Caseload

Discuss the content and style of the different clinical psychology doctoral training courses, the differences between them, placements, teaching, chat to other trainees and connect with other people who have places on the same course
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MissBrightside
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Caseload

Post by MissBrightside » Sat Apr 02, 2016 1:26 pm

Hi all.

I'm not sure if this is the right subforum place to ask this question but I was wondering how many clients/patients other trainees see in a day (on average) in adult secondary care?

I am able to manage my own caseload/number of clients I see and I'm wondering whether on a one day a week placement 3 clients plus one hour supervision might be too much? and whether I should see two clients and have supervision so that I have more breathing space and time to do reading and write notes and plan future sessions? Or should one hour at the end of the working day be enough to do case notes and preparation for supervision and the following weeks sessions?

I know it's not always helpful to compare to others but I'd still like some opinions if possible :) I'm wary of being perceived as lazy and it would almost be better if I was told how many clients I need to see rather than choosing on my own! :shock: I am a second year by the way.
"Nothing ever goes away until it teaches us what we need to know" ~ Pema Chodron

jamesivens
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Re: Caseload

Post by jamesivens » Sat Apr 02, 2016 5:22 pm

i think it'll be down to what's right for you in terms of your needs and your service needs. I was in an older adult cmht for one day a week and would see 4 people at my base; two in the morning, two in the afternoon with supervision and admin time. If i was doing home visits then 3 as it was covering a large rural area.

good luck with the placement!

haymond
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Re: Caseload

Post by haymond » Sun Apr 03, 2016 4:11 pm

I'm currently a first year trainee and I currently have about 5 people on my caseload, but I have 2.5 days a week on placement, if that helps. I don't think caseload size is a case about being 'lazy'. I see it as primarily about what your learning needs are. This will be informed by your level of experience, the complexity of the people on your caseload and so on. Having said that, I do feel it is important to push yourself, so that you develop your skills to manage caseloads that qualified psychologists may be expected to manage, whatever that is. However, you will know best what your level of competence is and you are still training. This maybe something to discuss further insupervision.

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memifer
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Re: Caseload

Post by memifer » Sun Apr 03, 2016 8:34 pm

I have a caseload of 6 regular clients on my AMH placement, seen over three days. I will also cofacilitate group work, do some screening assessments plus spend time completing admin, preparing for sessions, attending team meetings and approx two hours supervision per week (one hour formal, one hour informal). I feel comfortable with this balance as I'm not overwhelmed but I don't feel like I'm slacking in any way. Maybe if I was more experience (so final year rather than first year) I would be able to pick up an extra client or two as I may not need to spend as much time on my pre-session prep.

Alex
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Re: Caseload

Post by Alex » Sun Apr 03, 2016 9:23 pm

I am not a trainee now but the trainees on placement with us take 9 cases over three days (my course said 8 cases). So 3 per day. If you work 7.5 hour day then that leaves 4 and a half hours in a day to write notes, plan sessions and do any liasing. Though that is based on a AMH setting, in child and older adults the liasing can be a lot of work so it depends on context.

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miriam
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Re: Caseload

Post by miriam » Sun Apr 03, 2016 11:13 pm

The typical caseload for trainees I have supervised as suggested by the course is 6-10 and the reality is usually 8-14 over a 3 days per week placement, unless they are very complex cases. We tend to go upward from the suggestion as some drop out and some are just for small pieces of work (eg an assessment, or a specific piece of work) and you need enough to write up, discuss and feel you are contributing to a placement.

I did a half day slot into an Action for Children post abuse service as part of a specialist placement and held a caseload of 2-3 clients there (and I think 8-10 in the remaining 2.5 sessions in my NHS placement), so I would think 3 in a day is manageable. You won't need an hour of admin and an hour of supervision for every 3 sessions of clinical work, let alone for every two, and a day contains 7.5 working hours!
Miriam

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lakeland
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Re: Caseload

Post by lakeland » Mon Apr 04, 2016 8:21 am

The placements I found most helpful for preparing me for the 'real' world were the ones where I wasn't overly protected. Obviously cases were still selected at a level suitable for a trainee, but I think (for me) that it was excellent experience to have to see 4-5 clients a day, because then when I qualified, I was prepared for the realities of the NHS.

However, I do think during training it is important that you have prep time before sessions, even though this is often not the case in some settings. The cases you spend time reading around and trying different models / formulations etc provide a foundation for your future practice - so even if you don't have prep time, you might recall something you did with a similar client during training.

Ultimately, it's for you to decide, you might want to start low and see how you manage, then ask your supervisor for an extra case if possible.

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enid
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Re: Caseload

Post by enid » Wed Apr 06, 2016 9:35 am

I think I have 8 currently - 3 says a week (sometimes 2 if I take a study day).

MissBrightside
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Re: Caseload

Post by MissBrightside » Thu Apr 07, 2016 8:13 am

Thank you all for your thoughtful responses! I think I will go for 3 (forgot to say I also attend a 1 hour meeting in the AM). Supervision is now 1.5 hours. So I will have a decent enough time for prep and admin although possibly I won't get all my reading done, but that's okay. Probably seemed a silly question but it was really helpful to have people's varied thoughts and experiences!
"Nothing ever goes away until it teaches us what we need to know" ~ Pema Chodron

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workingmama
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Re: Caseload

Post by workingmama » Mon Apr 11, 2016 9:57 am

MissBrightside wrote:although possibly I won't get all my reading done
:lol: :lol: :lol: :wink:

I haven't got all my reading done yet for placement 1, and I'm nearly out the other end of the course.
Fail, fail again, fail better.

astra
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Re: Caseload

Post by astra » Mon Apr 11, 2016 2:43 pm

workingmama wrote:
MissBrightside wrote:although possibly I won't get all my reading done
:lol: :lol: :lol: :wink:

I haven't got all my reading done yet for placement 1, and I'm nearly out the other end of the course.


Neither have I and i'm nearly 10 years qualified now LOL. When I retire I may get all my reading done!
From the point of view of mindfulness, as long as you're breathing there's more right with you than wrong with you. Jon Kabat-Zinn

Alex
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Re: Caseload

Post by Alex » Mon Apr 11, 2016 9:02 pm

astra wrote:
workingmama wrote:
MissBrightside wrote:although possibly I won't get all my reading done
:lol: :lol: :lol: :wink:

I haven't got all my reading done yet for placement 1, and I'm nearly out the other end of the course.


Neither have I and i'm nearly 10 years qualified now LOL. When I retire I may get all my reading done!
haha me three - qualified with year 1,2 and 3 reading still needs to be completed. It all starts with good intentions.

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BlueCat
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Re: Caseload

Post by BlueCat » Mon Apr 11, 2016 9:05 pm

astra wrote:
workingmama wrote:
MissBrightside wrote:although possibly I won't get all my reading done
:lol: :lol: :lol: :wink:

I haven't got all my reading done yet for placement 1, and I'm nearly out the other end of the course.


Neither have I and i'm nearly 10 years qualified now LOL. When I retire I may get all my reading done!
Same here! 11 years out and I'm sure there's still stuff from my first year that I haven't read!
There's no such thing as bad weather, just the wrong clothes. Billy Connolly.

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ell
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Re: Caseload

Post by ell » Tue Apr 12, 2016 10:56 am

This also depends so much on what other things you are doing on your placement. As we're constantly being told, CP is about more than just the direct individual work. On my current placement I am heavily involved in helping the service meet standards and evidencing this (so I'm chairing meetings, supervising audits, admin stuff around this), rewriting a bunch of the service leaflets and supervising the AP in doing some of this, attending team meetings, attending county-wide and beyond meetings, providing education slots for the team, liaising with the team about what they want from psychology (with some minor involvement in waiting list management). I'm 3rd year, so my duties are a bit more varied and leadership focused (an interest of mine anyway), but during my first year placements I was involved in more than just my individual client work (small scale research project, audit work, teaching/training, supervising).

I guess my point is that there is no specific number, and it should be based on your learning needs rather than trying to reach a total. Courses usually state a minimum anyway. My course states six pieces of longer term client work at minimum, over the 6 months, but there is an expectation that you would be doing other stuff as well if you were at that minimum number. It also depends on the clients - if you are following a fairly structured protocol with a client with a relatively straightforward presentation then you might need less time than if you were seeing someone with high risk and/or a lot of MDT working.

MissBrightside
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Re: Caseload

Post by MissBrightside » Thu May 05, 2016 11:21 am

Glad I'm not alone with the reading issue... :) I try and read in the evenings but it never quite works out...

I am involved in service development on my placement too and shadow a lot of my supervisor's work and attend MDT meetings. Plus I travel a lot during the day from base to base. So it's not just client work. I feel like I want to be SuperTrainee and do it all but I probably need to be a bit more realistic and think 3 is probably about right (maybe 4 on a good day!)
"Nothing ever goes away until it teaches us what we need to know" ~ Pema Chodron

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