Increasing access to psychotherapy has long been a strategic objective and charitable goal for UKCP. We are determined that everyone should have access to a full range of psychotherapies, regardless of their circumstances. As such, we have spent the past three years lobbying Ministers, MPs, Peers, civil servants and NHS policymakers to expand the role of psychotherapy across all NHS and other publicly funded settings.
We are therefore delighted at the recent announcement that funded trainee places will be made available in NHS Improving Access to Psychological Therapies (IAPT) services. The majority of these will be non-CBT roles and all of them will be recruited from outside the existing IAPT workforce.
This is an opportunity we have been calling for and it is fantastic to see NHS England respond. We hope this is part of a new wave of opportunities for psychotherapists to work across NHS settings, turning the tide after many years of structural barriers obstructing their progress.
Anyone interested in applying for these roles can find out how to apply here.
Over recent months, we have been working alongside Health Education England (HEE) on a project to identify and address the barriers psychotherapists and counsellors face entering the NHS workforce, or progressing their careers once employed. We are thankful to the many members who have given up their time to inform this work.
We have identified consistent barriers to psychotherapists across NHS work settings, including:
We are hugely grateful to HEE for working with us and other professional bodies to begin to address these issues. The announcement of new IAPT roles is a much-welcome sign that this work is already having a positive impact, leading to a genuine choice of therapies for those referred to IAPT and creating good quality job opportunities for psychotherapists and counsellors. We are hopeful there will be similar progress in other areas, such as NHS services for people with severe mental health issues.
In our submission to the government’s Spending Review last autumn, we called for investment in HEE to support workforce recruitment and training, accompanied by an increased deployment of the psychotherapy workforce in NHS primary and secondary care settings. We are delighted that this ask was met and that this additional investment has enabled this recruitment to take place.
IAPT is the avenue to free-to-access talking therapies for a vast number of people in England. In 2019/20, 1.7m people were referred to IAPT services for support with depression and/or anxiety. There is a commitment in the NHS Long Term Plan to substantially increase the number of people accessing IAPT services and, in the wake of COVID-19, the demand for support is likely to increase.
Some psychotherapists and counsellors have historically raised concerns about elements of the IAPT model such as the limited number of sessions, the manualised models of therapy, the marginalisation of non-CBT therapies and, in some instances, the requirement for self-funded top-up trainings. However, at this moment of expansion, it is critical that the millions of IAPT service users have access to a choice of therapies and the best chance of finding what works for them.
Working in an IAPT service is by no means for everyone. But we know from speaking to members that many psychotherapists are eager to find NHS work at this level, particularly if a smooth pathway into these roles is created. The opportunity to work with a diverse range of clients, work within a team environment and the potential for supervisory training is attractive to many. Furthermore, if we wish to bring about further positive changes to IAPT, our professions will need to establish a stronger foothold within it.
To this end, we are very pleased that the psychotherapy and counselling professions will now be formally represented within the IAPT Expert Advisory Group, having previously been excluded from this influential setting. This is further testament to the benefit of a more collaborative model of working.
We have consistently called for both the expansion of non-CBT therapies in IAPT and the creation of paid training routes into these therapies – which include Dynamic Interpersonal Therapy (DIT), Counselling for Depression (CfD), Couples Therapy for Depression (CTfD) and Interpersonal Therapy (IPT). These asks are essential to achieve a choice of therapies for IAPT service users and a viable pathway for psychotherapists and counsellors to enter the workforce.
We are therefore delighted that both these asks have been met with the recent announcement.
In the coming weeks, IAPT services across all regions of England will be advertising High Intensity Therapist posts in DIT, CfD, CTfD, IPT and CBT. Successful applicants will receive training in the relevant therapy model and all posts are salaried and training fees fully funded.
In addition to the models of therapy more closely aligned with typical UKCP trainings, NHSE have emphasised that they are also encouraging any interested psychotherapists and counsellors to apply for CBT roles.
With such ambitious plans for the expansion of IAPT and other NHS mental health services, the greatest challenge to deliver these is workforce. As we have been saying for years, the NHS will only be able to meet its targets if it taps into the existing, highly trained workforce of psychotherapists and counsellors. We are glad to see this message has landed and we are looking forward to working alongside the NHS on similar initiatives in the coming months, not just in IAPT but in all NHS mental health services across the four nations.
The Improving Access to Psychological Therapies (IAPT) programme was launched in 2008 to provide NICE-recommended psychological therapies for adults with mild, moderate and severe depression and anxiety disorders. In the past year alone more than one million people accessed NHS IAPT services for help to overcome their depression and anxiety, and better manage their mental health. IAPT services are provided directly by the NHS, as well as by third sector providers commissioned by the NHS.
IAPT offers a ‘stepped care’ system. At Step 2, qualified Psychological Wellbeing Practitioners (PWPs) provide high volume, low intensity CBT-based interventions, for people with mild to moderate depression and anxiety disorders. At Step 3, qualified High Intensity Therapists deliver a range of NICE-recommended evidence-based therapies, including:
Therapists need to have been trained in the particular therapy or therapies that they deliver in IAPT, with linked professional accreditation with the relevant professional body.
NHS England and Improvement and Health Education England is now investing an additional £20 million in the training and recruitment of new High Intensity posts in IAPT services across England as part of a special initiative to accelerate the expansion of services. These trainee posts are open to people with a core profession (including many qualified counsellors and psychotherapists) who are not currently working within an IAPT service.
The training posts are salaried, training fees are funded and services will be strongly encouraged to make the posts permanent. Nationally, posts will cover several IAPT modalities (CBT, Counselling for Depression, IPT, DIT and Couples Therapy for Depression) and will be available in every region of England. The majority of posts and associated training will start in June 2021.
The NHS Long Term Plan set out ambitious plans to see the number of people with anxiety disorders or depression who can access talking therapies through IAPT increase by an additional 380,000 per year to reach 1.9 million by 2023/24. In addition, the COVID pandemic has led to an increase in need, especially for the High Intensity therapies. This will require a rapid and substantial expansion in the IAPT workforce and bringing in new talent to our NHS-funded services.
This initiative is specifically focussed on recruiting people from outside of IAPT with a core profession to support expansion of IAPT as set out in the NHS Long Term Plan. However, in addition to this specific initiative services recruit for High Intensity Therapist Trainees all year round and all of these posts are also open to people with a core profession (see more detail on who can apply below). If these roles are of interest to you, but timing is not right there will be further opportunities beyond this specific initiative and we would very much encourage you to contact your local IAPT service for more information.
Counsellors and psychotherapists interested in applying for these posts will need to meet the professional accreditation requirements set out in the IAPT Manual for the specific modality training.
To apply for a High Intensity therapist trainee role in a non-CBT modality (e.g. Counselling for Depression, DIT, IPT, Couple Therapy for Depression) you will need of one of the following professional accreditations:
To apply for a High Intensity CBT trainee post you will need a BABCP-recognised core professional qualification as set out here (counselling, psychotherapy/psychotherapeutic counselling, social work, mental health nursing, occupational therapy, clinical, counselling, health, educational or forensic psychology, medicine or art therapy).
Further details will be set out in the job descriptions of advertised posts.
Potential applicants must apply directly for a trainee High Intensity role with an IAPT service, who are the employing organisations. Posts will be advertised by IAPT services on the NHS Jobs website. Some roles may also be advertised on local job sites or other recruitment platforms such as Indeed.
To find a trainee post in your region, search using keywords ‘IAPT’, ‘Trainee’ or the name of the modality you are interested in (eg High Intensity CBT, Counselling for Depression). Individual posts will set out further details about the eligibility criteria for applying.
Services are already starting to advertise posts and will be continuing to do so over the next few months, so do keep an eye out on the NHS Jobs website. Some roles may also be advertised on Indeed or other recruitment platforms.
Outside this specific initiative, IAPT services recruit to High Intensity Trainee posts across the year and are always looking to recruit people from outside the existing IAPT workforce with core professions. Keep an eye on jobs.nhs.uk or the website of your local IAPT service to find these roles in the future.
In addition, the NHS offers a huge range of exciting and challenging opportunities for people who are passionate about making a difference. NHS services (including IAPT services, GP surgeries, secondary care mental health services and physical healthcare services) are always looking for talented people to join their workforces and contribute to the delivery of quality care for service users, families and carers. Posts are advertised on the NHS Jobs Website. For details of careers in the psychological professions see https://www.ppn.nhs.uk/resources/careers-map.