Re-Accreditation of 2011-2013 GPMHSC Approved Activities

Instructions for applicants

This application form is for training providers seeking accreditation from the GPMHSC for education activities to be recognised as ‘Focussed Psychological Strategies Skills Training’ (FPS ST).

Activities require prior accreditation with RACGP and/or ACRRM before adjudication by the GPMHSC.

Training providers can seek accreditation from RACGP and/or ACRRM using this form.

If you require RACGP and/or ACRRM accreditation, this application must be submitted directly to the relevant College. If you have existing accreditation for this activity with the RACGP and/or ACRRM, you may submit this application directly to the GPMHSC Secretariat.

Training providers are strongly encouraged to view the mental health education standards outlined in the documents: Mental health educations standards 2014-2016: A handbook for GPs and Mental health education standards 2014-2016: A handbook for training providers. Re-accreditation of 2011-2013 GPMHSC approved activities

Training providers who have had FPS ST activities accredited with the GPMHSC in previous trienniums, will need to apply for re-accreditation for the 2014-2016 triennium using this form.

In addition to this completed form, training providers seeking re-accreditation will also need to submit:

A letter outlining the changes that have been made from the original FPS ST application that have been incorporated into this application; and

A copy of an evaluation form report containing aggregated data from the activities conducted in the previous triennium. The report can be identical to the evaluation report submitted to the RACGP and/or ACRRM.

Key contact details:

If you are applying for GPMHSC accreditation of an activity that does not have prior accreditation with RACGP and/or ACRRM, this form must be forwarded to:

RACGP QI&CPD Program ACRRM PD Program

Contact your relevant state/territory faculty: P. 1800 223 226 www.racgp.org.au/qicpd/contacts E. [email protected] W. www.acrrm.org.au

For currently accredited RACGP and/or ACRRM activities applying for GPMHSC accreditation, this form must be forwarded to: GPMHSC Secretariat, 100 Wellington Parade, East Melbourne, Vic 3002 P. 03 8699 0556, F. 03 8699 0570, E. [email protected]

of 17 To applicants:

Please complete Section 1 or 2 and Sections 3 - 8 of this application

Section 1 Please indicate which organisation(s) you are seeking accreditation from using this form:

I want to use this form to seek RACGP QI&CPD I want to use this form for ACRRM PD Program Program accreditation. accreditation. Please complete all orange shaded 'RACGP' sections. Please complete all light green shaded 'ACRRM' sections. Please forward a copy of this application to the RACGP for adjudication. Please note that providers who do not have an existing ‘Provider Contract’ with the QI&CPD Program will be required to pay an adjudication fee. Please complete the Tax invoice included at the back of the form

Section 2 Please indicate if you already have accreditation and are seeking only GPMHSC accreditation:

I already have RACGP QI&CPD accreditation for this I already have ACRRM accreditation for this activity activity and seek GPMHSC accreditation only. and seek GPMHSC accreditation only.

RACGP activity number: ACRRM activity number:

Section 3 Training provider and activity information

of 17 3.1 PROVIDER DETAILS

EAR Name: EAR number:

Provider/organisation: Provider number:

3.3 ACTIVITY DETAILS

Title:

Delivery mode

E-learning URL Blended learning URL

Face to face: Please supply the post code Post code Other (please explain)

Frequency One-off event Repeated activity (identical activity repeated at different times and/or locations) Regular education (such as monthly education) Continuous education (such as online education)

Total hours of educational content Activity must be a minimum of 6 hours of educational content.

3.4 ADVERTISING

Accredited activities are automatically advertised on the QI&CPD accredited activities list. Don’t display on the RACGP website

GPMHSC accredited activities are automatically advertised on the GPMHSC webpage. Don’t display on the GPMHSC website

Attendees Target Audience Select one Select one By invitation only GPs Only available to members GPs and Practice team All attendees welcome

Third Party Sponsors

Name: Details:

Partnering Organisations

Name: Details:

3.5 ATTENDANCE How many GPs do you anticipate will attend? How many facilitators will assist? Please indicate how this activity will be funded, and the

of 17 anticipated cost to general practitioners:

3.6 SESSIONS

Date Time Venue Postcode

3.7 GP INVOLVEMENT IN PLANNING/DEVELOPMENT OF THIS ACTIVITY

Name of GP(s) AHPRA number RACGP QI&CPD Number

3.8 CURRICULUM MATRIX Domains

Communication Applied Population Curriculum Statements Organisational skills and the professional health and the Professional and Please mark the curriculum area(s) and legal relevant to the activity mapped patient-doctor knowledge and context of ethical role dimensions against the educational domain(s) relationship skills general practice

General statements Common training outcomes Philosophy and foundation of general practice People and their populations Aboriginal and Torres Strait Islander health Aged care

Children and young people’s health

Disability

Doctor’s health

Genetics

Men’s health

Multicultural health

Population health and public health

Rural general practice

Women’s health

of 17 Presentations Acute serious illness and trauma

Chronic conditions

Dermatology

Drug and alcohol medicine

Eye and ear medicine

Mental health

Musculoskeletal medicine

Occupational medicine

Oncology

Pain management

Palliative care

Sexual health

Sports medicine

Processes of general practice Critical thinking and research

Undifferentiated conditions

E-health

Multidisciplinary care

Integrative medicine

Quality and safety

Practice management

Procedural skills

Quality use of medicines Teaching, mentoring and leadership in general practice

Other: please supply further information 3.9 SPECIFIC REQUIREMENTS To be eligible as a Specific requirement Accredited Activity, content must represent more than 50% of the total activity Mental health skills training Cultural safety training Anaesthetics Cultural awareness training Acupuncture Women’s health Breast medicine Radiology Surgery

Please attach evidence documentation 3.10 CPR CPR skill training must form a minimum of 1 hour of the education and be consistent with the ARC guidelines.

Will the activity include CPR? Yes No

of 17 Please attach evidence documentation 3.11 ACTIVITY TYPE

Conference Workshop Distance Education Skills based training (including simulator training) Other – please specify: 3.12 CURRICULUM AREA(S) AND EDUCATIONAL DOMAIN(S) Education Domains l t s h g g a x d e c n n i n e i i e a t t t c o t t g i Please mark with a X the curriculum o n n e e r a s o t e s s p s c n l g

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of 17 Section 4 Overview of activity 4.1 ACTIVITY SUMMARY Aim What is the aim of the activity? Needs assessment All needs assessments need to be supported by current and clinical evidence based references, in accordance with the RACGP QI&CPD guidelines, demonstrating that this activity is valid to GP needs. The needs assessment for this activity may include information from one or more of the following: information from expert bodies including references to peer reviewed medical literature and/or recognised health organisation documentation references to federal and/or state government policy; relevant guidelines, reports and initiatives GP perspective, e.g. formal GP participant survey - Note: anecdotes, informal surveys, personal opinions and single ‘expressions of interest’ are not valid community perspective, e.g. information from community groups, other health professionals, GP divisions and consumer groups.

Attach a copy of your needs assessment including references ACTIVITY OVERVIEW

Responses to the following points should incorporate clear examples from the program development process and/or content where appropriate and relevant. The overall educational goal of FPS ST is to provide GPs with quality training in the provision of focussed psychological strategies (FPS) for the treatment of common mental disorders. OFFICE USE ONLY

5.1 4.2 Please give an overview and summary of the activity (please note that this section may [ ] Criterion Met be used as a publishable summary of your activity if accredited) [ ] Criterion Not Met

of 17 4.3 Please detail the specific learning outcomes for this activity. [ ] Criterion Met Please note RACGP applications must include at least one learning outcome that addresses [ ] Criterion Not Met patient safety using a systems based approach.

4.4 GP participants may have various levels of prior knowledge and expertise. Please provide details of how this activity is adaptable to diversity in participants’ existing knowledge and skills.

4.5 FPS ST must include at least 20 hours of interactive, structured learning. Describe the duration and format of the activity, including the different learning methodologies that will be utilised, opportunities for participant interaction etc.. Your response should demonstrate a high level of interactivity, with a focus on participant engagement and active learning, including opportunities for:  scripting and rehearsing  demonstration of techniques  supervised practice of skills  case based discussions The 20 hours must contain a minimum of 12 hours of face-to-face or live/interactive contact time, plus a further 8 hours of interactive structured learning activities Meal breaks, predisposing and reinforcing activities such as pre/post tests do not contribute to the 20 hour minimum total training..

Attach a detailed program timetable or outline

4.6 Describe how participants are given the opportunity to prepare for the activity and set their own goals (i.e. a predisposing activity)? [ ] Criterion Met [ ] Criterion Not Met

Attach a copy of predisposing activity material

4.7 Describe how participants are given the opportunity for reflection to ensure learning is reinforced/strengthened back into practice (i.e. a reinforcing activity)? [ ] Criterion Met [ ] Criterion Not Met

Attach a copy of reinforcing activity material

4.8 Describe how the activity will be evaluated. [ ] Criterion Met [ ] Criterion Not Met RACGP REQUIRED INFORMATION: Applicants for RACGP QI&CPD accreditation must include three mandatory questions

of 17 within post program evaluations, These are: 1. to what degree were the learning outcomes met (each learning outcome listed), 2. to what degree were your learning needs met, and; 3. rate to what degree this activity was relevant to your practice.

Attach a copy of all evaluation materials

4.9 Describe the active involvement of general practitioners in program: planning, development, delivery and review. [ ] Criterion Met [ ] Criterion Not Met  planning (required);  development (required);  delivery (required); and  review (required). Provide the name, qualifications and organisational affiliation of general practitioners involved.

4.10 The perspectives of consumers of and the carer perspective are frequently different; both must be addressed within MHST Describe the active involvement of mental health consumers within program:  planning (required);  development (required);  delivery (required); and  review (required). Please also briefly detail consumers' organisational affiliations (e.g. with recognised advocacy groups) and past experience in similar roles. For information on consumer and carer participation, refer to Section 4 within the document Mental health education standards 2014-2016: A handbook for training providers’ available from [ ] Criterion Met www.gpmhsc.org.au [ ] Criterion Not Met

of 17 4.11 The perspectives of consumers and carers are frequently different; both must be addressed within FPS ST Describe the active involvement of mental health carers within program:  planning (required);  development (required);  delivery (required); and  review (required). Please also briefly detail carer's organisational affiliations (e.g. with recognised advocacy groups) and past experience in similar roles. For information on consumer and carer participation, refer to Section 4 within the document Mental health education standards 2014-2016: A handbook for training providers’ available from [ ] Criterion Met www.gpmhsc.org.au [ ] Criterion Not Met

4.12 Describe the active involvement of appropriately trained mental health professionals in program: [ ] Criterion Met [ ] Criterion Not Met  planning (required);  development (required);  delivery (required); and  review (required). Provide the name, qualifications, experience in providing FPS and their teaching experience.

Section 5 Content areas – Focussed Psychological Strategies

The GPMHSC has endorsed two FPS program variations:

Programs which are based on Programs which are based on cognitive behaviour therapy (CBT) interpersonal therapy (IPT)

Programs predominantly based on CBT must provide skills Programs predominantly based on IPT must at a minimum orientated training in 1, 2, 3, 4 (4.1), 5 (5.1) and any one provide skills orientated training in the areas listed below. strategy from 6 or 7, from the list below. 1. Psycho-education 1. Psycho-education 2. Motivational interviewing 2. Motivational interviewing 3. Theory and principles underlying IPT 3. Theory and principles underlying CBT Mental disorders linked to 4 types of relationship difficulties 4. Behavioural interventions (loss, role disputes, role transitions and interpersonal deficits) 4.1 Essential: behaviour modification 4. IPT training

of 17 4.2 Optional: activity scheduling  Exploration of patient’s perceptions, expectations of others and relationships 4.3 Optional: exposure techniques  Identification of problems with relationships 5. Cognitive Interventions 5.1 Essential: Cognitive analysis, thought challenging &  Use of affect to bring about change cognitive restructuring  Problem-solve to get resolution of relationship 5.2 Optional: self instructional training, attention regulation issues and control  Communication analysis and training 6. Relaxation strategies  Role-play changed behaviour 7. Skills training (problem-solving, communication training,  Use of the therapeutic relationship parent management training, stress management)

5.1 Is this program a CBT based program, or an IPT based program?

CBT based program  Complete Sections 5.2, 5.3 and 5.5 - 5.11 IPT based program  Complete Section 5.2, 5.4 and 5.5 - 5.11

Responses to the following should incorporate brief, and clear, examples from the program content to demonstrate how each learning outcome is addressed. Training providers are encouraged to structure their response to the specific objectives outlined in the documents: Mental health educations standards 2014-2016: A handbook for GPs and Mental health education standards 2014-2016: A handbook for training provider.

5.2 Learning outcome: demonstrate an understanding of the range of evidence-based FPS and [ ] Criterion Met the rationale for their use in different clinical circumstances [ ] Criterion Not Met

5.3 Learning outcome: be able to provide CBT based FPS to consumers as part of a treatment plan for common mental disorders

CBT based programs: Please provide details of the where and how this learning [ ] Criterion Met objective is addressed within the program for each FPS. [ ] Criterion Not Met

1. 1. Psychoeducation

2. 2. Motivational interviewing

3. 3. Theory and principles underlying CBT

4. 4. Behavioural interventions 4.1 Behavioural modification (essential)

4.2 Activity scheduling (optional)

4.3 Exposure techniques (optional)

of 17 5. 5. Cognitive interventions 5.1 Cognitive analysis, thought challenging and cognitive restructuring (essential)

5.2 Self instructional training, attention regulation and control (optional)

6. 6. Relaxation strategies

7. 7. Skills training (such as problem solving, communication training, parent management training and stress management)

5.4 Learning outcome: be able to provide IPT based FPS to consumers as part of a treatment plan for common mental disorders

IPT based programs: Please provide details of the where and how this learning objective is [ ] Criterion Met addressed within the program for each FPS. [ ] Criterion Not Met

1. Psychoeducation

2. Motivational interviewing

3. Theory and principles underlying IPT

4. IPT training  Exploration of patient’s perceptions, expectations of others and relationships  Identification of problems with relationships  Use of affect to bring about change  Problem-solve to get resolution of relationship issues  Communication analysis and training  Role-play changed behaviour  Use of the therapeutic relationship

5.5 Outline several mental health conditions and the related FPS/treatment models [ ] Criterion Met covered within your program (eg. graded exposure, phobic disorders) [ ] Criterion Not Met

5.6 Are the skills in this program transferable? Please provide clear examples where [ ] Criterion Met possible [ ] Criterion Not Met

5.7 Where and how does the program explain aetiology and epidemiology of the [ ] Criterion Met conditions covered? [ ] Criterion Not Met

5.8 Where and how does the program cover integrated FPS and medication? [ ] Criterion Met [ ] Criterion Not Met

5.9 Where and how are modes of assessment explained within the program? [ ] Criterion Met [ ] Criterion Not Met

[ ] Criterion Met 5.10 Where and how does the program discuss progress review? [ ] Criterion Not Met

[ ] Criterion Met 5.11 Where and how are issues of closure covered in the program? [ ] Criterion Not Met

6.1 Learning outcome: demonstrate a greater understanding of practice systems and other issues that safeguard patient safety in providing mental healthcare [ ] Criterion Met [ ] Criterion Not Met

6.2 Learning outcome: demonstrate a greater understanding of the experience of mental illness from the perspective of consumers and their families, friends and/or carers [ ] Criterion Met [ ] Criterion Not Met

6.3 Learning outcome: demonstrate an understanding of the value of supervision and other professional development to maintain and extend skills in the provision of FPS over time [ ] Criterion Met [ ] Criterion Not Met

of 17 6.4 Learning outcome: demonstrate a working knowledge of the MBS item numbers for provision of FPS by GPs [ ] Criterion Met [ ] Criterion Not Met

Section 7 Attachments

Please ensure that you have attached all relevant documentation, including copies of all resources and materials provided to participants.

Attachment checklist:

advertising material/program flyer

detailed program timetable or outline

predisposing activity material

reinforcing activity material

evaluation material

participant resources/workbooks

needs assessment (with references)

of 17 3 DVD copies featuring a video recording of the consumer and carer perspective (if applicable and requires prior approval from GPMHSC Secretariat)

If applying for re-accreditation, please ensure the following items are included:

a covering letter outlining the changes that have been made from the 2011-2013 accredited course

a summary of evaluation reports containing aggregated data from the activities conducted during the 2011-2013 triennium

Section 8 Acknowledgement of responsibilities

Providers of accredited MHST are required to: notify the GPMHSC if any changes to the activity will be made such as, content and speakers, that differ from this application during the 2014-2016 triennium submit to the GPMHSC an activity report which includes the aggregated evaluative data within 4 weeks of completion of the training activity. This can be the same report provided to the RACGP and/or ACRRM.

I, agree to comply with the requirements outlined above for providers of FPS ST.

ADDITIONAL INFORMATION FOR RACGP AND/OR ACRRM ACCREDITATION RACGP REQUIRED INFORMATION: complete only if seeking RACGP accreditation with this form. Questions relating to completion of this section should be directed to the RACGP QI &CPD Office in your state (refer to www.racgp.org.au/qicpd/contacts for contact details)

9.1 Shared information consent: Do you give permission for program information to be shared Yes with researchers and interested GPs for continuing education purposes at the discretion of the RACGP QI&CPD Program. The RACGP may use the information in this application for its No own research and evaluation.

of 17 9.2 Declaration: I declare that: I am the Education Activity Representative (EAR) and/or and authorized person to submit activities on behalf of the organisation The development and delivery of this activity as described above meets the relevant requirements, educational standards and criteria of the RACGP QI&CPD Program All administration requirements will be in accordance with the RACGP QI&CPD Program The information provided by me in this document is accurate and complete I understand and acknowledge that the RACGP reserves the right to withdraw accreditation of the activity if in the opinion of the RACGP the activity does not meet the relevant requirements, educational standards and criteria I understand that on request I must be able to produce and provide all information relating to this activity for the purpose of Quality Review

Activity developers full name: Date:

Signature:

ACRRM REQUIRED INFORMATION: complete only if seeking ACRRM accreditation with this form. Questions relating to completion of this section should be directed to the ACRRM Professional Development Program – [email protected]; 07 3105 8200.

By submitting this application you agree to provide ACRRM with the following: A program outlining the session content and times Pre and post activities One month following the activity provide electronic copies of: Attendance list with ACRRM member details and ACRRM membership numbers A summary of the event evaluation results

Name of contact person for providing documentation:

Position:

Phone: Email:

PAYMENT COSTS/TAX INVOICE The adjudication fee is only applicable for training providers that have not purchased a ‘Provider Package’ (products and service agreement) with the RACGP QI&CPD program

Adjudication fees: $577.50 (includes $52.50 GST) for each application. All prices quoted include GST. This form becomes a tax invoice upon payment. Please retain this original form for your record. ABN 34 000 223 807

Payment enclosed for $

of 17 Card type Cheque AMEX Please make cheques payable to The RACGP Visa MasterCard

Card number

Cardholder name

Expiry date

Cardholder signature

Please submit your application and payment with this invoice to your QI&CPD Unit.

RACGP QI&CPD Unit contact details:

VIC [email protected] (03) 8699 0483 SA/NT [email protected] (08) 8267 8330 QLD [email protected] (07) 3456 8944 WA [email protected] (08) 9489 9555 NSW/ACT [email protected] (02) 9886 4700 TAS [email protected] (03) 6278 1644

Postal addresses and fax numbers are available at www.racgp.org.au/QICPD