BABCP/IAPT standpoint on PWPs -> CBT

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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baa
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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by baa » Wed Oct 05, 2011 9:35 am

jamesivens wrote:
Surely the fact that you got on to High Intensity training, and Will, on a band 6 PWP, and for other PWPs who have progressed into other areas - is this not counter evidence for pwp's being at a 'disadvantage'? d in the pwp role
I think that this press release is a reaction to that! I got the message that i was extremely lucky (with very good timing) to be on the course in the first place. I got the sense that they're cracking down on That Sort Of Thing.

And band 6 PWP posts are as rare as rocking horse poo.
At least I'm not as mad as that one!

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by jamesivens » Wed Oct 05, 2011 10:59 am

baa wrote:as rare as rocking horse poo
that's a phrase I'll be using in the future!

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by CBTer » Wed Oct 05, 2011 5:30 pm

Reading through the document there is a level of assumption that PWP's would be inexperienced, which I can see is not backed up with evidence. I think however the primary reason for using this assumption is to back up the argument to retain the PWP workforce. There are a limited batch of qualified PWP's to recruit and as a consequence IAPT are fearful of losing step 2.
It was quite a disheartening read as I was also a GMHW (with 2 years plus experience and previous MH background) but again feel like I have been 'lucky' to get to train as a HI. I echo some of the previous posts that actually it was those on my course who did have a professional qualification who struggled to pass their therapy tapes with a years worth of CBT training (counsellors, nurses). All previous Graduate workers on my course passed their therapy tapes and assignments first time. Also one previous graduate worker received a distinction for her CBT diploma!
However, I can also see that potentially IAPT/BABCP are trying to look for reasons to retain PWP's and so to take what they have said with a pinch of salt!

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by LIWY » Mon Oct 10, 2011 8:39 pm

I saw a job ad for one of those rare things, a Band 6 PWP role. It had, as an essential criteria, a psychology degree or a core profession. So....IAPT/BABCP does not advise recruiting PWPs with qualifications that might mean they might hop off the PWP workstream sooner rather than later, they want people with a dedication to step 2. Meanwhile, a Band 6 PWP job ad has essential criteria that cut out people with the different background that IAPT advise recruiters to look for.

Dots not joining up here...

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by littlelady » Mon Oct 17, 2011 2:27 pm

In our service at the interview stage we were actually told the natural progression for us would be to high intensity, now it seems they're putting everything into place to stop us low intensity workers from progressing. I ahve done this job for 2 years now and starting to get itchy feet as there is little career progression available to us now :twisted:

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by michael2806 » Sat Nov 26, 2011 10:00 pm

(This comes from the perspective of somebody who is now a trainee CP, having left IAPT as a PWP roughly a year post qualification)

Personally I feel that whilst IAPT PWP's are generally a devoted bunch of people who are enthusiastic about their roles, they are also intelligent graduates who have aspirations and want to develop their personal and professional skills. Sadly, IAPT doesn't allow for these facts and provides very little in the way of career development and progression. Couple that with the ridiculous tendency to demand high contacts, with very little emphasis within the model on the patient as an individual, and PWP's very quickly become aware of the drawbacks of their role, get downbeat about it, and ultimately look elsewhere to fulfil their aspirations.

As such if IAPT is going to get people to stay in the role in the long term, they need to build a progressive pathway for their staff, providing more opportunities for PPD, whilst supporting them and allowing them to adopt flexibility in the role! Sadly having seen this document, it seems like IAPT services will chain people to the profession in a forceful fashion, as opposed to changing services to make them WANT to stay of their own volition. :evil:

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by CBTer » Sun Dec 18, 2011 1:43 pm

This really does make me mad :evil:

When IAPT came along and I had been a graduate worker for far too long in my opinion, I thought at last somebody has recognised the need to develop the skills and opportunities for Psychology graduates. As a graduate worker within a multidisciplinary team I was treated like somebody without any knowledge. I had a developing knowledge and more knowledge of CBT than any of the other professionals who merely assessed patients and didn't in my opinion to alot else other than this. I heard recently that in one service all those without a core profession who were applying for HI posts were automatically put in the reject pile (for not being experienced enough). This is wholly unfair and demeaning of the knowledge and skills that Psych grads could potentially offer services.It is also assuming that Psych grads don't have the necessary experience just based 'on paper' and qualifications. In my opinion Psych grads have to work alot harder to carve out their career paths than say Psychiatric Nurses and Social Workers. We have to be creative, send ourselves on numerous postgraduate courses, bust a gut to get the necessary experience that employers are looking for, and this is after a 3 year degree working hard to at least get 'somewhere'.

I am so annoyed about this document I want to write a letter to BABCP and IAPT to put my point of view across. Alot of really talented PWP's who have amazing interpersonal skills are wanting to leave IAPT to pursue Clinical Psychology because they are so frustrated with the lack of career progression. I will be incredibly sad to see them go as sometimes they are having better outcomes with patients than us HI lot! They also put themselves down alot and cannot see just how valuable they really are

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by LIWY » Mon Dec 19, 2011 11:40 pm

CBTer wrote:This really does make me mad :evil:

... the need to develop the skills and opportunities for Psychology graduates. ...

I am so annoyed about this document I want to write a letter to BABCP and IAPT to put my point of view across. Alot of really talented PWP's who have amazing interpersonal skills are wanting to leave IAPT to pursue Clinical Psychology because they are so frustrated with the lack of career progression. I will be incredibly sad to see them go as sometimes they are having better outcomes with patients than us HI lot! They also put themselves down alot and cannot see just how valuable they really are
I agree with you about the last point and if you find anyone/where to actually address a letter to, I would join in. As I said before, I find it cowardly that that statement had no names attached. However, I don't think IAPT was anything to do with providing for the development of psychology graduates. Step2 is about easier access to less intensive therapies surely? The people who provide that may be psyc grads but IAPT vision was mostly that it would be people with a variety of backgrounds, particularly community volunteering. No one has an obligation to develop careers for psyc grads. Psychology degrees have exploded in numbers over the last 25 years due to demand from those who wish to study and teach it, universities seem to respond to demand and leave the publicity a bit murky about what will happen to the supply of grads.

In my service at the moment, the lack of development has led to a mass exodus of PWPs (50%). Most of those that are left hope to get onto clinical this year. Meanwhile, step3s are being sent on extra training for DIT, IPT and couples therapy. We have no Band6 PWPs and have been told there will be no such positions created.

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by Borrowed Cone » Tue Dec 20, 2011 1:28 pm

I have been following this thread for some time now, and what I am about to post might be quite controversial; but I wonder what we might make of it.

What I am hearing is:
As a PWP, why am I not being trained or developing the skills that will look good on my clinical psychology application?
and/or
As a PWP, why am I not being trained or developing skills beyond the PWP role?
Please bear in mind these are "working" hypotheses of mine and open to change.

I understand that the PWP post is a helpful career step to further applied psychology training, but we must also remember that a PWP position does not exist for the purposes of career development. They fulfil a distinct role as part of the increasing access scheme. My thoughts are that it is sometimes easy to feel a sense of entitlement and/or frustration due to one's own career aspirations, whilst forgetting the very purpose of the job which is primarily to help people with mild psychological difficulties.

I'm not saying this is what anyone in particular on the forum is doing, I just thought it was worth reframing this debate with a slightly different perspective.

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by matt.berlin » Tue Dec 20, 2011 7:07 pm

I can see Cone's point but to my mind there are a number of relevant issues that help explain this.
  • The general word a few years ago was that after a few years doing PWP-ing, people would be able to get onto High Intensity training. This was never going to be a realistic long-term situation, it was more about the then shortage of High Intensity Workers given the expansion of IAPT services.
  • In my experience, many PWPs feel they are in a dead-end job with little natural career progression in sight.
  • Being a PWP can be crazily busy and sometimes it feels like it is with little reward - and that it is not a very well valued role by some other professionals.
  • All of the above taken together is difficult for a bright, young, graduate workforce - i.e. the workforce that was often recruited in IAPT services.
As a somewhat aside, I do wonder in the wisdom of insisting on core professions for High Intensity. It would make far more sense in my opinion to create a clear process by which PWPs could, over time, develop the skills needed to move on to HI roles. When the State has spent a lot of money training social workers, OTs, nurses and psychologists - and that there are / have been / will again be shortages in these professions, it makes more sense to have a clear pathway for PWPs to aim for if they want to stay in CBT.

That doesn't mean people with those core professions shouldn't be able to move over to IAPT, just that it seems silly to put the majority of focus on getting people from those groups when there is an existing IAPT workforce that could have a lot to contribute if there are the incentives to stay.
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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by LIWY » Wed Dec 21, 2011 11:37 am

Borrowed Cone wrote:I have been following this thread for some time now, and what I am about to post might be quite controversial; but I wonder what we might make of it.

What I am hearing is:
As a PWP, why am I not being trained or developing the skills that will look good on my clinical psychology application?
and/or
As a PWP, why am I not being trained or developing skills beyond the PWP role?
Please bear in mind these are "working" hypotheses of mine and open to change.

I understand that the PWP post is a helpful career step to further applied psychology training, but we must also remember that a PWP position does not exist for the purposes of career development. They fulfil a distinct role as part of the increasing access scheme. My thoughts are that it is sometimes easy to feel a sense of entitlement and/or frustration due to one's own career aspirations, whilst forgetting the very purpose of the job which is primarily to help people with mild psychological difficulties.

I'm not saying this is what anyone in particular on the forum is doing, I just thought it was worth reframing this debate with a slightly different perspective.

The Cone
Cone - I really wonder how you are hearing this because, apart from the point by CBTer that seemed to imply "someone ought to be doing something for psyc grads to be able to work in psychology", this is nothing about getting enough experience to get on clin psyc or be given something over and above what they were promised. Masses of PWPs have got onto clinpsyc so it is a good basis for getting on. The problem here is for those who don't want to get on and want to progress their careers in other ways. No job exists for career development of course, but I don't get why you make this point? Do you think clin psycs would be happy if they never got to expand on their training or there was no way to get more responsibility and a higher salary if that was part of their career plan?

A few points:

This thread was begun about a direction put out by a faceless bunch of people from IAPT/BABCP with an arbitary three year cut off to move to hi training and nothing to do with getting into clinical at all. For a profession that so loves its research, it is frankly a joke that they make an arbitary statement rather than backing it up with any evidence. I know that many PWPs are too inexperienced after 3 years to move on to Hi, but some are not. Some came in with masses of past experience.

Various good points have been made highlighting the inconsistencies in the statement which I won't go over again.

PWP has mostly become a discrete job with no career progression in most services. It was not sold that way - hence those in it are having to adjust to having been sold a vision that is not materialsing - hence lots of frustration and decisions to be made about sticking with the job or moving on. Many services are, it seems to me, knowingly burning out PWPs at the moment because services want to meet KPIs to keep contracts, especially with GP commissioning on the horizon.

My point about step3s now being offered training while PWPs are not is not down to any self-entitlement, it is just pointing out that, people who have just received training that costs double that of PWP training unexpectedly get more while PWPs are told there is nothing that can be done for them. Services say, we are not creating Band6 positions, tough.

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by Borrowed Cone » Wed Dec 21, 2011 8:05 pm

LIWY, I thought my post might aggravate you, hence my cautious approach.
LIWY wrote:
Cone - I really wonder how you are hearing this because, apart from the point by CBTer that seemed to imply "someone ought to be doing something for psyc grads to be able to work in psychology", this is nothing about getting enough experience to get on clin psyc or be given something over and above what they were promised.
My opinions were formed by reading all the posts over time. The two examples I used were possible subtexts to the posts, not necessarily anything anyone in particular had explicitly stated. That is how I am hearing it. A sort of, reading between the lines, kind of thing.
LIWY wrote:Masses of PWPs have got onto clinpsyc so it is a good basis for getting on.
I don't dispute that it is a "good basis for getting on". We agree on this point.
LIWY wrote: The problem here is for those who don't want to get on and want to progress their careers in other ways. No job exists for career development of course, but I don't get why you make this point? Do you think clin psycs would be happy if they never got to expand on their training or there was no way to get more responsibility and a higher salary if that was part of their career plan?
As non-qualified members of staff, there are intrinsic limits to the amount of training and responsibility PWPs can be receptive to within that role. This is a primary reason why progression is limited. The difference being that clinically qualified staff are able to hold responsibility for client care, which automatically opens up the amount of training that they can be receptive to within their roles. This isn't putting down PWPs, it is just noticing the differences. And by "receptive", I don't mean individually, intellectually; I mean the role.

However, you make a good point here and of course I understand that people in PWP roles want to progress whether or not they want to change to CP and I think that further training and education should be supported where possible, for the good of the service. But, from a commissioning point of view, there is no point training workers with skills they cannot use.
LIWY wrote: This thread was begun about a direction put out by a faceless bunch of people from IAPT/BABCP with an arbitary three year cut off to move to hi training and nothing to do with getting into clinical at all. For a profession that so loves its research, it is frankly a joke that they make an arbitary statement rather than backing it up with any evidence. I know that many PWPs are too inexperienced after 3 years to move on to Hi, but some are not. Some came in with masses of past experience.
We agree on this point.
LIWY wrote: PWP has mostly become a discrete job with no career progression in most services. It was not sold that way - hence those in it are having to adjust to having been sold a vision that is not materialsing - hence lots of frustration and decisions to be made about sticking with the job or moving on. Many services are, it seems to me, knowingly burning out PWPs at the moment because services want to meet KPIs to keep contracts, especially with GP commissioning on the horizon.

My point about step3s now being offered training while PWPs are not is not down to any self-entitlement, it is just pointing out that, people who have just received training that costs double that of PWP training unexpectedly get more while PWPs are told there is nothing that can be done for them. Services say, we are not creating Band6 positions, tough.
I can only imagine the frustration. However, this does not change the objective perspective I am trying to take on this emotive issue. Only the majesty of debate will do that, in time.

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by LIWY » Thu Dec 22, 2011 10:28 am

Borrowed Cone wrote:LIWY, I thought my post might aggravate you, hence my cautious approach.


LIWY wrote:

As non-qualified members of staff, there are intrinsic limits to the amount of training and responsibility PWPs can be receptive to within that role. This is a primary reason why progression is limited. The difference being that clinically qualified staff are able to hold responsibility for client care, which automatically opens up the amount of training that they can be receptive to within their roles. This isn't putting down PWPs, it is just noticing the differences. And by "receptive", I don't mean individually, intellectually; I mean the role.

However, you make a good point here and of course I understand that people in PWP roles want to progress whether or not they want to change to CP and I think that further training and education should be supported where possible, for the good of the service. But, from a commissioning point of view, there is no point training workers with skills they cannot use.

The Cone
Thanks for coming back Cone. I am not sure why you call PWPs non qualified - the PWP Cert is a qualification, a basic one, but a qualification nevertheless. Senior PWPs most certainly can hold responsibility for patient care in the mild to moderate ranges. Part of the difficulty of getting step2 working smoothly has been the lack of supervisors for PWPs who have actually done the role, so supervisors end up encouraging the creep to full CBT in step2 interventions. If a step2 workforce were to work effectively, they would be supervised by people who had done the job and, within the management team, there would be people who are clear about the conditions and the skills needed to run Step2 services.

In our service, they have started to realise the error of the strategy of recruiting young psych grads who wish to be clin psycs to the PWP role and our latest round of recruiting after mass exodus to dclinpsyc has brought in a more mature and varied staff with community experience. These people can contribute greatly to the running of services but as managers are Band 8 and there are no PWP type positions inbetween Band 5 and Band 8 - how are they going to get there?

Anyway, with the proposed changes in health commissioning, I am not expecting any development of the Step2 services as my experience has been that GPs do not like centralised services and want counsellors back in their surgeries with a centralised, specialist psychology and psychiatric service being available for those with complex difficulties, disorders etc..

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by Borrowed Cone » Thu Dec 22, 2011 4:24 pm

LIWY wrote: Thanks for coming back Cone. I am not sure why you call PWPs non qualified - the PWP Cert is a qualification, a basic one, but a qualification nevertheless. Senior PWPs most certainly can hold responsibility for patient care in the mild to moderate ranges. Part of the difficulty of getting step2 working smoothly has been the lack of supervisors for PWPs who have actually done the role, so supervisors end up encouraging the creep to full CBT in step2 interventions. If a step2 workforce were to work effectively, they would be supervised by people who had done the job and, within the management team, there would be people who are clear about the conditions and the skills needed to run Step2 services.

In our service, they have started to realise the error of the strategy of recruiting young psych grads who wish to be clin psycs to the PWP role and our latest round of recruiting after mass exodus to dclinpsyc has brought in a more mature and varied staff with community experience. These people can contribute greatly to the running of services but as managers are Band 8 and there are no PWP type positions inbetween Band 5 and Band 8 - how are they going to get there?
Sorry, by non-qualified I mean't non-qualified clinically in mental health: as per the IAPT standpoint, the PWP qualification does not constitute professional training.

Just to say briefly, I think this is where we are going to disagree.

I don't believe "senior PWPs" should be managing services.

To say that they cannot supervise step2 because the end up "creeping" into full CBT isn't really a satisfactory argument against qualified staff supervising PWPs despite not having been a PWP.

This stance is, of course, protective of CP as a profession. I make no apology for that.

I would also like clarification from someone (perhaps baa) re clinical responsibility, as it is my understanding that PWPs do not hold this for their clients.

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Re: BABCP/IAPT standpoint on PWPs -> CBT

Post by Will » Thu Dec 22, 2011 5:05 pm

Borrowed Cone wrote:I don't believe "senior PWPs" should be managing services.
Had to respond to this one :wink: Why not? The PWP role requires specialised skills and is very different to many other jobs. Additionally it's a new role and many services are still developing. In my opinion, someone who has experience of the role is well placed to manage a service.
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