Low-intensity working with children & young people: CWPs & EMHPs

Written by Kirsty McNeilis (@drysdale_kirsty on Twitter)

This is the first post in a blog takeover, bringing in the perspective of Kirsty McNeilis, a low-intensity practitioner working with children and young people. Kirsty is keen to note that she is certainly not a CWP guru, but is excited to be joining the blog…

Introducing myself

As a new voice to the blog, with the great honour of hosting for the next few months, it seems appropriate to begin with a short introduction. Hello, I’m Kirsty, and I’m a Children & Young Person’s Wellbeing Practitioner or CWP (or, if you’re in the North West, a CYWP – to avoid confusion with Cheshire & Wirral Partnership NHS Trust, also known as CWP. Confused yet?).

“a direct relative of the PWP… a younger sibling perhaps”

What is a CWP? Well, it’s a role that is still relatively new to the worlds of IAPT, low intensity working and children and young people’s mental health services. The first cohort began training in 2017, and as this post is published, we are now in the early weeks of training Cohort 6. A CWP is most certainly a direct relative of the PWP… a younger sibling perhaps, with some family resemblance to be seen, but a distinct personality of its own.

I began my training as part of that 2017 pilot cohort, having spent the previous 8 years as a support worker in an inpatient CAMHS service. For me, finding the training post was a serendipitous discovery, browsing NHS jobs, not quite sure what I was looking for but knowing I wanted to progress somehow in my career. With no core profession (generally considered as nursing, social work, or occupational therapy within CAMHS) my options were somewhat limited, and the job posts coming up within my local CAMHS services required qualifications I didn’t have. The BSc in Behaviour Analysis I had completed in my early 30s had left me keen to study further, and I had looked at PWP courses with interest. But there was something holding me back from applying… I really enjoyed working with children and young people and was loathed to move away from this.

“this was a doorway into the services I had hoped to work within”

The discovery of this advert for an IAPT trainee position, ‘like a PWP’ but with children and young people, and a post-graduate qualification as part of the package, ticked all the boxes I didn’t know I had identified. Part of CYP IAPT, this role was a new development within the plan to transform children and young people’s mental health services. This is one of the ways CWPs differ from our predecessors, PWPs, in that we aren’t designed to work in standalone IAPT services, but rather, would be joining our high intensity CYP IAPT colleagues within established CAMHS services. For me, this was a doorway into the services I had hoped to work within.

Similar, I believe, to the PWP role, the CWP training attracted people from a range of backgrounds. ‘My’ cohort, up in the North West collaborative, included those from a psychology undergrad (and masters) background, some from CAMHS support worker roles, some from education settings, counselling, youth work and social care.

“2017 brought us a new low-intensity sibling…”

Since I trained the role has continued to develop, and the publication of the Green Paper (Transforming Children and Young People’s Mental Health Provision: A Green Paper) in 2017 brought us a new low-intensity sibling… the Education Mental Health Practitioner or EMHP. This role initially maps onto the training modules of the CWP, covering context and values, assessment and engagement, and evidence-based interventions. However, the EMHP role is targeted very specifically towards education settings (as the name would imply…), and further modules focusing on working in these settings are undertaken too.

The roles both have the same ‘bread and butter’, in that we work to support children and young people, and their families, with mild to moderate low mood, anxiety and behavioural difficulties. We offer brief interventions and work as part of a stepped care model, able to step cases up to high intensity support if needed. Supervision is an integral part of the role. And, if I do say so myself, we become really, really good at assessment.

There are some key differences between EMHPs and CWPs, with the level of qualification being one. Where the CWP training programme includes 1 day per week with the education provider (HEI) to 4 days in service, and a postgraduate certificate qualification on completion, the EMHP programme splits as 2 days study and 3 days in service, and the additional modules completed awards a postgraduate diploma on completion. I recall this variance causing some ripples of disconcertment through the CWPs I knew at the time the EMHP programme was launched… I guess much in the same way a toddler, fresh to the world themselves, might need time to adapt when a ‘newer version’ joins the family in the form of a baby. You would hope, with time, that they learn to live together. I would certainly like to think that within the family unit of low-intensity practitioners, there is room for us all to live harmoniously – the well-developed, mature PWP, and the newer additions of CWP and EMHP, still finding their feet.

“So many thoughts!”

There may well be future posts during my ‘takeover’ of the blog, where I discuss the differences in the roles in more detail. I have so many thoughts I’d like to share around the role I am so passionate about. Thoughts around the upcoming registration of the CWP/EMHP roles (again, following in the footsteps of our PWP sibling)… thoughts on the training year and how to not just survive it, but thrive in it… thoughts on development of the roles, retention in posts, further training available etc. etc. So many thoughts!

I am now in the privileged position of teaching on the programme through which I trained… talk about dream job. I get to attempt to inspire the same passion I feel for this role in further cohorts of students, and what an honour that is. Maybe, with the exciting opportunity offered to me here in hosting the Not a Guru blog, I’ll spread that passion and excitement a little further… watch this space and we’ll see…

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