Standards for the accreditation of psychological wellbeing practitioner training programmes

Transcription

1 The British Psychological Society Promoting excellence in psychology Standards for the accreditation of psychological wellbeing practitioner training programmes October

2 Contact us If you have any questions about Accreditation through Partnership, or the process that applies to you please feel free to contact the Partnership and Accreditation Team: Tel: +44 (0) Our address is: Partnership and Accreditation Team The British Psychological Society St Andrews House 48 Princess Road East Leicester LE1 7DR If you have problems reading this document because of a visual impairment and would like it in a different format, please contact us with your specific requirements. Tel: +44 (0) ; P4P@bps.org.uk. For all other enquires please contact the Society on: Tel: +44 (0) ; mail@bps.org.uk Printed and published by the British Psychological Society. The British Psychological Society 2017 Incorporated by Royal Charter Registered Charity No

3 Contents 4 Introduction 4 What is accreditation? 4 Benefits of accreditation 4 Our standards 5 This document 6 The core training of a psychological wellbeing practitioner: Statement of intent 8 Programme standard 1: Programme design 11 Programme standard 2: Programme content (learning, research and practice) 22 Programme standard 3: Working ethically and legally 23 Programme standard 4: Selection and admissions 25 Programme standard 5: Student development and professional membership 26 Programme standard 6: Academic leadership and programme delivery 30 Programme standard 7: Discipline-specific resources. 31 Programme standard 8: Quality management and governance 33 Appendix 1: Module Delivery 34 Appendix 2: Module assessment strategy accreditation through partnership 3

4 Introduction The British Psychological Society ( the Society ) is the learned and professional body, incorporated by Royal Charter, for psychology in the United Kingdom. The key objective of the Society is to promote the advancement and diffusion of the knowledge of psychology pure and applied and especially to promote the efficiency and usefulness of members by setting up a high standard of professional education and knowledge. The purpose of the Society s accreditation process is to further that objective. What is accreditation? Accreditation through Partnership is the process by which the British Psychological Society works with education providers to ensure quality standards in education and training are met by all programmes on an ongoing basis. Our approach to accreditation is based on partnership rather than policing, and we emphasise working collaboratively with programme providers through open, constructive dialogue that allows for exploration, development and quality enhancement. Benefits of accreditation Delivering a programme that meets the standards required for accreditation is a significant commitment, and there are many reasons why Society accreditation is worth your investment of time and money: It is a highly regarded marker of quality that prospective students and employers value. It enhances the marketability of your programmes. It gives your graduates a route to Society membership, an integral part of students development as psychologists, or as part of the wider psychological workforce. It is a high quality benchmarking process aimed at getting the best out of programmes. It provides an opportunity for you and your students to influence the society and its support for education providers and students. Together we have a powerful voice in raising the profile of psychology and psychological practice in the UK and internationally. Our standards In 2017, the Society s Partnership and Accreditation Committee (PAC) and its constituent Education and Training Committees reviewed the overarching programme standards, with the aim of providing greater clarity and more effective signposting to other relevant guidance in a way that is helpful to programmes when they articulate their work. Our standards are intended to be interpreted and applied flexibly, in a way that enables programmes to develop distinctive identities that make the most of particular strengths shared by their staff team, or those that are reflected in the strategic priorities of their department or university. During partnership visits, the questions that visiting teams will ask will be designed specifically to give education providers every opportunity to confirm their achievement of the standards. Our standards are organised around eight overarching standards, as follows: 4

5 1. Programme design 8. Quality management & governance 2. Programme content 7. Discipline-specific resources 3. Working ethically & legally 6. Academic leadership & programme delivery 4. Selection & admissions 5. Student / trainee development & professional membership The standards have been derived following extensive consultation between the Society and education providers, and must be achieved by all accredited programmes. Each overarching standard is followed by a rationale for its inclusion, together with guidance and signposting of other relevant resources. This document This document sets out the accreditation standards for the accreditation of psychological wellbeing practitioner training programmes. The standards came into operation on 1 October If you are submitting a new programme for accreditation, or are preparing for an accreditation visit or review, you should read these standards in conjunction with the relevant process handbook. All handbooks can be downloaded from Accredited programmes produce graduates whose competencies are consistent with the national requirements for the training of Psychological Wellbeing Practitioners. Graduates who are Society members or subscribers are eligible to apply for entry on to the Society s PWP register. accreditation through partnership 5

6 The core training of a psychological wellbeing practitioner: Statement of intent Psychological Wellbeing Practitioner training programmes provide the knowledge and professional skills for people to work as Psychological Wellbeing Practitioners (PWPs) with people with common mental health problems. The PWP role was originally developed to work within Improving Access to Psychological Therapies (IAPT) services in England, providing assessment and low-intensity interventions, and PWP training programmes accordingly prepare people to work as PWPs in IAPT services. PWP training programmes in other nations may prepare people to work in analogous roles in primary care mental health services. Psychological Wellbeing Practitioners are trained to assess and support people with common mental health problems principally anxiety disorders and depression in the self-management of their recovery. Interventions are designed to aid clinical improvement and social inclusion, including return to work, meaningful activity or other occupational activities. PWPs do this through the provision of information and support for evidence-based low-intensity psychological treatments, mainly informed by cognitive-behavioural principles, but also include physical exercise and supporting medication adherence. Behaviour change theory and models provide the framework which support an integrated approach to the choice and delivery of the interventions that PWPs provide. National Institute for Health and Care Excellence (NICE) guidance for common mental health disorders and for each of the anxiety disorders and depression sets out the range of different types of low-intensity evidence-based interventions appropriate for delivery by PWPs 1. Principal among these are support for low-intensity self-help interventions informed by cognitivebehavioural principles. Typically these are supported by the use of self-help materials which can be provided in written or digital form (e.g. computerised cognitive behavioural therapy (ccbt)). Treatment is provided to groups of people as well as one-to-one to individual patients, and is provided by telephone and increasingly through electronic media as well as face-to-face. Lowintensity psychological treatments place a greater emphasis on patient self-management and are less burdensome than traditional psychological treatments. Support is specifically designed to enable patients to optimise their use of self-management recovery information and may be delivered through face-to-face, telephone, or other contact methods. PWPs also provide information on common pharmacological treatments and support patients in decisions that optimise their use of such treatments. They also provide information on and support for the promotion of physical activity. PWPs normally operate within a stepped care service delivery model, such as Improving Access to Psychological Therapies (IAPT, services in England, or similar service delivery models elsewhere 2. Stepped care operates on the principle of offering the least intrusive most effective treatment in the first instance; patients can then be stepped up to a more intensive treatment if required. In the IAPT service delivery model, PWPs provide care at step 2 of the stepped care model supporting low-intensity interventions. They work alongside high-intensity workers and other clinicians delivering CBT and other evidence-based step 3 1 For programmes operating outside of England, other equivalent evidence-based national guidance may apply. Programmes should ensure that, regardless of their geographical location, trainees are familiar with the NICE guidance for common mental health disorders and for each of the anxiety disorders and depression. 2 Programmes working with services that operate outside of IAPT (including those based outside of England) will need to demonstrate that their trainees are able to take an approach to their work that offers equivalence to the specific characteristics of the IAPT service delivery model, as outlined in this document. 6

7 treatments across the therapeutic modalities. Knowledge of IAPT services including the stepped care model of service delivery, regular and routine clinical outcomes measurement, case management and supervision are accordingly generic competencies that PWPs need for the satisfactory performance of their duties. accreditation through partnership 7

8 Programme standard 1: Programme design The design of the programme must ensure that successful achievement of the required learning outcomes is marked by the conferment of an award at the appropriate academic level. 1.1 Credits and level of award: Training programmes for Psychological Wellbeing Practitioners must comprise at least 60 credits and must result in the award of a level 6 or level 7 qualification (level 10 or level 11 in Scotland). 1.2 Duration of studies: PWP programmes incorporate a minimum of 45 days training, typically over a period of up to one year s duration The Society does not stipulate a maximum study period within which an accredited programme must be completed. 1.3 Award nomenclature: The education provider must ensure that the title of any award accurately reflects the level of students achievements, represents appropriately the nature and field(s) of study undertaken and is not misleading, either to potential employers or to the general public. 1.4 Assessment and progression requirements: Programmes must have in place an assessment strategy that maps clearly on to programme and module learning outcomes, and which reflects students development of knowledge and skills as they progress through their studies. Each of the core content areas specified in Programme standard 2, below, must be separately assessed at the appropriate level, and should reflect the requirements outlined in Appendix 2, p.34; see also the requirements relating to the structure of PWP training outlined in item 2.2 below The education provider must demonstrate that the regulations for trainee progression and award of the qualification require all modules to be passed. Because of the critical nature of clinical competence, there can be no compensation/condonement for a failed clinical competence assessment The education provider must specify a maximum number of assessment attempts for individual assessment tasks as part of its regulations; this should not normally exceed two attempts (initial assessment plus one resit opportunity). The education provider must also have in place a process for advising services that a trainee who fails a competency assessment within the maximum permissible attempts has not demonstrated clinical competence, and therefore it may not be appropriate for them to continue to work with patients Training providers and services should have in place an agreed process for deciding when trainee PWPs are ready to see patients. This point may vary across providers as the timing of the introduction of the different forms of clinical activity will depend on when the relevant content is assessed on the local training programme. This process, along with protocols for supporting those trainees who do not demonstrate readiness to begin direct patient work within agreed timescales, should be clearly documented. 8

9 1.4.5 Clear information should be available to programme staff, service partners and trainees indicating the fitness to practise mechanisms or their equivalent that are in place, and how these, and/or any other disciplinary procedures, may be invoked should the need arise The education provider and employing service must ensure that adequate procedures are in place to ensure that trainees who have failed their clinical competency assessment in relation to modules 1 and 2 within the maximum permissible attempts (see above), are incompetent, not fit to practise, or whose behaviour is unethical do not receive the accredited award. Where trainees are required to exit the programme, the education provider will need to work with the service to ensure that they understand the implications of programme failure for the trainees future employment In addition, systems should be in place to support routine, ongoing communication between the education provider, service and the trainee (as appropriate) regarding progress, results, conduct and any concerns that may arise. Our experience suggests that it is good practice to include a data protection waiver within the documentation or records that trainees complete when they initially register with the University, to ensure that information may be shared as appropriate. This will enable all parties to ensure that trainees for whom performance issues are raised are identified as early as possible, provided with support, and are not allowed to continue with their training if remedial action is ineffective Assessment rules, regulations and other criteria should be published in a full and accessible form and made freely available to students, staff and external examiners Assessment practices should be fair, valid, reliable and appropriate to the level of the award being offered. Assessment should be undertaken only by appropriately qualified academic staff, who have been adequately trained and briefed, and given regular opportunities to enhance their expertise as assessors Education providers should ensure that detailed and up to date records on student progress and achievement are kept. Throughout a programme of study, students should receive prompt and helpful feedback about their performance in relation to assessment criteria so that they can appropriately direct their subsequent learning activities Education providers should have in place policies and procedures to deal thoroughly, fairly and expeditiously with problems which arise in the programme of assessment of trainees. These should include mechanisms for dealing with extenuating circumstances in relation to the assessment process, the grounds for trainee appeals against assessment outcomes, and the process that trainees should follow if they wish to pursue an appeal. 1.5 Inclusive assessment: Education providers should have inclusive assessment strategies in place that anticipate the diverse needs and abilities of students Where reasonable adjustments need to be made for disabled students, these should apply to the process of assessment, and not to the competencies being assessed. accreditation through partnership 9

10 Rationale for inclusion The Society has clear expectations about teaching, learning and assessment on accredited programmes, and the provisions that should be built into the design of those programmes to ensure quality. The standards outlined above will ensure that those seeking entry to specific grades of Society membership on the basis of having completed an accredited programme have met the stipulations set out in the Society s Royal Charter, Statutes and Rules. Guidance and signposting Part A of the UK Quality Code addresses Setting and Maintaining Academic Standards, and signposts relevant qualifications and credit frameworks, as well as guidance on the characteristics of different qualifications. Providers may also find it helpful to refer to a further five chapters from Part B of the Quality Code ( Chapter B1: Programme Design, Development and Approval Chapter B3: Learning and Teaching Chapter B6: Assessment of Students and the Recognition of Prior Learning Chapter B9: Academic Appeals and Student Complaints Chapter B11: Research Degrees The Health and Care Professions Council sets out its requirements around programme design and delivery and assessment in its Standards of Education and Training (SETs 4 and 6; Information on the threshold level of qualification for entry to the HCPC Register is provided in SET 1). The Equality Challenge Unit has produced guidance on Managing Reasonable Adjustments in Higher Education, which providers may find helpful ( The Society s accreditation standards make provision for students to undertake some study or placement time abroad as part of their programme (up to one third of the total credits of the accredited programme). Study abroad opportunities may not be available for all students, and arrangements will vary across different providers. Where study abroad opportunities are available, the UK provider must ensure that the study abroad being undertaken allows students to cover all of the required curriculum appropriately by the time they have completed their programme (though not necessarily in the same way as others on their cohort), and that this learning will effectively support their progression. More detailed information is available in our guide to studying abroad on an accredited programme, which can be downloaded from Where more than one third of the total credits for the programme are undertaken outside of the UK, the Society considers this to be a separate programme requiring separate accreditation. Information regarding the Society s international accreditation process can be found at The Society does not specify a maximum study period for an accredited programme. It is expected that individual education providers will have in place regulations governing the maximum permissible period of time that may elapse from initial enrolment to completion, regardless of individual circumstances, to ensure the currency of their knowledge, their competence, and the award conferred upon them. 10

11 Programme standard 2: Programme content (learning, research and practice) The programme must reflect contemporary learning, research and practice in psychology. 2.1 Programme content requirements Learning and practice outcomes for PWP training programmes relate to three core areas of competence: Engagement and assessment of patients with common mental health problems Evidence-based low-intensity treatment for common mental health disorders Values, diversity and context, including working with diversity from an inclusive values base, and working in the context of IAPT and related primary care mental health services Specific learning outcomes are set out in the paragraphs below. Individual providers may adapt the wording of the learning outcomes to suit their own needs, provided that they can demonstrate that the learning outcomes are reflected within their programme in their entirety Required learning and practice outcomes for psychological wellbeing practitioner training programmes 1. Engagement and assessment of patients with common mental health problems PWPs assess and support people with common mental health problems in the self- management of their recovery. To do so they must be able to undertake a range of patient-centred assessments and be able to identify the main areas of concern relevant to the assessment undertaken. They need to have knowledge and competence to be able to apply these in a range of different assessment formats and settings. These different elements or types of assessment include screening/triage assessment; risk assessment; provisional diagnostic assessment; mental health clustering assessment; psychometric assessment (using the IAPT standardised symptoms measures); problem focused assessment; and intervention planning assessment. In all these assessments they need to be able to engage patients and establish an appropriate relationship whilst gathering information in a collaborative manner. They must have knowledge of mental health disorders and the evidence-based therapeutic options available and be able to communicate this knowledge in a clear and unambiguous way so that people can make informed treatment choices. In addition, they must have knowledge of behaviour change models and how these can inform choice of goals and interventions. Specific learning outcomes to be demonstrated are as follows: a. Demonstrate knowledge, understanding and critical awareness of concepts of mental health and mental illness, diagnostic category systems in mental health and a range of social, medical and psychological explanatory models. accreditation through partnership 11

12 b. Demonstrate knowledge of, and competence in applying the principles, purposes and different types of assessment undertaken with people with common mental health disorders. c. Demonstrate knowledge of, and competence in using common factors to engage patients, gather information, build a therapeutic alliance with people with common mental health problems, manage the emotional content of sessions and grasp the patient s perspective or worldview. d. Demonstrate knowledge of, and competence in patient-centred information gathering to arrive at a succinct and collaborative definition of the person s main mental health difficulties and the impact this has on their daily living. e. Demonstrate knowledge of, and competence in recognising patterns of symptoms consistent with diagnostic categories of mental disorder from a patient-centred interview. f. Demonstrate knowledge of, and competence in accurate risk assessment of patient or others. g. Demonstrate knowledge of, and competence in the use of standardised assessment tools including symptom and other psychometric instruments to aid problem recognition and definition and subsequent decision making. h. Demonstrate knowledge, understanding and competence in using behaviour change models in identifying intervention goals and choice of appropriate interventions i. Demonstrate knowledge of, and competence in giving evidence-based information about treatment choices and in making shared decisions with patients. j. Demonstrate competence in understanding the patient s attitude to a range of mental health treatments including prescribed medication and evidence-based psychological treatments. k. Demonstrate competence in accurate recording of interviews and questionnaire assessments using paper and electronic record keeping systems. 2. Evidence-based low-intensity treatment for common mental health disorders PWPs aid clinical improvement through the provision of information and support for evidence-based low-intensity psychological treatments and regularly used pharmacological treatments of common mental health problems. Low-intensity psychological treatments place a greater emphasis on patient self-management and are designed to be less burdensome to people undertaking them than traditional psychological treatments. The overall delivery of these interventions is informed by behaviour change models and strategies. Examples of interventions include providing support for a range of low-intensity self-help interventions (often with the use of written self-help materials) informed by cognitive-behavioural principles. Support is specifically designed to enable people to optimise their use of self-management 12

13 recovery information and pharmacological treatments and may be delivered individually or to groups of patients and through face-to-face, telephone, or other contact methods. PWPs must also be able to manage any change in risk status. Specific learning outcomes to be demonstrated are as follows: a. Critically evaluate a range of evidence-based interventions and strategies to assist patients to manage their emotional distress and disturbance. b. Demonstrate knowledge of, and competence in developing and maintaining a therapeutic alliance with patients during their treatment programme, including dealing with issues and events that threaten the alliance. c. Demonstrate competence in planning a collaborative low-intensity psychological or pharmacological treatment programme for common mental health problems, including managing the ending of contact. d. Demonstrate in-depth understanding of, and competence in the use of, a range of low-intensity, evidence-based psychological interventions for common mental health problems. e. Demonstrate knowledge and understanding of, and competence in using behaviour change models and strategies in the delivery of low-intensity interventions. f. Critically evaluate the role of case management and stepped care approaches to managing common mental health problems in primary care including ongoing risk management appropriate to service protocols. g. Demonstrate knowledge of, and competence in supporting people with medication for common mental disorders to help them optimise their use of pharmacological treatment and minimise any adverse effects. h. Demonstrate competence in delivering low-intensity interventions using a range of methods including face-to-face, telephone and electronic communication. 3. Values, diversity and context PWPs operate at all times from an inclusive values base that promotes recovery and recognises and respects diversity. Diversity represents the range of cultural norms including personal, family, social and spiritual values held by the diverse communities served by the service within which the worker is operating. Workers must respect and value individual differences in age, sexuality, disability, gender, spirituality, race and culture. PWPs must also take into account any physical and sensory difficulties people may experience in accessing services and make provision in their work to ameliorate these. They must be able to respond to people s needs sensitively with regard to all aspects of diversity. They must demonstrate a commitment to equal opportunities for all and encourage people s active participation in every aspect of care and treatment. They must also demonstrate an understanding and awareness of the power issues in professional / patient relationships and take steps in their clinical practice to reduce any potential for negative impact this may have. accreditation through partnership 13

14 PWPs are expected to operate in a stepped care, high-volume environment. During training, trainee PWPs should carry a reduced caseload, with the number of cases seen depending on their stage in training, building up to a maximum of per cent of a qualified PWP s caseload before completion of the training. PWPs must be able to manage caseloads, operate safely and to high standards and use supervision to aid their clinical decision-making. PWPs need to recognise the limitations to their competence and role and direct people to resources appropriate to their needs, including step-up to high-intensity therapy, when beyond their competence and role. In addition, they must focus on social inclusion including return to work and meaningful activity or other occupational activities, physical activity promotion to address both psychological and/or physical health outcomes as well as clinical improvement. To do so they must have knowledge of a wide range of social and health resources available through statutory and community agencies. They must have a clear understanding of what constitutes the range of highintensity psychological treatments which includes CBT and the other IAPT approved high-intensity therapies and how high-intensity treatments differ from low-intensity working. Specific learning outcomes to be demonstrated are as follows: a. Demonstrate knowledge of, and commitment to a non-discriminatory, recovery orientated values base to mental healthcare and to equal opportunities for all and encourage people s active participation in every aspect of care and treatment. b. Demonstrate respect for and the value of individual differences in age, sexuality, disability, gender, spirituality, race and culture. c. Demonstrate knowledge of, and competence in responding to people s needs sensitively with regard to all aspects of diversity, including working with older people, the use of interpretation services and taking into account any physical and sensory difficulties patients may experience in accessing services. d. Demonstrate awareness and understanding of the power issues in professional / patient relationships. e. Demonstrate competence in managing a caseload of people with common mental health problems efficiently and safely. f. Demonstrate knowledge of, and competence in using supervision to assist the worker s delivery of low-intensity psychological and / or pharmacological treatment programmes for common mental health problems. g. Demonstrate knowledge of, and competence in gathering patient-centred information on employment needs, wellbeing and social inclusion and in liaison and signposting to other agencies delivering employment, occupational and other advice and services. h. Demonstrate an appreciation of the worker s own level of competence and boundaries of competence and role, and an understanding of how to work within a team and with other agencies with additional specific roles which cannot be fulfilled by the worker alone. 14

15 i. Demonstrate a clear understanding of what constitutes high-intensity psychological treatment and how this differs from low-intensity work. 2.2 Structure of training 1. The curriculum is designed so that it can be available at both undergraduate (level 6) and postgraduate certificate level (level 7), normally based on three modules (see above) delivered over 45 days in total. It requires completion of 60 credits in accordance with the learning and practice outcomes specified above, typically resulting in the award of a Graduate Certificate or a Postgraduate Certificate. PWP training may also be incorporated into other undergraduate or postgraduate awards, provided that academic learning is supported by appropriate practice experience, and provided that those who have completed PWP training as part of their award may be readily distinguished from those who have not (normally through conferment of a distinctive award title). 2. The delivery of 45 days training is essential to meet the learning objectives specified within the curriculum. Although each module has a specific set of foci and learning outcomes, the clinical competencies build on each other and courses are expected to focus the majority of their teaching activity on clinical competence development through clinical simulation / role play. 3. The curriculum is normally organised into three modules. Modules and credit ratings can be adapted by education providers to comply with their academic timetable and tailored to suit local needs. Similarly, providers may choose how they wish to deliver these modules to best prepare trainees for the work they are undertaking in services; for example, they may choose to deliver modules one and two, relating to assessment and treatment, either concurrently (e.g. by frontloading teaching) or consecutively. An indicative structure for module delivery is suggested in Appendix 1, p The curriculum includes both theoretical learning and skills practice within the education provider, and practice-based learning (activities directed by the education provider that extend learning into practice). Over the 3 modules of 45 days, days are delivered as theoretical learning and skills practice and days as directed practice-based learning. Skills based competencies will be learnt through a combination of clinical simulation in small groups working intensively under close supervision with peer and tutor feedback, and supervised practice through supervised direct contact with patients in the workplace. Knowledge will be learnt through a combination of lectures, seminars, discussion groups, guided reading and independent study. Providers are encouraged to explore and keep abreast of developments and innovations in pedagogy that facilitate active learning. Directed practice-based learning tasks include shadowing / observation, role play / practice with peers / colleagues of assessment and interventions, self-practice of interventions with reflection (i.e. applying techniques to issues from own life), and directed problem-based learning. All 45 days should comprise a specified programme of learning directed by the education provider in accordance with the learning outcomes specified in item 2.1 above. It is acknowledged that some activities (e.g. flipped classroom accreditation through partnership 15

16 approaches, problem-based learning) may relate to more than one of the three categories outlined in the bullet points above; in such cases, programmes should be able to provide a rationale for their particular delivery model. 5. Assessment focuses primarily on trainees practical demonstration of competencies. Skills based competency assessments are independent of academic level and must be passed. Trainees may not necessarily possess previous clinical or professional expertise in mental health and can undertake academic assessments at either undergraduate or postgraduate level, depending on their prior academic attainment. 6. Assessment strategies for each of the three modules are outlined in Appendix 2, p.34. Providers will be expected to demonstrate how their module assessments align with the specified strategies. All clinical skills should be assessed by practical tests of clinical competence using recognised competency assessment tools. While the assessment strategies for assessing practical clinical skills are set out for each module, the assessment of academic skills and knowledge may be in the form of a written exam(s), coursework (including seminars and presentations), case report or essay and will be expected to cover the academic content of all three modules. 7. The training programme requires trainees to learn from observation and skills practice under supervision while working in fully functioning IAPT services, or other services providing placements to trainee PWPs in line with the requirements set out in section 2.4 of this document, as well as through the theoretical teaching, skills practice and practice-based learning directed by the education provider. Trainees should complete: a minimum of 80 clinical contact hours with patients (face-to-face 3 or on the telephone) within an IAPT service (or equivalent stepped care service) as a requirement of their training and should undertake a range of activities during this time; and a minimum of 40 hours of supervision of which at least 20 hours should be case management supervision 4 and at least 20 hours should be clinical skills supervision 5. 3 Clinical contact hours should be calculated on the basis of the length of assessment and treatment sessions undertaken with clients, not on the number of clinical contacts, and should not be rounded up. For the purposes of calculating clinical contact hours, one hour spent working with a group counts as one hour of clinical contact, regardless of the number of participants in the group. Time spent on administrative tasks (e.g. contacting clients who have not attended an appointment/dna) should not be counted towards clinical contact hours. For example: a trainee completes a telephone screening of 20 minutes, an initial assessment of 35 minutes, has an extended treatment session because of use of translation services which takes 65 minutes, and also has two DNAs. The total clinical contact hours in this instance is two hours. 4 Case management supervision is undertaken weekly for a minimum of one hour on a one-to-one basis with a suitably qualified member of staff. Case management supervision is supported by an IT system that enables outcomes to be effectively incorporated into clinical decision-making, often relating to the stepping-up of treatment intensity or offering alternative low-intensity treatments. Case management supervision is highly structured and should be a review of the current caseload held by the PWP, in which the PWP selects appropriate cases for supervision and presents the cases according to clinical and organisational criteria (e.g. scheduled reviews, risk). The PWP should demonstrate the competencies of being able to present clinical and demographic information about each patient in a succinct manner to enable discussion of key points and shared decision-making to take place. Case management supervision is key to effective clinical governance and ensuring patient safety. 5 Clinical skills supervision for PWPs can be undertaken on a one-to-one basis or in a group, for a minimum of one hour per fortnight. Supervision is an accountable process which supports, assures and develops the knowledge, skills and values of the PWP. The purpose of clinical skills supervision is to provide a safe and confidential environment for PWPs to reflect on and discuss their work and their personal and professional development, providing an environment to enable reflection on their low-intensity practice and ensuring fidelity to the evidence base and clinical method. 16

17 These 80 clinical contact hours and 40 supervision hours are in addition to the practice-based learning days directed by education providers. 2.3 Teaching and learning: A clear programme specification must be in place that provides a concise description of the intended learning outcomes of the programme, and which helps students to understand the teaching and learning methods that enable the learning outcomes to be achieved, and the assessment methods that enable achievement to be demonstrated with adequate breadth and depth. The programme specification (and any module specifications) must include learning outcomes that reflect the specific programme content requirements outlined above Education providers must be able to document the intended programme and module learning outcomes, and the ways in which these are mapped on to the programme content requirements and assessment strategies outlined in this document. Providers will need to provide a rationale for the design of their programme, highlighting any ways in which it varies from the suggested threemodule structure that has been outlined in item A teaching timetable must be available to staff and trainees that identifies the module or programme unit to which each teaching session relates. Education providers will need to be able to demonstrate that at least 50 per cent of the time is focused on the development of clinical skills As noted above, trainees must be provided with days of directed practicebased learning which is timetabled in addition to the required days of theoretical learning and skills practice. Programmes should have systems in place for monitoring the work that trainees have completed during their directed learning days The programme must include an appropriate induction programme, of a minimum of five days duration. This induction to the PWP role comprises part of the days of theoretical learning and skills development, and should be focused on front-loaded skills development in assessment. Any induction or orientation to resources (library, IT) or formal registration with the education provider should be undertaken in addition to the induction to the PWP role as outlined above The education provider must outline the ways in which it supports trainee PWPs in understanding the role of high-intensity therapists as part of their learning. This should be addressed in relation to the learning outcomes specified for Module 3 to guard against potential drift towards high-intensity ways of working. Providers may also wish to consider how trainees understanding of the full range of other workers at step 3 can be supported, including those working in different modalities and in the context of the full range of IAPT extension programmes Trainees are entitled to expect a learning experience which meets their needs, and which is underpinned by evidence-led teaching, and a supportive and enabling learning environment Programmes should address matters relating to difference and diversity within all teaching, not only within the module where values and diversity are the specific focus. accreditation through partnership 17

18 2.4 Supervised practice 6 : Education providers should have a quality assurance process in place to evaluate the suitability and quality of the practice placement and / or supervised practice opportunities offered by service partners. This quality assurance process should be established with input and agreement from the local NHS education commissioner (where applicable), and should be communicated to service providers to ensure that they are aware of their responsibilities to ensure that the following standards are met: 1. IAPT services and other services providing placements to trainee PWPs in line with the Society s requirements must: follow a stepped care system with coherent integrated care pathways and clear protocols for initial allocation and stepping up/down; provide interventions that are in line with NICE guidance; have good quality CBT-based self-help materials and ccbt packages available for trainees to use; have suitable office and clinical accommodation for PWP trainees to use; and provide adequate equipment for routine audio and video recording of PWPs clinical work. 2. IAPT services and other services providing placements to PWPs in line with our requirements must be able to provide an effective practice learning environment for trainees. A service provider is considered to offer an effective practice learning environment where trainee PWPs: access appropriate cases, materials and local service protocols to develop the skills they have been taught by the education provider; have access to the full range of presentations and modes of assessment and treatment that are required for completion of the programme; have caseloads that are compatible with an effective training experience (e.g. gradual build up of caseload; types of patients seen) services should commit to agreeing appropriate caseloads with the education provider; use their designated practice-based learning days for completing the directed learning assignments set by the education provider, rather than for routine clinical work; are able to complete 80 clinical contact hours and 40 supervision hours by the time they complete their training. 3. IAPT services and other services providing placements to PWPs in line with our requirements must identify sufficient clinical and case management supervisors to work with trainees in the workplace. Supervisors must: have demonstrable knowledge and experience of delivering low-intensity interventions; be conversant with the service s CBT-based self-help and online materials and site protocols; 6 Standards in this section draw from the document Roles in PWP training of NHS education commissioners, university training courses, IAPT service placement providers, and BPS as accreditation body (March 2015), available from

19 have attended a PWP supervisor training course (see below); and provide weekly case management supervision and fortnightly clinical skills supervision to their trainee PWPs. Supervision must be consistent with and reinforce taught content to ensure that trainee PWPs develop as competent practitioners. As such, services must work closely with the education provider to jointly deliver a coherent training experience that ensures PWPs achieve the learning outcomes specified in this document As indicated in (3) above, training should be made available to supervisors to enable them to adequately support trainees undertaking high volume, lowintensity psychological therapies with an appropriate range of patients. Supervisors should understand: 1. the course content; 2. the clinical practice outcomes identified in relation to the three modules outlined above; and 3. the expectations surrounding their role, including the essentials of clinical case management supervision Education providers must demonstrate that supervision meets the following standards: 1. The supervisor must negotiate, sign and date a supervision contract 7 which clarifies boundaries and responsibilities of both the supervisor and the supervised trainee. This should include engagement in weekly case management supervision and fortnightly individual and group supervision aimed at case discussion and skills development. 2. The supervisor must use a range of strategies to engage in the supervision process, including focused face-to-face contact, allocated telephone appointment time and contact. 3. The supervisor must facilitate ongoing practice learning and experience for the trainee to ensure that she or he has the opportunity to develop appropriate competence in clinical skills. 4. The supervisor must carry out observation of the trainee s work, directly and indirectly, to develop and be able to evaluate the level of competence. 5. The supervisor must identify the trainee s strengths and any shortfalls in development, identifying objectives with the trainee and how these may be achieved, and discussing with academic staff where difficulty is envisaged or issues regarding a trainee s progress are encountered. 6. The supervisor must ensure that trainees complete the clinical practice outcomes outlined within the practical skills assessment document, within the required period, and that appropriate records are made. 7. The supervisor must ensure with the trainee that supervision logs are completed so that there is a record of supervisory contacts in a format 7 Clinical skills supervision and case management supervision are often provided by different supervisors, and should therefore normally be covered by separate supervision contracts. Where clinical skills supervision is conducted in a group, this should be addressed in a group contract. accreditation through partnership 19

20 agreed by the education provider. This is to ensure that the trainee meets the requirement to undertake a minimum of 40 hours of supervision of which at least 20 hours should be case management supervision and at least 20 hours should be clinical skills supervision. Programmes are encouraged to review those supervision records with the service on a regular basis. 8. The supervisor must complete an interim report on progress at the halfway point of the timescale for the achievement of the practice-based outcomes. 9. The supervisor must make a recommendation to the programme on the progress of the trainee in achieving the practical skills outcomes specified within each of the programme modules. 10. Supervisors need to satisfy themselves that they have sufficient evidence of trainees performance in relation to the required practice outcomes in order to sign off their achievement of those practice-based outcomes The programme team must monitor the clinical experience of trainees, and their experience of the supervision provided, and have a process in place to help resolve any problems that may have arisen. This process must be timed such that if problems are identified there will still be time available to overcome the problems, if this is feasible. The process must include the opportunity for a member of the programme team to hold discussions in private with the trainee and supervisor individually prior to a joint discussion. A written record of the monitoring and any action plan agreed must be held on file Programmes must have a formal, documented audit process for clinical placements and supervision in partnership with service leads and supervisors. Mechanisms must be in place for considering the outcomes of each audit, and there must be procedures for seeking to overcome any problems that are identified. These would normally include the following: 1. Where NHS Trusts or other IAPT service providers do not meet standards for PWP placement provision specified in (1) above, education providers should report concerns to the education commissioner (or equivalent) with a view towards resolving any specific placement quality issues that are impacting upon the experience of trainees who are currently undertaking their clinical placement with the service provider(s) concerned. 2. Where the education provider declines to use a particular IAPT service placement, the local NHS education commissioner should be advised of the reasons for this decision, and their support or arbitration may be sought. 20