What is the view on the Clinical Associate Psychology Masters?

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IanF
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What is the view on the Clinical Associate Psychology Masters?

Post by IanF » Wed Dec 19, 2018 2:52 pm

I'd be interested in the views of the Forum on the new MSc in Clinical Associate Psychology offered by Exeter University, particularly in relation to its potential as an alternative route to clinical training. What has been the experience in Scotland, for example? Thanks, Ian.

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IanF
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Re: What is the view on the Clinical Associate Psychology Masters?

Post by IanF » Fri Dec 21, 2018 5:49 pm

Here's the link to the MSc course: http://cedar.exeter.ac.uk/programmes/mcaps/. There's also a new Apprenticeship standard for Associate Psychologists that's being worked on: https://www.instituteforapprenticeships ... chologist/. This looks like the start of the response to the inevitable decline of the current monolithic three-year full-time DClin. What do people think?

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by beluga » Sat Dec 22, 2018 12:36 pm

Hi Ian,

I am not a trained CAAP but I have worked with a number of CAAPs in Scotland and a few points have come up in discussion.

The CAAP course was not intended to be a stepping stone to further training on the doctorate. However, in reality this seems to be what has happened in many cases. There seems to be a lack of CAAP jobs in Scotland. When there are jobs available, I've heard that some have been offered a role at band 6, despite a qualified CAAP being at a band 7 position. As such, there also seems to be limited career progression for qualified CAAPS. I believe some CAAP courses are now stipulating that a minimum time period passes before you can apply for the doctorate course.

If, like you suggest, the introduction of CAAP courses were to signal a replacement of the doctoral training some of the above issues have the potential to iron out, but that's an assumption. Also, I'm not too sure on the finer points regarding the difference between a CAAP and a PWP in England - persumably they are not restricted to IAPT services?

Anyway, I hope you can find some CAAPs to give you their experiences!

~b~

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by IanF » Sat Dec 22, 2018 9:10 pm

Dear Beluga.

Thanks for your thoughtful comments. I should 'declare my interest' here - I'm involved in the delivery of the Exeter MSc programme. The intended role for CAPs in England is to function as Applied Psychologists under the supervision of a Clinical Psychologist, rather than as PWPs. You're correct that I'm making assumptions about the future of the DClin in England - and I don't have any privileged insider information here. However, I'd be amazed if Health Education England continue to support the current three year full time paid training model for much longer.

The DClin is now almost the only pre-HCPC registration programme that is funded in this way; everyone else (including nurses, physics, OTs, Speech Therapists etc) have to fund their own pre-reg training. I think we're going to move quite quickly to a much more flexible, modular route to training. My guess is that the CAP (in England) or CAAP (in Scotland) will be seen as the first step (or rather second step, following a conventional Graduate/Assistant Psychologist role). As you suggest, it is likely that employers will lock their staff into a couple of years post-MSc work (but then, they will be getting the Masters for free and be paid during training).

In this regard it's interesting that Cornwall Partnership NHS Trust are 'locking' their current CAP trainees into two years (at Band 6) after training; though their Chief Exec has publicly committed to funding five more cohorts over the next five years. He's paying their salaries and paying for the training, so that's quite a commitment!

I'm thinking we might well be heading 'back to the future' where individual Trusts make their own workforce planning decisions to recruit and second graduate psychologists to a CAP programme in the first instance, and then pick from these to support further training at Doctorate level. I don't think anyone knows what this is going to look like yet. It is my hope that this will open up more flexible training routes and reduce the current blockage at the doctorate gateway. I'm hoping that this will help us to finally widen participation and access to the profession, and create an 'interim' Associate Psychologist profession at Band 6 (which after all is a career grade for most AHPs in the the NHS). All these staff will need to be supervised by a doctorate-level qualfiied Clinical Psychologist, so I think that rumours of the demise of the profession are premature!

However, as you suggest, the situation in Scotland could suggest otherwise. What do people think?

All the best

Ian

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by miriam » Sat Dec 22, 2018 10:08 pm

The existence of CAAPs in Scotland hasn't changed the value of CPs, or the amount of funded places. I think it is perfectly predictable that lots of cash-strapped universities are trying to create new offerings to milk the aspiring CP market of psychology graduates, but it seems a bit grandiose/pessimistic to think this will lead to the inevitable end of the funding of CP training - particularly given the continuing need for qualified CPs in the NHS and the high level of trainees passing the course. It might be that at some point in future the funding of CP training changes, but I can't see it disappearing in the foreseeable future, whether or not some applicants come through a CAAP pathway.
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Re: What is the view on the Clinical Associate Psychology Masters?

Post by lingua_franca » Sun Dec 23, 2018 1:44 am

IanF wrote:
Sat Dec 22, 2018 9:10 pm
The DClin is now almost the only pre-HCPC registration programme that is funded in this way; everyone else (including nurses, physics, OTs, Speech Therapists etc) have to fund their own pre-reg training. I think we're going to move quite quickly to a much more flexible, modular route to training.
This isn't comparing like for like. Junior doctors are paid even though they are still in training because they are fulfilling all the demands of a band 5 role at the same time. Trainee clinical psychologists and psychoanalytic child psychotherapists are performing band 6 duties, and their salaries reflect that.

The bursary for other AHPs should never have been cut, but the reason they had bursaries rather than salaries in the first place was because they weren't working at the same level. A trainee CP can hold a caseload from a very early stage; a trainee RMN can't. Some student nurses are seconded to train, but they are only paid at the rate of a senior healthcare assistant, as that wage is commensurate with the role they're fulfilling at this stage. There is a clear logic for paying trainee CPs what their work is worth. The fact that other AHPs are being short-changed is an argument for re-instituting their bursaries, not for cutting CP funding, and I think universities ought to be campaigning for that rather than trying to capitalise on the possibility of more cuts. I'm an academic myself and I believe we have an ethical responsibility to do so.

Finally, I don't understand why there is a need to introduce another tier to the selection process when the one we have functions well. The dropout rate on the DClinPsy is very low. It's a well established and well regarded profession. What exactly would a Master's offer that the current training process doesn't?
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by IanF » Sun Dec 23, 2018 9:50 am

Dear Miriam and Lingua_Franca,

Thanks for your comments. I agree that there is a risk of the universities trying to cash-in here, but surely it's better for trainee Associate Psychologists to have their Masters paid for by an NHS Trust (or via the Apprenticeship levy) and to receive a Band 5 salary, rather than having to fund themselves by extending their student loan? As a former DClin Admissions Tutor, my take is there are essentially two tests applicants need to pass to be in the running - are they able to manage the academic demands of a Doctorate-level training, and can they evidence the fundamental clinical skills and values?

I think it's become the de-facto standard that DClin applicants have a Masters (or even PhD) level award to evidence the first test. Seeing so many of our undergrads going on to self-funded MSc programmes (of sometimes dubious quality), I think that the proposed development of the CAP route would be an improvement in broadening access to those who are not in a financial position to self-fund through Masters-level training.

I agree with both of you that the profession is in good shape, and I'm sure that the Course Directors are doing all they can to lobby the funders. However, I do believe that this very strength will inevitably push the costs of training back on to the Trusts, courses and (hopefully not) trainees themselves. I think the priority now is to develop flexible routes that improve access to clinical training, rather than defending the status quo.

With best wishes

Ian

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by maven » Sun Dec 23, 2018 5:03 pm

I think it's become the de-facto standard that DClin applicants have a Masters (or even PhD) level award to evidence the first test.
I don't think that's true. I see plenty of people who get onto training without a postgrad qualification (and like yourself, I'm sceptical about the value of many of the masters programmes that have sprung up).

I'm strongly against modifying the training pathway or developing "flexible routes to training". We have a great success rate on doctoral training, and the vast majority of people spend many years in the NHS to repay the investment in senior level roles. I don't want to water down our standards, or pretend that like much of mental health services are prone to at the moment, that some cheaper compromise is good enough as the cost per head is lower. CPs are valued because they are the structural engineers of the therapy world, with doctoral level research knowledge, indirect ways of working, and skills that cover the lifespan and a wide variety of client groups. Don't let the austerity mindset persuade you otherwise. Clinical training isn't broken, and doesn't need fixing.
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

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by IanF » Mon Dec 24, 2018 12:14 pm

Dear Maven. Thanks for your comments. My motivation for initiating this thread was to explore the possibility that the training pathway is soon going to be modified, whether we're against it or not. I take Miriam's point that it would be rather 'grandiose' of the universities to believe that they can influence the future organisation of training; I think that the funders are going to impose that on us whatever we do - and soon.

However, I do strongly believe that we can grasp this as a positive opportunity to develop more flexible routes to training. I agree that the dropout rate on the DClinPsy is very low; as a supervisor and clinical tutor I have been impressed by the resilience of trainees. However, I think this conceals a huge dropout rate earlier in the process, whereby thousands of academically able and caring graduates who would make excellent Clinical Psychologists become disillusioned with the narrowness of the gateway they are expected to squeeze through.

I think this Forum is an excellent place for us to include those who are currently going through all the tortuous processes to participate in the debate. Do we want to lobby the BPS to work with the employers to develop a Level 8 Doctorate Apprenticeship? How about self-funding through Doctorate loans from the Student Loans Company that are now available for the Professional Doctorates? That route's not likely to work as it's currently constructed, since the total available loan of £24k wouldn't even cover a three-year undergrad course, never mind a full time Doctorate. Can we work with the employers to develop 'in-service' options that cover salary and contribute to course costs?

None of these are going to be straightforward or pain-free options. However, I really don't think that 'we like it as it is and we don't want it to change' is a sustainable strategy. I could well be wrong; perhaps the current funding regime will endure for the foreseeable future, as Miriam hopes. However, I do think it's a good idea to explore potential alternatives, especially if that can help to improve access to training.

With best wishes

Ian

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by lingua_franca » Mon Dec 24, 2018 4:11 pm

Ian, I'm puzzled here - in an earlier post you say you don't have any privileged insight about changes to doctoral funding, yet by asking questions such as, "Can we work with the employers to develop 'in-service' options that cover salary and contribute to course costs?" you're talking as though changes are definitely going to happen. More than that, universities setting up special MSc courses to train apprentices looks awfully like they're trying to sway things that way.

I don't want to lobby the BPS for apprenticeships or self-funded doctoral loans. I want the BPS to stand by the training structure as it is, and to support other representative bodies in campaigning for the reintroduction of bursaries for other AHPs. Those bursaries should never have gone. Salaries for doctoral-level training shouldn't go either. Adopting an "it's inevitable" approach is caving to the austerity politics that Maven mentioned. This was exactly how politicians tried to sell austerity to the public in the first place, as a necessary evil that couldn't be avoided. But it wasn't. It was a political choice and one that we should absolutely resist. It's already inflicted damage on the NHS and rather than going along with it and trying to make it palatable we should be saying no.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by kezkel » Mon Dec 24, 2018 4:39 pm

Hi Ian,
Can I ask what you think people will do once they are qualified a a CAP and have completed the required 2 years. Do you think they will then apply for a doctorate? If not what progression opportunities do you foresee there being? My concern with a role like this is where there is only one english trust (currently) offering the role people will get stuck on band 6 doing the same role in the same place without progression.
(Just to declare my interest I am considering applying)

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by miriam » Wed Dec 26, 2018 11:17 pm

lingua_franca wrote:
Mon Dec 24, 2018 4:11 pm
Ian, I'm puzzled here - in an earlier post you say you don't have any privileged insight about changes to doctoral funding, yet by asking questions such as, "Can we work with the employers to develop 'in-service' options that cover salary and contribute to course costs?" you're talking as though changes are definitely going to happen. More than that, universities setting up special MSc courses to train apprentices looks awfully like they're trying to sway things that way.

I don't want to lobby the BPS for apprenticeships or self-funded doctoral loans. I want the BPS to stand by the training structure as it is, and to support other representative bodies in campaigning for the reintroduction of bursaries for other AHPs. Those bursaries should never have gone. Salaries for doctoral-level training shouldn't go either. Adopting an "it's inevitable" approach is caving to the austerity politics that Maven mentioned. This was exactly how politicians tried to sell austerity to the public in the first place, as a necessary evil that couldn't be avoided. But it wasn't. It was a political choice and one that we should absolutely resist. It's already inflicted damage on the NHS and rather than going along with it and trying to make it palatable we should be saying no.
This. I get really frustrated with people who have internalised austerity so much that they are prepared to compromise our professional standards on the basis that such changes are inevitable. It is equally a non-sequitur to say that because there are many more aspiring applicants than funded places on training that means the system isn't working and needs transforming. Many professions are competitive and have many people who don't achieve their goal and end up having to change career, or compromise and settle in associated professions. We don't say that means we need to set the bar lower for law or medicine, we want the best candidates to be in those roles and the runners up to be in support roles. That isn't to say that we don't need to think about the diversity issue. But I think you are throwing out the baby with the bathwater for no reason by assuming that training needs to be changed, whether or not there are future pressures on funding.
Miriam

See my blog at http://clinpsyeye.wordpress.com

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by lakeland » Wed Jan 09, 2019 12:48 pm

Interesting thread. Does anyone know what happened to the cohort of Associate Psychologists trained in England when New Ways of Working came out? I assume that there were issues when we then became regulated by the HCPC because Associate Psychologist is not a recognised title.

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by Fiona123 » Sat Jan 12, 2019 1:18 pm

Hi

I'm the programme director of the CYP Clinical Associate Masters programme in Edinburgh. The perception of an Clinical Associate role within this thread is very different from the role that is fully integrated into the Scottish NHS and which we have worked very hard to develop over the last 10 years. Our training was developed to meet Scottish NHS workforce demands, and to provide training for psychology graduates who want to work therapeutically with children and young people (in our case), but who were not necessarily invested/interested in going on to do the doctorate. Our training is specifically designed to support individuals in developing a discrete areas of evidence based practice and skills needed to work with a Tier 2 CAMHS population. Indeed developing skills to work with a discrete population is one of the requirements of BPS draft accreditation standards of associate training courses. The associate role is highly valued, especially with the current focus on prevention and early intervention within the Scottish NHS, which has led to an increase in our training numbers this year. Our training was not developed as an alternative training pathway for Clinical Psychology, nor has it impacted the number of Clinical Psychology training places available. We see these roles working in parallel and highly value both.
Thanks Fiona

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Re: What is the view on the Clinical Associate Psychology Masters?

Post by miriam » Sat Jan 12, 2019 4:08 pm

I've only ever heard of positive things about the Scottish system of CAAPs, and I think it is something quite different. Most importantly, I think the bit that got people's backs up was the idea that clinical psychology doctorates were doomed, and that placing this type of qualification as a step in between a psychology degree and clinical training was the way forward.
Miriam

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