DESCRIPTION OF PLACEMENT:
Specialist Psychotherapy Service for North Cumbria which covers a large geographical catchment area, serving dispersed rural populations as well as more densely populated urban areas. The department undertakes out-patient psychotherapy in a variety of treatment modalities, and is also pioneering a day-patient Therapeutic Community facility (piloted for the DH and NIMHE NW as part of the National Programme for the Development of Services for People with Personality Disorders).
Out-patient services: individual and group analytic, psychodynamic, systemic, and solution-focused therapies.
Itinerant Therapeutic Community services:
-structured day-hospital programme 2days/wk including formal small-groups, community meetings and art therapies
-24-hr access to community-member support via a dedicated service-user led website
-outreach work to improve engagement and facilitate transition into/out of the community.

CORE PLACEMENT: No
(Specialist placement approved for General Adult training)

ROLE OF TRAINEE:
Active role as a member of the clinical team, participating fully in weekly referral/allocation meetings, and initially joining other team-members for new patient assessments before undertaking these individually. Over the 12 months it is envisaged that the trainee will take on their own case-load, including a number of individual long-cases and family/couple cases, in addition to working as a generic therapist at the therapeutic community one day per week.
In addition to educational supervision, the trainee will attend weekly clinical supervision and also the therapeutic community supervision groups with other team members. The trainee will be encouraged to reflect on internal and dynamic processes in their own and others’ cases, thereby additionally fostering skills in supervising others.

EXAMPLE SPR TIMETABLE:

ON CALL: 1:10 always with Consultant supervision

SAFETY AND INDUCTION: Trust breakaway training provided on induction, departmental lone-worker policy and orientation provided on arrival. Mobile phone for on-call work available from General Adult services.

FACILITIES:
SpR has own office and computer, departmental secretarial support, and 24 hour access to the Hospital library.
For trainees living too far to commute, single bedroom accommodation can be provided in the recently refurbished doctor’s residence on the hospital site (with shared kitchen, living room and bathroom). Funding for this is authorised by the Directorate.

SUPERVISION: weekly supervision of clinical cases and therapeutic community work, and 1hr educational supervision. Regular review of learning objectives and ongoing appraisal. If general psychiatry supervision for on-call work is required following the on-call period, this will be available from a general adult trainer.

TEACHING/ACADEMIC EXPERIENCE:
Weekly psychiatry academic meetings including case-conferences and journal-clubs. Opportunity to undertake formal teaching sessions for SHOs and GP VTS trainees, eg interview skills training.
Weekly psychotherapy teaching for all junior medical staff.

AUDIT/RESEARCH OPPORTUNITIES:
Opportunities for both audit and research under Consultant supervision within the department, including involvement in assessing the local and national evaluations of the personality disorder pilot.

MANAGEMENT TRAINING:
The trainee will participate in weekly operational meetings and monthly audit meetings. Additionally, he or she will be invited to attend Directorate and Consultant meetings, Clinical Governance meetings, DH reviews of the pilot where appropriate, and to be involved in inter-agency liaison such as promoting or planning service changes.

ADDITIONAL EXPERIENCE AVAILABLE:
• undertaking joint community outreach visits and screening work.
• attending the department’s multi-agency training course on personality disorder.
• opportunities for teaching junior medical staff and multi-disciplinary staff within the department.
A full-time trainee will be a new addition to the team, so there will be additional opportunities for the trainee to be involved in further defining their role and training experience once in post.

DESCRIPTION OF ANY SPECIAL INTEREST SESSIONS OFFERED:
The department can support special interest sessions in all the psychotherapeutic modalities listed above with systemic therapy and therapeutic community work, in particular, lending themselves to ‘training on the job’ as a member of a multidisciplinary team. After a period working generically within a team it should be possible to take on a co-therapist role.