The Matrix

A Guide to Delivering Evidence Based Psychological Therapies and Interventions in Scotland

 Scottish Government Home
Home Support for training and implementation Training Guidance

Training Guidance

Training Guidance

To improve access to high quality, effective psychological therapies and interventions we must focus training efforts and resources where they will have maximum impact on people who require services. Training and supervision, and skills development in both, are key to increasing the capacity of new staff and current workforce to deliver safe and effective interventions at the volume required to achieve timely access. 

In order to achieve outcomes similar to those described in the treatment literature, all training and supervision should replicate as far as possible those described in the research papers from which the evidence base is drawn, with clearly defined competences that are assessed, quality assurance, and ongoing supervisory support in practice. 

Common traps in training delivery include: selecting training that does not reflect best evidence, delivering training in a way that fails to develop competences or confidence in using them, or where the wider system is not aligned with application of competences in practice. NES Psychology recommends that the training is designed and delivered in line with Implementation Science principles to improve implementation. 

Implementation Drivers

Implementation drivers set out the visible infrastructure elements that are required for effective implementation. The components of implementation drivers are categorised into two categories:

  • competency drivers, which are systems for selecting the right staff, delivering training with clearly defined competences, coaching staff to embed skills in practice and assessing fidelity to the intervention, approach or practice

and

  • organisation drivers, which are systems for administration and data supports, business operations and partnerships that create an environment for successful implementation

Together, organisation drivers and competency drivers ensure the development of skilled staff, and  a strong organisation and system.  

Commissioning Quality Training

Training may be commissioned from an external body, accessed via a national provider, such as NES, or developed and delivered internally.  Factors which need to be considered in the commissioning of quality training include:

  • Clarity around the competences necessary for safe and effective delivery of each type of intervention or practice 
  • Benchmarking the training against the competences required, although this is not in itself sufficient to guarantee that trainees/staff will emerge as competent practitioners. 
  • The baseline knowledge and skills of the group targeted for training 
  • A curriculum designed and evaluated on sound educational principles 
  • Integral training components developing skills over time through supervised clinical practice or coaching as aligned with implementation science models
  • Ongoing quality assurance in practice and ongoing support for therapist wellbeing following training. 
  • Evidence that the relevant competences have been acquired by staff delivering the intervention/therapies through systematic assessment of knowledge and skills acquired during training. 
  • The knowledge, skills and experience of trainers to deliver training effectively. 

In the case of courses which aim to equip trainees to deliver psychological therapies and psychological interventions, it is the view of NES that 

  • Training pathways should include guidance on psychological models, competence frameworks for staff, supervision and clinical governance arrangements and assessments of competence.
  • Trainers should be properly trained in the therapy in question, and should have significant experience in delivering the intervention in practice.
  • Direct observation of practice (whether in-vivo, or by recorded practice samples) is an essential element of assessment of competence.
  • Use of competence frameworks/checklists to support practice development and provide feedback should be used wherever possible.
  • Support the delivery of the waiting times target, or other Scottish Government priority area, through building the skill and capacity within the NHS workforce to deliver evidence based psychological interventions.
  • Be based on the evidence summarised The Matrix guidance
  • Meet the needs of the local population served.
  • Include a range of different enhanced and specialist workforce to ensure capacity is built across the system by up-skilling multi-disciplinary groups.
  • Be provided through high quality education and training delivered by experts in their field.
  • Be designed using the principles of Implementation Science.
  • A framework is used to ensure the ongoing quality of education provision.

The Psychology Directorate provides a Quality Assurance Framework (https://www.nes.scot.nhs.uk/our-work/provision-of-psychological-interventions-and-therapies-guidance/#qualityassuranceframework4) for reviewing the quality of education and training in psychological therapies and interventions. Based on the principles of implementation science, the framework aims to provide standardised forms and tools for describing and assessing the overall quality of education programmes. Criteria are mapped and evidenced against the competence, leadership and organisational drivers that are essential to effective implementation. Working through the framework can provide an action plan for educational programmes to support ongoing improvement.

Training Pathways

Each psychological intervention that is recommended in the Matrix evidence tables has detailed information on training pathways (see the ‘explore the interventions section’) to support managers and staff making decisions about training in psychological therapies and interventions. The training options listed are intended to be indicative and are not exhaustive or exclusive. Managers and staff should ensure specific training courses will equip staff with the skills required to meet service needs and with appropriate ongoing supports for implementation in practice.

 

The NES Psychology directorate provides training in various interventions and therapies. Information on these options is included in the intervention summaries and further information can be found on the NES Psychology website.