Training With Greater Impact


Executive Summary

This project was commissioned by Health Education England (HEE) to identify the psychological practice skills required by all aspects of the mental health workforce. It has developed a model to upskill practitioners across the specialist clinical mental health workforce and beyond.

The project aims to:

  • identify the psychological practice skills that are required to deliver psychologically informed mental healthcare in line with the delivery of care cluster intervention
  • arrange these in accessible, simple, yet detailed models
  • differentiate the skills according to levels of practice, paying consistent attention to the differentiation of roles, identifying both the skills required by the broader mental health workforce and the specific skills provided by psychologists with different levels of experience. It highlights skills that should be prioritised across a range of domains
  • utilise expert opinion and the current evidence base in the development of the models
  • identify key factors in organisations which promote the successful transfer and maintenance of psychological practice skills for the benefit of service users
  • incorporate all of the above into an integrated skills development model

Introduction and Background

Why the need for this project?

HEWM is undertaking a programme of development of the Specialist Mental Health Workforce. Key to the delivery of commissioned West Midlands Care Clusters (delivering recovery-focused, safe, effective and high quality services) are evidence-based talking therapies.

    Historically, there has been a significant investment in developing high-level Psycho-Therapeutic skills associated with models of psychological practice.

    The priority now is to take a whole system view of psychological skills that will:

  • Provide increased psychological safety for service-users
  • Reduce demand for high-level psychological services
  • Integrate requirements into pre-registration programmes and maximise the value of future spend on continuing professional development to extend psychological skills
  • Increase the therapeutic benefit of each contact a service-user has with patient-facing staff along the patient journey by ensuring that all staff have a clearly defined framework of psychological competences associated with their role.

Psychological practice refers to all elements of the provision of psychologically-informed healthcare. It occurs within the context of continued professional development and clinical supervision; self-reflection and self-care.

Whilst psychological practice is the foundation of all secondary mental healthcare, the models of psychological practice presented here focus specifically on the psychological components of healthcare delivery.

These models of psychological practice complement the range of generic competency frameworks and skills models that are already available in NHS and social care settings. The majority of these frameworks are generic and cover the skills required to perform the full spectrum of work-based activities undertaken by mental health staff.

Alternatively, those which are exclusively psychological in focus tend to present competency frameworks relating to the delivery of specified models of psychological therapy. There is little literature to guide organisations in ensuring that the workforce has the right skills mix to deliver psychological practice, broadly defined, and do not provide the breadth of this model does across all practitioner groups.

During the consultation process the importance of good psychological communication skills was constantly highlighted. This model is novel too as it includes a focus on recognising staff stress. It incorporates the inclusion of self care and staff well being.

Policy Context

There is increasing recognition that well-developed psychological practice skills within the health and care workforce underpin effective delivery of National Policies and Best Practice Guidance.

It is important to situate the upskilling in psychological practice skills in the context of key national strategies and policy implementation related to the delivery of healthcare and the promotion of well-being. It is evident that the current and growing need for psychological practice skills is implicit in any implementation of major national healthcare policies. The effectiveness of psychotherapeutic and psychosocial interventions has been increasingly recognised as highly cost efficient by NICE. The use of psychological practice skills is known to improve client and carer well-being and satisfaction with service delivery and reduces complaints and adverse incidents.

Although the focus of this model concerns upskilling the secondary mental health service workforce in psychological practice skills, it is increasingly evident that such skills are relevant to all aspects of healthcare delivery.


(Focus Groups and ERG’s)

Frontline practitioners in the West Midlands workforce were consulted to determine what they considered to be the “skills gap” in psychological practice across all areas of the organisation. Using a research based approach; multi-disciplinary focus groups were convened to include practitioners, service managers and training providers.

This consultation enabled the project team to understand the current gaps from the perspective of those responsible for delivering mental health care and support.

The focus groups were asked two broad questions:

  • What are the psychological practice skills required by the MH workforce?
  • Does the current regional training offer provide the skills required?

The development of the skills models incorporated wide scale consultation and collaboration with mental health professionals (from the 7 regional mental health Trusts) in the West Midlands along with synthesis of existing competency frameworks, skills models and national and professional guidance on best practice in service delivery.

Three expert reference groups (ERG’s) of psychologists from across the region refined the models using a Q sort technique and thematic analysis to develop Q sets.

Three model leads, (psychologists with appropriate specialism and expertise), led on the development of care cluster specific models, supported by the project research team. These leads were responsible for reviewing existing literature, assimilating recommendations made by the expert reference groups, and consulting with multidisciplinary colleagues, clients and carers, and national leads to develop the following models.

  • Psychological practice skills required to deliver secondary mental healthcare to clients living with severe and complex mental health conditions (Care Clusters 3-8)
  • Psychological practice skills required to deliver secondary mental healthcare to clients living with psychosis (Care Clusters 10-17)
  • Psychological practice skills required to deliver secondary mental healthcare to clients living with dementia (Care Clusters 18-21)

The research team, project leads and national advisors met regularly to ensure concordance across the three models. Further feedback was sought from clients and carer groups, senior colleagues working in multi-disciplinary settings and service managers throughout the process.

This website was created in conjuction with Inclusion Imperative.