EA and SEA Competency Framework ENGAGEMENT AND ASSESSMENT EA Training Module/Skills Area Engagement with the client. Specific Competences

Transcription

1 EA and SEA Competency Framework ENGAGEMENT AND ASSESSMENT EA Training Module/Skills Area Engagement with the client Domain Core Skills with clients Specific Competences An ability to draw on knowledge of the importance of working collaboratively with the client: A consistent commitment to the notion that the client and the advisor work together to do the work. Awareness that the aim of intervention is to help clients tackle their problems by harnessing their own resources. An ability to draw on knowledge that the development and maintenance a good working alliance is usually seen as having three components: The relationship or bond between advisor and client. Consensus between advisor and client regarding the techniques/methods employed in the therapy. Consensus between advisor and client regarding the goals of any intervention. An ability to listen to the client s concerns in a manner which is non-judgmental, supportive and sensitive, and which conveys a comfortable attitude when the client describes their experience. An ability to use appropriate interviewing techniques to help the client describe the main issues that concern them and ways in which these impact on their life. An ability to ensure that the client is clear about the rationale for the intervention being offered An ability to gauge whether the client understands the rationale for the intervention, has questions about it, or is sceptical about the rationale, and to respond to these concerns openly and nondefensively in order to resolve any ambiguities.

2 Assessment Engagement with therapists and other professionals Assessment and Triage Supporting and reviewing interventions An ability to help the client articulate their goals for the intervention, and to gauge the degree of congruence in the aims of the advisor and client. While maintaining professional boundaries, an ability to show appropriate levels of warmth, concern, confidence and genuineness, matched to client need: An ability to engender trust An ability to develop rapport An ability to adjust the level of activity and structuring of a meeting to the client s needs An ability to convey an appropriate level of confidence and competence An ability to avoid negative interpersonal behaviours (such as impatience, aloofness, or insincerity) Knowledge of the relevant assessment processes and tools to assess employment needs in IAPT and related services Knowledge of case identification and mental health assessment methods in the work place and employment support services An ability to undertake an individual assessment of employment needs in the context of a mental health service to determine employment support needs and the relation to mental health problems. Note: the mental health assessment is to be conducted by an appropriately qualified IAPT clinician, not by the employment advisor) An ability to work with therapists to identify and articulate the barriers to work for individuals, for example how agoraphobia can impact on an individual s ability to take part in work. An ability to develop interventions in collaboration with the clients, IAPT staff and work place and employment support staff, to address employment needs An ability to review and adjust a care plan in collaboration with the clients and IAPT staff and work place and employment support staff where indicated

3 For Senior Employment Adviser Only: Disclosing information about mental health problems Employment Interventions Establishing a context for the service and providing rationale for the client of an employment intervention Ability in collaboration with senior staff in the work place or employment support services to develop and maintain effective referral pathways between IAPT and employment support services and providers. Knowledge of the relevant legislation about the work place and disability and the disclosure of information about health problems. An ability to support client choice in order to make an informed decision regarding what may be disclosed to a potential employer about having a disability including what specific information m ight be disclosed (e.g., a depressive disorder) and offers examples of what could be said to employers. EMPLOYMENT INTERVENTIONS Knowledge of the range of employment interventions relevant for people with employment needs and a mental health problem including; advice on the range of employment support services, specific interventions to support job seeking, work place based interventions and advice training and support for employers and IAPT staff. An ability to help the client understand that the main purpose of the intervention is to focus on the development of employment related skills and knowledge and their relation to any mental health problems the client has. An ability to provide a rationale for an employment intervention to clients in an encouraging and realistic manner. An ability to establish a context for the intervention, through clear explanation of the advisor role. An ability to ensure that the client understands the nature of the intervention and the schedule of contacts. An ability to convey the client led, collaborative nature of any employment intervention. An ability to draw on knowledge and awareness of the importance of the client putting what has been

4 agree goals for the intervention learned into practice between meeting (e.g. practice assignments, or homework ). An ability to help the client generate their own goals for the intervention, and to reach a shared agreement about these, by helping them: to translate vague/abstract goals into concrete goals to identify goals which will be subjectively and objectively observable and potentially measurable (i.e. to ensure that if change takes place it will be noticeable to the client and to others) An ability to work with the client to ensure that goals reflect the issues/problems with which they present. Capacity to adapt interventions in response to client feedback Planning client led interventions Delivering client led interventions An ability to work with the client to ensure that goals are realistic and achievable. An ability to accommodate issues the client raises explicitly or implicitly, or which become apparent as part of the process of the intervention. An ability to respond to, and openly to discuss, explicit feedback from the client which expresses concerns about important aspects of the intervention. An ability to detect and respond to feedback which indicates that the client has concerns about aspects of the intervention (e.g. as indicated by nonverbal behaviour, verbal comments or significant shifts in responsiveness). An ability to plan a work based programme to support job retention for those newly in employment or whose employment (e.g. presenteesism) may be at risk including negotiation the plan with the client and work place based staff. An ability to develop in collaboration with an IAPT therapist a work based programme to address a work place based psychological problem which may also support job retention for those newly in employment or whose employment (e.g. presenteesism) may be at risk including negotiation the plan with the client and work place based staff. An ability to deliver employment advice and job seeking skills for people with employment and mental health needs in individual and groups setting.

5 An ability to convey the client led, collaborative nature of an employment intervention. An ability to work with the client, work placed based staff, other employment support services and IAPT staff to help the client resolve difficulties encountered in the implementation of the agreed programme. An ability to understand in individual or group settings the use of appropriate self-help materials (including written materials) and self-monitoring materials, and support the client in the use of relevant and effective materials. An ability to help the client problem solve difficulties encountered in the use of written materials, and self-monitoring materials. An ability to help the client think through the rationale for performing homework and related tasks, and to identify and problem solve any anticipated difficulties in carrying out tasks. Capacity to structure meetings and maintain pace. Delivering advice and support in the work place An ability to communicate effectively about the delivery, implementation and monitoring of interventions both in face-to-face contacts and in telephone contacts. An ability to maintain adherence to an agreed agenda and to pace a meeting in a manner which ensures that all agreed items can be given appropriate attention (i.e. ensuring that significant issues are not rushed) Knowledge of the range of work place environment and employment support services (e.g. Job Centre Plus) and the potential training needs of such settings, the capacity of local services to adapt to the mental needs of employees and relevant guidance and legislation (e.g. reasonable adjustments in the work place and access to benefits). An ability to assess the awareness of mental health problems of work place or employment support staff and the need for further training to support the uptake and retention of employment. An ability in conjunction with work place or employment support staff (and IAPT staff when needed) to implement mental health focused interventions in the work place.

6 An ability to deliver at the individual, group and organisational level advice and support on mental health issues to work place or employment support staff. Delivering training on employment and mental health to stakeholders An ability to regularly liaise with work place or employment support staff to ensure effective joint working at both the individual and organisational level. An ability to deliver or facilitate the delivery of mental health training (focused on a basic understanding of mental health problems and their impact on employment and intervention to address the problems) to work place or employment support staff. An ability to deliver or facilitate the delivery of employment training (focused on a basic understanding of the employment support services and the work place and their impact on mental health the problems) to IAPT staff. CASELOAD MANAGEMENT Caseload Management An ability to manage and if necessary adjust a caseload (e.g. number of clients, case mix and balance of type of work) in order to function optimally. An ability to identify risks to or from clients on the caseload and escalate concerns to Senior Employment Adviser or IAPT Practitioner. An ability to recognise and help resolve problems of caseload management, including time management, overall workload and relationships with referrers. An ability to use both electronic and paper based information systems for information gathering and review to inform effective case management.

7 MENTAL HEALTH KNOWLEDGE AND INTERVENTIONS EA Training Module/Skills Area Mental Health Interventions IAPT Interventions Outcome measurement Domain Knowledge of mental health services Knowledge of triage and assessment systems Knowledge of models of IAPT interventions, and the ability to understand how they are employed in practice Knowledge of basic principles of core IAPT interventions and rationale for treatment Integration of Mental Health and Employment Interventions Specific Competences Knowledge of the basic structures of mental health services in primary and secondary care and their relationship to the IAPT service and other employment services for people with mental health problems. Knowledge of the key elements of IAPT assessment and triage systems and their application in local protocols for both high and low intensity interventions. An understanding of the factors common to all therapeutic approaches. Knowledge of all IAPT therapies including selfhelp, behavioural activation, CBT, counselling, EMDR, IPT, dynamic interpersonal treatment, couples therapy behavioural couples therapy and mindfulness based cognitive therapy. Knowledge of the impact of IAPT Treatments on a person s functioning and ability to find employment, remain in employment and return to employment. Knowledge of the different models of joint working (collaboration, joint working, supporting the implementation of a work or employment based psychological intervention) between employment advisors and mental health professionals in particular IAPT staff. An ability to work collaboratively with IAPT staff in the development and implementation of a plan of care to address both psychological and employment needs. Knowledge of the purpose and objectives of outcome measurement and its value in the evaluation of client and service outcomes. Knowledge of the IAPT Minimum dataset and its use in IAPT services.

8 Mental Health Focussed Employment Interventions Establishing a context for the service and providing rationale for the client of the intervention Facilitating client led interventions Capacity organise meetings appropriate pacing An ability to draw on knowledge of commonly used questionnaires and rating scales for mental health and employment outcomes. An ability to work with the client to ensure that measures of the targeted employment problem are meaningful to the client (i.e. are chosen to reflect the client s perceptions of the problem or issue). An ability to draw on knowledge of measurement to ensure that procedures for self-monitoring are relevant (i.e. related to the question being asked), valid (measuring what is intended to be measured) and reliable (i.e. reasonably consistent with how things actually are). An ability to use and to interpret relevant measures routinely throughout the intervention, with the aim of establishing both a baseline and indications of progress. An ability to support in context a MH intervention, through clear explanation of the advisor role An ability to ensure that the client understands the nature and the timing of meetings and the schedule of contacts An ability to understand the use of appropriate self-help materials (including written materials) and self-monitoring materials, and support the client in the use of relevant and effective materials. An ability to help the client problem solve difficulties encountered in the use of written materials, and self-monitoring materials. An ability to communicate effectively about the delivery, implementation and monitoring of interventions both in face-to-face contacts and in telephone contacts An ability to maintain adherence to an agreed agenda and to pace the session in a manner which ensures that all agreed items can be given appropriate attention (i.e. ensuring that significant issues are not rushed) An ability to balance the need to maintain adherence and pacing while being appropriately responsive to client need:

9 Long Term Physical Health Conditions Awareness Knowledge of the range of presenting issues in people with physical health problems Knowledge of the impact of and adjustment to long term physical health conditions on the client when planning a course of action an ability to structure the session in a manner which is congruent with specific issues (e.g. the client s capacity to concentrate) an ability to balance the need to maintain an appropriate pace against following up important issues raised by the client an ability to use judgment to decide when issues needs to be pursued and when they could act to divert attention from the primary (and agreed) focus of the intervention Knowledge of the presenting issues characteristic of physical health problems and the concerns commonly experienced by clients presenting with these problems Knowledge of the ways in which physical and mental health problems can interact and impact on functioning and individual development (e.g. capacity to maintain, family and social relationships, or to maintain employment and study). Knowledge of the impact of long-term conditions on the development of functional independence (e.g. on personal care, mobility and communication) Knowledge that chronic illness can: result in lower quality of life lead to disruption in family structures lead to higher levels of depression and anxiety in comparison to healthy peers Knowledge that positive adjustment to illness can be thought of as the maintenance of positive emotional wellbeing, Knowledge that understanding the relationship between psychological and physical health problems is critical when planning an intervention, given that: mental health issues may be a precursor or a consequence of a physical disorder, or may be independent of (and unrelated to) the client s health difficulties Knowledge that intervention strategies should focus on the factors that are most likely to help

10 the client manage their health condition more effectively: Understanding Clients With Long Term Physical Health a focus on mental health issues may not always be relevant, and hence may not be acceptable to clients helping clients to adopt more effective strategies for better condition management may be more relevant than a direct focus on mental health issues Knowledge of psychological theory in explaining how people respond to illness (e.g. their knowledge of about, their illness, attitudes to risk, their perceptions of the illness) Knowledge of the relationship between illness, psychological factors and individual differences in predicting disability and positive adjustment to illness (e.g. anxiety and depression, beliefs about control, coping style) SUPERVISION COMPETENCIES EA Training Module/Skills Area Effective Supervision Domain apply the principles of adult learning Knowledge of educational principles which enhance learning Specific Competences An ability to undertake supervision in a collaborative manner which assumes that learning is a two-way process (in which the supervisor can expect to learn from the supervisee) An ability to apply the principles of adult learning, incorporating active learning and promoting supervisee s reflection on their learning An ability to help supervisees identify their own strengths and weaknesses, and formulate learning objectives to address identified gaps An ability to take account of the supervisee s preferred approaches to learning, particularly with regard to any mismatches between their approach and the supervisor s usual preference An ability to draw on knowledge of relevant educational models, and their implications for supervision practice e.g.: that learning is best seen as part of a cycle of activities, rather than as a one-off event:

11 1 learning is enhanced by taking supervisees though an iterative cycle that exposes them to new ideas gives them the opportunity to apply these ideas in practice know: 2 learning is most likely to take place when supervisees experience an optimal level of discomfort, generated by a perception of a gap between the knowledge they currently have and the knowledge they need to make sense of their experiences use direct observation and contingent feedback to enhance learning in supervision 3 learning is most likely to take place if new information is presented in a way which links it to knowledge and experience An ability to draw on knowledge of the benefits of behavioural techniques in supervision (i.e. linking observation with contingent feedback) an ability to identify and make use of contexts for observation best suited to desired learning outcomes - e.g.: direct observation of work (including the use of taped material) role play within supervision observation and practice of specific techniques within supervision An ability to draw on knowledge that feedback is most effective when it is: adapt supervision to the organisational and governance context accurate (i.e. direct and avoiding dissimulation) focused on specifics (rather than general observations) offered contingently to specific actions (rather than as global feedback that could relate to many actions) as far as possible focuses on behaviours rather than on imputed personal characteristics An ability to act on knowledge of the organisational context within which the supervisee is operating, and any implications this has for the ways in which supervision is conducted, for example: contractual relationships between training institutions and the work setting

12 establish a professional framework for supervision local governance arrangements local arrangements for risk management An ability to conduct supervision in a manner which is congruent with relevant ethical and professional frameworks An ability to negotiate a contract for supervision which specifies its aims An ability to ensure that supervisees are clear about procedures which will be followed should there be significant concerns about their practice establish a structure for supervision sessions agree expectations about which cases will be presented facilitate reflection An ability to be open to feedback from the supervisee should any aspect of supervision content or structure deviate significantly from that which has been agreed An ability to impart information about the usual content (and expected focus of) supervision sessions An ability to negotiate and implement basic expectations regarding supervision, for example: frequency and duration of supervision sessions alternative supervision arrangements if the supervisor is on leave or unexpectedly unavailable supervision arrangements in the case of emergencies An ability to agree with the supervisee a clear rationale for their work, aiming to ensure that: the supervisor is aware of progress with the supervisee s complete caseload there is explicit agreement about the basis for selecting which cases to discuss there is no systematic and/or undisclosed bias in selection of cases for discussion (e.g. supervisee only bringing cases which are progressing well) An ability to implement educational models within which there are explicit opportunities for reflection and self-appraisal An ability to help the supervisee reflect on their experience (as gained both in work settings, in

13 supervision and from academic input), with the aim of increasing the accuracy of their self-appraisal An ability to help supervisees use specific techniques to aid reflection, such as learning logs gauge the supervisee s capacity to reflect create a context for giving feedback An ability to respond in a respectful manner to supervisee s reflections, so as not inhibit any future reflection An ability to gauge the supervisee s ability to engage in accurate self-appraisal An ability to gauge the supervisee s ability to respond to feedback in a manner that is consonant with the content of the feedback (i.e. in a manner which is neither dismissive nor over-reactive) An ability directly to discuss difficulties in the supervisee s ability to reflect on feedback or to accurately self-appraise their work An ability to ensure that the relationship between supervisor and supervisee is good enough to allow summative and formative feedback to be accepted (and reflected on) by the supervisee An ability to detect whether the supervisee is able to engage with feedback, and (if relevant) to identify and explore any factors which make this difficult for the supervisee An ability to ensure that the supervisee is in a position to understand the feedback (i.e. that the feedback is congruent with their current level of understanding/ learning) give feedback in an appropriate manner An ability to detect when feedback may have a negative impact on the supervisee (e.g. supervisee withdrawal, shame, increased anxiety), and to manage any consequences in a supportive manner An ability to give feedback which: is balanced (i.e. identifies what the supervisee did well, as well as what was done less well) clear and appropriately direct focuses on specific aspects of the supervisee s work (rather than making general or global observations)

14 When commenting on perceived problems in clinical work, an ability to suggest alternative actions the supervisee could take An ability to phrase feedback in a manner which avoids the imputation of personal failure: gauge the supervisee s level of competence by focusing on examples of behaviour (as opposed to attributing problems to the supervisee s personal qualities) by phrasing comments in a manner which directs attention to the issues rather than to characteristics of the supervisee An ability, after giving feedback, to be receptive to (and to engage with) feedback from the supervisee An ability to develop criteria for appraising competence which are reliable and which are adapted to take account of the supervisee s level of experience, usually in the domains of the supervisee s: factual knowledge skills ability to implement interventions in a way which demonstrates an understanding of the rationale for the intervention (i.e. to be able to make links between theory and practice) capacity to reflect accurately on progress interpersonal skills ability to work effectively with professional colleagues ability to apply ethical and professional standards in practice Adapting process and content of supervision An ability to relate criteria for competence to relevant standards (e.g. those set by professional accreditation bodies, by relevant course curricula, or National Occupational Standards) An ability to match the process and content of supervision to the supervisee s stage of development An ability to identify gaps in knowledge and skills and to identify the best learning strategies for managing these

15 An ability to use professional judgment to monitor the supervisee s learning and emotional needs as these relate to client work and to any organisational issues An ability to use professional judgment in order to balance the need to ensure that the supervision agenda is comprehensive in its coverage against the need to be responsive to current and specific supervisee needs