Role and day to day duties of a LIW/PWP

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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kelebek
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Role and day to day duties of a LIW/PWP

Post by kelebek » Mon Nov 09, 2009 10:44 pm

Mod: Discussion split from this wiki.

My experience is quite different as my service is fairly new.

I do not have any GP's and I don't get to see clients at all. All our work is done over the phone. We wont be having any face to face work in this service.

I am not doing uni as I was upgraded to band 5, qualified position soon after I started as band 4. Although, I have started to question this decsion as it seems like a ''money saving project'' for my service. But I am going to push them for top up training as it gets accrecited now.

I contact up to 15 patients every day. I usually get hold of 5 to 6 of them. go thorugh an assessment with them, it usually involves risk assessment. The patient and I decide suitable treatment for them, usually guided self helo cCBT or groupd work. I then type a letter to send them with our decisions about treatment.

I am going to run depression and anxiety groups very soon, that will give some face to face patient contact.

We have a reflective group meetings every week where we off load all our isues as a team. I have not received any supervison yet despite asking my manager every single day. I have been working without supervision for 2 months. But I got a promise today I am starting to receive supervision from this thursday onwards.

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Hayley Tyson
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Post by Hayley Tyson » Mon Nov 22, 2010 11:19 am

Hey!

I was wondering whether either of you could shed a bit of light on what actually goes on in your first session with a client....

In a recent interview for a trainee PWP role i was asked to do a role play where a male presented with symptoms of depression as a result of his partner leaving him. He also had some stress at work.

I think it would really help for future interviews if i knew the structure of a first session so that i could emulate this in the role play!

Any suggestions would be gratefully recieved!!!

Thanks! :) x

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Will
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Post by Will » Mon Nov 22, 2010 6:00 pm

Hello Hayley,

I was taught to follow the following protocol in an assessment. I'm writing this from memory (and it's 5pm) so apologies if I miss anything.

Intro - Introduce self, elicit patient's preferred name, explain job role, explain purpose of session and set agenda / time scale, discuss confidentiality and note taking.

Gather info -Use 4 W's to structure questions:

What is the problem?
Where does the problem occur?
With whom is the problem better or worse?
When does the problem happen?

Gather information on autonomic, behavioural and cognitive aspects of the problem. Enquire about triggers and environmental factors.

Discuss impact on personal, social and occupational functioning.

Brief history - how long been a problem, previous help

Risk assessment -

Thoughts? How intense?
Plans in place?
Vulnerability? Protective factors?
Respond appropriately.

Formulation -

Feed back problem statement
Produce formulation and facilitate to model

Goal setting -

What does patient want from therapy

Conclusion -

Review problem, discuss plan of care.

Hayley Tyson
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Post by Hayley Tyson » Tue Nov 23, 2010 8:20 pm

Hey Will...

Thanks so much for that, its really helpful!! Hopefully i will remember at least some of it for my next interview :shock:

Which areas would you spend longer talking about in the session/an interview role play?

How long would you spend explaining the model to the client in a normal session?

I guess i'm wondering which areas are priorities so that I can emphasise these in the 5 minutes that I have to show that I'd be good for the position of PWP!

Thanks so much!

Hayley

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maven
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Post by maven » Wed Nov 24, 2010 2:16 am

The Wiki isn't the place for a Q&A. The forum section is where discussion and careers advice should happen, and there is a specific IAPT section.

Can one of the wiki keepers or mods please add the useful content to the wiki and split the thread into the right place please?
Maven.

Wise men talk because they have something to say, fools because they have to say something - Plato
The fool thinks himself to be wise, but the wise man knows himself to be a fool - Shakespeare

LIWY
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Post by LIWY » Wed Nov 24, 2010 10:28 pm

Hi Kelebek. Can I ask some questions?

When you contact patients for assessment, is that based on GP's referrals or do they have to call and ask to be assessed as well? Has there been any gateway triage before they get to you?

How long are your assessments? Six a day sounds exhausting if it's like the assessments in our service which can often take around an hour and are very comprehensive.

Do you have to write up the assessments on PC-Mis or IAPTus?

How long is your letter? Does it contain a summary of the assessment as well as treatment recommendation?

You say that usually it is guided self help or group work. Do you get a lot of people thinking/hoping they will get 1-1 face to face counselling? What happens when you have people with severe depression/anxiety or possible disorders? Do they have to do step 2 first to get help?

Thanks, really interested to know how others work.

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baa
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Post by baa » Thu Nov 25, 2010 10:18 am

I was thinking that actually my week in the life of a LIW is probably quite out of date, given that phone work probably forms the bulk of people's work now.
At least I'm not as mad as that one!

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Will
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Post by Will » Thu Nov 25, 2010 11:35 pm

Hayley Tyson wrote:Hey Will...

Thanks so much for that, its really helpful!! Hopefully i will remember at least some of it for my next interview :shock:

Which areas would you spend longer talking about in the session/an interview role play?

How long would you spend explaining the model to the client in a normal session?

I guess i'm wondering which areas are priorities so that I can emphasise these in the 5 minutes that I have to show that I'd be good for the position of PWP!

Thanks so much!

Hayley
Remember that in an interview role play they're not expecting you to do a full assessment. It's a chance for them to find out what you're like sat in a room with a client. You'll have 5-10 minutes to show that you can be confident, warm and empathic. As you mentioned, it's about showing that you'd be right for the position.

I wouldn't worry too much about the details - I'd focus entirely on what they're asking you to do. If it's an info gathering role play, then gather as much information as you can in relation to your ABCE. Unless they specifically tell you not to, be sure to ask about risk in as much detail as possible (and not just suicidal ideation but things like safeguarding children issues, self harm and neglect).

As for how long to spend discussing the formulation, that all depends on how long you have for your roleplay. In practice I would only spend a few minutes talking about it in the assessment - I would introduce it to them and work in what they've told me but then I'd send them away with something to read. If you are including this in your role play then remember to be collaborative, ask the person if they can suggest things for each area and use as many of the things they've mentioned as possible.

Hope that helps.

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Will
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Post by Will » Thu Nov 25, 2010 11:37 pm

My service is also set up in a rather different way. Perhaps it would be a good idea for a few of us to do a 'week in the life of' so that we can demonstrate some of the differences between areas?

This seems to be a topic that comes up fairly often!

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baa
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Post by baa » Fri Nov 26, 2010 9:13 am

Will wrote:My service is also set up in a rather different way. Perhaps it would be a good idea for a few of us to do a 'week in the life of' so that we can demonstrate some of the differences between areas?

This seems to be a topic that comes up fairly often!
That would be really good, mine was written 6 months after IAPT was set up, so things are very different now :whenIwasyoungthiswasallfields:
At least I'm not as mad as that one!

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Will
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Post by Will » Mon Nov 29, 2010 5:47 pm

When I get a minute of time outside work going spare (around interviews, clinical applications, voluntary work and a dissertation) I'll get something written :lol:

sockmonkey
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Re: Role and day to day duties of a LIW/PWP

Post by sockmonkey » Sun Mar 10, 2013 3:43 pm

I'm about to start my new job as a LI PWP soon and have been trawling through to get a better idea of what I will be doing daily. Came across this thread but see there havene been any updates since 2010!! Anyone want to/ got the time to write about their average week in their iAPT service nowadays? Il certainly do the same once I have been there a while :-)

ImaginePsych
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Re: Role and day to day duties of a LIW/PWP

Post by ImaginePsych » Mon Mar 11, 2013 12:50 am

Is it a trainee or qualified post?

sockmonkey
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Re: Role and day to day duties of a LIW/PWP

Post by sockmonkey » Mon Mar 11, 2013 1:59 am

SparkyMarky wrote:Is it a trainee or qualified post?

trainee :-)

ImaginePsych
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Re: Role and day to day duties of a LIW/PWP

Post by ImaginePsych » Mon Mar 11, 2013 4:13 pm

Ah right ok. I started a trainee PWP contract the middle of last month so still really finding my feet. We did our first 2 weeks block at university having introductory classes and skills workshops. From hereafter we will be at university 1 day a week and we are allocated 1 day of self directed study in practice each week aswel (to keep ontop of assignments).

My cohort have found that you really need to be pro-active and work on initiative for the first part of the year. We have been told that we wont be seeing clients face to face unsupervised until we have passed out first module in July (interventions). So at the moment our weeks are taken up by uni work - training- and shadowing.

As a 5th week trainee this week will consist of:

Today: Self-directed study (composing an assessment tool and a behavioural activation tool for use in roleplays at uni).
Tuesday: AM - Shadowing a PWP's Initial Assessment. PM - Supervision
Wednesday: AM - Screening & Telephone self-help training. PM - Spending the afternoon with the other trainees roleplaying.
Thursday: Our University day.
Friday: AM - Shadow telephone screening. PM: Risk and Clinical recording training.

Hope this is of some help. As I say I'm only coming into my 5th week as a trainee and wont have an actual caseload until the summer. But the key at this stage is to network and try and meet as many people as possible to ask to shadow for face to face and telephone assessments/interventions.

Cheers,
Sparky.

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