New funded trainee places to be made available in the NHS

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.

New roles

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.

Addressing barriers to NHS work

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:

• inconsistent pay
• failure to recognise existing competencies, resulting in repetitious training requirements
• exclusion from progression to supervisory, managerial or leadership roles
• misunderstanding of psychotherapy among commissioners, managers and sometimes psychologist colleagues
• failure to replace retiring psychotherapists
• lack of a fully funded training route (in contrast to clinical psychology).

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.

Why IAPT?

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.

Our calls answered

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.

Only the beginning

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.

Adam Jones

UKCP Policy and Public Affairs Manager

Email

policyukcp@ukcp.org.uk

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