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NHS Talking Therapies for Anxiety and Depression

The NHS Talking Therapies for Anxiety and Depression previously known as the Improving Access to Psychological Therapies (IAPT) programme builds on the ground breaking programme that started in 2008.

About

The NHS Talking Therapies (previously known as IAPT) programme began in 2008 and has transformed the treatment of adult anxiety disorders and depression in England. It is a widely-recognised as the most ambitious programme of talking therapies in the world and in the past year alone more than one million people accessed these services for help to overcome their depression and anxiety, and better manage their mental health.

Plans set out in the NHS Long Term Plan build on the ambitions of the Five Year Forward View for Mental Health, and will see the number of people with anxiety disorders or depression who can access talking therapies through IAPT increase significantly by 2023/24.

Details of local NHS Talking Therapies services are available on the NHS website. The NHS Mental Health Implementation Plan 2019/20 – 2023/24 provides a new framework to ensure delivery, at the local level, on the commitment to pursue the most ambitious transformation of mental health care in England.

NHS Talking Therapies for anxiety and depression services are characterized by three things:

  1. Evidenced-based psychological therapies: with the therapy delivered by fully trained and accredited practitioners, matched to the mental health problem and its intensity and duration designed to optimize outcomes. From April 2018 all clinical commissioning groups are required to offer NHS Talking Therapies services integrated with physical healthcare pathways. The IAPT Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms guidance is intended to help with implementation and sets out the ideal pathway for NHS Talking Therapies services.
  2. Routine outcome monitoring: so that the person having therapy and the clinician offering it have up-to-date information on an individual’s progress. This supports the development of a positive and shared approach to the goals of therapy and as this data is anonymized and published this promotes transparency in service performance encouraging improvement.
  3. Regular and outcomes focused supervision so practitioners are supported to continuously improve and deliver high quality care.

HEE supports the growth and development of the NHS Talking Therapies workforce to achieve these ambitions. HEE commissions education programmes that enable growth and upskilling, aligned to these principles. It also tracks the growth and development of the NHS Talking Therapies workforce and works closely with NHS England to support service development through workforce interventions.

Our work:

We commissioned NHS Benchmarking Network to conduct a workforce census of the NHS Talking Therapies for Anxiety and Depression (formerly known as IAPT) workforce across England as of 31 March 2022 (this document is also available in the related documents section of this page) . This workforce census covers NHS commissioned NHS Talking Therapies services delivered by NHS and non-NHS service providers. 

The census supports the commitment, set out in the NHS Long Term Plan, to enable an additional 380,000 adults and older adults with anxiety and/ or depression to access NHS Talking Therapy services by 2023/24, taking the total number of those able to access these services to 1.9 million.  

To meet accessibility requirements, you can also download this NHS Talking Therapies Workforce Census 2021/22 accessible version (this document is also available in the related documents section of this page).  

If you have any feedback or comments, please email mentalhealth@hee.nhs.uk

The workforce census of the Adult IAPT workforce across England as of 31 March 2021 is also available. The Adult IAPT Workforce Census 2021 covers NHS commissioned IAPT services delivered by NHS and non-NHS service providers. 

To meet accessibility requirements, you can also download this Adult IAPT Workforce Census 2021 accessible version

 

PWP and HIT CBT Curricula 

Based on the priorities within the NHS Long Term Plan and as a result of the COVID-19 pandemic the curriculum review was commissioned. In 2022, the national IAPT Expert Advisory Group and partners reviewed the PWP and HIT CBT curricula to ensure that these maximise competence in this workforce to improve patient outcomes and to bring all the content up to date, in light of learning.  The curricula are expected to be mandated for delivery from September 2023 following a re-contracting/re-procurement exercise for both training programmes, led by HEE. Education providers seeking to deliver either of these programmes going forward should align their training to the new curricula as soon as possible though their processes.

Psychological Wellbeing Practitioner (PWP) Curriculum

HIT Cognitive Behaviour Therapy Curriculum (depression and all anxiety disorders)

Other core IAPT curricula

Eye Movement Desensitisation and Reprocessing (EMDR) Therapy NHS National Curriculum

HIT Counselling for Depression Curriculum (suitable for BACP accredited counsellors)

HIT Advanced Behavioural Couples Therapy for Depression Curriculum (suitable for qualified Relate Counsellors)

HIT Behavioural Couples Therapy for Depression Curriculum (suitable for other HI CBT Therapists)

HIT Couples Therapy for Depression curriculum (suitable for qualified Relate Counsellors)

HIT Couples Therapy for Depression curriculum (suitable for other HI CBT Therapists)

HIT Interpersonal Psychotherapy for Depression (suitable for BACP accredited counsellors and other qualified mental health professionals)

HIT Brief Psychodynamic Psychotherapy for Depression Curriculum

HIT Mindfulness based Cognitive Therapy Curriculum for reducing relapse in recurrent depression. This treatment is recommended by NICE as a second line intervention to reduce relapse rates in individuals who have already received a first line intervention - psychological or pharmacological- for a depressive episode. The training is designed for qualified high intensity CBT therapists who are already working in IAPT services.

 

To support the expansion of the programme, we are commissioning continued professional development (CPD) training for qualified Psychological Wellbeing Practitioners and High Intensity Therapists. The training focuses on high intensity and low intensity approaches to support people with mental health problems and physical long-term conditions or persistent and distressing medically unexplained symptoms. The NHS Talking Therapies for Anxiety and Depression Education and Training Expert Reference Group have developed evidence based curricula to support the commissioning of two new training programmes.

 

IAPT-LTC Curricula

PWP top-up curriculum

HI top-up curriculum for CBT therapists

HI non-CBT psychological therapies for Depression in the context of LTC

 

New online IAPT Long Term Conditions (LTC) training module for long-covid 

HEE, elearning for healthcare and NHS England and NHS Improvement have come together to develop new online learning which will help IAPT staff to treat and care for patients and service users with long COVID. 

An estimated 1.2 million people in the UK (1.9% of the population) were experiencing self-reported long COVID (symptoms persisting for more than 4 weeks after the first suspected COVID-19 infection that were not explained by something else) as of 31 October 2021.  

The LTC Long Covid elearning is available to the entire IAPT workforce, including administrative staff. The session takes approximately 20 to 30 minutes to complete, and a certificate is available to download after completion to evidence continuing professional development.

The new module, which has been developed by a group of subject matter experts, will explore the physical and psychological impact of long COVID and outline low- and high-intensity interventions for use within IAPT services.  

The modules enable and support the NHS Long Term Plan ambitions related to supporting long-term conditions services and delivering more evidence-based talking therapies to provide access to services for 1.9 million people by 2023/24. 

EMDR therapy training programme and curriculum FAQs  

Eye Movement Desensitisation and Reprocessing (EMDR) is a specific psychological therapy recommended by NICE for Post-traumatic stress disorder (PTSD) in adults.  

To support the expansion of mental health delivery in response to the NHS Long Term Plan, NHS England aims to ensure a suitable level of availability of NHS EMDR practitioners across Adult IAPT, adult community mental health and specialist perinatal mental health services in England. HEE has also collaborated with partners to deliver a new and comprehensive NHS EMDR training programme starting in 2023. 

As a result, a new national NHS EMDR therapy curriculum, aligned with the EMDR competence framework, has been developed by a clinically led-multidisciplinary working group with input from EMDR and other clinical experts. The curriculum ensures EMDR practitioners will be trained to the highest standards and complete a period of practice under specialist supervision to deliver as recommended by NICE and achieve full accreditation in the approach.

EMDR training programme status

HEE is in the process of procuring a training provider to deliver the EMDR training programme aligned to the National Curriculum for EMDR and is working towards opening registration for the first cohort from March 2023.The training location of the first cohort will be London, followed by a second cohort with training delivered in Birmingham and Manchester later in the year. Training places are limited and further information on which NHS services can utilise the training places and the process for allocation of training places is outlined below.

NHS services eligible to nominate trainees

The training is available for NHS commissioned services in England, services can nominate practitioners who meet the eligibility requirements* for the training programme from the following services:

- Community adult mental health services

- Improving access to psychological therapies services now known as NHS Talking Therapies for Anxiety and Depression

- Specialist perinatal mental health services

Allocation of training places

Training places for each cohort will be allocated to each HEE region and HEE regional mental health leads will then designate places to service providers with eligible practitioners. Services should consider prioritising staff to undertake this training who are able to become future supervisors of EMDR.

*Entry requirements for the EMDR training programme can be found in the National Curriculum for EMDR which covers the requirements for candidates and service setting requirements.

FAQs

To provide stakeholders and partners with further clarity about the new NHS-funded EMDR Therapy training programme and curriculum requirements, HEE recently produced a set of FAQs: FAQs - NHS-Funded EMDR National Curricuum Training for Adult IAPT, Adult Community and Perinatal Mental Health Services - Final 13.2.23.pdf

A Competence Framework for EMDR Therapy

HEE commissioned and developed the EMDR competence framework in partnership with National Collaborating Centre for Mental Health (NCCMH) which is a collaboration between the Royal College of Psychiatrists and University College London. The framework supports the Adult IAPT workforce delivering EMDR therapy to provide treatment for Post-Traumatic Stress Disorder (PTSD).

All clinicians who work in NHS Talking Therapies for Anxiety and Depression services should be qualified to deliver the treatments that they supply or be a trainee on an approved training course.

 Psychological Wellbeing Practitioners

Training 

Psychological Wellbeing Practitioner (PWP) training is commissioned by the NHS and delivered by local universities. PWP training usually consists of one day per week of academic work and four days of supervised practice. PWP training follows a national curriculum and trainees are all taught the same specific low-intensity interventions including; behavioural activation, graded exposure, cognitive restructuring and panic management. Training is typically completed within 12 months and the curriculum is accredited by the British Psychological Society (BPS). 

Preceptorship year and beyond

All newly qualified PWPs will need support to develop their practice further, develop their confidence and refine their skills. The PWP Preceptorship Guidance sets out recommendations for a structured preceptorship year for PWPs who have completed their BPS accredited PWP training programme. The guidance offers suggestions for suitable PWP continuing professional development opportunities, during and beyond the preceptorship year. 

High-intensity therapy Cognitive-Behaviour Therapy training

High-intensity therapy (HIT) Cognitive-Behaviour Therapy (CBT) trainees undertake training on a specifically commissioned high-intensity CBT course accredited by the British Association for Behavioural and Cognitive Psychotherapies (BABCP). Training, which follows a national curriculum, consists of two days a week at university and three days of supervised practice in a clinical setting over 12 months.

Short training courses

The NHS Talking Therapies for Anxiety and Depression (previously known as IAPT) programme also provides shorter courses for existing mental health professionals who wish to develop their skills in other NICE recommended psychological therapies for depression. Each course is based on a national curriculum and is accredited by an appropriate professional body. The courses are specifically developed for people who are already working in NHS Talking Therapies services or are contracted to do so shortly. As well as attending workshops, trainees see a prescribed number of depression training cases while receiving regular supervision.

An exciting new training pilot, launched by Health Education England (HEE), offers a three-year salaried and funded training pathway for 60 trainee psychotherapeutic counsellors to work in NHS IAPT (now known NHS Talking Therapies for Anxiety and Depresion) services to deliver specified NHS Talking Therapies services for adults with depression. This NHS training route will exist alongside and add to other existing routes for counsellors to enter and work in NHS Talking Therapies for Anxiety and Depression. For further information, visit HEE's media page.