For all PWP workers how do you like the work you do?

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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For all PWP workers how do you like the work you do?

Post by Rachie » Tue Jun 21, 2011 1:44 pm

I am about to start a new role as a PWP in just over a month. I've been really excited about this role as I enjoy doing CBT and haven't had as much clinical work in my current role as I would have liked. However coming on here recently there seems to be a lot of negativity about the role which is making me slightly nervous. As they are funding me to do an accredited course I don't want this to be another 1 year post and would really like to try and stick around for a bit and possibly make a career in IAPT. Please can PWP's let me know a bit more about how they feel about their jobs, how long they have worked there, whether it is NHS or non etc? Hopefully I may find some who are happy in their roles!! [*:D ]

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Re: For all PWP workers how do you like the work you do?

Post by Molly » Tue Jun 21, 2011 4:25 pm

Hi Rachie,

I'm a PWP who really likes their job! I've worked in two different IAPT teams so far and have had positive experiences in both. I did do a research role in between but in total I've been working as a PWP for about 2 years. I like working in a primary care setting and from a CBT perspective. I find the role really rewarding, however, I do think from reading peoples experiences on here and from listening to my friends who work in a different IAPT service to me that I am one of the lucky one's. In both services I always work face to face, we offer telephone appointments to clients who can't make the appointments but face to face is the norm. The IAPT service I work for now has a really clear vision of what it wants to be/provide and it's managed really well. Also the NHS are the sole provider in this area which I think helps. In my last PWP role the service was made up of the NHS/charities/private sector which did cause some problems.

Also in both roles I've been encouraged to get involved in health promotion, designing service leaflets and self help materials, promoting the service to GP's, co-ordinating cCBT so I have gained a variety of skills and experiences from this.

I also get good supervision from a high intensity worker who used to be a PWP so they really understand the work at step 2. I have group clinical supervision fortnightly from a senior CBT therapist where we formulate problems, focus on certain techniques, have some teaching. There is also strict criteria for who should be seen at step 2 and I never see clients who should be step 3 so managing the 35 contacts a week seems ok at the moment! Contacts are classed as half hour sessions so it's 17.5 hours out of a 37.5 hour week, leaving 10 hours for admin, team meetings, supervision. I can appreciate if there was a lot of travelling involved then fitting in admin might be more difficult.

I hope you enjoy the new job! Things that have made my job easier are reading the self help material before meeting with clients as it's easier then to explain the materials and know what materials to select in session. I always take a folder of self help materials with me to sessions so I have everything handy and it makes me feel more organised. Also try and seek out different experiences, like co-ordinating groups, health promotion as it does bring some variety to the role and broadens your skills too!


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Re: For all PWP workers how do you like the work you do?

Post by LIWY » Tue Jun 21, 2011 6:15 pm

Molly's service sounds great, I hope it can be held up as a model.

I'm afraid it is not such a happy story in our place. Every PWP is actively applying for other jobs/training. I would say this is mostly due to exhaustion from relentless triages, many of whom have very complex and/or upsetting backgrounds and no proper place to "offload" the stories other than a 5 minute case management with case managers constantly changing their availability. There is also hostility between the IAPT and secondary care services so you are left with a feeling that you are a pain in the backside and over exagerating risk if you try to refer on. Plus, PWPs are often the bearers of bad news to patients that there is no service that will see them. Our service is full CBT so PWPs also have to deal with difficult conversations explaining to people that they need to independently seek counselling from private or third sector if they don't want CBT or CBT seems wrong for them. No supervisors have ever worked at Step 2 and few make an effort to understand it. There is not sufficient travel time allowed for those running groups or doing face to face work in locations far from base and not sufficient admin time allowed for recording group contacts. Most of us do get satisfaction from GSH work but there is no skills development within it, our service doesn't produce any materials and we are always looking for materials that other services put out and using them.

That said, no point in worrying about it all in advance Rachie, hopefully you're joining a good service (I know it isn't ours as there is recruitment freeze) If not, there may well be room for the PWPs to push for change. IAPT will probably look quite different in a couple of years anyway so I'd say get all you can out of the experience and never be scared to ask for change. Molly's service sounds like how it should be done, ours not, so you know what you are aiming for if change needs to be pushed for.

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Re: For all PWP workers how do you like the work you do?

Post by Scottybottybanana » Wed Jun 22, 2011 11:14 pm

I saw some of the IAPT positions advertised recently and the claims that they wanted to recruit over '100' of them in the london area so did some reading of the handbook and the measures and was wondering how people actually felt about doing the work. It appears to me as if its almost a macdonalds approach to healthcare reducing innovation and autonomy and trying to remove the human contact aspect of things and farming people off to computer programmes? Reading the handbook it reads like the job is similar to a market research / call centre role?

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Re: For all PWP workers how do you like the work you do?

Post by Rachie » Thu Jun 23, 2011 9:35 am

I wouldn't say the role is like a market research/call centre role. There is a strong emphasis on audit and performance but this is to be expected from commissioned services, especially nationally commissioned services. All commissioners want to know that the money is being well spent and they don't just want clinicians stating it is. Therefore the only way to do this is to have quantifiable data that demonstrates the effects of a service. i.e. 40% of service users returned to employment, 75% of service users stated they found the treatment beneficial etc. The ways of collecting this data are quite standardised but this is because commissioners want to make comparisons nationally about the effectiveness of the service. Over time with feedback from service users and clinicians I am sure the ways of measuring this will be developed and will become more user-friendly. In nearly all services that I have worked in there has been a focus on audit and performance, for instance checking we are meeting the standards and targets outlined by governing and other bodies such as NICE etc.

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Re: For all PWP workers how do you like the work you do?

Post by Rachie » Thu Jun 23, 2011 9:42 am

Oops meant to say thank-you all for replying to my post! I think the difference between services is quite notable! I have been told that I will be doing face to face, telephone contacts and group work but I got the impression that a lot was face to face due to people talking about booking rooms in advance and travelling to different locations dependent on where your client base was. Hopefully I will land in one of the good services! I know they are doing a lot of service developments i.e. implementing this in CAMHS and looking at older adults which for me is always a good sign of a service trying to move forward. Fingers crossed it will work out OK. :D

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Re: For all PWP workers how do you like the work you do?

Post by River » Tue Jun 28, 2011 12:03 pm

I have just started in a PWP trainee role and am really enjoying it so far. I previously had the view that it was very call centre type work and was dubious about the support you can give someone over the phone for short periods of time. However, having done it, a lot of clients do seem to feel very supported a really benefit form the service. Often the people we see would have been on a waiting list, so the support calls are better than that! It is often the case that after a couple of calls, normalising their experiences and direction to reading material client's feel much more confident and in a better place than they were before coming to our service. Everyone that I work with seems to be very happy and it's a lovely team.

I have previously tried without success to get on the D.Clin, but I think now I will be very happy to stay in IAPT for a good few years.

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Re: For all PWP workers how do you like the work you do?

Post by jamesivens » Tue Jun 28, 2011 4:15 pm

congrats on the job Rachie, and glad you are enjoying the role River.

I've been a pwp in the NHS for almost 2 years and find it, on the whole, enjoyable. We are encouraged to do 70:30 split of face:telephone work. But we're big on access, so its up to the patient as to how they want to get pwp support. Generally, most like a mixture between the two.

We also do a lot of the assessments for step 3 work, as its not always clear what is appropriate from the referral form. So instead of sitting on a waiting list, they get an assessment pretty quickly, we discuss treatment options , monitor risk where necessary and step up/down/across as appropriate.

There may be scope to 'specialise' in other areas with your role. I expressed an interest in Older Adults, so I was supported in being the pwp lead for this. I say 'specialise' as I don't do anything necessarily different and continue to have a normal case-load, however, I now get triaged anyone 65yo>, get to attend further training and sit in on the Older Adult CMHT meetings which can has really increased my understanding of working with this group. Similarly, my colleagues had interest in other areas e.g. addictions, students and were supported in getting access to these groups.

I'm aware that the pwp role can vary greatly depending on the service, as you and LIWY pointed out. I think this partly contributes to a lot of people not being aware of what the actual job entails. Saying that, I think a lot of the clin courses are now acknowledging the experience and skills gained in this role, judging by the feedback of a lot of the pwps who have got on the course in the past two intakes.

all the best


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Re: For all PWP workers how do you like the work you do?

Post by sunshinegal » Mon Jul 04, 2011 2:54 pm

Hey Rachie,

I've only been in post as PWP for 6 months, so still very much in the middle of uni work etc. At the moment we do a lot of telephone triages, with the expectation of doing the majority of GSH over the phone, but some face to face. I'm still unsure as to how i feel about this but only time will tell if i enjoy it. I guess the proof will be in the pudding - if clients are getting good outcomes with telephone interventions then thats fine by me.

Our's is a brand new service and we have two clinical leads, one for hi intensity, one for pwp's. we're also a partnership so NHS and charities. We get a lot of supervision, sometimes feel a little supervisioned out! but its good on the whole. We've also had the chance to specialise a bit with the development of psychoeducation classes (so we will still be getting to see people face to face delivering these). And seem to be pretty involved when it comes to deciding which GSH matierials we will use as a service (though some of these were decided before we started).

One recommendation i would give with regards to the uni course - im sure yours will be the same as ours, keep a record of all clinical skills supervisions from the start, get a copy of the portfolio you have to hand in sharpish and use the form to keep an electronic record - we didn't and its a pain in the behind trying to catch up!

Good luck with the job :-) hope you enjoy it!

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