Paraprofessionals delivering brief psychological interventions: Qualitative accounts of training and supervision

Aim: In response to the ever-increasing demand for access to mental health provisions in the United Kingdom, there have been innovative studies examining brief interventions. Some services are increasing their efforts to train and supervise paraprofessionals to deliver brief, low-intensity psychological interventions. It is essential to consider paraprofessionals' experiences in acquiring and providing new interventions. This qualitative improvement project aimed to learn about paraprofessionals' experiences of receiving training and supervision to provide brief psychological interventions.

Methods: All providing paraprofessionals in two secondary care adult mental health community teams in the East of England completed a semi-structured interview, which was transcribed and subjected to thematic analysis.

Results: Self-directed learning helped build participants' understanding of the interventions and repeating procedural skills helped build their confidence. Shadowing, peer support and availability of supervising psychologists emerged as important factors in the service of learning. Following the skill acquisition stage, many participants described an increase in their comfort to work flexibly and reported being patient-centred in their approach. Paraprofessionals described natural uncertainties arising when learning a new intervention, demonstrating self-reflection over their practice.

Discussion: This qualitative improvement project provides evidence that recognised learning processes and models in developing therapists' skills are also applicable to paraprofessionals with little experience. With a focus on using manuals to ensure consistency of the delivery of interventions, the paraprofessionals' journey also highlights the different needs in ever-changing community settings. Future research directions are considered.