Learning from service user and carer involvement in clinical psychology training

Purpose – The purpose of this paper is to build a theoretical model of how and what clinical psychologists
learn from service user and carer involvement in their training.

Design/methodology/approach – A qualitative research design was adopted, and verbatim transcripts of
semi-structured interviews conducted with 12 clinical psychologists were analysed using grounded theory
methodology.

Findings – Findings indicated that clinical psychologists learned from service user and carer involvement in a variety of ways and a preliminary model was proposed, encompassing four main categories: “mechanisms of learning”, “relational and contextual factors facilitating learning”, “relational and contextual factors hindering learning” and “impact”.

Research limitations/implications – Further research is required to establish to what extent the current
findings may be transferrable to learning from service user and carer involvement in the context of educating professionals from other disciplines. Additionally, participants had limited experiences of carer involvement, and more research in this area specifically would be useful.

Practical implications – This study advocates for service user and carer involvement in clinical psychology training, and specific recommendations are discussed, including service user perspectives.

Originality/value – Service user and carer involvement has become mandatory in Health Care Professional Council-approved training programmes for mental health professionals, yet if and how learning occurs is poorly understood in this context. This study makes an important contribution in evaluating outcomes of service user and carer involvement in clinical psychology training by advancing theoretical understanding of the learning processes involved. The authors are unaware of similar work.

Allport, G.W. (1954), The nature of prejudice, Addison-Wesley, Cambridge, MA.

Bandura, A. (1977), Social learning theory, Prentice Hall, Englewood Cliffs, NJ.

Barnes, D., Carpenter, J. and Dickinson, C. (2006), “The outcomes of partnerships with mental health service users in interprofessional education: A case study”, Health and Social Care in the Community, Vol. 14, No. 5, pp. 426-435.

Benbow, S.M., Taylor, L., Mustafa, N., and Morgan, K. (2011), “Design, delivery and evaluation of teaching by service users and carers”, Educational Gerontology, Vol. 37, No. 7, pp. 621-633.

Charmaz, K. (2006), Constructing grounded theory: A practical guide through qualitative analysis, Sage, London.
Cowden, S. and Singh, G. (2007), “The ‘user’: friend, foe or fetish? A critical exploration of user involvement in health and social care”, Critical Social Policy, Vol. 27, No 1, pp. 5-23.

Cook, J.A., Jonikas, J.A., and Razzano, L. (1995), “A randomized evaluation of consumer versus nonconsumer training of state mental health service providers”, Community Mental-health Journal, Vol. 31, No 3, pp. 229-238.

De Waal, F. B. (2008), “Putting the altruism back into altruism: the evolution of empathy”, Annual Reviews in Psychology, Vol. 59, pp. 279-300.
Department of Health (2005), “Creating a patient-led NHS”, Author, London.

Department of Health (2007), “Putting people first: A shared vision and commitment to the transformation of adult social care”, Author, London.

Department of Health (2009), “New horizons: A shared vision for mental health”, Author, London.

Department of Health (2010), “Equity and excellence: Liberating the NHS”, Author, London.

Dirkx, J. M. (2006), “Engaging emotions in adult learning: A Jungian perspective on emotion and transformative learning”, New Directions for Adult and Continuing Education, Vol. 109, pp. 15-26.

Doel, M. (2007), Participation: Finding out what difference it makes. Stakeholder participation – Resource guide, Social Care Institute for Excellence, London.

Freud, A. (1936), Ego and the Mechanism of Defense, Hogarth Press, London.

Glaser, B. (1992), Emergence vs forcing: Basics of grounded theory analysis, Sociology Press, Mill Valley, CA.

Happell, B., and Roper, C. (2003), “The role of a mental health consumer in the education of postgraduate psychiatric nursing students: The students’ evaluation”. Journal of Psychiatric and Mental Health Nursing, Vol. 10, No 3, pp. 343-350.

Henwood, K. and Pidgeon, N. (2003), “Grounded theory in psychological research”, in Camic, P, Rhodes, J, and Yardley, L. (Eds.), Qualitative Research in Psychology: Expanding Perspectives in Methodology and Design, American Psychological Association, Washington, DC, pp. 131–155.

Health Professions Council (2013), “Involvement in education and training programmes – consultation responses and our decisions”, available at http://www.hpc_uk.org/assets/documents/100040C1Enc08Serviceuserandca... (accessed 10 July 2013).

Ikkos, G. (2005), “Mental health service user involvement: Teaching doctors successfully”, Primary Care Mental Health, Vol. 3, No. 2, pp. 139-144.

Involve (2004), Involving the public in NHS, public health and social care research: Briefing notes for researchers, (2nd ed.), Involve, Eastleigh, Hampshire.

Involve (2007), “The impact of public involvement on research: A discussion paper from the INVOLVE evidence, knowledge, and learning working group”, available at www.invo.org.uk (accessed 4 March 2012).

Khoo, R., McVicar, A. and Brandon, D. (2004), “Service user involvement in postgraduate mental health education. Does it benefit practice?”, Journal of Mental Health, Vol. 13, No. 5, pp. 481- 492.

Klein, M. (1940), “Mourning and its relation to manic-depressive states”, International Journal of Psychoanalysis, Vol. 21, pp. 125-153.

Kolb, D. (1984), Experiential learning: Experience as the source of learning and development, Practice Hall, New Jersey.

Lave, J. and Wenger, E. (1991), Situated learning: Legitimate Peripheral Participation, Cambridge University Press, Cambridge.

Link, B.G. and Phelan, J.C. (2001), “Conceptualising stigma”, Annual Review of Sociology, Vol. 27, pp. 363-385.

Link, B., Yang, L.H., Phelan, C. and Collins, P.Y. (2004), “Measuring mental illness stigma”, Schizophrenia Bulletin, Vol. 30, No. 3 , pp. 511-541.

Mason, T., Carlisle, C., Watkins, C. and Whitehead, E. (2001), Stigma and social exclusion in healthcare, Routledge, London.

McCusker, P., MacIntyre, G., Stewart, A., Jackson, J. (2012), “Evaluating the effectiveness of service user and carer involvement in post qualifying mental health social work education in Scotland: Challenges and opportunities”, The Journal of Mental Health Training, Education and Practice, Vol. 7, No. 3, pp. 143-153.

Mezirow, J. (2000), Learning as transformation: Critical perspectives on a theory in progress, Jossey Bass, San Francisco.

Minogue, V., Holt, B., Karban, K., Gelsthorpe, S., Firth, S. and Ramsay, T. (2009). “Involvement in mental health education, training and research: A literature review”, Mental Health and Learning Disabilities Research and Practice, Vol. 6, No. 2 , pp. 211-227.

O’Reilly, C.L., Bell, J.S. and Chen, T.F. (2012), “Mental health consumers and caregivers as instructors for health professionals: A qualitative study”, Social Psychiatry and Psychiatric Epidemiology, Vol. 47, No. 4, pp. 607-613.

Rush, B. (2008), “Mental health service user involvement in nurse education: A catalyst for transformative learning”, Journal of Mental Health, Vol. 17, No. 5 , pp. 531-542.
Rush, B. and Barker. J.H. (2006), “Involving mental health service users in nurse education through enquiry-based learning”, Nurse Education Practice, Vol. 6, No. 5, pp. 254-260.
Spencer, J., Godolphin, W., Karpenko, N., and Towle, A. (2011). “Report: Can patients be teachers?” , The Health Foundation, Newcastle.

Strauss, A. and Corbin, J. (1998), Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.), Sage: Thousand Oaks, CA.

Tew, J., Holley, T. and Caplen, P. (2012). “Dialogue and challenge: Involving service users and carers in small group learning with social work and nursing students”, Social Work Education: The International Journal, Vol. 31, No. 3 , pp. 316-330.

Thornicroft, G. (2006), “Shunned: Discrimination against people with mental illness”, Oxford University Press, Oxford.

Tickle, A., Davison, C. (2008), “Sowing the seeds of change: trainee clinical psychologists' experiences of service user and carer involvement on placement”, The Journal of Mental Health Training, Education and Practice, Vol. 3, No. 1, pp.33 – 41.

Townend, M., Tew, J., Grant, A., and Repper, J. (2008), “Involvement of service users in education and training: A review of the literature and exploration of the implications for the education and training of psychological therapists”, Journal of Mental Health, Vol. 17, No. 1, pp. 65-78.

Vandrevala, T., Hayward, M., Willis, J., and John, M. (2007), “A move towards a culture of involvement: involving service users and carers in the selection of future clinical psychologists”, The Journal of Mental Health Training, Education and Practice, Vol. 2, No. 3, pp. 34-44.

Willig, C. (2001), Introducing qualitative research in psychology: Adventures in theory and method, Open University Press, Maidenhead.

Wood, J., and Wilson-Barnett, J. (1999), “The influence of user involvement on the learning of mental health nursing students”, Nursing Times Research, Vol. 4, No. 4, pp. 257-270.