What is a clinical associate psychologist? (CAP)

Dr Marianne Trent (: 00:00

Coming up today, we are diving back in for a look at the role of clinical associate psychologists. What is it? How do you train? Do you get paid? All the details you need to know. Hope you find it so useful.

(: 00:16

Hi, welcome along to the Aspiring Psychologist Podcast. I am Dr. Marianne Trent. I'm a qualified clinical psychologist. Now, we are going to be chatting today with a fellow qualified clinical psychologist who has a very different role to me and I just love the diversity of the profession. Hope that you will find this really useful. We have spoken about the role of clinical associate psychologist before, that was about two years ago with Elise Dyer, and we were speaking about children and young people. So if you might find that episode helpful, please do dig that out. Otherwise, I hope you find this really useful and I'll look forward to catching up with you at the end of this. Hi, just want to welcome along our guest for today, Dr. Dawn Reeves. Hi Dawn, thanks for joining us.

Dr Dawn Reeves (: 01:03

Hi. You're welcome. It's nice to be here.

Dr Marianne Trent (: 01:04

Thank you for your time. So we're getting together today because you are a qualified clinical psychologist, but also we are thinking today about your current role, which is training clinical associate psychologists or caps as we kind of think of them in psychology.

Dr Dawn Reeves (: 01:24

So I work in EPUT and we have a CAP apprenticeship training programme, and we run that in partnership with Essex University. So it's an 18 month programme, but just 12 months of those cover the academic aspect of the programme. And throughout those 18 months, you should be on a work placement. You're employed in NHS, usually it's an NHS setting and you're supervised by a clinical psychologist.

Dr Marianne Trent (: 01:57

Great. So always supervised by a clinical psychologist?

Dr Dawn Reeves (: 02:01

Yes. Yep. I believe it can also be a registered psychologist. So it could be that it be a counselling psychologist, but you need, I believe the stipulation is that you have to be HCPC registered as a practising psychologist.

Dr Marianne Trent (: 02:16

Okay. So we're looking for the practitioner psychologist. So sometimes when people are thinking, oh, I'd love to be a clinical psychologist one day, they can be dissuaded by being supervised by different discipline. But I was actually supervised by a forensic psychologist as the role before I got onto training. And so in my experience, it's the practitioner psychologist element that's really important rather than necessarily which discipline it is.

Dr Dawn Reeves (: 02:42

Absolutely, yeah. So it's about being registered and recognised profession within psychology.

Dr Marianne Trent (: 02:50

Could just before we really think and delve deep into the CAP role and your role within that, could you tell us a little bit about your background, how you got into psychology and where you trained, those sort of things, if that feels okay.

Dr Dawn Reeves (: 03:05

Okay. So way back as an undergraduate student, I went to Brunell University and back then they used to run a very thin sandwich undergraduate degree, which would be six months study and six months work placement. You did that for three years and then your final fourth year would be one academic year. So there were often a lot of them placements for prisons or student psychologists in prison. So I worked in a prison for about six months on a sex offender treatment programme. So that gave me an insight into that kind of more, I suppose, clinical work. But I did most of the assessment work. So when I graduated I wanted to work in that area, but I didn't manage to be successful in getting through the selection process for working in the prison services because back then it would be a master's programme. Then I thought about doing educational psychology At that point, my psychology degree didn't have enough maths, I believe was their point about why couldn't train as a teacher, which you needed to do to be an educational psychologist.

(: 04:18

And then I started to apply for assistant psychology posts. So I managed to get one of those and learned about how you could apply for clinical training from other assistants that I was working with. So I gave that shop and I was very lucky that I actually got accepted on a course, Solomon's course, my first application. So I think a large part of that was because I had done that work in the prison service and in another placement on a third year, I'd also worked in educational psychology department. So I had that sort of work experience before I actually graduated, which I think made a difference. So yeah, after I finished my doctorate, I worked and specialised with older people. So I've worked in different community mental health teams, some in London, Leicester and in Bedfordshire. And I've always been involved in some level of teaching or education. When I was a qualified psychologist, I would do some of the, what they call honorary lecturing in doctorate psychology courses and give some workshops on older people and mental health. That was my specialty. And I worked for a time in Saudi Arabia for a couple of years on a clinical psychology programme there helping to develop that. So does that give a good summary?

Dr Marianne Trent (: 05:49

It really does. What a varied career you've had, and I've never stopped getting blown away by the variety people have within their career. And I can just imagine all of these different experiences just crystallising in your brain as experience working in forensic services and then working in Saudi such novel, but important things that you learn so much about working with people, working with systems, working with teams, working about with clinical populations. We really do do such varied work, don't we? In our profession?

Dr Dawn Reeves (: 06:27

Absolutely. There won't ever be. I don't think there's ever a repetitive day. And I think that's what for me made psychology attractive. And probably what's kept me in the role for this long is that I don't feel one week is the same to the next week. And you can get involved in or be asked as well to get involved into so many pieces of work, educational work, training work, there's research, there's therapeutic work, there's staff work and teams work organisational work. So you can sort of find where your interests lie. I think it's not a dull job, I don't think. I dunno what you think.

Dr Marianne Trent (: 07:12

Oh, it's not at all. No, I agree. And I think people that often don't understand what we do in clinical psychology might say, isn't it just loads of people moaning all the time? And I'm like, no,

(: 07:23

It's not that. Even when you're doing therapy or direct work with clients, it's not that. It isn't that. If that's all it is, then you're not doing your role properly. It's not a passive process. It should be really active and you should be constantly trying to, in my experience, constantly trying to fit a bespoke approach for this client, which means that it's a very active process for the professional, but also a really active dynamic process for the client. It isn't just a venting space to go and moan. In my experience, that's not at all the case.

Dr Dawn Reeves (: 08:03

Yeah, I mean if you're going to get anything out of psychology, you have to put something in, don't you? I mean, I think a large part of a lot of psychologists, they are kind of trainers and teachers because trying to help when you're doing individual work, individuals learn different ways of doing things to try and help with whatever situation has brought them to your service. Yeah,

Dr Marianne Trent (: 08:29

Lovely. So tell us about your current role then working with trainee caps.

Dr Dawn Reeves (: 08:38

Okay, so the CAP role is relatively new and I work in an NHS Trust E, and we have created a CAP apprenticeship programme.

Dr Marianne Trent (: 08:55

What does that for Dawn, what

Dr Dawn Reeves (: 08:57

Does EPUT for? It's, sorry, it's Essex Partnership University Trust. Thank you. I work in a training department, so they've developed the MSC for the CAP clinical associate in psychology that's in partnership with Essex University. So I have worked on that programme since it began, and I'd say we're developing it with each cohort. We're now on coming up to cohort five, we started with focusing on adult mental health caps. So they were in placements in NHS Adult Focused services. And for us, that was across Essex and Hertfordshire. So it's not necessarily that you have to work in EPUT, essex Partnership Unviversity Trust, but it's kind of around geographically which programmes nearby because quite a few programmes around the country now. So I've helped with setting up the CAPS programme initially started with being a module lead for developing one of the modules, which was on assessment formulation and presentation.

(: 10:18

I'm currently a deputy lead on that programme, so that can involve lots of different roles, helping develop, continue to develop the course, be a course tutor. So you work with CAPS and their placement supervisors, which is actually quite an important part of the CAP programme you have to have. Yep. So there's a tripartite review that has to be scheduled for every 12 weeks during the 18 month programme. And that's done with the student, the clinical supervisor and the core student. So that's just to keep an eye on what's going on in placement, how the student is progressing in learning objectives through their workplace and adjusting for any issues that might be coming up as well.

Dr Marianne Trent (: 11:14

That sounds really important. It was bringing back nightly horrifying memories of being a trainee and having mid placement reviews. And that question where it gets asked, is there any chance that the trainee could fail this placement? Is it that kind of thing? But you're doing it every 12 weeks.

Dr Dawn Reeves (: 11:31

It is. And the 12 weeks is to, if there are any early indications that the placement might not be going well, it's about figuring out what we can do about that. Because something that can come up is about opportunities for learning. So if a student, but most of the time students and supervisors find that maybe there's not as many cases available to them to carry out some of the objectives that they need to complete for their training. So we can think through what other opportunities there might be mean. So is it be better to give an idea? So if we for instance, have a student who's working in an assessment only service, a part of the CAP trainings, you have to do some amount of intervention work. You have to learn intervention skills. So it might be that that's difficult for a supervisor and the student to access those sort of cases. So we can use meetings like that to think about how that can be done.

Dr Marianne Trent (: 12:35

Great, thank you. And what is involved in a typical kind of trainee or even for that matter, qualified cap intervention? What might be typical?

Dr Dawn Reeves (: 12:47

Gosh, I don't think there would be a typical, because it really depends on the service. So caps, I think that's the distinguishing part about CAPS training is they're trained into a service. So if you think about clinical psychology, doctorate, you get trained, typically you will be trained in difference or services across those three years, you'll be having usually a six month placement and coming in and out. I know some courses now the placements are for a bit longer, but typically it would be about six months. So with the cap, they're in one service, they're employed in the service, and the hope is that that cap would continue in that service once they've qualified. So the service is train them up to be skilled in that particular area of work. So you can think that the different services that we have our CAP students in at the moment can be learning disability services, adult mental health services, health psychology services. We've got some older adult services, autism assessment services. So it's a real mix. So each cap is going to have a very different experience of their training from the perspective of their actual placement, although the learning objectives are all going to be the same. So each placement has to meet specific learning objectives set out by the apprenticeship standards and BPS standards as well.

Dr Marianne Trent (: 14:20

Great. Thank you for that. And am I right in thinking that it's not only is it a master's programme, but it's also a funded programme as well, so you get paid to do your master's and paid to do your training. So it really is incredible as an opportunity for people?

Dr Dawn Reeves (: 14:36

Yes. So it's a fully paid master's apprenticeship. So the apprenticeship part of it is where the funding comes from. So your master is paid for, you're not paying for the masters and you are in paid employment. You are employed by the trust that you are in a placement with. So you're not employed by, for instance, epu, the NHS trust that's providing this training programme. For instance, the one that I work with, you're employed by your service that you're working into. So yeah, you're employed at a band five, perhaps I should say that as well. So as an apprentice, you'll be employed at Band five. Once you qualify as a cap, you should then go up to be employed as a band six. In terms of thinking about where someone's level will remain, there's no reason why, for instance, as a cap, you would then perhaps progress into the banding once you're qualified. But that will depend obviously on further training in England. As far as I know, in Wales, I think they've recently started or they're developing their CAPS training programme, and I believe they're going to start working at Band seven once they're qualified. So there is some variation in the different regions, but in England you would start at Band six once you're qualified.

Dr Marianne Trent (: 16:01

Right. It's so brilliant. And actually in terms of diversity and inclusion and reducing inequality in psychology, because a master's is not a cheap thing, and if you're not able to work either because studying for your master's, it's really difficult. So it is a really wonderful way of people being able to access higher education and they may choose to stay as a cap. That might just be, I guess that's the trust's hope that they will just stay as a qualified cap really. But it's such a brilliant and inclusive way of being able to access a Master's qualification.

Dr Dawn Reeves (: 16:40

Yes. I mean I think services are very different as well in what they're doing with their caps once they qualify. So yeah, absolutely services would like them to stay and work as a cap, but I know that services are actually investing in their qualified caps as well and providing access to further training. So there's more specialist training. There is a limit when you are qualifying as a cat because it's NHS England funded apprenticeship, that means that you can't access any further funding NHS funded training for another two years once you qualify. But if you were to pay for a course yourself, or if your service decided to pay for it and budget for that, you could still go and do it. So you're not restricted in that way, but there's a limit in terms of the amount of funding you can get from the NHS. I hope that makes sense.

Dr Marianne Trent (: 17:32

It really does. It really does. Yes. So in 2020, it was announced by Health Education England that that limit would be around, and it was almost around immediately, but there was some petitioning done. It was led by a white who was an aspiring psychologist at the time and is now a trainee. And that was overhauled and delayed for a couple of years, but certainly that is in force now.

Dr Dawn Reeves (: 17:59

Sorry. So in the beginning we had some caps that didn't apply to, so they were able to, I believe, access funding sooner. But the caps that are on training now, there's that two year limit.

Dr Marianne Trent (: 18:13

And if things don't go well, do people sometimes choose to stop in the middle of their training or sometimes do they not meet the criteria? So they're in essence kind of retired from the system? Has that happened so far?

Dr Dawn Reeves (: 18:30

Yes. I mean, there is flexibility within the apprenticeship rules that you can actually take a break in learning. So if you find that whatever circumstances are going on that mean you can't carry on with your training at the moment, it could be through health or life circumstances, could be the placement itself. You can actually request a break in learning. And we have had examples of that, and I believe you can have a breakup to 12 months up to a year. Typically the person will carry on working in some capacity, just not in that cap role. And then you can come back into the programme at the point at which you left. So in terms of the learning stage that you left, you will have to, in those situations, make your own efforts to find a new placement. So the course could help give you advice and guidance, but ultimately the student is the one that would be responsible for looking to see what other cap apprenticeships are being advertised and to apply for those and hopefully be successful. And the advantage for those employing services are that this CAP student won't have to take as long to finish because they would've done part of their cap training before then. So there's some flexibility, much like any sort of educational programme, you can actually take breaks in learning. So in a way that's been quite a revelation to me because I never knew these things when I wasn't working in education.

Dr Marianne Trent (: 20:06

So if for example, a trainee clinical psychologist started year one or year two and were driving hours and hours and hours of placement each day and they thought that might be sustainable, but obviously we know that that was always going to be a tricky ask. There isn't that flexibility to example move from an Edinburgh course to a Lester course at the moment because they're entirely separate. And that's really tricky because when you are deciding to leave a trainee psychologist role, you're essentially saying, I'm done, or I will start again somewhere else. And it sounds like there's more flexibility in a trainee cap role.

Dr Dawn Reeves (: 20:43

Yes, I think there is. I mean, I don't know of any examples where people have actually switched from one programme to another, but it is possible in theory because each programme is having to follow the same learning objectives, it's quite a specific expectations from the apprenticeship side and the BPS side of what actually they need to learn. So I guess it would be more difficult if they were being trained in one of the more specialist areas like learn disabilities or older adults or health, if they then tried to get back into a programme that was mainly adult focused. I'm not sure if there are any other courses that have had this happen yet, but I'm sure there's room for precedent. I think it would be more easy to come back into the same course, but having taken a break and changing workplace. So we definitely have an example of that in our programme. Somebody's taken a break and then come back in later on in a new placement.

Dr Marianne Trent (: 21:43

Great, thank you. And just before we finish, have you got any of your top tips, even just a top tip for how to reduce burnout in aspiring psychologists? Because we do ask a lot of our aspiring psychologists at times, don't we?

Dr Dawn Reeves (: 22:00

So I would say to bear in mind that psychology is not everything. I know when a person is younger or when they're quite focused on an ambition and have really clear plans of how they're going to get there, it can kind of take over a bit. It can be a very challenging profession to get into, but I would say to everybody, don't give up if that's really what you want to do, stay focused on it, but enjoy other aspects of your life as well. Psychologists are better when they're more rounded people and when they have particular interest in certain areas. So that's going to help you have a longer career if you aren't just solely focused on psychology in all the things you do. So I would say you've got to have, looking after your health in terms of physical health, looking after your mental health in terms of wellbeing, keep good friends, have hobbies, a range of things that you're interested in. It also makes you, I think it makes you a good practitioner too, if you've got other things that you're involved in. It certainly helps with conversation. If you're a well-rounded person, your clients are going to get that impression, you're going to find a relationship building a lot easier. I hope that answers the question.

Dr Marianne Trent (: 23:34

It really does. Yeah. You've got to be a human first and a psychologist second, haven't you? And it's about being personable because those conversations where you're walking from reception to clinic room, that's where you're supposed to be a little bit more natural, a little bit more human, and I dunno what your experiences are, but I found since the pandemic that there's been much more person in clinicians because it's really been a levelling experience that really does put us all kind of in a similar position of uncertainty and threat and menace and all of that. And that really did affect, I think, yeah, everybody that I've spoken to has sort of said, yeah, it is different now. It is just a bit different. I

Dr Dawn Reeves (: 24:20

Think it gave people the time to reflect on what people say, the work life balance, work life, home balance, family relationships, downtime, how important it is to keep that balance going. If you're giving too much at work, you're not, you haven't got that time to recharge yourself, you're going to be a better clinician for your clients and you're going to be a better colleague for the people you work with. If you've got that sort of balance, it's not always going to be perfect, but if you've got it in mind of why it's important to keep it going, that's going to help you a long way from trying to protect yourself from burnout and always take your annual leave as well. That would be another thing I'd say, I mean, annual leave is there for you to take at regular points. I know it's easy to think, you just want to keep it for one long chunk, but my advice would be take bits of time off regularly throughout the whole year and do something that's completely unrelated to your work, unrelated to psychology. Have some fun, charge that aspect of yourself that's not the psychologist. Yeah,

Dr Marianne Trent (: 25:37

I so agree. Such brilliant advice. Thank you so much for your time in speaking with us today, Dawn. It's been a really, really interesting insightful episode.

Dr Dawn Reeves (: 25:47

You're welcome. I hope it can give some of your listeners, your viewers, some confidence and encouragement to keep going with their ideas about becoming a psychologist and where they can perhaps train in different roles, different psychological roles.

Dr Marianne Trent (: 26:11

Absolutely. It absolutely will do. Thank you again.

Dr Dawn Reeves (: 26:14

You're

Dr Marianne Trent (: 26:14

Welcome. Thank you for watching, and thank you so much for my guest's time talking through this important area, which I really do think is an exciting development for psychology. So it has been around a few years now, but hopefully it will become a really viable and enjoyable career for people and not just seen as a hop step and a jump to be able to get on to do a doctorate. I'd love to know what you think about this. Has this inspired you to look for Trainee cap roles? Do come and let me know in the Aspiring Psychologist community pre-Facebook group. I'd also love it if you take a moment to rate and review us on either Apple Podcasts or Spotify, as that helps the podcast to be reaching a wider audience, whatever time of year it is. It's always a good time to dive into the book's Clinical Psychologist Collective and the Aspiring Psychologist collective too. Thank you so much for being part of my world. I will look forward to bringing the next episode to you, which will be available from 10:00 AM on Saturdays on YouTube, and from 6:00 AM on Mondays as an mp. Three. Thank you again and be kind to yourselves.

Jingle Guy (: 27:30

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