Training Psychologists to Work in Learning Disabilities

1
Training Psychologists to Work in Learning
Disabilities

• Reflections on the Bristol experience

2
Background

• 3 courses in South West SHA
• Bristol programme evolved from the Plymouth
  course
• Covers AGW area
• Currently based at UoB
• 3 year doctoral programme
• Previous experience psychology graduates,
  assistant psychologists, range of backgrounds

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Philosophy

• Reflective-scientist-practitioner model
• Personal, academic clinical development
• Adult learner model
• Exposure to range of therapeutic models
• Systemic, CBT, Psychodynamic, Humanistic
• (person-centred)
• Constructively critical approach
• Themes Inequalities (class, ethnicity, gender,
  disability), Spirituality
• Client and carer involvement

4
Course Content

• Academic teaching (3 month block extended
  teaching days combined with AMH)
• 5 month clinical placements
• Course work (case studies, service evaluation,
  psychotherapy process study)
• Research thesis, literature review

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LD Teaching Content (1)

• Aetiology prevalence
• Key issues Empowerment person-centredness,
  constructional approaches
• History of LD service provision
  institutionalisation, normalisation.
• Policy Valuing People (Now) MCA MHA.
• Ethical issues e.g. choice capacity best
  interests duty of care human rights

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Teaching Content (2)

• Adaptations to all therapeutic models
• e.g. CBT simplified language greater use
• of pictures short pictorial rating scales
  briefer
• sessions, diagrammatic formulations, memory
• aids, etc
• Specific topics e.g. PCP, parents with LD,
  sexuality, risk assessment, abuse, medication,
  accessible information, group work

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Placements (1)

• With supervisor in clinical setting
• Set goals in Competence Areas Relationships
  Assessment Formulation Communication, Training
  Consultation Management Organisation
  Professional Practice Supervision Personal
  Development
• Typically caseload of 6 cases (assessment
  intervention)

8
Placements (2)

• Issues for Trainees
• Often new to LD personally challenging
  impoverished controlled lives shocking
  attitudes of carers and other professionals.
• Misconceptions its all behavioural, dont
  offer individual therapy
• Forced to work more creatively (AMH therapy model
  limited) more work with systems through
  others working in teams.
• Communication issues paramount.
• Many pleasantly surprised!

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Conclusions

• Working in LD can be very challenging for new
  clinicians
• Model of intensive teaching specific LD
  placement seems to work (good feedback)
• Majority of learning takes place in service
  settings, in MDTs
• High commitment to clinical supervision
  reflective practice enables personal
  professional development

10
The Future ???

• Uncertainty re future intakes in Bristol
• Commitment from SHA services and course team to
  continue to provide high quality training.
• Challenges Greater multi-professional training,
  whilst retaining distinctive features of
  psychology greater service user carer
  involvement preparation for work in a changing
  NHS e.g. FTs, New Ways of Working, etc