1. ASSESSMENT AND INTERVENTION
PgC / UCAPD
LOW INTENSITY
ASSESSMENT AND INTERVENTION
SKILLS FOR
PSYCHOLOGICAL WELLBEING PRACTICE
SUPERVISOR WORKSHOP
8th January 2020

2. Welcome
The aim of today is to enhance your knowledge and understanding of the role of the supervisor within :
The Postgraduate Certificate (PgCert) and University Certificate in Advanced Professional Development (UCAPD) Low Intensity Assessment and Intervention Skills for Psychological Wellbeing Practice.
Underpinned by the 2015 National Curriculum for the Education of Psychological Wellbeing Practitioners (PWPs) and supported by the Reach Out student materials

3. Staff Contact Details Course Leader Deborah Rafter Room H1.12
Centuria Building
Tel:
Module Leader
Paul Thompson
Room H1.20
Tel:
Dr Sarah Fishburn
Room H1.28
Tel:

4. Introduction
The Improving Access to Psychological Therapies (IAPT) programme was established across England in 2008 with the aim of establishing psychological therapy services to enable people with common mental health problems to receive evidence-based, NICE approved psychological therapies and interventions.
The Psychological Wellbeing Practitioner (PWP) has a key role within the IAPT service to assess and support people with anxiety and depression – in the self-management of their recovery. Assessment is underpinned by the use of evidence-based measures for clinical, social and employment outcomes as part of a national outcome system utilising the behavior change model.

5. Introduction
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 based upon Cognitive Behavioural Therapy (CBT) e.g. behavioural activation, exposure, cognitive restructuring, panic management, problem-solving, sleep hygiene.
PWPs also provide information on common pharmacological treatments and support patients in decisions which optimise their use of such treatments. Low-intensity psychological treatments place a greater emphasis on patient self-management and are less burdensome then traditional psychological treatments.

6. Introduction
Achieving cultural competence is an essential requirement for the Psychological Wellbeing Practitioner so that each practitioner is able to recognise their own reaction to people who are perceived to be different.
PWPs are expected to operate in a stepped care, high volume environment carrying as many as 45 active cases at any one time, with workers completing treatment for between patients per year. The IAPT minimum level of PWP supervision is weekly individual case management and fortnightly clinical skills supervision in groups of no more than 12. The success of the programme crucially depends on the availability of fully trained practitioners who are able to supervise trainees to deliver the expected performance benchmarks for recovery.

7. Introduction Information gathering Information giving
This content can be summarised as six core themes that run through the course via three modules. The themes assist in anchoring the course to the National Curriculum (2015) and Reach Out (2011) materials:
Information gathering
Information giving
Shared decision-making
Low intensity interventions
Supervision
Values, policy, culture and diversity

8. Practice / Professional Skills
Act autonomously in relation to collaborative, client-centered and evidence-based assessment and decision-making for people with common mental health problems.
Demonstrate autonomous practice and originality in relation to the collaborative planning and implementation of a range of specific low intensity interventions for clients with common mental health problems.
Demonstrate autonomous practice with regard to a collaborative risk assessment.
Practice ethically, promoting an inclusive and non-discriminatory approach towards the care and treatment of people with common mental health problems.

9. Practice / Professional Skills
Demonstrate professionalism and proactively to meet the challenges of multi-professional and multi-agency working within primary mental health care.
Critically evaluate a range of employment, occupational and wellbeing strategies to assist patients manage their emotional distress and disturbance.
Critically engage in an appropriate supervision process demonstrating effective evaluation of client work.
Demonstrate autonomy in using behaviour change models and approaches to promote choice in relation to goal and intervention planning and to support recovery orientated working.

10. Attendance
One hundred percent attendance in theory and practice is a requirement of the course. Attendance will be monitored and absence will be discussed with the student  and also the clinical setting.
If you have any concerns about a trainees attendance then please contact me.

11. Absence
Absence over three consecutive days could lead to an interruption of studies. This needs to be discussed and negotiated with the trainee, Course Leader and Service Manager.
In certain circumstances leave of absence may be granted, however this must be discussed with the Course Leader and the appropriate documentation completed.

12. Following Absence
It is the trainees responsibility to ensure that they catch up with all elements of the session and the details are provided in the Course Handbook.
If you are concerned about the trainees absences (or any other issues) please contact the Course Leader.

13. Catch Up Document (Available on Blackboard)

14. Supervision
It is crucial for safe and effective practice and learning that students receive clinical skills and clinical case management supervision:
Clinical Case Management Supervision – at least one-hour every week in which all patients on the caseload are reviewed.
Clinical Skills Supervision – at least one-hour, every two weeks which could be provided on an individual basis or as part of a group.
Supervision Hours
By the end of the programme the student must evidence at least 40 hours of supervision (20 CMS & 20 CSS).

15. Practice Supervisor
As a supervisor of a PWP student you must ensure you are familiar with low intensity assessment, low- intensity interventions undertaken by PWPs and the two contrasting supervision methods. If PWPs are using self-help materials, supervisors should be fully familiar with the content of these materials. Supervisors should also be conversant and comfortable with any computerised treatment programmes in use.

16. Practice Supervisor
It is also essential that PWP supervisors familiarise themselves with local stepped care protocols operating in clinical services and the wider provision of health and social care services available locally, so that you can assist PWPs with their clinical decision-making around stepped care, case management and signposting. In order to familiarise themselves with the PWP methods, it is highly desirable – if not essential – that supervisors will have delivered treatment to patients themselves using PWP protocols. Supervisors should ensure that they have sufficient time to devote to supervision.

17. Group work
From your experience supervising trainees what are the key / common difficulties experienced.
How do we overcome this ?

18. Supervised Learning
In addition to the 25 classroom days it is essential that students complete 20 days supervised learning in the workplace. This will be facilitated through a range of practice-based tasks linked to each of the session themes. The tasks will be allocated via a Task Booklet, given to the student PWP. The Directed Practice Learning Task Booklet provides instructions for you and your student and explains the tasks in more details.
It is important that you work with students in relation to the completion of these learning activities and provide evidence of this by signing to verify the student’s engagement with the learning activity. This is not assessment material – it is a learning activity and forms part of the students attendance and is supportive evidence of achievement of practice outcomes.

19. Clinical Practice Outcomes
In order to pass the course, students must demonstrate that they have achieved nine ‘clinical practice outcomes’. It is the role of the Practice- based Supervisor to support the student in achieving these practice outcomes.
Supervisors must monitor and assess the developing clinical skills of the student through a variety of methods, for example, direct observation, the use of video tapes of clinical interviews undertaken by the student, and reflections by the student on their developing practice.
The ‘Clinical Practice Outcomes’ are summative assessment components and are therefore essential elements of the programme and must be completed.

20. Clinical Practice Outcomes
It is the student’s responsibility to provide evidence of achievement to the supervisor so that the supervisor is satisfied that the student has met their outcomes. The supervisor testimony sheet can be located at the back of the Directed Practice Learning Task Booklet.
Examples of Evidence
Direct observation and Shadowing
Supervision discussion and Discussion following sessions
Client feedback
Recorded sessions and client documentation
Reflective logs
Role-play

21. Working with Clients
Students will need to be deemed competent in order to work independently with clients. Evidence of this should be agreed in a Learning Contract between you and your supervisee at the beginning of the course and each module
It is recommended that a graded approach be used for introduction to clinical work. It may be helpful to think about this as a continuum.
Scheduled supervision
High clinical exposure
Direct supervision
Low clinical exposure
Role-play with live supervision Independent clinical work

22. Working with Clients
It is important that the client is made aware of the trainee status and this should be done following the policies and procedures of the employing organisation.
It is essential that client confidentiality be maintained at all times. Client work should not be discussed in class without obtaining consent following the correct University procedures. You must observe the student gaining consent and sign the relevant form. Each student has access to this.

23. Communication Tripartite Communication
Tripartite discussions can provide opportunities to clarify issues, discuss learning needs and the opportunities available. Tripartite meetings may also provide a forum for evaluation of performance in relation to all practice summative assessment components. If you wish to arrange a tripartite meeting, contact the course lead.  
Supervisor Workshop – yearly

24. Self Directed Study Preparing, Planning and Participating
It is essential that trainees take responsibility for and organise their own learning in order to make the most of the opportunities available to them.
Should traineess come to you with questions regarding the academic requirements of the programme it is important to direct them to the course team who will deal with such issues.

25. Student Support
The course team will provide the trainee with support and guidance in relation to all aspects of the learning experience and address any concern that the trainee may have.
The Practice Supervisor will provide teaching, facilitation of learning, observation and supervision in relation to your knowledge and skill development within the practice area.

26. 2020 PWP Course Increased numbers Increased staffing resources
Course fees funded
Interface with other disciplines
Working with diversity – from M3 to Induction
Introduction to Supervision – from M3 to induction

27. Course Delivery
The curriculum includes both classroom and workplace learning delivered in 45 days across the three modules. There will be an additional two day induction. Students will also have access to a range of university resources to support their learning. It is essential that students take responsibility for their own learning and make the most of the learning opportunities presented to them.

28. 2020 Course Delivery January January - March March - June
Module
Induction
Advancing/
Promoting Low Intensity Assessment Skills for Common Mental Health Problems
Promoting Low Intensity Intervention Skills for Common Mental Health Problems
Advancing/ Promoting Reflective, Non-discriminatory Practice
Duration
January
January - March
March - June
September - December
Classroom teaching
5 days
10 days
Workplace learning
Clinical hours requirement
40 hours
Clinical Assessment sessions
Clinical Intervention sessions
Supervision
Sessions (20 CM and 20 Clinical)

29. Assessment Strategy
The assessment strategy has been developed to meet the standards of the National Curriculum for Psychological Wellbeing Practitioners (IAPT, 2015). It is also important to have an accurate overview of the assessment schedule. The following table summarises the assessment requirements for this programme.
Formative and Summative Assessment
The aim of formative assessment is to monitor progress and provide feedback that can be used to improve learning and performance. Summative assessment is used to evaluate overall progress and will determine achievement of the learning outcomes for the module.

30. Module 1 Module Name Formative Assessment Type and Week of Completion
Summative Assessment Type and Week of Submission
Advancing/ Promoting Engagement and Assessment Skills for Common Mental Health Problems
Video-recorded simulation of an assessment session for a client with either depression or anxiety disorder – Week 5
Triage video-recorded assessment - Week 3
1,500-word Written Formulation - Week 4
Video-recorded simulation of an assessment session for a client with either depression or anxiety disorder – Week 7
Achievement of Practice Outcomes - Week 10

31. 1. Simulated Triage Assessment with Written
On the day of the summative assessment students will be allocated 15 minutes to conduct a triage assessment.  This will be video-recorded and students must demonstrate achievement of competence (≥ 3 on a scale of 0-6) in relation to:  
Introduction to session 
Engagement competencies
Interpersonal competencies 
Information-gathering competencies
Information giving: suitable to the problem
Shared planning and decision making

32. Students are then required to submit a 1,500-word written formulation, which will be assessed against the following criteria:
A comprehensive probable diagnosis using DSM - V criteria
A comprehensive risk management plan based upon risk factors identified by the client.   
A detailed and comprehensive level of intervention required for the client following the stepped-care model.
4. Adherence to the SOHSC guidelines for presentation and referencing.  

33. Assessment Role-Play  The simulated assessment will be audio-visually recorded for marking, feedback, self-assessment and moderation purposes.
  Students must demonstrate achievement of competence (≥ 3 on a scale of 0-6) in relation to:  
Introduction to session 
Engagement competencies
Interpersonal competencies 
Information-gathering competencies - problem-focused
Information-giving competencies - suitable to the problem
Shared planning and decision-making competencies
Failure to address risk appropriately leads to automatic fail.

34. Task Book
5 practice tasks to complete

35. Practical and Professional learning outcomes
Demonstrates competency in undertaking and recording a range of assessment formats.  This should include both triage within an IAPT service and problem-focused assessments.
Demonstrates experience and competence in the assessment of presenting problems across a range of problem descriptor including depression and two or more anxiety disorders.
Demonstrates the common factor competencies necessary to engage patients across the range of assessment formats.

36. Module 2 Module Name Formative Assessment Type and Week of Completion
Summative Assessment Type and Week of Submission
Advancing/Promoting Low Intensity Intervention Skills for Common Mental Health Problems
Video-recorded simulation of a treatment session for a client with either depression or anxiety disorder – Week 16
Written Exam - Week 14
Video-recorded real treatment session for a client with either depression or anxiety disorder – Week 18
Achievement of Practice Outcomes - Week 20

37. Assessments Exam 90 minute exam 3 scenarios
2 questions on each scenario
Interventions / risk / supervision and stepped care / medication
You must answer all questions
Marking criteria on BB
Example on BB

38. Treatment Video Treatment video 30 – 40 minute treatment video
Any stage of treatment
You must demonstrate knowledge of the intervention
Interpersonal skills essential
COM-b
Marking criteria is on BB
Must have consent – written and verbal
Must follow your services IG policy
Treatment Video

39. Task Book
5 practice tasks to complete

40. Practical and Professional learning outcomes
Demonstrates experience and competence in the selection and delivery of treatment of a range of presenting problems using evidence-based, low-intensity interventions across a range of problem descriptor including depression and two or more anxiety disorders.
Demonstrates the ability to use common factor competencies to manage emotional distress and maintain therapeutic alliances to support patients using low-intensity interventions.
Demonstrates high quality case-recording and systematic evaluation of the process and outcomes of mental health interventions, adapting care on the basis of these evaluations.

41. Interventions Depression and BA Cognitive Restructuring
Anxiety with Avoidance and Exposure Therapy
Sleep
Physical Activity and Exercise
Medication Management
Worry Management
Problem Solving
Relapse Prevention
Interventions

42. Module 3 Module Name Formative Assessment Type and Week of Completion
Summative Assessment Type and Week of Submission
Advancing /Promoting Reflective, Non-discriminatory Practice
Video-recorded clinical case presentation – Week 23
Video-recorded clinical case presentation – Week 25
3,000-word essay – Week 28
Achievement of Practice Outcomes Portfolio - Week 30
Advancing/ Promoting Reflective, Non-discriminatory Practice

43. Recorded Case Presentation
Required to gain consent from a client from the trainees work-based caseload and prepare a case presentation in order to demonstrate a recovery-focused and antidiscriminatory approach to assessment and intervention.
The presentation should be 15 minutes in duration

44. Trainees must demonstrate the ability to
Operate with respect, sensitivity and collaboration in complex inter-cultural situations towards people who are different or are perceived to be different.
• Communicate effectively with people from diverse cultures, establishing ways of working together and considering clinical implications.
• Critically reflect upon personal values, beliefs and reactions to people who are perceived to be different and the implications for practice.
• Demonstrate comprehensive and detailed knowledge of culture and the related values and factors effecting culture.
• Adhere to the School of Health & Social Care guidelines for consent and confidentiality.

45. 3,000-word Written Reflective Commentary
Comprehensive and critical knowledge of the supervision process and a practical understanding of its application.
• Synthesise and evaluate the caseload management and clinical decision-making.
• Critical reflection of own performance and development needs.
• Adhere to the School of Health & Social Care guidelines for presentation and referencing.
• Adhere to the School of Health & Social Care policy for confidentiality and consent.

46. Task Book
10 practice tasks to complete

47. Practical and Professional learning outcomes
Demonstrates the ability to engage with people from diverse demographic social and cultural backgrounds in assessment and low- intensity interventions. This could include adaptations to practice working with older adults, using interpretation services/self-help materials for people whose first language is not English, and/or adapting self-help materials for people with learning or literacy difficulties.
2. Demonstrates the ability to effectively manage a caseload including referral to step up, employment and signposted service

48. Practical and Professional learning outcomes
. 3. Demonstrates the ability to use supervision to the benefit of effective (a) case management and (b) clinical skills development. This should include: a) a report on a case management supervision session demonstrating ability to review caseload, bring patients at agreed predetermined thresholds and provide comprehensive and succinct case material; b) a report on use of clinical skills supervision including details of clinical skills questions brought, learning and implementation.

49. Standards for Work-based Placements (IAPT 2015)
Yes/No
Comment
The service should operate a stepped care system, with coherent integrated care pathways and clear protocols for initial allocation and stepping up/down in place.
The service should deliver interventions that are provided in line with NICE guidance.
The service should have good quality CBT-based self-help materials and cCBT packages available for students to use
Suitable office and clinical accommodation should be available.
student caseloads must be compatible with an effective training experience (e.g. gradual build-up of caseload, type of patients seen) and services should commit to agreeing appropriate caseloads with the relevant courses.
students should have access to the full range of presentations and modes of assessment and treatment that are required for completion of the course.
Services should work with courses to address identified problems by making relevant adjustments to individual support, supervision and training/development.

50. Standards for Work-based Placements (IAPT 2015)
Yes/No
Comment
Supervisors should demonstrable knowledge and experience of delivering LI interventions and are conversant with the service’s CBT-based self-help and online materials and site protocols
All PWP supervisors have attended a PWP supervisor training course
Regular case management and clinical skills supervision should be provided.
students must be able to access the required number of practice based learning days, and these should not be used for routine clinical work.
Services should have availability of adequate equipment for routine audio and video recording of sessions by PWP students
Roles in PWP training of NHS education commissioners, university training courses, IAPT service placement providers and BPS as accreditation body

51. Feedback
The School of Health & Social Care relies on feedback as a key method of assuring and enhancing the quality of its learning and teaching. Please contact the programme team with any feedback that you have.

52. What's to come … PWP Apprenticeship September 2020
Consultation Event in Feb
standards/psychological-wellbeing-practitioner-pwp/

53. Supervisor Support Site
intensity-interventions/
Timetable etc is all on this site

54. References
Department of Health (2015) Improving Access to Psychological Therapies Implementation Plan: Curriculum for Low Intensity Therapy Workers. London: HMSO.
Department of Health (2015) Psychological Wellbeing Practitioner Best Practice Guide. London: HMSO.
Richards, D. & Whyte, M. (2011) Reach Out Student Materials. 2nd ed. RETHINK.
Richards, D.A., Chellingsworth, M., Hope, R., Turpin, G. & Whyte, M. (2010). Reach Out National Programme Supervisor Materials to Support the Delivery of
Training for Psychological Wellbeing Practitioners Delivering Low Intensity
Interventions. (