Opinions on the IAPT scheme?

This section is for discussion relating to the Layard report, and subsequent schemes like Improving Access to Psychological Therapies where lower intensity inteventions are offered in primary care
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Spatch
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Re: Opinions on the IAPT scheme?

Post by Spatch » Fri Apr 13, 2012 10:49 am

The other thing that strikes me is the increasing potential use of unpaid labour in IAPT. In the Psychologist Appointments this month there was this advert for voluntary graduates:

http://www.psychapp.co.uk/JobSeeker/Sea ... cyID=14855

Looking for 1 to 2 days a week unpaid, and to justify the necessary training presumably it will need to be for more than a couple of months. I know in fashion, media, arts and politics the structures are now set up to have a rolling stock of fresh graduates come in for a year or so to work for free and it probably wouldn't take too much tinkering to have a similar set up in IAPT for "internships".

What this has done in charities etc has meant most of the entry level posts that used to be paid are no longer paid and the free labour has made everyone else feel far less secure in their work. Also because there are people willing to work free, it has had similar downward drag on pay, as you have to do more and more to justify your salary.

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baa
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Re: Opinions on the IAPT scheme?

Post by baa » Fri Apr 13, 2012 12:08 pm

Urgh. I have tried to type something more profound, but, urrgh.

Someone suggested that a while back in my service, but thankfully it was shot down.
At least I'm not as mad as that one!

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Re: Opinions on the IAPT scheme?

Post by Ruthie » Fri Apr 13, 2012 1:34 pm

Would this happen in physical health care? I'm feeling quite outraged on behalf of clients of these services - we'll get some whipper snapper who is desperate for experience straight out of uni to treat you for free... :evil:
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Re: Opinions on the IAPT scheme?

Post by LIWY » Fri Apr 13, 2012 1:50 pm

Ruthie wrote:Would this happen in physical health care? I'm feeling quite outraged on behalf of clients of these services - we'll get some whipper snapper who is desperate for experience straight out of uni to treat you for free... :evil:
I would imagine that physical health care is considered more "difficult" than mental health.

There was talk of services taking on unpaid honorary PWPs who were paying for their own PG Cert but I don't think anything came of it so far?

Unpaid mental health work in primary care is nothing new - counselling trainees do it all of the time. Admittedly they are often mature career changers rather than straight out of uni but still not necessarily full of experience. I know of several London IAPT services where they state that they offer counselling for depression; people are referred to an agency where the counsellors are people who are building up hours for full BACP accreditation and not getting paid. Actually, it is rare that counselling psychology trainees are paid on placement isn't it? These counselling placements are no easy gig either, lots of referrals of people who are considered unsuitable CBT, perhaps with backgrounds of abuse or interpersonal difficulties.

In that way, so far this has been a good thing about the IAPT scheme, it has meant more paid positions at the entry levels at least which would perhaps raise respect for the work.

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Re: Opinions on the IAPT scheme?

Post by Pink » Sat Apr 14, 2012 9:36 am

Will wrote:Also PWP career development is something that has been discussed at length on this site - I think my response to that is to question why it's IAPT's responsibility? For many, the PWP role will be considered a career in itself. It's an interesting and varied role, with plenty of opportunities for personal and professional development. If people want to apply the skills they develop to chasing other roles (e.g. management, clinical training, HIT) then that's for them to do individually - there's nothing stopping them! You don't hear of people complaining of the lack of a pathway within other jobs (e.g. support work). I think the main problem is PWP roles are often held by young, ambitious psychology graduates, who are looking for an alternative to the AP role in preparing them for applying for CP. The knee jerk reaction to prevent PWPs from applying for HIT without two years experience is, in my opinion, the wrong way to go about it. To encourage them to stay in the role, PWPs should be able to develop within the remit of the role - pursuing interests, training, having opportunity to do promotion and group work etc. - but I think it's important PWPs recognise the differences between the AP and PWP role and not 'expect' a clear career path up the payscale to be laid at their feet. And I say this as a PWP making no secret of my long term plans to pursue CP!
Spatch wrote: We have to accept from an NHS organisational perspective, there is a huge economic pressure on not allowing people to climb up the bands or progress up the ranks. This isn't only for IAPT but for almost every discipline.
So, what is the solution? (Not rhetorical, genuinely don't know... ). Someone needs to come up with an answer though, as I think the sustainability of the PWP role is one of the key issues that needs to address if the IAPT model is going to work long-term.
This is not the answer you are looking for, but the more cynical part of me would suggest that in recruiting PWPs they could start to deliberately target graduates that a) are obviously caring, b) have non psychology backgrounds c) ideally have fairly medicore or below average academic ability, which would preclude them making it onto a DClinPsy and d) don't have the resources to do any costly self funded training that would be an alternative escape ladder out of PWPing (like counselling or other psychotherapies). Sweeten the deal by giving them a more flashy title like "Primary care specialist" and Houston, we no longer have a problem*.

*This is clearly satirical, but I am probably not too suprised if they are thinking of this already.
I think both Will and Spatch highlight a really valid point. There has been much discussion on this board about the lack of career progression in the PWP role, much of which appears to have come from frustrated psychology graduates who chose to take on a funded training position paid for by the NHS to train them to do a particular role, but who appear to regard this role as the newest version of an AP post (and a potential stepping stone to clinical training) rather then a career in its own right. Whilst I understand their frustration I think Spatch's point is valid: this population are perhaps not the 'best fit' in terms of recruiting for the PWP role. Recruiting more widely however is not necessarily a bad thing: in one IAPT service I was aware of the band 5 counsellors had all been made redundant as a result of the service changes, and many of these undertook PWP training and are happy to stay in the role. So they are qualified MH professional happy to stay on a band 5 salary, often older and more experienced than the average psychology graduate. There were also a number of former STR workers recruited: again older people with years of experience working with complex and chronic MH issues, who regarded the PWP role as an opportunity to improve their skills, learn a theroetical framework, gain some career safety and have a clearly defined role. Perhaps services thinking more carefully about recruitment and how PWP training roles are advertised would be a good development for IAPT as a whole.

With regard to the issue of unpaid assistants posts in IAPT-haven't these roles always existed in psychological services? I did a voluntary AP post in a paediatric clinical neuropsychology service in 2001 as an undergrad: fantastic experience and I learned a huge amount. The post that Spatch linked would offer similar opportunities. I appreciate that this brings up different issues about selection/who is able to work for free etc, and that the AP in question would effectively be doing a pwp role for free: my only point is that this has always happen in psychological services and isn't particular to iapt.

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baa
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Re: Opinions on the IAPT scheme?

Post by baa » Sat Apr 14, 2012 12:28 pm

I dont like unpaid posts in any psychological services, so not liking ones in iapt is just an extension of that witn added training ishoos.
At least I'm not as mad as that one!

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Re: Opinions on the IAPT scheme?

Post by nettle » Thu May 03, 2012 11:59 am

There was talk of services taking on unpaid honorary PWPs who were paying for their own PG Cert but I don't think anything came of it so far?
Exeter are about to start a 3 year undergraduate PWP training, so I guess students might need voluntary placements as part of their course?

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Re: Opinions on the IAPT scheme?

Post by LIWY » Sat May 05, 2012 12:40 pm

nettle wrote:
There was talk of services taking on unpaid honorary PWPs who were paying for their own PG Cert but I don't think anything came of it so far?
Exeter are about to start a 3 year undergraduate PWP training, so I guess students might need voluntary placements as part of their course?
That's a new development. Is it starting this year do you know?

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baa
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Re: Opinions on the IAPT scheme?

Post by baa » Sat May 05, 2012 2:33 pm

i was tryin to find that and failed, I was on a useless PC though! I found a broken link referring to an Msc in Pwp stuff however. Stuff? Eloquent baa :lol:
At least I'm not as mad as that one!

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Re: Opinions on the IAPT scheme?

Post by runner7791 » Sat May 05, 2012 4:18 pm

baa wrote:i was tryin to find that and failed, I was on a useless PC though! I found a broken link referring to an Msc in Pwp stuff however. Stuff? Eloquent baa :lol:
Is this it? http://psychology.exeter.ac.uk/undergra ... sychology/

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Re: Opinions on the IAPT scheme?

Post by Peach » Sun May 06, 2012 12:23 am

runner7791 wrote:
baa wrote:i was tryin to find that and failed, I was on a useless PC though! I found a broken link referring to an Msc in Pwp stuff however. Stuff? Eloquent baa :lol:
Is this it? http://psychology.exeter.ac.uk/undergra ... sychology/

That course sounds really good. I think it's a great idea to incorporate PWP training into an undergraduate psychology degree.
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Re: Opinions on the IAPT scheme?

Post by runner7791 » Sun May 06, 2012 12:31 am

Peach wrote:
runner7791 wrote:
baa wrote:i was tryin to find that and failed, I was on a useless PC though! I found a broken link referring to an Msc in Pwp stuff however. Stuff? Eloquent baa :lol:
Is this it? http://psychology.exeter.ac.uk/undergra ... sychology/

That course sounds really good. I think it's a great idea to incorporate PWP training into an undergraduate psychology degree.
I agree, I wish I had had an opportunity to do this (although the entry requirements are probably too high for my past A-level self to have gotten on anyway)

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Re: Opinions on the IAPT scheme?

Post by PsychBrainiac » Sun May 06, 2012 10:12 am

I also think this is a good idea and hope other Universities incorporate PWP training into a UG degree.

It will be very interesting to see pass rate with presumably, a cohort with very little to no clinical experience apart from the clinical placement that is offered within the degree. I also wonder how individuals who have completed the PG (Cert) will feel about the qualification being available within a undergraduate degree. I think the placing of this route differs from the Graduate Certificate where individuals on this route often train alongside side PG (Cert) students. Furthermore, GC students need to have substantial experience to enter the training as they don't have a degree. Some or many of the UG students on this route will not have a degree or substantial clinical experience. The course does have a high entrance AAA-AAB with a science A level at grade A and some GCSE subjects at B grade or higher, however this course is really about clinical competence.

Will be one to watch!
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Re: Opinions on the IAPT scheme?

Post by fledgling » Sun May 06, 2012 3:09 pm

It sounds like a great course. However, one thing that occurs to me is that it won't help the issue of the sustainability of the PWP role, except that services will not have to pay so much to train them. The course still includes enough core psychology content to confer GBC, and has very high entry requirements...so this is going to produce highly academically-able psychology graduates, who will already have clinical experience from their placements and have GBC. These people are even less likely to stick around as PWPs than 'traditional' psychology graduates!

I imagined an undergrad route to being a PWP would be like the undergrad routes into other health professions (nursing, OT, physio, etc), thereby giving a similar professional status to the role and attracting people who like the sound of it for what it is. Incorporating the training into a Psychology BSc will just attract those who want a faster track to clinical training! Though on the other hand, in the 'current climate' it is important that degree courses people are paying a small fortune for provide them with skills that make them employable, and being a nearly-qualified PWP on graduation would be a huge advantage- I'd like to have done it!

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Re: Opinions on the IAPT scheme?

Post by Peach » Sun May 06, 2012 3:57 pm

To be honest I don't think there is much that can be done to retain PWPs so I think incorportating it into undergrad degree is a smart move. I think it's great that psychology graduates will have the opportunity to graduate with the ability to deliver low intenstity therapy, given the expense of an undergrad degree. I think if this became more widespread the money that would have been used for the PGCert training could be used for additional training for PWPs so that they are better skilled and equipped to deal with the medium intensity creep.
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