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1 Widening participation to Psychological Wellbeing Practitioner training Project report to Health Education England Centre for Outcomes Research and Effectiveness University College London October 2017

Project report to Health Education England Centre for Outcomes … · 2018-03-07 · Psychological Wellbeing Practitioner training Project report to Health Education England Centre

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Page 1: Project report to Health Education England Centre for Outcomes … · 2018-03-07 · Psychological Wellbeing Practitioner training Project report to Health Education England Centre

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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:[email protected]

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.