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The Clinical Associate in Psychology (CAP) is a new role recently introduced in England. The role is designed to provide greater access to psychologically informed services, filling the gap between assistant psychologists and registered practitioner psychologists.
A Clinical Associate in Psychology (CAP) from our PPN South West CAP Community of Practice has conducted interviews with an apprentice CAP, a clinical tutor and lecturer on a CAP training course, and a carer of a service user, to give a taste of what the role entails, what the future holds, and the impact that the role can have on the lives of the people CAPs support. The interviews include insights on what makes the role different and the challenges and opportunities it presents, as well as the story from a parent of a young service user about how the support from a CAP helped her daughter and their family.
Apprentice CAP Victoria Helsby
Gloucestershire, Complex Emotional Needs Service
What it is like working as an apprentice CAP who is close to graduating?
My role is varied, I work alongside nurses and care coordinators, and I also do a bit of care- coordinating. When I started, I pictured a lot of direct clinical work – one-on-one work with clients. However, I do a lot of indirect work. For instance, I provide supervision for people, I feel very confident in my multidisciplinary team now bringing psychological perspective to teams. My role is different every day.
How does this role differ from the other roles you have held in the past? Are there any challenges?
In my current role working as a CAP, I feel I am more like a resource for others. This role feels like a step up from my previous roles. When I was working as a Band 4 worker previously I felt a bit stuck, I did not feel confident answering people’s questions, but following my training and experience as a CAP, now I feel more confident answering their questions and supporting others with their work.
In terms of challenges, this can be a double-edged sword. When people come to me with questions, I have to think whether I am the right person to answer all these questions. I suppose I have to remind people that I am still fairly new, and direct people to more experienced colleagues.
I am confident to say I am a psychologist now, it took some time for people to really understand what our role was, what being a CAP meant, and the remits of our work. It is getting better, and an increased number of CAPs are trained and coming into services now.
What has the training been like for you?
The teaching was excellent. It feels like it was a long time ago. At first, it did not feel easy at all, but looking back now it was well-rounded. The transferability of the things we were taught was spot on. There is real applicability of what we learnt. It covered lots of things, and the ethos of the university, like thinking systemically, and the way of working with people considering values has been beneficial. I enjoyed how university taught us certain ways of thinking and working such as considering themes of power, diversity, inclusivity that run all the way through and are crucial.
What resources have been beneficial to you during your training?
The book Formulation by Rudy Dallas & Lucy Johnson has been my absolute ‘go-to’ book, and bible. I read this book back-to-back. I came back to study ten years after graduating. The university library service and support have been immensely helpful. It really helped me with accessing articles, finding the right resources, and taught me how to access journal articles. We did everything remotely, and I like going into a library and using hard copies. The library services really helped me do all my searches electronically.
What are your hopes and aspirations for the future?
I like the service I am in; we are providing a service for people with personality disorder diagnosis. I am hopeful I will stay in this team and there is a clear progression for me. I’d love to progress here to a more senior position. The academic side of the program was exhausting, so I now would love to focus on my clinical work and enjoy working with my clients. I am excited about this.
During my time working in the recovery team I noticed how having a psychological perspective in the team CAPs bring can bring huge benefits to teams. Providing a formulation early on for people have been incredibly valuable. I know our clients appreciate having this work provided for them earlier on in their journey. Things are shifting from a psychiatric understanding to a more psychological understanding.
What would be your one tip for future apprentice CAPs?
My mischievous answer would be to cancel all your plans, stock up the fridge, and take care of yourself!
My advice is to persevere in the beginning. There is so much uncertainty at the start; people are asking questions about your role, and not knowing your work and its remits which can be uncomfortable. I sometimes felt like I did not know how much I could continually answer people’s queries about my role. This is part of the process, people are finding out and learning about your role, and part of the journey is to make it work for you and the service you are in. Keep going, it gets better. When I look back I am not bitter, it was all worth it. Look after yourself, especially during hand-in times.
Alison, the mother of a young person who received support from a CAP through a Children and Adolescent Mental Health Service
Pseudonyms have been used to protect interviewees’ confidentiality
Please tell us about yourself, and what brought you to services
I am Alison, and my daughter Gi is 16. We sought help from CAMHS services because our daughter has been experiencing severe anxiety, which impacted her studies, social life, and overall wellbeing.
What was the help you received from a CAP?
The help we received was very reassuring and comforting, and we were supported as a family well. The service came just in time for my daughter; the school was not listening to us and kept sending attendance letters, which added pressure on us as a family. They did not understand ‘Social Anxiety’, and we felt very lonely and helpless as we did not know how to help our daughter; and what to do precisely to support her. We were lucky to have met the CAP quickly following the GP referral. The CAP enabled us to understand what was going on, how to support her, and most importantly, helped us build the bridges between school and our daughter. We were provided with a school consultation where we met our daughter’s teachers, and our daughter’s CAP steered the conversations providing us with psychological information to understand what was going on for our daughter. This meeting was crucial and helped us to cement those good relationships with her school where we worked as a team for our daughter’s wellbeing.
What aspects of the help and support you received from the CAP have been most beneficial to you?
A real understanding of anxiety, recognizing this as a mental health difficulty, not just “school refusal.” It was hard to handle the school’s “get on with it” attitude, at the beginning, which did not help our daughter. When we started receiving help from a CAP, we felt heard about the seriousness of her difficulties – where she was. Our daughter felt very isolated and alone with her experience of anxiety. Hearing from her CAP that her difficulties were social anxiety symptoms, and normalising some of her feelings for her helped her feel heard and validated. Our daughter received the type of help she needed at the right time from a trained professional, who was warm, approachable, knowledgeable and understanding. We are grateful for that.
Were there any challenges around receiving support from a CAP?
No, we did not experience any challenges. The referral process was smooth. We were seen fairly quickly by the CAP. The most helpful for our daughter was CAP offering home visits and meeting our daughter at school in the hub which helped her at the beginning of this process. The CAP took my daughter for walks for some of the sessions when she was feeling unwell, I think this helped her normalise her feelings, a professional approaching her just like a young teenager and offering flexible sessions rather than full-on clinical treatment. The help my daughter received from her CAP was flexible, and the pace was in line with her needs. We have an incredibly positive experience and can’t praise her CAP enough.
What would you say to family and friends about CAPs?
It could not have been more necessary. I wish more parents could have access to it. I hope these services are made available in more areas. It really helped our daughter when she needed help, and she is now thriving, got a part time job, has amazing friendships, and is enjoying her life completely anxiety-free thanks to the support she got from her CAP within CAMHS.
Joanna Ede, CAP, Clinical Tutor & Lecturer
CAP MSc Programme, Plymouth University
How does your CAP professional identity differ from the other roles you have held?
When I applied for the CAP training role, I was acutely aware that in I was missing an appropriate qualification to prove my standing as a professional. Training as a CAP, I realised that the duties I was learning about were the very things I held true as my values as a practitioner. As a CAP now, I often reflect on the duties I trained and qualified in. I champion them in my professional role. This supports me in advocating for the role’s development. I am proud to have this qualification and professional standing. It is perceived by people in the mental health field as a key part of the professional interaction I have with them.
What is it like working as a Clinical Tutor & Lecturer in the Plymouth University CAP program? Are there any challenges, and what resources do you need to overcome those challenges?
I was very excited by the development of the Clinical Tutoring/ Lecturing role in the CAP program. I spent some time consolidating my experience upon qualification from the CAP course. I knew this was a new skill set to be able to try and help others train in the same context. It is a busy week, and there are lots of tasks associated with the pastoral care of the apprentices. There are lots of planning activities, trying to make sure that the program makes the most sense to apprentices and employers. There are lots of exciting opportunities to champion the CAP role outside of the program, for instance career talks, work experience for college students, and promoting the CAP role to prospective employers.
My personal challenge is to remain working in the field as a CAP, so I do an honorary contract for my local NHS trust. This helps me stay up to date as a CAP, use real life examples to support apprentices and employers with context of how the CAP role works in the real world.
How has your professional life changed since you completed the MSc CAP course?
Since completing the course, I have had more opportunities than in my entire adult career. I was able to supervise others formally, I received more pay as a qualified clinician compared to other unqualified roles. I had more of a voice in the services I worked for. I feel more satisfaction as a result. As a parent, I also know that I have a strong professional work identity, and I try to balance with home life as much as possible.
What are your hopes and aspirations for the future of CAPs?
I have been extremely excited about new CAPs training in our program and also nationally. CAPs are appearing in much more diverse roles where Psychology hasn’t been before. As part of the program team, I joined the national agenda for CAP career progression, and I am excited by some of the conversations taking place such as accreditation with the British Psychological Society. My hopes for the future include recognition as a Psychological Profession, and that the autonomous part of our profession will be recognised via registration with the Health and Care Professions Council.
Where could aspiring CAP tutors find information about their future career prospects?
I am happy to respond to questions about how I diversified my career upon the CAP qualification, I can be contacted at