Reflections upon Stage 2 Training as an Independent Practitioner

Reflections upon Stage 2 Training as an Independent Practitioner

Sally Lopresti, BSc (Hons), MSc, MBPsS, Independent Forensic Psychologist in Training

For the majority of Forensic Psychologists in Training (FPiTs), Stage 1 of the Qualification in Forensic Psychology is satisfied through completing an accredited masters degree programme in forensic psychology. A list of these courses can be found through the BPS website.

Stage 2 involves the submission of work for assessment. Two exemplars must be submitted for each of the four core roles. Alongside this work, daily practice diaries must be kept, including a log of supervision sessions. A competency log must be maintained and quarterly supervision plans written in collaboration with your supervisor. When you come to present core roles for assessment, a reflective account of the work must also be submitted.

As one of the first generation of trainees to commence the current route to chartership I was very unclear as to what my exemplars should ‘look like’ and what the benchmarks are for passing or failing submissions for assessment. This was compounded by my entry into independent practice in 2008, which meant that I had a much smaller cohort of FPiT colleagues to share experiences with.

In this article I hope to, through describing my own exemplars, offer readers examples / ideas of work that have been deemed appropriate for submission as exemplars of the four core roles. In a subsequent article I will outline the feedback received in each case from assessors.

Core Role 1: Conducting Psychological Applications and Interventions

Exemplar 1A - Conducting a range of structured risk assessments with prisoners to inform the Parole Board of level of risk of re-offending and outstanding treatment needs.

I submitted three case studies for assessment:

i)                    Case 1 was a Category C prisoner who had been convicted of offences relating to possession of child pornography. He also had some history of generalised violence. I was asked by his legal representative to undertake a psychological risk assessment in preparation for his client’s upcoming parole hearing. In order to assess levels and nature of risk and need I applied the Risk Matrix 2000 (RM2000), the Risk for Sexual Violence Protocol (RSVP) and the International Personality Disorder Examination (IPDE) Screening Questionnaire.

ii)                   Case 2 was also a Category C prisoner who had been convicted of the rape of an adult female. I was asked by HMPS to conduct a Structured Assessment of Risk and Need (SARN) following the prisoner’s completion of sex offender treatment and in preparation for his upcoming parole hearing. The individual appeared to experience some barriers to progressing in treatment, which I explored and subsequently made a recommendation for an assessment of executive functioning.

iii)                 The third case related to the provision of a psychological risk assessment to contribute to an offender’s upcoming parole hearing. The individual was a Category C prisoner serving a mandatory life sentence for the murder of an adult male. The offence involved callous and excessive violence. In assessing risk and need I applied the HCR-20 (Historical, Clinical, Risk Management) tool as well as the International Personality Disorder Examination (IPDE) Screening Questionnaire. In formulating the case I recognised symptoms consistent with Attention Deficit Hyperactivity Disorder, which appear to have impacted upon previous treatment outcome, and so recommended assessment in this area.

Exemplar 1B - Undertaking treatment need analyses and/or individual treatment work with offenders with a view to further reducing their risk of re-offending.

Again, three case studies were submitted:

i)                    The first of these cases related to a Category A prisoner who had recently relocated to the prison estate having spent over a decade in secure psychiatric units. His convictions related to acts of violence with a strong sexual element. He also had an extensive history of committing non-contact sexual offences. I received a referral from Sentence Planning Board members to undertake a Structured Assessment of Risk and Need (SARN) in order to identify outstanding needs and make recommendations for future treatment avenues. This resulted in a referral to the Dangerous and Severe Personality Disorder (DSPD) service.

ii)                   The second case related to a Category A prisoner located in a Close Supervision Centre (CSC). He had requested engagement with a psychologist in order to explore his offending behaviour.  Having first had to demonstrate the feasibility of this work to more senior managers, I undertook six sessions of cognitive behavioural treatment exploring the function of the individual’s acts of violence and violent ideation, with a view to identifying pathways for future treatment and risk management.

iii)                 The third case study related to a Category C prisoner who had been precluded from attending HMPS’s Healthy Relationships Programme due to certain aspects of his offending. The independent psychology practice that I am associated with was contacted by the lifer manager at the individual’s prison and asked to undertake a risk and need assessment followed by a course of treatment to address risk of spousal assault, if deemed appropriate. Based upon the needs identified I subsequently delivered six sessions of cognitive behavioural treatment which were rooted in psychological theory linked to attachment style and patterns of violence akin to the client’s.

 Core Role 2: Research

Exemplar 2A - Assessing the predictive qualities of the Offender Assessment System (OASys) in relation to Psychopathy Checklist - Revised (PCL-R) score among adult male prisoners in HM Prison Service's High Security Estate.

PCL-R scores were gathered as part of the data collection stage of a needs analysis being conducted within HM Prison Service’s High Security Estate between January and May 2008. For each of the offenders for whom PCL-R score-sheets were available, full OASys assessments were also collected. Logistic regression was performed to assess the reliability of selected OASys risk items in predicting PCL-R outcome.  The discussion section of my research report outlined strengths, limitations and applications of the study and its findings, as well as directing future research.

Exemplar 2B - An explorative study of hopelessness and the effect of ethnic background upon level of suicide risk amongst adult male prisoners.

My aim in conducting this study was to identify whether previously reported differences between ethnic groups in relation to suicidality were upheld once a significant psychological factor – hopelessness – was controlled for.  The study drew upon data from a larger scale doctorate study with which I was involved. Data was collected over a three month period from prisoners within the first days of their arrival within a Category B prison.  This allowed researchers to measure psychological variables, including hopelessness and suicide risk, whilst prisoners were experiencing a period of particularly high risk of self-harm or suicidal behaviour. An analysis of covariance was conducted to compare the significance of two factors known to affect risk of suicide (ethnic group and level of hopelessness). As with Exemplar 2A, the strengths, limitations and applications of the study were outlined in the Discussion section of my research report, alongside directs for future research.

Core Role 3: Communicating Psychological Knowledge and Advice to Other Professionals

Exemplar 3A: Developing the contributions of psychologists to risk assessment and management at HMP X.

In December 2005 I started a new role as the Lead Risk Assessment Psychologist. This coincided with the initiation of processes by which a number of teams, including Psychology, Probation, Sentence Planning, CARATs and Offending Behaviour Programmes would all merge to become the Case Management Function. The new approach meant changes to the way in which psychologists contributed to sentence planning and risk assessment. I was tasked with conceptualising and implementing these changes. The most significant of these included:

·         Designing, implementing and managing the new OASys+ psychological risk assessment service.

·         Developing strategies for psychological input to RAM Boards.

·         Improving the quality of OASys assessments, through training and supervision of assessors and their supervisors.

Practice diary and supervision log entries demonstrated ways in which I developed new skills and knowledge in order to overcome, over time, difficult dynamics within the newly formed team so that I could deliver the psychological input that was required of me.

Exemplar 3B: Providing a psychological contribution to the selection of uniformed staff for HMP X’s Discrete Units.

In January 2008 I was temporarily promoted to Manager F and took the position of Research and Short Interventions Team Leader. The team’s primary purpose was to offer a psychological input to the establishment’s discrete units, including segregation, healthcare and the CSC (Close Supervision Centre). This exemplar focused upon two pieces of work that I carried out in relation to discrete unit staff selection. The first involved working alongside the segregation unit’s principal officer in order to develop a staff selection interview. I went on to interview candidates for officer and senior officer positions and subsequently provided candidates with written feedback on their performance in interview. The second project was carried out in collaboration with the CSC’s principal officer. In this case, we reviewed the existing staff selection process and updated it in order that it mapped onto the new Competency and Qualities Framework (CQF), which had been recently launched by HM Prison Service. This included developing a new interview schedule, in line with the competencies outlined in the CQF.

Core Role 4: Training Other Professionals in Psychological Skills and Knowledge

Exemplar 4A: Provision of training for new Focus facilitators.

This exemplar detailed my contribution to the professional development of Focus facilitators. Focus is a substance use rehabilitation programme that is aimed at providing intensive cognitive behavioural group treatment to prisoners with severe histories of drug and/or alcohol use. I was a Focus facilitator between January and August 2004. I was subsequently the programme’s treatment manager until October 2005. The exemplar outlined the way in which in 2007-2008 I was able to subsequently apply my knowledge and understanding of the Focus programme to support the treatment manager and wider treatment team at a time when professional development needs were high but availability of resources to address training needs was relatively low.

Exemplar 4B: Identification of training needs and consequent planning and delivery of training in anticipation of job role changes within Psychological Services at HMP X.

This exemplar demonstrated my competence in recognising a situation where additional training was required, liaising with key personnel in relation to the identification of training needs, design and delivery of training and, finally, evaluating the impact of the training. In September 2007 plans were put in place at HMP X to significantly change the way in which forensic psychologists in training (FPiTs) were able to apply their skills and develop professionally. Rather than being assigned a particular role, FPiTs entered a placement system, whereby they would change role every six to twelve months. This was with a view to increasing breadth of experience and learning in order to meet the competency-based approach to Chartership. In undertaking the work described within the exemplar, I provided key managers with relevant information regarding the team’s skills profile, allowing them to make more informed strategic decisions. I also assisted FPiTs and their line managers to anticipate training requirements in order that FPiTs could aim to address their skills and knowledge gaps prior to assuming a new role.

In my next article I will discuss the way in which my exemplars were presented for assessment, as well as sharing with readers the feedback received from assessors in relation to my submissions.