High intensity therapist

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

You’ll make a difference to people's quality of life by providing a range of evidence-based interventions.


Life as a high intensity therapist 

You’ll be based in an NHS Talking Therapies for Anxiety and Depression service (formerly IAPT), working with adults from a variety of backgrounds. 

You’ll see individuals face-to-face or facilitate therapeutic groups. You’ll work with people 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. Once treatment begins, you’ll meet with service users regularly, usually weekly, to measure and review progress and tailor treatment accordingly.

Gareth Stephens

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

To work as a qualified high intensity therapist, you need to undertake training in a one of the high intensity therapies such as: 

  • cognitive behavioural therapy 
  • 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 given formal training in the therapy or therapies that you deliver in NHS Talking Therapies and will be accredited by the relevant professional body. 

You’ll work independently with service users and collaborate closely with other healthcare professionals, managing referrals and signposting to other agencies as appropriate. 

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.

A clinical supervisor will support you in your work to help you engage in self-reflection, seek and respond to feedback, and develop your professional knowledge and skills. 

You may, in turn, provide supervision to other members of your team. 

How much can I earn? 

If you’re employed by the NHS, you’ll be on a national pay and conditions system called Agenda for Change (AfC). 

There are nine pay bands and you’ll usually be paid at band 6 as a trainee. Once you qualify, you’ll usually move up band 7 and will have opportunities to progress with experience. 

Terms and conditions can vary if you are employed outside the NHS.

How about the benefits? 

As a high intensity therapist, you can make a difference. If you’re employed by the NHS, you’ll also have good holiday entitlement and access to:
  • fully funded training plus a salary while you train and a job in the service when you qualify 
  • an excellent pension scheme
  • NHS discounts in shops and restaurants

Must-have skills

In this demanding but rewarding role, you’ll need a range of clinical, organisational and leadership skills, 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 NHS Talking Therapies. 
  • a critical understanding of the current, evidence-based pharmacological and psychological treatment for all conditions seen in NHS Talking Therapies
  • ability to identify triggers, patterns of avoidance and safety-seeking behaviours
  • the use of standard and idiosyncratic measures to evaluate outcomes ability to develop formulation and use this to develop treatment plans/case conceptualisation

You'll also need to be able to demonstrate the values of the NHS Constitution.

Entry requirements 

To become a qualified high intensity therapist, you’ll need to gain a postgraduate diploma in CBT or one of the other therapies while working as a trainee high intensity therapist within an NHS Talking Therapies service. 

Selection is carried out jointly between the NHS Talking Therapies service and academic course provider. If successful, you will be offered both a job and a training place on a British Association for Behavioural and Cognitive Psychotherapies (BABCP)-accredited postgraduate diploma in CBT or one of the other therapies. 

While training, you’ll spend two days a week at university and the remaining three days working in your NHS Talking Therapies service under supervision.

Entry requirements vary, depending which type of therapy you choose, so it’s important to check carefully before you apply. 

You might also be able to secure a trainee position if you are a healthcare professional with a degree or the academic equivalent and relevant healthcare experience. Usually, you would hold a British Association for Behavioural and Cognitive Psychotherapies (BABCP)-recognised core professional qualification. 

If you don’t have a core profession, you may be able to secure a trainee role if you can demonstrate your competence via a Knowledge, Skills and Attitudes (KSA) portfolio of evidence. Find out more information about compiling a KSA portfolio on the BABCP website.

You can also apply for a traineeship if you are a psychological wellbeing practitioner (PWP) who has passed the PWP course requirements for CBT and have two years’ continuous employment. The only exception to this two-year rule is if you hold a previous core professional qualification recognised by the BABCP.

How to become a high intensity therapist

The first step to becoming a trainee high intensity therapist is to apply for a trainee post within an NHS Talking Therapies service which are provided directly by NHS or third-sector providers. 

Vacancies can be found on the NHS Jobs website and you can see some current vacancies below. They may also be advertised on charity websites, such as Mind, Rethink and Turning Point.

If you are currently working within an NHS Talking Therapies service, speak to your manager to find out which courses are available to you.

Where a career as a high intensity therapist can take you

There is a wide range of opportunities for qualified high intensity therapists. You could move into a role with more senior responsibility, such as clinical leadership, supervision, quality improvement or service management/leadership. Or you could take on a research or teaching role.

It’s important to note that a two-year psychological professions funding rule policy was implemented on 1 April 2022. This means that if you start NHS-funded psychological professions training from April 2022, you won’t be eligible for NHS funding for further psychological profession training for two years from the expected completion date of your first training, where it would lead to a change in your job role.   

Visit the funding for psychological professions training programmes web page for more information about NHS funding.  

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