Psychological Interventions Competence

This competence is designed to reflect the wide variety of settings and client groups that a Health Psychologist may work in and with. Therefore each sub-section – Assessment, Formulation, Intervention and Outcome/Evaluation – should be seen as applicable to work with individual clients, groups, communities and organisations.

Range of experience

Candidates must have experience of delivering interventions both face-to-face with individuals, and in a different setting (i.e. not involving direct contact with an individual), such as group work or online. Candidates’ competence in working with individual clients on a face-to-face basis should be observed by their supervisor (this can be the workplace supervisor, workplace contact, or the coordinating supervisor), such that the supervisor can attest to the candidate’s ability to assess, formulate and deliver an intervention with an individual client (note: to complete this requirement observation of more than one session may be required).

 

Candidates must demonstrate:

A detailed understanding of broad knowledge and applied health psychology skills that are required to plan, develop, deliver and evaluate psychological interventions within healthcare contexts. The competencies are based on the Health Behaviour Change Competency Framework (Dixon & Johnston, 2010), but encompass a breadth of psychological interventions. It is expected that, prior to commencing Stage 2 training, all candidates will evaluate the extent to which they have achieved the competencies outlined in the Dixon & Johnston framework that are recommended to deliver low intensity interventions. This self-evaluation should be used to identify priorities for the candidate’s development of clinical skills.

The process of undertaking an intervention should begin with a comprehensive assessment of individual needs that will result in the development of a formulation model of the theory, along with processes and constructs to be addressed in designing an effective intervention for that individual. The models, techniques and strategies that are utilised to deliver the intervention should be clearly described within the context of their content (theory, techniques, and outcomes) and their implementation processes (the therapeutic relationship, communication issues, application procedures, reflective practice). This competence is designed primarily to enable trainees to gain clinical and professional skills in the engagement and applied practice of communicating, relationship building with clients/individuals (central to intervention effectiveness) and delivering therapeutic intervention techniques in real life practice. Trainees must ensure that that they can make professional judgements, communicate feedback about the outcomes and impact of the interventions involved an individual’s care based on their assessment and formulations to manage complex and unpredictable situations.

 

Evidence to be submitted:

(i) a reflexive report of 3000 words (maximum) in the record of completion, summarizing personal and professional development as a health psychologist. Candidates should reflect on the extent to which their experience has allowed them to acquire specified competence in each component and to have their supervisor approve these comments.

(ii) a 3,000 word (maximum, excluding references and appendices) Case Study of a psychological intervention that has been implemented through face-to-face work with an individual client, and which includes all elements of the process: assessment, formulation, intervention and evaluation. This should be submitted together with a report from the candidate’s supervisor detailing observation of the candidate working in this way, and the report should attest to the candidate’s ability to assess, formulate and deliver an intervention with an individual client (note: to complete this requirement observation of more than one session may be required).

(iii) a 2000 word (maximum, excluding references and appendices) Case Study of a psychological intervention that has been implemented through a medium other than face-to-face work with an individual client (e.g. through group work or online), and which includes all elements of the process: assessment, formulation, intervention and evaluation.

2.1 To conduct psychological interventions within a healthcare context to change behaviour of individuals and groups.

Attainment of competence in this unit involves demonstration of the ability to:

• 2.1a      Select or design and implement appropriate health psychology tools to conduct health psychology baseline assessments of the needs of the client/patient population addressing the targeted health behaviour outcomes for this individual/group.
• 2.1b     Develop a working formulation model regarding the cognitive, emotional and behavioural processes that should be addressed within intervention methodology based on the assessment information, data and outcomes.
• 2.1c      Provide detailed feedback about the outcome of the assessment and formulation as appropriate to the service and role of the health psychologist delivering/directing the intervention.
• 2.1d     Design, plan and implement health psychology interventions based on the assessment and formulation.
• 2.1e      Evaluate and communicate the outcomes of health psychology behaviour change interventions.

2.1a To select or design and implement appropriate tools to conduct psychological baseline assessments of the needs of the client/patient population addressing the targeted interventional outcomes for this individual/group, the competent health psychologist will be able to:

1. Define and gather relevant information to determine the target behaviour/s, the targeted individuals, groups, communities or organisations and the targeted health and/or health service outcomes.
2. Determine the use of appropriate theories and models to inform the structure and content of the assessment.
3. Define and gather relevant information to determine the history, context and risk to the individual client as a result of their health behaviour / psychological factors and outcomes.
4. Specify the resources (including personnel, equipment and financial resources) necessary to conduct the assessment and who will conduct the assessment, where and when.
5. Determine own professional competence to proceed with assessment based on preliminary investigations and undertake appropriate training and supervision to conduct assessment as necessary.
6. Assess the current status of the behaviour (e.g. frequency, duration, intensity, variation, context).
7. Assess the behavioural antecedents (that precede or cause the behaviour) and consequences (that follow or are caused by behaviour). Antecedents and consequences may be environmental, social, physiological or psychological.
8. Communicate effectively and professionally to establish rapport, engender empathy, utilise active listening and questioning skills, collaborative decision making and information giving.
9. Accurately record, document and store relevant information gathered during the assessment according to professional standards and local governance policies and procedures.

2.1b To develop a working formulation model regarding the cognitive, emotional and behavioural processes that should be addressed within intervention methodology based on the assessment information, data and outcomes, the competent health psychologist will be able to:

1. Describe and evaluate the information gained from the assessment to determine the pattern of behaviour and its relationship to antecedents and consequences/ health outcomes.
2. Use appropriate theories, models and the evidence base to identify role of cognitions and affect in behaviours associated with the target health outcomes.
3. Formulate working hypotheses of the interactions between biological, medical, psychological, social and cultural factors relevant to the target health behaviour (gained from the evidence base and the assessment process).
4. Gather formal feedback or further information from relevant others.
5. Decide whether additional information and further assessment are necessary.
6. Revise the working formulation regarding the maintenance processes involved in the targeted health behaviours as appropriate.

2.1c To provide detailed feedback about the outcome of the assessment and formulation as appropriate to the service and role of the health psychologist delivering/directing the intervention, the competent health psychologist will be able to:

1. Provide appropriate feedback matched to the needs of the client, with a summary and review of information gathered during the assessment to facilitate the collaborative relationship and to obtain relevant additional information.
2. Indicate specific areas that require further clarification within the assessment and formulation.
3. Consider the outcomes of the formulation and any implications for the client(s).
4. Refer client(s) on to alternative services, professionals or agencies for further intervention if appropriate.

2.1d To design, plan and implement health psychology interventions based on the assessment and formulation the competent health psychologist will be able to:

1. Define the cognitive, emotional and behavioural objectives or health outcomes of an intervention.
2. Design the methodology (content and processes) of the intervention required to conduct an effective intervention based on the assessment and formulation.
3. Use the evidence base and the formulation to select appropriate elements of theories or models to inform the intervention strategies, techniques, components and methods.
4. Identify and evaluate psychological, cultural, environmental, organisational and societal facilitators of, and barriers to, the implementation and/or effectiveness of the intervention.
5. Plan how to enhance the facilitators and reduce the barriers to the intervention effectiveness and outcomes.
6. Identify the resources required to implement the intervention and address any gaps in resources that may impede effective delivery of the intervention.
7. Identify and address (where possible) any communication or relationship factors between trainee and client that may reduce the intervention effectiveness (e.g. conflicts of interests, personal issues).
8. Deliver an appropriate psychological intervention based on the assessment and formulation model, the resource analysis, the barriers and facilitators evaluation and the intervention methodological plan.

2.1e To evaluate and communicate the outcomes of psychological interventions the competent health psychologist will be able to:

1. Identify or design relevant outcome and process measures to determine the efficacy and mechanisms of the intervention.
2. Identify effective components of the psychological intervention.
3. Conduct an intervention review with the client/s to develop plans to maintain health change outcomes and reinforce factors influencing lasting change.
4. Recommend changes to improve the efficacy of the intervention.
5. Determine whether further follow-up is required to maintain change or whether referral on to other services, professionals or agencies is required.