COVID-19 working - Please note that although our office is closed, you can still contact us by telephone 0330 320 0851 or email babcp@babcp.com

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Guidance for individuals working towards BABCP practitioner accreditation in relation to the COVID-19 outbreak

This document is intended to provide guidance for people training in CBT and working towards individual CBT practitioner accreditation where this has been affected by the COVID-19 coronavirus outbreak.

Please note that there is separate guidance for BABCP accredited programmes 260320 COVID-19 Interim Guidance for Accredited Programmes v3.0 and their trainees which has been shared with all accredited programme leads. We have an ongoing relationship with courses which are accredited by us, or those which have made a direct commitment with BABCP to becoming accredited. We are not able to give direct advice to courses which are not accredited; however, we are working to provide up-to-date information and guidance to all our members.

It is intended to cover three months from 23 March 2020 after which additional guidance will be offered.

·       BABCP expects that all individuals training in CBT and the courses and placements they attend will follow current NHS and UK government guidance, as well as their training institution’s advice on attendance and assessment.

·       The intention is to offer guidance on how individuals can continue to develop and demonstrate competence in CBT; to maintain continuity as far as possible, and is intended to advise on interim measures while the public health emergency continues.

·       This document is also based on the expectation that duty of care and protection of the public are paramount, and that any flexibility employed will be as a temporary measure. It is not reducing or changing any of our training standards. Please see our Minimum Training Standards (MTS).

·       Any changes must also be consistent with our Standards of Conduct, Performance and Ethics and Data Protection legislation, including GDPR.

·       BABCP also expects that courses and placements will support CBT students’ wellbeing in the circumstances, in particular if they are working in isolation.

·       Exceptions and specific issues will be dealt with on a case-by-case basis.

·       BABCP is also grateful for the input of colleagues in all of the home nations, and their commitment to ensuring quality CBT training and provision in difficult circumstances.

Area of learning/training standards

Guidance

Evidence

Individuals working towards practitioner accreditation are invited to consider how they will gather evidence that they have met the Minimum Training Standards if the usual means of demonstrating this have changed.

Teaching

 

The key guidance is to consider how CBT courses are facilitating students in demonstrating competence and skills in delivering CBT change methods.

The Minimum Training Standards require for 200 hours’ face to face teaching, with up to 20% delivered by distance learning with a ‘real-time/live’ interactive element.  

 

BABCP practitioner accreditation will recognise teaching delivered using remote means as long as:

·       Students are able to interact in real time, take part in discussion and ask questions

·       The teaching includes the opportunity for small group work

·       The teaching includes the opportunity for skills development, such as demonstrations and role play

·       The expectation of a 50:50 ratio of theoretical to skills teaching is followed

There are a variety of platforms available to deliver real time taught content remotely. Different Higher Education Institutions are at a different stage of implementation, however, if the programme is able to deliver according to the above, the taught content will be regarded as contributing to the MTS as if it were ‘face to face’.

Need for additional guidance due to having to deliver clinical work remotely.

Students will be expected to follow appropriate guidance on use of remote formats to deliver CBT, and courses or placements may offer this. They should always be appropriately supported and clinically supervised in their placement. In addition, guidance can be found on our website

·       In particular, students/therapists must consider whether use of different modes of delivery will have an impact on access for any particular group, for example when someone has additional needs which may be affected by changes in modes of delivery of care.

·       Access to equipment and technology and training in their use for both the student and the client

·       The client’s privacy and digital security and how to mitigate any potential shortcomings.

Assessments

The Minimum Training Standards must be met, in terms of assessing competence in clinical practice and theoretical understanding according to BABCP’s current expectations.

Adaptations to assessments may be required during the current public health emergency, and this will be guided by the training institution’s policy on assessments in these circumstances. The MTS must still be met for assessment.

CPD events and top up training to meet required hours

Please see BABCP’s guidance on CPD during the current public health emergency.

Leave of absence

It is understood that more people than usual may need to take leave due to illness, self-isolation or caring responsibilities. While it is anticipated that the usual training provider’s processes will be followed for such leave, it is recognised that students may need to extend their training in order to meet the requirements for accreditation.

Early graduation before completion of all minimum training standards.

At present it appears possible that some health care professionals will be graduated early with recognition that further training or experience or assessment is required to meet all of the standards.

This may apply to clinical psychology trainees for example.

The Minimum Training Standards and all other criteria must still be met in order to achieve practitioner accreditation.

Clinical work during training

 

The requirement for 200 hours’ face to face clinical contact to meet MTS

Appropriate consent forms for online/remote working and recording of sessions for clinical supervision should be adapted and used where modes of delivery are changing.

Where students are delivering sessions via video-conferencing as a result of the public health emergency, they can ‘count’ these towards their 200 hours’ face to face contact during the three months covered by this document.

There is still an expectation that face to face sessions will take place, either because this happened before the measures to work remotely were in place, or that they will take place once contact restrictions are removed.

BABCP has issued guidance on the evidence for remote delivery and adaptation of specific change, and will provide updates when possible. Some interventions may be delivered using ‘live’ video-aided sessions with the therapist.

This means that while students are able to accumulate clinical hours towards meeting Minimum Training Standards, their clinical placement activity should also take account of interventions and competencies in delivering change methods which they need to develop, and whether working remotely has an impact on this.

Interventions delivered via telephone only

Appropriate consent, security and data protection must be in place. Updated forms for online/remote working and recording of sessions for clinical supervision should be adapted and used where modes of delivery are changing.

Face to face sessions will be required to meet Minimum Training Standards. Appropriately delivered telephone interventions which are as a result of the outbreak will be ‘counted’ towards the 200 hours face to face contact required for the three months covered by this document. The situation will be reviewed and guidance updated before the end of this timeframe.

Clinical work with Children and Young People, and Evidence-based parenting training

It is recognised that very few CYP services are set up for telephone/Skype/remote delivery, although they are working hard to adapt. Delivering family interventions may be particularly challenging.

Courses and placements will be considering issues around consent, technology, privacy and how sessions may be set up.

If it is not possible to deliver interventions appropriate to students, the most appropriate course of action may be to extend the training.

Clinical supervision

The Minimum Training Standards must still be met for clinical supervision, taking into account the needs of students delivering CBT remotely.

We will recognise clinical supervision delivered via video-conferencing, as long as the usual expectations for ‘close’/ live clinical supervision are met.

In addition, any training needs for clinical supervisors in using remote methods should be considered when planning adaptations to training/methods of delivering supervision.

Some clinical supervision may also be delivered via telephone; either as appropriate to the mode of delivery of therapy, or as an interim measure. This will be ‘counted’ towards clinical supervision requirements for the duration of the three months covered by this guidance, and further updates will be provided by the end of that time frame.

Guidance from people with personal experience

Courses and therapists are encouraged to continue to consult and collaborate with people with lived experience on dealing with this situation, so that the potential consequences of remote working are taken into account in relation to training. Course directors are invited to share insights which may assist other programmes in adaptations which are most useful.


Other resources

NHS guidance on digital working

https://www.nhsx.nhs.uk/key-information-and-tools/information-governance-guidance?fbclid=IwAR0A2wPDbu9gY9XNN8aSIOoMpED6vtAltH7q_5LQMpEk4aI_PrVn_LtBrjI

Guidance on remote working with trauma, (Wellcome Trust, OxCADAT)

Guidance on remote working with trauma document

Let’s Talk About CBT podcast – Copy with anxiety about coronavirus

http://letstalkaboutcbt.libsyn.com/coping-with-anxiety-about-coronavirus

BABCP guidance on remote working

https://www.babcp.com/Therapists/Remote-Therapy-Provision.aspx

Please note that additional guidance is being prepared on specific presentations and interventions, and these will be shared with members as soon as they are available.


Statement from Health Education England for information:

1.    Keeping psychological services and psychological therapies services open through the immediate crisis

1.1.  Psychological and psychological therapy services are essential services that save lives;

1.2.  Although difficult prioritisation decisions may be necessary, there should be no premature moves to redeploy of staff from these services or to shut them down;

1.3.  Where redeployment becomes unavoidable in order to staff other parts of the system, this should be managed to minimise disruption to psychological therapy and intervention already underway;

1.4.  Where there is a drop off in immediate demand for some services, thought should be given to the best use of the practitioners' skills if temporarily redeployed, for example psychological professionals may be asked to switch focus to staffing help lines or supporting NHS staff;

1.5.  Leaders may be tempted to redeploy psychological professionals into roles seen as more 'front line'. This temptation should be weighed against the immediate and later lack of capacity to support and treat vulnerable patients, including those at risk of suicide, self-harm, neglect and abuse. These patients are seen in all parts of the mental health system including IAPT. It is also important to remember that senior leaders will be needed to be maintained in role to help plan and deliver the right psychological response now and into the future;

1.6.  Psychological professionals are NHS key workers for the purposes of receiving special services such as access to schooling for their children;

 

2.    Maintaining psychological professions training programmes

2.1.  It is very important that psychological professions training programmes keep going through the pandemic period, so that trainees graduate and enter the workforce as soon as feasible. They will be needed to ensure capacity to support a likely surge in need into next year;

2.2.  Psychological professional trainings can be delivered through remote means with the same level of live interaction with trainers. We are working with course accrediting bodies to enable flexibility in the mode of recruitment, delivery and assessment, whilst ensuring trainees become competent practitioners;

2.3.  Planned expansion of training programmes programmes should continue in order to maximise workforce capacity into next year and beyond. Where prioritisation decisions are needed, training programmes that expand the workforce should be prioritised.

 

Helen Macdonald BABCP Chief Accreditation Officer, 26 March 2020