Improving Access to Psychological Therapies (IAPT) services provide a range of evidence-based, NICE recommended therapies alongside Cognitive Behavioural Therapy (CBT) to ensure service users can benefit from a range of treatment options suited to their needs. In the first of a series of blogs from members of the IAPT workforce, Sarah Aldridge tells us about her experience of working as a counsellor:

I have been working as a counsellor in Ealing IAPT service since June 2016 but my career as a counsellor began in 2010.

Before joining the Ealing IAPT team I worked with complex clients within a home visiting psychotherapy service, which was highly rewarding but I missed the relational aspects of the role. I took up a part-time role in Ealing IAPT service as the idea of working in a structured service in a therapeutic capacity was attractive.

To secure such a role, counsellors usually require NHS primary care experience, some clinical practice in short-term work and must be accredited by the British Association for Counselling and Psychotherapy (BACP) or registered with United Kingdom Council for Psychotherapy (UKCP).

IAPT counsellors are also known as high intensity therapists and we work at step three of the mental health stepped care model.

The stepped care model is a system that provides the least intrusive and most appropriate level of care to meet the needs of the person; only ‘stepping up’ to more specialist treatments as clinically required. At each step within the pathway IAPT services deliver National Institute for Health and Care Excellence (NICE) recommended, evidence based therapies to people with depression or anxiety disorders.

Since joining IAPT, I have completed additional training and I am now qualified to deliver different types of therapy to my clients including Dynamic Interpersonal Therapy (DIT) and Couple Therapy for Depression (CTfD).

Couple therapy for depression is helpful where there is relationship distress and depression in one or both partners. DIT is a type of therapy delivered over 16 sessions and it is particularly helpful for people with relationship problems, especially when it is linked to attachment difficulties.

One patient found DIT highly beneficial as she was better able to understand her family relationships, saying: “I was pretty desperate and needed external help outside of friends and family as I was depressed; anxiety and panic were a daily part of my life. Meeting week on week proved to be very helpful to enable me to unpack some deep hurts, pains and unhelpful beliefs that I had about myself. As the weeks went on I was able to see things for what they really were and not always what I thought about those around me and myself.  I have more energy and have a positive outlook on my personal life, work and most of all, myself.”

High intensity therapists can also train in other interventions, including interpersonal psychotherapy for depression (IPT) and counselling for depression, so there is a lot of scope to diversify your skillset and gain the appropriate qualifications.

I didn’t know how my career might develop when I joined IAPT but thanks to the training opportunities available to me, my experience has exceeded my expectations. Recently, I was promoted to senior counsellor, which means I now provide supervision and have managerial responsibilities.

Not only have I had the chance to develop my career but I also get to work with a variety of clients. It is interesting working with people of different ages and from a range of nationalities and backgrounds although the nature of the work can sometimes be challenging, as we juggle large caseloads with steep targets.

It is fast-paced and I often find myself moving between a couple to an individual, from one type of therapy to the next, and from a more reflective piece of work to then providing a client with more immediate support. However, being able to see positive changes in clients and helping them gain insight and understanding about their psychological wellbeing is a privilege.

Being a counsellor within an IAPT service is really valuable. We work alongside Psychological Wellbeing Practitioners (PWPs) and CBT therapists and thanks to our diverse experience, we can share our different perspectives on approaches to treatment.

Counselling is an important offering in IAPT and I hope it remains a key part of the IAPT provision for many more years to come.

• The NHS Long Term Plan commits to expanding access to IAPT services for adults and older people with common mental health problems. By 2023-24, an additional 380,000 adults and older adults will be able to access NICE-approved IAPT services.
• Find out more about working in IAPT, especially the role of a high intensity therapist.