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Remote and hybrid training models for CAT Training

ACAT Training Committee Consultation paper agreed on 1st July 2022
Dawn Bennett & Steve Jefferis

 

Background

A small working group met to review the paper ‘Remote and Hybrid Training Models draft 1’ presented to ACAT Training Committee 4th March 2022. We also reviewed 

• HEE Blended Learning Guidance for preregistration training and undergraduate healthcare registration. It reviews psychological therapy training and includes the advice of professional bodies (this document and a summary by Dawn are available on request)  

• DClinPsychol Manchester developments and plan for blended learning for implementation Oct 2022: This is essentially that trainers are requested to design their training as 1/3 digital (for theoretical content eg narrated slides, video, online materials) and 2/3 in person (with a skills emphasis)   

• Invited views of ACAT Technology Assisted Supervision Therapy and Training (TASTT) group 

A proposal for consultation (version 2) was discussed with ACAT Training Committee and Trustees on 1st July 2022 and approved for implementation as below.

 

Remote and hybrid training models for CAT Training 

ACAT training requirements will retain some flexibility with a proportion of online training components to allow trainees to operate within their service requirements and to maximise the opportunity for ACAT trainers to build on their expertise in online training. ACAT Training Committee will continue to review the impact for trainees and trainers to ensure the quality of training delivery and that trainees are able to achieve the CAT competences.

 

1. Training days  

ACAT training days are in-person as it allows us to share and demonstrate how we use CAT theory more effectively and it allows for better group and skills work. 

After trialling livestreaming for some of our courses, we have reverted to fully in person training days and don’t offer hybrid training, online days or livestreaming from an in person training day as this fundamentally changes the nature and content of the training days. It is both our experience and reported in a publication (in press) that a livestream from an in person day offers a poor learning environment for people remotely, they can’t really join in, it is hard for the trainers to focus on the room and engagement is poor online. We make this clear in our advertising and address it at interview, and expect trainees to take this into account when deciding whether to enrol on a CAT training course. 

We add the following caveats.

• Some courses may take the decision to offer livestreaming in instances of necessity, for example, if a large number of the group where unable to attend in person. However this isn't universal among courses and trainees should be clear about attendance requirements and options before embarking on training.
• If a situation arose that a trainee was having difficulty attending in person this would need to be discussed and a plan considered to support the trainee to pause or continue training.
• If livestreaming was accepted due to necessity, no more than 30% of the training days can be attended by livestreaming. 

 

2. Delivering seminars as part of the academic programme 

Through the pandemic we have noted advantages of on-line groups allowing a mix of trainees who would not usually have the opportunity to work together if the groups met as home/local groups, greater flexibility in meeting arrangements and wider access to facilitators and reduced costs and time. With the return to in person training days the trainees will all have met in person which satisfies our general guidance that any online component follows in person meeting. 

ACAT therefore proposes that where courses have seminar/peer learning groups separate from the taught days these can be in person or on-line. This is course and trainee choice. For courses where the groups are integrated into the taught days the models in point 1 will apply 

 

3. Clinical practice

Trainees may be limited by their service as to the proportion of CAT therapies they can deliver in person or online that would make up their training cases. Trainees will also need to consider patient preference/need, for example, those who can’t work virtually. 

ACAT proposes a minimum of 50% clinical hours in person but will be flexible and consider difficulties trainees may have meeting this. This recommendation should allow accommodation of the patient’s voice. 

NB see section 7 below: Training to include knowledge and skills in the delivery of CAT online. ACAT to develop an appendix to the professionals document in the current competences framework

 

4. Supervision of clinical practice 

The preference is for in person supervision because CAT is a relational and tool based therapy, we use supervision to teach the skills of how to do CAT in person, e.g. developing and sharing reformulation diagrams. However, CAT is now also delivered on line allowing for modelling in the supervision group. In agreeing the proportion of in person vs online supervision consideration will be given to the medium of supervision paralleling that of the therapy and on evidence where possible of the effectiveness and experience of online supervision. Online supervision would increase access to CAT training to those who may not be able to access supervision by an accredited supervisor within a reasonable distance.  

ACAT proposes in person supervision as the preferred model of training supervision but supervision can be conducted on-line if all members of the group agree. Groups that meet remotely would benefit from meeting in person occasionally and this would be usual. There may be exceptions. There would be reflection on the medium in the clinical appraisal form  

 

5. Training therapy

The central principle is that CAT is a relational therapy and the aim is for in person training therapy. However, CAT is now offered remotely and trainees have the experience of delivering this. Trainees can therefore experience the same form of CAT therapy that they are delivering and remote training therapy is accepted. 

 

6. Written assignments 

We will continue to accept the submission of course work for therapies conducted online and review the writing and marking guidelines for these, especially against any developments in the curriculum for best practice in delivering CAT online

 

7. CAT Competencies Framework 

https://www.ucl.ac.uk/clinical-psychology/competency-maps/cat-map.html

• Are there areas of the framework that require or are best delivered through in person training? 

• Monitor the impact of online training on the development of CAT competences   

• Extension of the competence framework to include knowledge and skills in the delivery of CAT online, identifying relevant sections e.g use of CAT tools; working with emotion 

• Formation of a professional document as an extension of UCL listing to cover these competences. Initially this can be in the form of an appendix to the professionals’ document. 

 

8. Documentation review in light of competence framework and remote working 

• Supervisor appraisals

• Essay titles

• Writing and Marking guidance 

• New competences appendix 

 

9. Access

Models of CAT training with a proportion of the training conducted online can enhance access to individuals who may otherwise not be able to train in CAT. It is this that allowed CAT to develop internationally. This needs to balance with evidence for the quality of training and skills acquisition. Monitor enquiries for distance learning and ability of ACAT courses to meet this need. 

EDI working group may propose additional areas to broaden access to CAT training 

 

10. Monitoring

• Course reports, Vice Chair and Admin reports to Training Committee to comment on enquiries for distance learning and livestreaming. 

• Standing item on Training Committee agenda to monitor the impact of and need for online training and hybrid models across ACAT trainings. 

• Moderators group and reports to highlight the impact of and need for online and hybrid models. 

• End of course feedback to also address trainees’ experiences of the model of training.

 

Dr Dawn Bennett & Dr Steve Jefferis ACAT Training Committee 1st July 2022

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