Case study

High intensity therapist — Hayley

Hayley needs excellent collaborative skills and empathy to deal with the high demands of her service. Find out more about her typical working day

How did you become a high intensity therapist?

After graduating from Newcastle University with a degree in psychology, I completed a Postgraduate Certificate in Low Intensity Therapies alongside working full time as a psychological wellbeing practitioner (PWP) within a stepped-care Improving Access to Psychological Therapies (IAPT) service. Here, I gained experience of working within a busy primary care setting to support individuals experiencing common mental health problems.

I began developing my knowledge and skills in delivering interventions based on a cognitive behavioural therapy (CBT) approach. Following this I became a senior PWP, which involved service development projects, developing links with other healthcare providers and providing clinical supervision to PWP colleagues, alongside my own clinical caseload.

I've recently completed the Postgraduate Diploma in Cognitive Behavioural Therapy at Newcastle University to qualify as a high intensity therapist. I continue to work in a busy IAPT service in the North East of England

What's a typical working day like?

A typical day involves providing one-to-one therapy to individuals presenting with moderate to severe depression and anxiety disorders. I usually see five people per day, with sessions lasting an hour. Therapeutic interventions are based on a shared understanding of the individual's difficulties and are underpinned by evidence-based models of CBT, in line with NICE guidance. Usually, clients receive between 12 to16 sessions on a weekly or fortnightly basis.

High intensity therapists within our service also run therapy groups, support colleagues from other modalities and carry out occasional telephone assessments. I'm supported to manage a caseload of approximately 35 clients through regular clinical and case management supervision.

What do you enjoy about your job?

I feel it's a real privilege to be with someone on their therapeutic journey. The most enjoyable part of my job is making discoveries with clients and exploring how new learning can result in meaningful change and symptom improvement.

What are the challenges?

At times it's a challenge to work in IAPT as it can be a target driven, dynamic environment.

It can also be challenging to share in a client's most distressing experiences and to manage the impact on yourself as a therapist.

However, I have found that engaging in positive self-care strategies and utilising support from supervision and peers is effective in developing my resilience and helping me to look after myself.

How has your role developed?

The high intensity therapist role appears to have developed since its inception to include work with cases of increased complexity and a wider variety of presenting problems. I'm looking forward to consolidating my existing CBT knowledge and skills and creatively applying them to work with these cases. I aim to develop a special interest within the field of CBT as my career progresses.

What advice would you give to other aspiring high intensity therapists?

My advice to anyone considering a career as a high intensity therapist would be to gain as much mental health experience as possible prior to applying.

You also need to be willing to work as an autonomous professional in a dynamic, ever-changing environment.

Don't always expect to have the answers. Maintain a curious stance, both with clients and in personal and professional development.

Find out more