High intensity therapist

You'll usually work with adults experiencing conditions such as:

• depression
• generalised anxiety disorder (GAD)
• obsessive-compulsive disorder (OCD)
• panic disorder
• post-traumatic stress disorder (PTSD)
• social anxiety disorder.

You'll also manage referrals and work with other healthcare professionals to support patients and coordinate their care.

High intensity therapists typically work in NHS Talking Therapies for anxiety and depression services in England and in psychological therapy services in Wales. They may also work in other mental health settings throughout the UK, under titles such as cognitive behavioural therapist (CBT therapist).

Types of intervention

As a high intensity therapist, you'll specialise in one or more evidence-based psychological therapies, depending on your training and qualifications. Cognitive behavioural therapy (CBT) is the most widely delivered, but other approaches include:

• couple therapy for depression
• dynamic interpersonal therapy
• eye movement desensitisation and reprocessing
• interpersonal psychotherapy
• mindfulness-based cognitive therapy
• person-centred experiential counselling for depression.

Find out more about types of talking therapy.

What does a high intensity therapist do?

As a high intensity therapist, you'll need to:

• assess patients' mental health needs and suitability for high intensity therapy, referring them to other services where appropriate
• assess and manage risks to patients' safety and wellbeing, including risks of harm to themselves or others
• develop a shared understanding of patients' difficulties (known as clinical formulation) and agree treatment plans and achievable goals with them
• deliver evidence-based high intensity psychological therapy, usually through individual sessions but sometimes in groups, using methods such as face-to-face, telephone and video consultations
• monitor patients' progress using standardised outcome measures, regularly reviewing and adapting treatment as needed
• involve family members or carers in treatment where appropriate and with the patient's consent
• work with other healthcare professionals and external agencies to coordinate care and provide specialist advice when needed
• attend team meetings to discuss referrals, treatment plans and patients' progress
• attend regular clinical supervision to review your work and maintain professional standards, and provide supervision to others as you gain experience and appropriate training
• maintain accurate, confidential patient records to support clinical decisions and monitor treatment outcomes.

High intensity therapist salaries

• In England, trainee high intensity therapists usually earn between £39,959 and £48,117, Band 6 of the NHS Agenda for Change (AfC) pay rates.
• Qualified high intensity therapists typically earn between £49,387 and £56,515 at Band 7.
• With experience you can progress to senior roles that include additional management and specialist responsibilities. Salaries at this level (Band 8a) range from £57,528 to £64,750.

The NHS pays a London high-cost area supplement at 20% of basic salary for inner London, 15% for outer London and 5% for fringe areas, subject to minimum and maximum payments.

NHS pay rates in Wales differ slightly from those in England. Salaries in the voluntary and independent sector may vary.

Income figures are intended as a guide only.

What hours does a high intensity therapist work?

You can expect to work a standard 37.5 hours per week, usually Monday to Friday. Some services require evening work to accommodate patient appointments.

Part-time and flexible working arrangements may be available, including hybrid working. Career breaks and fixed-term contracts are also possible.

How do I become a high intensity therapist?

To become a high intensity therapist, you'll need specialist training in an evidence-based psychological therapy and accreditation or registration with the relevant professional body. Entry requirements and training routes vary depending on your chosen specialism.

High intensity CBT training

One of the main routes in England is to complete a postgraduate diploma in high intensity cognitive behavioural therapy (CBT), accredited at Level 2 by the British Association for Behavioural and Cognitive Psychotherapies (BABCP). The course usually takes one year full time, combining university-based learning with supervised clinical practice.

You'll usually need to come from a BABCP-recognised core profession, such as mental health nursing, occupational therapy, psychology or social work, and have relevant professional experience. BABCP requires at least 12 months' relevant experience for accreditation.

Check the BABCP core professions list for full eligibility requirements.

If you don't have a recognised core profession, you may still be eligible for training through BABCP's Knowledge, Skills and Attitudes (KSA) portfolio route. This route is also open to experienced psychological wellbeing practitioners (PWPs) who meet the entry requirements.

You'll undertake the training while working in a paid trainee post with an NHS Talking Therapies service or NHS-commissioned provider. Posts are usually advertised on NHS Jobs, and training is fully funded.

Find suitable courses on the BABCP Level 2 accredited courses list, looking for NHS Talking Therapies (NHSTT) high intensity pathways.

On successful completion, you'll qualify as a high intensity CBT therapist and can apply for BABCP accreditation, provided you meet its requirements.

Other high intensity therapy training

You can also qualify through training in other recognised therapies, such as counselling for depression, interpersonal psychotherapy or dynamic interpersonal therapy. Each has its own training and accreditation requirements. Find out more about the different pathways and relevant professional bodies from NHS England.

What skills does a high intensity therapist need?

You'll need:

• a commitment to equality, diversity and inclusion to provide inclusive, culturally sensitive care
• active listening skills and empathy to understand patients' experiences and respond sensitively to their needs
• assessment and clinical decision-making skills to identify patients' needs, evaluate risks and plan appropriate treatment
• communication and interpersonal skills to build trusting therapeutic relationships with patients and explain treatment approaches clearly
• organisational and time management skills to manage your caseload, keep accurate and confidential patient records, and meet service targets
• resilience and emotional awareness to support patients experiencing distress and manage the emotional demands of the role
• teamworking skills to collaborate with other healthcare professionals and coordinate patient care.

High intensity therapist work experience

Relevant clinical experience in mental health services is usually required for entry to high intensity therapy training. Experience in primary care, community mental health teams or NHS Talking Therapies services can be particularly useful. Individual courses and employers may have additional experience requirements.

If you're considering this career, volunteering with mental health charities or community support organisations can help you develop communication skills, empathy and an understanding of mental health difficulties. However, volunteering alone is unlikely to meet the professional experience requirements for training.

To learn more about the role, consider contacting your local NHS Talking Therapies service to ask whether you could speak to a high intensity therapist about their work.

Find out more about the different kinds of work experience and internships that are available.

Who employs high intensity therapists?

You may be employed by NHS trusts in England or NHS health boards in Wales.

In England, other employers include voluntary and independent healthcare organisations commissioned to provide NHS Talking Therapies services, such as Turning Point, Everyturn Mental Health and Vita Health Group.

You'll usually work in community-based services, with settings including:

• dedicated talking therapies clinics or hubs
• GP surgeries
• health centres
• hospitals.

Qualified therapists may also find opportunities in specialist mental health services, prison healthcare and private practice, depending on their qualifications and specialism.

Look for job vacancies at:

• Everyturn Mental Health
• Jobs in CBT
• NHS Jobs and NHS Wales - for trainee and qualified posts.
• Turning Point
• Vita Health Group

You can also search LinkedIn and individual NHS trust and health board websites.

Set up job alerts to receive notifications of suitable vacancies, particularly trainee high intensity therapist posts.

For advice about local training and recruitment opportunities, contact your local NHS Talking Therapies service.

Where can a career as a high intensity therapist lead?

As a qualified high intensity therapist, you'll need to undertake continuing professional development (CPD) and regular clinical supervision to maintain your skills and relevant professional accreditation. CPD activities can include courses, workshops, conferences and peer learning. You can also develop your expertise through further postgraduate study, such as a Masters degree or PhD.

As you gain experience, you can develop specialist expertise in areas such as post-traumatic stress disorder (PTSD) or working with particular patient groups. You may also undertake further training in other psychological therapies, such as eye movement desensitisation and reprocessing (EMDR).

The NHS offers opportunities to progress into more senior roles as you develop your skills, knowledge and experience. You could become a senior high intensity therapist, clinical lead or service manager. Responsibilities may include:

• contributing to research and service development
• developing and delivering training
• improving the quality and delivery of psychological therapies
• leading teams and managing services
• providing clinical supervision and supporting the development of other therapists.

You could also move into teaching or research or work as a psychological therapist in other healthcare settings or private practice, depending on your qualifications and specialism.