University of Sheffield Doctor of Clinical Psychology Log Book: Core Competencies and Experiences 2013 Trainee Name ----------------------------------------------------------------- Aug 2013 1 7.5 Core Competencies and Experiences Log Book: Overview of Training Progression Contents 1. Introduction to the Log Book 2. Clinical Learning Objectives (broad) 3. A Guide to Developing Core Competencies 4. Sources of Information for Completing the Core Competencies Log 5. Instructions for Completing the Core Competencies Log 6. The Core Competencies Log 7. Instructions for Completing the Log of Placement Experiences 8. The Log of Placement Experiences Aug 2013 2 7.5 Introduction The purpose of this core competencies and experiences log book across placements is for you to be able to: 1. Track experience and acquisition of core competencies and experiences across the three years of training in order to ensure that BPS requirements are met 2. Track identified learning needs across training The log book can help identify gaps in your experience and competency development which can help in placement planning. It can also help external assessors to evaluate the learning experiences and competency developing we are providing on the programme. The log book is organised as follows: The first document outlines the broad definitions of the twelve clinical competency areas (Relationship Building, Assessment, Formulation… etc) that trainees are expected to achieve by the end of training. Guidance is then provided to help gain clarity around the expectations regarding competency development across the three years. Some sources of information that can be utilised to rate competency development are given. Instructions for how to complete the Core Competencies Log are given before the Log for completion at the end of every placement. The final document comprises the Log of Placement Experience with guidance for completion. It is the trainee’s responsibility to ensure the Log Book is completed at the end of every placement. Clinical tutors and supervisors can aid this process. Aug 2013 3 7.5 Clinical Learning Objectives (Broad) Relationship Building The trainee clinical psychologist should be able to facilitate and maintain a therapeutic alliance with clients, carers, groups and staff, and manage challenging situations. Psychological Assessment The trainee clinical psychologist should be able to select, administer and interpret psychometric and idiosyncratic assessments, including risk assessment. Psychological Formulation The trainee clinical psychologist should be able to develop and use formulations to prepare an action plan and reformulate in light of further information. Psychological Intervention The trainee clinical psychologist should be able to make theory - practice links, and adapt interventions within differing theoretical models to individual needs. Evaluation The trainee clinical psychologist should be able to evaluate the effectiveness of interventions, audit clinical practice and critically appraise pertinent research evidence. Communication The trainee clinical psychologist should be able to write and give oral reports of work undertaken and adapt style of communication to specific? requirements of the audience. Service Delivery The trainee clinical psychologist should be able to demonstrate knowledge of the organisational setting and the need to work collaboratively with other professionals, colleagues and service users. Teaching and training The trainee clinical psychologist should be able to plan formal and informal teaching and training sessions appropriately, facilitate the co-operative engagement of the training group and monitor effectiveness. Diversity The trainee clinical psychologist should be able to understand and respect the impact of difference and diversity upon self and others and use this awareness to inform their work. Aug 2013 4 7.5 Personal and Professional Development The trainee clinical psychologist should be able to demonstrate a range of personal development strategies and professional attitudes and behaviour. Supervision The trainee clinical psychologist should be able to prepare effectively and engage in the supervisory process. Research The trainee clinical psychologist should be able to conduct appropriate research and to carry out service evaluation. Aug 2013 5 7.5 Guidelines for the Development of Core Competencies Each trainee starts the programme with differing experiences and levels of competency. Each trainee has to demonstrate their competence in all areas on the programme. However, because of their previous experience, knowledge and skills it may be easier for some trainees to develop some competencies and for other trainees to develop others. There is not therefore a universal route in the development of core competencies, and the focus is on the individual training needs of the trainee. This document aims to develop some guidance for the development of competencies, rather than a prescriptive route. There is also an expectation that upon qualification competencies will develop further in line with continued professional development. Within the individual training pathway there are some expectations about the development of core competencies. The following offers some guidance around the 12 competency areas. 1. Relationship Building In Year 1, trainees should be able to demonstrate their ability to build and maintain relationships with service users with complex needs. Trainees should have some experience and understanding of personal and professional boundaries, the significance of endings in therapy and of challenging situations (e.g. being an object of negative transference). In Years 2 and 3 the trainee should be able to increasingly form and maintain relationships with individuals and groups (service users, carers, multi-disciplinary staff, medical teams) and within more complex, multisystemic situations. Throughout there is an expectation that trainees will develop good enough working relationships with their supervisor and other colleagues, aiming to understand and resolve ruptures where they may arise. 2. Psychological Assessment In Year 1 trainees are expected to conduct a clinical interview/ conversation and jointly construct and make meaning of an individual client’s personal history. Trainees should demonstrate some ability in the use and interpretation of different assessment methods (interview, psychometrics, questionnaires, cognitive/neuropsychological assessment) and show an awareness of the assessment and management of potential risk to clients and to others. In Years 2 and 3 trainees should demonstrate an ability to conduct assessments in more complex situations (e.g. groups, systems). Trainees should be able to creatively design, use and interpret a wider range of assessments and show an ability to assess and manage risk in complex situations. As a minimum requirement, trainees need to have administered, scored and appropriately fed-back the findings from a Wechsler Adult Intelligence Scale (WAIS), Wechsler Aug 2013 6 7.5 Intelligence Scale for Children (WISC) and a memory test in a clinical setting by the end of training. 3. Psychological Formulation Year 1 trainees should demonstrate their ability to formulate within one therapeutic model or psychological approach (e.g. CBT, CAT) in complex situations and use this formulation with clients to inform the work. Some creativity and flexibility in formulating and reformulating in light of further information should be demonstrated. Year 2 and 3 trainees should formulate (and reformulate) flexibly and creatively within two or more psychological models or approaches. This may require taking an integrated approach with more complex situations (e.g. groups, systems). Throughout there is an expectation that formulations will incorporate a variety of factors (including interpersonal, societal, cultural and biological perspectives) and be actively shared where appropriate as an aid to interprofessional learning. 4. Psychological Intervention Within Year I trainees are expected to carry out interventions within one psychological model or approach with people with complex clinical presentations. An awareness of theory-practice links and the importance of endings in therapy should be demonstrated. Within Years 2 and 3 trainees should show the ability to be able to intervene creatively and innovatively using a number of different psychological models and approaches, with people with more complex clinical presentations. Trainees should show an increased ability to assess when further intervention is appropriate and not appropriate and communicate this clearly and sensitively to others. Trainees should demonstrate an ability to work collaboratively with, and indirectly through, others (e.g. staff, carers). Throughout their training trainees should demonstrate an awareness of local and national guidelines and best practice in relation to the development of psychological interventions. 5. Evaluation In Year 1 trainees should show an awareness of the appropriate methods to evaluate their clinical practice. Trainees should show ability in the use of individual and departmental auditing procedures and should be critically aware of the relevance of research evidence to clinical practice. In Years 2 and 3 trainees should show an increasingly creative and sophisticated ability to use and interpret evaluation procedures. Trainees should demonstrate an understanding of the range of research and evaluation methods that may be applied to clinical practice at an individual and service level, their purposes, advantages and disadvantages. 6. Communication Throughout the three years of training there is an expectation that trainees will produce clear and timely written and verbal reports of their clinical work in a range of formats. It is expected that information will be Aug 2013 7 7.5 communicated in a style appropriate to a variety of audiences, and with people with a wide range of cognitive functioning and communication needs. Trainees are required to keep appropriate notes and/or use electronic information systems. Trainees are expected to maintain good lines of communication with their supervisor and other colleagues. In Year 1 communication will usually concern complex situations and there will be a need for feedback and for the trainee to use this feedback effectively. In Years 2 and 3, communication will generally involve more complex systems. 7. Service Delivery Year 1 trainees should show an understanding of the organisational setting, professional roles of teams members (including the psychologist) and be able to contribute to inter-professional and where possible multidisciplinary work. Year 2 and 3 trainees should show an increased understanding of team structures and effective team functioning through theoretical knowledge of group dynamics. Trainees should work effectively in and with a number of different systems, organisations and contexts relevant to the client(s). It is expected that trainees will make a significant contribution to inter-professional and multi-disciplinary team activities and work effectively with service users and carers to facilitate their involvement in service planning and provision. Trainees should demonstrate their understanding of change processes and their ability to understand and use consultancy models. Throughout the three years of training there is an expectation that trainees are aware of the legislative and national planning context of service delivery and clinical practice. 8. Teaching and Training There is an expectation that trainees will engage in teaching or training of staff. In Year 1 this may be alongside the supervisor, the trainee may have a limited role (e.g. preparing materials, taking responsibility for leading a group activity) or the teaching/training may be in a more informal setting (e.g. case presentation to the team or psychology service). In Years 2 and 3 there is an expectation that the trainee will take on the responsibility for a significant role in teaching/training and in more formal settings (e.g. leading part or all of the teaching, workshops). Throughout the trainee is expected to prepare effectively, be clear about the aims and to evaluate the effectiveness of teaching/training. Across the three years of training the trainee is expected to use a variety of different teaching formats (e.g. informal vs. formal). 9. Diversity Throughout the three years there is an expectation that trainees will develop their awareness and understanding of personal and professional issues relating to difference, diversity and similarity. It is expected that trainees will develop an awareness and understanding of the impact of difference and diversity on themselves and others, including an understanding of discrimination (positive and negative) on the grounds of difference. Trainees should also reflect on how they impact on clients, Aug 2013 8 7.5 services and systems. Trainees should demonstrate their ability to promote and practice understanding for the personal and professional culture, values and belief systems of others throughout their training and endeavour to work within a multi-cultural framework. They should be able to develop their awareness and understanding of the ways in which services are provided and the degree to which they reflect the diversity and needs of the communities they serve. Trainees should develop an appreciation of inherent power imbalances (e.g. the power they hold in the therapeutic relationship) and demonstrate an awareness of how to address oppressive practice when they encounter it. 10. Personal and Professional Development There are a number of issues pertinent to PPD that it is expected must be demonstrated within all years of training as follows: Observe professional standards and maintain a professional and ethical value base, including that set out in the HCPC standards of conduct, performance and ethics and Guidance on conduct and ethics for Students and the BPS Generic Professional Practice Guidelines. Show sensitivity to the demands made in law and the professional regulation of all professions to ensure an inter-professional approach to the exercise of duty of care. Ensure confidentiality and informed consent, which underpins all contact with clients and research participants. Work effectively at an appropriate level of autonomy with awareness of limits of own competence, and accept accountability to relevant professional and service managers. Effectively organise workload and manage priorities and competing demands. Show a degree of independence appropriate to stage of learning, i.e., be able to take responsibility and carry out work after general discussion, and recognise when further consultation is necessary. Adhere to service courtesies, dress code, punctuality, health and safety, confidentiality, and other minimum quality standards. Throughout the three years trainees are expected to show an increasing ability to develop their self-awareness and explore the impact of themselves on others. Trainees are expected to gain insight into and manage their own learning needs and over the three years to develop strategies to deal with these. Trainees are also expected to develop strategies to handle the emotional and physical impact of the work, attend to self-care and seek help where necessary. 11. Supervision Initially there is an expectation that the trainee may have a limited awareness of their own needs in supervision, with a focus on content rather than process issues. As trainees progress into years 2 and 3 they should show an increased awareness of their supervision needs, an ability to focus on process and content issues, and the ability to be creative within the supervision context. Throughout the three years there is an 9 Aug 2013 7.5 expectation that trainees will actively prepare and take responsibility for their own supervision. This will involve demonstrating contracting and reflexive skills. Trainees can usually expect to have their work observed by their supervisor and to receive feedback, and vice versa. Observation can be through joint work, the supervisor observing a session that the trainee leads, or via video and audio-taping. 12. Research In Year 1 trainees are usually expected to demonstrate the effective application of research methods to examine the process and outcome within a Single Case study. In Year 2 trainees are usually expected to demonstrate the effective application of research methods via a Service Evaluation on placement. In Years 1 and 2 trainees must demonstrate their ability to conduct and write up Case Studies from placement experience. Trainees must be able to identify research questions, understand ethical issues, chose appropriate methodology and appropriate pathways for dissemination. Additional small research, evaluation or audit projects may be undertaken on placement at any stage of training according to the requirements of the service/placement. Aug 2013 10 7.5 Sources of Information for Completion of the Core Competencies Log The following provides some suggestions for sources of information for completion of the Competencies Log. This is not meant to be an exhaustive list and some sources may be more relevant for certain competencies than others. Assessment of Clinical Competence (ACC) Regular Supervisor feedback Completion of self-rating therapy forms Client feedback Carer feedback Feedback from professional colleagues Teacher/Training feedback Audio/Video tape records Audit of own paperwork Audit of case notes Audit of letters / reports Case presentations Other Aug 2013 11 7.5 Instructions for Completing the Core Competencies Log The core competencies log should be completed at the end of every placement. It can be shared with your next supervisor to help the planning process on your placement. This is primarily a self-appraisal process, but the information utilised from the differing sources provided on the previous page can help you appraise your level of competence more accurately. There may be some competencies that you have not had the opportunity to develop on a particular placement and this should have been negotiated with your supervisor and clinical tutor. The aim is for you to develop all the competencies across the three years of your training. Record this as 0 in the relevant box and this will help highlight that you need to develop this competency area on a future placement. To complete the log: Take some time at the end of placement and in your study time to reflect on all of the available sources of information. One column should be filled in at the end of every placement. Give yourself a rating based on the following rating scale: 1. I need to address this area as a matter of urgency 2. I need to consider this an area for further development 3. I have reached an appropriate level of competence in this area for my stage of training 4. I have progressed beyond the expected level in this area 5. This area is a particular strength 6. Unable to address this area on this placement Aug 2013 12 7.5 Core Competency Ratings Log CORE SKILLS 1 1. 6 Relationship Building Ability to: 2. PLACEMENT 2 3 4 5 Show sensitivity towards and demonstrate empathic and respectful attitude to clients and carers. Establish clients’ and carers’ trust and confidence and form effective therapeutic alliances. Show an awareness of boundary issues. Establish staff members’ trust and confidence, showing sensitivity to staff communications. Develop relationships with staff in other disciplines and/or formal carers, in order to facilitate interventions and provide the best care for clients. Develop effective working relationships with supervisor(s). Demonstrate skills in managing challenging relationships and situations. Psychological Assessment Ability to: Aug 2013 Identify and assess health and social care needs of a range of clients in a variety of contexts. Interview and take a detailed history from clients, taking account of a range of psychological, developmental, social and physical/biological factors Select, use and interpret a broad range of appropriate assessment methods, e.g., formal procedures, systematic interviewing, structured and idiosyncratic methods. Administer and interpret psychometric assessments (minimum requirement: WAIS-III, WISC-IV and one of the following: Wechsler Memory Scale (WMS), Adult Memory and Information Processing Battery (AMIPB), California Verbal Learning Test (CVLT), Doors and People Test). Conduct appropriate risk assessment. Identify need for involvement of other services/ agencies and make appropriate referrals where necessary. 13 7.5 3. Psychological Formulation Ability to: 4. Develop formulations of presenting problems or situations, integrating information and evidence from assessments, incorporating inter-personal, societal, cultural and biological factors. Draw on theoretical psychological models to inform formulation. Show capacity to reformulate problems in light of further information and ongoing intervention. Use formulations with clients to facilitate their understanding of their experience. Use formulations to plan appropriate interventions that take the client’s perspective into account. Use formulations to aid inter-professional understanding. Demonstrate an awareness of the multiplicity of formulations and work effectively whilst holding competing explanations in mind. Psychological Intervention Ability to: Aug 2013 Demonstrate an awareness of local and national guidelines / best practice in relation to development of psychological intervention. Carry out procedures, intervention and treatment appropriate to the presenting problem and to the psychological and social circumstances and organisational context of the client(s). Apply knowledge flexibly to clinical problems, e.g., adapt theoretical ideas to specific presentations, understand the meaning of theory for practice, generalise and synthesise prior knowledge and experience, devise innovative procedures. Work collaboratively with others to implement intervention where appropriate, e.g., clients, partners, carers, couples, families, groups, services, colleagues. Monitor risk and understand the need to maintain the safety of clients and others. Have an awareness of termination issues, recognise when to stop intervention and communicate this sensitively to others. 14 7.5 5. Evaluation Ability to: 6. Communication Ability to: 7. Select and implement appropriate methods to evaluate the effectiveness, acceptability and broader impact of interventions (both individual and organisational) and use this to inform and shape practice. Audit clinical effectiveness through use of individual and departmental evaluation / auditing procedures. Identify and critically appraise research evidence relevant to clinical practice. Express aims and nature of assessment and intervention clearly and demonstrate careful assessment of outcome, when reporting to and liaising with clients and colleagues. Demonstrate clarity, appropriateness and timeliness of written, verbal and electronic communication. Communicate clinical and non-clinical information effectively in a style appropriate to a variety of different audiences. Adapt style of communication to people with a wide range of cognitive functioning, sensory acuity and modes of communication: verbal, electronic, written. Demonstrate skill in the use of information technology for recording and communicating information. Service Delivery Ability to: Aug 2013 Understand team structures and effective team functioning through theoretical knowledge of group dynamics. Understand professional roles of all team members. Understand change processes in service systems. Develop the skills, knowledge and values to work effectively with systems, organisations and contexts relevant to clients including: statutory and voluntary services, self-help and advocacy groups, user-led systems and the wider community. 15 7.5 8. Teaching and Training Ability to: Prepare and provide formal and informal 9. Contribute to interprofessional and multidisciplinary team activities, including meetings, case conferences and reviews. Work with users and facilitate involvement in service planning and provision. Understand and use consultancy models and how consultancy contributes to practice. Observe and understand leadership in practice. Understand and participate in quality control and quality assurance processes. Demonstrate an awareness of the legislative and national planning context of service delivery and clinical practice. teaching, training and seminars (considering aims, needs of participants, facilities available and the use of different teaching formats). Facilitate the co-operative engagement of training group / individual (use of language, awareness of response of training audience and adaptation of content to a changing process). Monitor effectiveness of teaching / training, using structured and unstructured feedback mechanisms and self-appraisal. Diversity Ability to: Promote and practice understanding and respect Aug 2013 for others’ personal and professional culture, values and belief systems. Understand and respect the impact of difference and diversity upon self and others. Consider the ways in which services are provided and the degree to which they reflect the cultures in which they are located and the diversity of the communities which they serve. Understand discrimination on the grounds of difference. Demonstrate an awareness and application of anti-oppressive practice. Appreciate inherent power imbalances (in particular between practitioners and clients and how to manage this, ensuring it is not abused). 16 7.5 10. Personal and Professional Development Ability to: 11. Observe professional standards and maintain a professional and ethical value base, including that set out in the HCPC Code of Conduct and Ethics for Students and the BPS Generic Professional Practice Guidelines. Show sensitivity to the demands made in law and the professional regulation of all professions to ensure an inter-professional approach to the exercise of duty of care. Ensure appropriate confidentiality and informed consent, which underpins all contact with clients and research participants. Work effectively at an appropriate level of autonomy with awareness of limits of own competence, and accept accountability to relevant professional and service managers. Effectively organise workload and manage priorities and competing demands. Show a degree of independence appropriate to stage of learning, i.e., be able to take responsibility and carry out work after general discussion, and recognise when further consultation is necessary. Develop self-awareness and explore impact of self on others and vice-versa. Manage own personal learning needs and develop strategies for meeting these. Develop strategies to handle emotional and physical impact of own practice, seek appropriate support where necessary, and attend to self-care with good awareness of boundary issues (being aware of issues relating to fitness to practice). Adhere to service courtesies, dress code, punctuality, health and safety, confidentiality, and other minimum quality standards. Supervision Ability to: Aug 2013 Understand the function of supervision and be able to use this effectively. Understand supervisory methods (including creative approaches), roles and processes for both supervisee and supervisor. Be prepared for supervision, open to learning and responsive to feedback. 17 7.5 12. Offer and receive ideas and constructive criticism. Think critically and reflectively, and evaluate work in supervision. Use supervision to discuss support issues and needs. Show awareness of boundaries between supervision and personal support. Demonstrate skills in the provision of supervision at an appropriate level, within own sphere of competence. Research Ability to: Conduct Service Evaluation and small n research. Conduct case studies, single case experimental design, SAQs. Identify research questions, understand ethical issues, choose appropriate methodology, report and select appropriate pathways for dissemination. Use databases for audit, evaluation and research purposes. , Aug 2013 18 7.5 Instructions for Completing the Log of Placement Experiences This part of the log book is intended for trainees, and their supervisors and tutors, to monitor the variety of experiences on placement. This range of experience will not be available within any one placement; however, the aim is for trainees to be aware of the potential range of work and to experience as much of this as possible during the course of their training. The log of placement experiences should be completed by the end of each placement, although it is recommended that you complete the log as you go along. It can be used to help the planning process on your current and future placements. Log of Placement Experiences Trainee name..................................................................... Core experiences: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 Speciality/ies Supervisor(s) Clinical Tutor Age Range: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 0-5 6-11 12-18 19-40 41-64 65-80 80+ Range of difference and diversity on this placement (please state low, moderate, or high variation): Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 Ethnicity Sexuality Class Disability Aug 2013 19 7.5 Gender Faith/religion Other Presentation: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 Acute /short term Enduring/long term Mild Moderate Severe Contributing factors: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 Organic Psychosocial Abuse/trauma Social Physical health problems Bereavement Other Special Needs: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 Placement 4 Placement 5 Placement 6 Challenging behaviour Intellectual impairment Physical disability Communication problems Other Focus of work: Placement 1 Placement 2 Placement 3 Individuals Groups Carers Families/couples Organisation Service user/ public involvement Community Aug 2013 20 7.5 Service Setting: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 Placement 4 Placement 5 Placement 6 High dependency: Inpatient /residential (acute) High dependency: Inpatient /residential (long-term) Outpatient clinic Community team Day services Primary health care Secondary healthcare Specialist (e.g. eating disorder service, assertive outreach) Agencies outside NHS Modes/types of work: Placement 1 Placement 2 Placement 3 Direct work Indirect work through staff / carers Multidisciplinary team work Experience / observation of service development or planning Group work Teaching/Training others Inter-professional learning Working with interpreters Aug 2013 21 7.5 Interprofessional Learning/Other Educational activities (visits, seminars, workshops, observation of other professionals etc.): Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 Neuropsychological tests (please note that, as a minimum requirement you need to have administered the WAIS-IV (or WAIS III), WISC-IV, and one of the following: Wechsler Memory Scale (WMS), Adult Memory and Information Processing Battery (AMIPB), California Verbal Learning Test (CVLT), Doors and People Test by the end of your training) Aug 2013 22 7.5 Test Function (eg differential diagnosis) Placement/client group WAIS -IV WISC - IV Memory assessment: Other psychometric assessment tools/tests: Models: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 CBT Psychodynamic Systemic Personcentred/ humanistic CAT Social approaches (community, critical, social constructionist etc Other Supervision arrangements: Placement 1 Placement 2 Placement 3 Placement 4 Placement 5 Placement 6 No of supervision sessions Joint work with supervisor Supervisor’s work observed Sessions observed by supervisor Aug 2013 23 7.5 Aug 2013 24 7.5