New ways of working for applied psychologists

1. New ways of working for applied psychologists Gary Latchford after Tony Lavender

2. Wider changes • National Institute for Mental Health in England (NIMHE) proposed changes to workforce: • Recruit more staff • Develop roles and skills: • Take on new tasks • Better meet needs of service users & carers.

3. Why? • Philosophy: people with mental health problems want a more inclusive approach • Demand on services continues to grow • Staff recruitment a problem in some areas • Nb Shortage of psychiatrists (12% vacancies amongst Consultant Psychiatry posts) • Nb No shortage of applicants for psychology

4. Layard report: Improving access to psychological therapies • Huge levels of untreated mental health problems • Causes suffering and severe economic burden • Evidence based treatments (e.g. CBT) available but not resourced • Proposes manualised interventions in treatment centres

5. Implications for training • Define competencies underpinning provision of therapy • Look at education, training and service provision, and contribution of NWW

6. NWW for Psychiatrists • Need for change: • Mental health NSF, demand, need for a cultural shift • Change: • new role in team • focus on service users with most complex needs • patient centred approach • Major shift - GMC clarified guidance on medical responsibility: • Consultants retain responsibility for those in their care & for the advice & support to teams. They are not accountable for the actions of others in the team.

7. NWW for other professions • New roles and responsibilities e.g. Social workers, nurses, allied health professions etc. • E.g. Advanced [nurse] practitioner • Contribution of different professions • Role and training route linked • Ten essential shared capabilities

8. Ten essential shared capabilities • Working in partnership • Respecting Diversity • Practising Ethically • Challenging Inequality • Promoting Recovery • Identifying People’s needs and strengths • Providing service user centred care • Making a difference • Promoting safety and positive risk taking • Personal Development and learning

9. NWW for psychology • Graduate primary care mental health workers • “1000 new graduate PCMHWs trained in brief therapy techniques of proven effectiveness, will be employed to help GPs manage and treat common mental health problems in all ages, including children”NHS plan, 2000 • Some good examples (Mike Lucock, South West Yorkshire • Fit in to tiered model of CBT interventions • Future now?

10. NWW for psychology • Associate Psychologists • Addresses longstanding concern: • 13,000 graduate psychologists a year • 500 DClin places (Nb but changes!) • Alternative career structure for long term assistants? • Northumbria pilot (Bruce Gillmer) • 24 month in-service MSc • Will be appropriately supervised and remunerated within NHS structure

11. NWW for psychology • Clinical psychologists: • Changes to traditional role? • Supervision • Teaching & presenting • Consultancy • Leadership • Teamworking • Etc.

12. NWW for psychology • All applied psychologists: • education and training • organisation of services • career pathways • new roles • working psychologically in teams • Implications of MH Act • improving access to psychological therapies

13. New ways of working for applied psychologists group • Led to bi-monthly meetings • Joint BPS/NIMHE initiative – and jointly chair

14. Membership • Membership of 37: • Representatives from all Divisions • Service Users/Carers (BPS/NIMHE) • Professional Practice Board Representative • Representatives from NIMHE, Department of Health, Skills for Health, AMICUS • Representatives from other professions (Psychiatry, Nursing, Social Work, Allied Health Professions) • Representatives from Psychologists in Scotland, Wales and Northern Ireland

15. Inaugural meeting • NWW overview & issues for psychologists • Identified 7 key work streams and associated key questions • 7 project groups to carry out tasks • Each with a lead • Feedback to core group • Stakeholder events to consult • BPS/NIMHE web and publications to communicate

16. Organising, leading and managing psychological services in trusts • Lead: Tim Cate • Questions: • What are the best models for organising psychological services within Trusts that enhance recruitment, retention, morale and effective service delivery? • What are the leadership and management development needs of staff?

17. Emerging work • 2008 Vision: Key drivers • PBR • NICE Guidelines • 18 week care pathways • Increasing psychological practice of whole workforce • Need to identify principals to consider in establishing structures • Board level appointments: Psychological Therapies Directors • Psychology Advisors • Identify Leadership Development – 4 levels • Pre Registration • Multi Disciplinary teams • Career grade leadership & management • Director Development

18. Career pathways and roles • Lead: Tina Ball • Questions: • What roles and at what times in career? • What proportion of time will need to be spent supervising others? • What is the relationship between National Occupational Standards (NOS) and Knowledge and Skills Framework (KSF) and continuing professional development? • What should be the role of the National Assessors?

19. Emerging work • Using available data to map current career work patterns – is this right for the future? • Developing translation aids between KSF & NOS and linking to role of national assessors. • Identifying key points in career development and role of national assessors. • Identifying national examples of good practice “Applied Psychologists doing it well in the NHS”

20. New roles related to applied psychology • Lead: John Taylor • Questions: • What roles, career structures, training and supervision should be available to psychology graduates in health and social care and in particular in mental health? • What role can Assistants/Associates play in ensuring user access to psychological therapies services and what are the implications for training? • To what extent can new roles play a part in improving the psychological welfare, performance of health and social care staff and the organisational culture in mental health services?

21. Emerging work • The truncated professional pyramid – broaden (PCGMHW, Assistants, Associates and all that) • Learning the lessons – PCGMHW and associate developments. • How to regulate. • New roles – improving organisational and staff health

22. Improving access to Psychological therapies • Lead: Roslyn Hope/Graham Turpin/Ruth Duffy • Initially established as sub-group of NIMHE IAPT & NWW for Applied Psychologists • Reports to NIMHE IAPT Board • Considers workforce requirements of IAPT national demonstration and pilot sites and DofW&P Pathways to Work Initiative • Different professions & organisations • Large and complicated (5 subgroups involving multi-professional and reps from Psychotherapy Bodies) and future as NWW Applied Group in some doubt • Need to refocus on implications of IAPT Programme for Applied Psychologists

23. Key issues • Implications from new initiatives for training (Commissioning/Development) • Implications of development of psychological therapies competences for pre and post reg. training • Identify current Service User pathways: What are the barriers, how might they be improved?

24. Emerging work • Developing competencies with Skills for Health for delivering psychological interventions (starting with CBT) • Survey of training that exists nationally in psychological therapies (training capacity) • Assessing user’s experiences of access - learning the lessons.

25. Teamworking • Lead: Steve Onyett • Question: • What are the best ways that applied psychologists can contribute to the work and development of teams?

26. Emerging work • Redeveloping and updating the DCP Teamworking Publication for Applied Psychologists • Tackling Issues • Separation vs. integration • Team size • Psychologists role – the leadership issue • Pre qualification and post qualification training content • Evaluating the creating capable teams workforce development tool

27. Mental Health legislation • Leads: Kate Bailey/Peter Kinderman • Question: • What are the implications of the new legislation for the role and training of applied psychologists?

28. Emerging work • Understanding what will be in the new legislation – with the drop of the Bill. • Identify competencies and training required • Clarifying registration arrangements for psychologists • Participating in reviewing the scenario planning

29. Training models • Leads: Mike Wang/Jan Burns • Questions: • Are the current models of training applied psychologists good enough and fit for future purposes? • How can these models be enhanced?

30. Emerging work • Review current training models • Reviewing feasibility of Kinderman related models – generic year across applied • Applied Psychologists’ influence on under graduate (GBR) and A level curricula development

31. Clinical Psychologist Counselling Psychologist Health Psychologist Forensic Psychologist The ‘Kinderman model’ Undergraduate degree in Psychology (BSc) Associate psychologist MSc (2 years) Research Assistant (MSc equivalent) Research Assistant (MSc equivalent) Postgraduate professional training (D.Psychol.) Generic applied psychology training (2 years) Final year specialisation (Clinical / Counselling / Health / Forensic) APEL Forensic Psychologist Consultant Psychologist

32. Another question • Identified at inaugural meeting: • “to what extent does undergraduate curriculum prepare people for work in the applied psychologies and , more specifically, for work concerned with mental health?” • Link with mental health in higher education project

33. Next steps • Stakeholder Conference – 14 July 2006, Wolverhampton • Project Groups working at and between Core Group • Stakeholder Conference (possibly February) outcomes • Final Report & Conference Launch – March/April 2007

34. Comments and questions…