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Research Watch: therapists’ working conditions and their implications for service users’ social inclusion

Sue Holttum (Salomons Centre for Applied Psychology, Canterbury Christ Church University, Royal Tunbridge Wells, UK)

Mental Health and Social Inclusion

ISSN: 2042-8308

Article publication date: 12 December 2018

Issue publication date: 11 February 2019



The purpose of this paper is to highlight possible implications of therapists’ working conditions on social inclusion of service users.


A search was carried out for recent papers on cognitive behaviour therapy (CBT) therapists.


One study highlighted that over half of their sample of 201 UK therapists in Improving Access to Psychological Therapy (IAPT) services reported burnout. In a second study, in interviews with ten IAPT workers in inner London services, therapists said they had to fight for extra time to adapt CBT for people who had learning disabilities, and the additional stress made them feel less positive about working with these clients. A third study, on therapists working with people with multiple sclerosis, highlights the importance of adapting CBT for people with physical conditions.


Taken together, these three papers highlight concerning implications of current working conditions for many therapists working in IAPT services. They highlight that sources of stress include services’ rigid focus on targets and inability to make expected adjustments. With regard to the UK, this may be due to the current national service model, but it has implications for the social inclusion of some service users.



Holttum, S. (2019), "Research Watch: therapists’ working conditions and their implications for service users’ social inclusion", Mental Health and Social Inclusion, Vol. 23 No. 1, pp. 5-11.



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