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Wideningparticipationto

PsychologicalWellbeingPractitionertraining

ProjectreporttoHealthEducationEngland

CentreforOutcomesResearchandEffectivenessUniversityCollegeLondon

October2017

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WideningparticipationtoPsychologicalWellbeingPractitionertraining:ProjectreporttoHealthEducationEngland

1. ExecutiveSummary1.1 HealthEducationEngland(HEE)commissionedUniversityCollege LondontoundertakeaprojectonwideningparticipationtoIAPT PsychologicalWellbeingPractitioner(PWP).ThemajorityofcurrentPWP traineesareyoungwhitefemalegraduates,particularlygraduatesof psychologyandrelateddegreecourses,andtheHEEbriefwastodevelop aseriesofrecommendationstowidenthepotentialpoolofapplicantsto thePWProleandtraining.1.2 AnationalprojectgroupofPWPcourseleadsandrepresentativesofIAPT servicesacrossEnglandcarriedouttheproject.Evidenceobtained included:

• Surveysofstakeholderswithresponsesfrom12PWPcoursedirectors,51IAPTservices,160PWPsandPWPtraineesand6HEEareamentalhealthleads

• InformationfromPWPcoursesonapplicationandparticipationrates• AnanalysisofacademicrequirementstoundertakethePWPtraining

androle1.3 Stakeholderswereunanimousabouttheneedforandbenefitsof wideningparticipation.Peopleovertheageof35(currently18%ofPWP traineesacrossallcourses)wereconsideredtobethemostimportant targetgroup,followedbyminorityethnicgroups(currently22%across allcourses,but34%inLondon)andmen(currently16%acrossall courses).Keybenefitsofwideningparticipationpromotedby stakeholderswere:

• Bringingagreatdiversityofexperiencetotherole(especiallybymorematureapplicants),

• BetterrepresentingthepopulationseenbyIAPTservices• Thepotentialthatthesemorediversegroupswillstaylongerinthe

PWProlecomparedtotheyoungerPWPswhocommonlyusethisasasteppingstonetofurthertrainingandrolesinpsychologicaltherapiesandmentalhealth.

1.4 Keyrecommendations,clusteredbyresponsibilityfortakingforwardthe recommendationare: RecommendationstoNHSEnglandandHEE1.5 ThereshouldbeanationalstrategytopromotethePWProletothe generalpublictoincreaseawarenessofthePWPjobroleandofPWP training.ThisshouldbelinkedwithpromotionofIAPTasawhole.Online videosofworkinIAPTserviceswithserviceusertestimonyandtalking headsofstaff,includingdiversePWPs,shouldbepartofthisstrategy.

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1.6 HEEshouldjointlyconsiderwithSTPs,HEIsandIAPTserviceproviderstheprovisionofalternative/varianttypesofPWPtraining,suchasundergraduateroutes,part-timeoptions,trainingoveralongerperiodoftimeandapprenticeshipvocationaltraining,whichmightsuittheneedsofsomepeoplefromnon-traditionalbackgrounds.AllsuchvarianttrainingroutesshouldtrainpeopletodeliverthePWPnationalcurriculumlearningoutcomesatacompetentstandard.

Recommendationstoprofessionalbodies(BPSandBABCP)

1.7 TheBritishPsychologicalSociety(BPS)andBritishAssociationof BehaviouralandCognitivePsychotherapies(BABCP)shouldeach promotetheroleofPWPsascontributingtotheavailabilityof psychologicalandcognitivebehaviouralinformedinterventionstothe public

RecommendationstoSTPsandCCGs

1.8 STPsandCCGsshouldsupportHEIsandIAPTserviceprovidersinlocal targetedmarketingapproachestoattractawiderrangeofapplicantsto PWPtraining.1.9 STPsshouldsupportHEIsandIAPTserviceprovidersindevelopmentof accessschemestohelppeoplefromnon-traditionalbackgroundbebetter preparedforPWPtrainingandbetterequippedtomakesuccessful applicationsfortraining.1.10 STPsshouldjointlyconsiderwithHEE,HEIsandIAPTserviceproviders theprovisionofalternative/varianttypesofPWPtraining,suchas undergraduateroutes,part-timeoptions,trainingoveralonger periodoftimeandapprenticeshipvocationaltraining,whichmightsuit theneedsofsomepeoplefromnon-traditionalbackgrounds. RecommendationstoPWPcoursesandIAPTserviceproviders1.11 IAPTservicesprovidersandHEIPWPcourseprovidersshould collaborateonlocaltargetedmarketingapproachestoattractawider rangeofapplicantstoPWPtraining.Theyshouldbesupportedinthisby STPs,whichwillincreasinglyhaveakeyroleinlocalworkforceplanning, andcollaborativeinitiativesarelikelytoworkbestattheSTParealevel. Suggestionsandexamplesoftargetedmarketinginitiativescanbefound insectionXofthisreport.1.12 IAPTserviceprovidersandHEIsshoulddevelopaccessandsupport routestohelppeoplefromnontraditionalbackgroundbebetterprepared forPWPtrainingandbetterequippedtomakesuccessfulapplicationsfor training.Theyshouldconsiderbothformalschemessuchasaccess courses,NVQtraining,foundationdegreesandassistantpractitioner schemesandmoreinformalapproachessuchasmentoring,shadowing,

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secondments/placements/workandvolunteerexperienceinIAPT services.FormalschemesshouldbesupportedbySTPs.1.13 IAPTservicesprovidersandPWPcourseprovidersshouldjointlyreview andagreerecruitmentandselectioncriteriaandprocessestoensure thesedonotindirectlydeterordisadvantageapplicantsfromnon- traditionalbackgrounds.Reviewshouldcover(1)advertising/ recruitmentprocesses(includingadvertisingtimetables)(2)thewritten (applicationform)andinterviewquestionsandtasks(e.g.roleplays) usedforshortlistingandinterviewdecisions(3)bothacademic andrelevantexperienceoperationalcriteriausedinshortlistingand selectionfollowinginterview(i.e.numericalscoringsystems).1.14 Whereverpossible,thereshouldbejointselectioninterviewsbetween PWPcoursesandIAPTservicesproviders.1.15 PWPcoursesandIAPTservicesprovidersshouldroutinelymonitorthe applicationandselectionratesofkeydiversegroupstocheckiftheyare lesslikelytobeselectedand,ifso,considerwhethermodificationsto recruitmentandselectioncriteriaandprocessesmightbeappropriate.1.16 PWPcoursesandIAPTservicesprovidersshouldconsiderwhat additionalsupportmightbeneededforPWPtraineesfromnon- traditionalbackgroundsduringtheirPWPtrainingandputinplace supportsystemsaccordingly.1.17 HEE,STPs,HEIsandIAPTserviceprovidersshouldjointlyconsiderthe provisionofalternative/varianttypesofPWPtraining,suchas undergraduateroutes,part-timeoptions,trainingoveralonger periodoftimeandapprenticeshipvocationaltraining,whichmightsuit theneedsofsomepeoplefromnon-traditionalbackgrounds.Allsuch varianttrainingroutesshouldtrainpeopletodeliverthePWPnational curriculumlearningoutcomesatacompetentstandard.1.18 IAPTserviceprovidersshouldconsiderwaystomakethePWProlemore attractiveasacareer,includingcontinuingtrainingandcareer developmentopportunities.2. Introduction2.1 HealthEducationEnglandcommissionedUniversityCollegeLondonin February2017toundertakeaprojectonwideningparticipationtoPWP training.Thebackgroundtothisapproachwasrecognitionthatthe majorityofPWPtraineesareyoungwhitefemalegraduates,particularly graduatesofpsychologyandrelateddegreecourses.Thecommissioning briefwastoidentifybarriersforapplicantsfromadiversebackgroundin beingabletoapplyandbeselectedforPWPtraining,whileconsidering therequirementsofPWPtrainingandtheclinicalroleandtodevelopa

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seriesofrecommendationsthatcouldbetestedbyservicesandHEIstobe abletowidenthepotentialpoolofapplicantstothePWProle.3. Methods3.1 AsmallprojectgroupofPWPcoursedirectorsandrepresentativesof IAPTservicesfromacrossEnglandledtheproject(membershipat Appendix1).3.2 Theprojectgroupdevelopedaseriesofsurveysoftheexperienceand viewsofdifferentstakeholdersincluding:

• PWPcoursedirectors• IAPTserviceleads• PWPsandPWPtrainees,especiallythosefromadiversebackground• HEEareamentalhealthleads

ThesurveyswerecarriedoutinMay2017.3.3 12PWPcoursedirectors,51IAPTservices,160PWPsandPWPtrainees and6HEEareamentalhealthleadsrespondedtothesurveys 3.4 Followinganalysisofthesurveydata,additionalinformationwas obtainedfromPWPcourseleadstoclarifyspecificissues:

• PercentageofPWPtraineesfromkeytargetgroups(older,BME,maleandundergraduateintake)

• ApplicationratesfromtargetgroupscomparedtonumbersselectedontoPWPcourses

• ConsensusonminimumacademicabilityrequiredforpeopletomeetthenationalPWPcurriculumlearningobjectivesinareasonablelengthoftrainingtime

3.5 Adraftreportofthefindingswithrecommendationswasthendrawnup andcirculatedtothesamesetofstakeholderswithinvitationto comment.Stakeholdersendorsedtherecommendationsandmadea numberofadditionalsuggestionsthatwereincorporatedintothefinal report.4. Summaryofstakeholdersurveyfindings4.1 Theresultsofthestakeholdersurveysaresummarisedunderheadingsof:

• Targetgroupsforwideningparticipation• Barriers/obstaclestothesegroupsapplyingforandenteringPWP

training• Ideas/suggestions/initiativesforincreasingapplications/involvement

ofthesetargetgroupsinPWPtraining

4.2 FullresultsofthePWPcourseandserviceleadsandindividualPWPandPWPtraineestakeholdersurveysareatAppendix2.

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Targetgroupsforwideningparticipation4.3 BothPWPcourseandIAPTservicesidentifiedthesamethree

demographicgroupsastheirtoptargetsforwideningparticipation.Thesewereinorder-olderapplicants(variouslydefinedfrom30+upwards),minorityethnicgroupsandmen.Oftheseolderapplicantswerementionedby61%ofIAPTservices(comparedto31%forminorityethnicgroupsand27%formen).OtherdemographiclinkedgroupsmentionedlesscommonlywereLGBT,disability,otherthanmiddleclass,alternativereligiousgroupsandbilingual.

4.4 Peoplewithmore,longerand/orwiderlifeexperiencewerethenext

mostfrequentlyidentifiedtargetgroup.Thiscategorywouldbeexpectedtooverlapwiththe“older”demographicgroupidentifiedasthetoppriority.Stakeholdersmadesuggestionsofavarietyofdifferentkindsofspecificworkexperience/rolesthatmightbeparticularlyusefultotarget.TheseincludedotherNHSandsocialcareprofessionals(includingnurses,socialworkers,OTscounsellors),supportworkers(includinghousingsupportworkersandSTRworkers),peoplewithexperienceworkinginothermentalhealthroles,peopleworkingincharitable/thirdsectororganisationsandteachers.“Careerchangers”werementionedbyanumberofstakeholders,acategorywhichagainislikelytooverlapwiththewiderlifeexperienceand“older”categories.

4.5 Non-graduatesandpeoplewithloweracademicqualificationsweregiven

astargetsbybothcoursesandservices.Whileonlymentionedbyaminorityastargets(25%courses,8%ofservices),theissueofacademicqualificationsfiguredsignificantlylaterinthesurveyinrelationtobarriers/obstacles(seebelow).

4.6 AnumberofIAPTservices(11%)gavepeoplelivinglocallyand/orwho

arelocalactivemembersofthecommunity(e.g.communitydevelopmentworkers)askeytargets.

4.7 Peoplewithlivedexperienceofmentalhealthproblemswerementioned

bytwoIAPTservices. Barriers/obstaclesforwideningparticipation4.8 ThebarriersandobstaclesidentifiedbyPWPcoursesandIAPTservices

wereratherdifferentfromthoseidentifiedbythesurveyrespondentsfromPWPandPWPtraineesfromdiversebackgroundsastheobstaclesthattheypersonallyexperiencedintheirjourneytoPWPtraining.Possiblereasonsforthedifferencesarediscussedattheconclusionofthissection.

4.9 ThetopobstacleidentifiedbyPWPcoursesandserviceswasacademic

qualificationrequirementsand/orapreferencefor“traditional”candidateswithhigheracademicachievement/potential.Thisacademic

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requirement/preferencewasseenasbothdeterringnon-traditionalcandidatesfromapplyingandleadingtothemnotbeingselected.Bycontrast,noneofthediversePWPsurveyrespondentsmentionedthisashavingbeenanobstacleforthemontheirpathwaytoPWPtraining.However,thesesamePWPsdididentifythisasanissuetoconsiderintermsofideas/suggestionsforincreasingapplicationsfromdiversegroups(seenextsection)

4.10 ThesecondtopbarrieridentifiedbybothIAPTservicesandcoursesand

alsoonsomediversePWPstakeholderlistswereaspectsofrecruitmentpracticesandselectioncriteriaandprocedures.Whilesomeoftheseoverlappedwiththeacademicqualificationrequirements/preferencesissueabove,thesecommentswereaboutawiderrangeandmorespecificoperationalaspectsofrecruitmentandselectionprocedures.Theseincluded(1)advertisingonNHSJobswithacapafterthefirst100or200applicantsadvantagingthepreparedtraditionalcandidate(2)formalpersonspecificationsforthePWProlebeingskewedtowardstraditionalapplicants(3)theabilitytocompleteapplicationsformsandanswerinterviewquestionswellbeingmoredifficultformorediverseapplicantswithoutthesameknowledgeoftheroleandwhattosayandoftenwithoutthesamewritingandverbalskillsastraditionalapplicantsand(4)thequantitativeoperationalcriteriausedinshortlistingandinterviewsfavouringtraditionalapplicants(5)thehecticpaceandhighvolumeofrecruitment/selectionleadingtothoseselectingusingmorerestrictedcriteriaratherevenwherewiderselectioncriteriahavebeenagreed.AninterestingaspectofsomeIAPTserviceandPWPcoursesresponseswasthattheyattributedaspectsofselectionproceduresdeterminedbytheotherpartyasreflectingapreferencefor“traditional”overmorediversecandidates.Whileonlyaminorityofbothmadecommentsalongtheselines,itwasnoteworthythatwherethisoccurredeachconsideredtheotheras,inthewordsofonerespondent,“havingswayovercandidateappropriateness”.

4.11 LackofawarenessofthePWPjobroleandavailabilityoftrainingforthe

roleamongthegeneralpublicandwiderpoolofpotentialapplicantsinparticularwasthethirdtopobstaclementionedbybothcoursesandservices.WhilenotmentionedasapersonalobstaclebythediversePWPsrespondents,thismayhavebeenastheyinterpretedthisquestionastheirjourneyfromlearningaboutthePWPjobroletogettingontoacourse.TothesurveyquestionaskinghowtheyfirstheardaboutthePWProle,theolderPWPsoftenmentionedthishappeningbyhappenstanceandinthelaterquestiononideas/suggestionsforincreasingpublicvisibilityoftherolefiguredhighlyintheiranswers(seebelow),soPWPsthemselvesclearlyidentifiedthisasanissue.

4.12 Bycontrast,thetoptypeofobstaclesidentifiedbydiversePWPintheir

journeytoPWPtrainingwerepracticalissuesregardingfinances(dropinsalary,borrowingmoney),geography(havingtomovetoanothertown),

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childcareand,forolderPWPs,thedifficultdecisioninthefirstplacetomakeacareerchange.

4.13 ThesecondtopbarrieridentifiedbydiversePWPswasdifficulty

obtainingrelevantvolunteerorpaidmentalhealthorotherrelevantexperiencetogetselectedontoPWPtraining.

4.14 BothPWPsrespondentsandservicesidentifiedviewsofthePWProleand

ormoregenerallyjobrolesintalkingtreatments/mentalhealthasbeingeithernotforpeoplelikethem(notformen/notforapersonfrommyminoritybackground)orbeingveryawarethattheywouldbeaminorityintrainingandworkasbarrierstobeovercome.SomePWPrespondentscommentedaboutbeingveryawareofthisduringtheirtrainingandattimesfeelingthattheirtrainingcoursewastargetedtowardstraditionalcandidatesandhaddifficultyadaptingtotheirdifferentexperience.

4.15 AfurtherbarriermentionedbybothservicesandolderPWPtraineeswas

anxietyaboutgoingbackintoeducationand/ormanagingcourserequirementsafteralongtimeawayfromeducation.Thismayinpartbearealisticanxiety-someolderPWPscommentedthatitwasindeedhardduringtheirPWPtrainingtogetbackintodoingcourseworkandexams.

4.16 Otherbarriersmentionedbycoursesand/orserviceswere(1)lowpay

forthePWProle(2)lackofcareerprogressionintherole(3)requirementtotrainfulltimeand(4)geographyofcourses(beingtoofarfromwherepeopleareliving).

4.17 ThedifferencefoundbetweentheobstaclesidentifiedbythediversePWP

surveyrespondentscomparedtothoseidentifiedbycoursesandservicesmaybeduetoanumberofreasons.First,certainbarriersidentifiedbycoursesandservices(e.g.academicqualifications)maywellnothavebeenpersonallyanobstacleforthePWPsurveyrespondentsandthisiswhytheyweresuccessfulingettingontoPWPtraining.Second,asnotedthePWPsurveyrespondentsmayhavefocusedtheirresponseaboutobstaclesononlyapartoftheirjourneyfromlearningaboutthePWPjobroletogettingontoacourseandnotonthefulljourney.Theirresponsestoothersurveyquestionscertainlyindicateawarenessofawiderrangeofpotentialobstaclestothosetheypersonallyfaced.

Ideas/suggestion/initiativesforwideningparticipation4.18 Surveyrespondentsmadearangeofsuggestionsofwaystowiden

participationinPWPtraining.Allstakeholdergroupsmadesimilartypesofsuggestions.Inaddition,coursesandservicesdescribedavarietyofwideningparticipationinitiativestheyhadundertaken(25initiativesinall)–inresponsetoaspecificsurveyquestionaboutinitiatives.Theseideasandinitiativesfellunderthefollowingbroadheadings,inorderoffrequency:• PromotingandmarketingthePWProleandtraining

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• Reviewingrecruitmentandselectioncriteriaandprocesses• Developingaccess/mentoring/supportroutes• BetterpayandcareerdevelopmentopportunitiesforPWPs• Alternativetypesoftrainingcourses• Supportfordiversetraineesoncourses• Examplesofspecificsuggestionsandinitiativesaregiveninboxes.

4.19 SuggestionsandinitiativesaroundpromotingandmarketingthePWP

roleandtrainingwerebyfarthemostfrequent,witharoundhalfofeachtypeofstakeholderrespondent(courses,servicesanddiversePWPs)makinggeneralorspecificsuggestions.Stakeholdersdescribedbothaneedforuniversalpromotionandmarketingtothegeneralpublic,givenlowawarenessofthePWProleandtraining,andtargetedmarketinginitiativestospecificgroups.Ideasforpromotiontothegeneralpublicincluded:• nationalTVandradioadvertising• stallsatjobfairs• promotionviaJobCentres• careertalksinschools• PWPcourseand/orIAPTserviceopendays/events.

Ideasformarketingtotargetedgroupsincluded:• makingclearincoursematerialsandwebsitesthatolderpeople,BME

groups,peoplewithoutstandardacademicqualificationsandothermorediversegroupsareencouragedtoapply(withvideovignettesandquotesofdiversePWPtraineesandstatingthatadiversebackgroundcanbeanadvantage)

• advertisinginlocalmedia• postersincommunityvenues• outreachtolocalcommunitygroups/viacommunityleadersto

identifypeoplewhomightbesuitable• advertisingonBMEandLGBTwebsites• advertisinginmedia/onwebsitestopickupspecificsecondcareer

groups(e.g.mothersre-enteringtheworkforce,teachers,otherhealthandsocialcareprofessionals)

• liaisingdirectlywithemployers/occupationalhealthdepartmentswheresomeemployeesmaynolongerbeabletoundertakethephysicalrequirementsoftherole(fireservice,ambulanceservice,military)

• useofsocialmedia• openeventsforspecifictargetedgroups• promotionbyIAPTemploymentadvisors.

MarketingcampaignforolderapplicantsHealthEducationEnglandNorthCentralEastLondoncommissionedUniversityCollegeLondontopilotamarketingapproachtoattractmorematurepeoplewithawiderrangeoflifeexperiencetoPWPtraining.

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Amarketingexpertwascommissionedtoadviseonandcoordinateamarketingcampaign.ThemaincampaigninvolvedastrikingadvertintheGuardian(olderreadership)coordinatedintimewithemailsfromaspecialistmarketingcompanyto250,000emailaddressesofpeopleintherelevantdemographictargetgroup(age35-65,livingintheLondonarea,etc).BothnewspaperadvertandemailslinkedpeopletoanEventbritepagetosignuptoOpenEveningeventsaboutPWPtraining,togetherwithlinkstowebinformationaboutPWPtraining.PWPsandseniorPWPsdescribingtheirexperienceoftrainingandtherolewerecentraltotheopenevents.ThetwoOpenEveningEventswereoversubscribed.Ofthosewhoregisteredandattended,45madeapplicationstoPWPtraining.Therewasanoverallincreaseinthenumberandproportionofapplicantsfromamaturebackground(age35+)from95inthepreviousyearto256intherecruitmentroundfollowingthemarketingcampaign.

LocallytargetedrecruitmentTheLincolnshireIAPTsteps2changeserviceservesalargeruralcounty.Assuchitperhapsnotappealingtoyoungerworkersandtheyfoundmanytraineeslefttheservicewhenqualified.TheydecidedinsteadtotargetrecruitmentatcurrentHealthCareSupportWorkersintheTrust.TheadvantagetothisapproachwasthatthestaffarealreadyworkingandlivinginLincolnshiresoknowwhatitisliketoliveinaruralcountyandtheyalsohaveexperienceofworkingwithpatientswithmentalhealthissues,thereforebringingawealthofexperience.Thishaschangedthemakeupofthestaffinggroup,fromgenerallyyoungerfemalestoavarietyofagesandmoremales.Theyanticipatethiswillleadtoalowerturnoverandthatourpatientsreapthebenefitsofanexperiencedmorediverseworkforce

Targetingspecificminoritygroups TheOrthodoxJewishcommunityisasignificantreligiousminorityinSalford.In2011theproportionsofpatientsaccessingtheIAPTservicefromthisminoritygroupwasconsiderablyshortofthelevelsexpected.SixDegreesSocialEnterprise,thestep2IAPTserviceprovider,developedtheEisLedaberprojecttoaddressthisdisparity.EisLedabermeans‘timetotalk’inHebrew.TheprojecthasbeensuccessfulinachievingitsaimsofincreasingtheuptakeofNHSfundedIAPTservicesandaddressinghealthinequalitieswithinthiscommunity.Akeyelementoftheproject’ssuccesshasbeenthetargetedrecruitmentofTraineePWPsandvolunteersfromtheOrthodoxJewishcommunity.TheadvertisingsourcesdifferedfromtraditionalroutesandSixDegreesworkedcloselywiththecommunityandHigherEducationInstitutestoovercomequalificationbarriers.SixDegreeshashadtobeflexibleto

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accommodatethereligiousneedsoftheOrthodoxJewishstaffingrantingflexibleworkinghoursandunderstandingtheiruniqueculturalreferencepointsandboundaries.Theembeddedworkershavetoohadtodealwithpersonalchallengesasaconsequenceofbothlivingandworkingwithinarelativelyclosedcommunity.In2013,SixDegreesidentifiedasignificantincreaseinthenumberofrequestsforPolishinterpreters.Therewerehigherattritionratesandculturalissuesaffectingtreatmentoutcomes.SixDegreesrecruitedPolishspeakingtraineestoassistSixDegreestoaddressandimprovehealthoutcomesanddeveloporganisationalculturalcompetence.Thiswasverysuccessful,bothintermsofrecruitment,increasedaccessratesandimprovedrecoveryrate.InordertosupportthePolishspeakingtrainees,theservicerunaspecialistBMEsupervisiongroupthatenablesstafftodeveloptheircompetenciesindeliveringculturallyadaptedlowintensityinterventions.

4.20 Reviewingandamendingrecruitmentandselectioncriteriaand

processesandmonitoringtheseinpracticewasthesecondbroadthemethatstakeholdersmadecommentson.Theseincludedreviewingpersonspecificationsfortherole,reviewingapplicationsandinterviewprocessesandreviewingshortlistingandselectioncriteriatomakeitmorelikelythatpeoplefromadiversebackgroundwillapplyandbeselected.Specificsuggestionswithinthiswere:• requiringservicesanduniversitiestojointlyagreecriteriaand

whereverpossiblejointlyinterviewcandidates• givingcreditinshortlistingandselectioncriteriaforawiderrangeof

workandlifeexperiencesasrelevant(andgenerallyweightingmoretowardstolifeexperienceandlesstowardsacademicachievement)

• reviewingspecificaspectsoftheapplicationprocess(writtenapplicationformandinterview)whichmayfavourpeoplewithadegreeandinsideknowledgeofIAPTandbiasagainstthosewithamorediversebackground

• consideringalternativeselectiontaskslikeroleplayswhicharebothrelevanttotheroleandmaybelessbiasedinfavouroftraditionalapplicants.

4.21 RoutestopreparepeopleforPWPtrainingwasthethirdstrandofideas

advancedbyallstakeholdergroups.Specificsuggestionsincludedbothformalschemesandarrangementssuchasaccesscourses,NVQtraining,foundationdegreesandassistantpractitionerrolesandmoreinformalapproachessuchasmentoring,shadowing,secondments/placements/workandvolunteerexperienceinIAPTservicesandotherbridgingopportunitiesthatwouldhelppeoplefromnontraditionalbackgroundbebetterpreparedfortrainingandbetterequippedtomakesuccessfulapplicationsfortraining.

AssistantPractitionersforIAPTServices

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TheNorthWestPsychologicalProfessionsNetworkinCollaborationwithHealthEducationEnglandhaspioneeredtheintroductionofanAssistantPractitioner(AP)rolewithinIAPTServices.In September 2016 three trainee APs were recruited to work withinIAPT teams across Greater Manchester, linked with undertaking aFoundationDegreeatTheUniversityofBolton.TheFoundationDegreeprovides foundation degree level training for assistant practitionersworkinginarangeofhealthservices.12monthsintothispilotscheme,theAProlewithinIAPThascometobeseenasanexcellentsupportingroleforPWPsandanopportunityforcareerprogressionwithintheIAPTserviceSince the pilot began, there has been growing regional and nationalinterest in the apprenticeship levy and a Higher ApprenticeshipAssistant Practitioner standard and training is being developed. TheNorthWestIAPTrecruitmentandcareerdevelopmentprojectnowaimsto link with this and collaborate with educational providers of APapprenticeship to create a training programme to achieve sustainablerecruitment and training for those wishing to progress with the IAPTservice.Formoreinformationcontact:paul.barber1@nhs.net

4.22 WaystomakethePWProlemoreattractiveasacareerwerementioned

asafactortoaddresstoattractdiversecandidatesbyallstakeholdergroups.Specificsuggestionswerehigherpayandanimprovedcareerstructureandopportunitiesforcareerprogression.ThiswasparticularlymentionedbyolderPWPsandmalePWPs(NBagreaterproportionofthemalesurveyrespondentswereage35+thanfemalesurveyrespondents–40%vs28%).ThatolderPWPshadmentionedfinancesasapersonalbarrier/obstacletotrainingasaPWPunderlinesthisasasignificantissue.

4.23 Developmentofalternative/varianttypesofPWPtrainingroutewas

suggestedbyolderPWPrespondentsandbothcoursesandservices.Specificsuggestionsweremoreundergraduateleveltrainingroutes,part-timetrainingoptions,longerandmoreflexiblecoursesthatcouldtrainpeoplewhowouldbenefitfromlongertrainingandapprenticeshipandvocationaltrainingroutes.ThecurrentdevelopmentofaPWPapprenticeshipstandardwasmentionedbybothservicesandcoursesasastructurethatcouldbeusedtodeliveravocationalandmoreflexibleapproachtotrainingthatmightbebettersuitedtotrainingpeoplewithlimitedacademicqualifications.

PWPApprenticeshipTrainingInSeptember2016aworkinggroupwasestablishedtoexplorethepossibilityofprovidinganalternativerouteintoPWPtrainingthrough

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theApprenticeshipScheme.AswellastheapprenticeshipschemeofferinganalternativefundingstreamforPWPtraining,oneaimofthisdevelopmentwastoprovideadifferentaccessroutethatwouldallowlocalIAPTserviceprovidersmoresayinthedemographicofpeoplewhoarebroughtintotraining.Thismightincludeselectingandtailoringtrainingtopeoplewithdifferentqualificationlevelsandfromrelevantlocalcommunitiesanddemographicbackgrounds.Thehopewasthatasupportedrouteintotrainingthroughapprenticeshipprocessescouldfacilitateahome-grownworkforcetoemergethatcouldpotentiallyproduceamorerepresentativeandstableworkforceinthefuture.Theprojecthasnowbecomeaformalstandarddevelopmentcommitteeandisworkingoncompletinganapprenticeshipstandardandanassessmentschedule,whichwillleadtotheformalrecognitionofthisalternativerouteintotrainingandaccesstothealternativefundingstrandsassociatedwithapprenticeships.Followingdiscussionwithallstakeholdersthefocusofthestandardhasmovedtowardsensuringthatthereiscontinuityandparitywithexistingtrainingprocessesastheapprenticeshipbecomesarealitytocontinuefundingandsupportforfutureworkforcetrainingprovision.Thefocusoftheapprenticeshipprocessonserviceledselection,recruitmentandtrainingwillfacilitatelocalinitiativesfocusingontargeteddemographicstoemergealongsiderigorousassuranceofparitytoexistingtraining.TheapprenticeshipprocesshaspotentialinthiswaytosupportlocalisedworkforceplanninganddevelopmentandthewideningparticipationagendaaswellassecuringasecondfundingschemeforPWPtrainingintothefuture.ItishopedthestandardwillbereadyfordeliverybySeptember2018/19

4.24 FinallytheolderPWPsurveyrespondents,butnootherstakeholder

group,madesuggestionsaboutPWPcoursesprovidingadditionalsupportandguidanceformorediversetraineesinassignments/submissionsandotheraspectsofthecourse,especiallyiftheyhavenotbeeninformaleducationforalongtimeandmaybeneveratuniversitylevel.Theyinadditionsuggestedthatcoursewebsitesandpromotionalmaterialshouldincludetheavailabilityofsuchsupporttopeoplefromadiversebackgroundasapartoftheirmarketingstrategy.

5. Currentparticipationandapplicationratesfromkeytargetgroups5.1 Followinganalysisofthesurveydata,additionalinformationwas obtainedfromPWPcourseleadson:

• PercentageoftraineesonPWPcoursesfromkeytargetgroupsidentifiedbysurveyrespondents-older,BME,maleandnongraduates

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• ApplicationratesfromthesetargetgroupscomparedtonumbersselectedontoPWPcourses

Responseswereobtainedfrom12courses.Averageproportionoftraineesfromthetargetgroupsincurrentandrecent(upto3previousyears)cohorts(totalPWPtrainees=1278)fromtherespondingcourseswere:• Age35+=18%• BME=22%• Male=16%• Onundergraduate(vspostgraduateroute)=7%

5.2 Therewassomevariationbetweencoursesinproportionage35+and BMEtrainees.Whilemostcourseshadsimilarproportionsage35+,the UniversityofCentralLancashirehadamuchhigherproportionintheir twocohorts(36%).ProportionofBMEtraineesoncoursesvariedfrom 2%to34%onthewholereflectinggeographyofthecourses(with Londonthehighest).Proportionofmenwasverysimilarbetweencourses (13%-21%).Proportionontheundergraduaterouteweregenerallylow (1%-8%),buttwocourseshadhigherundergraduatenumbers (Birmingham17%,Teeside13%).5.3 Informationonapplicationratesfromtheidentifiedtargetgroupswas onlyobtainedfromtheUCLcourse.Asrecruitmentformostcourseswas ledbyservicesandservicesmostlyusedNHSJobsonwhichinformation majorityofcourseswereunabletoaccessthedatarequiredtocompare applicationtoselectionratios.RecruitmenttotheUCLcourseinrecent cohortshasbeenbyapplicationdirectlytoUCL,hencethebetter availabilityofapplicationdata.ForUCL,therelativeproportionsapplying andstartingPWPtrainingfortwoyearsofcohortswere:

• Age35+:Applications=459/2460(19%);starting24/243(10%)• Male:Applications=405/2460(16%);starting33/243(14%)• BME:Applications=724/1791(40%);starting66/196(34%)

5.4 Thesefiguresindicatethatolderapplicantswerelesslikelytobeselected andtherewasasimilartrendforapplicantsfromBMEbackgrounds.For olderapplicants,UCLundertookanauditofselectionofoldercandidates foronecohorttoexploretherelativecontributionofuniversityand servicestoanyselectionbias.ThiswaspossibleasUCLoperatesatwo stageshortlistingprocedureforselectionforinterviewswhereuniversity shortlistforinterviewfromtheremainingcandidates.TheUCLaudit suggestedthatbothuniversityandservicesselectedoutmoreolder applicants,theuniversitylonglisting92/256(36%)ofage35+vs45% (393/871)ofyoungercandidatesandservicesshortlisting45/92(49%) ofthelonglistedolderapplicantsvs267/393(70%)oftheyounger longlistedcandidates.Onceshortlisted,atinterviewolderandyounger candidateswereequallylikelytobeselected.

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5.5 ThelackofdataaboutapplicationratesfromuniversitiesotherUCLmean thatitisnotpossibletodrawfirmconclusionsabouttherelative contributionoflowapplicationratesvsselectionprocedurestolow participationfrommorematurepeople,men,BMEgroupsandpeople withoutanundergraduatedegree.However,reportsfromothercourses confirmthedatafromUCLofveryhighapplicationratesfromyounger femalegraduates,theonedifferenceatUCLbeingthatahighproportion werefromBMEbackgroundsratherthanpredominantlywhite.Thus wideningparticipationhastostartbyincreasingapplicationratesfrom theseunder-representedgroups.6. AcademicrequirementsforPWPtraining6.1 Giventheinterestofstakeholdersurveyrespondentsinbroadening

accesstopeoplewithoutstandardacademicqualificationsandthecommentsofsomerespondentsthatacademicrequirementswereunnecessaryorexcessiveincurrentPWPtraining,theprojectgroupundertookananalysisofthePWPacademicrequirements.

6.2 ThestartingpointforthisanalysiswasthePWPnationalcurriculum.This

setsoutlearningoutcomesthatPWPtraineesneedtoachievebytheendoftheirtrainingcourse.TheselearningoutcomesineffectdefinethecompetenciesrequiredofPWPstoundertakethePWProle.TheyweredefinedatthebeginningofthenationalIAPTrolloutandhavebeenamendedinonlyminorwayssince.ThecurrentPWPnationalcurriculumlearningoutcomesaresetoutinAppendix3.TheyareincorporatedintotheBPSaccreditationstandardsforPWPcourses.

6.3 Theselearningoutcomesincludedemonstrationofknowledgeand

understandingofanumberofareasrelevanttoPWPpracticeaswellasdemonstrationofcompetenceinusingthisknowledgeandunderstandingaspartofrole-playedandliveclinicalworkwithpatients.Togethertheselearningoutcomesrequire“academic”(knowledge,understandingandanalytic)aswellas“clinical”(interpersonal,practicalanddecisionmaking)skills.

6.4 ShowingevidencethatPWPtraineeshavemettheselearningoutcomesanddemonstratecompetenceinpracticeisthefunctionofassessments,bothwrittenassessmentsandclinicalcompetencyassessments.WrittenassessmentsevidencethetraineePWP’sunderstandingandknowledgeofkeyareasrelevanttoPWPpractice;clinicalcompetencyassessmentsevidenceusingthisknowledgeandunderstandingtogetherwithappropriateskillsinrole-playedand/orliveclinicalwork.ThepassmarkforassessmentsistheboundarythatdetermineswhetheraPWPhasmetthelearningoutcomesandiscompetenttopractice.

6.5 AtthebeginningoftheIAPTprogrammeitwasestablishedthatthe

absoluteminimumrelevantknowledgeandunderstandinganduseofthisinpracticerequiredtodemonstrateachievementoftheselearning

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outcomeswasequivalenttopassinganundergraduate(level6)course.Theminimumpassmarknormallysetatlevel6is40%,whichcorrespondstogradedescriptorsassociatedwithaminimumlevelofknowledgeskillsandanalysisatthisacademiclevel.Theexpectedknowledgeskillsandcompetenceatlevel7(apostgraduatecourse)aresignificantlymorestringentand,inaddition,arenormallyaresetat50%level.Thesystemoflevelsofqualifications(fromlevels1-8,fromNVQlevel1todoctorate)andminimumpassmarkforeachprovidesthestandardwell-establishedsystemforbenchmarkinglevelsofreasoningandthinkingskillsrequiredfordifferenttypesoftaskandroles.Assuchthechosenlevelofassessmentreflectsthestandardpracticalmethodofestablishingandassessingthatstudentshavemetminimumstandardsforcompetencytopractice.

6.6 Movingfromassessmentofcompetenceatendoftrainingtoselectionof

appropriatecandidatesforPWPtraining,akeyquestionforselectioniswhethercandidatesarelikelytobeabletoachievetherequiredlearningoutcomesinareasonablelengthoftrainingtime.Thestandardwaytodecidewhethersomeonehasthelearningpotentialtoachievelearningoutcomesandpassacourseataspecificlevelofqualification(level6forPWPsonanundergraduateroute)isthattheyhaveobtainedqualificationsatahighenoughpassmarkatapreviouslevel.Thisisfineforpeoplewhohaverelevantqualifications.ForPWPstherelevantqualificationsareeitheranundergraduatedegree(level6),whichindicatestheylikelyhaveabilitytopassaPWPcourseatpostgraduatelevel(level7);orevidenceofsuccessfulstudyatlevel5,whichconfirmstheylikelyhaveabilitytopassaPWPcourseatundergraduatelevel(level6).Forcandidateswhodonothavearelevantqualification,trainingcourseshavetouseothermethodstoevaluatelearningpotentialinordernottoselectcandidateswhoareathighriskoffailingtoachievethePWPnationalcurriculumlearningoutcomesandfailingtodemonstrateadequatecompetencebytheendoftheirtraining.GeneralapproachesusedbothbyPWPandothercoursesare:• Usingselectiontestsorothertasksatadmissiontoassesslearning

potential.Somemedicalschoolsroutinelyusesuchtestsinselection.APWPcourseexampleissettingawrittenessaythatcandidatescompleteintheirowntimeoverafewweeks(seebox).

• Evaluatingwhethercandidatespriorexperienceandachievementsareequivalenttotheusualpre-requisitequalificationfortheprogrammeofstudy.Thusacandidatewhoroutinelywrotecomplexreportsaspartoftheirworkmightbeconsideredinthesereportstodemonstrateanalyticskillsequivalenttothoseachievedonalevel6degreecourse.Accreditationofpriorexperientiallearning(APEL)isaformalprocessofthiskind,althoughusuallyusedtodemonstratethatstudentscanbeexcusedfromelementsofacourseratherthantodemonstrateequivalencebyexperienceofentryqualificationstoacourse.

• Assessingwhethercandidatescanusetheirpriorexperienceandlearninginnewcontexts(seebox),aprocessreferredtoas

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encapsulationofpriorlearning.Candidatesarerequiredtoundertakealearningmoduleandtodemonstratethroughnewlearningthattheyareabletoacquireknowledge,understandingandanalysiscommensuratewithstudyatlevel5.Thisisamorerigorousapproachthanthetwoabove,butwouldallowaccessforthosewhomightbeunabletodemonstratethisbytheotherapproaches.

Anessaytasktoselectnon-graduatesTobroadenaccessandofferequalopportunitiestothosewithnon-traditionalbackgroundswhocannotbeconsideredthroughtheAPELroute,whichcontinuestohaveafocusonacademicachievement,theUniversityofSouthamptonoffersanalternativeroute.ThisrouteispredominantlytakenupbythosealreadyemployedinTrustsatpresent,butthiswouldnotbeconsideredtheonlyoption.Potentialcandidates,eitheridentifiedpriortoapplyingforaposition,orafterapplyingandhavingbeenidentifiedasnothavingevidenceofstudyatL5,areaskedtowritea2000wordessayonatopicsetbytheprogrammelead,currentlyabouttheadvantagesofbehaviouralapproachesovercognitiveones.Thepotentialapplicantissenttheessaytitle,butarealsosentthemarkinggridwhichwillbeusedtoassessthelevelsotheyunderstandwhatisbeinglookedforbythemarker.Theyaregivenupto4weekstocompletethisandareremindthatthisneedstobetheirownworkasultimatelyifsomeoneelsecompletesthisforthemthentheycouldwellstruggleontheprogramme.Theessayisthenmarkedbyoneofthecourseteam,againstthecriteria.Ifthecandidatedoesnotmeettherequiredstandard,butisassessedtobenottoofarfromtherequiredlevelthenthecandidateisprovidedwithstructuredfeedback(asastudentwhofailedanacademiccomponentonaprogrammewouldbe)andoffereda2ndattempt,againtobecompletedin4weeks.Successfulcompletionofthis,oratthe1stattemptthensatisfiesthecoursedirectorthatthiscandidateshouldbeabletomanagetherequiredlevel.Ofthosewhohavegainedentrytotheprogrammethiswayallhavecompletedtheprogramme,buthavegenerallyrequiredadditionalsupport.

Ane-learningmoduletoassesslearningpotentialTheUEAcoursehascreatedane-learningmoduletoenableaccesstoPWPtrainingawiderpoolofnon-graduateswithoutrecentstudyexperienceorusualqualificationlevel.Servicesareabletoshortlistnon-graduatesthatmayordinarilynotmeetuniversityentrycriteria.Iftheyaresuitableatinterview,theyreceiveanofferdependentontheircompletionoftheaccessmodule(12hours)priortotheinductionweek.

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Thee-learningmoduleteachesthenon-graduatesaboutIAPT,teachesstudyskillsandteststheirknowledgeinaninteractiveformattoenablethecoursetomeettheuniversityentrycriteriainacreativeway.Thee-learningmoduleincludeslotsofvideosandblendedlearningtaskssoacademicstudyskillsareembeddedwithinIAPTrelevantlearningandseemrelevanttotheperson.Studentsareprovidedwithanacademicmentorforsupportastheycompletethemodule.

6.7 Learningpotentialclearlyinteractswithlengthoftraining.Sowitha

longertrainingandmoresupport,somepeoplemightbeabletoachievelearningoutcomesandmeetminimumcompetency,whowouldbeunabletodothisinashorterlengthoftime.Butthisclearlyincreasesthecostsoftraining.Atsomeextensionoflength,atrainingisprobablybetterdeliveredastwolinkedcourses,forexampleasaninitiallevel5foundationdegreefollowedbyalevel6PWPundergraduatetrainingrouteandrelatedexamplesofaccessschemesdescribedintheprevioussection.Forexampleassociatepractitionerstrainedtolevel5ingenericmentalhealthpracticemaywishtousethisfoundationtoaccessaPWPqualificationatlevel6andtomoveonbeyondthistocompleteaformalhonoursdegree(seeboxabove).

7. Recommendationsforwideningparticipation7.1 Ourrecommendationsforwideningparticipationdrawheavilyonthe

stakeholdersurveysuggestionsandarestructuredunderthesameheadings:• PromotingandmarketingthePWProleandtraining• Developingaccess/mentoring/supportroutes• Reviewingrecruitmentandselectioncriteriaandprocesses• Supportfordiversetraineesoncourses• Alternativetypesoftrainingcourses

PromotingandmarketingthePWProleandtraining7.2 ThereshouldbeanationalstrategytopromotethePWProletothe

generalpublictoincreaseawarenessofthePWPjobroleandofPWPtraining.ThisshouldbelinkedwithpromotionofIAPTasawhole.OnlinevideosofworkinIAPTserviceswithserviceusertestimonyandtalkingheadsofstaff,includingdiversePWPs,shouldbepartofthisstrategy.

7.3 IAPTservicesprovidersandHEIPWPcourseprovidersshould

collaborateonlocaltargetedmarketingapproachestoattractawiderrangeofapplicantstoPWPtraining.TheyshouldbesupportedinthisbySTPs,whichwillincreasinglyhaveakeyroleinlocalworkforceplanning,andcollaborativeinitiativesarelikelytoworkbestattheSTParealevel.SuggestionsandexamplesoftargetedmarketinginitiativescanbefoundinsectionXofthisreport.

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Developingaccess/mentoring/supportroutes7.4 IAPTserviceprovidersandHEIsshoulddevelopaccessandsupport

routestohelppeoplefromnontraditionalbackgroundbebetterpreparedforPWPtrainingandbetterequippedtomakesuccessfulapplicationsfortraining.Theyshouldconsiderbothformalschemessuchasaccesscourses,NVQtraining,foundationdegreesandassistantpractitionerschemesandmoreinformalapproachessuchasmentoring,shadowing,secondments/placements/workandvolunteerexperienceinIAPTservices.FormalschemesshouldbesupportedbySTPs.

Recruitmentandselectioncriteriaandprocesses7.5 IAPTservicesprovidersandPWPcourseprovidersshouldjointlyreview

andagreerecruitmentandselectioncriteriaandprocessestoensurethesedonotindirectlydeterordisadvantageapplicantsfromnon-traditionalbackgrounds.Reviewshouldcover(1)advertising/recruitmentprocesses(includingadvertisingtimetables)(2)thewritten(applicationform)andinterviewquestionsandtasks(e.g.roleplays)usedforshortlistingandinterviewdecisions(3)bothacademicandrelevantexperienceoperationalcriteriausedinshortlistingandselectionfollowinginterview(i.e.numericalscoringsystems).

7.6 Whereverpossible,thereshouldbejointselectioninterviewsbetween

PWPcoursesandIAPTservicesproviders.7.7 PWPcoursesandIAPTservicesprovidersshouldroutinelymonitorthe

applicationandselectionratesofkeydiversegroupstocheckiftheyarelesslikelytobeselectedand,ifso,considerwhethermodificationstorecruitmentandselectioncriteriaandprocessesmightbeappropriate.

Supportfordiversetraineesoncourses7.8 PWPcoursesandIAPTservicesprovidersshouldconsiderwhat

additionalsupportmightbeneededforPWPtraineesfromnon-traditionalbackgroundsduringtheirPWPtrainingandputinplacesupportsystemsaccordingly.

Alternativetypesoftrainingcourses7.9 HEE,STPs,HEIsandIAPTserviceprovidersshouldjointlyconsiderthe

provisionofalternative/varianttypesofPWPtraining,suchasundergraduateroutes,part-timeoptionsandtrainingoveralongerperiodoftime,whichmightsuittheneedsofsomepeoplefromnon-traditionalbackgrounds.Thisshouldincludeconsiderationofapprenticeshipvocationaltraining,asamodelwhichcouldsupportamoreflexibleapproachtotrainingthatmightbebettersuitedtotrainingpeoplewithlimitedinitialacademicqualifications.Allsuchvariant

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trainingroutesshouldtrainpeopletodeliverthePWPnationalcurriculumlearningoutcomesatacompetentstandard.

MakingthePWProlemoreattractiveasacareer7.10 IAPTserviceprovidersshouldconsiderwaystomakethePWProlemore

attractiveasacareer,includingcontinuingtrainingandcareerdevelopmentopportunities.

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Appendix1–ProjectgroupmembershipJohnCape,DirectorofPsychologicalTherapiesProgramme,UniversityCollegeLondon(convenorofprojectgroup)SimonGrist,CourseDirector,PWPtrainingprogramme,UniversityofSouthamptonKellyHylton,SeniorOperationalManager,SixDegreesSocialEnterprise,SalfordLizKell,SeniorLecturerpsychologicalinterventions,UniversityofCentralLancashire,andChairoftheNorthWestPsychologicalWellbeingPractitionerProfessionalNetworkStephenScott,ProgrammeLead,PWPIAPTProvision,UniversityofEssexHeatherStonebank,LeadPWP,SheffieldIAPT,andLeadPWPClinicalAdvisor,YorkshireandtheHumberClinicalNetworks AndrewWright,ServiceManager,NorthYorkshireIAPTService,andIAPTClinicalAdvisor,Yorkshire&HumberClinicalNetwork

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Appendix2–PWPwideningparticipationsurveyresultsIntroductionTwosurveyswereundertaken:

1. AsurveyofPWPcourseleadsandIAPTserviceleads2. AsurveyofPWPsfromdiversebackgrounds

Thesurveyswereconductedonsurveymonkey.Linkstothesurveyswereemailedto:

1. PWPcourseleadsaskingthemtocompletethefirstsurveythemselvesandtocirculatethesecondtotheirPWPtraineesandex-trainees(eithertoallorjustthosefromadifferentbackgroundtotheusualyoungishrelativelyrecentgraduates).

2. RegionalIAPTclinicalleadsaskingthemtocirculateacoveringemailwiththetwosurveylinkstoallIAPTserviceleadsintheirRegion.Theemailforwardedtoserviceleadswassimilartothattocourseleads,requestingtheycompletethefirstsurveythemselvesandtocirculatethesecondtoPWPsintheirservices(eithertoallorjustthosefromadifferentbackgroundtotheusualyoungishrelativelyrecentgraduates).

ThesurveyswereemailedoutinthefirstweekofMay2017andincludedadeadlinedateof31May2017tocompletethesurvey.Intheevent,thesurveywasclosedafewdaysafterthedeadlineon5June217Survey1-PWPcoursesandIAPTservicesResponserateTherewere67responsesfromcoursesandservices.12wereresponsesfromPWPcoursesand55wereresponsesfromservices(oneoftheservicerespondentsassumedthesurveywasaboutwideningaccesstoservicesbyserviceusersandwasdiscarded).Therewereafurther41surveyformsstarted,butwithnorelevantresponsesfilledin(someofthepeoplestartingandnotcontinuingaformcamebacklaterandcompletedafurthersurveyform).Structureofsurvey1ThereweretwopartstothePWPcourseandIAPTserviceleadssurvey:

1. Informationaboutwideningparticipationinitiatives(ifany)whichtheservice/coursehadbeeninvolvedin,whathasworkedandobstacles/barriers

2. Courseandserviceviewsastotargetgroupsforwideningparticipation,currentobstacles/barrierstotheirparticipationandideas/suggestionsforincreasingapplications/involvementofthesetargetsgroupinPWPtraining

Resultsofthetwosectionsarereportedinturn.

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Courseandservicewideningparticipationinitiatives9initiativeswerereportedby7courses(twocoursesdescribing2separateinitiatives).Ofthecourseinitiatives:

• 5relatedtonon-graduateentry.3ofthesewereabouttheavailabilityofanon-graduateentryoption,onewasaboutusinganessayassignmentasawayofscreeningacademicpotentialinnontraditionalapplicantsandonewasabouthavingane-learningpre-coursemoduleasawayofgettingnontraditionalapplicantsuptospeedbeforestartingthecourse

• 3relatedtomarketing/advertisinginitiativestonon-traditionalroutesvia(1)localcafes,mothersgroups,localpapers(2)anationaladvertisingcampaignandopenevents(3)throughtheIAPTprovider’sTrustintranet

• 1relatedtoprovidingplacementsinnon-IAPTsettings16initiativeswerereportedby13services(3servicesreporting2initiatives).Theinitiativeswereasfollows:

• 5relatedtoadvertising/recruitingfromwithintheIAPTproviderorganisation;adminstaff,band3nursingassistants,STRworkersandassistantpsychologistsspecificallymentioned

• 3relatedtorecruitingfromeitherotherNHSprofessions–OT,nursing,physiotherapists,healthtrainers(relevanceforLTCinitiativecommentedonbyone)–andfromemotionalandwellbeingworkers

• 2mentionedexpressionsofinterestinthePWPapprenticeship• 1involvementinatraineeassistantpractitionerpathwayasafeederfor

PWPtraining• 1advertisinglocallyoutsideNHSjobs• 1reviewingtheiradvertisingtoattractabroader/widergroupand

keepingthisinmindthroughtherecruitment/selectionprocess• 2mentionedtheLTCinitiative(relevanceunclear)• 1mentionedNHSEnglandfundingfromtraineePWPposts(?LTC

backfill)Targetgroups,obstaclesandideas/suggestions(courses)10coursesrespondedtothispartofthesurvey.Fortwoofthesecourses,therewereresponsesfrom2separatepeople;theresponsesofthesearecombinedbelow.Targetgroupsmentionedinorderoffrequencywere:

• Olderage(8courses):twocoursessaid30+,one35+,two40+,oneolderpeople,therestnotspecified

• Ethnicdiversity(6courses)• Male(5courses)• Non-graduates/loweracademicqualifications(3courses)• More/longer/widerlifeexperience(2courses)• Disability(2courses)• OtherNHSworkforce/otherhealthandsocialcareprofessionals/people

withphysicalhealthtraining(e.g.nurses)(2courses)

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• Careerchangers(1course)• Peoplewhowouldliketowork(andtrain)part-time(1course)• Otherthanmiddleclass(1course)• Teachers(1course)• Bilingual(1course)

Obstaclesmentionedbycourseswere:

• Academicqualificationrequirementsand/orpreferenceforhigheracademicachievement/potential(4courses)

• Servicespreferthetraditionalapplicantsandthisisreflectedintheirselectioncriteriaandpractices(3courses)

• Thehighproportioninapplicantsofyoungacademicallyablegraduatesleadsinevitablytothesebeingmostrepresentedinthoseselected(2courses)

• Lackofawarenessoftheroleinthegeneralpublic/widerpoolofpotentialapplicants(3courses)

• PaygradeofPWPand/orlackofcareerprogressioninPWProleputsoffawiderpoolofapplicants(3courses)

• Thoselessacademicallyableand/orwithoutthe“usual”backgrounddonotwritesuchgoodapplicationformsand/ordolesswellatinterviewsodon'tgetselected(2courses)

• Preferenceforcandidateswithapsychologyorhealthrelateddegreeleadstootherdegreesbeingignored(1course)

• Asaresultoftheverylargenumberofapplicantsselectionprocessesinevitableenduptousingatargetedapproachthatmakesitharderformore“unusual”applicantstogetselected(1course)

Suggestionsforincreasingapplicationsandwideningparticipationincluded:

• Increasingpublicawarenessoftherole,includingtoserviceusers(4courses)

• Improvedadvertisingandtargetedadvertising(3courses)• RecruitingfromexistingstaffofTrust/organisation(2courses)• ChangingJD/PS,shortlistingcriteria,applicationprocessandinterview

selectionprocesstomakeitmorelikelymorediverseapplicantswillapplyandbeselected(includingrequiringjointserviceanduniversityinterviews)(4courses)

• Moreavailableundergraduatetrainingroutes(2courses)• MoreopportunitiesforPWPcareerprogression(2courses)• ApprenticeshipPWPtraining(1course)• Workexperience,NVQtraining,assistantpractitionerapprenticeshipand

relatedapproachestopreparingpeopleforPWPtraining(1course)• Part-timetraining(1course)• IntegratingPWPtrainingwithnursingandotherNHStrainings(1course)

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Targetgroups,obstaclesandideas/suggestions(services)Therewere51responsesfromIAPTservicestothispartofthesurvey.Morethanoneresponsefromaservicecouldbeidentifiedinacoupleofcases,butmostwerefromdifferentservices.Targetgroupsmentionedinorderoffrequencywere:

• Olderage(31respondents):foursaid30+,one30-60,one40+,one50+,one65+,five“older”people,therestnotspecified

• Ethnicdiversity(16respondents)• Male(14respondents)• More/longer/widerlifeexperience(9respondents)• Otherhealthandsocialcareprofessionals(includingnurses,SWs,OTs,

counsellors)/peoplewithphysicalhealthtraining(9respondents)• Peoplewithexperienceworkinginmentalhealthroles/withmental

healthproblems(9respondents)• Supportworkers,band3/4physicalandmentalhealthsupportworkers,

STRworkers,housingsupportworkers(8respondents)• Peoplelivinglocallyand/orwhoarelocalactivemembersofthe

community(e.g.communitydevelopmentworkers)(6respondents)• LBGT(6respondents)• Non-graduates/loweracademicqualifications(4respondents)• Careerchangers(4respondents)• Disability,includingAspergers/LD/LTHC(3respondents)• Peopleworkingincharitable/3rdsectororganisations(3respondents)• Bilingual/secondlanguage(3respondents)• Peoplewithlivedmentalhealthexperience/serviceusers(2

respondents)• Alternativereligiousgroups(1respondent)• Teachers(1respondent)• Peoplewithhealtheducationbackgrounds(e.g.healthtrainers)(1

respondent)• Peoplewithexperienceworkingwithgroups(1respondent)

Obstaclesmentionedbyserviceswere:

• Academicqualification/educationalrequirementsand/orpreferenceforhigheracademicachievement/potential(18respondents).Thisbothputtingpeopleoffapplyingandleadingpeopletobescreenedout.

• Recruitmentcriteriaandprocessesappeargearedatnewgraduatesandagainstvaluingexperience(7respondents).Thisseenasuniversityledinsomeresponses–“academicsnobbery”,“universitieshaveswayovercandidateappropriateness”

• LackofawarenessofthePWProleandtraininginthewiderpotentialpoolofapplicants(8respondents)

• PaygradeofPWPand/orlackofcareerprogressioninPWProleputsoffawiderpoolofapplicants(4respondents)

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• Viewbyapplicantsthattherole/typeofwork(mentalhealth/talkingtreatments)arenotformen,notforapersonfrommyminoritybackground+stigmaofmentalhealthwork(5respondents)

• Anxietyaboutbeingabletomanagetherequirementsofacourseespeciallyifnotbeenineducationforalongtime(3respondents)

• Lackoftargetedadvertisingthatreachesamorediversewiderpoolofapplicants(3respondents)

• Requirementtotrainfulltime(2respondents)• Requirementtohaveapsychologydegree,healthdegreeorcore

profession(2respondents)• PerceptionofPWProleasalowpaidgraduatesteppingstone(2

respondents)• Geographyofcourses–toofaraway(2respondents)• Poorinterviewskillsofmorediverseapplicants(1respondent)• LimitedcapacitytoworkatfastpacerequiredofIAPTPWPs(1

respondent)• Shortadvertising/applicationwindow(1respondent)• RequirementtocompletelengthyKSA(1respondent)

Suggestionsforincreasingapplicationsandwideningparticipationincluded:

• Publicising/marketingtherole/training(26respondents).SpecificideasincludedpromotinginjobcentresandviaIAPTemploymentadvisors;outreachtocommunitygroupstoidentifylocalpeoplewhomightbesuitable;LGBT&BMEwebsitesandpublications;Trustwebsites;opendays;nationalTVandradioadvertising;socialmedia;stallsatjobfairs.

• RoutestopreparepeopleforPWPtrainingsuchasaccesscourses,foundationcourses,secondments/workexperienceinIAPTservices,(7respondents)

• Changingshortlistingcriteria,especiallyweightingmoreforlifeexperience(6respondents)

• Longerand/ormoreflexiblecourses(including,butnotonly,apprenticeshiproutes)thatcouldtrainpeoplewhowouldbenefitfromlongertraining(5respondents)

• BetterstartingpayandclearopportunitiesforPWPcareerprogression(4respondents)

• Part-timetrainingoptions(2respondents)• Developvocationaltrainingroutestotargetnon-graduates(2

respondents)• Moredegreeleveltraining(1respondent)

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Survey2–IndividualdiversePWPsResponserateTherewere160responsesfromindividualPWPs.Demographicbreakdownoftheseisgivenbelow.Gender:

• 27weremale• 124female• 9gendernotspecifiedoridentifiablefromfirstnameorother

informationonthesurveyformAgedistribution:

• 60+=2• 50-59=12• 40-49=19• 35-39=12• 30-34=25• 22-29=84• Agenotspecified=6

Age35+=45/154(29%)oftotalwithagespecified:10/25(40%)ofmale,35/124(28%)offemalerespondentswithageandgenderspecifiedEthnicity

• White112• Irish2• Polish2• Greek1• Turkish1• Mixed9• Asian(Indian,Pakistani,Bangladeshi,Bengali)10• Chinese1• Black(African,Ghanaian)4• Othernonwhitenotspecified2• Notspecified16

Ofthe27maleapplicants,10wereage35+(seeabove)andafurther5werefromanethnicminoritybackground.Only11(41%)wereunderage35andwhite/whiteBritish.Justunderhalftherespondents(n=77)werefemale,whiteandunder35,sonotfromtheexpecteddiversegroupsthesurveywastargetedtowards.Theintroductiontothissurveysaid“YouwillbeawarethatthemajorityofPWPtraineescomefromarelativelynarrowdemographic(young,relativelyrecentgraduates,femaleandwhite)…..WeareinterestedintheexperienceofPWPswhocametoPWPtrainingfromdifferentbackgrounds.Ifyouwouldconsiderthistobeyourexperience,wewouldbeverygratefulifyouwouldcompletethis

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survey.”OneyoungerwhitefemalerespondentinthebackgroundsectionofthequestionnairementionedhavingseveralLTCs,andanumberofthe30-35yearoldwhitefemalesdescribedworkinginnon-traditionalPWPbackgroundrolesbeforemovingtothePWProle.Someofthesewhitewomenunderage35mayhavebeenfromdiverseornon-standardbackgroundsofotherkinds(e.g.workingclassbackgrounds,LGBT).ButmostrespondentsdescribedratherstandardyoungerPWPapplicantbackgroundsandacoupleevencommentedthattheywere‘typical’and‘notthatdiverse’.ThePWPcoursestherespondentsreportedcurrentlybeingonorhavingtrainedonasaPWPwereasfollows:

• Birmingham–22• ChristchurchCanterbury–1• DeMontfort–1• Exeter–17• LiverpoolJohnMoore–3• Manchester–2• Newcastle–3• Nottingham–1• Reading–15• Sheffield–18• Southampton–18• Surrey–8• Teeside–5• UCL25• UCLAN–2• Ulster–1• York–6• Nouniversitygiven-11

ResponsetosurveyquestionsThesurveyquestionswere:

• PleasedescribeyourbackgroundandexperiencebeforetrainingasaPWP?

• HowdidyoufindoutaboutthePWProle?• Pleasedescribeyourexperience/journeyfromfindingoutabouttherole

togettingintoPWPtraining?• Pleasedescribeanyobstaclesyouhadtoovercomeinyourjourneyto

PWPtraining?• WhathelpedinyouinovercomingobstaclesandgettingtoPWPtraining?• Doyouhaveanyideasandsuggestionsforattractingandhelpingpeople

fromdifferentbackgroundsintoPWPtraining?• Anyothercomments?

Responsestoeachquestionaregivenbelow

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BackgroundbeforetrainingasaPWPResultstothisquestionaregiveninfullonlyforthoseage35+asthisisthe“non-traditional”groupforwhomthisismostrelevant.AnumberdescribedmorethanonesignificantrolepriortotrainingasaPWP,inwhichcasebothwereincludedintheclustering:

• Supportworker/MHworker(notfromarecognisedprofession)-17• Business/engineer/media/accountancy/army/HRandothernon-

health/care–12• Counsellor–8• Socialcare/3rdsectormanager/communitydevelopment-5• Nurse–4• Police/prison/probationofficer-4• Drugsworker–3• Teacher–1

12(10%)PWPsagedlessthan35describedcareerbackgroundsinanotherfieldpriortoPWPtraining.MostofthesePWPswereage30-34.Thecareerbackgroundsdescribedwere:

• Industry/advertising/marketing–3• Counsellor/psychotherapist-3• Teacher-2• Mentalhealthnurse–2• Occupationaltherapist–1• Socialworker-1

HowfoundoutaboutthePWProleResultstothisquestionareaggregatedseparatelyforthoseage35+andforthosefromaBMEbackground,asthemostrelevantdiversegroupsforthisquestion.Asnotedabove,thesetwogroupsincludedamajority(58%)ofthemalerespondentstothesurvey.PWPsage35+:

• NHSJobs–11• Otherexternaladvert–3• ThroughTrust/organisationwhereworking(whichemploysPWPs)–6• WorkingorvolunteeringinaMH/counselling/probation/3rdsector

organisation(withoutanIAPTservice)andhearingaboutPWProle–8• University/trainingcourseinformedaboutIAPT/PWProle–3• Website(BPS,BACP,MIND)–3• Internet(researchingMH/CBT/rolesonline)–4• Friend/wordofmouth-3

PWPswithBMEbackgrounds:

• Friends/colleagues(fellowuniversitystudents)/family–11• Lectureroncourse-3

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• SuggestedbysomeonewhereIwasworkingasanassistantpsychologist/MHworker–4

• NHSjobs–4• Otheradvert/site/googlesearch–4

Forcomparisonpurposes,responsesofwhitefemaleandmalePWPsagelessthan35wereasfollows:

• Friends/colleagues/wordofmouth/family–21• University/lectureroncourse–19• NHSJobs–12• Otherexternaladvert(newspaper&web)–5• ThroughTrust/organisationwhereworking–15• WorkingorvolunteeringinMHorrelatedorganisation–8• Website(MIND,NHSCareers,DClinPsychonline,AssistantPsychologist

FacebookNetwork)-4• Internetother(e.g.searchingonline)–12

JourneytoPWPtrainingResultstothisquestionsareaggregatedseparatelyforthoseage35+andthosefromaBMEbackground.Inaddition,oneresponseofamalePWPthatspecificallymentionedgenderasanissueisnoted.PWPsage35+:

• Themostcommonresponsewastodescribethejourneyasrelativelystraightforward(16respondents).Examplesare:

o Iwassuccessfulalmostwithnoproblems,Iobtainedaninterviewstraightaway.

o IappliednotthinkingIwouldbesuccessfulasdidn'thaveadegree,however,Iwasinvitedforinterviewonthebasisofwritinganessaytodemonstratemyabilitytomanageauniversitycourse,….andwassuccessfulatinterview

• However,somerespondentsdescribedtheprocessasmuchmoredifficultandstressful(7respondents).Examplesare:

o Ittook4yearsasneverenoughexperience-frustratingo Oneword-stressful.Iappliednumeroustimesandwas

successfulinapplicationsuntilIgottoaninterviewstage,whereIoftendidnotimpressenough.IwasfinallysuccessfulinaninterviewbutfailedtheUniversityexamasImisconstruedtheexamquestionbeingaskedtome.

o Ifounditverycompetitive,IwasupagainstmanyyoungerpeoplewhohadjustcomeoutofeducationhavingstudiedPsychologyandonmyfirstinterviewwasnotofferedaplace.However,theleadwasverykeenformytoreapplyonthenextcohortastheystatedthatthereisaneedforolderPWP'swithinserviceandofferedverygoodadviceandsupportinaidingmynextapplication.

o WhenIfoundtheroleIwasveryexcitedbutwassoscaredabouttheexams...whenIhadaknockbackthefirsttimeroundthisreinforcedmybeliefthatIcouldnotdoitandIwentonajourney

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ofmyown..IthenpulledmyselftogetherandmadeaplanandreappliedIputallmystrengthandenergyintoitandpassedeverythingandateachstageIstartedtobelieveinmyselfandgotmoreconfident.IwishIhadfindityearsago..

• Anumberofrespondentscommentedonmakingarrangementstogetrelevantexperiencefirstassupportworkersandsimilar(7respondents)

o JustneededtogetrelevantexperienceinMentalhealth.• Oneapplicantfocusedonpracticalarrangements:

o Thoughtabout,couldIcommittoit,Ihavea3yearoldson,sortedoutchildcarearrangements,domesticarrangements

• Afewapplicantscommentedonapathwayleadingfromanotherrelatedpossiblecareer(3respondents):

o AstherewaslittlepaidcounsellingworkIdecidedtoretrainasaPWPtoincreasemyworkoptions

• Therewereafewcommentsthatrelatednottotherouteintotraining,buttonegativeexperiencesinPWPtrainingitselfasanolder/untypicalapplicant(3respondents):

o Ifoundtheinterviewprocesswiththeserviceproviderreallygoodandsupportiveandtheteamintheservicewasalsoverywelcomingandhelpful.TheUniversitystaffwerelesshelpfulandIfeltamongstotherswhohadcomefromvariedemploymentsbackgroundsthatwewereviewedaslesscapablethangraduatesandwerediscriminatedagainstandjudgednegatively,Ididonmorethanoneoccasionthinkaboutleaving.

o Iwasgiven'achance'toattendPWPtrainingandexpectedittobereallychallenginggivenIhadnodegreeandwastoldthatIwould'struggle'.Ididnotstruggle,mymainissuewaslearninghowtowriteessaysagain.IfeltsomewhatchallengedbythestudentsIwereworkingalongsidegiventheywereall20,white,recentgraduateswithlittleofnolifeexperience.IfoundtheconversationsintrainingdifficultastherewasnootherrepresentationofthegeneralpublicandsoIfeltjudgedandisolated.

PWPswithBMEbackgroundsalsomostlyreportedthejourneyasrelativelystraightforward(14respondents)althoughafewalsocommentedaboutbeingquiteanxiousaboutapplyingortheinterviewprocess:

o Itwasn'ttoodifficultifI'mhonest,IthinkIgotlucky!IappliedandgotaninterviewforalltherolesI'dappliedwithandgotoffered2outofthe3

o Iheardaboutit,thoughtitwasagreatopportunity.Failedmyfirstinterviewbutperformedwellinmysecond.

o Findingoutabouttheroleandconsideringthispositionmademefeelverynervous.IwasunsurewhetherIwouldbeofferedaplaceasIdidnothaveapsychologicalbackground,whichIfeltwasadisadvantageforme.….IwasveryhappytoknowthatIwasofferedplacesoonaftertheinterviewasIthoughtitdidnotgotoowell.

o Theinterviewwasquiteanxiety-provokingasIwasstillunsureofexactlywhattheroleentailedbutthepanelhelpedtoputmeateaseandguidemethroughtheinterviewwithclearquestions

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OnerespondentreportedgettingadedicatedBMEPWPpost,butnotbeingofferedastandardPWPpost:

o OneofthejobsIappliedforwasaBMEcommunitydevelopmentPWPpost.IhavepersonalandprofessionalexperienceofworkinginBMEcommunitiesandIamawareofthedifficultiesthatdiversegroupsfacewhenaccessingmentalhealthservices(whichIwouldliketohelpchange).Iwasofferedthispostandwentontoacceptit.Duringmyjobsearch,IwasalsogivenaninterviewforthestandardPWProle;however,Iwasnotsuccessfulinobtainingthatpost.

7respondentsdescribedarranginginitialsupportworker,volunteerworkorsimilarinpreparation.2oftheserespondentsobtainedassistantPWPpostsinthefirstinstanceOnly2respondentsdescribedlesspositiveexperiencesandoneofthesewasfeelingillinformedabouttheprocess:

o Theuniversityprocesswasnotdiscussedindetail,i.erequirementsapplication,groupdiscussionandinterview

TherewasonecommentfromamalerespondentabouthisjourneytoPWPtrainingthatspecificallynotedgenderasanissue.Thiswas:

o Tough,longandwithlotsofrejectionduetonothavingenoughexperience.IfoundthatoftenbeingmaleandwithvastArmyleadershipandexperiencesandculturalunderstandingandbeingolderandhavingexperienceotherthanbeingagraduatewasahindranceongettingjob.havingdyslexiawasahugebarrierthatshouldhavenothaveexistedbutunfortunatelydid.

ObstaclestoPWPtrainingResultsareaggregatedseparatelyforthoseage35+andthosefromaBMEbackground.Inaddition,oneresponseofamalePWPthatspecificallymentionedgenderasanissueisnoted.PWPsage35+:

• 8respondentsresponded“none”tothisquestion.• 7respondentsdescribedpracticalissuesregardingfinances,geography,

childcareandthedifficultdecisiontomakeacareerchange:o Thedecisiontochangecareercompletely.Acceptingthatitwould

meansomelossofincomeandachangeinlifestyle.Adjustingtothatchange.

o IwasfortunatethatIcouldaffordtospendthetimeandmoneytogetthetrainingandexperienceandwasnotputunderpressurebymyfamilytomaintainmyearningabilityasanAccountantwhichwasclearlydoublemyearningsinthisrole.

o Childcarearrangements,mentalblocksi.e.doIwanttodomoretrainingafter4yearsoftrainingtobeatherapistalready

o Havingworkedforanumberofyears,Ihavehadtoadjustmyfinancesinordertoaccommodatetheannuallossinsalary-evenwithLondonwaitingit'sasignificantreductioninincomefromwhatIhavebeenusedto.

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• 6respondentsfocusedoninitialdifficultiesobtainingaPWPpostsuchasneedingtoapplymorethanonce,securevolunteerorotherrelatedworkinitially.OnerespondentconsideredthatlifeexperiencehadnotbeentakensufficientaccountofinappointingPWPs:

o lackofcreditgiventootherexperiencesandliferoles.disabilitybarriers.overlyfocusofgradates,andthequalitiestheybringandnotofothercareersandtheperspectivestheybringonmentalhealth.

• 3respondentscommentedontheselectioninterviewasbeingthebiggestobstacle:

o Attendingtheuniversityselectionday.Completingthewrittentesto Interviews

• 9respondentsansweredthisquestioninrelationtoobstacles/issuesexperiencedasamorematurestudenthavingarrivedonthecourse,commentingondifficultiestheyfound:

o OnfirstarrivingatuniversityitbecameapparentveryquicklyIwas'old',havingcompletedafoundationdegreeinhealthandsocialcarethepreviousyearwithpeersmyownage,thiswasashocktothesystem.

o Thecourseworkwasverydifficultduetonothavingsatanexamforover20years

o Theattitudesoftheuniversityteachingstaffwerethebiggestobstacletoovercomeduringthetraining.

o IhavesometimesfeltthatthetrainingisverymuchaimedatthosewhohavejustleftUniversityandhavenootherlifecommitmentssuchasfamily,pets....

o age,limitedtocommunityexperienceandcoursesoldassteppingstonebypeers

o Outofformaleducationfor10years+andunfamiliarwithsomeofacademicwritingmodels

o Italsotooksometimetoadjusttoworkingwithaworkforcewheremypeersareyoungerandhavelessgeneralexperienceintheworkplace

• 7otherrespondentscommentedonotherobstacles/issuesexperienceswhiletraining,ratherthaninrelationtotheirjourneytotraining.Theseincludedaspectsoftheteachingandcourseworkandlifeeventsthatcreatedobstaclestotraining:

o IsolationMakingmyself'fit'themodelsFrustrationandangero WantingsomethingsomuchthatIputtoomuchpressureon

myself

PWPswithBMEbackgrounds:• 4respondentsanswered“none”andanother3didnotanswerthis

question• 7respondentsdescribedpracticalissuesregardingfinances,geography,

andthedecisiontogobackintoeducation:o Itisn'tinmycountrysoImovedtoEngland.

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o Englishasthesecondlanguagehadanimpactonmyconfidencepriortoapplying.Iwasnotsure,whethermybackgroundwouldnotbeanobstacleintogettingthepost.

o Iwentdowntheself-fundedroutesoensuringthatIwasfinanciallywellenoughoffbeforecommencingthetrainingwassomethingthatIhadtogreatlyconsider.

o RelocatingtoLondontocompletethetrainingwasfinanciallytaxing.Ialsohadborrowmoneyfromfamilyatthetimetoaidemyrelocation.

o TheobstaclethatIthoughtwouldbedifficultisbecomingastudentagainandbalancingworkandacademiclife

• 7respondentsdescribeddifficultiesobtainingaPWPpostsuchasbeingrejectedandneedingtoreapplyseveraltimesandrequirementstoobtainsuitableworkexperiencefirst:

o Strugglingtogetclinicalexperienceduetonotbeinga'goodteamfit'

o Beinganolderpersonwithlimitedmentalhealthexperienceputmeatadisadvantageincertainareas(age33FAsianbackgroundrespondent)

o TherewerenoactualobstaclesotherthanmostIAPTserviceswereandstillarelookingforunrealisticamountofworkexperiencebeforeyoucanapplyforthetraining.

o Lackofconfidencestraightafterfinishingstudies,soneededmentalhealthworkexperience.Don'thaveadrivinglicensewhichisusuallyanessentialrequirement.

o ThemostdifficultstepwasgettingtherelevantexperienceandbreakingthroughintotheNHS.AftergraduatingwithBScandwithlimitedexperience,itwasnighimpossibletogetanypaidpositionwithinNHS,andIcouldn'taffordtoconsidervoluntary/honorarypositionsasIwhollydependedonmyincome(beingfromabroad,Ididn'thaveanyfinancialsupportintheUK).ThatwasbyfarthebiggestobstacleinmycareerpathtowardsbecomingaPWP

• 2respondentscommentedonaspectsoftheapplicationprocess:o Notanythingunusual-gettingenoughinformationabouttherole

inordertopasstheinterviewo EnsuringIwrotemyapplicationinawaythatmetallthecriteria.

• 9respondentsansweredthisquestioninrelationtoobstacles/issuesexperiencedhavingarrivedonthecourse,commentingondifficultiestheyfound,althoughonly2oftheserelatedthistobeingfromadiversebackground:

o IsometimesfeelIamdiscriminatedagainstforbeingAsianordifferent.

o ThiswasmyfirsttimeasuniversitystudentintheUK.IfoundextremelydifficulttowriteessaysandtounderstandtheBritishmentalhealthandlegalsystemsowhenIreadabouthistory,policiesandlawsittookmealongtimetosummariseandgettherightinformationformyessays.

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o Ihaveasmallchildandchildcarewasdifficult.theemotionaldifficultiesofsuchademandingcoursewhilebeingasinglemotheralso.tiredness,lifedemandsetc!

Therewasonecommentfromamalerespondentaboutobstacleshehadtoovercomethatspecificallynotedgenderasanissue.Thiswas:

o Knowingthattherolewasnotacoreprofession.ThefactthatnooneknowswhataPWPis.Evenpsychologists/GPsetc.KnowingthatmostPWPsdon'tlast2years.KnowingthatthereisnoaccreditationprocessforPWPs.Workingasamaleinapredominantlyfemaleenvironmentcanbechallenging.Iconsiderthistobeawidersocietalissueandmoreshouldbedonetotryandcombatthisatanationallevel.

Forcomparisonpurposes,responsesofwhitefemalePWPsagelessthan35wereasfollows:

• 10respondentssaidtherewerenoobstacles• 16mentionedpracticalissueslikefunding(4respondents)andneeding

torelocateorcommutelongdistances(8respondents)• 15gavetheirlackofrelevantexperienceand/orneedtoobtainrelevant

mentalhealthtypeexperienceinordertobeselectedontotrainingasanobstacle

• 13describedaspectsoftheapplicationandselectionprocessasobstaclesincludinggettinginformationon/understandingtheapplicationprocess(2respondents),veryshortapplicationdeadlines(3respondents),shortnoticeofinterviews(2respondents),stressofinterviews,writtenessayrequirementsand/orgroupselectiontasks(4respondents)

• 15answeredthisquestioninrelationtoobstacles/issuesexperiencedhavingarrivedonthecourse.

WhathelpedinovercomingobstaclesResultsareaggregatedseparatelyforthoseage35+andthosefromaBMEbackground.PWPsage35+:

• 11olderPWPsgavepersonalcharacteristicsaskeytohelpingthemdealwithobstaclesontheirjourneytoPWPtraining.Mostcommonlymentionedweremotivation,determinationandtenacity(7respondents);alsoconfidence/believinginoneself(3respondents)andpatience/acceptanceofdifficulties(2respondents)

• 8respondentsmentionedcontact,informationandsupportfrompeoplewhoknewaboutIAPTservices(includingfriendswhowerePWPs)andcolleaguesandmanagersintheirpre-PWPtrainingworkexperiencerole.

• 4gavepracticaland/oremotionalsupportasimportant.• Commonlymorethanoneofthereasonsabovewasmentioned:

o BeingdeterminedandsupportedandhavingafriendinthefieldwhogavemetheinformationbecauseIdoubtIwouldhavecomeacrossIAPTasanoptionotherwise.

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o Confidenceinmyownabilityandanunderstandingoftheexpectations(afterspeakingtopeoplewhomhadcompletedthecourse)

o Motivation.Beingabletotakeahitfinanciallyforayear.Supportfromhusband

• 3respondentsgave“luck”intermsofgettingapre-trainingortraineepost.

• TheolderPWPswhohadansweredtheobstaclesquestionintermsofobstacleswhileonthePWPtrainingcourse(ratherthanobstaclesonjourneytogettingontoaPWPtrainingcourse)gavesupportfromotherPWPtrainees(6respondents),supportfromtheirservices(6respondents)andfromtutorsonthecourse(3respondents)

o IhaveaverysupportivemanagerwhoremindsmeregularlywhenImentionbeing'old'thatIhaveahugeamountofexperiencetobringtotherole.

PWPswithBMEbackgroundsgavesimilarresponsestoPWPsage35+:

• 4gavepersonalcharacteristicsaskeytohelpingthemdealwithobstaclesontheirjourneytoPWPtrainingincludingdetermination/motivation(2respondents)andconfidence(2respondents)

• 4describedhelpfromotherswhoknewabitmoreaboutIAPTthantheydid:

o Speakingwithpeoplewhosuccessfullyappliedo Speakingtoothersandfindingouthowapplicationsare

shortlisted.• 4gavesortingpracticalissuesandpracticalandemotionalsupportfrom

familyaskey• 4respondentsdescribedgettingmentalhealthexperienceasthekeystep

inovercomingthisobstacleonthepathtoPWPtraining• ThePWPswhohadansweredtheobstaclesquestionintermsofobstacles

whileonthePWPtrainingcourse(ratherthanobstaclesonjourneytogettingontoaPWPtrainingcourse)gavepersonalqualities/self-reliance(2respondents),supportfromtutors(2respondents),employers(1respondent)andfriends(1respondent)ashelpful.Oneresponseisworthquotingasitspecificallyrelatestobeingfromnon-Englishspeakingbackground:

o Itwasdifficulttoaskforsupportfrommytutors,Iwasembarrassedandwastheonlypersonwhosefirstlanguagewasn'tEnglish.IdidnotwanttobeperceivedasifIcouldn'tmeettheacademicrequirementsofthecourse.IknewIwascapableofdoingthejobandIenjoyedmysessionswithpatients.IspoketofriendswhoproofreadmyessaysandIboughtacoupleofbooksabouthowtowritecriticalessays.Ididspeaktoonetutorlateronthecourseandheputmeincontactwithadepartmentattheuniversityforforeignstudents.Theywereabletogivemetwooneoffsessionsforimprovingmyessays.

Forcomparisonpurposes,responsesofwhitefemaleandmalePWPsagelessthan35wereasfollows:

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• 16respondentsgavepersonalqualities,especially“persistence”,askeytoovercomingobstaclesontheirjourneytoPWPtraining

• 12respondentsdescribedsupportandadvicefromtheirworkplace,supervisorortutors

• 9respondentsdescribedsupportfromfamily• 6respondentsdescribedsupportfrompeers,especiallypeoplewhowere

aheadofthemonthejourneytoPWPtraining• 7respondentsgaveobtainingoneormorerelevantexperience

opportunitiesaskey• PWPswhoansweredthequestionaboutobstaclesintermsofobstacles

duringthetrainingexperienceitselfratherthanobstaclesgettingintotraining,gavepersonalqualities(5respondents),supportfrompeers(5respondents)andsupportfromeitherthecourseoftheirworkplace(5respondents)aswhathelpedthemovercometheobstaclesintraining

Suggestionsforattracting/helpingpeoplefromdifferentbackgroundsResultsareaggregatedseparatelyforthoseage35+andthosefromaBMEbackground.Inaddition,thesuggestionsof4malePWPsthatspecificallymentionedgenderwerenoted.PWPsage35+:

• Almosthalf(20)olderPWPsrespondingtothisquestionsuggestedsomeformofadvertisingorpromotionofthePWProleandtraining,eithertomakeitmorevisibletothepublicgenerallyorspecificallytargetingolderpeopleorothergroupsthroughtargetedmarketing(e.g.opendays,communityvenues/sites)andmakingclearinmaterialsandcoursewebsitesthatolder,peoplewhodon'thaveacademicqualificationsandotherdiversegroupsareencouragedandthesupportavailabletohelpcompletethecourse.

• Betterpaywassuggestedby2respondentsaskeyforolderapplicants,while1respondentsuggestedbettercareerprogressionopportunities

• ProvidingIAPTvolunteering/shadowingaPWPandotherbridgingopportunitiesweresuggestedby3respondents

• 14respondentsfocusedonshiftingtheemphasisinallaspectsofrecruitment(advertisingandselectioncriteria)togreateremphasisonlifeexperienceandlessonacademicability.3oftheserespondentssawthisasprimarilyacaseofchangingattitudesofuniversitystaff.Another3respondentslinkedthiswithneedtopromotethePWProleasavaluedcareerinitsownright

o Ibelievelifeexperienceisessentialandgivingpeopleachancetoprovetheycandoit.Ireallyfeeltheroleissoundervaluedandinmyopinionweworkthehardestiniaptservices.….IgetupsetwhenIseethetimeusedasasteppingstoneandthusfrustratesmeasIfeelitissuchavaluablerolebutsounderratedincomparisontothehigherintensityrole.

o My"diversity"ismyageandifeelthatthisroleisperceivedasayoungerpersonsrolewithinmostsituations.Ifeelthattheuniversity(bothingeneralandinthisspecificrole)shouldbe

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sellingitselfmoreto"older"people.Forinstanceireceivednoofferofmentor-shipfromamaturestudentoriwasofferedno"special"maturestudentopendays.IfeelthatthiswouldhelpboththeuniversityandthePWPcourseinattractingpeoplewithvastlifeskillswhowouldbefantasticinthejobandwhowouldexcelwithinuniversity.

• 2respondentssuggestedaneedtoaddressspecificaspectsoftheapplicationprocess(writtenapplicationformandinterview)whichfavourpeoplewithadegreeandwithknowledgeofIAPTandbiasagainstthosefromamorediversebackground:

o Thewrittenapplicationprocessrequiresspecificevidenceandastyleofwriting.Unlessyouunderstandhowtowritethis,youwon'tgetaninterview.Wouldhelpopenuptheprocessifthiswasdemystified.

o Myunderstandingisthatthereareplentyofpeoplefromdifferentbackgrounds,agegroupsandgenderswhowouldliketotrainasPWP,however,atinterviewtheypossiblydonotperformsowellasothersandthereforedonotscoresowellontheinterviewquestions.So,possiblythisshouldbeaddressed!

• 2respondentssuggestedamoreradicalchangetoPWPtraining,consideringitdoesnotrequireanyacademicqualificationandwouldbemoresuitedasavocationaltrainingorin-workapprenticeship

• 1respondentsuggestedpart-timetrainingwouldbehelpful• TheneedforsupportonPWPcoursesformorediversetraineeswas

mentionedby2respondentso Workwithacademicstaffabouttheirattitudesinaccepting,

encouragingandsupportingapplicantswithyearsofexperienceinthecommunitywhomaynotholdadegree.

o Theacademicsideisverychallengingifyouhavebeenoutofacademiaformanyyears.Itwouldbehelpfultohavemoreguidanceandhelpwithacademicsubmissions.

• Amorediverseteachingstaffwassuggestedbytworespondents• Theuniversitystaffandthosethatinterviewedmewereethnically

diversebutseemedverymiddleclass-moreinclusivitymighthelp.• FinallythedifficulttargetdrivennatureofthePWProlewerementioned

bytworespondents:o BehonestBEFOREofferingpostthatitisaveryhard,rather

relentlessworkloaddaily!!!Itgrindspeopledownthesheervolumeofpeoplethatneedtobeseen.

PWPswithBMEbackgrounds:

• ThegreatestnumberofsuggestionsbyfarwerearoundincreasingawarenessandpromotingthePWProleandtrainingbothgenerallyandspecificallytopeopleofBMEbackground(16respondents):

o Awareness.AlotofpsychologicalrolestendtobedominatedbyWhitefemales.Ithinkinordertochangethisandhavetheworkforcemorediversified,youneedtotargetpeopleatanearlierage.

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o IthinkaposterorquotesfromPWPsfromdifferentbackgroundsbeingadvertisedwiththetrainingwouldbehelpful.Itwouldattractattentionandmakepeoplefeelmoreconfidentinapplying.

o RaisingawarenessofPWProleandtrainingamongpeoplefromdifferentbackgrounds,bycollaboratingcloselywithcommunityorganisations.Promotingandadvertisingjobthroughcommunityleaders.Acknowledgingthatdiversebackgroundcanbeanadvantage,ratherthandisadvantage.

o Encouragingpeoplefromdifferentbackgroundstousetheirowncultureandexperiencetohelpotherscouldbeagoodincentiveforpeopletoundertakethetraining.

o Dotalksatuniversities-holdaneventforBMEstoinformthemabouttheroleandencouragethemtoapply

o Setupapwpwideningparticipationworkinggrouptoencouragediscussiononwaystopromotethecourse-membersofthegroupcanplayakeyroleinpromotingthecourseintheirowncommunitiesMoreworkneedstobedoneinBMEcommunitieswheretherecontinuestobeahugestigmaaroundparticipatinginmentalhealthcareers.

o IbelievethatPWPtrainingisveryaccessibleasitis-fullyfunded,bi-annualintake,largecohorts,goodprogressionopportunities.Ibelieveit'ssufficienttoattractalotofpeoplefromdifferentbackgrounds.However,Ihavenoticedthatsignificantcompetitionforthecourse,andthefactthatthemajorityofPWPscomefromaverynarrowbackgroundmightpreventsomepeoplefromminoritybackgroundfromapplyingtothecourse(IhavecertainlyheardpeopledoubtingtheirchancestogetintothePWPtraining,astheyfeartheydon't"fit"thePWPimage-e.g.white,middleclass,female).Ibelievehighlightingtheneedforpeoplefromminoritybackground,anddiversifyingtheteamswouldreassuresuchpeopleandpotentiallyincreasethenumberofapplications.

Othersuggestionswere• Providingplacementstogivepeopleanideaoftheroleandtherelevant

experiencetoapply(1respondent)• Wideningtheselectioncriteriatoallowforabroaderrangeof

backgroundexperience(2respondents)andforpeoplenottohaveadegree(1respondent):

o MakingtheentryrequirementsrealisticasnotmanypeoplearegoingtobeprivilegedtohaveexperienceinIAPTorwithCBT

• Havingamorediverseinterview/selectionpanel(1respondent)Theseweresuggestionsfrom4malerespondentsthatspecificallyreferencedgender:

o Advertisetoareaswheremenworkinmentalhealthsuchashospitalsorsendoutemailsforthisandrealisticallyexplainwhatisexpectedfromtherole

o Inordertohaveagoodshotatbeingacceptedontoatrainingcourseandgetatraineejobyouneedtobeagraduate.It'svery

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hardtogetasuitableacademicreferenceifyou'renot…….Mystudyexperiencesuggestsmostpsychologygraduatesarewhiteandfemale.Mymoney'sontheacademicrequirementdeterringpeoplefromotherbackgroundsrequired.……Ifyouwanttoattractmorediversebackgroundsplacelessemphasisontheacademiccomponent,offersuitablecareerprogression,makethePWProleacoreprofession(likeeveryotherroleinmentalhealth),andputpressureoncommissionersandservicestomaketheIAPTworkloadmoresensible.

o Unfortunately,theroleofaPWPisoftenseenasasteppingstoneforsomethingelse,namelyclinicalpsychologyorhighintensitytrainingtoalesserextent.Psychologyattractsmorefemalegraduatesthanmalessoitwouldbenaturalthatyouwouldreceivemoreapplicantsfromthisdemographic.Iamunsureoftheethnicitysplitinpsychologygraduates.Sadly,PWPsdon'tseemtobetreatedverywellinorganisations,oftenseenascheaplabourwhoseworkloadsandworkpracticesareoftenswitcheduptoaccommodateunsustainableserviceneeds.Theunsustainablenatureoftheroleitselfmakesitdifficultforittobeseenasanythingmorethanasteppingstone.Theroleitselfneedstobemorecareerdriven,limitedseniorrolesaren'tenoughtoattractpeoplein.Iwouldsuggestthatminoritygender/ethnicityPWPsshouldhelpinrecruitmentandbringawarenesstotherole,i.e.thesePWPstovisituniversityandcollegedaystospeaktoundergraduates/collegestudentsabouttheroleandactasrolemodelswithintheirspecificdemographic.

o Awareness.AlotofpsychologicalrolestendtobedominatedbyWhitefemales.Ithinkinordertochangethisandhavetheworkforcemorediversified,youneedtotargetpeopleatanearlierage.

Forcomparisonpurposes,responsesofwhitefemalePWPsagelessthan35wereasfollows:

• Justoverhalf(n=38)respondingtothisquestionsuggestedsomeformofadvertisingorpromotionofthePWProleandtrainingeitheringeneralortospecifictargetgroups.UnlikeolderPWPs,theycommonlysuggestedpromotingtherolewithinuniversities

• 12madesuggestionsaroundtheapplicationandselectionprocess.Onesuggestionfrom2respondents,whichhadnotbeenmadebythemorediversePWPs,wasforacentralisedapplicationschemetoallPWPcoursestoassistdiversePWPsinidentifyinglocaltrainingopportunities.Othersuggestionswerevaluing/weightingselectioncriteriaforawiderrangeofexperience(4respondents)orforpeoplefromlocalcommunities(1respondent)and,moreradically,replacing”relevantexperience”asacriterionforselectionwithOSCEcompetencytasksatinterview(1respondent)

• 3madesuggestionsabouthelpingpeopleobtainexperiencetoapplythroughvolunteer,workexperienceandassistantpractitioneropportunities

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• 4advocateddifferentormoreflexibletrainingroutesincludingnon-graduateandpart-timetrainingoptions.

• 13focusedonpay,thePWProleitselfandcareerprogressionaskeytoattractingpeople.11oftheserespondentsmadecommentsontheimportanceofcareerprogressionopportunities.

OthercommentsResultsareaggregatedseparatelyforthoseage35+andthosefromaBMEbackground.Inaddition,theothercommentsof4malePWPsthatspecificallymentionedgenderarenoted.Age35+:

• 3respondentsaddedspecificcommentsrelatedtobeinganolderPWP:o AsanoldermaleIfindmyselfinasmallminorityinIAPTon

accountofmy1age2genderI'veneverfeltdiscriminatedagainstonaccountofeitherofthesefactors,butitmaybeoffputtingforsome?

o IhaveseenthereisahighturnoverofPWP's,Ithinkifitwasaimedtowardsmorematureexperiencedcandidateslikemyselftherewouldbelessofaturnover,personallyI'mheretostay.

o Asastudentinmy40sIfeelmorecomfortableintheroleespeciallywhenseeingpatientsbecauseIamthatmucholder.Ialsohavelifeexperiencewhichhelpstoo.

• 1respondentsuggestedhavingabuddyduringtrainingmightbehelpful:o Itwasveryhelpfultohavea'buddy'inservicewhoknewtheropes

andwouldhelpoutwithquestions.Itmayhelptohaveasimilarbuddysystematuniversity-especiallyforthosewithamorediversebackground.

• 1participantcommentedthatpart-timePWPworkwouldbehelpful• 5commentswereaboutretentioninthePWProle:2ofthesewereabout

pay,2suggestedPWPprofessionalaccreditationwouldhelpand1focusedoncareerdevelopmentopportunities:

o Iwouldliketoseetherolemorevaluedandbetterpaybettertrainingtodevelopandalsoaccreditationandafarmoresupport.Iliketoleadfromothersandshareexperiences.IgetcrosswhengraduatesenrolandtheundergraduatesgetdiscriminatedagainstprofessionalsnobberyIcallit.

• 5additionalcommentswereaboutexpectationsandworkloadintherole,affectingbothretentionbutalsoimplicationsforrecruitmentofdiversegroupsintotherole:

o It’sthenatureoftheworkloadwhichleadstosomanypeopleleavingsoquicklypostqualification.Itisnotahumanask.Alsotheroleistoorelentlessandrepetitive,especiallyinprotocoltargetdrivenIAPTservices.

o PeopleshouldbemadeawarethatasaPWPtheywillhavetoseeasmanypatientsastheycanseewithintheshortestperiodoftimethattheycanallow

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o Youneedtoexamineworkloadandadmininordertoretainworkersnationally.statscomesbeforeworkforcewellbeingandpatientcare.

o TheIAPTmodelonpapertalksaboutmildtomoderateproblemsseenatstep2.However,inrealitythisdoesnothappenatall!!!Weseemuchmorecomplex,difficultpeoplewithtrans-generationalissuesdeeplyingrainedinthemandtheirfamilies'lives.Thereforemuchhardertoshift.SeeingthesetypesofpresentationstypicallyinthevolumePWP'sseeeachday/week/monthwithsuchamassivefocusontargetstargetstargetsistrulyhard.Peoplearereallyburnedoutand,inmyopinion,that'swhypeopleleavesofrequently.MyparticularservicehasnicemanagementwhoarecaringandrespondtoindividualsbutIhaveworkedinotherIAPTservicesasaPWPwereitwashorrendousandpeople(PWP's)wereintearsthroughstress.ThisshouldbelookedataswordofmouthspreadsandthePWProleisn'talwaysseenasmanageable

o Thetrainingisawful.Thedeptheadtourtheclassoffastripearlyonoverregistrationissues,anditwasnotthefaultofthepeopleshenamedandshameditwasauniversityadminissue.ThisisfromsomeonewhoisanexperiencedPWPandcourseleader.Theuniversitykeepsmovingtheboundariesforthingse.gassessmentssoeveryonegetsunnecessarilystressedwhenthisisnotneeded.TheformatiswrongasitisclearthataPWPisnotrespected.Thisiswhysomanyunqualifiedareabletobeinpostandcontinuetobeinpost,andthosewithnoexperienceareexpectedtodotheroleprior,andduringtrainingwithnosupport.Theassessmentisreallyjustacallcentrespeech-thereforethespeechandformatshouldbegivenout,withtheuniversitymarkingcriteriaonday1.Thenitcouldbeadaptedbystudentsforindividualityanddifferentservices.Itistopossibletosticktotheformulawithrealpeople.Itisalsoclearthatinpracticetherearetwomainissues-firstlythewaythingsaredonemeetafinancialincentiveandsecondlybybeingsoobviouslyfinanciallydrivenitisnotpersoncentredasitisnotadaptive.Thiscanbedemonstratedbytheamountofpeoplewhoreturntoservicefor'anothergo'.Longtermitcannotworkasitdoesnotaddressthecausesofdistress,thereforetorefertoCBTasatreatmentismisleadingandunfairandfalseadvertising-itisonlyaninterventioninthisformat.ThegreenfootprintofIAPTmustbetakenintoconsideration.ThepressureofworkonPWPtoworki.e.fitinassess,treatandwriteupnotesonatleasttwodatabasesisaskingfortrouble.Thereisalackofrealitythatmostpeoplebydefinitionofnearlyallresearchavailablewillattendwithaminimumofthreeproblems,thereforethissystemsetspeopleuptofail,asinrealityallwillneedStep3butarebeingforcedintoStep2.Thewaytheuniversitiesdeliverthecoursewouldnotencouragepeoplefromdiversebackgrounds,wouldnotencouragepeoplewhohavelittleformalqualificationsbutareexperiencedatworkingwithpeopleinneed,andthelack

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ofpreparationforexamsetcisbeyondbelief.Ihopethesystemchangessoon.

PWPswithBMEbackgrounds:

• 3respondentsaddedspecificcommentsrelatedtobeingfromaBMEbackground:

o Thecourseneedstointegratediversityconsiderationsthroughoutnotjustacoupleoflecturesattheend.Ifeltthatsomeoftheraceandculturelectureswherepinnedontotheend,andnotreallythefocithroughout.Moresupportneedstobemadeavailableforpeoplewhorelocateforthecourse,especiallythosewhocomefromlowerclassbackgrounds.Ierelocationbursary.

o IdothinkthatmoremenareneededinthepwproleespeciallywhereIworkthereareonly2outof13traineeswhoaremale.Ifeelitcanmakeadifferencetohaveamaletherapist,sometimesIfeelitcanhelpmetorelatethembetter.SoIbelievethisinitiativeisverygood.Ialsofeelthesameaboutsomeonethatisfromadifferentcultureandwithdifferentbeliefsforthepatientdemographic.Ashavingadifferentbelief,Imightfinditabithardtosharethiswithsometherapistswhomightnotunderstandit.

o SometimesfeelIamdiscriminatedagainstforbeingAsianordifferent.

• 3additionalcommentswereaboutexpectationsandworkloadintherole,affectingbothretentionbutalsoimplicationsforrecruitmentofdiversegroupsintotherole.OneofthesecommentswasfromanolderPWPfromBMEbackgroundandisincludedintheolderPWPsothercommentsabove:

o NotashighlypaidwhenmanagingriskandIthinkbeingPWPisnotsomethingyoucandolongtermduehighcaseload

o Pleaseseeaboveandpleasetrytohavealookatwhythere'sahugeturnoverinIAPTandhowtokeepthecurrentstaff,generallyinanypsychologyrelatedjobattractsyoungfemales.

Therewereothercommentsfrom4malerespondentsthatspecificallyreferencedgender:

o IdothinkthatmoremenareneededinthepwproleespeciallywhereIworkthereareonly2outof13traineeswhoaremale.Ifeelitcanmakeadifferencetohaveamaletherapist,sometimesIfeelitcanhelpmetorelatethembetter.SoIbelievethisinitiativeisverygood.

o Youdidn’taskmysexuality,orlifestage,I'magayman,divorcedandtwokidsandworkparttime

o AsanoldermaleIfindmyselfinasmallminorityinIAPTonaccountofmy1age2gender.I'veneverfeltdiscriminatedagainstonaccountofeitherofthesefactors,butitmaybeoffputtingforsome?

o TheonlywaytomakesurethatPWPsarerepresentativeofthepopulationistomakesurethatthePWProleisanattractiveone.Asitstandsitisnot.Morefocusshouldbeputontostaff

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retentionratherthantryingtorecruitfromawiderdemographicpool.

OnefinalcommentfromamalePWPisworthnoting: o Topromotetheroleandtheposition,IAPTneedstobehonestand

providemeaningfulresearchregardingitsefficacy/effectivenessratherthanallowservicestocookthebooks,ignoreNICEguidelines,etc.inordertomeettargets.Ifthejobistoohighpressured,lacksreward,andisethicallydubiousthenitwillbedifficulttokeepanystaff.

Additionalcommentsfromtheyounger(age35orless)whitefemalerespondentscoveredsimilarthemesonthewhole,withsomespecificcommentsthatareworthquoting:

o Iwouldsay,don'tassumeIwouldnotbeconsidereddiverseasIamwhite.Ihavedyslexia(notalwayseasytomanagewithinthePWProle!).Iwasandstillamthefirstinmyfamilytogotouniversity,Iamfromalowincomebackgroundanddidnotgotoagoodschool.

o IdofeelthatIAPTworkersaretypicallyrepresentedbyyoungmiddleclassfemalesandthisisatdetrimenttotheservice.EducationandopportunitytodounpaidworkarenottheonlyindicatorsofhowsuccessfulaPWPwillbeabletoworkwithindividualsexperiencingmentalhealthdifficultiesandcanresultinhighstaffturnoverduetostaffwishingtomoveforwardwiththeircareers,whichinturndevaluestheroleofthePWPandleadstoastaffgroupwhichlacksexpertise.

o ThePWProleisafantasticstartingpointinanIAPTservice.ForthoseindividualswhowanttoprogresstoHItraining,thereshouldbemoresupportandopportunitytodothisearlierthan2years.Especiallyifyouarelookingforthosepeoplewhohavecomefromotherprofessions,whomaybeolder.Thepayisnotsustainableandthesepeoplearegoingtobe-understandably-keentofindaroletheycansettleinandbuildtheirskills.

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Appendix3–PWPNationalCurriculumLearningoutcomesThesearethePWPtraininglearningoutcomesextractedfromtheNationalCurriculumfortheEducationofPsychologicalWellbeingPractitioners,3rdedition(January2015)Engagementandassessmentofpeoplewithcommonmentalhealthproblems:1)Demonstrateknowledge,understandingandcriticalawarenessofconceptsofmentalhealthandmentalillness,diagnosticcategorysystemsinmentalhealthandarangeofsocial,medicalandpsychologicalexplanatorymodels.2)Demonstrateknowledgeof,andcompetenceinapplyingtheprinciples,purposesanddifferenttypesofassessmentundertakenwithpeoplewithcommonmentalhealthdisorders3)Demonstrateknowledgeof,andcompetenceinusing‘commonfactors’toengagepatients,gatherinformation,buildatherapeuticalliancewithpeoplewithcommonmentalhealthproblems,managetheemotionalcontentofsessionsandgrasptheclient’sperspectiveor“worldview”.4)Demonstrateknowledgeof,andcompetencein‘patient-centred’informationgatheringtoarriveatasuccinctandcollaborativedefinitionoftheperson’smainmentalhealthdifficultiesandtheimpactthishasontheirdailyliving.5)Demonstrateknowledgeof,andcompetenceinrecognisingpatternsofsymptomsconsistentwithdiagnosticcategoriesofmentaldisorderfromapatient-centredinterview.6)Demonstrateknowledgeof,andcompetenceinaccurateriskassessmenttopatientorothers7)Demonstrateknowledgeof,andcompetenceintheuseofstandardisedassessmenttoolsincludingsymptomandotherpsychometricinstrumentstoaidproblemrecognitionanddefinitionandsubsequentdecisionmaking.8)Demonstrateknowledge,understandingandcompetenceinusingbehaviourchangemodelsinidentifyinginterventiongoalsandchoiceofappropriateinterventions9)Demonstrateknowledgeof,andcompetenceingivingevidence-basedinformationabouttreatmentchoicesandinmakingshareddecisionswithpatients.10)Demonstratecompetenceinunderstandingthepatientsattitudetoarangeofmentalhealthtreatmentsincludingprescribedmedicationandevidence-basedpsychologicaltreatments.11)Demonstratecompetenceinaccuraterecordingofinterviewsandquestionnaireassessmentsusingpaperandelectronicrecordkeepingsystems.Evidence-basedlow-intensitytreatmentforcommonmentalhealthdisorders:1)Criticallyevaluatearangeofevidence-basedinterventionsandstrategiestoassistpatientsmanagetheiremotionaldistressanddisturbance.2)Demonstrateknowledgeof,andcompetenceindevelopingandmaintainingatherapeuticalliancewithpatientsduringtheirtreatmentprogramme,includingdealingwithissuesandeventsthatthreatenthealliance.3)Demonstratecompetenceinplanningacollaborativelow-intensitypsychologicalorpharmacologicaltreatmentprogrammeforcommonmentalhealthproblems,includingmanagingtheendingofcontact.

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4)Demonstratein-depthunderstandingof,andcompetenceintheuseof,arangeoflow-intensity,evidence-basedpsychologicalinterventionsforcommonmentalhealthproblems.5)Demonstrateknowledgeandunderstandingof,andcompetenceinusingbehaviourchangemodelsandstrategiesinthedeliveryoflow-intensityinterventions6)Criticallyevaluatetheroleofcasemanagementandsteppedcareapproachestomanagingcommonmentalhealthproblemsinprimarycareincludingongoingriskmanagementappropriatetoserviceprotocols.7)Demonstrateknowledgeof,andcompetenceinsupportingpeoplewithmedicationforcommonmentaldisorderstohelpthemoptimisetheiruseofpharmacologicaltreatmentandminimiseanyadverseeffects.8)Demonstratecompetencyindeliveringlow-intensityinterventionsusingarangeofmethodsincludingface-to-face,telephoneandelectroniccommunication.Values,DiversityandContext:1)Demonstrateknowledgeof,andcommitmenttoanon-discriminatory,recoveryorientatedvaluesbasetomentalhealthcareandtoequalopportunitiesforallandencouragepeople’sactiveparticipationineveryaspectofcareandtreatment2)Demonstraterespectforandthevalueofindividualdifferencesinage,sexuality,disability,gender,spirituality,raceandculture.3)Demonstrateknowledgeof,andcompetenceinrespondingtopeoples’needssensitivelywithregardtoallaspectsofdiversity,includingworkingwitholderpeople,theuseofinterpretationservicesandtakingintoaccountanyphysicalandsensorydifficultiesserviceusersmayexperienceinaccessingservices.4)Demonstrateawareness&understandingofthepowerissuesinprofessional/serviceuserrelationships.5)Demonstratecompetenceinmanagingacaseloadofpeoplewithcommonmentalhealthproblemsefficientlyandsafely.6)Demonstrateknowledgeof,andcompetenceinusingsupervisiontoassisttheworker’sdeliveryoflow-intensitypsychologicaland/orpharmacologicaltreatmentprogrammesforcommonmentalhealthproblems.7)Demonstrateknowledgeof,andcompetenceingatheringpatient-centredinformationonemploymentneeds,wellbeingandsocialinclusionandinliaisonandsignpostingtootheragenciesdeliveringemployment,occupationalandotheradviceandservices.8)Demonstrateanappreciationoftheworker’sownlevelofcompetenceandboundariesofcompetenceandrole,andanunderstandingofhowtoworkwithinateamandwithotheragencieswithadditionalspecificroleswhichcannotbefulfilledbytheworkeralone.9)Demonstrateaclearunderstandingofwhatconstituteshigh-intensitypsychologicaltreatmentandhowthisdiffersfromlow-intensitywork.