HEALTH EDUCATION THAMES VALLEY - HIGHER TRAINING SCHEME FOR DUAL CERTIFICATION IN

GENERAL ADULT PSYCHIATRY AND MEDICAL PSYCHOTHERAPY (ST 4-8)

Contents

Page

A. About Health Education England - Thames Valley ………………… 1

B. General Information on the Integrated Dual General Adult Psychiatry and Medical Psychotherapy Training Programme(Advanced) ……. 2

C. Rotations and the Employing Trusts ………………………………….. 4

D. Components of Training ……………………………… ……………….. 12

E. Responsibilities and Opportunities ………………………….. 15

F. Main Conditions of Service …………………………………………….. 16

A. About Health Education England - Thames ValleyHealth Education England – Thames Valley office covers Berkshire, Buckinghamshire and Oxfordshire. Our vision is to ensure the delivery of effective workforce planning and excellent education and training to develop a highly capable, flexible and motivated workforce that delivers improvements in health for the population of Thames Valley. HEE Thames Valley is responsible for the training of around 2000 Foundation and Specialty trainees.

HEE Thames Valley is a relatively small organisation with a defined geographical area which serves as a single unit of application. In the majority of cases successful candidates will be asked to preference their choice of location for the first year. Future placements will usually be based on individual training and educational needs.

Please note that applications are to the Health Education England - Thames Valley as a whole. This may mean that you may be allocated to any geographic location within this area, depending on training needs.

Trainees should be able to travel effectively and efficiently to all Trust and associated sites for work purposes.

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B. General Information on the Integrated Dual General Adult Psychiatry and Medical Psychotherapy Training Programme (Advanced)

The General Adult and Medical Psychotherapy training programme is a 5-year programme starting at ST4. During this time the trainee's work will be monitored for satisfactory progress and subject to an annual review of competence progression (ARCP). Progression on the programme will be dependent upon a successful outcome at these reviews.

The placements on this rotation have been approved for Specialist Training by the Royal College of Psychiatry. The StR posts attract National Training Numbers and provide training towards separate Certificates of Completion of Training (CCTs) in General Adult Psychiatry and Medical Psychotherapy.

On successful completion of the programme, trainees will be eligible to be placed on the Medical Register as specialists in both Medical Psychotherapy and General Adult Psychiatry, and apply for specialist posts as a "Consultant Psychiatrist in Medical Psychotherapy" or a “Consultant Psychiatrist in General Adult (In-patients or Community) Psychiatry”.

There is no provision for endorsements (eg Substance misuse, Rehabilitation or Liaison) as there is not enough time for trainees to spend the required amount of time in the sub-specialties for an endorsement to be recorded, although it is possible to obtain special interest experience in these areas.

The Postgraduate Dean has confirmed that this post has the necessary educational and staffing approvals.

Although this is a new post in HEETV, integrated dual training in General Adult Psychiatry and Medical Psychotherapy has been running across different regions of the UK for several years and trainees who obtained CCTs have succeeded in being appointed to consultant posts in either of the specialities. Currently there are a number of consultant posts nationally where both CCTs are required as the posts are split between the two specialties.

Essential Information

Job title Specialty Registrar ST4 – 8

Specialty General Adult Psychiatry and Medical Psychotherapy

Location Health Education England - Thames Valley

Employers Oxford Health NHS Foundation TrustBerkshire Healthcare NHS Foundation Trust

Salary scale MN25

Annual leave entitlement At Pts 0-2 of MN25: 5 weeksAt Pt 3 and above: 6 weeks

Standard hours 40

Out-of-hours duties Vary with placement

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The Integrated Dual Training Programme runs over 5 years and in each year the trainees spend time in the same week in both of the specialities.

For full-time trainees the week is divided as follows:

ST4 and ST53 days a week (60% of WTE) in GA Psychiatry and 2 days a week (40% of WTE) in Psychotherapy;

ST6 to ST8 2 days a week (40% of WTE) in GA Psychiatry and 3 days a week (60% of WTE) in Psychotherapy

Less than full time (LTFT) Trainees spend the same proportion (60% / 40%) of their actual working time at each training (ST) level.

Each year the trainee has two Clinical Supervisors (CSs) - one from each speciality - and one Educational Supervisor (ES) who will be from the Speciality in which they spend the majority of time – ie in ST4 & ST5 the ES is a General Adult Psychiatrist and in ST6 to ST7 the ES is a Medical Psychotherapist.

At the end of each year the Higher Trainee has one joint ARCP panel consisting of representatives from both specialties and progression to the next level is contingent on fulfilling competencies in both specialties. WPBAs should be spread across both specialties and should reflect the time spent in each specialty (40% / 60% split). Trainees will do on-calls in General Psychiatry throughout the 5 years and the out-of-hours work pattern will depend on the Trust where they are placed for their General Adult component.

Although the total amount of time spent in each specialty is the same as in the sequential training model (two years in General Adult Psychiatry followed by three years in Medical Psychotherapy) the integrated model ensures that trainees spread each component over the five years with more gradual progression and more time to consolidate knowledge, skills and attitudes. Another advantage to parallel progression in both specialities is that it facilitates links between the competencies from both specialities – the simultaneous development of psychotherapeutically -informed psychiatrists and psychiatrically-competent psychotherapists. At the end of the programme the trainees are up-to-date in both specialties and used to applying psychotherapy skills in day-to-day psychiatry work as well as acute psychiatric skills in psychotherapy setting. Also, it provides a longer period of development within training therapy as it is spread over five years rather than usual three.

The training in psychological therapies offered by the HEE Thames Valley programme is tailored to the contemporary needs of the NHS. The programme is broadly psychodynamic in its approach, but there is a strong emphasis on NHS services needing to offer a variety of therapies in a broad range of settings and formats. There are good training opportunities in cognitive, behavioural, systemic and other therapies, taught in a way which integrates them into the overall scheme.

This is the first, and currently the only integrated dual training post in General Adult Psychiatry and Medical Psychotherapy in HEETV although it is envisaged that there will be more integrated dual trainees in years to come.

Currently there are 3 single-specialty Psychotherapy StRs based in Oxford Health and 26 General Adult / Old Age trainees based in community and hospital settings in Oxfordshire, Buckinghamshire and Berkshire. Trainees move between the bases to accommodate training

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needs. In the Psychotherapy component of the training such moves do not take place annually as part of a rotation, but are organised individually. In General Psychiatry trainees usually move to different bases on an annual basis to ensure that all components of the curriculum are covered. Trainees can also spend parts of their week in different services around the area to gain specialist experience, by agreement with the ES and Training Programme Director (TPD).

The TPD for the Psychotherapy component is Dr Chris Newrith (Aylesbury) and TPD for GA Psychiatry is Dr Farooq Ahmad (Reading). The trainee, clinical supervisor, educational supervisor and programme director liaise and meet at the beginning of the year (and if necessary periodically throughout the year) to ensure that educational objectives are being met.

Trainees will meet their CSs weekly for supervision. They will meet their ES at least every three months to review the training and plan details of the programme.

C. Rotations and the Employing Trusts

1.General Adult Psychiatry Component

Oxford Health NHS Foundation Trusthttp://www.oxfordhealth.nhs.uk/

Oxford Health provides mental health and community services across Oxfordshire, Buckinghamshire, Swindon, Bath and North East Somerset and Wiltshire. The Thames Valley Forensic Mental Health Service based in Oxford provides a forensic service to Oxford, Bucks and Berkshire and Milton Keynes. Trainees on the programme may work at any of the following hospital sites but in addition community services are delivered from a number of community sites and bases (not listed here):

Littlemore Mental Health Centre, OxfordThis is the site of one 22-bed general psychiatric male ward (Phoenix ward), the Intensive Psychiatric Care Unit (Ashurst ward) and is also the site for the various forensic services. A number of in-patient services are provided in separate units, ie Oxford Clinic (medium secure), Wenric House (low secure), Thames House (a service for women) and Lambourn House pre-discharge unit. There are opportunities for general adult trainees to spend special interest sessions in the forensic service. There is a separate rotational higher training scheme in Forensic Psychiatry.

Warneford Hospital, OxfordA general psychiatric hospital with three acute admission wards. It is also the site of the Early Intervention Service, an out-patient department, a day hospital and an occupational therapy department. There is an excellent library and the Clinical Psychology Department, the Psychological therapies Department and the Highfield Family & Adolescent Unit are on site. The University Department is on this site as well as a number of research facilities.

Whiteleaf Centre, AylesburyThis is a purpose-built general psychiatric unit which opened in 2015. It has two acute single-sex wards, (Ruby and Sapphire Wards), one older adult mixed ward (Amber Ward)

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and a rehabilitation ward (Opal Ward). The Chiltern Adult Mental Health team is based here and runs its Day Hospital from here, as are Psychological Services, the Buckinghamshire Eating Disorder Service, Older Adult CMHT and Buckinghamshire Early Intervention in Psychosis Service. It is also a base for the North Buckinghamshire Recovery College, some of the Healthy Minds (IAPT) Service, the ASD and ADHD Services and the Perinatal Service. The Buckinghamshire Complex Needs Service (CNS) has its base in the Wing Unit on site.

John Hampden Unit, AylesburyA progressive, well-established, community-oriented department of old-age psychiatry, serving Aylesbury Vale and West Hertfordshire and located on the Stoke Mandeville Hospital site. It is committed to a flexible approach to the assessment and management of patients over 65 years of age with mental health difficulties, and offers wide-ranging therapeutic opportunities. There are close links with the physicians and surgeons at Stoke Mandeville Hospital, which are mutually valued.

The Fulbrook Centre, Churchill Hospital, OxfordA general hospital with two in-patient assessment and treatment units for older adults.

The Fiennes Centre, BanburyA 17-bed in-patient assessment and treatment unit for older adults.

Malborough House, Milton KeynesA medium secure forensic unit.

Berkshire Healthcare NHS Foundation Trusthttp://www.berkshirehealthcare.nhs.uk/

Berkshire Healthcare NHS Foundation Trust provides mental health and community services to all ages across Berkshire. Services are organized across six localities alongside the unitary authorities (Reading, Wokingham, Newbury, Slough, Windsor and Maidenhead and Bracknell). Having redesigned mental health services in 2011 under a programme of Next Generation Care, the Trust has moved all in-patient facilities to one base which is purpose-built Prospect Park Hospital in Reading. In addition to re-organization of services around the localities, the re-design resulted in a single access service for the county (Common Point of Entry 8am-8pm), a service for acute care (CRHTT which is 24/7 service) and local community teams (Care Pathways, previously known as CMHT’s). Trainees on the programme may work at any of the following hospital sites but in addition community services are delivered from a number of community sites and bases, not listed here.

Prospect Park Hospital, ReadingProspect Park Hospital is a purpose-built general psychiatric hospital, opened in 2003, that provides in-patient services for the whole of the Berkshire population of approximately one million; a Learning Disability short-term assessment and treatment service (Campion) and a PICU (Sorrell) for the whole of Berkshire. There are out-patient facilities on site and it is also the site of the Reading Care Pathways team, and the CRHTT West hub and the ECT suite. It has excellent training, office and library facilities and also the offices for the Medical Education Administrator and Director of Medical Education.

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Royal Berkshire Hospital ReadingThe RBH is one of the largest general hospital foundation trusts in the country providing acute medical and surgical services to the west of Berkshire and specialist service to the county. The BHFT jointly with RBH provide Psychological Medicine Services for A&E and rest of the acute hospital, RBH. Trainees choosing a special interest in Liaison psychiatry will have an honorary contract enabling them work in this setting.

List of General Adult Psychiatry Placements:

Specialty Location Clinical Supervisor

OxfordshireGeneral adult Warneford Hospital, Oxford Alvaro BarreraGeneral adult Warneford Hospital, Oxford Smita PanditGeneral adult Warneford Hospital, Oxford Simon HampsonGeneral adult Warneford Hospital, Oxford Rob ChaplinGeneral adult Warneford Hospital, Oxford Digby QuestedGeneral adult Warneford Hospital, Oxford Olga TsatalouGeneral adult Warneford Hospital, Oxford Andrew MolodynskiGeneral adult Warneford Hospital, Oxford Julie ChalmersEarly Intervention Warneford Hospital, Oxford Belinda LennoxLiaison John Radcliffe Hospital, Oxford Bart SheehanLiaison John Radcliffe Hospital, Oxford Luke Solomons

BuckinghamshireGeneral adult Whiteleaf Centre, Aylesbury, Bucks Sue ThomasGeneral adult Whiteleaf Centre, Aylesbury, Bucks Sophie JohnsonGeneral adult Whiteleaf Centre, Aylesbury, Bucks David Welchew*Rehabilitation Whiteleaf Centre, Aylesbury, Bucks Karen DaunceyGeneral Adult Valley Centre, High Wycombe Fiona PharoahGeneral Adult Valley Centre, High Wycombe Evangelos VassosLiaison Stoke Mandeville Hospital, Aylesbury Pavan Joshi

BerkshireGeneral adult Slough community/ Prospect Park Hospital,

ReadingJavaid Sultan

General adult Reading community/ Prospect Park Hospital, Reading

Farooq Ahmad

General adult Newbury community/ Prospect Park Hospital, Reading

Farzana Abid

General adult Churchill House, Bracknell community/ Prospect Park Hospital

Sohan Derasari

General Adult The Old Forge, Wokingham community/ Prospect Park Hospital

Garyfallia Fountoulaki

Liaison Royal Berkshire Hospital, Reading Matt LoweLiaison Royal Berkshire Hospital, Reading Babu Mani

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2. Medical Psychotherapy component

Oxford Health NHS Foundation Trusthttp://www.oxfordhealth.nhs.uk/

Oxford Health Foundation Trust has three Clinical Directorates: the Child and Families Directorate, the Older People Directorate and the Adult Directorate. Psychological Services sits within the Adult Directorate.

At the time of writing, provision of psychological therapies is being re-shaped under the Psychological Therapies Integration Project. This will embed psychological therapists within the Adult Mental Health Teams, offering support and supervision as well as continuing to offer therapies in a range of modalities. Psychological Services consists of Consultant Psychiatrists in Psychotherapy, Psychologists and Psychotherapists providing a range of time-limited individual and group therapies and psychoeducational courses including Psychodynamic Psychotherapy, Cognitive Behaviour Therapy, Cognitive Analytic Therapy, Interpersonal Therapy, Mindfulness-Based CBT, Mentalization-Based Psychoeducational classes and Group Analysis.

Psychological Services also provides supervision and support, both within the service and to other services, and is involved in training of junior medical staff and staff from other modalities.

The specialist trainee will have access to supervision in a range of modalities and will have the opportunity to work in the Complex Needs Service. They will also have opportunities to be involved in working with other services, supervising, training and gaining management experience.

Berkshire Healthcare NHS Foundation Trusthttp://www.berkshirehealthcare.nhs.uk/

Berkshire Healthcare NHS Trust was formed on 1 April 2001. It is responsible for delivering mental health and learning disability services in the towns of Ascot, Bracknell, Maidenhead, Slough, Windsor, Reading, Henley, Newbury, Wokingham, Hungerford and the surrounding areas. The in-patient base is currently at Prospect Park Hospital.

Psychotherapy in Berkshire is integrated into CMHTs in the form of Integrated Psychological Therapies (IPT) teams. There are six localities (six CMHTs with corresponding IPT teams): Slough; Bracknell; Windsor, Ascot and Maidenhead (WAM); Wokingham; Reading and Newbury. Each IPT consists of psychotherapists and clinical or counselling psychologists that deliver a range of therapies: group therapies (CBT, psycho-educational and dynamic), Cognitive Analytic Therapy, Dynamic Interpersonal Therapy, Psychodynamic/Psychoanalytic Psychotherapy, CBT, Compassion Focused Therapy, Acceptance and Commitment Therapy, Schema Therapy, Integrated/Art Therapy and others. There are two consultants in medical psychotherapy: a part-time consultant in Slough and a full-time consultant in Reading and WAM.

The consultant based in Reading and WAM supports non-medical psychotherapists, has a role of Psychotherapy Tutor for Berkshire and runs a consultation service for complex cases alongside the clinical work.

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In Slough, the consultant medical psychotherapist leads, together with a clinical psychologist, successful ASSiST and EMBRACE services, mainly aimed at service users diagnosed with a personality disorder and requiring more intensive work.

There is a personality disorder service called IMPACTT that runs across the county and offers MBT and DBT.

Consultant psychiatrists in psychotherapy in HEETV

1. OXFORDDr Melanie Bowden Consultant Psychiatrist in Psychotherapy, UKCP (Southern

Counties Psychotherapy)

Dr Steve Pearce Consultant Psychiatrist in Psychotherapy;Honorary Senior Clinical Lecturer in Psychotherapy, University ofOxford; Member of the Institute of Group Analysis

Dr Gerti Stegen Consultant Psychiatrist in Psychotherapy, UKCP (Southern Counties Psychotherapy)

2. BUCKINGHAMSHIRE: HIGH WYCOMBE and AYLESBURY Dr Chris Newrith Consultant Psychiatrist in Psychotherapy

Dr Stella Newrith Consultant Psychiatrist in Psychotherapy

3. BERKSHIRE: READING, WAM & SLOUGHDr Alex Pavlovic Consultant Psychiatrist in Psychotherapy

Dr Rex Haigh Consultant Psychiatrist in Psychotherapy

4. MILTON KEYNES, NORTH BUCKINGHAMSHIREDr Farouk Okhai Consultant Psychotherapist

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Training Opportunities in Psychotherapy

1. OXFORDSHIRE1.1 Psychological Services Department, Oxford Consultant Psychiatrists in Psychotherapy: Dr Melanie Bowden; Dr Gerti Stegen.

The Warneford Hospital is the main clinical and training base in Oxford for psychotherapy specialist trainees, and also offers placements for specialist trainees in Adult Psychiatry and core trainees from the Thames Valley Core Psychiatry Training Scheme. The medical staff of the Department work in conjunction with non-medical specialists in psychotherapy to provide a broad range of out-patient psychotherapeutic treatments:

Short- and long-term individual dynamic psychotherapy Cognitive analytic therapy Cognitive behavioural therapy Group analytic therapy Psychodrama Systemic family therapy

The department also provides substantial teaching and training activities for medical students, trainees and career grade staff in psychiatry and other mental health professions, and offers a consultative service to colleagues in psychiatry, general practice and other disciplines. Much of the clinical work of the Department is carried out, under supervision, by trainees.

1.2 Complex Needs Service Consultant Psychiatrist in Psychotherapy: Dr Steve Pearce

A pilot day treatment service for patients with severe personality disorder was opened in 2003, with a multidisciplinary staff team from the Psychotherapy Department, wards and CMHTs. In 2004 the Trust was funded to develop (in conjunction with other agencies and developments across the Thames Valley) a full multi-tiered personality disorder service comprising a therapeutic community day programme, a number of intensive out-patient satellite services in market towns in the county, and an assertive engagement community service. In 2016 the Complex Needs Services in Oxfordshire and Buckinghamshire were integrated in to a single trust-wide service. There is also an education and training resource for the Thames Valley. Service information: www.tva2i.net and www.psox.org/ocns

1.3 Isis Centre Oxford The Isis Centre is a psychodynamic counselling service which operates from shop-front premises in central Oxford. The staff offer individual, couple and group therapies and also undertake a broad range of consultative and supervisory work with NHS and other agencies. The Isis Centre has developed strong links with counsellors in general practice settings, and runs a Diploma Course in Psychodynamic Supervision with Oxford University. The Centre is directly involved in the management of three primary care counselling and psychology services for several areas of Oxfordshire, and a service for postgraduate medical trainees for HEE Thames Valley. It also supports innovative programmes for counselling at a Surestart project in a deprived area of East Oxford, and a black / ethnic minority development programme.

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1.4 Oxford University Student Counselling Service Head of Counselling: Ms Elsa BellConsultant Psychiatrist: Dr Phil Davison

StRs have access to training placements at this student counselling service, which offers both psychodynamic and cognitive behavioural counselling / therapy in a Higher Education setting.

1.5 Oxford Adult Eating Disorders ServiceConsultant Psychiatrist: Dr Rebecca Park

Training opportunities are available to StRs in this service, which provides out-patient, day and in-patient treatment programmes which include CBT and systemic family therapy.

2. BERKSHIRE

2.1 Integrated Psychotherapy Services, County-wide

Consultant Psychiatrist in Psychotherapy: Dr Alex Pavlovic

There is psychotherapy within Integrated Psychotherapy Therapies services at WAM, Slough, Wokingham, Bracknell, Reading and Newbury. It provides a range of psychodynamic consultation and treatment, including CAT, psychodynamic psychotherapy and group therapy. It is closely integrated with mental health services in taking tertiary referrals, and aiming to respond flexibly to service needs. A well-established weekly multidisciplinary psychotherapy training programme (for core psychiatry and other trainees) is held at Prospect Park Hospital, and StRs can participate in organising this.

2.2 ASiSST and EMBRACE

Consultant Psychiatrist in Psychotherapy: Dr Rex Haigh

The ASSiST service uses an ‘assertive engagement’ process to provide a psychotherapeutic pathway for those who are have spent a substantial length of time in hospital with non-psychotic conditions. The EMBRACE group is mainly aimed at service users diagnosed with a personality disorder and requiring more intensive work, or a relational approach, than the locality services have the resources to provide. This involves a modified therapeutic community style of work, with a weekly ‘hub group’ on Tuesdays and numerous other weekly groups and activities, including mindfulness, greencare and others.

Higher trainees would be supervised by Professor Rex Haigh and be able to do any one or more of the following activities: (1) join the ASSiST service and become involved in assessments (usually on acute wards and in hospital-based groups) (2) psychotherapeutic engagement sessions (1 - 3 times weekly for usually up to 12 weeks)(3) become part of the weekly EMBRACE group, the hub of the community service (requires regular Tuesday attendance 11.30am - 3pm) (4) join other weekly group activities (for example the Thursday greencare group, 9.30am – 4.30pm).

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Group and individual supervision would be available on Monday, Tuesday or Thursday afternoons. An StR placement would need to be between 1 and 4 sessions per week, for a minimum of six months.

2.3 Psychology Department, Prospect Park Hospital The West Berkshire Psychology Department is staffed by clinical psychologists, and provides a variety of services including specific cognitive and behavioural interventions. There is an eating disorder service with psychotherapy input, and a jointly-managed trauma service. The psychologists also provide liaison services in general hospital and general practice settings. StRs are encouraged to seek experience in this department, which could form a useful part of their training programme.

3. BUCKINGHAMSHIRE

3.1 Psychological Services Department, Aylesbury and High Wycombe

Consultant Psychiatrist in Psychotherapy: Dr Stella Newrith

The Psychological Services department is based at The Whiteleaf Centre in Aylesbury and at the Valley Centre in High Wycombe. There is a 0.6WTE Consultant Psychiatrist in Psychotherapy who provides joint clinical leadership with a Band 8d Clinical Psychologist. Each locality team employs approximately fifteen individuals with a range of experience and working in a range of modalities (see above).

3.2 Complex Needs Service Consultant Psychiatrist in Psychotherapy: Dr Chris Newrith

In 2006 a day treatment service for patients with severe personality disorder was opened with a three days per week therapeutic community day programme in Aylesbury, a two half-days per week service in High Wycombe, and an assertive engagement community service. In 2016 the Complex Needs Services in Oxfordshire and Buckinghamshire were integrated into a single trust-wide service. There is a long tradition of providing high quality training programmes for both medical and non-medical trainees within the service.

4. MILTON KEYNES Consultant Psychotherapist: Dr Farouk Ohaki

The Milton Keynes service has a general hospital base and is developing a new service. There is scope for trainees to participate in this.

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D. Components of Training

General Adult Psychiatry Component1. In-patient post – minimum of 6 months WTE

2. Out-patient (CMHT) posts – minimum of 12 months WTE

3. Special interest placements:

a. Early interventionb. Liaisonc. Rehabilitation/Assertive outreachd. Substance misusee. Eating disorders

4. On-call component – participation on the on-call rota for the whole five years of training is available at some of the sites. There is extensive opportunity to get experience in emergency psychiatry across the school.

5. Both Trusts have established ECT departments and are approved by ECTAS. There are opportunities for special interest and research in ECT at both Trusts.

Medical Psychotherapy Component

1. Treatment

The range of available supervised therapies includes:1.1 Individual psychodynamic psychotherapy1.2 Group analysis1.3 Therapeutic community work1.4 Mentalisation-based therapy and general management with people suffering from

personality disorder1.5 Mentalisation-based psychoeducational classes1.6 Mindfulness-Based Cognitive Therapy1.7 individual Cognitive Behavioural Therapy (CBT)1.8 Group CBT (Emotional Regulation Groups)1.9 Cognitive analytic therapy (CAT)1.10 Systemic family therapy1.11 Interpersonal Therapy1.10 DIT1.11 EMDR

The programme is arranged so that the specialist treatment approach in which trainees will ‘major’ is psychodynamic, with an emphasis throughout the training on obtaining extensive clinical experience and on evidence-based treatments. To meet the specified local training requirements for a psychotherapy CCT as well as the Royal College of Psychiatrists’ requirements, StRs will need to undertake 700 hours of supervised psychodynamic psychotherapy over the training period and100 hours each of cognitive behavioural therapy (CBT) and systemic family therapy (SFT). Clinical experience will be gained in a range of settings. The Online Portfolio is used in the annual ARCP process.

We encourage StRs to develop a special interest and specialist expertise in a specific area. Possible areas which could be supported locally include personality disorder, therapeutic environments and in-patient liaison, medical education, psychosis and general hospital/psychosomatic presentations.

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2. Assessment of patients for psychological treatment

StRs will participate in psychodynamic and brokerage assessments undertaken by consultant Psychiatrists in Psychotherapy before proceeding to undertake their own weekly assessment interviews with patients. This work will be supervised, and will afford the opportunity to learn about the indications for, and goals of, different psychological treatments. Although a minimum of 40 assessments is required for CCT, this total will be substantially exceeded.

3. Balint and other group workThere are opportunities to co-lead Balint groups or Work Discussion Groups and conduct reflective staff groups in psychiatric wards and other settings, and to obtain experience of many different models of therapy groups (see above). Some of the training services have staff sensitivity groups, in which specialist trainees will be expected to participate.

4. Consultation

There is an emphasis on consultative work with other psychiatric teams, general hospital units, general practices or other appropriate agencies. StRs will liaise with a specific community mental health team for the duration of their training to facilitate this aspect of training.

5. The academic component of training

5.1 Joint Psychotherapy Academic ProgrammeTo achieve a CCT, 400 hours of academic study is required, of which 150 hours must be in didactic teaching. Previously the multidisciplinary Southern Counties Psychotherapy training, organised by NHS psychotherapists in the region, met these requirements for CCT trainees but as of October 2014 this has been replaced by an Academic programme run by West Midlands and HEE Thames Valley Medical Psychotherapists. This programme has been cited as an example of good practice in the GMC Small Specialties Review. The regular course meetings take place in three annual terms of eight weeks on Wednesday afternoons. These involve lectures, clinical seminars, academic seminars, and a students’ reflective peer group.

5.2 Other academic events Specialist trainees will also be expected to participate in other academic meetings in Oxford such as those which are organised primarily for them to study particular areas of interest in more depth. These include reading seminars, case presentations, journal clubs, research workshops and other academic presentations. The conferences, seminars and workshops which are held by the different departments and services around the Deanery are also recommended.

The Oxford University Department of Psychiatry organises a weekly programme of lectures, seminars and research meetings that the StR will be encouraged to attend.

Other relevant events, such as those organised by the Royal College of Psychiatrists, the Society for Psychotherapy Research and other organisations, can also be valuable components of training, and attendance is encouraged. One-year introductory courses in group work and in family therapy are available in Oxford, providing the essential introductory components for advanced courses at the Institutes of Group Analysis and Family Therapy in London. Study leave and expenses may be available for attendance at these training activities.

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6. Teaching and supervision

Specialist trainees contribute to the teaching programmes of the services and departments in which they work. In Oxford, this can include instruction in the basic principles of psychotherapy for core psychiatry trainees and/or medical students, the Oxford Postgraduate Psychiatry Course for core trainees, and teaching in the principles and practice of psychodynamic psychotherapy for clinical psychology trainees. StRs can also obtain experience of supervising core psychiatry trainees who are carrying out individual psychodynamic psychotherapy as part of their general professional training, and other mental health professionals who are undertaking introductory clinical work in psychotherapy.

7. Personal therapy

The appointee will be expected to undergo personal therapy throughout the five-year programme. This will be at a minimum frequency of twice weekly with a suitably qualified therapist, or equivalent if agreed with the ES and TPD. Members of the Higher Specialist Training committee can help advise StRs about personal therapy, if required. Personal therapy is considered an essential training expense.

E. Responsibilities and Opportunities

1. Clinical duties

The clinical duties in each placement will vary according to the type of service being delivered by the consultant but across the whole programme a wide range of clinical experience is available. The out-of-hours service provision is being reviewed in both Trusts and the opportunity to be on an on-call rota varies between trusts and may change. StRs are required to maintain familiarity with the Mental Health Act and obtain approval under Section 12 (2).

2. Management and administrative skills

There are opportunities both in each post and across the programme. There are opportunities to represent the junior staff on several committees at Trust and Deanery level. HEETV is committed to providing management training for specialist trainees in the course of their rotations.

3. TeachingIn both Trusts there are well established weekly academic programmes attended by trainees and medical staff, in protected time. There are many additional opportunities to attend other postgraduate meetings in the University Department in Oxford. Both Trusts have excellent training departments with opportunities to participate in multi-professional training.

4. Teaching others

There are opportunities to teach medical students from Oxford and Southampton medical schools, foundation and core trainees from the Oxford deanery, and other professionals in multi-professional settings.

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5. Research and Audit Both the Oxford and Reading Psychotherapy Departments have ongoing audit projects to evaluate the clinical service provision. StRs will be expected to participate in these and will be required to undertake one or more special projects, for which academic supervision is funded if undertaken as part of the SCP dissertation. There is access to computer facilities within the departments, and trainees are encouraged to become conversant with use of relevant IT in routine administration and research work.

There will be widespread opportunities to meet audit and research competencies. The Programme has close links with the University of Oxford Department of Psychiatry based at Warneford Hospital in Oxford. The University Department has wide research interests and a number of NHS consultants are honorary clinical lecturers who are active in research. As well as promoting world class research by 21 research groups the department has close links with clinical services and training programmes. Many trainees wishing to pursue academic psychiatry and research have taken time out of programme to pursue this successfully. Currently the psychiatry programmes also includes ACF and ACL trainees who apply through a different route but who rotate alongside their clinical trainee colleagues to ensure clinical competencies are achieved in the same way.

In Berkshire there are links to Reading University, including the Charlie Waller Institute of Evidence-Based Psychological Treatment. The Trust is part of the Mental Health Research Network (MHRN) and has an active research portfolio. Training and guidance for new researchers can be provided by the R&D department and trainees are actively encouraged to participate in research. There are two consultant research leads from whom trainees can also receive advice.

6. Administration

Specialist trainees will learn about the administration of a clinical service and training centre by contributing to the internal administrative organisation of the Psychotherapy Department in which they are based. They will also have opportunities to observe and participate in the management responsibilities of consultants in a wider context. All StRs are required to attend management training workshops held within Thames Valley, or equivalent events elsewhere.

F. Main Conditions of Service Appointments to this programme are subject to the Terms and Conditions of Service (TCS) for Hospital Medical and Dental Staff (England and Wales) applicable at the time of appointment. For further information please refer to NHS Employers:http://www.nhsemployers.org/your-workforce/pay-and-reward/medical-staff/doctors-and-dentiStRs-in-training/terms-and-conditions-contracts

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