Case study

High intensity therapist — Stephen Holland

Stephen enjoys the rewarding nature of his role. Find out how he uses CBT with patients to discover what they need in order to recover

How did you become a high intensity therapist?

After graduating with a degree in psychology, I worked as a support worker and team co-ordinator for a brain injury service. A couple of years later, I trained as a psychological wellbeing practitioner (PWP) and then worked for three years providing low intensity psychological interventions for patients with mild to moderate common mental health problems.

This experience enabled me to get a job as a trainee high intensity CBT therapist, while at the same time completing the Postgraduate Diploma in Cognitive Behavioural Therapy.

Now qualified, I work as a qualified high intensity CBT therapist for Insight Healthcare/Talking Helps Newcastle.

What's a typical working day like?

I provide CBT to patients experiencing common mental health problems (typically depression and anxiety disorders) with moderate to severe symptoms. I see five patients in an average eight-hour day. Sessions last for 60 minutes and involve working collaboratively with each patient to understand their issues and formulate a plan to improve their mental health and wellbeing.

I also receive supervision for my clinical work, and provide clinical supervision to some of our service's PWPs.

What do you enjoy about your job?

Because of the collaborative nature of CBT, each patient is involved in their treatment and therefore no two cases are the same. There is freedom to be creative in therapy, and sessions often involve venturing outside into various public settings to test out patient's predictions and fears.

I find it incredibly rewarding when patients make significant gains through their sessions, and enjoy hearing about how they use their learning in the context of their everyday lives.

What are the challenges?

I sometimes find it challenging when working with a patient who is expressing a high risk of hurting themselves. Despite careful risk assessments, I find myself worrying about patients who are vulnerable in this way, outside of our therapy sessions.

It can sometimes be challenging to manage a high caseload too.

How relevant was your psychology degree?

During my degree I took several modules in psychoactive medication, anxiety disorders and depression, which provided useful background information for when I began my clinical training.

How has your role developed?

Progressing from trainee to qualified CBT therapist has seen a rise in my caseload and a rise in the complexity of the patients I treat. Recently, I've also begun to supervise some of our service's low intensity therapists.

I would like to further my career by working towards publishing one of my clinical case studies. I would also like to train as a CBT supervisor and potentially get involved with providing workshops for the teaching/training of new therapists.

I would also consider pursuing more advanced clinical training, such as applying for an MSc in Cognitive Behavioural Therapy.

What tips do you have for others interested in high intensity therapy?

Get experience of working in mental health services as early as possible. I found the role of psychological wellbeing practitioner invaluable in providing me with clinical skills and knowledge, as well as the confidence to apply for the trainee high intensity therapist role.

Find out more