Committee on Training in Clinical Psychology Criteria for the Accreditation of Postgraduate Training Programmes in Clinical Psychology

Transcription

1 Membership and Professional Training Board Committee on Training in Clinical Psychology Criteria for the Accreditation of Postgraduate Training Programmes in Clinical Psychology October 2008

2 Contents Introduction 3 Accreditation criteria 8 Policy statements of the Membership and Professional Training Board Relevant to the accreditation of postgraduate training programmes 29 Appendix 1: Policy and Good Practice Documents 31 Appendix 2: The Ten Essential Shared Capabilities 34 Appendix 3: The Knowledge and Skills Framework 43 Appendix 4: Guidelines on Clinical Supervision 65 Appendix 5: Supervisor Training 72 Appendix 6: Accreditation criteria checklist 74 2

3 Criteria for the accreditation of postgraduate training programmes in clinical psychology Introduction This document sets out the criteria for the accreditation of postgraduate training programmes in Clinical Psychology. It is based on the policies of the Society concerning postgraduate training outlined in Quality Assurance Policies and Practice for Postgraduate Training, 3 rd edition (Membership and Professional Training Board, June 2005). The Committee on Training in Clinical Psychology (CTCP) has prepared this document for use in the accreditation process on behalf of the Board. The criteria listed below will be reviewed by the Committee on Training in Clinical Psychology in conjunction with the Division of Clinical Psychology s Professional Standards Unit, and in consultation with a variety of stakeholders, normally at least once every five years. The criteria provide guidance for members of visiting teams taking part in the peer-review of Training Programmes and assist the Committee on Training in Clinical Psychology in formulating its recommendations in a way which helps to ensure fairness and comparability in the assessment of different Programmes. It is anticipated that the criteria will also assist in the self-monitoring carried out by the Programmes as they develop to meet changing needs. As such, they form a policy statement by the Society on what programmes should achieve and, by inference, the minimum requirements for clinical psychologists who seek registration as Chartered Psychologists. This booklet is divided into two sections: the accreditation criteria, and the policy statements of the Membership and Professional Training Board. In order to gain accreditation a programme must meet the accreditation criteria, and comply with all relevant policies of the Board. Programmes are also expected to reflect the precepts of the Code of Practice for the Assurance of Academic Quality and Standards in Higher Education (Quality Assurance Agency for Higher Education, ). The Code of Practice is available from the QAA s website, at Programmes should also note the following policy statements of the Committee on Training in Clinical Psychology: 1. The aims of the criteria are to specify minimum standards that programmes should achieve. It is not the intention of the CTCP to reduce the diversity between programmes or impair their flexibility to respond to local and changing circumstances. 2. In reading this document, it is essential to recognise that although the various aspects of working as a competent clinical psychologist are described separately, it is the combination and integration of these components that are particularly important. This is true both for the required outcomes of training and for the process of training. 3. In meeting the requirements of a professional training in Clinical Psychology, programmes should be sufficiently flexible in content and structure to adapt readily to current and future needs and to the emergence of new knowledge in clinical psychology and related fields. They should also play a major part in the identification of such needs and the development of innovative practices. Programmes should refer to the minimum standards which are identified and revised from time to time by the Division of Clinical Psychology s Faculties and Special Interest Groups (SIGs) for guidance in relation to the expected capabilities which a trainee should gain to fit them for work with specific populations and groups. 3

4 4. Higher Education Institutions may offer two or more programmes in the same branch of applied psychology and these will be considered as separate programmes. Statement of Shared Principles in relation to the Quality Assurance of Healthcare Education The Society is a member of the national Partners Forum!"#$ %&'$ ()*+,%-$.//)#*01'$ "!$ &'*+%&1*#'$ '2)1*%,"03$ 4&*%$ 5#")6$ &*/$ *5#''2$ *$ /%*%'7'0%$ "!$ /&*#'2$ 6#,01,6+'/$ %&*%$ )02'#6,0$ 6*#%0'#/8$ 9)*+,%-$ *//)#*01'$ *1%,:,%-3$ 4&'$ /%*%'7'0%$,/$ 6#'/'0%'2$ ;'+"<=$ *02$ %&'$ >"77,%%''$ "0$ 4#*,0,05$,0$ >+,0,1*+$?/-1&"+"5-$ )02'#%*@'/$ %"$ 1*##-$ ")%$,%/$ *11#'2,%*%,"0$!)01%,"0$,0$ *11"#2*01'$ <,%&$ %&'$ 6#,01,6+'/$ 1"0%*,0'2$%&'#',03$A)#%&'#$1"77'0%*#-$"0$%&'$*,7/$*02$";B'1%,:'/$"!$%&'$*11#'2,%*%,"0$6#"1'//$,/$*+/"$ 6#":,2'2$;'+"<3$ Introduction This Statement of Shared Principles is derived from discussion of partnership values at meetings of the Partners Forum for Quality Assurance of healthcare education in It is built upon the QA principles within the National Standard Contract framework agreed between the Department of Health (England) and Higher Education representative bodies, and it is compatible with the Concordats of the Higher Education Regulation Review Group (HERRG) and Healthcare Commission, and thereby with wider government policy on effective regulation. Purpose The identification of Shared Principles in relation to the quality assurance of healthcare education is intended to: 1. Facilitate effective and efficient quality assurance activity that is conducive to the enhancement of the quality of health care education, thereby enriching learners experience and supporting the development of a competent and skilled healthcare workforce. This will in turn enhance the quality of health care provision and ultimately patients experience of care. 2. Ensure that the rationale and values underlying quality assurance processes are clear and transparent. 3. Provide a shared point of reference when considering the appropriateness of quality assurance activity. 4. Provide a basis for delineating areas where partners consider shared interest/action to be appropriate from areas which are identified as being a specific function/responsibility of an individual partner organisation. Shared Principles The quality assurance of health care education seeks to support:! Public safety, through accountability of commissioners and providers and public confidence in the quality and appropriateness of provision! Public choice, through publication of information 4

5 ! Proportional and risk based approaches which offer value for money whilst also assuring agreed standards are maintained! Quality enhancement, through the identification and dissemination of good/notable practice and action plans designed to remedy any shortcomings where identified! Minimisation of burden and duplication through the identification and sharing of existing evidence, where this is available! Parity of practice based education with academic education! Delivery of health care education through effective partnerships! The engagement of learners and service users in quality assurance judgements and processes, thereby informing future education commissioning and quality enhancements, and leading to demonstrable change! Inter-professional learning approaches where two or more professions learn with, from and about each other where possible! Recognising and valuing the different roles, contributions and responsibilities of individual stakeholders involved in quality assuring health care education! Organisational and individual reflection upon and evaluation of the quality of provision The aim of accreditation The aim of accreditation is to secure for potential Chartered Psychologists a high standard of professional education by co-operating with organisations able to provide professional education of the requisite standard. In this context, a potential Chartered Psychologist is a person holding or eligible to hold the Society s Graduate Basis for Registration as a Chartered Psychologist who has been accepted onto an accredited programme. The objective of accreditation Accreditation will ensure that programmes meet the criteria for accreditation devised by the Society s Training Committees under the auspices of their respective Divisions of the Society, and the Membership and Professional Training Board of the Society. Graduates of accredited programmes Statute 12 (3) states that: to be included in the Register of Chartered Psychologists an applicant shall be a Member of the Society and shall both: 1. (i) have passed a Qualifying Examination set by the Society; or 5

6 (ii) have obtained a first degree conferred by a University or the Council for National Academic Awards for which psychology has been taken as a main subject and which is regarded by the Board of Trustees as covering the general areas of psychology at least as broadly as required by the Qualifying Examination referred to in (i) above and to the same standard; or (iii) for graduates not covered under (i) and (ii) above, have such further experience or postgraduate qualifications in psychology as shall assure the Board of Trustees that the applicant has at least as broad a grasp of the general areas of psychology as that required by the Qualifying Examination referred to in (i) above and to the same standard; and 2. since the date of passing the Qualifying Examination or from the first date of becoming eligible for exemption from it under (1)(ii) or (1)(iii) above shall have successfully completed a period of study of, or practice in, psychology, or a combination of both, acceptable to the Board of Trustees and shall be judged by the Board of Trustees to have reached a standard sufficient for professional practice in psychology, the relevant period being of three years duration if full-time or an equivalent period if part-time or such greater period as the Board of Trustees may stipulate. Candidates for registration who have the qualifications referred to in (1)(i), (1)(ii) or (1)(iii) above may be referred to as having the Graduate Basis for Registration. Graduates of programmes which both comply with the above Statute and meet these accreditation criteria will be eligible for Chartered Clinical Psychologist status. All accredited clinical psychology training programmes confer a doctoral award upon successful completion. The following is drawn from the Frameworks for Higher Education Qualifications in England, Wales and Northern Ireland, and Scotland (QAA, January 2001): Doctorates are awarded to students who have demonstrated: i ii iii iv the creation and interpretation of new knowledge, through original research or other advanced scholarship, of a quality to satisfy peer review, extend the forefront of the discipline, and merit publication; a systematic acquisition and understanding of a substantial body of knowledge which is at the forefront of an academic discipline or area of professional practice; the general ability to conceptualise, design and implement a project for the generation of new knowledge, applications or understanding at the forefront of the discipline, and to adjust the project design in the light of unforeseen problems; a detailed understanding of applicable techniques for research and advanced academic enquiry. Typically, holders of the qualification will be able to: a make informed judgements on complex issues in specialist fields, often in the absence of complete data, and be able to communicate their ideas and conclusions clearly and effectively to specialist and non-specialist audiences; 6

7 b continue to undertake pure and/or applied research and development at an advanced level, contributing substantially to the development of new techniques, ideas, or approaches; and will have: c the qualities and transferable skills necessary for employment requiring the exercise of personal responsibility and largely autonomous initiative in complex and unpredictable situations, in professional or equivalent environments. The Committee on Training in Clinical Psychology will ensure that all accredited programmes accord full importance to the issues outlined above. 7

8 What do clinical psychologists do? Accreditation Criteria Clinical psychologists aim to reduce psychological distress and to enhance and promote psychological well-being by the systematic application of knowledge derived from psychological theory and research. Clinical psychology services aim to enable service users to have the necessary skills and abilities to cope with their emotional needs and daily lives in order to maximise psychological and physical well-being; to develop and use their capacity to make informed choices in order to enhance and maximise independence and autonomy; to have a sense of self-understanding, self-respect and selfworth; to be able to enjoy good social and personal relationships; and to access commonly valued social and environmental facilities. Clinical psychology services aim to enable other service providers to develop psychologicallyinformed ways of thinking; to use psychological knowledge to enhance and develop their professional practice to the benefit of their clients; to be able to enhance their sense of selfunderstanding, self-respect and self-worth; and to use psychological data to aid decision-making at a clinical, organisational and societal level. Clinical psychologists also work with staff from other professional groups, including psychological therapists, to develop, monitor and improve practice, basing this on a breadth and depth of understanding of relevant psychological theory, and on the psychologist s evaluative and reflective competencies. Clinical psychologists as scientist practitioners Clinical psychologists are more than psychological therapists. While many do practise psychotherapy at a high level, this is not a skill distinct to clinical psychologists, nor should it be. The background and training of clinical psychologists is rooted in the science of psychology, and clinical psychology is one of the applications of psychological science to help address human problems. The ability to design and carry out innovative applied research is a skill developed to doctoral level in training and is important for the development and delivery of evidence-based practice. In addition, one element of research competence is critical evaluation of research activity. While there are data that support many clinical activities, there are still major gaps in the knowledge base. One of the contributions made by clinical psychologists is the development and testing of new interventions and activities, based on psychological theory. Thus practice feeds and draws on research and theory that in turn influences practice. Clinical psychologists as reflective practitioners Clinical psychologists are cognisant of the importance of self-awareness and the need to appraise and reflect on their own practice. They are also aware of the importance of diversity, the social and cultural context of their work, working within an ethical framework, and the need for continuing professional and personal development. Use of clinical psychology services Clinical psychologists work with individuals, couples, families, groups (therapeutic, staff, informal carers) and at the organisational and community level. They work in a variety of settings, including hospital wards, day centres, Community Mental Health Teams, NHS Trusts, primary and social care contexts and forensic settings, and with all age groups from very young children to older people. 8

9 They work with people with mild, moderate and severe mental health problems, developmental and learning disabilities, physical and sensory disability, and brain injury; people who have substance misuse problems and people with a range of physical health problems (including HIV and AIDS, cancer, heart disease, pain, diabetes). Required capabilities and competencies This section of the document has explained what clinical psychologists do, or in other words, the capabilities they demonstrate by using and applying their competencies and knowledge base. The statements in section 1.1 set out the skills, knowledge and values trainee clinical psychologists need to develop during the course of their training, and, in section 1.2, the learning outcomes that training programmes will need to have in order to enable trainees to achieve these goals. The competencies that clinical psychologists need in order to be able to work in the ways described are outlined in further detail in section 1.3. Section 2 provides additional information on the knowledge base clinical psychologists draw on in their practice. 1. The required learning outcomes 1.1. Programmes must enable trainees to work as clinical psychologists with the range of clients and services specified below 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 as described in the document prepared by the Division of Clinical Psychology (DCP). 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. Programmes that meet these criteria will be considered to appropriately reflect current NHS policies such as The Ten Essential Shared Capabilities (See Appendix 1 for a list of current publications that complement these criteria, and Appendix 2 for further information on The Ten Essential Shared Capabilities). 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 9

10 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, 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. Generalising and synthesising prior knowledge and experience in order to apply them critically and creatively in different settings and novel situations. Demonstrating self-awareness and sensitivity, and working as a reflective practitioner. Ability to think critically, reflectively and evaluatively. Making informed judgements on complex issues in specialist fields, often 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. Exercising personal responsibility and largely autonomous initiative in complex and unpredictable situations in professional practice. Drawing on psychological knowledge of complex developmental, social and neuropsychological processes across the lifespan to facilitate adaptability and 10

11 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. 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 Assessment procedures in which competence is demonstrated will include:! formal procedures (use of standardised psychometric instruments)! systematic interviewing procedures! other structured methods of assessment (e.g. observation, or gathering information from others); and! assessment of social context and organisations. Conducting appropriate risk assessment and using this to guide practice 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 reformulating the problem. 11

12 Psychological Intervention On the basis of a formulation, implementing psychological therapy or other interventions 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 therapeutic techniques and processes as applied when working with a range of different individuals in distress, including those who experience difficulties related to: anxiety, mood, adjustment to adverse circumstances or life events, eating, psychosis and 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-behaviour 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 Evaluation 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. 12

13 Research Identifying, reviewing and critically appraising a substantial body of research evidence which is at the forefront of clinical psychology practice. Understanding applicable techniques for clinical research and advanced academic enquiry, including quantitative and qualitative approaches. Conducting service evaluation and small N research. Conducting collaborative research. Conceptualising, designing and conducting independent, original research of a quality to satisfy peer review, extend the forefront of the discipline, and merit publication: including identifying research questions, demonstrating an understanding of ethical issues, choosing appropriate research methods and analysis, reporting outcomes and identifying appropriate pathways for dissemination. 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 Personal and Professional Skills and Values Understanding of ethical issues and applying these in complex clinical contexts, ensuring that informed consent underpins all contact with clients and research participants. Appreciating the inherent power imbalance between practitioners and clients and how abuse of this can be minimised. Understanding the impact of differences, diversity and social inequalities on people s lives, and their implications for working practices. Understanding the impact of one s own value base upon clinical practice. Working effectively at an appropriate level of autonomy, with awareness of the limits of own competence, and accepting accountability to relevant professional and service managers. Managing own personal learning needs and developing strategies for meeting these. Using supervision to reflect on practice, and making appropriate use of feedback received. Developing strategies to handle the emotional and physical impact of own practice and seeking appropriate support when necessary, with good awareness of boundary issues. Working collaboratively and constructively with fellow psychologists and other 13

14 colleagues and users of services, respecting diverse viewpoints. Monitoring and maintaining the health, safety, and security of self and others Communication and Teaching Communicating effectively clinical and non-clinical information from a psychological perspective in a style appropriate to a variety of different audiences (for example, to professional colleagues, and to users and their carers). Adapting style of communication to people with a wide range of levels of cognitive ability, sensory acuity and modes of communication. Preparing and delivering teaching and training which takes into account the needs and goals of the participants (for example, by appropriate adaptations to methods and content). Understanding of the supervision process for both supervisee and supervisor roles. Understanding the process of providing expert psychological opinion and advice, including the preparation and presentation of evidence in formal settings. Understanding the process of communicating effectively through interpreters and having an awareness of the limitations thereof. Supporting others learning in the application of psychological skills, knowledge, practices and procedures Service Delivery Adapting practice to a range of organisational contexts, on the basis of an understanding of pertinent organisational and cultural issues. Providing supervision at an appropriate level within own sphere of competence. Understanding of consultancy models and the contribution of consultancy to practice. Understanding of leadership theories and models, and their application to service development and delivery. Awareness of the legislative and national planning context of service delivery and clinical practice. Working effectively with formal service systems and procedures. Working with users and carers to facilitate their involvement in service planning and delivery. 14

15 Working effectively in multi-disciplinary teams. Understanding of change processes in service delivery systems. Understanding quality assurance principles and processes. 2. The structure of training 2.1. It is essential that programmes provide a holistic experience of training that enables trainees to develop an integrated set of learning outcomes Programmes must provide a balanced and developmental set of academic, research and clinical experiences throughout training. The academic component needs to provide an integrated curriculum supporting the clinical and research training. The research training needs to be carefully planned and have sufficient time devoted to it to enable trainees to conduct research at a postgraduate level and to be in a position to contribute to the knowledge base of the profession. The clinical experience component of training needs to be delivered within the following framework The parameters described below aim to provide the framework for pathways through training, delineating client populations, clinical contexts and learning outcomes which contribute to a generic training in clinical psychology. It is important to recognise that the scope of clinical psychology is so great that initial training provides a foundation for the range of skills and knowledge demonstrated by the profession. Further skills and knowledge will need to be acquired through continuing professional development appropriate to the specific employment pathways taken by newly qualified psychologists Clinical experience will be gained in service delivery systems that offer a coherent clinical context. This will usually be a setting oriented towards a population defined by age (e.g. child, adult, older people), by special needs (e.g. learning disabilities, serious mental health problems, health-related problems, substance abuse), or by a service delivery focus (e.g. psychological therapy). In addition, clinical experience will be gained in a range of service contexts (primary, secondary and tertiary care, in-patient, out-patient, community), with service delivery models ranging from independently organised work through to integrated inter-professional working Programmes will be expected to structure the training patterns of their cohorts so that they reflect workforce-planning requirements within the NHS. These requirements will be shaped in part by National Service Frameworks and national policies, as well as by evidence of recruitment problems (for example, vacant posts) paying particular attention to specialities which have recruitment difficulties. National standards as set out by the Division of Clinical Psychology s Faculties and Special Interest Groups must also guide training patterns for each cohort of trainees (see Appendix 1 for a list of current documents). Not all trainees will necessarily follow the same pathway through training. Programmes therefore need to ensure, in consultation with local Faculties and SIGs and local placement providers, that across the trainee cohort there is optimum, effective and efficient use of all available placements Clients, services and modes of work: The learning objectives described above need to be demonstrated with a range of clients and across a range of settings. These are not defined prescriptively, and there are multiple pathways through which the required goals may be achieved. The range of clients and settings 15

16 is outlined below, together with an outline of the knowledge base that trainees need to develop to support their practice Clients A fundamental principle is that trainees must work with clients across the lifespan, such that they see a range of clients whose difficulties are representative of problems across all stages of development. In this context, trainees must demonstrate competence to be able to work clinically with:! a wide breadth of presentations from acute to enduring and from mild to severe;! problems ranging from those with mainly biological and/or neuropsychological causation to those emanating mainly from psychosocial factors;! problems of coping, adaptation and resilience to adverse circumstances and life events, including bereavement and other chronic, physical and mental health conditions; and! clients from a range of backgrounds reflecting the demographic characteristics of the population. Trainees will need to understand the impact of difference and diversity on people s lives (including sexuality, disability, ethnicity, culture, faith, cohort differences of age, socio-economic status), and their implications for working practices. It is also essential that trainees work with:! clients with significant levels of challenging behaviour;! clients across a range of levels of intellectual functioning over a range of ages, specifically to include experience with clients with developmental learning disabilities and acquired cognitive impairment;! clients whose disability makes it difficult for them to communicate; and! carers and families Service delivery systems Trainees must undertake substantial pieces of clinical work over a substantial period of time in each of a range of settings, including:! in-patient or other residential facilities for individuals with high dependency needs, both acute and long term;! secondary health care; and! community or primary care Modes and type of work! direct work;! indirect, through staff and/or carers;! work within multi-disciplinary teams and specialist service systems, including some observation or other experience of change and planning in service systems;! work (practice, teach, advise) in at least two evidence-based models of formal psychological therapy. This must include cognitive-behaviour therapy and at least one other evidence-based approach, such as brief psychodynamic or interpersonal psychotherapy, systemic, or integrative interventions.! work with complexity across a range of perspectives, demonstrating flexibility in application of whichever approach is most appropriate for the client or system; and 16

17 ! be critical of their own approach, and aware of how to practice in the absence of reliable evidence, as well as being able to contribute from their work to the evidence base The UK health care context and the application of clinical psychology Trainees work will need to be informed by a substantial appreciation of the legislative and organisational contexts within which clinical practice is undertaken, including for example:! legislation relevant to England and the devolved nations (e.g. Mental Health Act, Mental Capacity Act, Children Act, Disability Discrimination Act, Health and Social Care Act, Data Protection Act, employment legislation, etc.);! Government policy statements (e.g. National Service Frameworks, Ten Essential Shared Capabilities, Knowledge and Skills Framework, etc.); and! organisation of the NHS and social care in England and the devolved nations Where programmes are providing training for the Society s Statement of Equivalence in Clinical Psychology through the accredited programmes route, they must ensure that the quality assurance arrangements pertaining to this aspect of their provision are broadly consistent with those of the main, accredited programme Of the total programme time (exclusive of annual leave), at least fifty per cent must be allocated to supervised clinical experience. In addition, at least ten per cent must be available to trainees for self-directed study throughout the programme. Of the remaining time there must be an appropriate balance between research activity, and learning and teaching, to ensure that the criteria outlined in sections 10 and 11 can be met. 3. Programme specification 3.1. Programmes must have a clear programme specification. This will provide a concise description of the intended learning outcomes of the programme, and will help trainees to understand the teaching and learning methods that enable the learning outcomes to be achieved and the assessment methods that enable achievement to be demonstrated. The programme specification must include the learning outcomes specified in section 1 above Programmes must have a statement of orientations and values that underlie the programme specification. This statement should set out the standards by which the programme wishes to judge its own success The programme specification should be widely discussed and accepted by the major stakeholders in the programme. This will probably be achieved through the various committees and management structures that have been set up to plan, organise and monitor the programme. The content and organisation of the programme must reflect the orientations and values and the programme specification, which will need to be reviewed regularly Each programme must be able to highlight its own particular strengths in order to communicate these to both prospective candidates and the profession as a whole. These strengths might be related to (a) teaching and practice with a particular client group or in a particular clinical setting, (b) teaching and implementation of a particular conceptual model, (c) a discrete area of clinical research or perhaps (d) general all round strength. 17

18 3.5. Each Programme must be able to identify its own limitations and to indicate how it hopes to rectify these. This might include any limitations in providing learning and placement experiences with particular client groups or in particular clinical or service settings, and should indicate the likely impact of this for prospective trainees, commissioners and employers. 4. Staffing resources 4.1. Programmes must be managed by a Programme Director who has been appointed in accordance with the policies of the Membership and Professional Training Board (see p. 31 of this document), who has the programme as his/her major commitment and is free to devote sufficient time to ensure its effective and efficient running, or by more than one Programme Director, each of whom have been appointed in accordance with the Board s policies, and who together devote a substantial amount of time to it Leadership of a programme requires appropriate academic, clinical, research and managerial skills and experience, and knowledge of clinical psychology training. This would normally mean that the Programme Director would have at least Senior Lecturer status or an equivalent level. It is also acceptable to appoint Joint Directors, each with appropriate seniority and balance of requisite skills When making appointments to senior academic or programme-related NHS posts (Senior/Principal Lecturer and above, or Consultant NHS posts), appointment processes must give due consideration to academic, clinical and research expertise as appropriate to the person specification for the post. Appropriate use must be made of external assessors (e.g. National Assessors) Programmes must ensure that all newly appointed staff have adequate induction and support arrangements to ensure that staff meet criteria for institutional probation requirements Programmes must ensure there are appropriate staff appraisal and review systems, support for staff development and training and appropriate polices and procedures for promotion and reward Programmes must have adequate staffing to provide effective training that fulfils all the CTCP criteria. This means sufficient staff with enough time allocated to carry out the required tasks: management; teaching; organising, co-ordinating and monitoring clinical placements; training and supporting supervisors; research supervision; assessment and monitoring of trainees; and liaison with NHS staff. In particular, staffing levels must be such that trainees receive research supervision at a level consistent with the programme s aims and that research supervision loads for staff are appropriate to enable them to provide adequate supervision at the required level. The Programme Director(s) should ensure that the academic, clinical and research components of the programme are appropriately co-ordinated. Where staff have other duties (e.g. undergraduate teaching or clinical commitments) these must be taken into account in setting staffing levels and must be such that they do not interfere with the execution of the major responsibility of programme delivery The programme team (Programme Director(s) and those staff with a major commitment to the programme) must have an adequate range of skills and experience in order to fulfil the tasks identified in 4.6. The selection of staff must ensure that an appropriate balance is maintained in terms of staffing resources for the various components of the programme Clinical psychology members of the programme team must be involved in regular professional activity that has relevance to the training scheme. Across all programme staff this would 18

19 include a combination of direct client contact, clinical research and organisational work. Where this includes work in the NHS, staff must hold full or honorary contracts with the NHS organisations in which they work. For all clinical staff, it is important that clinical work is recognised and supported by their employers The programme must have adequate administrative and clerical support. 5. Physical resources 5.1. Programmes must have an academic base providing adequately sized and accessible teaching rooms clearly identified for the trainees regular (although not necessarily exclusive) use, including offices for individual tutorials and adequate audio-visual equipment Staff must have adequate office accommodation and equipment for the efficient and effective delivery of their duties Programmes must have access to good library services to facilitate trainees private study. Trainees must have access to appropriate computer hardware and software. There must be access to adequate office equipment to support the efficient running of the programme When trainees are on clinical placements they must have access to (at least) a shared office and telephone with their own desk on placement days. There must be adequate arrangements for secretarial and IT support for their placement work, and trainees must be given guidance on the facilities available. 6. Organisation and governance 6.1. The overall organisation of the programme (for both full-time and part-time programmes) must ensure the effective planning, delivery and monitoring of the programme. Whatever the structure, it must be sufficiently clear to work effectively There must be a clear channel of accountability for the work of the Director(s), acceptable to both the academic institution and the local NHS psychologists. A programme based in a University must be regarded as a joint enterprise between the NHS and the services associated with the programme and other relevant stakeholders The programme must have a Programme Board/Training Committee on which the Director(s), teaching staff, clinical supervisors, DCP Faculties and Special Interest Groups, heads of services, trainees, and purchasers of training are represented in a way that reflects the joint enterprise upon which the programme is based. The Programme Board/Committee must have a written constitution and terms of reference. It must ensure that the interests of the different stakeholder groups are respected; it must be involved with the overall policy of the programme and the long-term objectives, and should oversee the work of the programme team and any sub-committee structure. It must be acceptable to the different groups involved in the programme and have wide support Programmes must work collaboratively with service users, carers and community representatives to identify and implement strategies for the active participation of these stakeholders in the programme. These strategies, and the practical support available to implement them, must be acceptable to the different groups involved in the programme and have wide support. 19

20 6.5. Programmes will normally be associated with a particular geographical area and it is expected that the major part of the funding, teaching and placement resources required by the programme will be provided from that area. Development of any new programme or a major change in any existing programme (which could affect other existing programmes) must be made in consultation with other programmes and local psychologists within the area to avoid impairing the viability of existing programmes. Such consultation must be undertaken from the earliest stage of programme development Funding arrangements must be clear and transparent. Programmes must have sufficient core funding, such that there is normally an agreed minimum number of funded places in order to ensure stability and predictability in planning the programme. The budget must include funding adequate for agreed expenditure. The budget should be held by the Programme Director(s), or if there are other arrangements they must be clear and acceptable to the Programme Director(s), Programme Board/Committee and purchasers. The programme must have a financial plan detailing the funding available and how resources are/will be allocated. When a programme is expanding it is essential that the necessary additional resources required are identified and agreed with the purchasers before new trainees are accepted on to the programme. Similarly, any contraction of a programme must be managed in a clear and transparent way Programmes must have a means of identifying complaints and grievances, and mechanisms through which such difficulties can be satisfactorily resolved. In cases where complaints or grievances are upheld, Programmes should be able to offer individual redress and / or to change current systems or practices, and to make these changes known There must be a recognised structure for reviewing the programme on a regular basis and this must include consultation with relevant stakeholders. The review must include responses to reports of external examiners, monitoring the achievement of programme objectives, drop out rates, retention in the NHS and financial arrangements. 7. Selection and employment 7.1. The information available to potential applicants, for example in the Clearing House Handbook, must include details of entry requirements, an outline syllabus, types of clinical placements available, fees and other expenses, including those incurred in the course of clinical duties, and whether the programme has been approved by The British Psychological Society. There must be a clear statement of whether there are any special contractual obligations to funding bodies either during training or after completion of training. Programmes that offer unfunded places must have an explicit statement available to candidates of the full cost of training. This must include information about the local cost of living Both teaching staff and clinical supervisors must be fully involved in the selection of trainees. There must be opportunities for short-listed applicants to meet existing trainees Trainees should normally be paid on Agenda for Change terms and conditions or equivalent. Where this is not the case, funding bodies need to ensure that the pay of trainees is sufficient to enable them to meet training requirements, and the Programme Board/Committee must regularly review the situation The same selection criteria must apply to all applicants of each programme, however funded Institutions must have clear regulations demonstrating how partially qualified candidates whose prior learning is accredited via the Society's admissions processes (e.g. following 20

21 application to the Committee for the Scrutiny of Individual Clinical Qualifications), or the HEI itself, are accepted onto the programme. All such learning must have taken place after the candidate was eligible for GBR Programmes must have in place documentation detailing their selection procedures. This may include, for example, the evaluation criteria used at the shortlisting and interviewing stages. All criteria used in selection must be compatible with the aim of producing trained psychologists of the highest quality. Selection procedures must not discriminate between candidates on the grounds of gender, age, sexual orientation, ethnic origin, religion, creed or disability Programmes should take active steps to widen access to entry to the profession of clinical psychology, aiming for diversity within trainee cohorts, and must produce documentary evidence of these strategies. Programmes must periodically review their entry requirements and the ways in which potential to achieve competence is assessed at selection, to ensure that these are consistent with the overall aim of widening access to the profession, and are not discriminatory Programmes must ensure that those who are selected undergo appropriate checks (e.g. police and medical) as required by the employer and statutory requirements, NHS directives or any national guidance The Programme Director(s) must ensure that any additional honorary contracts that are required for trainees above and beyond their contracts of employment are in place at the appropriate juncture. This may include, for example, contracts that are required if trainees are undertaking clinical placements or research outside of their employing Trust, but will be dependent upon local circumstances. Trainees who are not NHS employees must hold honorary contracts or a letter of access with the appropriate NHS Provider, issued before they take up their appointments, and with other agencies where applicable. 8. Clinical experience 8.1. The aims of clinical placements are to ensure that trainees develop their core skills through experiences with different client groups and have a full range of psychological work in health and other settings. Requirements for this are described in section 2 above, which outlines the structure of training in terms of clients, services and modes of work. Trainees must gain an understanding of the psychological services in which they are working and the NHS generally. In addition there is an important need for setting the experience of clinical practice in as wide a range of social and cultural contexts as possible The national standards as set out by the Division of Clinical Psychology s Faculties and Special Interest Groups (see section 2.5) will provide the reference information for the minimum supervised practice commensurate with competence in an area of work. Based on this reference information programmes must develop, in consultation with local psychologists, their own guidelines on required experience, recommending an appropriate amount of clinical work. Programmes must identify gaps in placement experiences provided, both individual and across the trainee cohort, and plan how they will structure the pattern of clinical training to overcome any deficiencies Programmes must ensure that each trainee has a balanced programme of clinical experience building up over the course of their training. Each trainee must have a set of clinical placement experiences that enables them to gain a range of clinical experience and achieve the learning outcomes described in sections 1 and 2 of this document. The length of time in a placement, 21