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Adult Improving Access to Psychological Therapies (IAPT)

The IAPT Expansion Programme builds on the ground breaking IAPT programme that started in 2008.

About

The Improving Access to Psychological Therapies (IAPT) programme began in 2008 and has transformed the treatment of adult anxiety disorders and depression in England. IAPT is 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 IAPT 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 IAPT 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.

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

The census supports the plans set out in the NHS Long Term Plan 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. The census provides a high-level overview of the adult IAPT workforce across England. 

To meet accessibility requirements, you can also download this Adult IAPT Workforce Census 2021 accessible version. If you have any feedback or comments, please email mentalhealth@hee.nhs.uk

 

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 Improving Access to Psychological Therapies (IAPT) 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 IAPT 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. 

A Competence Framework for EMDR Therapy

We have 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 IAPT services should be qualified to deliver the treatments that they supply or be a trainee on an IAPT 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 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 IAPT 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 Improving Access to Psychological Therapies (IAPT) services to deliver specified IAPT 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 IAPT. For further information, visit HEE's media page.