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This study aims to improve the efficiency of the assessment process within a Step4 Psychological Therapies Service by identifying factors related to assessment non-attendance and service suitability for referred clients.

Referral and assessment information was accessed between October 2019 and March 2020 from Step4 routine service data, electronic client records where necessary and Step4 staff self-report questionnaires.

All clients offered an assessment during this time attended. Findings indicated several factors could influence service suitability in meeting client need. These included individual differences such as readiness to change, which was not necessarily identified at referral or prior to assessment, and potential systemic factors, such as the opt-in procedure, which possibly impeded access. Though the necessity for assessment in clarifying client needs and treatment was indicated, an assessment (from referral to assessment appointment) that led to discharge could take an excess of one working day of service time, associated with considerable opportunity cost to other clients awaiting assessment. Recommendations are made for improving assessment efficiency.

With a high prevalence of poor mental health in the UK, efforts must be made to identify and reduce additional demand upon service time and resources within mental health services to effectively meet people’s needs. Recommendations to improve assessment process efficiency include the use of a standardised referral form, offer of follow-up support procedures, increased client involvement, a streamlined opt-in battery and ongoing monitoring to ensure shared practice between clinicians. These are transferable to other mental health services, with implications for subsequent quality and timeliness of care.

Extant literature exploring service user (SU) involvement in clinical psychology training has been limited by its sampling from singular training programmes and its restricted application of psychological theory. This research seeks to counter limitations by exploring SUs’ experiences across multiple clinical psychology training programmes in the UK and by deductively applying psychological theory relating to power, recovery, identity and group development.

Semi-structured interviews were conducted with 14 participants. A deductive thematic analysis was used to analyse qualitative data.

Five main themes were identified: environment determines sense of safety; meeting challenges; sense of purpose, worth and value; the person you see now is not the person I was; and wanting to break the glass ceiling.

Carers are underrepresented and the sample does not contain SUs who were no longer involved in training.

It is important that the environment fosters psychological safety for SUs, via positive and supportive relationships with trainees and staff, with SUs being treated as equals and financially reimbursed as such. SUs and professionals need to explore managing and sharing power to enable SUs to feel valued and to reap benefits from involvement, including developing a positive sense of identity.

The research is part of the early literature exploring SUs’ experiences of involvement in clinical psychology training and is, to the best of the authors’ knowledge, the first to explore the personal effects of involvement across multiple programmes.

The involvement of service users within clinical psychology training is written into policy. However, the practice of evaluating involvement from both trainees’ and service users’ viewpoint is minimal. The purpose of this paper is to evaluate recent service user involvement in psychometrics and formulation teaching on a clinical psychology training programme, from both service user and trainee perspectives.

Focus groups were held with service users (n=3) involved in the teaching, as well as trainees (n=3). Additional questionnaire data were captured from trainees (n=11). Service user and trainee data were analysed separately using thematic analysis. Themes generated for trainees were also mapped on to a competency framework for clinical psychologists.

Both parties found the teaching beneficial. Service users enjoyed supporting trainees and engaged positively in their roles. They identified relational aspects and reflections on their own therapy as other benefits. Trainees reported enhanced clinical preparedness, critical and personal reflection. Trainee anxiety was evident. Learning mapped well to competency frameworks.

The samples were small and some data truncated. Findings speak to broader issues and may transfer to other involvement contexts.

A good degree of meaningful involvement can be achieved through such initiatives, to mutual benefit and enhanced learning.

Nature of the exercise and dual-aspect approach to evaluation described here helps to minimise tokenism. The mapping of findings to competency frameworks supports evaluative processes and helps to legitimise involvement initiatives that challenge the boundaries of existing practice.

Despite the popularity of team formulation, there is a lack of knowledge about workable implementation in practice. The purpose of this paper is twofold: first, to characterise team formulation, based upon examples from practice; and second, to identify factors perceived to support or obstruct workable implementation in practice.

An online survey recruited UK Clinical Psychologists (n=49) with experience in team formulation from a range of work contexts. Examples of team formulation in practice were analysed using both deductive and inductive framework analysis.

Four novel types of team formulation with different functions and forms are described: case review, formulating behaviour experienced as challenging, formulating the staff-service user relationship and formulating with the service-user perspective. A number of factors perceived to support and obstruct team formulation were identified including team distress, facilitating change, managing difference and informing practice. These were common across team formulation types.

The team formulation types identified could be used to standardise team formulation practice. Several common factors, including managing team distress, were identified as aiding workable implementation across team formulation types. Future research should investigate the key processes and links to outcomes of team formulation in practice.

This paper presents two original, practice-based and practice-informing frameworks: describing, first, novel forms and functions of team formulation and, second, the factors supporting and obstructing facilitation in practice. This paper is the first to highlight the common factors that seem to facilitate workable implementation of team formulation in practice.

This paper aims to address how one Doctorate in Clinical Psychology (DClinPsy) programme contributes to the shaping of attitudes of its trainee clinical psychologists (TCPs) towards cognitive behavioural therapy (CBT).

A total of 28 TCPs completed an online, mixed-methods questionnaire relating to their attitudes towards CBT, what factors had influenced their attitude and how competent they felt in applying CBT to clinical practice.

The majority of respondents reported a positive attitude towards CBT. There was a statistically significant positive change at an individual level in TCPs’ views of CBT between the point at which they applied for the DClinPsy and the present day. Thematic analysis of qualitative data identified influential factors on the development of TCP attitudes towards CBT. The vast majority of TCPs reported that they felt competent applying CBT in their clinical practice.

Overall, the DClinPsy has a positive effect on TCPs’ attitudes towards CBT. However, the influence of placements has a more mixed effect on attitudes. A small sample size reduced the reliability of these conclusions. Recommendations for further evaluation have been made.

This paper evaluates the effect of a DClinPsy programme on TCPs’ attitudes towards CBT. The value is that it establishes which components of the course have different effects on trainee attitudes.