Health & therapeutic disciplines: the route to qualification

Thursday, March 26, 2009

Community nurses: Health visitors and school nurses are registered with their professional body, the Nursing & Midwifery Council (NMC), on the Specialist Community Public Health Nurse register.

These professionals work to promote health and prevent ill-health in babies, children, young people and their families. This includes promoting breastfeeding, supporting parenting, promoting health and wellbeing in adolescence and raising awareness of sexual health and healthy eating.

To work in this area, applicants must be a registered nurse. Specialist Community Public Health Nurse programmes are based in higher education institutions. The majority of institutions offering this programme will provide a health visiting route and some will also offer a route into school nursing. All programmes are validated by the NMC and provide theory and practice training.

People who are interested in taking the programme in England must secure sponsorship or employment from a primary care trust (PCT) that is willing to offer a practice-based learning environment. People can do the programme on a part-time basis which usually takes two years, but depends on the PCT. Most institutions require the person to have some experience of working as a registered nurse following registration.

Opportunities also exist for practitioners from other disciplines, such as registered nurses, nursery nurses and unqualified support workers, to work within health visiting and school nursing teams.

Another route into community nursing is as an assistant practitioner, a new and developing role within the NHS designed to help and support the school nurse. The assistant practitioner qualification is a two-year, work-based foundation degree.

Child psychotherapists

Child and adolescent psychotherapists work in a number of settings, including consultation centres for adolescents, social services teams, community-based clinics, hospitals and schools working with pupils who have special educational needs. The Association of Child Psychotherapists recognises psychotherapy courses at five institutions in the UK. These courses can be studied either full time or part time.

As well as meeting the entry requirements of each institution, a student's previous qualifications must be approved by the membership committee of the association's training council. Candidates must also have an honours degree or equivalent and experience of working with children.

Child and adolescent mental health service practitioners

Child and adolescent mental health services (CAMHS) practitioners can include clinical psychologists, psychiatrists, social workers, teachers and nurses.

The Mental Health Social Work Award is regulated and offered by the General Social Care Council as a post-qualification social work award to social workers working in mental health.

However, there are now a few specific postgraduate courses in child and adolescent mental health. City University, for example, runs an MSc in Interprofessional Practice in partnership with YoungMinds, with child mental health included as one of the programme pathways. Anglia Ruskin University runs an MSc and Postgraduate Diploma in Child and Adolescent Mental Health. University College London and the CAMHS Evidence-Based Practice Unit, based at The Anna Freud Centre in north London, run the Outcomes-Based Leadership course for managers in the NHS to help them develop services that best meet the needs of children and young people with mental health problems. In September 2008, UCL and Islington PCT CAMHS will be offering the UCL Postgraduate Certificate, Diploma and MSc in Cognitive Behaviour Therapy and other Outcomes-Based Interventions with Children and Young People.

Specialist CAMHS staff will have a professional qualification in one of a number of disciplines, such as psychology, psychiatry, social work or education. Many will also hold post-professional awards in specific therapeutic approaches, such as family or art therapy. There is also a large workforce in universal children's services working, for instance, in family centres, schools and youth centres, some of whom will have had post-qualification mental health training. However, at present, most professional training includes very little about children's mental health.

Changes are under way, though. There are now specific programmes, mostly at postgraduate level, for primary mental health workers, with at least one programme in each of the nine government office regions in England. The National CAMHS Support Service is working to ensure there is consistency between these programmes.

The picture in Scotland is similar, although there is now a published set of competencies for CAMHS work and a framework document describing the minimum service characteristics. However, neither is linked to a specific qualification. This situation is replicated in Wales and Northern Ireland.

Play therapists

Play therapist trainees must have a first degree or equivalent - usually in psychology, nursing, teaching, social work, occupational therapy or a related field - and have at least two years' experience of working with children.

Trainees can then go on to complete a Postgraduate Diploma or MA in Play Therapy at one of three institutions in England and one in Scotland that are accredited by the British Association of Play Therapists.

The other main provider is the Academy of Play and Child Psychotherapy (Apac), which delivers play therapy courses in Bristol, Cambridgeshire, Dublin, Edinburgh, the Isle of Wight, Leeds, Manchester, Tunbridge Wells and has a summer school in the south of France. It also runs courses in-house for organisations. The minimum age of prospective students is 22 and they must have a degree or equivalent professional qualification. They should also have three years' experience of working with children in some capacity.

The Apac courses, run in a collaborative partnership with Canterbury Christ Church University, are split into four parts - introductory, certificate, diploma and MA by dissertation - with the certificate and diploma courses comprising five, three-day modules that balance theoretical, experiential and practical work. The Apac programme is the only one validated through clinical outcomes research. Apac courses are accredited by Play Therapy UK, Play Therapy International, the International Board of Examiners of Certified Play Therapists and the British Association for Counselling and Psychotherapy.

Hospital play specialists work with babies, children and young people and focus on the therapeutic, developmental and psycho-social aspects of children undergoing surgical or medical investigations and treatment, as well as palliative care. They also work closely with parents, carers, nurses, doctors, social workers and teachers, as well as contribute to the medical and nursing care plans.

The recognised professional qualification for hospital play specialists is a Btec Level 4 Professional Diploma in Specialised Play for Sick Children and Young People. After successful completion of the academic and practical elements of the programme, graduates are entered onto the register managed by the Hospital Play Staff Education Trust.

Students wishing to undertake the programme of study don't necessarily have to be working in a healthcare setting but are required to have some childcare qualification or experience of working with children. 

Speech and language therapy

Speech and language therapists work with children (from babies to school age), adolescents and adults with communication, swallowing or feeding problems caused by learning difficulties or physical disabilities.

They liaise with parents, teachers, nurses and other professionals. The NHS employs most speech and language therapists, although some work for education services or charities and others work ind-ependently and treat patients privately. They work in a variety of settings, including community health centres, hospital wards and outpatient departments, mainstream and special schools, and young offender institutions.

All speech and language therapists must complete a recognised three- or four-year degree course and register with the Health Professions Council before being able to practice. The courses combine academic study and practice and clinical placements, and most require three A-levels or five Scottish Highers as minimum entry qualifications. Some courses require specific GCSEs and A-levels, such as English and biology.

Applicants with an honours or equivalent degree may be able to undertake a two-year postgraduate qualifying course, but subjects in related fields such as psychology or linguistics are often preferred.

To apply for undergraduate courses, students should contact the Universities and Colleges Admissions Service. For postgraduate courses, they must contact the education establishment direct.

Opportunities also exist to work as speech and language therapy assistants or bilingual co-workers. There are no formal qualification or age requirements.

Sue Learner



Association of Child Psychotherapists 020 8458 1609

Health Professionals Council 020 7582 0866

Association of Educational Psychotherapists 0191 384 9512

Nursing and Midwifery Council 020 7333 9333

Play Therapy UK 01825 712312

British Association of Play Therapists 01932 828638

The Royal College of Speech and Language Therapy 020 7378 1200

YoungMinds 020 7336 8445



Kathryn Drechsler, specialist speech and language therapist, Hackney & the City Children's Integrated Speech and Language Therapy Service

Every day is different for Kathryn Drechsler. Her week could begin with a visit to a nursery and a play-based session with under-fives, and end with an appointment working with teenagers at a local secondary school.

Drechsler first thought about a career in speech and language therapy when she was 18, but decided to do a degree in communications at Sheffield Hallam University to keep her options open.

She says: "I was always interested in human communications, so when I finished my degree I did voluntary work experience at The Stroke Association before applying to do a two-year postgraduate speech and language therapy course at City University."

All speech and language therapists are required to study at degree level, but Drechsler believes that work experience was vital in preparing her for work. "The benefit of doing a postgraduate course was that I had a bit more experience than if I had just done an undergraduate qualification. Speech and language therapists work quite autonomously so that's important," she says.

Drechsler's advice to anyone thinking about a similar career is to do work experience. "Speech language therapists have really varied careers. There is a lot of scope for professional development, plus the opportunity to specialise in different areas."

Although Drechsler initially wanted to work with adults, she found she preferred working with children and young people after training in a variety of settings. "There are loads of good things about the job, from getting to play games with the children, to the variety of the work," she says.

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