Appendix 5: competence based training Introduction



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APPENDIX 5: COMPETENCE based training
Introduction
This summary of the competence areas trainees are expected to achieve is adapted from the BPS Criteria for the Accreditation of Postgraduate Training Programmes in Clinical Psychology, BPS (2010), BPS Standards for the Accreditation of Doctoral Programmes in Clinical Psychology (2014) and the HCPC Standards of Proficiency for Practitioner Psychologists (2015). The course is working in line with implementation of the updated BPS accreditation standards (2014). These will have a greater empahsis on demontrating that knowledge and skills have been benchmarked against competence frameworks; incorporation of systematic approaches to in vivo assessments; skills of clinical psychologists in indirect influence and leadership; and deepening collaborative practices with service users and carers.
These specify what training Programmes should achieve and, by inference, the minimum requirements for clinical psychologists who seek registration with the HCPC as Clinical Psychologists and seek Chartered Membership of the BPS and full membership of the Division of Clinical Psychology.
In line with the BPS, the Programme emphasises that although the various aspects of

competence are described separately in this guidance, it is the combination and integration of these components that are essential for working as a competent clinical psychologist.

The required learning outcomes and the structure of training
The following sections sets out the skills, knowledge and values trainee clinical psychologists need to develop during the course of their training, and the learning outcomes that training programmes will need to have in order to enable trainees to achieve these goals.

Programmes must enable trainees to work as clinical psychologists with the range of clients and services in a range of settings, especially those seen as having high priority within the National Health Service.

Newly qualified clinical psychologists should understand and embrace the core purpose and philosophy of the profession.

They should be committed to reducing psychological distress and enhancing and promoting psychological well-being through the systematic application of knowledge derived from psychological theory and evidence.

Their work will be based on the fundamental acknowledgement that all people have the same human value and the right to be treated as unique individuals.

Thus by the end of their Programme, trainees will have:

The skills, knowledge and values to develop working alliances with clients, including individuals, carers and/or services, in order to carry out psychological assessment, develop a formulation based on psychological theories and knowledge, carry out psychological interventions, evaluate their work and communicate effectively with clients, referrers and others, orally, electronically and in writing;

The skills knowledge and values to work effectively with clients from a diverse range of backgrounds, understanding and respecting the impact of difference and diversity upon their lives;

The skills, knowledge and values to work effectively with systems relevant to clients, including for example statutory and voluntary services, self-help and advocacy groups, user-led systems and other elements of the wider community;

The skills, knowledge and values to work in a range of indirect ways to improve psychological aspects of health and healthcare;

The skills, knowledge and values to conduct research that enables the profession to develop its knowledge base and to monitor and improve the effectiveness of its work; and

High level skills in managing a personal learning agenda and self-care, and in critical reflection and self-awareness that enable transfer of knowledge and skills to new settings and problems.

In order to achieve these goals Programmes will have the following learning outcomes:

Knowledge and understanding of psychological theory and evidence, encompassing specialist client group knowledge across the profession of Clinical Psychology and the knowledge required to underpin clinical and research practice.
A professional and ethical value base, including that set out in the BPS Code of Ethics and Conduct, HCPC Standards of Conduct, Performance and Ethics, the DCP statement of the Core Purpose and Philosophy of the profession and the DCP Professional Practice Guidelines.
Clinical and research skills that demonstrate work with clients and systems based on a scientist-practitioner and reflective-practitioner model that incorporates a cycle of assessment, formulation, intervention and evaluation.
Professional competence relating to personal and professional development, and awareness of the clinical, professional and social context within which the work is undertaken.
The following statements are intended as broad, high-level summaries of the required objectives that demonstrate competence.
Transferable skills


Deciding, using a broad evidence and knowledge base, how to assess, formulate and intervene psychologically, from a range of possible models and modes of intervention with clients, carers and service systems
Ability to draw on knowledge of a development, social and neuropsychological processes across the lifespan to facilitate adaptability and change in individuals, groups, families, organisations and communities.
Ability to initiate, develop and end a client-practitioner relationship.

Ability to use professional and research skills in work with clients based on a scientist-practitioner and reflective-practitioner model that incorporates a cycles of assessment, formulation, intervention and evaluation.

Generalising and synthesising prior knowledge and experience in order to apply them in different settings and novel situations
Demonstrating self-awareness and working as a reflective practitioner
Ability to think critically, reflectively and evaluatively
Ability to make informed judgements on complex issues in the absence of complete information.
Ability to communicate psychologically-informed ideas and conclusions clearly and effectively to specialist and non-specialist audiences, in order to facilitate problem solving and decision making.
Ability to assess a situation, determine the nature and severity of the problem and call upon the required knowledge and experience to deal with the problem.
Ability to initiate resolution of problems and be able to exercise personal initiative.
Recognition of personal responsibility for, and ability to justify, decisions. Exercising personal responsibility and largely autonomous initiative in complex and unpredictable situations in professional practice.
Understanding of the need for effective self-management of workload and be able to practise accordingly.
Demonstrate a level of skill in the use of information technology appropriate to practice.
Ability to change practice as needed to take account of new developments.
Understanding of the requirement to adapt practice to meet the needs of different client groups distinguished by, for example, physical, physiological, environmental, cultural or socio-economic factors.
Drawing on psychological knowledge of complex developmental, social and neuropsychological processes across the lifespan to facilitate adaptability and change in individuals, groups, families, organisations and communities.
Ability to work effectively whilst holding in mind alternative, competing explanations.

Psychological Assessment



Developing and maintaining effective working alliances with clients, including individuals, carers and services. Engaging service users and carers in planning and evaluating diagnostics, treatment and interventions to meet their needs and goals.
Ability to choose, use and interpret a broad range of assessment methods appropriate:

to the client and service delivery system in which the assessment takes place

to the type of intervention which is likely to be required
Ability to undertake and record a thorough, sensitive and detailed assessment, using appropriate techniques and equipment.
Assessment procedures in which competence is demonstrated will include

formal procedures (use of standardised instruments including psychometric instruments)

systematic interviewing procedures

other structured methods of assessment (e.g. observation or gathering information from others)


Ability to assess social context and organisational characteristics.
Ability to explain the nature and purpose of specific psychological techniques to clients.
Conducting appropriate risk assessment and using this to guide practice; to critically evaluate risks and their implications.
Recognition of the need to use interpersonal skills to encourage the active participation of service users.

Psychological Formulation



Developing formulations of presenting problems or situations which integrate information from assessments within a coherent framework that draws upon psychological theory and evidence and which incorporates interpersonal, societal, cultural and biological factors

Using formulations with clients to facilitate their understanding of their experience
Using formulations to plan appropriate interventions that take the client’s perspective into account
Using formulations to assist multi-professional communication, and the understanding of clients and their care
Revising formulations in the light of ongoing intervention and when necessary re-formulating the problem

Psychological Intervention




On the basis of a formulation, developing and implementing care-plans including psychological therapy or other interventions, based on evidence-based models of formal psychological therapy including the use of cognitive behavioural therapy, which are appropriate to the presenting problem and to the psychological and social circumstances of the client(s), and to do this in a collaborative manner with:

individuals

couples, families or groups

services/organisations


Understanding of therapeutic techniques and processes as applied when working with a range of individuals in distress including those who experience difficulties related to anxiety, mood, adjustment to adverse circumstances or life-events, eating, psychosis, use of substances, and those with somatoform, psychosexual, developmental, personality, cognitive and neurological presentations.
Ability to implement therapeutic interventions based on knowledge and practice in at least two evidence-based models of formal psychological therapy, of which one must be cognitive-behavioural therapy.
Having an awareness of the impact of psychopharmacological and other clinical interventions.

Understanding social approaches to intervention; for example, those informed by community, critical, and social constructionist perspectives.

Implementing interventions and care-plans through and with other professions and/or with individuals who are formal (professional) carers for a client, or who care for a client by virtue of family or partnership arrangements.
Recognising when (further) intervention is inappropriate, or unlikely to be helpful, and communicating this sensitively to clients and carers. Ability to make appropriate referrals.

Evaluation




Ability to evaluate intervention plans using recognised outcome measures and review the plans as necessary in conjunction with the service user.
Selecting and implementing appropriate methods to evaluate the effectiveness, acceptability and broader impact of interventions (both individual and organisational), and using this information to inform and shape practice. Where appropriate this will also involve devising innovative procedures.
Auditing clinical effectiveness

Research




Recognition of the value of research to the critical evaluation of practice. Understanding the need and value of undertaking clinical research and development post-qualification, contributing substantially to the development of theory and practice in clinical psychology.
Awareness of a range of research methodologies, including quantitative and qualitative approaches.
Conducting service evaluation and small N research.

Identifying, reviewing and critically appraising research evidence, which is at the forefront of clinical psychology, relevant to practice, and using this to inform own practice.

Conducting collaborative research

Ability to conceptualise, initiate, design, develop and conduct independent, original research of a quality to satisfy peer review, extend the forefront of the discipline, and merit publication i.e. identifying research questions, demonstrating an understanding of ethical issues, choosing appropriate research methods and analysis, reporting outcomes and identifying appropriate pathways for dissemination.

Quality control and assurance




Understand the principles of quality control and quality assurance
Recognise the need to monitor and evaluate the quality of practice and the value of contributing to the generation of data for quality assurance and improvement programmes.
Awareness of the role of audit and review in quality management including quality control, quality assurance and the use of appropriate outcomes measures.
Ability to engage in evidence-base practice, evaluate practice systematically, and participant in audit procedures.
Conducting service evaluation and small N research . Ability to gather information, including qualitative and quantitative data, that helps to evaluate the responses of service users to their care.

Ability to maintain an effective audit trail and work towards continual improvement.



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