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Training Outcomes in Relation to Difference and Diversity
for Trainee Clinical Psychologists completing the
UCL Doctorate in Clinical Psychology
March 2007
Sub-Department of Clinical Health Psychology
Gower Street
London WC1E 6BT
Prepared by an internal Working Party, UCL Doctorate in Clinical Psychology. Comments & queries to k.scior@ucl.ac.uk, Sub-dept of Clinical Health Psychology, University College London, Gower Street, London WC1E 6BT.
1. Introduction
This document has been prepared as part of a review of the Difference & Diversity unit on the UCL clinical psychology training course. Its key purpose is to set out learning outcomes which, if met, demonstrate trainees' ability to work effectively with clients from a diverse range of backgrounds. This document is strongly influenced by the guidance offered by Nimisha Patel et al. (2000) in their training manual Clinical Psychology, 'Race' and Culture, but aims to set out learning outcomes which take into account difference and diversity more broadly than only differences pertaining to culture and ethnicity.
BPS Accreditation Criteria
This document is in line with the current Criteria for the Accreditation of Postgraduate Training Programmes in Clinical Psychology (CTCP, 2002) which state that training providers need to ensure that trainees acquire:
B.1.1.2 The skills knowledge and values to work effectively with clients from a diverse range of backgrounds, understanding and respecting the impact of difference and diversity upon their lives;
B.1.3.7 Personal and Professional Skills, including understanding the impact of difference and diversity on people's lives, and its implications for working practices
In addition to these sections which make specific reference to difference and diversity, it is our belief that the ability to pay attention to the context of all those we come into contact with in our professional practice and respond sensitively and appropriately should be an intrinsic part of all our work, including assessment, formulation, intervention, evaluation and research.
Ethos of the UCL course
The Course has a pluralistic ethos: it aims to expose trainees to a variety of approaches within clinical psychology rather than just one. This is designed to ensure that trainees can respond flexibly to the demands that will be made of them in a rapidly changing NHS. The Course aims to promote strong links between theory and practice and is organised to ensure that the clinical, academic and research components of training are well integrated. Reflecting this concern: a) Diversity in teaching methods is encouraged, matching the method to the material to be taught. b) Skills teaching is integrated within the academic programme, along with the use of experiential teaching methods. c) Trainees are encouraged to adopt a hypothesis-testing approach to their work and to adopt a thoughtful and critical approach to the use of research evidence concerning the effectiveness of therapeutic techniques.
The Course tries to ensure that trainees can practice effectively and equitably in the context of the diversity that characterises clinical populations in London. The promotion of equal opportunities in the selection of trainees and in teaching is an important feature of the Course philosophy, and a theme of the programme.
2. Required Learning Outcomes
The following list is designed to assist course staff and other training providers in ensuring that trainees have acquired the ability to meet the needs of very diverse individuals and client groups, in whatever context or speciality they meet them. They reflect learning outcomes trainees should be able to demonstrate by the end of their 3 year training. Trainers should be very mindful of the huge variation in trainees' prior knowledge and experience and that trainees may follow different paths in achieving these outcomes. The learning outcomes set out are presented in line with the UCL curriculum.
2.1 Knowledge Base
· Trainees will develop an understanding of service delivery issues and current legislation, policies and guidelines which cover clinical psychology practice and refer to making services more accessible and appropriate to a diverse population. In working across different contexts and settings trainees will develop their ability to recognise institutional barriers to equitable access. They will also develop an understanding of the limitations of statutory services and how they fit with voluntary services.
· Trainees will develop their awareness of historic and social processes by which majority groups have marginalized minority groups, and the impact this can have on individuals' lives, views of self, and functioning as well as collective experience. This will include an understanding of racism, religious persecution, discrimination on the grounds of physical or intellectual disability, issues of social class, heterosexism and social power and how these processes may affect how people develop and experience psychological problems, and how they approach help.
· Trainees will learn to recognise the risks of multiple discrimination whereby members of minority groups may be further disadvantaged if they come into contact with services.
· Trainees will have a thoughtful appreciation of life span development and will recognise that the ways in which people live and think about their lives are very much affected by different beliefs, which are in turn influenced by their gender, culture, religion, sexuality and abilities.
· Trainees will recognise that constructs which psychologists frequently draw on, such as adolescence, autonomy or delusional beliefs to name just a few examples, as much as what is deemed 'normal' or 'abnormal' are not universal entities but are very much influenced by the social and cultural context.
· Trainees will learn about different world views, such as the emphasis placed on individualism versus collectivism and mind-body dualism, and their potential impact on help seeking and response to treatment
· Trainees will develop their ability to critically appraise the historical, social and cultural context which psychological models are grounded in.
2.2 Skills
2.2.1 Core Clinical Skills
· Trainees will use their critical analysis of prevailing theoretical models and therapeutic approaches in judging their applicability and in finding a fit between models and clients' needs.
· Trainees will develop their skills in working with interpreters and will develop an understanding of potential difficulties and challenges when working in this way.
· Trainees will develop an ability to carefully reflect on their work and to question assumptions about similarity and difference and their potential or actual effects on clinical situations.
· Trainees will increasingly be able to recognise their own values and assumptions about issues arising in their work, for example what is considered 'normal', ideas about parenting, gender relations, sexuality or age, and the impact these may have on their responses to clinical situations and their interactions with clients and others they come into contact with during their work.
· Trainees will develop their awareness of potential power differences between those they work with and themselves and how these may be influenced by, for example, social class, gender, ethnicity, religion, ability, age and professional status. They will develop skills in addressing power differences sensitively in their interactions with clients, carers and colleagues.
2.2.2 Assessment, Formulation & Intervention
· Trainees will develop their ability to respond sensitively and flexibly to the needs of clients and ask appropriate questions about clients' backgrounds and their pertinence for the presenting difficulties and help seeking.
· Trainees will develop their understanding of potential cultural specificity of psychometric and structured assessment tools. They will acquire an ability to plan and complete assessments which take clients' backgrounds into account and which are mindful of the potential impact of clients' minority status on their presentation and the results of any assessments.
· Trainees will develop their ability to reflect on their own beliefs and attitudes and their potential impact on engagement and the therapeutic process as well as their choice of assessment and intervention.
· Trainees will increasingly be able to demonstrate their awareness of issues of difference and diversity by incorporating these into their formulations and intervention planning. These skills should also be evident in trainees' report writing, as should the ability to evaluate the impact of their own background on their clinical work.
3. Mechanisms for achieving these competencies
The course should ensure that it provides trainees with the knowledge and skills needed to develop the competencies outlined in this document through a mixture of academic teaching and clinical placement experience.
3.1 Academic Teaching
Academic teaching will aim to enable trainees to achieve the learning outcomes set out in this document through a mixture of teaching which integrates issues of difference and diversity across the curriculum and specific teaching as part of a difference & diversity unit. For a table that sets out where in the UCL curriculum the learning outcomes outlined in this document may be primarily covered click here
3.2 Clinical Placements
click here for a table that identifies a number of learning outcomes which are most appropriately developed during clinical placements. It is the joint responsibility of clinical supervisors, trainees and course staff to ensure that clinical placement experience allows trainees to work towards these learning outcomes, through the placement contract, review in supervision, Clinical Log B and Mid-Placement Reviews.
Key References
BPS (1994). Equal Opportunities Policy Statement and Policy. British Psychological Society: Leicester.
BPS (2005). Good practice guidelines for UK clinical psychology training providers for the training and consolidation of clinical practice in relation to people with learning disabilities. Faculty for Learning Disabilities, Division of Clinical Psychology, British Psychological Society: Leicester.
BPS (2006). Good practice guidelines for UK clinical psychology training providers for the training and consolidation of clinical practice in relation to older people. PSIGE- Psychology Specialists working with Older People, Division of Clinical Psychology, British Psychological Society: Leicester.
Committee on Training in Clinical Psychology (2002). Criteria for the Accreditation of Postgraduate Training Programmes in Clinical Psychology. Membership and Qualifications Board, British Psychological Society.
Dept of Health (1999). National Service Framework for Mental Health.
Dept of Health (2001). National Service Framework for Older People.
Dept of Health (2004). National Service Framework for children, young people and maternity services.
Patel,N., Bennett,E., Dennis,M., Dosanjh,N., Mahtani,A., Miller,A. & Nadirshaw,Z. (2000). Clinical Psychology, 'Race' and Culture: a training manual. BPS: Leicester.
Members of the Working Group
Pasco Fearon, Senior Lecturer
Katrina Scior, Lecturer (Chair)
Kristina Soon, Clinical Tutor
all UCL Doctorate in Clinical Psychology
Appendix 3
Consultation
Thank you to the following organisations and individuals who provided comments on the initial draft during the consultation process:
Natasha Alexander, Learning Disability Service, Newham Primary Care NHS Trust
Jenny Jim, Child & Adolescent Mental Health Service, South London & Maudsley NHS Foundation Trust
Zenobia Nadirshaw, Chair of BPS S.I.G. Race & Culture, responding on behalf of S.I.G. Race & Culture
Peter Scragg, UCL & Camden & Islington Mental Health & Social Care Trust