I knew training as a PWP would not be easy. Highly competitive, academically demanding and combined with an in-service placement, one could never assume the year would be a breeze. For many motivated people armed with some sort of psychology degree or other social care background, the demanding nature at first seems inspiring. What I never considered was the added layer of complexity training from home would add. I’m sure I’m not alone, and I hope this article helps those out there who might feel the same. Despite all the challenges, I fully plan to continue working as a PWP after qualifying.
Lack of Support
Within a week of receiving my laptop and phone, I was given real life clients to assess after being ‘signed-off’ by my supervisor after a couple of role plays. Clients are supposed to be screened by IAPT to deem their suitability for assessment (for example, someone who has a diagnosis of bipolar, takes 3 types of medication and has concerns around their risk to self and others should be screened for assessment with at least a qualified experienced PWP or even a Step 3 assessment with a CBT therapist). However, due to short staff numbers/lack of time, screening is rarely completed. This means that despite being a trainee, within 2 weeks of starting I was having to assess people who could not keep themselves safe, either through risk of ending their life or self-harming, as well as people with severe enduring personality disorders. I felt completely out of my depth.
The shield of ‘being a trainee’ really does not exist when screening is not completed. Doing this from home meant I was alone hearing these things in my bedroom, and had no colleagues immediately to debrief with about what to do/the things I had just heard. Of course, like any good practitioner I notified supervisors/duty immediately (via phone) after the assessment due to concerns around risk or for urgent referrals, but somehow I still felt very alone at home managing such levels of distress over the phone. I imagine my colleagues who had met in person prior to moving to work from home may zoom call each other for a bit of a debrief, but knowing nobody in person, I do not have this same level of familiarity with people.
Pandemic Demands
Trainee PWPs are not supposed to be assessing / treating anywhere near the numbers their qualified counterparts are. However the pandemic has lead to an increase in referrals for IAPT, often with other NHS staff (nurses, Drs etc.) seeking support for the trauma and stress they are experiencing. Our service is struggling to meet the demands of the pandemic and as a result, as trainees we assess/treat almost 90% of the caseload of a qualified practitioner and we’re only 6 months in. We quickly went from 1 assessment a day to 5 or 6, which was a huge increase over a short amount of time. Any PWP knows, the admin of an assessment is also huge.
I know most of my trainee cohort feel exhausted combining this amount of work with university on the other days. We often work after uni just to catch up with the admin. Over time, this is leading to exhaustion and burnout. The service know, but as is common within IAPT, you sink or swim with it.
Growth
Despite the challenges mentioned above, the trainee role has developed me and pushed me out of my comfort zone like never before. I’ve learned to assess complex clients, to work independently (with supervision), to manage risk, to work with other services, and I am slowly learning treatment. It has been stressful, but I don’t know any other role where I would have developed so much in such a short space of time.
I’ve had real ‘feel good’ moments amongst the chaos. Some that spring to mind including doing additional questionnaires with clients (such as SPIN for social phobia, or OCI for OCD) and finding out from the client you were the first person to ever identify that that is what they were experiencing. Another memory was a good second treatment session where the client really engaged with CBT and I feel we are currently on a very good roll for them to recover.
Other good experiences have included the excellent support from my supervisor, my fellow trainee cohort who provide amazing peer support, and ultimately, knowing everyday that I go to work and make a difference.
I fully plan to continue into the qualified role, and look forward to being back in person.
