The study uses a descriptive phenomenological approach to investigate the lived experiences of High Intensity Therapists within adult Improving Access to Psychological Therapies (IAPT) services in England who provide treatment to patients whose mental health has been affected by trauma. It explores the nature of their clinical work, how this relates to their expectations given IAPT’s clinical remit, and the implications for them of the reality of this work. It investigates the psychological impact of treating PTSD upon High Intensity Therapists and gains insight into how undertaking this clinical work according to IAPT’s policies and working practices further contributes to the likelihood of such impact occurring. It then considers existing and potential protective or mitigating factors available to High Intensity Therapists treating PTSD in the IAPT setting. Findings from the study are discussed in the context of relevant existing research, policy and procedures, and used to inform suggestions for improvements to clinical and working practices. Participants were recruited purposively, and 16 semi-structured telephone interviews were conducted. These were analysed using an adaptation of Colaizzi’s seven step thematic approach, assisted by the use of computer aided qualitative data software. The study found that despite the IAPT remit to treat patients with a range of mild-to-moderate mental health problems, High Intensity Therapists’ work mainly involved working with trauma, and commonly involved treating patients whose clinical presentations were more complex than they regarded as appropriate to the IAPT setting, given their understanding of the service remit, the preparation they had received for their roles, and the requirement to achieve IAPT’s specific recovery and contact targets. Participants described experiencing various types of psychological impact from their work and their descriptions gave insight into aspects of the clinical work that influenced this. The study also showed that IAPT’s practices and policies increased the likelihood of these effects occurring. There were, however, some opportunities within IAPT to protect or mitigate against the impact. The study has contributed to the body of knowledge about these subject areas and has meant that changes to practices to benefit the psychological wellbeing of High Intensity Therapists could be recommended.
- IAPT, High Intensity Therapists, post-traumatic stress disorder, complex post-traumatic stress disorder, psychological impact of trauma work
A qualitative analysis of the experience and impact of undertaking trauma work for IAPT High Intensity Therapists
Ayrton, E. (Author). 25 Jun 2025
Student thesis: Doctoral Thesis › Doctor of Health (DHealth)