HS765-8-FY-CO:
Clinical Interventions and Skills 1

The details
2023/24
Health and Social Care (School of)
Colchester Campus
Full Year
Postgraduate: Level 8
Current
Friday 01 September 2023
Thursday 31 August 2023
15
22 February 2024

 

Requisites for this module
(none)
(none)
(none)
(none)

 

(none)

Key module for

CER C89F24 Applied Psychology,
DIP C89F24 Applied Psychology,
MSD C89F24 Applied Psychology,
DOCTC84036 Clinical Psychology (D Clin Psych)

Module description

The module is undertaken in all three terms of year one of the DClinPsych. It lays the foundation of clinical skills needed to work with adults and older people in the NHS and private and voluntary sector. This includes both generic clinical skills and specific skills in two major approaches cognitive behaviour therapy (CBT) and psychodynamic therapy.

The module combines a range of approaches to facilitate trainees development of knowledge, understanding and skills in relation to CBT and psychodynamic therapy.

Module aims

The aims of the topic areas within this module are outlined below:

Clinical Skills (Year 1)
The Clinical skills topic area is a key aspect of preparing trainees for placements through the development of the most relevant and fundamental skills required on the first year placements.

The aims and objectives for this topic include:
1. To understand key therapy principles and develop fundamental client-centred interaction skills and develop clinical interviewing skills.
2. To have a thorough understanding of the cycle of hypothesis testing, formulation and action-planning and evaluation.
3. To have a framework for writing reports, keeping records and communicating psychological assessments, formulations and interventions
4. To have a conceptual understanding of assessment needs, measurement and testing
5. To gain a clear understanding of what constitutes effectiveness in communication and to reflect critically on their own communication.

Cognitive-behaviour therapy (CBT)
This topic area is aimed at providing trainees with basic CBT skills, which form the foundation for more complex interventions in placements etc. The aims of this topic include:
1. To develop trainees’ understanding and skills of CBT-based assessment and formulation processes. This includes reference throughout the topic area to competency frameworks such as the competency framework for Cognitive Behavioural Therapy (CBT) developed by Roth & Pilling (2007) and downloadable at www.ucl.ac.uk/CORE/.
2. To develop trainees’ ability to plan effective treatments using a CBT framework.
3. To equip trainees with an understanding of fundamental CBT competencies and measures of competence (such as the CTS-R) and to take a baseline and subsequent measure of trainees’ own competencies in order to reflect on the development of their competence.
4. To understand the theory and to develop competence in the practice of fundamental CBT processes (e.g. agenda setting, structuring sessions, setting homework etc.) and fundamental CBT interventions (e.g. behavioural experiments, working with intermediate and core beliefs etc.).
5. To apply CBT processes and interventions to a range of common mental health areas and to focus on the use of CBT in clients with complex presentations.

Psychodynamic psychotherapy
This module is aimed at developing some of the basic competences that allow for the establishment of the structure for psychoanalytic/ psychodynamic therapy interventions. Such basic comptences are necessary in any analytically/dynamically informed intervention, and provide the backdrop to the more commonly applied techniques – such as working in the transference - that come under the domain of specific techniques. Specific psychoanalytic/ psychodynamic techniques are the core technical interventions employed in most applications – the set of commonly applied techniques found to a lesser or greater extent in most forms of psychoanalytic/ psychodynamic therapy. This module is not intended to train clinical psychologists to work as analytic psychotherapists, but rather to help them to acquire knowledge that can inform their generic practice. The module therefore only provides a partial contribution to the development of the knowledge base underpinning a sub-section of the ‘basic competences’. Specific techniques are discussed at an introductory level to raise awareness of the model of therapeutic action underpinning analytic approaches, but the module does not set out to provide trainees with the full range of competences in this specialist domain. Basic competences would need to be further supported by specialist clinical placements in the third year of training and further training post-qualification in order to reach competency in these various domains.

This module lays the foundations for developing the following competencies / knowledge in the course of the DClinPsych training:
1. Knowledge of the basic principles of psychoanalytic/ psychodynamic therapies. This falls into three areas: knowledge of the core principles of psychoanalytic/ psychodynamic therapy, of developmental theory and of a psychoanalytic/ psychodynamic model of the mind.
2. The ability to assess the likely suitability of psychoanalytic/ psychodynamic therapy. The aim is to raise awareness of the factors that would inform decisions about suitability for these approaches.
3. The ability to engage the client in the therapeutic work is fundamental to any approach. In psychoanalytic/ psychodynamic therapy this is achieved by listening attentively, maintaining the analytic attitude, and responding non-judgementally to the client’s conscious and unconscious experience.
4. The ability to formulate: a dynamic formulation accounts for the developmental origins of the client’s difficulties, the underlying unconscious conflicts, the defences associated with their management and the recurring interpersonal patterns and expectations of others. Clients will have areas where they show a good capacity for functioning as well as areas in which they are vulnerable or have difficulties (i.e. areas of deficit and of conflict), and formulations need to reflect this balance.
5; Establishing and managing the therapeutic frame and boundaries involves a range of activities and interventions, all of which are likely to have meaning for the client. For example, changes to the time of appointments or of the therapy room can be experienced as emotionally charged events for some clients. This is why when changes or deviations occur – and they invariably do – the psychoanalytic/ psychodynamic therapist works with the client to understand the unconscious meaning the deviation has for them and helps the client to link this with the interpersonal dynamics that are being explored in the therapy.
6. The ability to work with unconscious communication underpins the next two areas of competence, namely facilitating the exploration of unconscious feelings and of the unconscious dynamics influencing relationships. It refers to a particular quality of listening in which the explicit content of the client’s communications is considered to be the “tip of an iceberg” of reference and implication. Therapists need to take what the client is telling them at face value, but also to be attuned to meanings which are inherent or implied. In this sense they are listening to several levels of discourse simultaneously, making this a distinctive and sophisticated skill, and one which should be used judiciously
7. The ability to identify and manage difficulties in the therapeutic relationship is an important skill. The therapeutic relationship can suffer the strains of misunderstandings and mis-attunements. The therapist might also need to stand the test of the client’s hostility or of their mistrust. Such experiences need to be understood and discussed: the therapist’s interest and openness to making sense of these difficulties will set the tone and implicitly model for the client how conflict can be resolved.

Psychoanalytic/ psychodynamic approaches prioritise the exploration of the client’s subjective, unconscious experience, and therapists need the ability to work with both the client’s internal and external reality. The internal world is, however, always in a dynamic interaction with the external world. To get as close as possible to the client’s experience it is therefore essential to also take into account the external reality of the client’s life. The therapeutic relationship will also be affected by the perceived differences (e.g. of age, culture) and similarities between the client and therapist. These need to be openly and sensitively explored, not only because these perceptions are often rich in meaning, but also because, left unexplored, they can become the source of misunderstandings between client and therapist and can undermine the therapeutic alliance.

Module learning outcomes

Clinical skills (Year 1)
By the end of this module, trainees will be able to:
• use their understanding of the theoretical frameworks relevant to core competencies of assessment, formulation, intervention and evaluation to design and implement flexible and sophisticated psychological responses to a range of service user, staff and organizational referrals and problems in different settings.
• take into account biological, social and psychological factors in order to adapt the cyclical model of clinical thinking and action to accommodate the complexities of unique circumstances.
• conduct clinical assessments drawing on a range of different sources of information
• understand the nature, purpose and meaning of professional communications.
• consistently create ethically sound and professional competent and effective written communications.
• demonstrate integrative skills in the form of complex reports drawing on a variety of types of material and data.
• formulate clinical presentations
• evaluate the impact of a clinical intervention
• use clinical supervision effectively to reflect on their clinical competencies and professional development

Cognitive behaviour therapy
By the end of this module, trainees will:
• Have a thorough understanding of CBT competencies (and competency framework / assessments) and be able to relate their own generic and specific CBT competencies to their ongoing clinical practice
• Have fundamental competencies in relation to CBT-assessment, formulation and interventions
• Be proficient in applying CBT change methods appropriate to particular presenting problems and based on a collaborative case conceptualisation
• Understand the nature of behavioural experiments and demonstrate competency in using behavioural experiments across a wide range of presentations and problems
• Have a foundation in extending CBT to clients with complex presentations
• Have a basic understanding of third-wave CBT-related approaches (e.g. ACT, Compassion-focused approaches) and plan for the further development and application of such competencies in relation to ongoing, supervised clinical practice

Psychodynamic
By the end of this module, trainees will have:
• Acquired a basic orientation to the broad areas of difference and overlap within psychoanalytic theory and practice.
• Acquire knowledge of the affective and interpersonal focus of the therapy.
• The ability to apply the understanding of the dynamic interplay between external and internal reality to the beginning stages of therapeutic interaction
• An understanding of unconscious processes and object-relations
• An understanding of Freud’s and Klein’s understanding of the development of the mind.
• An understanding of the relationship between the internal world and notions of psychological health versus illness (i.e. how do external events impact on he mind).
• An understanding of the core features of the analytic attitude.
• An understanding of the important features of the therapeutic frame and its management.
• An understanding of and ability to work with in practice, constructs such as ‘projection’, ‘projective identification’, ‘enactment’ and ‘transference’
• The skills required for closely tracking therapeutic processes (i.e. attending closely to micro-processes in the therapeutic relationship so as gain a detailed understanding of the client’s internal world of relationships and conflicts).
• Skills relating to adopting a primarily receptive (i.e. non directive) stance
• An understanding of the relationship between therapist and patient as a source of information about the patient’s difficulties and of the difficulties that may arise in this relationship.
• To encourage the development of reflective practice through an applied case study.
• To acquire knowledge of the indications and contraindications for a psychodynamic approach
• To develop an awareness of how a psychodynamically oriented assessment differs from a generic assessment
• To recognise the main differences between a psychiatric and a psychoanalytic formulation of psychiatric difficulties.
• To develop awareness of the contribution of analytic ideas to working in the NHS.
• To encourage a more systematic consideration of the unconscious meaning of endings in therapeutic practice.
• To develop confidence in addressing the affective meaning of endings with patients

Module information

This is a module aimed at developing the clinical skills of DClinPsych trainees. These skills include generic clinical skills as well as more specialist skills relating to cognitive-behaviour therapy (CBT) and to psychodynamic therapy. The content of the psychodynamic and CBT module is based in part on the relevant competency frameworks

It is a module aimed at equipping trainees with foundational knowledge and skills in psychodynamic therapy, cognitive behavioural therapy (CBT) and generic therapeutic and related processes. Within topic areas such as CBT and Clinical skills, trainees will have the opportunity to supplement taught material in lectures with role play and additional skills practice with feedback / video feedback wherever possible. The aim of this is to support trainees' skill development throughout their first year's practice placements.

Learning and teaching methods

Teaching for HS765 mostly occur in the format of lectures, although these lectures have a particularly practical focus within the CBT topic area and the Clinical Skills 1 Topic area, in which role play, skills practice and problem-focused approaches are used in addition to workshops and experiential learning, to assist trainees in the development of generic and CBT-specific competencies and understanding.

Bibliography

The above list is indicative of the essential reading for the course.
The library makes provision for all reading list items, with digital provision where possible, and these resources are shared between students.
Further reading can be obtained from this module's reading list.

Assessment items, weightings and deadlines

Coursework / exam Description Deadline Coursework weighting
Practical   OSCE     100% 

Exam format definitions

  • Remote, open book: Your exam will take place remotely via an online learning platform. You may refer to any physical or electronic materials during the exam.
  • In-person, open book: Your exam will take place on campus under invigilation. You may refer to any physical materials such as paper study notes or a textbook during the exam. Electronic devices may not be used in the exam.
  • In-person, open book (restricted): The exam will take place on campus under invigilation. You may refer only to specific physical materials such as a named textbook during the exam. Permitted materials will be specified by your department. Electronic devices may not be used in the exam.
  • In-person, closed book: The exam will take place on campus under invigilation. You may not refer to any physical materials or electronic devices during the exam. There may be times when a paper dictionary, for example, may be permitted in an otherwise closed book exam. Any exceptions will be specified by your department.

Your department will provide further guidance before your exams.

Overall assessment

Coursework Exam
100% 0%

Reassessment

Coursework Exam
100% 0%
Module supervisor and teaching staff
Ms Caitlin Phillips, email: philcm@essex.ac.uk.
Antonella Trotta, Richard Pratt, Caitlin Phillips, Chris McCormack and External Lecturers
E: dcpadmin@essex.ac.uk

 

Availability
No
No
No

External examiner

Dr Magdalena Marczak
Coventry University
Lecturer in Clinical Psychology
Resources
Available via Moodle
Of 122 hours, 0 (0%) hours available to students:
0 hours not recorded due to service coverage or fault;
122 hours not recorded due to opt-out by lecturer(s), module, or event type.

 

Further information
Health and Social Care (School of)

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