Faculty of Health, Education and Society. School of Social Science and Social Work. Doctorate in Clinical Psychology. Placement Handbook

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1 Faculty of Health, Education and Society School of Social Science and Social Work Doctorate in Clinical Psychology Placement Handbook For All Trainees and Supervisors 2012/2013

2 CONTENTS WELCOME AND CONTACTS 1 CLINICAL PLACEMENTS 2 APPENDIX A Timeline 23 APPENDIX B Submission Dates 24 ESSENTIAL PAPERWORK, COMPRISING: APPENDIX 1 Clinical Placement Assessment; Clinical Competence Goals & Evaluation Form; Portfolio of Clinical Experience with In Vito Observation of Clinical Skills (completed by trainee & lead supervisor at mid & end years 1 & 2; end year 3) 27 APPENDIX 1.1 Guidance Notes For Clinical Competence Goals and Evaluation Form 67 APPENDIX 1.2 Code of Good Practice for Psychological Testing 81 APPENDIX 1.3 Placement Feedback Sheet for Clinical Tutor 86 APPENDIX 2 Placement Audit Form: completed by trainee at end of placement period 88 APPENDIX 3 Placement Audit Form: completed by trainee at end of placement period 90 APPENDIX 4 Suggestions for Induction of Trainees into Placement 97 APPENDIX 5 Clinical Studies & Psychotheraphy Process Study: Supervisor Declaration 98 APPENDIX 5.1 (A) Clinical Study 1 Formulation (mid-point year 1) - Guidelines 99 APPENDIX 5.1 (B) Clinical Study 1 Marking Sheet 105 APPENDIX 5.2 (A) Clinical Studies 2 and 3 Intervention (end of year 1 and 2) - Guidelines 107 APPENDIX 5.2 (B) Clinical Studies 2 and 3 Marking Sheet 114 APPENDIX 5.3 (A) Clinical Study 4 Professional Issues & Leadership (year 3) Writing & Marking Guidelines 116 APPENDIX 5.3 (B) Clinical Study 4 Feedback Sheet 117 APPENDIX 5.4 Psychotheraphy Process Study (from research module) (year 2) 119 APPENDIX 6 Placement Contracting Visit Checklist 122 APPENDIX 7 Placement Review Visit Checklist 127 APPENDIX 8 (A) Guidelines on Consent and Confidentiality 130 APPENDIX 8 (B) Consent Forms 136 APPENDIX 9 BPS Guidelines on Clinical Supervision 139 APPENDIX 10 Procedures for Managing Trainees at Risk of Failure 146 APPENDIX 11 SHA Special Conditions of Service for DClin Trainees DEFINED. ERROR! BOOKMARK NOT APPENDIX 12 (A) Supervision Feedback Process Supervisor Version 154 APPENDIX 12 (B) Supervision Feedback Process Trainee Version 161 APPENDIX 13 Appraisal Document (for trainee with clinical tutor) 167 APPENDIX 14 Overseas Placement Letter 171

3 Welcome and Contacts Clinical Handbook: Welcome and Contacts Plymouth University Doctoral Programme in Clinical Psychology 2012/2013 Thank you to supervisors for supervising a Plymouth Doctorate in Clinical Psychology trainee. Plymouth University hosts an on-line Practice Placement Information site (POPPI) which has open access. All Doctorate in Clinical Psychology placement paperwork will be available via a link on this site: There is also general information including standard University Policies, Procedure and Guidelines including Fitness to Practice. Students will find placement lists and Trust background information on this site. Placements are supported by the trainee s Clinical Tutor who usually visits each placement twice in placement years 1 and 2, and once in year 3. Clinical Tutors are based geographically:- East (Exeter & S Devon): Emma Wilson /2 Mid (Plymouth): Rebecca Holtom /2 West (Cornwall): Elaine Vickers /2 Clinical Psychology is regulated by the Health Professions Council (HPC): please see their website for Standards of Conduct, Performance and Ethics, Practitioner Psychology Standards of Proficiency, and other guidance. Thank you again for your partnership in training clinical psychologists in the West Country. Please keep in touch I can be contacted on or by Annie Mitchell, Clinical Director 1

4 Clinical Placements Trainees spend at least half their time in training on clinical placements. Since 2009 Clinical Psychology has been regulated by the Health Professions Council (HPC). HPC standards of proficiency for clinical psychology are based on, and extend, the previous BPS competence requirements. Placement experiences and supervision must meet HPC and BPS standards. Supervised clinical experience is gained through three placements, each (with associated academic preparation and research work) of a year s duration. The placement sequence is planned so that trainees develop their core competencies within a life-cycle developmental and cultural contextual framework for understanding psychological well- being and distress. We hope that their placements will enable trainees to apply their psychological knowledge and skills in ways that are informed by sensitive understandings of the complex worlds and circumstances in which people develop and live. Year One involves work with children/ families and/or with people with learning disabilities. Year one placemen comprises around 126 working days in total. Year Two involves work in services with adults through the life span (working age and beyond). Year two placement comprises around working 148 days in total. In both of these year-long integrated placements each trainee will usually have two supervisors, one from each of the two specialisms in which they will be working. These supervisors will usually negotiate between them for one to take a lead role and the other a link (subsidiary) role. The balance and timing of work across the two specialisms will be individually negotiated between the trainee and supervisors, assisted by the clinical tutor at placement visits. The balance as far as possible will depend on trainees previous strengths, prior experiences and current learning needs, but will be constrained by opportunities available and by supervisor availability. In terms of timing and integrating the two parts of the placement, we have found that frontloading placements with one specialism helps trainees to integrate into their new setting and find their feet, especially in year one when so much is new, before gradually building up work in the other area. Each locality/ Trust is evolving its own way of managing the yearlong integrated placement system and the Programme is keen to be responsive to local circumstances and trainee needs. In some Trusts, placement supervisors prefer to run the two elements of the placement consecutively, starting and completing in one specialism for 4/5 months, before moving on the second. Where this takes place, every effort will be made to ensure that at least some clinical work is long term and straddles the two components. The Programme does not require that trainees spend equal amounts of time in both specialisms, and in most cases the trainee will undertake more work in one specialism than the other. The bottom line is that overall the trainee gains substantial experience across client groups, settings and presenting problems, as specified in the rating standards for the Cumulative Record of Experience in the Portfolio of Clinical Experience, and that they are judged by their supervisor(s) as clinically competent using the Clinical Competence Goals and Evaluation Form These documents are combined into one submission as Clinical Placement Assessments. 2

5 Year Three is a consolidation and specialisation year in which trainees gain more in-depth opportunities to develop psychological approaches across competence areas, and fill in any gaps and consolidate their acquisition of core competencies and experiences as they prepare for their first qualified post. We hope that in this year trainees will also have opportunities to develop specialist interests. Year three placement comprises around 109 working days in total. Year three clinical work may be overseen by one clinical supervisor, or by more than one, depending on individual learning needs and placement opportunities. It is possible for year 3 to involve a month in a specialist placement setting elsewhere in the UK, or overseas, once research has been submitted and the trainee has successfully completed the Clinical Competence Goals and Evaluation Form. If so, additional expenses incurred must be met by the trainee. Overseas placement experience is governed by the University Faculty of Health Overseas Placement Handbook. Trainees complete three clinical modules through the course of training each module corresponds to one placement. Trainees clinical competence is assessed by the lead supervisor by means of the Clinical Competence Goals and Evaluation Form and by In Vivo Observation of Clinical Skills; their clinical experience is monitored by means of the Portfolio of Clinical Experience. These documents are combined into the Clinical Placement Assessment and submitted at the mid- and end-points of year 1 and 2 placements and near the end point of year 3. In addition, as part of the first two clinical modules, trainees submit four clinical studies: two in year one and one in year two (see appendices 1.2 and 1.3 for writing and marking guidelines for clinical studies). In the year 3 study, trainees will present a reflective account of their progress though training to demonstrate their awareness of professional and leadership issues. Their work on the other modules (academic and research) enables trainees to prepare for placements and to integrate theory and research into their role and practice as a clinical psychologist. We hope that trainees clinical placements will be enjoyable, satisfying and challenging. Of course, life and training are never perfect. Inevitably there will be challenges and difficulties to overcome. We will do our best to support trainees and supervisors through the difficult times and to share appreciation of the good times. We hope that trainees will be able to nurture and develop the skills, interests and qualities that they bring from previous experiences, so that they become humane, creative, innovative and rigorous reflective scientist-practitioners. 1.1 Clinical Placement Objectives The main objectives of clinical placements are to provide trainees with opportunities to acquire: 1. the overall standards of proficiency required of practitioner clinical psychologists which include: a. core competencies in direct psychological work across a wide range of experiences with clients across the life-span, with varied problems/ issues and in a range of service settings: assessment, formulation, intervention 3

6 (including psychological therapy) and evaluation with individual clients, couples, families, and groups, using more than one mode of psychological therapy to include CBT; b. core competence in indirect psychological work, including use and provision of supervision, consultation, research and evaluation /audit, service development, user involvement, leadership and management; 2. the professional values expected of a clinical psychologist including capability to work within the Health Professions Council Standards of Conduct, Performance and Ethics. 1.2 Placement Components Four essential aspects of trainees performance and development on placement are evaluated and/or monitored through various assessments and assignments Competence: assessed through the Clinical Competence Goals and Evaluation Form (supplemented by supervisors In Vivo observation of clinical skills) submitted twice in year 1 and year 2 and once in year 3. Core competencies in clinical psychology are those areas of activity (underpinned by theory, evidence and appropriate values), that are considered by our professional body, the BPS, to be central to our professional identity. These competencies have been incorporated into Health Professions Council Standards of Proficiency for Clinical Psychology. They are grouped into the following 7 broad areas for planning and assessing trainees clinical competence: relationships; assessment and formulation; intervention and evaluation; communication, training and consultation; management and organisation; professional practice; supervision and personal development. A competent clinical psychologist is expected to be able to integrate their skills, abilities and knowledge across these areas of competence, with a readiness to generalise, innovate and problem-solve in new fields. One of the supervisors, following consultation with the other supervisor and others who have been involved with the trainee s work, evaluates the trainee s competence at mid- and end point of years 1 and 2 and after the mid-point of year Experience: monitored through the Portfolio of Clinical Experience, submitted at mid- and end point of years 1 and 2 and after the mid-point of year 3. Trainees will develop their competence through undertaking a balanced range of experiences across settings and client groups. The BPS specifies the range of experience required to be covered in clinical psychology training: with clients, carers and families with a range of presenting problems, resources and abilities across the life span, based in a range of service delivery systems or settings, working at a number of different levels (direct, indirect, and within multi-disciplinary teams) and using and integrating more than one psychological approaches. The trainee records their experience through the 4

7 Portfolio of Clinical Experience which is signed off by themselves and both supervisors as an accurate record Knowledge: assessed through clinical studies submitted in years one (2 reports), two (1 report) and 3 (1 report). Trainees will critically evaluate, generalise and synthesise relevant knowledge and experience in order to apply them in different settings and novel situations. Clinical psychology draws on a wide range of theory and evidence. We expect that each trainee will develop his or her own individual integrated approach, thinking things out for him or herself in an appropriate and reflective manner, and adapting their approach to particular client and service needs, rather than simply relying on tradition or unquestioned authority. We try to provide a well-integrated approach to theoretical and practical learning. The academic curriculum is planned to provide an initial preparation for clinical experience, augmented by subsequent integrated learning and teaching, to provide and signpost some of the resources that trainees will need in order to make theory-practice links on placements and to promote an adult learner model, using a problem- based learning approach. We strongly encourage shared learning and mutual support in learning (including links with learners from other disciplines). Trainees are an important source of learning and support for one another, and collaboration and team work in learning and practice is essential in the modern NHS. Trainees will supplement core academic and research learning with their own reading and reflection on placement as part of an on-going commitment to continued professional development. Trainees are strongly encouraged to choose, early in the placement, one or two pieces of work as possibilities for write-up as clinical studies (for various reasons not every piece of work that is planned to be written up as a clinical study turns out not to be suitable, and therefore it is good to have some back up). They must show their supervisor the written up clinical study before submission. The supervisor completes a front sheet indicating that the work has been undertaken as described, and that the work has been suitably anonymised (with any identifying features altered); additionally the supervisor is invited to note any circumstances that may have affected the conduct or writing up of the clinical study, to be taken into account by the markers Reflection: Reflection is built into all aspects of trainees work and is assessed by marking criteria built into the assessment processes and by the clinical study in year 3. Trainees will engage in critical reflection on self, context and theory/evidence as they develop their professional, practitioner, scientist/researcher and personal identities as clinical psychologists. Their reflections will inform all aspects of their work, including their use of supervision, and form the basis of the trainee s preparation for their appraisal with their appraisal tutor after the mid-point of every year. Trainees keep a reflective log, which they draw on for various assignments and will form part of the basis for their final clinical study submitted in year 3 at final appraisal. 5

8 1.3. Essential information Trainees must familiarise themselves with the following documents in preparation for clinical placements. Trainees should check with supervisors as to whether there are any particular expectations with respect to ethical and good practice guidelines that pertain in their own practice settings. Health Professions Council (HPC) The HPC sets standards for registrants in the following areas: health; proficiency; conduct, performance and ethics; and continuing professional development. These standards determine the registrant s fitness to practice. Trainees must familiarise themselves with these standards, which can be found on the HPC website; further documentation will be made available to trainees once nationally finalised. Fitness for Practise The Health Professions Council defines fitness for practise in terms of the practitioner having the skills, knowledge, character and health to practice their profession safely and effectively. Overall trainees must meet the standards expected by the Health Professions Council, University of Plymouth and of our professional body, the BPS, as set out in Code of Ethics and Conduct (2006) and DCP Professional Practice Guidelines (1995), and failure to do so will be regarded as a serious professional issue. Trainees are bound by the University s Fitness to Practice Regulations, which are currently being revised to address the specific requirements for clinical psychology and which are available to trainees on the University placement (POPPI) website It is essential that all clinical psychology trainees should be persons of integrity and not have committed criminal acts which bring into question their clinical reputation. Failure to disclose any criminal convictions will be regarded as a serious professional issue. Trainees are expected to conduct themselves at all times in a responsible and professional manner and are expected to dress in an appropriate manner commensurate with current practice of professionals within the service setting. The University and the programme are very supportive of students and trainees with disabilities and health needs, and it is important that these are disclosed to ensure that we can make reasonable adjustments to deal with any special needs. Trainees must let their clinical tutor or academic tutor know if they are concerned about whether their ability to work professionally may be affected by any serious physical or mental health problem, and we will offer support and advice about appropriate actions or reasonable adjustments that may be needed. It is essential that the safe and effective practice of clinical psychology trainees is not compromised by serious and recurrent physical or mental health problems, the nature of which may threaten client safety and the proper conduct of assessment, formulation, treatment, research and other professional activities. Failure to disclose serious physical or mental health issues that may compromise capacity to work 6

9 safely will be regarded as a serious professional issue. Having said this, the University and the programme are very supportive of students and trainees with disabilities and health needs, and we especially welcome the diversity that people with long term conditions can bring into the profession. It is important that these are disclosed to ensure that we can make reasonable adjustments to deal with any special needs. Let your clinical tutor or academic tutor know if you are concerned about whether your ability to work professionally may be affected by any serious physical or mental health problem, and we will offer support and advice about appropriate actions that may be needed. British Psychological Society (BPS) Documents Code of Ethics and Conduct (2006) DCP Professional Practice Guidelines (1995) Record Keeping: Guidance on Good Practice (2008) Department of Health (DoH) Documents Key Points on Consent: The Law in England The Ten Essential Shared Capabilities for the whole of the Mental Health Workforce (2004) Health Professions Council (HPC) : Health Professions Council (2009) Standards of Proficiency: Practitioner Psychologists. London: Health Professions Council. Health Professions Council (2008) Standards of Conduct, Performance and Ethics. London: Health Professions Council. Trainees should check the Department of Health, BPS and HPC websites regularly to find out about new or revised policies and key documents Service Receiver Perspectives We expect trainees to understand, respect and respond to the strengths, needs, concerns and values of service receivers (i.e. those who receive and use services, and their carers) The programme is informed by service receiver input provided through the Service Receiver and Carer Consultative Groups (SRCCG), which is a sub group of the Service User and Carer Consultative Group (SUCCG) for the Social Work Programme. Trainees are invited to attend the SRCCG meetings, which meets once a term with the staff team and trainee representatives. The group has become an important resource for service receiver collaboration around selection, teaching, clinical skills development and research. We encourage supervisors to enable all trainees to access service receiver/carer groups linked with their placement services and expect service receiver perspectives to be considered in clinically related academic work. We also have links with other Service User Advisory groups in the region. Here is a list of some of the qualities that members of the Plymouth group have identified as important for Clinical Psychologists: 7

10 friendliness and human qualities such as humour, warmth and genuineness equality (recognise people s strengths and be open to learning from the client) honesty (if you don t know, say so!) ability to really listen and communicate (including good eye contact) courteousness e.g. being on time or let people know if you are running late awareness that their initial approach/contact is central in building trust sensitivity to clients needs and recognition of peoples strengths in a nonpatronising way ability to be reflective, transparent, honest and trustworthy not promising anything they can t deliver treats clients like a person and not a case understands the constraints of a person s situation is credible in their profession, with relevant experience and track record of having dealt with people with similar conditions does their homework between sessions and liaises with other professionals before and after work with clients when they know they are leaving, tells people so that they can prepare for the ending are sensitive to client expectations and professional standards in terms of dress code (e.g. gender, age group etc.) flexibility e.g. in where they might be seen or timing of sessions. It may come as something of a relief to realise that clients do not expect us to have all the answers, and that it is quite acceptable to have to do our homework between sessions. Service receiver/carer advice is in accord with the literature on therapeutic relationships. Do make sure that in your clinical practice you ask and do not assume that you know what it is that clients really want and need when they see you, and of course be mindful and appreciative of cultural differences in expectations and assumptions. Currently the SRCCG members offer the following range of input to our trainees: They are an integral part of our interview panels; induction session and input into first essay; co-facilitate reflective mentoring groups for all year groups with local supervisors; join the assessment panel for all Problem Based Learning presentations, provide research support and also help with third year clinical presentations and interview skills day. The SRCCG are always available for trainees to consult with via the service receiver/carer lead for the course or the chair of the SUCCG Placement Sequence and Submission Dates see separate time lines elsewhere in Handbook Role of the Trainee Clinical Psychologist on Placement The role of trainee on placement is primarily as learner and secondly as provider of a clinical service, under supervision. 8

11 Trainees are expected to prepare for, attend, and record key decisions generated in regular supervision. They should observe their supervisor(s) in practice and must have their own practice observed by their supervisor. As reflective practitioners, trainees have an obligation to share with their supervisor any concerns or issues that may impact on their performance on placement (e.g. personal or family crises, health issues), and to work to find ways of managing these issues. Trainees must always use the term Trainee Clinical Psychologist when introducing themselves to clients (see section below on informed consent). Trainees must also ensure that all letters and reports and notes in clinical records are signed appropriately. The British Psychological Society requires the following: Trainee Clinical Psychologist working under the supervision of. (Name of supervisor). Supervisors retain clinical responsibility for the work undertaken by the trainee, and so the usual practice is for supervisors to countersign trainees letters and reports, and entries into clinical notes, but trainees should check with supervisors on the expected practice within the Trust or Agency that they are working in Role of the Supervisors Supervisors have several complex roles in relation to the trainee, including trainer, facilitator of trainee s development and evaluator of his or her clinical practice. Some of the supervisory functions include: ensure that the trainee undertakes the necessary induction into the placement area and meets other team members and learners in practice, oversee and guide the trainee s work; facilitate his or her clinical and professional development; try to ensure that the trainee has access to adequate resources on the placement; observe and be observed by the trainee and share constructive criticism; enable the trainee to gain increasing autonomy in his/her work as he/she progress through the placement; ensure that the trainee has opportunities to gain a wide range of relevant experiences; evaluate the trainee's clinical competence; retain clinical and legal responsibility for the trainees work undertaken within their service during the placement period. Both supervisors will provide opportunities for supervised clinical practice within their specialism. Usually one supervisor, the lead supervisor, takes a key role in planning and providing the placement and evaluating the trainee s work, ensuring good communication between supervisors and the trainee, and liaising with the Programme team via the clinical tutor. The link/ subsidiary supervisor(s) will also provide supervision and will be involved in assessing and monitoring the trainees work. Supervisors are expected to make back-up supervision arrangements within their service in case of supervisor absence. Safe clinical practice requires that if regular appropriate and sufficient supervision becomes unavailable, then direct clinical work with clients should normally stop Role of the Clinical Tutor Clinical tutors monitor and enable placements, facilitate communication between the trainee, the supervisors and the Programme, help to build theory-practice links, appraise trainees progress, contribute to academic teaching and marking (including 9

12 clinical study marking), appraise trainee development and progression and contribute to pastoral care of trainees. Their specific tasks in relation to placements include: helping to ensure that the placement is planned to meet the trainee s training needs, taking into account trainees strengths and learning needs; ensuring supervisors are made aware of any particular issues that may affect the trainee s performance on placement; checking that the trainee is developing his or her clinical competencies and gaining relevant experiences on placement; checking that the placement is manageable for the trainee and the supervisors; liaising between the Programme team and the supervisor so that the supervisors have all the information they requires about the Programme and the trainee; over-viewing/ monitoring where supervision is carried out by a supervisor less than 2 years qualified as a clinical psychologist or where supervision is delegated to a member of another profession; devising and monitoring an action plan if the supervisors and trainee experience difficulties; feeding back any problems with the placement to the Clinical Director; providing regular personal and group tutorials. The clinical tutor visits placements regularly to monitor progress (see section below). The clinical tutor also provides individual tutorials and appraisals. The tutorials take place in the autumn term of each of the three years, and at each placement visit. The clinical tutor also offers 2 group tutorials every year for all tutees in their placement patch: the spring (around February), early summer (around May/June) and, if required, late summer (around July/ August). Appraisals take place as follows: Yr 1 1) Introductory appraisal in placement induction time in their first term. 2) progression appraisal towards the end of placement late June/July. Yr 2. Progression appraisal as above. Yr 3. 1) Progression appraisal at placement review; 2) Exit interview (Sept) Role of the Placement Co-ordinator Placement Co-ordinators are NHS clinical psychologists who take on their role in relation to Programmes in Clinical Psychology across most Trusts in the south west (NB some smaller Trusts/Agencies do not have a named Liaison Tutor/ Placement Co-ordinator. In these cases Heads of Service generally take on aspects of this role). The role of the Placement Co-ordinator is to act as a communicator between their Trust and the Programmes. More specifically, the functions include: to seek suitable placements for trainees within their Trusts (see section 7.1) and communicate these to the Clinical Director; to alert the Clinical Director to any difficulties envisaged with the provision of placements; to convey trainee placement plans to Trust clinical supervisors; to be available as a placement information resource to trainees and Programme staff; to attend Supervisors' Committee and pass on Trust news and developments; to pass on Programme news and developments to Trust psychologists (including the Head of Department); to communicate the training development requests of supervisors to the Clinical Director/Senior Clinical Tutors. 10

13 1.6.5 Role of the Clinical Director The Clinical Director s role is to oversee the clinical component of the Programme. Specific tasks include: work with Placement Co-ordinators, service providers and with other Clinical Training Programmes in the Region to monitor placements and ensure that placements are available and of suitable quality; plan the placement programme for all trainees; act as Module Lead for all 3 clinical modules; provide preparation and training for supervisors; provide teaching for trainees in preparation for placements; to oversee the work of clinical tutors; oversee Placement Audit; debrief trainees after placements and ensure that feedback about placements is forwarded to supervisors; work with other members of the Programme team to coordinate the clinical, academic and research aspects of the Programme; contribute to Programme research and teaching. 1.7 Placement Processes and Procedures Allocation to Placements Each trainee is allocated to a geographical area following selection. Each trainee will be allocated to one of four geographical areas in Devon and Cornwall: Cornwall, Plymouth, South Devon and Exeter/ East Devon. They should expect to have all or most of their placement experience in their allocated area. The Clinical Director liaises with Trust based Placement Co-ordinators, about nine months before each placement period, to identify who is available within Trusts to offer placements and to identify supervisor pairs across specialisms. Year 1 trainees are allocated to supervisors according to geographical location, taking into account, wherever possible, trainees previous experience. This is done by circulation, to available supervisors within each geographical patch, trainees own brief biographical summary. Placement Co-ordinators liaise with local supervisors and then with Clinical Director to enable the best supervisor-trainee match in accordance with trainees previous experiences. Year 2 placements are allocated through liaison between Clinical Tutors and Placement Co-ordinators, following identification of trainees anticipated learning and experience needs at mid-point of year 2. For year 3 placements, trainees submit their Placement Preferences to their Clinical Tutor based on identification of their learning needs with their clinical tutor and subsequent discussion of potentially available placements with their local Placement Coordinator(s). Placement Co-ordinators and Clinical Tutors attend a placement allocation meeting chaired by the Clinical Director at which a fair allocation of placements is established against clear criteria. In many cases the trainee will have more than one supervisor in year three but single supervisor placements are also possible. Year three placements may be in a new specialism, or trainees may prefer to gain further more in-depth experience in one of the specialisms in which they have already worked, especially if they hope to gain a first post in that specialism. In some cases, certain experiences may be required in year 3 in order to address gaps in training so far. Although most placements are organised within the area of their geographical base, (i.e. the base of their first lead supervisor) there may, by negotiation with other Programmes, be some limited opportunities to gain specialist experience elsewhere within the region, or even further afield in year three. 11

14 1.7.2 Travel Expenses on Placement Trainees can claim travel expenses from their host base (i.e. the base of the lead supervisor for their year one placement) regardless of where they are placed within their area for subsequent placements, unless the journey from their home to their subsequent placement base is a shorter distance. We try to ensure that each trainee has most of his or her placements within a reasonable commuting distance (about 25 miles) from their base. Trainees should, however, expect that at least part of at least one placement during the course of the Programme may well be based further away than this, given the rural geography of much of the southwest. We try to ensure that trainees particular needs e.g. disability, commitments as carers, will be taken into account in planning distant placement allocation. If the placement is geographically too distant to commute from home, it may be that trainees will need to arrange temporary accommodation. In such cases, trainees will need to liaise with supervisors/liaison tutors within the Trust to find hospital accommodation if possible, and if not, reasonably priced bed and breakfast or guest house accommodation. The cost of this accommodation will be covered; the trainee can claim travel expenses from host base to accommodation base at the beginning and end of each week and travel expenses within the placement will be calculated from the placement base. NB: Please see Special Conditions of Service from the Strategic Health Authority and the employing Trust for up-to-date information about expenses and entitlements for trainee clinical psychologists. 1.8 Supervisor Preparation, Support and Training for Placements Pre-placement Meetings All supervisors are expected to attend a pre-placement meeting in preparation for taking the trainee. Pre-placement meetings are an opportunity for: 1. supervisors to share with Programme staff, and with one another, up-to-date information about service issues that may impact on placements; 2. supervisors and Programme staff to share expectations about the placement and supervision; 3. programme staff to explain University requirements, including assessment procedures, based on the Programme Handbook; 4. mutual discussion of the relevant academic and research aspects of the programme seeking to ensure that the academic and research curricula both facilitate, and are facilitated by, placement learning; 5. attention to supervisors own learning and support needs in supervision 6. supervisors to network to provide mutual support for supervision. 12

15 1.8.2 Other Supervisor Training All new supervisors are encouraged to attend a five day supervisory training programme: Managing Learners in Practice which is run in co-operation with the Social Work Training Programme, and which meets the learning needs for the BPS Learning Centre Accredited Supervisor Scheme. Additional occasional supervision workshops and conferences take place throughout the southwest; the programme clinical directors liaise to co-ordinate training events. Supervisors attend bi-annual supervisors committee meetings which often contain a training component. In addition, supervisors are invited to attend relevant academic Programme events in the teaching block prior to the placement or in integrated teaching days Clinical Tutor placement visits Each trainee is allocated a clinical tutor, who monitors and supports the trainee s clinical progress through a series of placement visits throughout training. At each visit the clinical tutor will meet at least one supervisor together with the trainee (and the other supervisor if possible); with some individual time with each. In year 1 normally the clinical tutor visits at least three times: a contracting visit near the beginning, and a review visit prior to the mid-point, with third visit (contracting and/or review) in the second half of the placement. In year 2 normally the clinical tutor visits at least twice: a contracting visit near the beginning, and a review visit prior to the mid-point, with a third visit (contracting and/or review) in the second half of the placement if needed, for example where a new supervisor is in place, where the yearlong placement is divided into two halves, or where there are particular concerns to be addressed. In year 3 normally the clinical tutor visits at least once: either a contracting visit near the beginning or a review visit around half way through the placement. An initial contracting visit may also be arranged when needed; with additional visits where there are particular concerns to be addresses. 1.9 Trainee Preparation for Placements Induction days Several days are made available for an introduction to the placement early in the academic teaching block preceding each placement. During these days, trainees should do the following: 1. meet the both supervisors; 13

16 2. begin to discuss trainee s strengths and learning needs so as to set up goals for the placement (taking into account feedback from previous placement periods if this is not the first placement); 3. find out from the supervisors about possible experiences available within the placement and what isn t available; 4. familiarise self with Trust/agency policies and ensure an honorary contract is in place if required by the Trust/agency. 5. set up arrangements for required Trust/agency induction processes; 6. begin an induction into the work teams, to include introductions to key team members and to other trainees from other professional groups within the service; and clarification of the resources for the placement (e.g., desk, phone, secretarial support, filing cabinet space etc); practicalities such as parking permits if needed; 7. begin to plan the general placement outline; 8. plan the supervision agreement; 9. spend time with, alongside or shadowing service users and carers so as to learn about their life experiences; 10. identify any inter-disciplinary learning opportunities on the placement i.e. opportunities for mutual learning with students from other disciplines 11. observe and shadow the supervisor/s at work; 12. begin work on setting up a case load. 13. engage in activities related to the Problem-Based Learning exercise for the academic component of the Programme as required Setting up the Placement By the time the clinical tutor makes the contracting visit, (usually about a month after the start of placement) a draft of the following must be available for discussion (or this must be sent to the clinical tutor within one month of the start of placement where a contracting visit is not arranged): 1) General placement outline; trainee strengths, learning needs and specific goals for each competence area in the Clinical Competence Goals & Evaluation Form; 2) Early entries in Log of Clinical Experience from Portfolio of Clinical Experience; 3) Supervision Agreement to be signed by supervisor(s), trainee and clinical tutor. Additionally, for those trainees who were given a conditional pass or a referred rating for the previous placement period, by the end of the second full (four day) week on placement the trainee must send the clinical tutor a first draft of the general placement outline from the Clinical Competence Goals and Evaluation Form, including initial consideration of how those issues identified as requiring particular attention from the previous placement will be addressed. 14

17 Establishing a Supervision Agreement At the contracting visit the trainee, supervisors and clinical tutor finalise an overall supervision agreement. The trainee should have a total of at least one and a half hour s direct supervision each week, and the trainee s total contact time across supervisors should be at least three hours (the balance of how these are to be provided across supervisors will be individually negotiated). Some supervision may be group supervision as long as the trainee has at least one hour of direct one- to one time with a supervisor each week. The supervisors must observe and be observed by the trainee in practice, Supervision should provide opportunities to discuss on-going case and project work and clinical report writing, relevant literature, personal issues that relate to work, conflicts of culture or values and ethical dilemmas, power and empowerment (in supervision and in clinical work), and overall workload and organisational issues. Supervisors will need to divide responsibilities for covering these areas between them. The trainee must keep supervision notes for their own use, to include: a record of the date, duration and name of supervisor for each session; brief notes on content and process issues attended to during supervision; a clear record of decisions reached and agreed actions; a summary of any reviews of supervision Planning and Assessing Trainees Performance: Clinical Placement Assessment At the assessment points in each placement period, (mid- and end points of years 1 and 2, and after mid-point of year 3) trainees are required to submit three hard copies of their Clinical Placement Assessment (which comprises the Clinical Competence Goals and Evaluation Form, and the Portfolio of Clinical Experience). This MUST BE submitted by the required deadlines; if not, the trainee risks not progressing through to the next year, or not completing in time. Trainees must also keep their own copies in a ring bound file to retain a cumulative record of all their placement reports to share with subsequent supervisors. The Clinical Placement Assessment is reviewed by the clinical tutor who signs it off as an accurate record for moderation by the module leader (Clinical Director) before reporting to the Examination Board Planning and Monitoring Trainee Experience: Portfolio of Clinical Experience Early in the placement, the supervisors explain and describe for the trainee possible experiences that may be available within their specialism. The trainee and supervisors together review the experiences the trainee has had so far (using the 15

18 Cumulative Record of Clinical Experience within the Portfolio of Clinical Experience). They decide what opportunities the trainee should take up so as to ensure a balanced range of experiences across his or her training overall. These experiences will provide the framework within which the trainee develops his or her clinical competence. The trainee logs his or her experiences within the Portfolio of Clinical Experience. Towards the end of the placement period the trainee reviews their experience with their supervisor(s), and completes the Portfolio Planning and Evaluation of Clinical Competence: Clinical Competence Goals and Evaluation Form Early in the placement, the trainee and supervisors, taking into account the trainee s competence achieved so far, identify trainee strengths, learning needs and goals within each competence area, and agree overall placement aims, using the Clinical Competence Goals and Evaluation Form. Separate goals will be identified by the trainee with both supervisors but these will be drawn together into one document; one supervisor takes lead responsibility with the trainee for making sure these are co-ordinated. The plan is discussed and monitored at the contracting meeting, and reviewed at regular intervals by the trainee and supervisors and at placement visits. Towards the end of the placement period the supervisors complete their assessment of the trainee s performance by recording evidence and qualitative comments on the form, and the trainee adds their own reflections and summary of strengths and learning needs to be carried forward. One supervisor makes the final evaluation of the trainee s performance overall, after discussion with the other supervisor. The draft final Clinical Competence Goals and Evaluation Form should be completed in good time and supervisor and trainee components exchanged about two weeks before the submission date, to enable correction of any factual errors and discussion and mutual comment on the accuracy of the report before signing What is sufficient placement experience? It is impossible to specify what constitutes an acceptable range and amount of experience on any one placement, since opportunities vary and specialties and settings differ in the amount of direct, indirect and interdisciplinary work required. Typically (inclusive of both parts of the placement) a trainee may have between 6 10 or more direct clinical contacts on a 4 day week with individuals, carers, couples, families and/or groups (including contacts via observation of the supervisors work), with associated preparation and interdisciplinary work, along with a varied range of indirect clinical work and project work (including a small scale service evaluation in year one), supervision, report and letter writing; usually three hours or so a week are needed for placement-related reading and literature searching. 16

19 1.12 Monitoring Trainees on Placement Contracting Visit Contracting visits are arranged for all year one trainees and supervisors. At the contracting visit the clinical tutor monitors the placement plans and supervision arrangements; checks that the agreed goals are likely to meet the trainee s needs; ensures that plans are made to address issues identified as requiring attention by the previous lead supervisor in those cases where the trainee received a conditional pass or referred rating; checks that the placement plans seem manageable for the trainee and supervisors; answers questions about relevant programme requirements. The contracting visit should normally be within about a month of the start of the placement. Year two and three trainees will normally contract for the placement with their supervisors and bring any issues to the attention of their clinical tutors. Trainees must send their placement goals as set out on the Clinical Competence Goals and Evaluation Form to their clinical tutor within one month of the start of placement Placement review visits The main purposes of the placement review visits are to: 1. review the trainee s overall progress and to check with the supervisor whether the trainee is on course for passing the placement using the Clinical Competence Goals and Evaluation Form and reviewing experience using the Portfolio of Clinical Experience as a framework; 2. review the supervision agreement and to discuss the liaison between supervisors; 3. adjust goals in the light of progress; 4. make plans about what needs to be carried forward to the next stage of the training; 5. review the adequacy of the placement, in terms of opportunities for the trainee to develop competence and gain experience, access to placement resources, and supervision; 6. check whether the trainee and supervisor are receiving sufficient information and support from the Programme team; 7. give trainee and supervisor(s) individual time with the clinical tutor; 8. set up an action plan if there are any concerns about the trainee s progress. The clinical tutor tries to arrange the meeting at such a time that both supervisors can attend, if more than one are involved in providing supervision, where necessary one supervisor ( the current lead) seeks and reports the views of the other supervisor(s) and provides to them feedback after the meeting. 17

20 If there are concerns about the trainee s performance, or about the adequacy of the placement, an action plan must be drawn up at the meeting, indicating what needs to be done for the trainee s Clinical Competence and Experience to be evaluated as reaching a pass level by the supervisor. Clear arrangements must be set up to monitor the action plan and the trainee s progress, including, if necessary, a final placement visit Monitoring Placement Quality The main (lead) supervisor of a trainee is normally a Clinical Psychologist who has at least two years experience after gaining the qualification and eligibility for HPC Registration as a Clinical Psychologist, and who has clinical responsibilities in the unit in which the work is carried out. In certain circumstances, the main supervision may, at the discretion of the Programme Director or Clinical Tutor, be carried out by a Clinical Psychologist who has at least one year s experience after gaining the qualification and eligibility for HPC Registration as a Clinical Psychologist. When this occurs, the quality and quantity of supervision that is received by the trainee is monitored carefully by the Clinical Tutor at placement visits, and is overseen by an experienced local clinical psychologist. At the discretion of the Programme Director or Clinical Tutor, the supervision of specific aspects of the trainee s work may be formally delegated to a link or subsidiary supervisor who is usually an appropriately qualified and experienced Psychologist who is eligible for HPC Registration as a an Applied Psychologist, or an appropriately qualified and experienced member of another profession, either in one-to-one supervision or as part of a supervisory team. When this occurs, the quality and quantity of supervision that is received by the trainee is monitored carefully by the Clinical Tutor at placement visits and the lead supervisor ensures good overview and integration of the delegated supervision into the trainee s overall experience and progression. New placements are set up through liaison with the Clinical Director. When new placements or new supervisors are identified are within currently used Trusts/Agencies, the initial liaison is carried out via the local Trust Placement Coordinator who ensures that the supervisor meets the criteria above and encourages the supervisor to attend the Managing Learners in Practice supervision training. When new placements are set up with new agencies, the Clinical Director makes direct contact with the supervisor, visiting the placement as necessary and establishes telephone and contact with the supervisor. A new Workplace Agreement is set up between the agency and the University, overseen by a member of the University Placement Quality Development Team. All new supervisors are expected to attend the Pre-Placement Workshop in preparation for the placement, and receive additional support from the clinical tutor via placement visits, with additional time allocated as needed. 18

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