Workforce, training and education
East of England

Clinical Experience


The trainee will be expected to carry out a minimum of 700 clinical hours in their adopted major model of psychotherapy and 100 clinical hours in two supplementary models of therapy.

The three models in will be chosen from psychoanalytic psychotherapy, cognitive behavioural therapy and systemic therapy.  100 hours of clinical practice in the chosen supplementary model of therapy and 100 hours of a third model is required which can include supervision.  The Training Programme Director will decide with the trainee and Medical Psychotherapy Educational Supervisors what clinical experience and models of psychotherapy can contribute to the hours of experience required.

Work place based assessment of all psychotherapies will be undertaken, including the formative Structured Assessment of Psychotherapy Expertise (SAPE) during clinical supervision of therapy, Structured Assessment of Psychotherapy Assessment (SAPA) and a summative Psychotherapy Assessment of Clinical Expertise at the end of each therapy (PACE or Psychotherapy ACE). All these WPBAs are on line in the Royal College of Psychiatrists’ portfolio on line training website.



Clicinal Supervision: Primary Modality

The dual trainee will receive clinical supervision from practitioners both within the scheme in psychotherapy and also outside of the scheme as part of their external academic training.

In the early stages of training (ST4, ST5) clinical supervision is primarily from the Consultant Psychiatrists in Psychotherapy who have a Medical Psychotherapy CCT and who are trainers in the Medical Psychotherapy Training Programme.

Later in training (ST6 onwards) clinical supervision is sought from other professions with a registered training in the chosen model of psychotherapy.

The dual trainee is required to have 700 hours of supervised clinical practice in their primary therapy modality.

The clinical supervisors who supervise the clinical work within the scheme are invited to attend and contribute to the Deanery Medical Psychotherapy Training Committee to facilitate the development of the Medical Psychotherapy Training Scheme.

Clinical supervisor’s reports will be requested on a once yearly basis around six months before the Annual Review of Competence Progression (ARCP).

These Clinical Supervision Reports will be used to inform the annual assessment of the trainee’s progress and development for the Annual Psychotherapy Appraisal between the Trainee, Medical Psychotherapy Educational Supervisor and Training Programme Director prior to and in preparation for the Annual Review of Competence Progression (ARCP).

Trainees will observe assessments and be observed undertaking assessments in psychotherapy using the Structured Assessment of Psychotherapy Assessment (SAPA) to assess.

All trainees will be required to maintain reflective practice reports discussed in Educational Supervision of their psychotherapies and general psychiatry assessment feedback as part of self-reflective practice development in the Advanced Medical Psychotherapy Curriculum (2013).

Clinical Supervision: Supplementary Modalities

The trainee is required to have 100 hours of supervised clinical practice in two modalities other than their major therapeutic modality.


The clinical supervisors in the other modalities will also be called upon to prepare a Clinical Supervisor’s Report at around six months into the placement. Their contributions to the thinking about the development of the dual trainee will be sought and used as part of the annual ARCP. 


The trainee will have experience of assessments of patients for psychotherapy and other psychological interventions, as well as seeing patients for assessment as part of the consultation process.

The trainee is required to have a minimum of 60 hours of assessments.

Joint assessments will be undertaken with Medical and other Psychotherapists with experience of different modalities, and mental health colleagues and medical and psychiatric colleagues as appropriate.

Trainees will observe assessments and be observed undertaking assessments in psychotherapy using the Structured Assessment of Psychotherapy Assessment (SAPA) to assess.

Medical Psychotherapy Consultation

In the first and second years of dual training (ST4 and ST5) the trainee will be offered psychoanalytic consultation on some of the psychiatric cases they see in their training placement psychiatric settings or on call within Educational and Clinical Supervision with a Consultant Psychiatrist in Medical Psychotherapy.

In their first and second years (ST4 and ST5), the dual trainee is a member of a Consultant Psychiatrist in Psychotherapy facilitated (planned) Balint group for Advanced Psychiatry training peers in psychiatry.

From their third year onwards (ST6) the trainee will begin to participate in Medical Psychotherapy Consultation accompanying a Consultant Psychiatrist in Psychotherapy offering consultation on complex patients to other specialist colleagues working in psychiatry and to GPs and other professionals in primary care. In the fourth and fifth years (ST7 and ST8) the dual trainee will undertake their own supervised consultations.

Since clinical consultation is one of the most challenging aspects of the interface between the Medical Psychotherapist and their psychiatric colleagues, careful consideration will be given to the selection of cases and the supervision of this work.

The Medical Psychotherapy clinical consultation interface with other specialists represents the ‘coalface’ for the development of the trainee’s emergent psychotherapeutic and psychiatric identity. 

Medical Psychotherapy Consultation is therefore a crucial and central component of the dual training to become a Consultant Psychiatrist in Psychotherapy.

Work place based assessment (WPBA) of consultation will include cased based discussion (CBD) Structured Assessment of Psychotherapy Expertise (SAPE) and Assessment of Clinical Expertise (ACE).

The Work place based assessment (WPBA) Direct Observation of Non-Clinical Skills (DONCS) can be used for chairing professionals meetings or participating in a Care Programme Approach meeting as part of the ‘consultation sandwich’ approach developed in by colleagues in Leeds. The consultation sandwich includes seeing the professionals, then sometimes seeing the patient, then seeing the professionals again to formulate and offer recommendations on on-going patient care and management.

Tuesday, 27 November, 2018
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Tuesday, 27 November, 2018