Hostname: page-component-7479d7b7d-c9gpj Total loading time: 0 Render date: 2024-07-10T18:07:56.189Z Has data issue: false hasContentIssue false

Role Transition from Mental Health Nurse to IAPT High Intensity Psychological Therapist

Published online by Cambridge University Press:  21 November 2011

Simon Robinson*
Affiliation:
South West Yorkshire Partnership NHS Foundation Trust, UK
Stephen Kellett
Affiliation:
Centre for Psychological Services Research, University of Sheffield, and Sheffield Social and Healthcare NHS Foundation Trust, UK
Ingrid King
Affiliation:
University of Sheffield, UK
Val Keating
Affiliation:
Sheffield Hallam University, UK
*
Reprint requests to Simon Robinson, Consultant Nurse, Acute Mental Health Care, Barnsley Business Delivery Unit, South West Yorkshire Partnership NHS Foundation Trust, Barnsley, S70 3RD. E-mail: s.robinson@BarnsleyPCT.nhs.uk

Abstract

Background: The Improving Access to Psychological Therapies (IAPT) initiative has depended on the training of a new NHS mental health workforce. At step 3 of the stepped care model, capacity building has required the recruitment of a wide range of mental health professionals into high intensity therapists training posts. This shift naturally entails role transition on the part of trainees into delivering cognitive behavioural psychotherapy (CBP), but no previous research has examined the experience of such transitions. Aim: To describe the lived experience of transition from mental health nurse to IAPT high intensity therapist and to identify possible factors which moderate effective role conversions. Method: Six qualified high intensity therapists were interviewed using a semi-structured interview and the subsequent interviews transcribed. Thematic content analysis (TCA) was used to analyze personal accounts of role transition. All participants had previously been mental health nurses and attended the same IAPT high intensity therapist (HIT) training programme. Results: Six key themes were apparent from the TCA. Three interconnected themes concerning supervision (style, impact of approach and historical context) and three additional themes of the challenge of learning a new clinical approach, high need for support, and forming a new psychotherapist identity. Conclusions: Findings suggest supervision is the most important factor in supporting complex psychotherapy role transitions. Clinical supervisors may need to incorporate dedicated time on role and identity shift during CBP training to ensure effective assimilation and transition. Methodological short-comings are identified and discussed.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, R. (2007). Thematic content analysis, descriptive presentation of qualitative data. Downloaded from, http://www.wellknowingconsulting.org/publications/pdfs/thematiccontentanalysis.pdf.Google Scholar
Appleton, J. V. (1995). Analysing qualitative interview data: addressing issues of validity and reliability. Journal of Advanced Nursing, 22, 993997.CrossRefGoogle ScholarPubMed
Armenakis, A. A. and Bedeian, A. G. (1999). Organizational change: a review of theory and research in the 1990s. Journal of Management, 25, 293315.CrossRefGoogle Scholar
Ashforth, B. (1995). Work-role transitions: a longitudinal examination of the Nicholson model. Journal of Occupational and Organisational Psychology, 68, 157175.CrossRefGoogle Scholar
Becker, H. S. and Carper, J. W. (1956). The development of identification with an occupation. The American Journal of Sociology, 4, 289298.CrossRefGoogle Scholar
Bennett-Levy, J. (2006). Therapist skills: a cognitive model for their acquisition and refinement. Behavioural and Cognitive Psychotherapy, 34, 5778.CrossRefGoogle Scholar
Bennett-Levy, J. and Beedie, A. (2007). The ups and downs of cognitive therapy training: what happens to trainees perceptions of their competence during a cognitive therapy training courses. Behavioural and Cognitive Psychotherapy, 35, 6175.CrossRefGoogle Scholar
Bordin, E. (1983). A working alliance based model of supervision. The Counselling Psychologist, 11, 3542.CrossRefGoogle Scholar
Bower, P. and Gilbody, S. (2005). Stepped-care in psychological therapies: access, effectiveness and efficiency. British Journal of Psychiatry, 186, 1117.CrossRefGoogle ScholarPubMed
Bowditch, J. L. and Buono, A. F. (2005). A Primer on Organizational Behaviour (6th ed.). New York: Wiley.Google Scholar
Buchanan, D. and Huczynski, A. (1997). Organizational Behaviour: an introductory text (3rd ed.). New York: Prentice Hall.Google Scholar
Burnard, P. (1991). A method of analysing interview transcripts in qualitative research. Nurse Education Today, 11, 461466.CrossRefGoogle ScholarPubMed
Clark, D. M., Layard, D., Smithies, R., Richards, D. A., Suckling, R. and Wright, B. (2009). Improving access to psychological therapy: initial evaluation of two UK demonstration sites. Behaviour Research and Therapy, 47, 910920.CrossRefGoogle ScholarPubMed
Gilbert, P. (2007). Evolved minds and compassion in the therapeutic relationship. In Gilbert, P. and Leahy, R. (Eds.), The Therapeutic Relationship in the Cognitive and Behavioural Psychotherapies. London: Routledge.Google Scholar
Glen, S. and Waddington, K. (1998). Role transition from staff nurse to clinical nurse specialist: a case study. Journal of Clinical Nursing, 7, 283290.CrossRefGoogle ScholarPubMed
Granheim, U. H. and Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105112.CrossRefGoogle Scholar
Grant, A. (2009). Training for supervising CBT practitioners - and others. In Henderson, P. (Ed.), The Karnac Guide to Supervision (Vol. 2). The current challenges of supervision training. Hove: Karnac Books.Google Scholar
Grant, A., Townend, M. and Sloan, G. (2008). The transfer of CBT education from classroom to work setting: getting it right or wasting the opportunities? The Cognitive Behaviour Therapist, 1, 2744.CrossRefGoogle Scholar
Heppner, P. P. and Roehike, H. J. (1984). Differences among supervisees at different levels of training: implications for a developmental model of supervision. Journal of Counselling Psychology, 31, 7690.CrossRefGoogle Scholar
Hotho, S. (2008). Professional identity: product of structure, product of choice linking changing professional identity and changing professions. Journal of Organisational Change Management, 21, 721742.CrossRefGoogle Scholar
IAPT (2008). Improving Access to Psychological Therapies (IAPT): supervision guidance. http://www.iapt.nhs.uk/wp-content/uploads/2008/12/supervision-2008.pdfGoogle Scholar
Kennard, B. D., Stewart, S. M. and Gluck, M. R. (1987). The supervision relationship: variables contributing to positive versus negative experiences. Professional Psychology Research and Practice, 18, 172175.CrossRefGoogle Scholar
Ladany, N., Hill, C. E., Corbett, M. M. and Nutt, E. A. (1996). Nature, extent, and importance of what psychotherapy trainees do not disclose to their supervisors. Journal of Counselling Psychology, 43, 1024.CrossRefGoogle Scholar
Layard, R., Bell, S., Clark, D. M., Knapp, M., Meacher, M. and Priebe, S. (2006). The Depression Report: a new deal for anxiety and depression disorders. London: London School of Economics. Available at http://cep.lse.ac.uk. Centre for Economic Performance Report.Google Scholar
Lombardo, C., Milne, D. and Proctor, R. (2009). Getting to know the heart of clinical supervision: a theoretical review of the role of emotions in professional development. Behavioural and Cognitive Psychotherapy, 37, 207219.CrossRefGoogle Scholar
Miles, M. B. and Huberman, A. M. (1994). Qualitative Data Analysis: a sourcebook of new methods (2nd ed.) Thousand Oaks, CA: Sage.Google Scholar
Milne, D. (2009). Evidence Based Clinical Supervision: principles and practice. Oxford: Blackwell.Google Scholar
Murphy, E., Dingwall, R., Greatbatch, D., Parker, S. and Watson, P. (1998). Qualitative methods in health technology assessment: a review of the literature. Health Technology Assessment, 2, 1632.CrossRefGoogle ScholarPubMed
Nicholson, N. (1984). A theory of work role transitions. Administrative Science Quarterly, 29, 172191.CrossRefGoogle Scholar
Polit, D. F. and Beck, C. T. (2008). Nursing Research Generating and Assessing Evidence for Nursing Practice (8th ed.). Philadelphia, PA: Lippincott Williams and Wilkins.Google Scholar
Polit, D. F. and Hungler, B. P. (1995). Nursing Research Principles and Methods (5th ed.). Philadelphia, PA: Lippincott.Google Scholar
Pretorius, W. M. (2006). Cognitive behavioural therapy supervision: recommended practice. Behavioural and Cognitive Psychotherapy, 34, 413420.CrossRefGoogle Scholar
Ricketts, T. and Donohoe, G. (2000). Clinical supervision in cognitive behavioural psychotherapy. In Lawton, B. and Feltham, C. (Eds.), Taking Supervision Forward: enquiries and trends in counselling and psychotherapy. London: Sage.Google Scholar
Rosenbaum, M. and Ronen, T. (1998). Clinical supervision from the standpoint of cognitive behaviour therapy. Psychotherapy, 35, 220230.CrossRefGoogle Scholar
Roth, A. D. and Pilling, S. (2007). The competencies required to deliver effective cognitive and behavioural therapy for people with depression and with anxiety disorders. Available at www.ucl.ac.uk/CORE.Google Scholar
Sandelowski, M. (1986). The problem of rigor in qualitative research. Advances in Nursing Science, 8, 2737.CrossRefGoogle ScholarPubMed
Scaife, J. (2001). Supervision in the Mental Health Professions: a practitioner's guide. Hove: Brunner-Routledge.Google Scholar
Scanlon, C. and Weir, W. S. (1997). Learning from practice? Mental health nurses’ perceptions and experiences of clinical supervision. Journal of Advanced Nursing, 26, 295303.CrossRefGoogle ScholarPubMed
Schon, D. A. (1983). The Reflective Practitioner: how professionals think in action. London: Basic Books.Google Scholar
Silverman, D. (2005). Doing Qualitative Research (2nd ed.). London: Sage Publications.Google Scholar
Silverman, D. (2006). Interpreting Qualitative Data (3rd ed.). London: Sage Publications.Google Scholar
Sims, R. R. and Veres, J. G. (1987). Competency Based Training and Organisational Transitions. Emerald Back files. Accessed via SHU Blackboard literature searches. DOI, 10.1108/eb004066.CrossRefGoogle Scholar
Swetnam, D. (2004). Writing Your Dissertation. Oxford: How to Books Ltd.Google Scholar
Townend, M. (2008). Clinical supervision in cognitive behavioural psychotherapy: development of a model for mental health nursing through grounded theory. Journal of Psychiatric and Mental Health Nursing, 15, 328339.CrossRefGoogle Scholar
Townend, M., Iannetta, L. and Freeston, M. H. (2002). Clinical supervision in practice: a survey of UK cognitive behavioural psychotherapists accredited by the BABCP. Behavioural and Cognitive Psychotherapy, 30, 485500.CrossRefGoogle Scholar
Ward, L. G., Friedlander, M. L., Schoen, L. G. and Klein, J. G. (1985). Strategic self-presentation in supervision. Journal of Counselling Psychology, 32, 111118.CrossRefGoogle Scholar
West, M. and Rushton, R. (1989). Mismatches in the work-role transition. Journal of Occupational Psychology, 62, 271286.CrossRefGoogle Scholar
Yegdich, T. and Cushing, A. (1998). An historical perspective on clinical supervision in nursing. Australian and New Zealand Journal of Mental Health Nursing, 7, 3–2Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.