Application for Provisional Accred

PWP ACCREDITATION – ROUTE B

APPLICATION FOR BABCP ACCREDITATION

AS A PSYCHOLOGICAL WELLBEING PRACTITIONER (PWP)

ROUTE B

Applicant’s Name

All forms to be typed in Word, not hand-written (contact the BABCP office if this is not possible)
Attach additional sheets if needed
Ask your Clinical Skills Supervisor to complete the PWP Supervisor’s Report
Refer to the Criteria and Guidelines for PWPAccreditation when completing the application form

APPLICANT’S DETAILS

Full Name
Title / Mr Mrs Ms Miss Dr Prof Other (state)
Job Title
Address / Post Code
Tel Work
Tel Home / Mobile
E-mail
Enclosures
Please tick enclosure checklist below when you have included all enclosures
Application Fee payable to BABCP
(check with BABCP office for current fees) / Return all documentation to:
BABCP
Imperial House
Hornby Street
Bury
BL9 5BN
T: 0161 705 4304
E:
Clinical Skills Supervisor’s Report
Certificates / Evidence of Qualifications
Record Logs
Additional Information (where necessary)
CRITERION ONE: PWPProfessional Accountability & Practice

Applicants must have been working as a PWP continuously for the last 6 months in a stepped-care service using guided self-help in order to be eligible for PWP Accreditation

Give details of the last 6 months of your PWP Practice only, including to whom you are accountable
Dates(from & to) / Employer / Employed As / Professionally Accountable To
Name / Professional Position
For your PWP practice only, give details of the proportions of your practice spent on Clinical Practice, Supervision,and other activities, and give a summary of your current PWP practice
PWP Clinical Practice / % =
Receiving Case Management Supervision / % =
Receiving Clinical Skills Supervision / % =
Receiving Training / % =
Other (state) / % =
Summary of, and Additional Comments on Current PWP Practice
Provide information about the Low Intensity CBT informed approaches that you use
CRITERION TWO: Core Professional and Specialist PWP Training

Route B PWP Accreditation is for those who have a relevant Core Professional training to degree level or equivalentand specialist PWP training which must include PWP Top-up Training that incorporates Modules 1 & 2 of the IAPT PWP National Curriculum provided by an Accredited PWP training programme. In addition, applicants must provide supplementary evidence of meeting two essential core learning objectives as specified in the IAPT PWP National Curriculum for Modules 3 and 4

PART A: Core Professional Training

If you are unable to tick one of the Core Profession boxes on this page, you should contact an Accreditation Liaison Officer for advice, bye-mailing

Please tick only one of the Core Professions below, which is your main Core Profession in which you are have a recognised qualification
Applied Psychology
Clinical Psychology
Counselling Psychology
Educational Psychology
Forensic Psychology
Health Psychology
Nursing
Mental Health Nursing
Learning Disability Nursing
General Nursing
Medicine
Psychiatric Medicine
General Practice
Allied Health Professions (HPC Registered)
Occupational Therapy
Arts Therapist
Physiotherapist
Graduate Mental Health Worker(provided by a University Commissioned GMHW Course)
Graduate Mental Health Worker Training which included assessment of competency and fitness to practice
Other Helping Professions
Counselling, Fully Accredited by BACP, COSCA, FDAP (NCAC) or Registered Member CPC
Counselling Training obtained via a BACP Accredited training course of Undergraduate Diploma level or
higher
Social Work
Probation Service
Teacher of Special Education / Needs with additional special education training and counselling /
psychotherapy training
Psychotherapy/Psychotherapeutic Counsellor with UKCP Registration
For your Core Professional Training only, detail academic and professional qualifications
Dates
(from & to) / Qualification / Awarding Body / Institute / Evidence Enclosed / Labelled as
Membership of Professional Body
If you are a member of a professional body, you are required to give your professional membership number or PIN (e.g. NMC, GMC), and the name of the body with whom this can be checked; date of birth required to check
PIN / Body / Registration or Membership Type / Date of Birth
If membership of your professional body has lapsed, please provide a covering note stating the reason, and check this box
PART B: Specialist PWP Training

Route B PWP Accreditation is for those who have successfully completed an IAPT PWP Top-up training programme delivered by an Accredited training provider which specifically relates to modules 1 & 2 of the PWP National Curriculum

Give details of your PWP Top-up Training Course

Course Title / Institution / Start Date / End
Date / Certificate or Statement of Achievement Enclosed / Labelled as
PART C: Supplementary Countersigned Self-statements

Route B applicants must provide supplementary evidence of meeting some of the essential core learning objectives as specified in the IAPT PWP National Curriculum for Modules 3 and 4 relating to;

Module 3: Values, Policy, Culture & Diversity

Module 4: Working within an Employment, Social and Healthcare Context

Countersigned Self-statements must be provided that demonstrate how you have met the learning outcomes, including the acquisition of your knowledge and skills, and their application within your working role by giving an illustrative example for each section

The Countersigned Self-statements are also available as separate documents if you prefer to include them individually. See Guidelines for PWP Accreditation for details of information required and examples

Countersigned Self-Statement One – Module 3: Values, Policy, Culture & Diversity

Learning Outcome / Your Self-statement
Describe how you have acquired knowledge, skills and experience of working with individual difference, diversity, non-discriminatory equal opportunities, and respect for the values of individuals engaging in mental health care provision
Provide an illustrative example that demonstrates your respect for individual differences in age, sexuality, disability, gender, spirituality, race and culture, and show that these differences are valued
Provide an illustrative example that demonstrates your knowledge of and competence in responding to people’s needs sensitivelywith regard to all aspects of diversity, including the use of translation services
Provide an illustrative example that demonstrates your knowledge of and competence in working with Interpreters.
Provide an illustrative example that demonstrates your knowledge of and a commitment to equal opportunities for all and encouragingpeople’s active participation in every aspect of care and treatment. Take into account any physical and sensory difficulties clients may experience in accessing services and if required how you refer to appropriate services
Referee Attesting to Self-statement
Note to Referee: By signing you are confirming that the applicant’s Self-statement (above) is true
Referee Name
Position / Job Title
Email Address
Telephone Number
Professional Relationship to Applicant
Additional Referee Comments
Referee Signature
Date

Countersigned Self-Statement Two – Module 4: Working within an Employment, Social and Healthcare Context

Learning Outcome / Your Self-statement
Describe how you have acquired knowledge, skills and experience to appreciate and critically evaluate a range of employment, occupational and well-beingstrategies to help patients manage their emotional distress and disturbance
Provide an illustrative example that demonstrates knowledge of and competence in liaison with and signposting to other agencies delivering employment, occupational and other advice and services
Referee Attesting to Self-statement
Note to Referee: By signing you are confirming that the applicant’s Self-statement (above) is true
Referee Name
Position / Job Title
Email Address
Telephone Number
Professional Relationship to Applicant
Additional Referee Comments
Referee Signature
Date
CRITERION THREE: Supervised PWP Clinical Practice

Give details of 80 hours of clinical practice, including 8 cases, and specify the low intensity intervention used. The relevant supervisor must sign the grid below; should this not be possible, contact the PWP Accreditation Liaison Officers by e-mailing to identify alternative evidence

NOTE TO SUPERVISORS

By signing below, you are stating that the case was brought to supervision. For the remainder of the 80 hours, you are signing to attest that these have additionally been completed

Patient Identifier / PWP Intervention / No of Patient Hours / Supervisor Name / Signature of Supervisor
1 / Behavioural Activation
2 / Exposure Therapy
3 / Cognitive Restructuring
4 / Panic Management
5
6
7
8
Total Hours from 8 clients
Total Additional Hours
Grand Total Hours
CRITERION FOUR: PWP Supervision

Applicants must demonstrate that they have completedat least 25 hours of Clinical Case Management Supervision, and at least 25 hours of Clinical Skills Supervision. Of the Clinical Skills Supervision, up to 10 hours may have been received as part of your formal PWP training

You should provide a log of your Clinical Case Management Supervision, and your Clinical Skills Supervision, signed by the relevant Supervisors (if you do not have a log from your training provider, you can download one from the PWP Accreditation section of the BABCP website)

You must also provide a PWP Supervisor’s Report from your current PWP Clinical Skills Supervisor. If you have been receiving Clinical Skills Supervision from your current Supervisor for less than six months, you must also provide a Supervisor’s Report from your previous Supervisor

Whilst inclusion of a regular live element is recommended for ongoing Clinical Supervision, it is not a requirement between completing training and applying for accreditation

Check the boxes below to confirm that you have received at least 25 hours each of Clinical Case Management Supervision and Clinical Skills Supervision, and that you have enclosed logs as evidence

I confirm I have received at least 25 hours of Clinical Case Management Supervision from: a qualified PWP or;a Supervisor who has completed the PWP Supervision training at an IAPT PWP training programme or attended a CPD event in Case Management Supervision.
I have enclosed my completed Clinical Case Management Supervision Log / YES
YES
I confirm I have received at least 25 hours of Clinical Skills Supervision from a Supervisor who has training and experience, and is currently utilising CBT informed approaches within their own practice (can include up to 10 hours that may have been provided as part of the PWP training)
I have enclosed my completed Clinical Skills Supervision Log / YES
YES

Check the boxes below to confirm that you have enclosed your Supervisor’s Report

I enclose my PWP Clinical Skills Supervisor’s Report from my current Clinical Skills Supervisor, dated within the last month / YES
I enclose my PWP Clinical Skills Supervisor’s Report from my previous Supervisor (only required if had current Supervisor for less than 6 months) / YES
NO
CRITERION FIVE: Sustained Commitment to CPD and Supervision
PWP Accreditation is for a period of 3 years, after which an application for PWP Re-accreditation must be submitted, along with evidence of 16 hours of Continuing Professional Development per year, 3 years Supervision Logs (Clinical Skills and Case Management), and a PWP Supervisor’s Report
BABCP PWP Accreditation is for those who have an interest in relevant CBT informed approaches, and so at least 8 hours of your CPD activity each year must relate to relevant CBT informed approaches. At least 8 hours of your CPD activity each year must be skills development
You must undertake regular live assessment of your practice as part of your Clinical Skills Supervision arrangements for re-accreditation purposes, taken to mean at least two instances of live assessment per year demonstrating at least two different interventions, and ensure that you record such instances within your Supervision Log, which should also demonstrate at least 1 hour per week individual Case Management Supervision, and on average 1 hour per fortnight Clinical Skills Supervision

DECLARATION

I understand my commitment to Continuing Professional Development, and Case Management and Clinical Skills Supervision
Signature / Date
Criminal, Civil, Investigatory & Disciplinary Declarations
All applicants must answer each of the six questions below
If you answer YES to any question, please declare details on an attached statement
Question / Declaration / Additional Statement Enclosed / Labelled as

Have you ever been convicted of any criminal offence in any court in the UK or elsewhere which might prejudice the public’s trust in you, your profession, or the BABCP, if accurately informed about all the circumstances of the case?

/ YES
NO

Have you ever been found guilty of a civil offence?

/ YES
NO

Have you ever been refused / expelled from membership of any other professional body / register on the grounds of professional misconduct or other professionally related offence?

/ YES
NO

Have you ever been the subject of any professionally related disciplinary action (which may or may not have ended in dismissal)?

/ YES
NO

Are you currently / likely to be the subject of any criminal, civil, investigatory or disciplinary proceedings or enquiries?

/ YES
NO

To your knowledge, have you ever been, or are you likely to be involved in a situation or incident likely to result in disciplinary action against you as a member of the BABCP?

/ YES
NO

DELIBERATELY FALSE STATEMENTS WILL RESULT IN YOUR REMOVAL FROM THE LIST OF ACCREDITED MEMBERS

DECLARATION

I am a Member of the BABCP, and I adhere to the Standards of Conduct, Performance and Ethics for Members
The information contained in this application and any accompanying papers is accurate to the best of my knowledge
Signature / Date

PLEASE ENSURETHAT YOU SIGN HERE. YOUR SIGNATURE IS REQUIRED IN ORDER TO PROCESS YOUR APPLICATION. IF YOU HAVE NOT SIGNED THIS FORM IN THE APPROPRIATE BOXES IT WILL BE RETURNED TO YOU TO SIGN.

The Accreditation and Registration Committee Reserves the right to seek further information from relevant parties to the application

ACCREDITATION USER FEEDBACK

Name/Membership number (Optional):

The Accreditation and Registration team are interested in your opinion and levels of satisfaction with the various aspects of the accreditation process.

We would appreciate if you could please complete this feedback form and attach it to the front of your application.

This survey is anonymous unless you choose to provide your name and/or membership number.

By providing your name and/or membership number, you allow us to be able to look into your application.

This could provide valuable information to us about our process and highlight areas in need of improvement.

Feedback on the stages of the Accreditation Process and Communication from the team.

1. How did you find meeting the criteria for Accreditation?