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I'm Kevin Baker
I'm a clinical psychologist from Notts Healthcare, that's quite a long way away.
I'm seconded to
do the teaching on this course
and that's what we're going to talk about today.
I used to be a psychology lecturer as well, so teaching is quite natural, normal for me.
Briefly at first I'm just going to give you a brief overview of
the program that we're going to be talking about
is an IAPT programme that we run within the Faculty of Health
So IAPT stands for Improving Access to Psychological Therapies
and it's a national program and that is run in a number of universities across the country
to deliver psychosocial interventions for people who are experiencing
mild to moderate anxiety and depression. So it runs across England
and it offers psychological interventions which are based on NICE guidelines
so it's a very prescribed course and which is based on the evidence base
NICE guidelines people with anxiety and depression
Improving Access to Psychological Therapies in Primary Care
offers a number of different courses to people with mild to severe mental health
problems
but he one that we run a John Moores is for people with mild to moderate mental
health problems
So the students we have at John Moores
train to be psychological wellbeing practitioners
PWPs for short and
this role is a year-long course John Moores there
there with us and University one day per week and they're practice, thay're employed in
practice four days per week
to start to work as psychological wellbeing practitioners.
and I said it is to work with people with mild to moderate mental health problems.
we offer the course at undergraduate level
level 6 and also at postgraduate level 7
certificate level and the programme that we offer
and people come onto the course it's taught together
but people come on to the course and they're assessed whichever level
that they're on the program. So the programme started at John Moores
in 2008 we were successful in Manchester a new plan to deliver
PWP training in the North West and we've run the course twice per year
since 2008. Then in 2011
the SHA in the North West
agreed nationally to support and to fund the training to deliver
the same program for individuals who were deaf
and the tender went out in 2011 and again we were successful
to deliver that programme.
That programme is the same one-year programme at undergraduate or postgraduate level
same curriculum but is taught in BSL
for individuals taht are deaf to support people with mild to moderate mental health
problems who are deaf. So that started in 2012
and the first cohort that we have started in January
and that's the cohort Kevin's going to talk to you about as we go on today.
When we originally applied for the tender and
from a number of different levels at John Moores but also at the SHA
it was thought about that we would just deliver exactly the same
program
and same structure but just that
we will teach the program and we would have interpreters at the side
of us teaching students and naively on a number different levels we thought
that's what we would just do and it would work fine and it the delivery was quite...
that would be the same.
the more that we started to look into it the more
we all looked at that wouldn't be an effective program and it wouldn't have
worked on
a number of different levels so we then started to make numbers of different adaptations,
so we made afdaptations to the curriculum so
because people can't travel in from across all over the country
and we had to change the structure and that people can be traveling on one
day per week also that we have to look at the structure in the teaching
sessions,
the content and how they would be delivered we looked at that it wouldn't have been
effective or as effective
was to be teaching it with an interpreter so we were to look for
somebody who's able to teach the sessions which Kevin
is also fluent in BSL who then would be able to deliver the programme.
None the materials were in BSL so we ought to look adapting the materials
the National materials and all our own a local materials
the assessment guidelines and different things had to be looked at
and the assessment structure overall.
How we undertook the assessments, how we delivered exams
also had to be revised so from thinking it would be quite straightforward
there was lots of changes to the programme that happened
so from a program level we had to make changes
from a JMU level I think it was something that again as the Faculty and as a
University we needed to look at how we
how we were going to deliver this programme and make sure that it
was a successful program and the environment that we deliver the programme in
which is the Tithebarn Street Building
was an effective building so there was knowledge and
an awareness that we needed as as lecturers about working with students
who
are deaf and also about the support that we can offer
and identifying people within the Faculty who are also
fluent in BSL to able to support students coming to the University
and linking in with services and the disability services and linking in
with the support that they offer. It's been a learning curve
for us at JMU to make sure that we were delivering this program
effectively and then also for the professional body
again the professional body and which is the BPS the British Psychological Society
I think also thought that we'd just deliver this same program
and again just using interpreters and it would flow the same way
so we've had to have a lot of communication with those to make sure that
these tarinees will still come out is accredited practitioners and
can still practice and and be registered with the professional body
so that again has taken a lot of and emails meetings
to be able to ensure that we made some adaptations and it make it flows as well.
So it has I think now we're getting it right
and with that what we started with the beginning is very different program to
actually how it started to flow through
so Kevin's just going to go through the programme with you.
Thanks Lisa
I don't know where to start really because there was so much we needed to
change I must admit first when they asked me to do the teaching I said no
because there was so much to change so it's been a
by a along process as Lisa's explained
I mean in a way it's obvious but only in hindsight
because the reason we're using
and new way of teaching people to do PWP
training beacaue they're deaf and use BSL is the same reason we need to adapt stuff
in the University, you can't just go to a psychologist with an interpreter,
it just doesn't work. You can't just go to a counsellor
with an interpreter for a deaf person, there are lots of cultural aspects that are
different, and that's the same for the teaching situation as well
So who are teaching? We've got seven severely to profoundly deaf
students, one of them is somebody who has lost his hearing city so he
has fluent speech and
fluent English which bodes him quite well
because he can write and read fairly well. But the other students have quite a low level of
literacy and that's normal for deaf people.
Most of them are pre-lingually deaf, so they're born deaf
before they learn language. One of them is post-lingually deaf like I said, so he's a little bit different.
Most have some kind of spoken language but I would say
ninety percent of them, about six of them don't use speech at all.
They'll sign their voice is off
they've got a
reading age of 9 to 11 which is average
for a deaf person leaving school in this country. A few of them have worked really ***
their literacy
they're quite committed students they've obviously been through quite a lot
of experiences that have been quite difficult for them
they've striven quite hard to get to where they are at the moment
so that they're not normal students, they've worked really hard
But really the best way to think of them as
people with English as a second language even the guy who has hearing loss
lost his hearing he has fluent spoken English he still
gets tripped up by idioms and metaphors and things like taht
because he just doesn't hear them in everyday conversation. So we have normal
deaf gaps in knowledge so what a deaf gap is
that common current communication everyday
they miss out on, conversations in the background, in the corridors
the radio in the car that never happens, so they miss out
a lot of knowledge and that's normal.
So we have to work differently towards the Student if they have a gap in their knowledge.
I expect all of them to have average to high intelligence,
as a psychologist, I'm obviously interested in that.
I expect them to have more skill than the normal average deaf person
otherwise they wouldn't be here.
They're all fluent in British Sign Language, we did have somebody who
was fluent in Irish sign language
she cam on the course but had to leave for different reasons.
Like I said, they've all got very good coping strategies, they're role models
to other deaf people, which I think is a bit of a bonus for them being in PWP
they're used to revising, they're used to reviewing course
materials and they do it daily and weekly, not like the hearing students
I used to teach when I was at University
so that they're actually quite different animals from normal students
That makes it easy for us in a way as long as we can do the BSL. So you how do we know what to do with a deaf student
when you've got one? Well usually things happen quite differently to what we're doing,
that's what we're going to talk about.
Deaf education
education of deaf people is usually based on
these kind of things, the Warnock report in 1978 which is really about inclusive education
it's about mainstream about putting people mainstream
situations to include them in mainstream society. It's not very good
doesn't really work, Warnock doesn't like it any more. The Education Act were based on that and
educational policies in the
nineties based on the idea of inclusion and we can look at those policies and try and work
out what to do with the deaf student
and I'll explain what happens in a minute. There's also stuff in higher education
not very much of it there's some kind of stuff
some local areas of expertise in working with deaf students and some
universities
but not very often and they don't really published very much or whether
they want to keep all that information to themselves
to make them special but there's some useful
information fromthe Open University called "Hear to Help" on how to adapt your course
for a deaf student on a hearing course
not really useful for us but it's useful for other places
and the advice
all the intention, for all this contacts
teaching deaf in higher education is to provide sign language interpreters,
have loop systems in the rooms so they can switch their hearing aids on and hear
something, not very good if they don't use hearing aids
and maybe to have communications
support workers who would help translate the communication
into a simpler level of English or sign language.
Take notes or somebody on a Palan typewriter one of those
stenography machines to write something up in
in visual English rather than acoustic English and having vibrating alarms.
So all of these issues we had to do with in the course and the University
but a lot more because we doing it differently, we're not include
we're not having a deaf student in with a group of hearing students
which is really what this all about.
All these and mainstream inclusion
courses they have to adapt their written assignments as well
which does make it quite difficult when you've got one student in a cohort
of hearings students doing something differently. It's actually easier
for us. We know from the research and education
learning style are influenced by teaching styles, and learning styles influenced by the couse
context and pre-existing beliefs of a student.
Tha's the same for any student, hearing or deaf, that's what the research says.
We know there are two types of learning
at least one we could call menial
reconstructed oriented learning, we want the student to actually reconstruct
the meaning but we're trying to give to them and that's
linked to a deep approach by getting the students
to relate ideas to eachother using evidence
try and get a comprehensive understanding of
an area they may not know everything but they might
least know how to get to know everything and that's what we're trying
to teach to degree level and trying to encourage
active questioning of the lecturer seminar groups etc.
trying to get them to relate one module one topic in a module to other
topics
trying to get them to relate evidence to conclusions
and to think divergently. I think that's the aim of higher education.
But conversely we have reproductive oriented learning
where we take a surface approach, we're bound to a syllabus
as we are on the IAPT programme
I've forgotten what improvidence means so I'll leave that outside
but that tends to engender a fear of failure in the students
because they know they have a set criteria
of facts that I have to learn. In this situation we
encourage students to memorize stuff and I'm defining the task that
I want them to do this reliance on the detail they have to cover
and that usually engenders anxiety about
their own academic performance and also my anxiety about my students academic performance. I can see from
both of those approaches
they're both valuable, they both have places
but we may want to put more emphasis on the meaning or reconstructed
oriented learning at the end of a degree course, definitely in the third year
now in the the Postgraduate Certificate that we're after to think we're looking
for the same kind of thing
but because we're within the confines a program
of practical applied work being a psychological
wellbeing practitioner there's a lot of this to go through first.
I'm not promoting one above the other but they're both
important, but perhaps the meaning of reconstructed learning is the one
really want to end up with at the end of the course
But what does this tell us about deaf people you know does this apply to
deaf people in their experiences because of course it's
the pre-existing beliefs of the student
that makes teaching and learning easier
for a course and a tutor
this is all available to hearing students in 18 19, 20 the mid
20s a 30-year-old
hearing student can be easily access this theory
of information, deaf people don't so these
hypothesis there that deaf students come with pre-existing
expectation different from hearing student
because their experiences at deaf education is quite different.
and indeed it is actually. In mainstream settings
you usually get one or two deaf student and in a cohort
hearing students so they're the minority and they're different
and interpreters is there to help them access information that's the intention of
the inclusive education plan that Warnock
encouraged. I mean I from the research
that situation encourages reproductive learning style
because there's a preference when you have an interpreter in the room
everything is focused on teacher through the interpreter
we know the interpreters in higher education
have a style of inetrpreting that
encourages rote learning it doesn't encourage
deep learning because there is no opprtunity to question the interpreter.
or the lecturer and I'll explain why in a minute, there is a little bit of a delay
between the speech
and explanation or the metaphor used by the lecturer
and the interpretation
given by the sign language interpreter. We know that context can give a neutral and reproductive style of interpreting
and that's quite common in I'm intepreting situations
sign language interpreters tend to come to universities and they've also got a
reproductive style of learning in their heads and that's what they think the lecturer situation is about
so they don't actually interrupt the lecturer and say
"Oh hang on my deaf student didn't understand, can we have adiscussion about that?"
that doesn't happen because they've also got the interpreter now
in the situation of learning however
sign language interpreter training doesn't promote that idea
in interpreters and we know that from research in the
UK and in America to that interpreter training
can influence the context of learning in Universities.
So here's a typical interpreter situation
so we've got a lecturer there and an interpreter doing his job
and the lecturer's probably thinking "I know this topic really well that's why I'm teaching it"
but I don't know a thing about deaf students or BSL, but there's no need to worrry
because I've got the interpreter. So the lecturer
is already distancing him or herself from the deaf student.
So here's a situation again, class of hearing students,
lecturer talking away, sign language interpreter, a deaf signing
student in the corner separated off
and I they talk, the sign language interpreter is hearing things at the same time as the hearing students
but the interpretation comes a bit later so there's a delay.
But the sign language interpreter was probably thinking
"I don't understand this topic at all, I'm psychologists or a nurse or an OT or whatever
but I'll try my best in BSL, but I
hope the deaf student asks questions already inserprter's
putting themselves out of the responsibility of the learning situation
and then the deaf student's probably thinking
"I don't understand the interpreter, What is he going on about?" Blaming the interpreter.
Or, probably as well as, "I don't understand the lecturer, what is going about?"
"All this is all too complicated for me I bet all the hearing students
understand this!", which is a similar thought
or expectation that they probably had from school and at home in their family
most families of deaf children are hearing, so they get
used to that expectation. So the difficulties with this approach,
this inclusive approach to higher education is that the deaf student is really reliant on the quality
of the interpretation
and the experienced delay in interpretation
reduces their engagement with the topic provided through the lecture
or the seminar, and also the lecturer feels
disengaged with the student. Different languages expectations happening now.
It's difficult for the student to
engage with any group task, with any discussion and also the
incidental learning
reviewing their homework
or their their assignment topic in the cafe bar
doesn't really happen with the deaf student, they're on their own with their interpreter all the time.
So I would say arguably it's absolutely impossible to be fully
inclusive
and in fact the inclusive approach could do some harm
so what are we doing on this course?
Well's Lisa's given you a good idea it's not just an academic course, it's a practical
and applied course we're trying to teach people who don't have any experience
of counselling or very reduced experience of counselling some basic counselling skills
Which we'd build up on a kind of way that IAPT
want PWP's to be trained. There's some theory in there,
some history, some research evidence that we need to talk about, it's the NHS
contexts and psychological therapies contexts we need to teach them
because they don't know very much about that either
there's also opportunities for them to personally reflect on their own responses
to the situations, to the course, to the future
career and personal development going on so you have to have both
aspects, a meaning oriented approach
to learning and that kind of rote learning approach you need both
and so we've got a bit of a problem if the inclusive approach
just tends to promote reproductive learning.
So how are we doing it?
Well we're teaching all the seminars, all the discussions, all the lectures
in BSL with me doing all of that. We have used interpreters
but students hated it, they really didn't get on well with it because they
had that disconnection
with the lecturer and they couldn't ask questions.
However there's me doing everything in BSL
we did think about note taking
and having a note taker and a couple of students wanted that because that's what their
expectation
from mainstream inclusive courses, they would have somebody else sitting
down writing and we kind of ummed and ahhed about that for a few weeks
at the beginning of the course. I said well I don't really think you need it
because everything here is BSL we discuss it but note taking is different when you're deaf
because when you're signing in BSL you can't look down and write because you'll
miss everything that's going on so we have to pace lectures in a different
way
we have like 10 minutes discussion, lecturing
me dribbling on about something and then a five minute break for them
to write down but I know that all of them go home at night
and they spend an hour or two writing everything up. They try and look back through the day.
I think that's really noticeable with these students. But also to help this
I have an end of session summary discussion which records
on video which Neal organises for me which is
fantastic. So at the end of a teaching session
could be just a morning or an afternoon, I'll sit down with one of the students
with the camera on us and then I'll discuss what we've just taught.
so with me guiding that discussion and the rest of the class watching us
that's a form of note taking for them but also that
encourages discussion, encourage reviewing the whole topic
that we've learned not missing anything out and it is there permanently
for them to look at So that's something we've
had to produce because we're working in sign language, visual language
and can't take notes at the same time but I don't see why
that has to be a deaf thing that could be for any group of students
and it's quite a good way to review the subject. I used to do it on
some other courses but didn't really video it, I didn't need to. The students
were there writing their notes.
So that's something quite different. All our practical sessions
the role plays that we do, the counselling sessions that we practice were
recorded and we put them all on blackboard with the students permission that they can
review them
and then take notes at a later time
because usually at the end of a session we're all quite tired so
it's best have a bit of a gap and then they can review things
and the only way they can review things is on video.
The students are involved in discussions with each other because they're group of BSL using students and we have some
of the assessments in BSL.
not all of them because you are expecting them at the end of
their training to be professionals
in the NHS and they will have to write reports and letters, so encouraging them to use their
English is quite good
and shows them that we're quite serious about what they need to do. But there are also going to be some things that are actually
quite wrong with this kind of approach of doing everything in
in a deaf culturally acceptable and BSL
way and that's a little bit isolated from mainstream ideas
we miss out from the other hearing cohorts that are
developing their way of working and I think that's a bit dangerous
because the reason that Warnock did her report and we have socially inclusive
policies in education is because we don't want deaf
people to be ghettoised and separate and we know that's bad
we've got danger that happening on the course. We have a segregated group.
It's down to the individual deaf students characters whether they integrate
with the people in the university,
students on the other courses it's down to them actually
I don't really have anything to do with that, but maybe that should be a normal
expectation but there is a danger
of them being segregated. There is no inclusion with mainstream
hearing peers and that's a bad thing so I'm encouraging them to make links
locally with their IAPT services in the NHS
and 2 or 3 are doing it and when they do, you see a huge difference
because they're learning from a different way of doing
psychological wellbeing practitioner work but I can't provide
because I'm concentrating on deafness and mental health, so I'm encouraging that
to mitigate this problem.
And there's some references that we've talked about.