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.

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.

Success in sight....almost.

Photo, "Woman Climbing Rock" by olovedog, courtesy of www.FreeDigitalPhotos.net

At a time when you least think that the going can't get any tougher, it can.  Not insurmountably tough, but there's no point dressing it up in finery.  Gaining Chartership is a testing experience.  It is a test of academic ability, intellectual ability, resourcefulness, creativity, stamina, and, not least, resilience.  The submission of completed exemplars is one of those areas where more than just your ability to gather the evidence necessary to prove you're meeting the standard and string it into words is being tested.  Putting together the submission means applying a multitude of skills, and just as you are beginning to breathe a sigh of relief at having done as much as you thought was necessary to complete everything, the submission comes back at you with stern comments on what you didn't quite get right, or you didn't get right enough.  This is where resilience and determination kick in.

Photo "Don't Give Up" by Stuart Miles, courtesy of www.FreeDigitalPhotos.net

Firstly, I just want to spend a bit of time reflecting on those fine points of detail in making your submission that can affect how it is received.  You need to ensure that there is nothing confidential that can be identified in any way - there is no option but to be extremely thorough about this.  Just this point alone speaks volume about a trainee's professionalism.  Either remove identities or blank these out.  If posters advertising training events  you are delivering are to be used as evidence, any traces of any identities must be removed e.g. photos.  I'm sure there are readers who will contemplate, as I did, just how reliable evidence that has had all identity wiped clean can be, but it is something that must simply be done. A submission must be sent in duplicate hard copies as well as through an electronic version - the precise details as well as details of what must be signed by your supervisor is on the DFP site.  It is important to make sure you have original signatures because electronic signatures will not be accepted.

Then you wait for the submission to be returned and you will feel varying degrees of confidence almost day by day.  Recieving feedback can be difficult, and this is where resilience kicks in.  The first thing you focus on is whether competence has been demonstrated.  Perhaps it has and you will feel a welter of relief.  That's great.  More commonly, your first attempt - or indeed, early attempts - at submissions will come back with the glaringly harsh comment: "competence not yet demonstrated".  

At first impact the chances are you will move along a spectrum of emotions from outrage, to deep disappointment, to despondency, through despair, and then to grudging acceptance that something was not quite right with it.  I suggest putting it down, brewing a cup of tea and coming back to it once the weeping, wailing and gnashing of teeth is over.  Then read it through again because you may find, once you read it all through, that you  have passed all but one or two of the competencies, and then, there may just be some minor issues you have overlooked.  Feedback is there to provide you with a chance to improve that little bit more, to stretch youself those last few inches to reach the summit of your training, so it is worth making the most of it.

Assessors tend to give detailed feedback. Some may be more prescriptive in what they want you to submit and others less so. Once you have read through the feedback, discuss this with your supervisor so that you decide together what is going to be resubmitted in order to cover all the points.  Then you are up and running again.

Photo "Male Runner on Starting Blocks" by stockimages, courtesy of www.FreeDigitalPhotos.net

Most trainees do not pass their first submission.  But after five or more years working on this, not quite demonstrating competence is a difficult judgement to receive and accept.  In fact, when faced with having to rework a project that was completed perhaps a year or more previously, perhaps with a different employer, perhaps in a different part of the country, the task may seem completely impossible.  However, it is very rare for an assessor to want a submission completely reworked.  Usually there is a detail that is missing or needs further clarification or greater reflection.  Perhaps your practice diary may not be clear or a reference to a piece of evidence may be missing.  Most resubmissions are usually in the form of an additional report to demonstrate a very specific piece of learning, or perhaps another reflective piece, or new practice diary entries to show that you went over your statistical analysis and are content that you chose the right one, for example.  Breaking down the feedback and requirements of resubmission into its component parts will make the pill much less bitter to swallow, and the final stretch will appear that bit shorter.

What may be worth pointing out is that assessors vary in what they like and don't like to see in submissions. Some will compliment trainees on their reflective diaries, some may like a very formal approach, others will want a good deal of supporting evidence while others are less demanding as to quantity.  The best way of dealing with this is to make sure you have unfailingly followed the guidelines and that you have made clear anything that you are not sure about with the registrar.

For many trainees, dealing with some negative feedback and having to do yet more work before reaching the finishing post can be very disheartening.  I have written this from the perspective of someone who has to resubmit some work and I understand intimately the range of emotions that this sparks off.  But proving your professionalism and capabitlities is more than what you put on paper.  It is about taking the knocks, working with them, learning from them, shaking off the hurt and taking those next steps to achieving your goal.  Success is in sight.

Photo "Young Girl Rejoicing" by stockimages, courtesy of www.FreeDigitalPhotos.net