Thriving, Not Just Surviving…

Written by Kirsty McNeilis (@drysdale_kirsty on Twitter)

It’s that time of the year where new cohorts of students begin their training as Children & Young People’s Wellbeing Practitioners (CWPs/CYWPs). I was always the kid who got excited at the start of the new school year, eager for a trip to buy stationary, a new timetable to colour-code, new books, and lots of learning to come. So, you can likely imagine how much I enjoy the beginning of a new cohort… living somewhat vicariously through my students (although I do still get to colour-code a timetable.)

There is so much potential at this point in the year, but, alongside that, there is also a lot of information to take on board. The CWP and EMHP posts are recruit-to-train, which means as well as starting a new course the trainees are also starting new jobs. They will be getting to know new services and figuring out what their working week will look like, as well as meeting one another and getting their heads around the course content. All at the same time.

And, as those of you who have been through a CWP or EMHP training year (or other IAPT training programme) will surely agree, that year as a trainee can be intense. Working, learning, studying, meeting submission deadlines, managing a caseload, supporting young people. And not forgetting that the students on these courses are adults, with relationships, families, children, friends, responsibilities, interests and hobbies, and a multitude of other things to manage as well.

So, what can trainees do or know at the start of the training year, to make this demanding twelve-month period as successful as possible? What will make this a period to thrive? What do I wish I had known when I began my training year?

I have no magic wand but hope that my tips and suggestions will be of help to some.

My first bit of advice would be to make notes. On everything, literally. There will be so much information to take on board, particularly in the first few weeks of the course, but throughout as well. You won’t remember it all. So, find a way to note it down that works for you. Not everyone works or learns in the same way, so your version of “making notes” might look different from mine. I’m a paper and pen writer and list maker, but for you it might be typing notes, adding post-its to or highlighting handouts, recording voice-notes for yourself, taking photos of key information, using an app… a way to revisit the information later, when you realise that you need it, is a must. And this applies to the days spent in service, as well as the university-based days.

To add to the advice above, I would also recommend getting to know your course handbook and portfolio document even better than you know the back of your hand. These documents will contain practically all the information you need to know about the course. Get used to using them as your first step resource when a question pops up… before you email your tutor, or the course administrator, or message the cohort group in a panic; and before you spend the night worrying about how to submit that upcoming assignment, or what the word count is for that reflective document, or what you’re meant to include on that form from the portfolio. Double check the handbook and portfolio guidance and you may well find that you already have the answer, allowing you to rest easy. (If you don’t, send that email as the next step by all means).

Another set of documents I would recommend you become particularly familiar with are the marking criteria for your formal assessments – clinical recordings and written work. It might sound obvious but I’m going to say it anyway – these documents tell you exactly what the marker is looking for, so you should know what is in there. When it comes to clinical recordings, not only can you use these marking criteria to review recordings in supervision, ahead of deciding on suitability for submission; you can also use these ahead of going into an assessment or a treatment session, to plan for and practice what you need to include.

Is that what I look like? Is that how my voice really sounds?

Having just mentioned reviewing recordings in supervision, that leads us to my next bit of advice. And it’s a very simple one… take your session recordings to supervision. That’s it. That’s the advice. Record your clinical work. As often as you can. Record as many sessions, of assessment and intervention, as you can. Record as many different young people and families as you can (with appropriate consent of course). Watch the recordings back yourself. And take the recordings to supervision to watch with your supervisor and your peers.

Now, I know that it feels uncomfortable and awkward and cringey to watch yourself back on tape. I’m yet to meet someone who enjoys it, so it’s understandable that you might be somewhat avoidant of this. You might want to hold back a moment when your supervisor asks who is bringing a recording to share next time, hoping that one of your peers says they will first. Or maybe when discussing recording consent with a young person or family who shows some hesitation, you might want to jump in and tell them not to worry, it’s fine not to record. But please trust me on this point – recording your clinical work and viewing it back is such an integral part of the training (across all IAPT training, not just CWP and EMHP) and you will learn so much from it. So much.

If you can get past that awkwardness and embrace sharing your recordings (or at least tolerate it), then the feedback you’ll receive from your supervisor, and your peers in group supervision, will be rich with material for developing your practice. And your supervisor and peers will likely spot the good parts, the things you do brilliantly, the moments where you’re attuned to the young person you’re working with and are demonstrating your interpersonal skills, your questioning skills, your ability to collaborate and share an understanding, far more readily than you will be able to when viewing your own recordings or being present in the session itself.

The ability to reflect on your own practice, to identify strengths and areas for development, relate this to theory, and then plan for how to do things differently going forward is one of the most crucial skills to have. So, if you are coming to CWP or EMHP training without prior experience of reflective practice, I’d say start working on this as a priority. If you can build this skill, your reflective muscle so to speak, then it will help you through the rest of the training, and your ongoing career once qualified. This muscle can be given a weekly workout in supervision. Build it up and you’ll have that strength to bring to the reflections that you formally submit, alongside your session recordings.

Supervision. Supervision. Supervision.

Really engaging in supervision is the next tip I can give. You’ll likely be told from the very start of your training how important supervision is and what a fundamental role it plays in the training year. In my opinion this is completely true, and I don’t believe there is a trainee or qualified CWP/EMHP that I know who would dispute it – with experiences of good supervision cementing the belief, and experiences of less-than-ideal supervision highlighting the impact of its absence.

A turning point for me in my training year was the realization that I should turn up to supervision with something to bring to the table. I needed to come along with somewhat of a suggestion for what I might do about problem X, somewhat of a guess for how I might answer question Y, or somewhat of a reflection and understanding of why case Z wasn’t going quite to plan. Prior to this revelation, I had mostly been approaching supervision with a “I don’t know quite what I’m doing, please tell me” mindset (I’m quite sure that me not knowing what I was doing was not a revelation to my supervisor in those early days).

Changing my way of thinking about this and identifying potential solutions ahead of time to be discussed, meant I was getting far more from the process. Yes, this involved scheduling some supervision preparation time into my calendar – block this time off in advance (and if you’re like me, colour code it on your calendar too).

The solutions I suggested weren’t always the right way to go, so my supervisor, through some excellent modelling and demonstration of Socratic questioning, guided my discovery around this and helped me identify the right next steps. Did it initially frustrate me beyond belief that they wouldn’t just tell me the answer/solution/right thing to do… oh yes! But they stuck with their (absolutely correct) approach. And before long I found that I was able to suggest something that was likely to be beneficial, or a good way of finding the answer. Eventually I was able to give an accurate understanding of what hadn’t quite worked and present my ideas on how that could be developed going forward. My supervisor continued to support my thinking around this, and my confidence really began to grow.

Practice makes perfect… improvement.

So how do trainees get to the place where things start to go right, and confidence begins to grow? I think a key word that applies here is practice. Practice good self-awareness in knowing how you study best and how you can set yourself up to get the most from the academic side of the course. Practice good self-care to help get you through the year, with a work life-balance intact. Practice stepping outside of your comfort zone and trying the things that feel a bit uncomfortable or difficult – I promise you that tutors like myself don’t recommend the awkward things, such as watching yourself on tape or completing a role-play to be mean… we know that they work!

The key example of practice I want to add as my next tip, is making use of role play wherever possible. I’m aware I’ve already encouraged you to throw yourself into recording and sharing your clinical practice earlier on in this piece… now I have the nerve to add in role-play too?!  Yes. Yes, I do. Again, I completely acknowledge that it isn’t something many people enjoy and brings up similar embarrassing, uneasy, cringey feelings mentioned with recording yourself.  But again… it can be so very useful.

If there is a time to get things ‘wrong’, by which I mean stumbling over words, not knowing what to say, not being able to think of a follow up question, forgetting how to explain the rationale for the treatment model etc., then I would strongly argue that it’s less uncomfortable to do this in a role-play in front of your peers and supervisor than it is to do it with a ‘real life’ young person and family. (You may well have some of these things happen with young people and families as well, and you’ll be the one who notices it much more than they do I guarantee. But it’s far less likely to happen if you’ve practiced beforehand!)

Having a safe space to practice and test out how you might say things, or how you might ask things, with peers who are also figuring all this out is an important part of the learning process on these courses. So, lean into it and try not to avoid. You’ll likely have plenty of chance to role-play within the teaching timetable of the course, as small group work or pairs work in skills practice, as well as within your clinical skills group supervision. On top of this I would encourage you, particularly early in the training year whilst your caseload is light, to arrange further opportunities with cohort peers. The increase in remote access to one another since 2020 has meant students who are geographically distant within the cohort can still link up for these purposes… there must be some silver lining, I guess.

Now, we all know that hindsight is a wonderful thing.

At the time of being a trainee, did I practice what I preach here? (If you’re reading this as a former tutor or supervisor of mine, maybe skip the next couple of paragraphs…) I mean… some of it I did. I was fairly organised and was well acquainted with the course documents. But… I was somewhat avoidant of taping myself… I took the fewest recordings I could get away with to supervision for viewing… didn’t have any great fondness for role play… and I’ll be honest, tended to prefer bringing the cases that were going well to supervision for discussion. Who doesn’t enjoy a bit of positive reinforcement in the form of being told you’re doing things right?

Having the conversations about the cases that weren’t going so well? Nope. Didn’t enjoy that so much. I found it hard to receive (even the most constructive of) criticism, and really had to work on not letting that take me to a defensive or disengaged place. If I didn’t know the answer to a question that was asked, I became caught up in feelings of being a failure or inadequate. Why didn’t I know this? I had worked in CAMHS for over 8 years!

With the amount of experience and prior education all trainees bring, just to be accepted onto these training positions, I would suggest that most of us are used to being pretty good at what we do. So, coming into a training position, and moving out of our unconsciously competent comfort zone and into that position of being conscious of our incompetence in a new way of working… ohhhh that doesn’t always sit so easy.

IAPT, I would tentatively suggest, by its very design of learning across a year whilst also carrying a caseload from early on in that year (before all teaching is completed), tends to break you down before it builds you back up again. The key is sticking around long enough to get to the building back up part… and not letting the early stages of “what the heck is going on here, what am I meant to be doing?!” lead you to giving up.

Maybe going into the training year with someone giving you the heads up, that this course is likely to make you feel a little out of your depth, is helpful? I imagine that now, and going forward, there are likely to be more and more people in the position to give that advice to new trainees. There are more qualified practitioners out there (either still working as CWP/EMHPs, or with the experience of the role prior to moving on to something else) to share their thoughts. And of course, people sharing thoughts and experience in special interest groups, professional networks, and on the internet, via platforms like Twitter, or this wonderful blog.

With all that I’ve said above, I do need to acknowledge that yes, I made it through the course. I’m not saying that this isn’t perfectly possible to do… however… this is where I think the difference comes in between surviving the training year and thriving in your training experience. I survived. And it was a great year, where I learned a lot, met some wonderful people, and developed in ways I hadn’t even necessarily predicted that I would. But… it was stressful, and it was hard, and there were tears (a lot of tears!). And I kept things to myself, worried over them and ruminated on them, rather than asking the questions or seeking out the help.

Support is available in several forms through the training year. At minimum a CWP/EMHP trainee will have a clinical supervisor within their service and an allocated tutor via the training programme. There may also be a separate line manager in service, and possibly a second clinical supervisor (one for clinical case management supervision and one for clinical skills supervision). Services in which trainees are placed will also have occupational health and staff support options, should that be required.

My final piece of advice to share is to use that support. Don’t feel like you’re on your own, be that with your academic work, your clinical work, or even with the feelings that might come up as you move through the year. As well as the individuals listed above, you also have a cohort of peers who are training alongside you. Do what you can to support each other, be that by sharing resources and literature you have discovered, offering feedback on recordings brought to supervision, or simply giving some reassurance and validation – a message or quiet word to say “Wow, that session sounds like it was tough. Well done for managing it!” can go a long way. You’re not in competition with your course peers, so when the support is offered in your direction… take it.

As I’ve already said, the training year is tough. I do hope that the pieces of advice and tips I’ve covered above are useful for those undertaking CWP or EMHP training. I remember being a new trainee myself and being keen to hear anything that would help me know what to expect. Being part of the very first cohort made this a bit trickier… there weren’t any former students to ask for advice, so our (wonderful and patient) tutors were endlessly questioned instead.

It may be that this post is also useful for supervisors or line managers of CWP/EMHPs to consider, to give an understanding of what trainees will be focused on and how they might be feeling at this early stage. Similarly, trainees on other IAPT training courses might get something out of this… I imagine the hints and tips would generalise well.

I’d like to round this off by inviting anyone who has experience of these courses (as a trainee, supervisor, tutor etc.) to share additional tips you might have, or things you notice that I’ve missed… feel free to add them in the comments below this piece or tweet them over. Let’s create something useful for the trainees currently on the courses, and those in cohorts to come. Let’s offer our experience to help trainees navigate this intense, but oh so rewarding, year. Let’s do our best to help trainees not just survive their training year, but really thrive through it.