High intensity therapist

High intensity therapists equip people with the tools and techniques they need to overcome complex problems related to anxiety and depression.  

Working as a high intensity therapist is a rewarding career and you will have the opportunity to make a difference to people's wellbeing and quality of life by providing a range of evidence-based interventions.

"Seeing people change their lives for the better and knowing I’ve helped them do that is the best part of my job." Gareth Stephens, a high intensity cognitive behavioural therapist.

Read Gareth's story in full

Working life 

As a high intensity therapist in an Improving Access to Psychological Therapy (IAPT) service, you will work with adults from a variety of backgrounds.

You’ll usually work with them on an individual face-to-face basis or through facilitating therapeutic groups. You will work with service users with depression and anxiety disorders such as obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). A large part of your role will be to assess a service user’s suitability for evidence-based psychological interventions, formulating and implementing treatment and evaluating progress.

Cognitive behavioural therapy (CBT) is the most common intervention offered within IAPT services, but you may use a range of other high-intensity psychological interventions, including:

  • interpersonal psychotherapy for depression 
  • couples therapy for depression
  • brief dynamic interpersonal therapy
  • counselling for depression
  • mindfulness-based cognitive therapy
  • behavioural couples therapy 

You'll be formally trained in the therapy or therapies that you deliver in IAPT and will have a professional accreditation from the relevant professional body. 

You'll also offer specialist advice and consultation to other professionals, individuals, and groups across mental health trusts, community-based trusts and other voluntary agencies on the practice and delivery of specific therapeutic models and service provision.

You will receive regular clinical supervision to support your work. You may also provide supervision to other members of the team. 

Where will I work?

You’ll be employed as part of a team within an IAPT service, which may be within

You’ll work alongside psychological wellbeing practitioners and other clinicians who deliver evidence-based psychological therapies in IAPT, as well as employment advisers, GPs and support staff in both GP surgeries and community centres. 

You will work independently with service users and closely with other healthcare professionals, managing referrals and signposting to other agencies. 

Skills and values needed

The role can be demanding but it is also hugely rewarding. High intensity therapists meet with service users regularly, usually weekly, to measure and review progress, and tailor treatment accordingly. As a high intensity therapist, you’ll have experience of working with people with mental health conditions and will need to use a range of clinical, organisational and leadership skills on a daily basis, including:

  • excellent communication and interpersonal skills
  • empathetic listening skills
  • ability to remain solution-orientated
  • ability to work well in a fast paced, challenging environment
  • ability to provide supervision
  • ability to participate in shared decision making
  • a critical understanding of the phenomenology, diagnostic classifications and epidemiological characteristics for all conditions seen in IAPT
  • a critical understanding of the current, evidence-based pharmacological and psychological treatment for all conditions seen in IAPT
  • ability to identify triggers, patterns of avoidance and safety-seeking behaviours
  • the use of standard and idiosyncratic measures to evaluate outcomes with CBT
  • ability to develop formulation and use this to develop treatment plans/case conceptualisation

If you're applying for a role either directly in the NHS or in an organisation that provides NHS services, you'll be asked to show how you think the values of the NHS Constitution apply in your everyday work. The same will be true if you are applying for a university course funded by the NHS. 

Find out more about NHS values

Find out about the entry requirements and training to be a high intensity therapist

  • Most jobs in the NHS are covered by the Agenda for Change (AfC) pay scales.  This pay system covers all staff except doctors, dentists and the most senior managers. Trainees are appointed at band 6 or band 7, depending on their current psychological therapy expertise. High intensity therapists in the NHS will usually work standard hours of 37.5 per week, although there are some part time opportunities. Terms and conditions can vary for employers outside of the NHS.


  • Once you have qualified as a high intensity therapist, there are a wide range of opportunities. You could move into roles which include more senior responsibility such as providing clinical leadership, supervision, quality improvement and service management/leadership . Or you could contribute to future service developments and the development of the profession through research and teaching.

    If you start NHS-funded training from April 2022, you will normally be unable to access further NHS-funded training for a new occupation in the psychological professions until two years after your qualifying exam board. Visit the funding for psychological professions training programmes web page for more information on NHS funding.

  • Applications for trainee posts need to be made to an organisation providing Improving Access to Psychological Therapy (IAPT) services.  IAPT services are provided directly by NHS organisations or by third sector providers. 

    Selection is carried out jointly between service and academic course providers. If successful, both a job and a training place are offered. 

    Trainee high intensity therapist vacancies can be found on the NHS Jobs website or may be advertised locally within newspapers or local job sites. Vacancies may also be advertised on charity websites - such as Mind, Rethink and TurningPoint.

    If you're applying for a role either directly in the NHS or in an organisation that provides NHS services, you'll be asked to show how you think the NHS values apply in your everyday work.

    Find out more about NHS values

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