I am a Psychological Wellbeing Practitioner (PWP) working within North Staffordshire Wellbeing Service, and have been with the service since October 2016. I have now qualified, having completed a post graduate course in Low Intensity Psychological Interventions in October 2018. A PWP’s role is to provide talking therapy to clients who come to the service seeking support for mild to moderate common mental health problems. Although this is central to every PWP’s responsibilities, a working day for one PWP can differ considerably from another.  Please read on to find out more about my experience working as a PWP for North Staffordshire Wellbeing Service!

The training I have had has enabled me to guide clients to help themselves improve their wellbeing with the use of techniques based on Cognitive Behavioural Therapy. It is my job to inform the client of evidence-based techniques that could help, present relevant research and to motivate the client to change unhelpful ways of thinking and behaving that could be making them feel worse. It is not my job to tell the client what to do or what to change, and ultimately the only person who can make that change is the client themselves. Within sessions, I offer support to the client while they use the techniques and I review their goals and progress in an empathetic and compassionate way, as change is something that most of us, whether struggling with our health or not, find difficult.

The people I work with may be struggling with Depression, Generalised Anxiety Disorder, Panic Disorder and/or Obsessive Compulsive Disorder (that may be mild or have started to be a problem more recently). They may also be struggling with a long term condition such as Diabetes or Arthritis and therefore I work with many people who have completely different goals. My work may be helping a person overcome panic attacks so they are able to attend their lectures at University, or it may involve working with someone to help them overcome feelings of low mood and poor motivation, so they can interact with their family again. To help clients achieve these goals I can offer up to 10 weekly sessions that last up to 30 minutes long. Some sessions are face to face and some happen over the telephone, which can be more convenient for people than coming into the service every week.

For many people this way of working will be enough to empower them to make change and notice the benefits from this, ultimately recovering from the problem they first came to the service for. However, this is not the case for everyone and some people may need longer sessions looking at different techniques and more detailed aspects of their problem to notice improvement in how they feel. Due to this, a crucial part of being a PWP is knowing when your work is not working. This is when I need to make use of the ‘stepped care’ model and ‘step up’ a client to start working with a Cognitive Behavioural Therapist, Counsellor, Interpersonal Therapist or Community Psychiatric Nurse (CPN) within the service, or signpost to other third sector organisations.

"The moment it is identified that the client is not improving and for that client, working with a PWP if not sufficient, I think ‘I can’t help, but who can?’"

Knowing the limits of the PWP role - and therefore knowing that not everyone will improve working with you - naturally leads to working closely with other professionals. The moment it is identified that the client is not improving and for that client, working with a PWP if not sufficient, I think ‘I can’t help, but who can?’ This is when I use supervision, both case management and clinical skills, to reflect on the step 2 work completed and to discuss the next steps that could be offered to the client. For this reason, outside of sessions I spend a lot of time building relationships with different professionals and liaising with other organisations. I find this part of the work enjoyable and extremely valuable, as it has given me a greater awareness of other professional’s roles and has enabled me to have more detailed conversations with the client about their next steps, which I hope reduces the uncertainty that a change in support could bring.

I am lucky to have the opportunity within the service to potentially have contact with people right the way through  their recovery journey. For half a day within my week I work as part of the duty team, taking calls from other professionals and, most importantly, people who have decided ‘today’s the day to accept I’m not OK and ask for help’. Normally I spend around 5-10 minutes on the phone with people who call to understand the nature of their main difficulties so I can either book them in for their first appointment with a PWP or a CPN. I use all my therapeutic skills in that short call to communicate that they have reached a supportive service that cares. At a first appointment, I would spend one hour with a person to understand in more detail their main problem, their goals and to discuss treatment options. I would also explore self-help materials with them so they can learn more about how they may start working towards achieving their goals from their very first session. I offer 8 of these 'first sessions' a week; the rest of my week involves both face-to-face and telephone treatment sessions and weekly case management supervision, in addition to bi-weekly clinical skills supervision. I may actively be working with 18 clients in treatment at one time and am in sessions for approximately 4 hours of each day.

"I use all my therapeutic skills in that short call to communicate that they have reached a supportive service that cares."

I also need to complete thorough notes and administrative tasks within my working day. If a client needs more support, for example they are presenting with risk and need more urgent care arranging for them, this can make for a very stressful and busy day and can put other tasks on the backseat. Stress is inevitable within the PWP role, as it is characterised by working with a high volume of people. Therefore it is not only important for me to be flexible, organised and able to prioritise well, but also to be able to look after myself as well as the clients I am working with. So in the above scenario I would need to be flexible and spend more time with the client who needs more support, I would need to be able to organise potential cover for my next appointment if needed and prioritise by devoting complete time and attention to the needs of the distressed client in front of me. 

Finally, when the session is over, the client has been listened to and the appropriate next steps have been taken, I need to look after myself. For me this is talking to my colleagues, getting a cup of tea, talking to my partner at home and then going to the gym to release stress. I also talk to my supervisor; it always helps having someone who listens, can share similar experiences and who offers support. Self-care in the role was not always something I thought needed prioritising and it is still something I sometimes need to remind myself about. What works for one person will not work for another; but it is an essential part of my working day and enables me to be the best PWP I can be. For anyone wanting to become a PWP my advice would be to find your ways of managing stress – then use them!

"Self-care is an essential part of my working day and enables me to be the best PWP I can be."

The PWP role has a lot more to offer than purely working within clinic. Within my service I have opportunities to conduct research, become a service champion and to develop my leadership skills, all goals that are important to me. I am currently the Younger Adults Champion, which has given me the opportunity to project manage and liaise with other institutions such as the local University. I am directly involved with promoting the service to get more young adults accessing support for their mental health and am gathering information on ways of working with younger adults, including using digital resources with the aim to learn more about improving younger adult’s engagement with treatment. I also work as a ‘Buddy’ within the service, supporting new starters who are starting out in their career as a PWP. As a part of this I have developed the North Staffordshire Wellbeing Service PWP New Starter Pack, which offers information about the PWP role and working in our service, as well as opportunities that are possible to pursue as a PWP.

I look forward to my future working as a PWP within North Staffordshire Wellbeing Service. Although this is a stressful role, this is outweighed by how rewarding it is and how valuable the role is to our society as a whole due to the number of people we reach. This is an exciting time to be working as a PWP as more attention is being brought to the role nationally and we are being recognised for the hard work we do. I would recommend this role to anyone who is motivated and committed to wanting to help as many people as possible help themselves to recover from common mental health problems most of us will experience at some point in our lives.

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