Placement Information Full placement

							                                                                             Appendix 7

                                                           Placement guidelines
                                                      for work with older people

Overview of placement requirements
Since no two placements with older people will offer the same clinical experience it follows
that placements will vary with the setting, the supervisor's areas of expertise and the trainee's
experience and needs. However, some of the basic areas of experience that will usually be
met by this placement include:

   assessment and interventions of both functional and organic problems
   direct work with elderly people and indirect work with families and other carers
   experience which helps the trainee understand the organisational and legislative context
    of services for older adults
   experience of liaison with statutory and non-statutory agencies

The following guidelines, which expand on this basic outline, are intended to provide a more
detailed framework for the basic minimum content of this placement.

Expected caseload
Trainees will usually undertake at least 6 to 8 ongoing, substantive pieces of clinical work at
any one time. While it is important that trainees see a reasonable number of cases for direct
work, some of these "pieces" of work could be indirect work with staff or carers, or service-
related research. It is desirable for the trainee to see as many cases as possible from
assessment through to termination.

Observation and monitoring
Most trainees need to begin by observing their supervisors, and then moving progressively to
more independent work. The speed with which this is done will vary according to the
experience and capability of the trainee. It is usually helpful to move through clear phases of
a) trainee watches supervisor b) trainee and supervisor work together c) supervisor watches
trainee. This pattern is easier to follow when conducting assessments.

Observation should be seen as a routine part of training, despite the fact that being observed
can sometimes be experienced as uncomfortable (by trainees and supervisors).

It is worth noting that observation need not be "live". Sessions can be taped, and there is
particular value in trainees selecting portions of the session for detailed review within
supervision.
Template for the contract

Basic details
 Supervisor:                                    Trainee:

 Start date:                                    End date:

 Supervision day and time:
 Date for Mid-Placement Review:



Plans for induction and orientation
Consider the trainee’s prior experience, competencies, interests. What arrangements will be
made for orientation to the service?

Plans for modelling by supervisor and observation of trainee
The aim should be to agree on opportunities for modelling (observation of the supervisor and
professional colleagues conducting clinical work)

How will the supervisor observe the trainee? (e.g. participation in joint assessments, formal
observation of the trainee, taping)


Direct case experience – type of presentations
Essential 1: patients presenting with functional disorders. It is desirable that they see a range
of patients (both male and female), ranging in age from the elderly (65 - 74) to the very
elderly (85+,) presenting with a wide variety of functional disorders, including depression,
anxiety and inappropriate behaviour.

Essential 2: patients with dementia. It is desirable that they see a variety of patients ranging
from those with mild memory impairment through those with a moderate focal impairment,
e.g. dysphasia, visual agnosia, to those with a global cognitive impairment.

Essential 3: patients with adjustment problems consequent on the psychological and physical
events common in this age group, e.g. retirement, stroke, disability.

Service Context and delivery

Essential 1: direct clinical work with elderly patients. It is desirable that this work takes place
in a variety of settings, including the patient's own home.

Essential 2: indirect work with staff, families and other carers. It is desirable that indirect
work with staff takes place in more than one setting (e.g. day centre, long stay hospital,
residential home) and with staff from different disciplines (e.g. nursing, social work, health
visiting, occupational therapy).
Assessment skills
Developing clinical interviewing skills and building rapport with older people requires basic
knowledge of the range of physical problems older people commonly have to contend with,
e.g. heart disease, respiratory problems, arthritis and other mobility difficulties, etc., as well
as impairments of sight and hearing. In addition, it requires an awareness of social problems
such as poor housing, financial constraints and social isolation.

The person's previous life experience, experience of loss and former coping strategies, both
cognitive and behavioural, must also be built into the assessment procedure.

Essential 1: In order to conduct effective psychological care the trainee should be able to
conduct a holistic assessment of the person's current situation (including physical,
environmental, social and psychological domains) and be aware of the potential interaction
between these different variables.

Essential 2: Trainees need to acquire knowledge in and experience of using a range of formal
assessment procedures specifically designed for the elderly including cognitive and behaviour
analysis.

Intervention skills
Essential 1: Trainees should have an appreciation of the wide range of psychological
interventions and the ways that these are adapted for work with older people (e.g. therapies,
interviewing and assessment techniques).

Essential 2: Trainees should gain knowledge of psychological therapies designed for use with
older people.

Desirable 1: Trainees should have experience of designing individual care plans with realistic
but objective goals and planned interventions. This experience can be gained either in direct
work with the patient or in indirect work with staff, relatives or other carers.

Desirable 2: Trainees should gain experience of group interventions designed for older
people and/or their carers (e.g. reality orientation, reminiscence therapy, task-orientated staff
group, staff support group, relatives support group).



Experience of the organisation
Essential 1: Trainees should gain an understanding of the potential contribution that Clinical
Psychologists can make within the wider service provision of both the Health Service and the
Social Services, including their input to service planning.

Essential 2: Trainees should gain experience of working alongside and together with other
professionals and develop an appreciation of their responsibilities, problems and concerns.

Essential 3: Trainees should gain experience of provision for older people based in the
voluntary sector.
Teaching
Wherever possible trainees should be encouraged to make clinical or academic presentations
to colleagues or to undertake formal teaching. It is worth specifying these opportunities.

Expectations re: report writing and correspondence
The aim should be to specify your expectations about the ways in which trainees document
their work, whether it be in clinical notes, clinical reports or letters to referrers.

It is general policy for all letters to be countersigned by the supervisor.

In order to avoid any misrepresentation (and in line with recommendations of the DCP Ethics
Committee) trainees should always sign themselves as “Trainee Clinical Psychologist”.



Arrangements for ending the placement: What procedures will be followed?
 What are the expectations regarding arrangements for handing over clients, finishing reports
   (etc)
 There should be a formal End of Placement Review before the end of the placement at which
   the completed Supervisors Evaluation form and Trainee Evaluation of placement form are
   discussed.

Both trainee and supervisor should sign the contract and return a copy to college within the
first four weeks of the start of the placement.


                                                                              Revision November 2007