In 2010, the Psychological Interventions Team was set up by the Scottish Government’s Mental Health Directorate & NHS Education Scotland to support widening access to psychological therapies and interventions. Since this time the team has worked with key stakeholders to provide a national programme of core training in psychological therapies and interventions. The team has been tasked with increasing workforce capacity to deliver safe and effective evidence based psychological therapies and interventions.
We commission, design and deliver training in psychological therapies and interventions for staff working with adults who have mental health problems; such as anxiety, depression, eating disorders, psychosis, substance use, suicidality, and forensic mental health. Through this work we are supporting the national improvement programme to widen access and reduce waiting times for psychological therapies and interventions.
We have a strong track record in multidisciplinary engagement with all the national NHS boards and are committed to working with integrated mental health systems. We are committed to providing high quality education and training, based on Implementation Science, through work-based learning programmes & training pathways, that incorporate e-learning, interactive workshops, coaching and assessment of competence. We have worked collaboratively with local boards to gather data on the impact of the education and training provided by the team and have evidence of improved clinical outcomes for people who receive psychological interventions from staff following our training.
The NES Adult Mental Health training team supports the matched / stepped care service model through the provision of a national programme of education and training in evidence based psychological therapies and interventions. Training is provided to support practice at specialist, enhanced, skilled and informed level. Research on the use of evidence-based therapies & interventions highlights the importance of ongoing skills development with a programme of education, coaching and practice feedback in order to enhance the skills of staff. It is clear from the research that one-off training events do not lead to a change in practice on their own, but that coaching and observed practice with feedback are necessary to consolidate and implement new learning. Therefore, multidisciplinary staff working within mental health can access education and training in psychological therapies and brief psychological interventions that is based on implementation science and delivered within robust supporting infrastructures within the local NHS boards. Education in psychological therapies is provided in partnership with the South of Scotland CBT Programme, University of West of Scotland, University of Edinburgh, Mindfulness CBT Scotland, and MBT Scotland.
The Adult Mental Health national programme of training in psychological therapies and brief structured psychological interventions incorporates blended learning; online e-learning modules, training events focused on the practice of skills, and ongoing skills-based coaching to maximise the impact of the training on staff skills and effectiveness of the intervention. Training in brief psychological interventions is provided through work-based Turas Learn learning programmes that include; e-learning, interactive workshops, structured coaching sessions (that are embedded within routine clinical practice available within local board clinical supervision infrastructures) and a work based assessment of competence.
Core Psychological Therapies & Interventions for Alcohol and Substance Use
The Psychological Interventions Team within NES has continued to work towards increasing the accessibility of psychological interventions and therapies for those experiencing problems with substance use. The programme has provided skills-based training opportunities for a range of staff in Motivational Interviewing and Core Behavioural & CBT Skills in Relapse Prevention and Recovery Management, with staff also able to access training resources for working with trauma, dementia, and chronic health concerns.
Core Psychological Interventions for Anxiety
An Introduction to a psychological approach to anxiety
This e-learning module is designed for all staff working in the public sector with people who have anxiety problems. It aims to give the learner a fundamental understanding of anxiety, how it is expressed in the body and some basic psychological interventions which can help people manage their anxiety more effectively. Following this module, learners may wish to apply for the ‘Introduction to CBT for Anxiety’ learning programme to further develop their skills on this topic.
An Introduction to CBT for Anxiety (Enhanced Practice)
The most up-to-date research in Cognitive Behavioural Therapy has been reviewed to provide brief, structured and protocolised psychological intervention, that can be used by multidisciplinary staff to work more effectively with people who have anxiety problems. This learning programme is hosted within Turas Learn and consists of an e-learning module titled ‘Introduction to cognitive behavioural therapy (CBT) for anxiety : learning programme | Turas | Learn (nhs.scot)’, attendance at 2 interactive workshops and 4 structured coaching sessions (that are embedded within local clinical supervision) and an assessment of competence. They are specifically developed to help staff increase their knowledge and understanding of anxiety.
Core Psychological Interventions for Depression
Behavioural Activation for Depression (Enhanced Practice)
Behavioural Activation is an evidence-based psychological therapy that is recommended in The Matrix: A Guide for the Delivery of Evidence Based Psychological Therapies in Scotland (Scottish Government, 2011), the Scottish Intercollegiate Guidelines Network (SIGN) clinical guideline (2010) and the National Institute for Health and Clinical Excellence (2022) clinical guideline for the treatment and management of depression in adults. It is a psychological therapy that is ideally suited for delivery in a stepped care service model. In Scotland, NHS Education Scotland supports the delivery of two models of BA:
The Psychological Intervention Team has trained over 100 BA Trainers to provide local training in Behavioural Activation for Depression in health boards across Scotland
Core Psychological Interventions for Eating Disorders
Cognitive Behavioural Therapy for Eating Disorders (CBT-ED) (Specialist Practice)
This 3-day education programme aims to develop skills for working with adults with eating pathology, using evidence-based cognitive behavioural therapy for eating disorders (CBT-ED). The programme is targeted at multidisciplinary staff who have a recognised qualification in CBT and will introduce attendees to the competences and meta-competences needed to deliver evidence-based CBT for eating disorders for adults with the full range of diagnoses. It will outline and demonstrate key skills for addressing the core cognitive, emotional and behavioural elements of those eating disorders, including body image issues.
Core Psychological Interventions for Forensic Mental Health
Low Intensity Psychological Interventions in Forensic Mental Health Settings (Enhanced Practice)
The Low Intensity Psychological Interventions in Forensic Mental Health Settings training is delivered in partnership with the School of Forensic Mental. This 5-day practical skills training programme is designed to increase the psychological mindedness of staff and equip clinicians with the skills and competencies necessary to deliver an agreed suite of 'low intensity' psychological therapy programmes, which have been developed by the forensic matrix working group. This training is competency based and requires trainees to complete a written and practical skills assessment. An emphasis is placed on experiential learning to promote links between educational theory and practice.
See, Think, Act: Relational Security is an interactive online learning module that was created jointly with NES and the School of Forensic Mental Health. It is based on the ‘See, Think, Act’ reference material from the DOH- surrounding the theme of relational security. It has been developed for all staff working in secure forensic mental health services. The aim of this module is to help people to understand what relational security really means and to encourage individuals to think about how they can ensure it is maintained in their place of work.
Working with Personality Disordered (PD) Offenders is an interactive online learning module that was created jointly with NES and the School of Forensic Mental Health. This guide has been produced to support people working with offenders with a diagnosis of PD in both in- and out-patient settings. It provides information about personality disorder and practical advice on how to manage people who can be extremely challenging. It also considers the impact this work can have on staff wellbeing, identifying the signs and consequences, and suggesting how staff can protect themselves.
Core Psychological Interventions for Older Adults
The key remit of the Older Adult work stream within the Psychological Interventions Team is focussed upon supporting delivery of education and training of multi-professional staff. The aim is to increase access to evidence based psychological interventions and therapies for Older People across NHS Scotland, social care and third sector partners. Key project work includes supporting older adult supervision for staff undertaking CBT diploma level training (South of Scotland CBT course) and the provision of a national programme in brief psychological interventions.
An Introduction to Cognitive Behavioural Therapy for Anxiety Disorders in Older Adults (Enhanced Practice)
The learning programme, ‘An Introduction to CBT for Anxiety’ has been adapted for staff working within older adult settings. Highly interactive and experiential workshops are provided within this learning programme on Turas Learn and are aimed at multi-professional staff who do not have a recognised psychological therapies qualification. This is a blended learning programme that consists of completing the e-learning module “An Introduction to CBT for Anxiety” prior to attendance, attending the structured coaching sessions after the training, and submitting a competence assessment that demonstrates they have achieved the Intended Learning Outcomes.
Behavioural Activation for Depression (Enhanced Practice)
The learning materials within the Behavioural Activation learning programmes have been adapted for staff working within older adult settings. Highly interactive and experiential workshops are provided within this learning programme on Turas Learn and are aimed at multi-professional staff who do not have a recognised psychological therapies qualification. Three blended learning programmes are available; Behavioural Activation for Depression (BAD), Brief Behavioural Activation Treatment for Depression (BATD-R) and Behavioural Activation in Groups (BAG). All include completing an e-learning module prior to attendance, attending the structured coaching sessions after the training, and submitting a competence assessment that demonstrates they have achieved the Intended Learning Outcomes.
Core Psychological Interventions for Psychosis
This training has been developed for qualified multi-disciplinary staff working in adult and older adult mental health settings, who have a keyworker role and are working with people who experience psychosis. The Turas Learn Learning programme ‘Psychosocial interventions for psychosis’ are recovery focused, map onto the UCL CORE Competency Frameworks for severe and enduring mental health problems and focus on developing the ‘therapeutic stance, values and assumptions’ competencies for psychosis. The training has been co-produced with people who have lived experience of psychosis and is available on Turas Learn.
Core Skills for Suicide Prevention
The Psychological Intervention Team have been working collaboratively with the University of Glasgow Suicidal Behaviour Research Laboratory developing an e-learning programme on the Psychology of Suicidal Behaviour.
The four modules will be available on Turas Learn Early 2024 and shall provide individuals with an opportunity to access a learning programme which allows staff to exit when they feel is right for their role. Each module designed to build on the previous module and aimed at Informed moving to Skilled and then Enhanced and Specialist staff delivering psychological interventions. We hope to provide individuals working with suicidal behaviour a deeper understanding of the motivational and volitional factors involved in suicidal behaviour, acknowledging that the pathway to suicide is complex and not caused by a single factor.
We are also planning skills-based training opportunities for staff to become familiar with Enhanced Psychological Interventions for Suicide Prevention and hope to have these available in 2024.
Dr Sarah Weldon, Principal Educator for the Forensic Workstream for NHS Education for Scotland, recently showcased the work of NES & the School of Forensic Mental Health at the International Association of Forensic Mental Health Services in Montreal in July 2019. This was be a unique opportunity to demonstrate the impact NES & the SoFMH Training has had on increasing access to psychological therapies in forensic services.
The aim of the project was to pilot a series of adapted versions of the established NES training course “An introduction to CBT for Anxiety.” This was to meet the specific needs of staff working in three specialist areas (Older Peoples, Forensic and Substance Misuse Services) and to assess the acceptability of the new training.
The COBRA study (Richards et al, 2016) demonstrated that the provision of a simpler therapy, Behavioural Activation (BA), was as effective and cheaper than Cognitive Behaviour Therapy (CBT) in meeting the needs of people with depression. Working as part of the Scottish Government’s Mental Health Strategy to increase access to psychological therapies and interventions, NHS Education for Scotland (NES) trained a group of Scottish experts to provide training in Behavioural Activation for Depression (Martell, Dimidjian & Herman-Dunn 2010) within the NHS boards.
This cross-sector project and the web-based resources created, address a key recommendation identified in the Scottish Strategy for Autism (2011) regarding transitions and change and the associated learning needs highlighted in the NES Autism Training Framework: Optimising Outcomes (2014). They also complement the Principles of Good Transitions and the Autism Transitions Supplement produced by the Scottish Transitions Forum and Autism Network Scotland (ANS).
'The Delivery of Psychological Interventions in Substance Misuse Services in Scotland Report’ was published by the Scottish Government in June 2018. The paper was developed by the Lead Psychologists in Addiction Services Scotland (LPASS) in partnership with the NES PI&TAMH Substance use workstream. This guidance has been introduced as a framework to help local areas assess their own training needs and plan for the development of the workforce. Following the publication, a series of events looked at how to maximise the use of current education and training resources to support this report and highlight current training opportunities offered by NES to support workforce development.
The aim of this project was to evaluate partnership working between NHS Education for Scotland and Penumbra to train third sector staff in Cognitive Behavioural Approaches, a psychological intervention used to support people with mental health problems.
Evidence based psychological approaches (EBPA) help people make positive changes in their lives. Health Boards, Social Services and the Third Sector are increasingly working together in an integrated system to implement effective, evidence based psychological approaches for people with mental health problems. We know from Implementation Science that effective evidence based approaches are delivered successfully when effective implementation methods are used within an enabling context, resulting in positive outcomes for people. This pilot project aimed to investigate:
Last updated: 05/10/2023