, and their training tends to focus more on the biological side of mental health. Psychologists, on the other hand, focus on thoughts, emotions, behaviour, and relationships, and tend to work therapeutically through talking and psychological interventions.

In reality, the two roles often complement each other. Some people benefit from medication, some from therapy, and many from a combination of both.

2. What is your view of medication for mental health problems?

Medication can be incredibly helpful — and for some people, it’s an essential part of their recovery. That said, it isn’t the whole story. Medication can reduce symptoms, but it doesn’t always address the underlying patterns, experiences, or relationships that may be contributing to difficulties. I tend to think of medication as creating the space or scaffolding for therapy to work. When someone feels a little less overwhelmed, anxious, or low, they’re often more able to engage in the psychological work that leads to longer-term change.

3. Do you have a preferred therapy?

Like most psychologists, I’m trained in a range of approaches. Different people need different things at different times. Some want something structured and practical, others want space to reflect more deeply. Good therapy isn’t about applying one model all of the time for all people — it’s about adapting to the person sitting in front of you.

That said, since I started my training in EMDR in 2021 I have to say that EMDR is one of the most powerful therapies I offer. It has an ability to change peoples lives in a way that other therapies just can’t compete. So it is often my tool of choice.

4. How do you manage listening to people’s problems all day?

It’s a fair question — and usually asked with a slightly concerned look.

The honest answer is that it doesn’t feel like “listening to problems all day.” It feels like meaningful, human conversations. Of course, the work can be emotionally demanding at times. But psychologists are trained to manage this — through supervision, boundaries, and looking after our own wellbeing. I have supervision very regularly and this is a space where I reflect on my own work and emotions. However, importantly, the work isn’t just about distress. It’s also about resilience, growth, insight, and change — which is a privilege to witness.

5. Do you psychoanalyse your friends?

Short answer: no.

Longer answer: psychologists are just people outside of the therapy room. Relationships with friends are not therapy sessions. You might notice things differently when you’re trained in psychology, but analysing friends isn’t helpful and definately isn't welcome.

6. Do you watch Couples therapy and what do you think of it?

I do get asked this quite a lot.

Shows like Couples Therapy can be interesting, and in some ways they’ve helped bring therapy into more open conversation, which I think is a positive thing.

At the same time, it’s important to remember that it’s still television. What you see is edited, condensed, and shaped into a narrative. Real therapy is usually slower, less polished, and much more private.

That said, some of the themes you see — patterns in communication, emotional dynamics, misunderstandings between partners — are very real. So it can give a flavour of what therapy might explore, even if it doesn’t fully capture the process.

7. Do you ever take your work home?

In one sense, no — there are clear boundaries around confidentiality and working hours.

In another sense, it would be unrealistic to say the work never stays with you. When you care about your clients, of course you think about them. But part of being a psychologist is knowing how to hold that appropriately, so it doesn’t impact your work in the long term. Regular supervision is so important to support us in our work.

8. What kind of a psychologist are you?

I’m a clinical psychologist and I only work with adults.

What that means in practice is that I’m trained to understand a wide range of emotional and psychological difficulties, and to work collaboratively with people to make sense of their experiences and find a way forward.

9. Do you miss working in the NHS?

I left the NHS after 19 years in 2023. I was very sad to leave and it was a big decision for me to make. The NHS and the people it serves is part of the reason I am a psychologist today. I have had the privilege of working alongside some truly wonderful colleagues, learning from many experiences and services. It offers incredibly valuable experience, and I’m grateful for the experiences and everything it gave me since I joined in 2004. Private practice is different. It allows more flexibility, often more time with clients, and the ability to work in a way that feels more tailored and less constrained. Both have their place — and both come with their own challenges.

10. What exactly is it you do with people — is it just talking?

It might look like “just talking,” but there’s a lot more going on.

Therapy is a structured, evidence-based process. It involves understanding patterns, making connections, developing new ways of coping, and sometimes gently challenging unhelpful ways of thinking or relating. The talking is important — but it’s what happens through the talking that makes the difference. And when it comes to EMDR, actually that doesn’t involve a lot of talking at all!

Thinking about therapy?

If you’ve ever found yourself wondering about any of these questions, you’re not alone.

Starting therapy can feel like a big step, especially if you’re not quite sure what to expect. If you’re considering it, or just want to find out a bit more, you’re very welcome to get in touch.

I’m always happy to have an initial conversation to see whether working together feels like the right fit.