ACP-UK Supports Clinical Psychologists In North-West in Successful Lobbying Action

  • November, 2018

Question of Inclusion of Clinical Psychology in Supervisory Arrangements for Children & Young People’s Improving Access to Psychological Therapies Programme (CYP-IAPT)

The IAPT programme in England has been hugely successful in training up a large workforce of staff able to provide evidence based psychological therapies for adults, young people and children struggling with depression and anxiety, and an additional strand of work on parenting younger children with behavioural difficulties. This programme focussed initially on Cognitive Behavioural Therapy (CBT) but has expanded to include therapies such as Systemic Therapy, Interpersonal Therapy, CBT for psychosis and parenting interventions based on the Incredible Years programme. There is also a strand of work with children with learning difficulties and/or Autistic Spectrum Disorder.

The IAPT programme has meant that psychological therapies are much more available than they were 10 or 15 years ago and that services are more accessible and accountable. Although the programme has many areas where there is room for improvement, it is quite rightly seen as a success in terms of developing a new workforce and service structure across England. Many of the national leads of the IAPT programme are Clinical Psychologists, as are many service leads, supervisors and course tutors, so as a profession we have had an important part to play in shaping services.

Although there is currently less money available for workforce development than previously, there is a considerable number of new posts being developed in response to the Government Green paper on Child Mental Health. This will result in 9000 new Band 5 schools-based Educational Mental Health Practitioners, employed by the NHS, who will need one hour of supervision per week during their year of training, plus additional clinical supervision once qualified. Many IAPT training courses who are running this scheme have specified that supervisors for this programme need to have a diploma in CBT.

A large number of Clinical Psychologists do not have a diploma in CBT as their doctoral level training has made this additional qualification unnecessary. Typically, Clinical Psychologists can become accredited in CBT with the British Association of Behavioural and Cognitive Psychotherapies (BABCP) without a diploma in acknowledgement of this, provided they have accessed appropriate supervision and Continuing Professional Development (CPD).

This is the case even though many of the IAPT courses, such as the training for Children’s Wellbeing Practitioners and Educational Mental Health Practitioners, and the Enhanced Evidence Based Practice course teach a basic form of CBT that most Clinical Psychologists will be familiar with.

Trainees on the Educational Mental Health Practitioner programmes will be taught Behavioural Activation for Depression, a generic CBT approach to anxiety, and an Incredible Years informed approach to behavioural problems. Some courses will also include emotional regulation and self-harm management. Many Clinical Psychologists will be more than able to offer supervision for this work, particularly after accessing the short supervision courses that come with most of these training strands, which include a reminder about the model of intervention being used.

As it stands a Clinical Psychologist who has BABCP accreditation, or has contributed to the field through research or shown a strong commitment to CBT through their CPD, will be unable to supervise any of these trainees in some of the training regions. Whilst we recognise that some Clinical Psychologists will not have the skills to provide this we believe that there is a risk that the supervisory skills of a large part of the mental health workforce will be unavailable if the current restrictions remain in place.

In the North West, with the support of the Association of Clinical psychologists we have been able to successfully lobby the regional CYP-IAPT development group to ensure that the expertise of CPs is not lost to these training streams and that psychologists who have the right level of skill but who do not have a Diploma in CBT are included in the supervisory workforce.

It is important that Clinical Psychologists working in other regions ensure that local CYP-IAPT committees also acknowledge that many Clinical Psychologists can offer supervision into this new work stream. However, it is also important that Clinical psychologists continue to access relevant CPD and supervision in CBT to ensure that their skill set is up to date and relevant.

Andrew Beck, ACP-UK Member