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What IAPT CBT High-Intensity Trainees Do After Training

  • Sheena Liness (a1), Susan Lea (a2), Steffen Nestler (a1), Hannah Parker (a1) and David M. Clark (a3)...


Background: The UK Department of Health Improving Access to Psychological Therapies (IAPT) initiative set out to train a large number of therapists in cognitive behaviour therapies (CBT) for depression and anxiety disorders. Little is currently known about the retention of IAPT CBT trainees, or the use of CBT skills acquired on the course in the workplace after training has finished. Aims: This study set out to conduct a follow-up survey of past CBT trainees on the IAPT High Intensity CBT Course at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), one of the largest IAPT High Intensity courses in the UK. Method: Past trainees (n = 212) across 6 cohorts (2008-2014 intakes) were contacted and invited to participate in a follow-up survey. A response rate of 92.5% (n = 196) was achieved. Results: The vast majority of IAPT trainees continue to work in IAPT services posttraining (79%) and to practise CBT as their main therapy modality (94%); 61% have become CBT supervisors. A minority (23%) have progressed to other senior roles in the services. Shortcomings are reported in the use of out-of-office CBT interventions, the use of disorder-specific outcome measures and therapy recordings to inform therapy and supervision. Conclusions: Past trainees stay working in IAPT services and continue to use CBT methods taught on the course. Some NICE recommended treatment procedures that are likely to facilitate patients’ recovery are not being routinely implemented across IAPT services. The results have implications for the continued roll out of the IAPT programme, and other future large scale training initiatives.


Corresponding author

Correspondence to Sheena Liness, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, Denmark Hill, London SE5 8AF, UK. E-mail:


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Ashworth, P., Williams, C. and Blackburn, I. M. (1999). What becomes of cognitive therapy trainees? A survey of trainees’ opinions and current clinical practice after postgraduate cognitive therapy training. Behavioural and Cognitive Psychotherapy, 27, 267277.
Blackburn, I.-M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., et al. (2001). The revised Cognitive Therapy Scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431446.
Brooker, C. and Brown, M. (1986). National follow-up survey of practising nurse therapists. In Cormack, D. and Reynolds, W. (Eds.), Psychiatric and Mental Health Nursing: theory and practice (1st edn.). Dordrecht: Springer Science+Business Media.
Brooker, C., Saul, C., Robinson, J., King, J. and Dudley, M. (2003). Is training in psychosocial interventions worthwhile? Report of a psychosocial intervention trainee follow-up study. International Journal of Nursing Studies, 40, 731747.
Brosan, L., Reynolds, S. and Moore, R. G. (2008). Self-evaluation of cognitive therapy performance: do therapists know how competent they are? Behavioural and Cognitive Psychotherapy, 36, 581.
Department of Health (2008). IAPT Implementation Plan: national guidelines for regional delivery. London: The Stationary Office. Available at
Department of Health (2011). National Curriculum for High Intensity Cognitive Behavioural Therapy Courses, UK. London: The Stationery Office. Available at:
Dreyfus, S. E. and Dreyfus, H. L. (1980). A Five-Stage Model of the Mental Activities Involved in Directed Skill Acquisition: DTIC Document.
Fadden, G. (1997). Implementation of family interventions in routine clinical practice following staff training programs: a major cause for concern. Journal of Mental Health, 6, 599612.
Gournay, K., Denford, L., Parr, A.-M. and Newell, R. (2000). British nurses in behavioural psychotherapy: a 25-year follow-up. Journal of Advanced Nursing, 32, 343351.
Gyani, A., Shafran, R., Layard, R. and Clark, D. M. (2011). Enhancing Recovery Rates in IAPT Services: lessons from analysis of the Year One data. London: Improving Access to Psychological Therapies.
Herschell, A. D., Kolko, D. J., Baumann, B. L. and Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations. Clinical Psychology Review, 30, 448466.
Health and Social Care Information Centre (2015). Psychological Therapies: annual report on the use of IAPT services; England 2014/15. Leeds: Community and Mental Health team, HSCIC.
IAPT Programme NHS England (2015). 2014 Adult IAPT Workforce Census Report. Retrieved from
Kavanagh, D. J., Piatowska, O., Clark, D., O'Halloran, P., Manicavasagar, V., Rosen, A., et al. (1993). Application of cognitive-behavioural family intervention for schizophrenia in multidisciplinary teams: what can the matter be? Australian Psychologist, 28, 181188.
Kennedy-Merrick, S. J., Haarhoff, B. A., Stenhouse, L. M., Merrick, P. L. and Kazantzis, N. (2008). Training cognitive behavioural therapy practitioners in New Zealand: from university to clinical practice. New Zealand Journal of Psychology, 37, 817.
Kjøge, A., Turtumøygard, T., Berge, T. and Ogden, T. (2015). From training to practice: a survey study of clinical challenges in implementing cognitive behavioural therapy in Norway. The Cognitive Behaviour Therapist, 8 (e16), 116.
Kroenke, K., Spitzer, R. L. and Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16, 606613.
Lambert, M. J., Harmon, C., Slade, K., Whipple, J. L. and Hawkins, E. J. (2005). Providing feedback to psychotherapists on their patients’ progress: clinical results and practice suggestions. Journal of Clinical Psychology, 61, 165174.
MacLiam, F. (2015). Cognitive behavioural psychotherapy graduates in Ireland: a follow-up survey of graduates from an Irish university. Irish Journal of Psychological Medicine, 32, 187195.
Milne, D., Gorenski, O., Westerman, C., Leek, C. and Keengan, D. (2000). What does it take to transfer training? Psychiatric Rehabilitation Skills, 4, 259281.
Newell, R. and Gournay, K. (1994). British nurses in behavioural psychotherapy: a 20-year follow-up. Journal of Advanced Nursing, 20, 5360.
NHS (2015). Pay Circular - Agenda for Change 1/2015, UK: the NHS Staff Council. Available at:
Roth, A. D. and Pilling, S. (2008). Using an evidence-based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behavioural and Cognitive Psychotherapy, 36, 129147.
Ryan, D., Cullinan, V. and Quayle, E. (2005). A survey of trainees’ opinions and current clinical practice after behaviour therapy training. Journal of Psychiatric and Mental Health Nursing, 12, 199208.
Spitzer, R. L., Kroenke, K., Williams, J. W. and Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 10921097.
Vaillancourt, K., Manley, J. and McNulty, N. (2015). Why has our recovery rate dropped? An audit examining waiting times, starting scores and length of treatment in relation to recovery within an IAPT service. The Cognitive Behaviour Therapist, 8 (e7), 114.


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What IAPT CBT High-Intensity Trainees Do After Training

  • Sheena Liness (a1), Susan Lea (a2), Steffen Nestler (a1), Hannah Parker (a1) and David M. Clark (a3)...


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What IAPT CBT High-Intensity Trainees Do After Training

  • Sheena Liness (a1), Susan Lea (a2), Steffen Nestler (a1), Hannah Parker (a1) and David M. Clark (a3)...
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