Across Lancashire and South Cumbria, 24 Trainee Associate Psychological Practitioners (TAPPs), at a band 4 level, have been recruited to general practice and community settings to deliver a mental health prevention and promotion service. Once qualified, they drop the ‘T’ and become APPs, at a band 5 level. Some of the TAPPs are based within one or two GP practices and some are spreading the service they provide across a whole primary care network (PCN), which in one case means up to 10 practices.
Medication prescribed by GPs for emotional difficulties is increasing at what is, perhaps, an alarming rate. One in three GP appointments has a mental health component to it and the reported rate of psychological need has increased as a result of the covid-19 pandemic and associated restrictions. With statistics such as these now well known, I think it’s time that psychological professionals focus their attention upon general practice and community settings. Your local GP, close by, familiar, lacking the stigma and sometimes complex access associated with mental health services seems an ideal place to start. With the average GP offering 10-minute appointments, and many GPs saying they don’t feel appropriately skilled to work with mental health and it’s varying presentations, it’s perhaps not surprising that ‘watchful waiting’ or a medication prescription are two overused tools.
Brendan J Dunlop, Clinical Psychologist in training
Health psychology is a rapidly growing discipline with increasing opportunities and career pathways. However, for trainees and prospective students it can sometimes be difficult to envisage what a future career in health psychology might look like. It’s not always easy to find examples of health psychologists working in areas outside of your respective work environment, or to fully understand the variety of contexts in which health psychology could be applied. Similarly, for organisations interested in commissioning health psychology expertise, it can also be challenging to find examples of the different settings in which we work, or to understand what we might bring to the table.
Prof Lucie Byrne-Davis PhD CPsychol PFHEA FEHPS, Health Psychologist, Division of Medical Education, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester
Saiqa Naz: CBT Therapist, Sheffield Specialist Psychotherapy Service, Co-author IAPT BAME Positive Practice Guide, & Chair, BABCP Equality and Culture Special Interest Group)
Yorkshire and Humber Psychological Practitioners Network
Why I do more homework than my clients
If you've learned anything about therapy before, especially something structured like CBT, you will know about therapy 'homework' or between session work where you tasks are set to complete before you next meet up. Clients often have mixed feelings about doing this, sometimes it reminds them of school, for example. There's a lot of emphasis put on the idea of homework, so it's supposed to show how motivated people are and can affect the outcome (the more you put in, the more you get out). For the most part homework is set up with the therapist to be completed by the client, but sometimes there is also a bit of between session work done by the therapist too (usually completing surveys). However, that's not what I'm talking about when I say that I do homework for my clients.....
When I started looking at adapted interventions for the young people I work with in Early Intervention we started looking at ways to engage people using their own interests (this eventually became part of a project I run called heavy metal therapy but this isn't about that specifically). I started using music, lyrics and other media in the session that clients had selected to describe their feelings or experiences. What started happening was that people asked me to listen to stuff or watch things in between the sessions so that we could use the session time to reflect on it. Now obviously there are some pitfalls in this, not having infinite time being one of them, and the joys of playing very sweary metalcore in the office displeasing your colleagues. But, over time, I have been converted to this approach for a few reasons: