Final Reflections on the Stage 2 Training Process

It seems such a long time ago that I began this journey.  It has taken me 6 years and 10 months in total.  I remember after finishing my masters I felt that I had accomplished something, and that I had an experience that, whilst difficult and stressful, had been very rewarding. Finishing my Stage 2 did not feel like that, at least not at first.  I had a sense of relief that the work was finally over: no more practice diaries, no more placements, no more submission or re-submissions.  I just felt plain relieved.  Even when I received my BPS certificate and my HCPC certificate, I felt little joy or elation at my achievement.

Fast forward 6 months and I agree to attend the DFP Conference to accept my certificate in a more formal setting.  My partner and I decided to treat it as a small family holiday with our 6 month old and we drove to the conference.  My supervisor was there to greet me with hugs and congratulations and her old supervisor was also there and did the same.  I lined up with my peers who had also qualified and we sat in the front row of the conference hall waiting to be called on stage to collect our certificates.

As we waited, we whispered to one another our relief and confessed the length of time it had taken to complete, 6 years 10 months for me, some others shorter and some others longer but all of us united in the sense of gladness that it was finally over.  We collected our certificates and smiled for the obligatory group photo and then we all dispersed, back into the crowd and off back to our roles wherever we are, no one so much as looking over their shoulders.  But when I do look back at the event, I remember one thing very clearly. My little boy was the centre of attention and one lady, a senior psychologist, commented that despite the chartership, children are the greatest achievement.  And this really did place everything in perspective.

Before this, all I saw were the times of failure and the re-submissions. I had still held on to the feeling of being under constant stress and strain trying to complete the work and felt resentful of that.  I have since been able to let go of that burden, and that alone is an achievement.  To hear my peers express similar experiences and relief helped me recognise the enormity of the task we set ourselves and we came through it, slowly but surely.  More a case of the tortoise and hare than any prodigal speed to win a race but complete the race we did.  And also, if that lady was right and my little boy is my greatest achievement, then completing that chartership was an achievement along the way and I should acknowledge it as such.

I think what I am reflecting on now is that this was one of the toughest journeys I embarked upon and I know that peers on the BPS route and the doctorate are experiencing the same stresses and strains.  It is natural to feel relieved and want to push away all thought of the emotional challenges and feel bitter, but actually getting through is an achievement and each one of us should feel proud (although you won't see me applying to do any further studying for a while now, if ever!).

And also, this is one achievement, in a whole list of many that we will experience, some of which are not career related.  This profession and training can be all consuming, but it has helped me to remember that it is one part of what defines me and putting my achievements in context and in perspective has helped me take true enjoyment out of what I have done so far.

So to all of you still training, stick with it, you will get there, be brave and work through the failures - we all have had them.

To those of you starting out, don't just think about finishing fast. Think about the training route that will help you qualify, that is cost effective and that fits with the life that you want to live outside of your career. If that means choosing a slower route so that you can afford holidays and to travel and have children, then do just that; the training routes aren't going to disappear if you don't get it finished straight away, and neither is the profession.

And from me, this is my last post here as I move on to the next stage of my life.  Thank you to all those who have read, glanced over or accidentally clicked on the blog.  You have been a source of catharsis for me over these years.

Farewell.

My experience of Core Role 4

Looking back at Core Role 4, I feel this was actually the Core Role that I enjoyed the most.  This was because it took me past my nervousness at public speaking and gave me the confidence to present myself well in all aspects of my life.  It also taught me about my learning style and also my teaching style, which, I have to say, is probably a little informal.

There were aspects of this Core Role that had particular challenges in terms of the assessors.  Sometimes developing a rationale for training can be as problematic as developing a rationale for research.  Although it is understood that as a trainee you need to provide exemplars, there is no room for developing training "for the sake of it".  Assessors will pick up on this and will question whether the training was really needed by your organisation, and this in turn will suggest to them that you might not entirely understand how to identify learning and training needs in the context of working within your organisation.

On the other hand, sometimes you identify a need and there is little appetite for meeting it within the organisation.  I found that exploring literature around change and growth in organisations can help in this situation.  It can help you understand any resistance you meet and can help you develop strategies to get past this.  What you must do is provide evidence for the assessors to prove that you understand how to identify learning and training needs and that you can bring the organisation on board.

Another hurdle that you might need to overcome might be in the case of your organisation directing you to deliver training and the training is mandatory.  In these cases it is harder to demonstrate why you have identified the training needs and how you select appropriate participants for your training.  Instead, you might have to reflect on what you could do under different circumstances or perhaps you could do some additional work to check the need within your population.

With mandatory training it is vital that you consider the motivations to attend and what this might mean for people's willingness to engage and learn. It is important to consider what will affect a person's motivation to learn and how you will account for this and address this in your training.

Finally, a focus for the assessors is how you evaluate training.  They will want to see that you have used literature and research to develop evidence-based methods of determining if people have learnt from your training session.  Usually this is a form of questionnaire but you will have to have clearly demonstrated through your evidence why you have chosen this method and your reflections on your chosen method.  A final part to this will be evaluating your evaluation method through reflection.  Did your evaluation really test what you wanted it to?  What could you have changed?  What would you do next time?  They will also want to see how you have learnt and how you have applied these changes to your next training programme or seminar.

I should note that whilst a reflection on learning styles and how you have catered for them in your training is often wanted by the assessors, there is a huge amount of literature available recently which rejects the theory of learning styles.  You may want include and consider this when you are developing your training.

Core Role 3 - Advice and Consultation

It has been a few years since I completed Core Role 3 on Advice and Consultation. Initially I struggled to recall some of the exact details of the work I did to demonstrate competency in this area.  I then realised that the skills from this Core Role are applied daily and over time these have become par for the course, an integral part of what I do and how I.

This Core Role focuses on how you advise and guide the work of others.  This is not necessarily just students or other trainees, but includes colleagues, peers and even more senior persons.  Fundamentally, one of the roles of a psychologist is to provide their expert advice to others.  Very specifically, as a psychologist you cannot simply offer advice in any area of psychology.  Ethically, we are each bound to work only within our particular remit, so if forensics is your area, then your remit will be within areas directly related to offending behaviour, risk and rehabilitation.

Gaining expertise is part of a person's natural training journey. However in psychology there is an extra layer of depth.  We may, through training and experience, come to know know a good deal about a particular type of offender. However, to simply give advice based on "top of the head" information would run the risk of offering incorrect information and, as a consequence, could lead to harm to a patient or prisoner.  As we know, research and policy are changing all the time, and as a psychologist you need to be able to give the most up to date, relevant and quality information. Everything needs thought, reflection and advice based on thorough research whose application is fully justified to the case in question.

The skills that assessors are looking for in this Core Role are derived from your decisions you make on whether the requests you receive for your psychological knowledge are appropriate for you to respond to and  how you make these decisions and your subsequent response.  Assessors then want to see how you review all the relevant information; literature, psychological theory, policy, guidelines and so on, to provide the best possible advice.  They will also want to see how you deal with requests that are not appropriate, how and why you decide what these are, and how you manage the subsequent feedback and those professional relationships that these decisions impact.

Areas which are key to this Core Role are demonstrating how you can advise on policy and how you provide psychological information in high pressure situations, such as courts or parole board hearings.  With policy advice, part of this challenge will be finding the need for this in your placement. This issue can be quite challenging but your supervisor and your registrar can help with ideas on how best to do this to meet the criteria for this Core Role.  With courts or parole board hearings, not everyone will have this opportunity so finding forums where you are the "expert" and will need to defend your psychological knowledge in a similar way will be vital.  To do this, you will need to review the literature for skills in delivering information to the parole board and demonstrate how you have learnt these skills and applied them to your particular forum.  Again, this is an area that your registrar and supervisor can help you think through.

As with all the Core Roles, showing a clear link between literature and psychological evidence and then action is important.  But in this case you also need to show how evidence helps you think ethically about the advice you give, how you decide what to respond to, what information to provide within confidentiality limits, how you deliver the information and how you evaluate how the information was received and acted upon, both the good and the bad. Your skills in evaluation, decision-making and application are key.

Reflecting on Research: My experience in Core Role 2

This is possibly one of the toughest Core Roles to complete.  Opportunities for completing research are simply not as readily available as everyone might think.  Furthermore, it's not the case that you can complete the research just because you are interested in a subject; there has to be a rationale for it (See my previous blog post on Research, Readiness to Research).  Having said this, I learnt a few valuable lessons from my time completing this Core Role and you might find these tips helpful:

Ensure Clarity

The first is to be very clear in your proposal of exactly what you plan to do and what resources this requires.  This is particularly important if you are going to need staff to help you collect data.  Consider the impact this will have on their time and workload and think of ways you could minimise this or reimburse them for their efforts.  Funding is always limited and unlikely to be made available for trainee's research, however perhaps engaging and motivating staff to help you collect data might be another way to achieve this.

Simplicity and Relevance

Secondly, research for Stage 2 is not doctoral so it doesn't need to be huge and complicated.  It does need to be relevant and provide an opportunity for you to showcase your skills.  Nor do you have to demonstrate both qualitative and quantitative research: you can chose to do what you are best at.  The critical element, however, is that you have to clearly justify what methods you are using based on the available literature.  This is imperative when using both qualitative and quantitative methodology.  You must evidence and justify why you are using a particular method and why that method is the most appropriate.

The Replication Crisis

Thirdly, it is valuable to remember that there is a replication crisis currently in psychology.  And whilst it is not acceptable for the Stage 2 to replicate research (although considering the replication crisis, I believe this would be valuable as it would allow trainees to add to our current field of knowledge) you have to remember that another professional should be able to pick up your paper and replicate your methodology and results.  This being said, finding space in your paper to demonstrate reliability and validity as far as you can is valauable and being explicit in your methods will also go some why to achieving this.

Intelligent Communication

Finally, writing style is important. It is not just a question of being academic but of expressing yourself intelligently, in a fully referenced way and yet achieving accessibility to a wide range of professional readers.  Part of being able to complete research is being able to present the findings to people who are perhaps not academically-trained.  I found that having an additional document which demonstrated how I presented my findings to colleagues from a non-psychology background helped me to demonstrate that I was able to communicate my research findings to a broad audience.

My experience of Core Role 1 Assessment and Intervention

It has been a while since I have posted; a pause while I focused on completing the Stage 2 training, and I am happy to say that I am now qualified.

The space of time that I have taken between completing the training and returning to this blog has enabled me to look back at my posts and reflect on the wider training process.  I am going to write a few more posts on my reflections on each of the Core Roles for the Stage 2 training and write a final post at the end marking the culmination of my journey.  I hope these posts are helpful to trainees coming after me and continue to be of use to other colleagues and peers who are interested in this field.

Core Role 1

Core Role 1 in the Stage 2 Training is all about Assessment and Treatment.  This is the bread and butter of the work of any Forensic Psychologist; assessing a person's needs and developing suitable treatment options.  However, considering the nature of the cases and conditions that the people we work with bring to us, the complexities of the criminal justice system and the uncertainties of appropriate treatments, this task is not as simple as it sounds.

Demonstrating this knowledge and skill to the assessors is also not so simple a task.  When I started Core Role 1, it was acceptable to have separate exemplars for assessment and treatment and one could use a number of sessions of individual or group therapy to provide evidence of assessment skill, psychological theory and techniques and outcomes.  Towards the end of my training there was a shift towards the use of a Case Study approach for this Core Role and, although more prescriptive, it is actually the best approach for presenting competence to the assessors, as it can be done by following the Handbook exactly so that nothing is missed out.

The key messages in this Core Role are:

• to embed your work in the literature, 
• to evaluate your practice in as many ways possible, and,
• to demonstrate how you and your practice has changed and grown through this process.  

My key learning points were as follows:

Assessment:

Use the literature.  Demonstrate that you have read the literature and demonstrate that any decisions that you make regarding appropriate assessment methods and tools refer back to that literature.  Show that you have weighed up the literature and the options, and discussed this in peer supervision and with your supervisors.  Demonstrate that you have considered the patient or offender's needs and thoughts of their own needs, and considered any barriers to assessment and treatment and how you might overcome these. In your reflections, evaluate your practice as you go, what have you learnt, how could you do better.

Also an important factor in assessment is the demonstration of independent thinking and illustrating that you have checked the literature and are aware of the range of tools and methods appropriate to the person you are working with. Furthermore, you should have evaluated the pros and cons of using these and come to a decision.  Demonstrate that you have evaluated this decision afterwards and what you have learnt.  

Formulation:

This is also guided by literature and there is an excellent book; Forensic Case Formulation, by Sturmey and McMurran, that evaluates the different theories and models of formulation relevant to specific offenders such as violent, sexual or youth.  Demonstrate how your assessment has linked to your formulation and how your formulation changes over time as new information and evidence comes to light through the assessment and through your treatment programme.

The formulation should clearly identify treatment needs, and plans developed using the treatment or therapeutic literature of the most appropriate techniques to meet these needs.  The assessor should be able to follow a clear line from your assessment outcome, through needs identification, in the formulation to how each treatment session you hold addresses those needs and what the final outcomes are at the end of treatment.

Evidencing treatment needs and how they are met in each session:

From your session notes and reflective notes, an assessor should be able to see  how a patient or offender's needs have been addressed in the session: what did you do; what techniques were used; how did you agree these techniques with the patient; how did they react; if their reaction was negative, how did you respond and manage this; how did you manage the therapeutic relationship and what literature did you use to help you do this?  Whilst this may seem over the top, this is actually an excellent lesson in defensible, evidence-based practice.  If you are doing this properly, it should be the case that another professional could pick up your work and see exactly how and what you have done.  This creates space to check the reliability and validity of your work as well as demonstrating ethical practice. Your practice can only be ethical if it is based in evidence which demonstrates your techniques are safe and appropriate to use and that the patient understands and consents to those techniques after an informed discussion.

How outcomes are demonstrated and how one evaluates their own practice:

As with all evidence-based practice, you have to be able to demonstrate how you have evaluated your practice.  I made the mistake of thinking that the only outcomes that mattered were patient improvement. Through feedback and re-submission, I learnt that it is as important to evaluate my own practice within this.  How you plan to evaluate outcomes and practice should be agreed at the planning stage of your sessions and the assessors will then look to see if you have evaluated as you planned and evaluated appropriately.  Outcome measures are of course vital, but you also need to consider how you evaluate your own practice through supervision and peer supervision perhaps, what criteria you set to check your learning and development, whether you have met these and how you have grown and changed in the process.

Working with others:

Within this, you need to demonstrate to the assessors that you will be ready to start supervising people when you qualify, so reviewing and using the supervision literature and how you apply this to colleagues and how you evaluate your application of the theory is vital to demonstrating that you are ready to supervise others.

Whilst this is a brief summary of my learning and generic to both risk assessment and mental health assessment, I found these points to be the most salient in my learning.  I also found that being able to complete training in Structured Professional Judgement (SPJ) approaches really improved my skills in assessment and formulation, especially in considering scenarios of increased and decreased risk and how I advised other professionals of these issues.

Core Role 1 is exceptionally daunting and difficult but it is highly rewarding once completed.  The focus of having ethical, defensible, evidenced based psychological practice was important for my future learning.