Journal of Advanced Nursing, 1983, 8,321-328 Nurse therapist trainee variability: the implications for selection and training C. Brooker BA RMN Research Nurse, Tottenham Mews Day Hospital, The Middlesex Hospital. Mortimer Street, London Wl and R. D. Wiggins BA MSc DipStat Lecturer in Social Statistics Polytechnic of Central London, Wells Street, London Wl Acceptedfor publication 24 January 1983 BROOKER C. and WIGGINS R.D. {19%3) Journal ofAdvanced Nursing S, 321-328 Nurse therapist trainee variability: the implications for selection and training This paper examines some of the data obtained from the Joint Board of Clinical Nursing Studies Course Number 650, which ran at the Bethlem Royal and Maudsley Hospitals, London, 1978-1979. During this particular training programme, eight nurse therapist trainees treated a total of 251 patients assessed as suitable for behaviour therapy. Data were collected from patients by trainees on four separate occasions; before treatment, after treatment, and at follow-up intervals of 1 and 6 months. It was suggested that therapists would vary systematically in terms of the assessment scores used to measure outcome. This was explored using analysis of variance techniques, where several treatment outcome measures were used as dependent variables. The analyses, which were undertaken using SPSS and GLIM computer packages, clearly demonstrated therapist variability. The results are discussed within the theoretical framework of Sudman & Brabum's (1974) interviewing model and O'Muircheartaigh & Wiggins' (1981) consideration of response errors. The implications for the selection and training of nurse therapists are presented. Thefinalconclusion of the paper is that, although the patient's clinical outcome may be related to therapist allocation, the eight trainees allowed themselves to 'open' their activities to this evaluative approach — which in tum demonstrates their professionalism. BACKGROUND In 1975, the Joint Board of Clinical Nursing Studies (JBCNS) for England and Wales approved an 18-month course for qualified psychiatric nurses in adult behavioural psychotherapy. This was largely as a result of a 3-year pilot programme directed by Professor 1. Marks at the Maudsley Hospital. From these origins, 'nurse therapy' has grown. There are now three training centres at Maudsley, Chichester and Moorhaven and 60 nurses have completed the course since 1975. JBCNS Course Number 650 trains nurses to deal with an advanced clinical role using behavioural techniques. Characteristically, behaviour therapy, as discussed in the context of nurse therapy by Marks et al. (1977), 'tailors the treatment to the need of the individual patient by systematic application of suitable techniques to specified behaviours which the patient and thera- pist agree need to be changed'. Nurse therapists are trained to treat a certain section of the total psychi- atric population. Table 1 indicates the subclassifi- cation of the diagostic variable that is used to classify these specific problems at the Maudsley Centre. The authors recognize that behaviour therapy is in no sense a universal panacea, but rather that it is often indicated as the main approach for the group outlined in Table 1. Selection for nurse therapy courses is rigorous. All potential trainees must have as a minimum 0309-2402/83/070(M)321 $02.00 © 1983 Blackwell Scientific Publications 321