JOB DESCRIPTION. Clinical Psychologist Principal, Adult Learning Disability



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JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Clinical Psychologist Principal, Adult Learning Disability Department(s): Psychological Services Job Holder Reference: MHS301 No of Job Holders: 1 2. JOB PURPOSE The post holder is required to: Provide specialist psychological services to adults with learning disabilities in the Scottish Borders. Participate in the multidisciplinary services as a part of Psychological Services to the Scottish Borders Learning Disability Service. Undertake Research and Development activities, including clinical audit. Plan and organise complex assessment and treatment plans, requiring reformulation and adjustment on an ongoing basis Formulate, re-formulate and adjust complex interventions, care packages and wider service provision to meet changing clinical, organisational and service needs, both within and across professions and agencies.

3. ORGANISATIONAL POSITION See attached organisational chart 4. SCOPE AND RANGE The post-holder has responsibility for: Providing specialist clinical psychology services directly and indirectly to adults with learning disabilities. Clinical responsibility for own work and vicariously for supervised staff. Administration and utilisation of expensive test equipment used within the psychological service, highlighting to line manager when stock needs replenishment. The safe use of equipment other than which they personally use across a range of work environments, including NHS, statutory and voluntary provider services and people s homes. Planning and organising work of trainee clinical psychologists. Liaison with other clinicians in adult learning disability services over ongoing service provision and management of clinical cases. Liaison with other staff in Mental Health, statutory and voluntary provider services, Child Health, and Education. Expert consultancy to and training of other health professions and agencies. Carrying out and supporting applied research and development within adult learning disability services. The post-holder is managed by the Consultant Clinical Psychologist/Head of Learning Disability Specialty.

5. MAIN DUTIES/RESPONSIBILITIES The post-holder has responsibility for: Specialist psychological assessment, treatment and management of complex mental health problems and learning disabilities. Determining eligibility for adult learning disability services. Provide assessments of capacity used to inform decisions under the Adults with Incapacity (Scotland) Act 2000 and Sexual Offences (Scotland) Act 2009. Planning and organising the delivery and adjustment of complex intervention plans requiring formulation and re-formulation as required. Creating and maintaining clinical records. Providing highly specialist advice, consultancy, supervision and training to colleagues within Health, Social Work and provider services on treatment and management of individual adults with learning disabilities. Training trainee clinical psychologists on the University of Edinburgh/NHS (Scotland) doctoral training programme. Providing training placements for trainee clinical psychologists on the University of Edinburgh/NHS (Scotland) doctoral training programme. Auditing and evaluating the use of psychological services for adults with learning disabilities. Working within guidelines, policies and procedures laid down by, e.g. the Health Professionals Council, the British Psychological Society, NES, SIGN guidelines. Undertaking ongoing advanced training and study. Participation in the planning and organising of own continued professional development according to professional standards. Supervision of other qualified clinical psychologists, trainees and assistants. Developing clinical programmes and training staff across agencies in the use of psychological techniques and interventions. Designing, carrying out, disseminating, reviewing, applying and supervising research across Adult Learning Disability Psychological Services in conjunction with colleagues in other areas on an ongoing basis, as well as with colleagues in other agencies e.g. Mental Health or Child Services. Providing expert advice and support to others in relation to research methodology and statistics. 6. SYSTEMS AND EQUIPMENT The post holder is required to: 1. Use a range of formal psychometric tests measuring: Neuropsychological functioning Developmental functioning Adaptive functioning Mood and emotional state Specific behaviours

The post-holder is responsible for the care and maintenance of expensive and specialised psychological assessments across a range of settings. 2. Manage routine records of: Clinical work and outcomes Patient contacts Referral rates Waiting times Staff appraisal 3. Use a personal computer including fluency with the following: Word Excel Powerpoint Outlook Statistical programmes The post-holder is responsible for using computer software to develop or create documents, reports and training materials. 7. DECISIONS AND JUDGEMENTS The post holder is required to: Judge how best to assess and formulate complex psychological problems presented by clients, their carers and other professionals and agencies. Interpret performance and scores on psychometric tests. Based on multi-factorial assessment outcomes, decide which treatment or management approach is indicated for each particular client and how to implement this. Determine what the goals of each individual s treatment should be. Evaluate and adjust the focus and direction of ongoing assessment and therapy/management throughout contact with clients, their families and carers and other professions and agencies. Determine when therapeutic input should cease in each case, based on the particular evidence base and the best use of available resources for that case. Decide how best to report the outcomes of psychological assessments to other professionals and agencies. Decide how and when to work jointly with other professionals and agencies. Assess risk and work in compliance with statutory adult and child protection policies. Make assessments utilising a wide range of sources and theoretical models including statistically complex psychometric procedures.

8. COMMUNICATIONS AND RELATIONSHIPS The post-holder is required to: Provide and receive complex information from and to multiple sources (including clients, carers, families, other Health and Social Work colleagues, Education; as part of specialist multi-disciplinary team, which only accepts referrals for the most complex, specialist cases. Carry out and integrate information from highly specialised, multi-disciplinary, multiagency assessments in relation to all of the above. Communicate complex information to a range of people and agencies that is also highly emotive and disturbing on a frequent basis because it relates to areas such as abuse of adults with learning disabilities (physical, sexual and emotional), serious mental health and behavioural problems, adult and child-protection, selfharm, neglect etc. Communicate complex information to adults with learning disabilities and services e.g. in relation a client s mental health or behavioural problems, abuse or self-harm. Communicate information to which there may be significant barriers to others accepting it e.g. due to psychological denial, inadequate resources, conflicting policies and philosophies. Provide expert opinion to Learning Disability Services, Social Work, Mental Health Services and other Health colleagues. Respond in a sensitive and expert way to hostility (which can occur within clinical sessions and multi-disciplinary, multi-agency meetings), abuse and threats / actual suicide attempts and self-harm within clinical sessions. Work in a highly skilled way in a specialised Learning Disability Service, developing, delivering and evaluating predominantly verbal therapeutic interventions. The highly sensitive, complex, severely challenging and emotive nature of the difficulties experienced by the adults with learning disabilities referred to the services require the highest level of communication skills. Referrals will be for adults with severe challenging behaviour (e.g. aggression, violence, damage to property, sexually inappropriate behaviour) and serious mental health problems (e.g. psychosis, long-term or severe depression and anxiety, history of sexual and physical abuse, self-harm), who require to be seen by highly specialist services. Disseminate complex information by undertaking research. The post-holder is required to engage in routine communication by: Telephone Letters E-mails Face to face one to one, small groups and large groups Multidisciplinary and multi-agency meetings The post-holder is required to engage in functional relationships with: Multidisciplinary clinical team colleagues peers/co-workers

Specialist clinical learning disability psychology staff managing, supervising and supporting Consultant psychologist being managed, supervised and supported Trainee clinical psychologists providing clinical training and supervision Clients and their families and carers assessing, explaining, discussing and communicating about their problems and their treatment Referrers of clients liaison, reporting back, collaboration Other professionals and statutory agencies joint working, liaison, expert advice Fellow psychologists locally departmental business, shared training Fellow Special Interest Groups, peer supervision and national psychologist committees membership of Adult Learning Disability Psychology Special Interest Groups 9. PHYSICAL DEMANDS OF THE JOB The post-holder is required to: Drive for up to an hour and a half at a time at least once during most working days. Remain seated for periods of up to 2 hours when with patients. Administer practical tests of ability following very precise procedures. Have formal training in physical intervention techniques due to working with adults who have severe challenging behaviour; aggression; self-harm; violence. Operate within strict physical intervention/health and safety guidelines in relation to the above. Carry out psychometric testing requiring the simultaneous operation of complex physical skills i.e. timing, physical manipulation of test materials, scoring, giving instructions, engaging with the client. The majority of the tests require doctoral level training as a clinical psychologist and have to be carried out according to a strict protocol to ensure validity and reliability. The outcome of these tests have serious implications in terms of diagnosis and access to services. Carry out interventions and assessments, which involve actively engaging with adults with learning disabilities. This requires to be done within a therapeutic, theoretical and developmental context. Carry out naturalistic observations in a range of settings, requiring the need to be unobtrusive and responsive to the physical environment. This can involve responding to unpredictable and sometimes dangerous patients. Maintain physical fitness in relation to carrying out individual therapy, working with adults with learning disabilities. Carry out assessments and interventions, which require physical activity. Carry heavy and bulky items i.e. lap-top computer, brief cases containing case-files and psychological test equipment (which is in excess of 15 kilos). This needs to be manoeuvred in and out of a car and transported to clinics and community settings. Parking restrictions may mean that it is necessary to walk a considerable distance carrying these heavy items.

Drive for long distances across a large, rural area. This involves negotiating singletrack roads and hilly terrain. It requires the post-holder to safely negotiate snow, ice, fog and other adverse weather conditions while maintaining punctuality for appointments. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB The post-holder: Has an ongoing requirement in relation to physical intervention to deal with selfharm, aggression, severe challenging behaviour e.g. kicking, punching, spitting. Has an ongoing requirement to undertake protective strategies and avoidance measures to ensure the safety of self, the client and others. Can be exposed on a frequent (at least weekly) and ongoing basis to highly distressing and emotionally charged circumstances including clients: communicating suicidal intent, engaging in and reporting extreme self-harm, engaging in violence, aggression and threats of aggression, reporting abuse (physical, sexual and emotional), displaying symptoms of serious and complex mental health problems, family break-down, neglect, severe challenging behaviour, serious crime. Is required to disclose all of the above, where appropriate, to carers, staff and other responsible professionals. Is required to supervise and support other staff, who are exposed to similar distressing circumstances. Is required to work therapeutically with individuals who display regular and extreme severe challenging behaviour. Deals with regular and frequent hazards in the form of physical aggression and threats of aggression from patients and carers. Works within the homes of distressed, learning disabled and mentally ill patients, with no physical back-up, where behaviour is unpredictable and the setting can t be controlled. Deals with actual and/or threatened contact with bodily fluids including patients spitting, biting and spilling blood due to self-harm, urine, faeces, lice, fleas, body odours and dirt. Is at risk of being attacked in community setting by uncontrolled pets e.g. dogs. May be exposed to threat to self and property when entering deprived areas. Has an ongoing requirement in relation to physical intervention to deal with selfharm, aggression, severe challenging behaviour e.g. kicking, punching, spitting. Has an ongoing requirement to undertake protective strategies and avoidance measures to ensure the safety of self, the patient and others. Faces emotionally distressing situations on an ongoing and frequent basis as previously outlined. Is at risk of exposure to false allegations.

11. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB The post-holder is required to have: Undergraduate honours degree in Psychology Postgraduate doctoral training in Clinical Psychology Teaching and training knowledge and skills Mature communication and interpersonal skills Awareness of relevant NHS strategies and policies Research and audit skills Planning and organisation skills Care Planning and Co-ordination skills Self-management skills There is a requirement for ongoing development of specialist knowledge and skills in the following areas: Adult learning disability, mental health, developmental disorder. The post-holder is required to undertake ongoing advanced training and study e.g. risk assessment, challenging behaviour. The supervision of other qualified clinical psychologists. Research relating to the service i.e. evidence-based practice and to demonstrate the theoretical underpinning of service provision in relation to Adult Learning Disability Services. Planning and organising own continued professional development.

NHS Borders Person Specification Post Title Clinical Psychologist Principal, Adult Learning Disability (Band 8A) Post Reference Number : MHS301 Person Specification Criteria QUALIFICATIONS & TRAINING Essential Desirable Postgraduate Doctorate in Clinical Psychology. Registration with the Health & Care Professions Council Other CPD related to adults with learning disabilities and complex psychological and mental health difficulties. EXPERIENCE Essential Experience of working with adults with learning disabilities who present with complex psychological and mental health difficulties and in cognitive testing. Experience/awareness of models/ approaches to developing psychological care in a learning disability setting. Desirable Experience in team working in multi disciplinary team/ multi agency settings including learning disability services. Evidence of consultation skills in learning disability services. KNOWLEDGE Essential Knowledge of psychological theory and therapies relevant to adults with learning disabilities and complex psychological and mental health difficulties and understanding of neuropsychological functioning and appropriate selection of psychometric tests. Knowledge of psychological theory as applied within the wider learning disability setting. Desirable Knowledge of evidence-based psychological therapies for people with learning disabilities and psychological intervention for people with learning disabilities and severe challenging behaviour. COMPETENCIES & SKILLS Essential Desirable Psychological assessment, formulation and treatment. Neuropsychological assessment and analysis. Research and audit. Ability to manage and relate well to adults with learning disabilities and psychological difficulties. Ability to communicate highly complex information to other clinicians, professionals and families/carers involved in the patient s care. Driving license required. Training in supervision of Trainee Clinical Psychologists. Delivery of supervision and training to other health professionals. PERSONAL CHARACTERISTICS AND OTHER Essential Desirable Ability to work as part of a multidisciplinary team. Self motivated to achieve optimum outcomes for clients and their carers. Self-awareness of the emotional impact of clinical practice. Self-assured, enthusiastic, good problem-solving skills.

TERMS AND CONDITIONS Grade and salary: Hours of work: Annual leave: Public Holidays: Band 8a, 39,632-47,559 per annum Permanent 18.75 hours per week 27 days per annum Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbooks. 8 days per annum on dates designated by NHS Borders Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbook. Superannuation: The post-holder is entitled to join the NHS superannuation pension scheme. If Unsuccessful: If you have NOT heard from us within 4 WEEKS of the closing date, then we regret that your application has not been successful on this occasion. However, we appreciate your interest in working with NHS Borders and your time and effort in completing the application form. We would welcome your application for future posts. Equal Opportunities: In NHS Borders, we believe that all staff should be treated equally in employment. We will not discriminate against any member of staff, or job applicant, on grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Trade Union membership. Disclosure checks: We carry out criminal record checks on new staff who fall within certain staff groups within NHS Borders, through Disclosure Scotland. We send out Disclosure Forms to all shortlisted candidates for these staff groups, and ask for these to be completed and returned at interview. If a successful-at-interview candidate forgets to bring their completed form to interview, then they will be required to return the form (and proofs of identity) within 7 days, otherwise the provisional job offer will be withdrawn. Unsuccessful candidates forms will be shredded. The Rehabilitation of Offenders Act does not apply to this post. Tobacco policy: We have a Tobacco policy in place. When selecting staff, we do not discriminate against applicants who smoke, but staff must observe our policy on smoking.

Hepatitis B: We offer Hepatitis B immunisation through our Occupational Health Service (OHS). If you think you may be at risk of contracting Hepatitis B through your job, you should ask for this immunisation at OHS. If your work involves exposure-prone procedures, you must keep to the document Protecting Health Care Workers and Patients from Hepatitis B, and the NHSiS Management Executive Directive on this issue. You must be immune to Hepatitis B, and if you cannot prove that you are immune, OHS will investigate to find out whether you are Hepatitis B positive or not. Health and Safety at Work: You must look after the health and safety of yourself and anyone else who may be affected by what you do at work. You must also co-operate with us to make sure that we keep to legal and organisational safety regulations. You can get more information from the NHS Borders Health & Safety Adviser. The closing date for completed application forms is: 5pm on Thursday 15 January 2015