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Psychological therapies for severe mental health problems

Psychological therapies for people with severe mental health problems (also referred to as severe mental illness) are a key part of the new integrated offer for adults, as set out in the NHS Long Term Plan. Severe Mental Health problems include psychosis, bipolar disorder, 'personality disorder' and eating disorders. These difficulties often occur alongside mood difficulties including depression, anxiety and post-traumatic stress disorder (PTSD).

Upskilling the workforce is central to improving access to a range of psychological therapies and we are working closely with NHS England and NHS Improvement to ensure the adult and older adult mental health workforce has the competences to deliver a range of evidence based psychological therapies to increase capacity, capability, and service user choice across the system. 

The Psychological Interventions for People with Eating Disorders Competency Framework.

The framework was commissioned by and developed in partnership with HEE and is designed to be accessed online and downloaded from the University College London (UCL) website. It is relevant to all professionals working with people with eating disorders, identifying competencies and skill gaps, and to develop and/or commission educational training to support the development of healthcare staff. Psychological treatment can offer a route to improvement and recovery. This framework outlines how the NICE recommended psychological interventions for ED should be converted into delivery in practice, allowing for the development of truly evidence-based training curricula that will allow multiple professional groups to train to deliver the interventions.

We have commissioned, and are currently in the process of commissioning a number of training programmes for community mental health services in England. Details can be found below:

Cognitive behavioural therapy (CBT) for psychosis and bipolar disorder (Full training and top-up training).

This two year postgraduate diploma provides a foundation in CBT for a range of problems including anxiety and depression, followed by a specialist training in CBT for  psychosis and bipolar disorder . Approximately 72 days of training will be delivered over the course of the two years alongside associated clinical supervision.  Year one (approx. 36 days) covers depression and anxiety disorders including PTSD. Year two (approx. 36 days) is the specialist pathway focused on psychosis and bipolar disorder. Staff with specific existing CBT competences can undertake just the second year of the training, as "top-up" training. the end of the training we expect all graduates to meet individual accreditation standards as a cognitive behavioural therapist with the British Association of Behavioural and Cognitive Psychotherapies (BABCP).

Training places are available at: Greater Manchester Mental Health NHS Foundation Trust (GMMH), University College of London (UCL), University of Exeter, University of Hull and Oxford Health; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

 

Cognitive behavioural therapy (CBT) for personality disorder (full training and top-up training).

This two year postgraduate diploma provides a foundation in CBT for a range of problems including anxiety and depression, followed by a specialist training in CBT for personality disorder. Approximately 72 days of training will be delivered over the course of the two years alongside associated clinical supervision.  Year one (approx. 36 days) covers depression and anxiety disorders including PTSD. Year two (approx. 36 days) is the specialist pathway focused on personality disorder. Staff with specific existing CBT competences can undertake just the second year of the training, as "top-up" training. By the end of the training we expect all graduates to meet individual accreditation standards as a cognitive behavioural therapist with the British Association of Behavioural and Cognitive Psychotherapies (BABCP).

Training places are available at: Greater Manchester Mental Health NHS Foundation Trust (GMMH), University College of London (UCL) and University of Exeter; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

 

Cognitive behavioural therapy (CBT) for eating disorders (full training and top-up training).

This two year postgraduate diploma provides a foundation in CBT for a range of problems including anxiety and depression, followed by a specialist training in CBT for eating disorders. Year one covers depression and anxiety disorders including PTSD. Year two is the specialist pathway focused on eating disorders. Staff with specific existing CBT competences can undertake just the second year of the training, as "top-up" training. By the end of the training we expect all graduates to meet individual accreditation standards as a cognitive behavioural therapist with the British Association of Behavioural and Cognitive Psychotherapies (BABCP).

Training places are available at University College of London (UCL) and University of Sheffield; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

Please note:  practitioners attending these courses are expected on average to devote a minimum of three days a week to the learning and delivery of the particular therapy.

Dialectical Behaviour Therapy (DBT) (full training and top-up training).

This two year postgraduate diploma will provide trainees with advanced conceptual. understanding and skills in the practical application of DBT to a defined standard of competency. One year ‘top-up’ training (in the form of the second year of the training) is available for staff with existing training and experience in DBT equivalent to the first year.

During the first year of training, the programme will deliver a minimum of 10 in-person training days with additional monthly contact time.  During the second year of training, in addition to training days and video / telephone conference calls, all trainees must complete a minimum of 20 hours of individual supervision and 15 hours of group supervision, plus 10 hours of video or audio review of their individual DBT therapy sessions.

Training places are available at British Isles DBT Training; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

Please note:  practitioners attending these courses are expected on average to devote a minimum of three days a week to the learning and delivery of the particular therapy.

Mentalization-based treatment (MBT).

This course provides the knowledge and conceptual understanding of mentalizing, its relevance to clinical problems associated with borderline personality disorder and the clinical skills to deliver MBT to a defined standard of competency to equip trainees to become skilled and creative independent MBT practitioners under expert supervision.  Trainees will be expected to attend 5 days of training and to attend 1 hour supervision sessions at least twice a month (for 22 sessions).  They will also need to attend 40, weekly peer supervision sessions.

Training places will become available early in 2021; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

Please note:  practitioners attending these courses are expected on average to devote a minimum of three days a week to the learning and delivery of the particular therapy.

This video gives an introduction into the principles and impact of MBT, with explanations and insights from one of MBT’s creators Professor Peter Fonagy and Marsha McAdams an expert by experience who says MBT was not only life saving but also life-changing.

 

Family interventions for psychosis and bipolar disorder

This course provides a theoretical base and skills training to facilitate development of family interventions for psychosis and bipolar disorder to a defined competency.  The course will deliver a minimum of 10 days training plus expert supervision over the course of a year.  It will provide opportunities to develop critical knowledge of the theoretical and research literature relating to family intervention for psychosis and bipolar disorder and develop practical competency in delivering these.

Training places will become available early in 2021; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

Please note:  practitioners attending these courses are expected on average to devote a minimum of three days a week to the learning and delivery of the particular therapy.

 

Understanding psychosis and bipolar disorder.

This two-day whole team training provides an update for staff on recent developments in the understanding of psychosis and bipolar disorder.  It provides a holistic, trauma-informed bio-psychosocial perspective of these presentations, both in terms of how we can understand them and to appreciate the range of interventions that can help.

Training places will become available early in 2021; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

 

Structured clinical management (SCM).

SCM provides a pragmatic psychological approach to delivering a service for people presenting with problems associated with a diagnosis of 'emotionally unstable personality disorder'/ 'borderline personality disorder'.  SCM follows the principles of consistency, coherence, and continuity of interventions to target, the specific difficulties associated with  'personality disorder' and meets all the recommendations for structured clinical care outlined in the NICE Guidance.

SCM training runs for a minimum of 12 months, with 4 days of training and a minimum of 22 hours of supervision with an expert SCM supervisor.  There is also an expectation to attend 40 peer supervision sessions over the course of the training year.  Trainees will be expected to assess and prepare a minimum of 4 patients for SCM and co-facilitate an SCM group for at least 9 months. 

Training places will become available early in 2021; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

 

Adult eating disorders - whole team training.

This training will ensure members of the team jointly have knowledge and skills to enable the smooth, safe, and effective functioning of a dedicated adult eating disorders team.

Training places are available at: South London and Maudsley NHS Foundation Trust SLaM; please contact your local Chief Psychological Professions Officer or HEE lead for mental health for details.

 

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