Severn Postgraduate Medical Education Advanced Training in Forensic Psychotherapy
Introduction
This training scheme offers five years of higher specialist dual training in Forensic Psychotherapy. The objective of the training is to prepare the trainee for future appointment as either a Consultant in Forensic Psychotherapy, a Consultant Forensic Psychiatrist with special responsibility for Forensic Psychotherapy, or a Consultant Psychiatrist in Psychotherapy. The training scheme has been designed to conform with the Royal College of Psychiatrists guidelines for training. The scheme is based on two established single specialty training schemes in the Severn Postgraduate Medical Education in Forensic Psychiatry and Medical Psychotherapy. This combined training will lead to a dual award with CCTs in Forensic Psychiatry and Medical Psychotherapy.
Organisation of Training
The scheme is designed so that Forensic Psychiatry and Medical Psychotherapy training are integrated throughout the five year programme. The Training Programme Directors for the schemes are Dr Elizabeth O’Mahoney (for Forensic Psychiatry) and Dr Thanos Tsapas (for Medical Psychotherapy). Training committee meetings are regularly held with both training programme directors and trainee present.
Progression through Training
In years 1 and 2, the major component of the training will be Forensic Psychiatry. In years 3, 4 and 5 the major component will be Medical Psychotherapy. The scheme has close links with the Pathfinder Service in Bristol, which provides a specialist forensic personality disorder service and through this the trainee can gain experience in Forensic Psychotherapy. There may also be opportunity for links with the forensic psychotherapy at Broadmoor Hospital. There will be a gradual progression from gaining a solid grounding in Forensic Psychiatry and Medical Psychotherapy to increasing specialisation in Forensic Psychotherapy. There will be academic components throughout the programme in Forensic Psychiatry, Psychotherapy and in Forensic Psychotherapy. Full time psychiatry advanced trainees spend six sessions with their clinical trainers and are entitled to two special interest sessions and two non-clinical special interest sessions. These sessions can be arranged following discussions with the Training Programme Directors and clinical trainers and are regularly reviewed. In Forensic Psychotherapy dual training the special interest sessions are used to integrate and maintain competency in the two specialties. Throughout the five-year training there is special interest time allocated to research, teaching, leadership and management.
The main training in Forensic Psychiatry is at Fromeside medium secure unit and Wickham low secure unit, both at Blackberry Hill Hospital, Bristol, within Avon and Wiltshire Partnership NHS Trust. The training will comprise in-patient work within the women’s and men’s services, prison sessions, access assessments for secure services, and court work in the form of writing reports and giving evidence. The trainee will also undertake a minimum of 30 days gaining experience in a high secure setting at Broadmoor Hospital. The special interest sessions will be devoted to Psychotherapy.
The major psychotherapeutic modality of the Medical Psychotherapy Training Scheme is psychodynamic / psychoanalytic. The trainee will also gain significant experience in other modalities, such as Cognitive Analytic Therapy, Mentalisation Based Treatment, Family therapy and Narrative Therapy. There are also opportunities to train in Dialectical Behavior Therapy and be a part of the DBT team at Fromeside. The Medical Psychotherapy training involves working at different sites with different clinical and educational supervisors: Bristol Complex Psychological Interventions Service (trainer: Dr Thanos Tsapas, Avon and Wiltshire Partnership NHS Trust), South Gloucestershire Psychological Therapies Service (trainer: Dr Claire Davis, Avon and Wiltshire Partnership NHS Trust), Somerset Psychological Therapies Service, (trainer: Dr Jason Hepple, Somerset Partnership NHS Foundation Trust) and Complex Psychological Interventions Service (trainer: Dr Svetlin Vrabtchev, 2gether NHS Foundation Trust). As this part of the training progresses the trainee will have the opportunity to become confident in assessing for, and delivering, psychological therapies in individual and group settings, as well as having the opportunity later in training to clinically supervise less experienced psychotherapists, such as Core Psychiatry trainees and the medical students participating in the Bristol Medical Student Psychotherapy Scheme. The trainee will have special interest time allocated to Forensic Psychiatry in order to consolidate experience. There will be opportunities for specialist Forensic Psychotherapy assessments and supervised casework in Forensic Psychotherapy and consultation work in different forensic settings. The trainee will be encouraged to make links with Consultant Forensic Psychotherapists in Devon Partnership Trust and Broadmoor Hospital.
The small number of training posts in both the Forensic Psychiatry and Medical Psychotherapy programmes offers the opportunity for an ongoing assessment of the trainees’ needs and the flexibility to meet their needs according to their interests.
Upon completion of the Medical Psychotherapy training trainees are eligible to register with the College of Medical Psychotherapists within the UK Council for Psychotherapy.
On call experience
The Forensic Psychotherapy trainee is currently on the Forensic Psychiatry senior on call rota, which covers Fromeside medium secure and Wickham low secure units. This is a 1:15 on call rota.
Personal Psychotherapy
Trainees are expected to engage in personal psychotherapy at least once a week for the duration of their Medical Psychotherapy training. The trainee in Forensic Psychotherapy is encouraged to engage in personal psychotherapy throughout both components of their dual training. Personal psychotherapy provides the trainee with the unique opportunity to think about the emotional challenges of working with patients in different settings. Severn Postgraduate Medical Education acknowledges the importance of this commitment and financially supports the trainees. They are eligible to claim £2,500 per year during the Medical Psychotherapy part of training towards their personal therapy fees.
Teaching and Education
The trainees are strongly encouraged to become involved with the Medical Education Department and undertake educational roles. Trainees can apply to become Associate locality Tutors and get involved in Postgraduate and Undergraduate Education and teaching. There are also Senior Clinical Teaching Fellowship opportunities for advanced trainees.
The trainees are also encouraged to consider postgraduate teaching qualifications, such as the MSc Teaching and Learning for Health Professionals at the University of Bristol.
Research
The University of Bristol has an active Centre of Academic Mental Health with a strong research culture. Areas of research include maternal depression and its impact of child development and Personality disorders.
The advanced trainees are encouraged to participate in existing research projects or develop and conduct their own qualitative research project using methodology that would be in keeping with their clinical interests (i.e. Narrative analysis).
Management and Leadership
The trainees are expected to actively engage with management and leadership opportunities and Quality Improvement Projects. They are also expected to develop their own projects, which could take the form of introduction of Psychotherapy related services in different psychiatric and primary care settings.
Additional training in psychotherapy and supervision
The advanced trainees are strongly encouraged to undertake additional psychotherapy related training.
Strong links have been established with the MSc Psychological Therapies Practice and Research (Psychodynamic/Psychoanalytic Therapy) at the University of Exeter.
Also, trainees can undertake Cognitive Analytic Therapy Foundation Training.
The clinical requirements of the above trainings are met by the clinical experience gained during the trainees’ NHS work.
Advanced trainees are encouraged during the last year of the programme to undertake training in offering clinical psychotherapy supervision. Locally this could be achieved at the Bath Centre for Supervision and Team Development.
For more information please contact the Training Programme Directors.