Interview with Takunda Karima Apprentice Clinical Associate Psychologist (CAP)

1. Could you please tell us more about the CAP role?

CAP is a new role with myself being a part of the third cohort of trainees. CAP’s tend to be psychology graduates who study an 18-month integrated master’s apprenticeship programme with a participating NHS trust. The role aims to fill an identified gap between Assistant Psychologist and qualified Clinical Psychologist roles. We aim to provide high quality evidence based psychological support within the community.

I am based in a Lewisham secondary care CMHT and I work with adult service users with complex mental health difficulties. My role involves working independently on a day-to-day basis with my work regularly supervised by a registered practitioner psychologist who ultimately holds the clinical responsibility over my work. Over the course of training, I have learnt to provide psychological assessments, formulations and deliver brief psychological interventions to the communities we serve.

2. Where did your interest and passion for psychology originate and can you tell us you’re your favourite element of the CAP role is?

 Coming from an ethnic minority background a part of my passion for psychology and being involved in the workforce comes from noticing the lack of representation of people who look like me in the field. I am particularly interested in increasing the representation of black men who are able to access psychology in a safe manner. We all know about the discrepancies and disproportionate representation of black men under the mental health act and involuntary admissions. I am curious by this and want to be part of a profession constantly aiming to tackle this issue. I am also really grateful that in my role so far, I have received positive feedback from service users who have appreciated working with a professional they can relate to.

This is also something I thoroughly enjoy about the CAP role. We can provide psychological support to people who might not ordinarily receive or be able to access therapies. Sometimes service users experience difficulties coming to team base or aren’t ready for an intense highly specialised therapy, but the CAP role is step towards trying to fill in that gap in my current service. We are able to address issues like readiness and engagement by providing brief psychological interventions and we try to meet service users where they are in their journey towards recovery. This acts as my favourite part of the role – seeing a gap in provision and filling it!

3. Can you tell us a little bit about your journey into the CAP role? And if someone was interested in starting training, what steps would they need to take?

I initially worked in digital media at the beginning of my career. In my early 20’s I had first-hand experience of mental health difficulties whilst being a carer for someone living with depression and this inspired me to pursue a career in psychology. I completed a post-graduate psychology conversion degree and then gained initial mental health experience by volunteering with a crisis support line and some paid work as a graduate mental health worker.

For anyone interested in applying for CAP training the essential criteria is having that approved qualification in psychology what confers eligibility for graduate basis for registration with the British Psychologist Society (BPS). Also, some experience of paid work supporting people experiencing mental health difficulties is required. These tend to be the core first steps if you are interested in training as a CAP.

4. What does a day look like for a CAP?

 Whilst in the training post your time is split between teaching days at a higher education institute and clinical days at your work setting. On the teaching days we have lectures taught by Clinical Psychologists with a broad range of experience and expertise. This covers a broad range of learning topics aimed at supporting us to work psychologically across various types adult mental health settings. We are also trained in specific formulation and evidence-based interventions approaches derived from CBT or DBT skills that can be applied flexibly depending on the CAP’s work setting.

On my clinical days I am getting involved in MDT meetings, and providing care to service users, offering 1:1 assessments and brief therapeutic interventions as part of a stepped care psychology offer. These range from psychoeducation & coping skills to transdiagnostic approach to interventions offering graded exposure, behavioural activation and emotion regulation support interventions as agreed with my clinical supervisor, based upon formulation of an individual’s presenting difficulties.

Contributing to audit/research/QI within the Trust also tends to be a salient aspect of the CAP role. As part of the master’s degree we are required to carry out a piece of research or audit in our clinical setting. I am currently carrying out an audit on the Dialog use in the CMHT I am working in and how that is being implemented in the team. This supporting the quality improvement focus currently underway to improve the uptake of this within the team.

5.  What opportunities are available for CAP’s beyond the role?

As the CAP role is new and developing there is some ambiguity and uncertainty around the future of the role but there is also some excitement. As this role is developing, us current CAP’s and supervisors have the opportunity to help shape the identity of the role over time. I see a lot of opportunities for CAP’s to gain experience in a variety of clinical areas within adult mental health service. A variety of CAP’ roles are being advertised across mental health services including in inpatient, community, crisis and home treatment teams, eating disorder, etc. Due to the nature of the role and the wealth of experience you gain, there is also opportunities for further training. For those who are interested in further progression they can move onto doctoral training for clinical/ counselling programmes.

So, the future is uncertain but also broad!

6. Do you have any advice for those who are interested in the CAP role?

I would highly recommend the CAP role to anyone who is interested! It is a new and exciting role and it creates more opportunity and access for people to work psychologically outside the traditional roles. In my experience, majority of people entering the workforce through the CAP role have been met with enthusiasm and optimism. There is also an element of financial security whilst training which is always helpful!

However, at times you may also face some resistance to change. It can be difficult for the wider MDT to understand this role and accept changes in the development of new roles. I think as someone interested in this role it is important to be aware of the context you are entering and the position of CAP’s alongside other roles. Also, I would encourage any incoming CAP’s to use supervision to reflect on some of the challenges and how to manage some of the uncertainty.