The Hexagon: An Exploration Tool
The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.
Usability - Rating: 4
4 - Usable
The intervention has operationalised principles and values, core components that are measurable and observable, tools and resources to measure fidelity, and identified modifiable components
Usability
Core Components
Psychodynamic Psychotherapy (PP) is used in treatment of children, adolescents, and adults with a range of mental health diagnoses, including depression, anxiety and eating disorders. Founded on core psychoanalytic concepts, PP works with both the conscious and the unconscious by means of paying attention to and interpreting in the hear-and-now the feelings, beliefs, inner conflicts, and repeating relational patterns linked to past experiences. PP focuses on psychological roots of emotional suffering in order to help patients achieve a more coherent and functional sense of self, which may lead to the reduction of symptoms.
Key PP principles include: 1) reflecting on early-life experiences that shaped personality and continue influencing the individual’s responses; 2) understanding how feelings and beliefs link with unconscious predictions that affect behaviours in current life; 3) helping patients to gain insight into themselves and their responses, which may lead to the patient making changes in their life; 4) considering defence mechanisms the person resorts to in order to reduce their emotional suffering; and 5) transference and countertransference phenomena.
A consistent and boundaried therapeutic relationship is key to delivering PP as it encourages patients to talk without reservation about their emotions, beliefs, and experiences. It provides a containing space where patients could reflect on themselves and their relationships. This allows patients to question how they perceive the world and how their past experiences have influenced their current beliefs. Within this therapeutic relationship, the therapist considers transference and countertransference, and interprets these concepts as they apply to the patient, in order to help the patient understand themselves and their relationships, and make changes in their life.
Fidelity
Modifiable Components
Whilst typically delivered in a traditional face-to-face individual or group format, psychodynamic psychotherapy can be delivered remotely (https://pubmed.ncbi.nlm.nih.gov/24283446/) via a secure online platform.
The length of therapy is determined by the complexity of the patient’s difficulties, the short term therapy (Short-term PP) typically consisting of 25-40 sessions delivered weekly over 6-12 months and the longer-term therapy delivered weekly over a number of years. Individual sessions last 50 minutes and group sessions last 1.5 hours. Groups usually consist of 8-10 participants and are facilitated by 1 or 2 therapists.
Psychodynamic psychotherapy can be applied across a range of presenting conditions and may be adapted to target particular disorders, some of these adaptations for specific conditions are outlined below.
Panic Disorder:
This includes Panic-focused Psychodynamic Psychotherapy (PFPP) for people with panic disorder - a manualised, individual treatment for adults with panic disorder.
PFPP is a time-limited treatment that is typically delivered twice weekly, over 12 sessions, each session lasting about 45 minutes. It typically involves the identification of the content and meanings of panic episodes, addressing dynamics associated with vulnerability to panic and the persistence of symptoms and with addressing managing feeling associates with termination of treatment. Panic-focused Psychodynamic Psychotherapy (PFPP) is also available as Panic-Focused Psychodynamic Psychotherapy (PFPP) - eXtended Range (PFPP-XR), to address a range of disorders including panic disorder, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder, and related psychological problems.
Eating disorders:
In the context of anorexia and bulimia nervosa, PP may be conducted as Focal Psychodynamic Psychotherapy (FPT), also known as brief psychodynamic psychotherapy. The standardised time limited intervention aims to address the patient’s internal conflicts that are central to the eating disorder. It therefore helps to clarify the individual’s understanding of how their feelings and beliefs about themselves and people in their lives are associated with the eating disorder behaviours. Understanding of the origins of the eating disorder is expected to translate to lasting therapeutic changes.
PP may be conducted as Child and Adolescent Psychodynamic Psychotherapy (CAPP), a manualised, time-limited intervention delivered in twice weekly sessions, over 20-24 sessions, to children aged 8 to 16 years diagnosed with GAD, social phobia, or separation anxiety disorder.
Supports - Rating: 3 - 4
Support for Organisation / Practice
Implementation Support
Implementation support is provided by trained supervisors in local Psychotherapy Departments, who support the application of Psychodynamic Psychotherapy within each therapist’s practice. Support for implementing Psychodynamic Psychotherapy is also available through the NES Supervision workstream, which offers Psychodynamic Psychotherapy supervisor training workshop.
Training in Psychodynamic Psychotherapy is provided as part of the NHS psychiatry specialist training (ST4-8) for those who have chosen to train as a Medical Psychotherapist with an emphasis on psychodynamic/psychoanalytic psychotherapy; this includes additional external psychoanalytic training with a non-NHS training organisation. Non-medical members of staff at present may choose to undertake psychodynamic/psychoanalytic psychotherapy training through various independent organisations at a cost.
Start-up Costs
Costs apply because psychodynamic/psychoanalytic psychotherapy training is provided by independent organisations. Start-up costs include costs of training seminars, these vary depending on the course and could be up to £9,000 per year of training, additional weekly supervision fees during training, and additional several times per week personal psychotherapy fees during training. Professional accreditation fee after qualification – the current British Psychoanalytic Council full accreditation fee is £357/year and the current United Kingdom Council for Psychotherapy full accreditation fee is £302/year. There are also costs associated with CPD required as part of ongoing practice.
Building Staff Competency
Qualifications Required
Staff will hold an undergraduate degree in a relevant clinical area (e.g., medicine, nursing, social work) and will have completed or work towards completing postgraduate training via an independent training organisation accredited by the British Psychoanalytic Council (BPC) or by the United Kingdom Council for Psychotherapy (UKCP).
Training Requirements
Training in Psychodynamic Psychotherapy is provided as part of psychiatry specialist training in the NHS for those who have chosen to train as a Medical Psychotherapist. Medical Psychotherapists in Scotland, who specialise in PP, also undertake external training in psychoanalytic psychotherapy (individual or group) via independent training organisations accredited with BPC or UKCP. Psychodynamic or psychoanalytic psychotherapy training for other NHS professionals can be provided through independent training organisations at a cost.
Supervision Requirements
It is recommended practice in Scotland that PP is conducted under regular supervision with a practitioner, who is trained as a psychodynamic/psychoanalytic psychotherapist and has significant expertise in delivering PP. Supervisors discuss the therapeutic process with the supervisee and address the therapist’s adherence to the model.
NES specialist supervision training is available.
- NES Generic supervision competences training (GSC) (or equivalent)
- NES Specialist Supervision Training: Psychodynamic Psychotherapy
For further information please see: Supervision of Psychological Therapies and Interventions.
Supervision training at a cost is also available via independent training organisations.
Evidence - Rating: 4 - 5
4 - Evidence
The intervention has demonstrated effectiveness with one rigorous, external research study with the focus population and a control group.
5 - High Evidence
The intervention has demonstrated evidence of effectiveness based on at least two rigorous, external research studies with the focus population and control groups, and has demonstrated sustained effects at least one year post treatment.
Evidence
Theory of Change
Founded on core psychoanalytic concepts, Psychodynamic Psychotherapy works with both the conscious and the unconscious by means of paying attention to and interpreting in the hear-and-now the feelings, beliefs, inner conflicts, and repeating relational patterns linked to past experiences. PP focuses on the psychological roots of emotional suffering in order to help patients achieve a more coherent and functional sense of self, which may lead to the reduction of symptoms.
Children and Young People - Bulimia - Rating: 4
Evidence for psychodynamic psychotherapy for the management of eating disorders in children and young people is limited. Best available evidence includes an RCT of young people with Bulimia Nervosa (Stefini et al 2017). This paper included 81 female adolescents. Treatment included a mean of 36.6 sessions and the primary outcome was remission from symptoms. Follow up was 12 months.
Outcomes
Children and Young People Outcomes for Eating Disorders
Compared to FBT, the following outcomes were observed;
- Comparability in full remission between treatment groups at post-treatment and 12 month follow up (Stefini et al, 2017)
Children and Young People - Depression - Rating: 5
Some of the best available evidence for PP in the management of depression in children and young people include three Randomised Controlled Trials (RCTs). These are described below.
- Recently, Lindqvist et al (2020) conducted a RCT to compare the effectiveness of affect-focused internet-based psychodynamic therapy (IPDT) (delivered with therapist support) to an internet-based supportive control for depression management in adolescents. The RCT included 76 adolescents, aged 15-18 years, who fulfilled the criteria for unipolar major depressive disorder. IPDT was delivered over 8 weeks via a secure online platform. The study was conducted by researchers in Sweden.
- Goodyer et al (2017) conducted a multi-centre RCT to compare psychological therapies in the management of adolescents with unipolar major depression. The RCT included 465 adolescents, aged 11–17 years, who met the diagnostic criteria for major depression including those with suicidality, depressive psychosis and conduct disorder. Short-term psychodynamic psychotherapy was delivered over 30 weeks in up to 28 individual sessions plus up to seven parent/guardian sessions. The study was conducted in England.
- Trowell et al (2007) conducted an RCT to determine the effectiveness of individual psychodynamic psychotherapy in childhood depression. The study included 72 patients aged 9–15 years, who met diagnostic criteria for major depressive disorder and/or dysthymia. Treatment was delivered over 9 months, and consisted of sixteen to thirty 50 min sessions of individual therapy, plus individual parent sessions (one per 2 sessions of child’s psychotherapy). The multi-centre study was conducted in London, Athens, and Helsinki.
Outcomes
Children and young people Outcomes for Depression
Compared to internet-based supportive control conditions and other treatment models groups (i.e. CBT, brief psychosocial intervention, and family therapy), the following outcomes were observed:
- Comparable reduction (compared to active control) in the prevalence of major depressive disorder and dysthymia at post-treatment in between group analysis. Effects were sustained at 6-months (Trowell et al, 2007)
- Comparable reduction (compared to active control including CBT and Brief Psychosocial Intervention) in the depressive symptom score and quality of life score at post-treatment in between group analysis. Effects were sustained at 1-year after treatment (Goodyer et al, 2017)
- Significantly greater reduction in depression and anxiety symptoms (compared to internet based supportive control) at post-treatment, sustained at 6-months follow-up (Lindqvist et al, 2020)
- Significantly greater improvement in emotion regulation and self-compassion at post-treatment (Lindqvist et al, 2020)
Children and Young People - Social Anxiety Disorder (SAD) - Rating: 4
The evidence for PP in the management of SAD in CYP is limited. Best available evidence which focused specifically on CYP with SAD comes from one RCT (Salzer et al, 2018). The multi-centre study compared the efficacy of psychological interventions (i.e. CBT and PP) in 107 adolescents aged 14-20 years. The psychological interventions were delivered in 25 individual sessions. The study was conducted in Germany.
Outcomes
Children and Young People Outcomes for Anxiety
Compared to wait-list control, the following outcomes were observed;
- Significantly greater reduction in emotional symptoms at post-treatment, maintained at 6-months follow-up (Göttken et al, 2014)
Significantly greater reductions in internalising problems, externalising problems, total problems, and total difficulty scores at post-treatment, maintained at 6-months follow-up (Göttken et al, 2014)
Children and Young People Outcomes for SAD
Compared to waitlist control, the following outcomes were observed:
- Significantly reduced anxiety symptoms at post-treatment, sustained at 12-month follow-up (Salzer et al, 2018)
- Significantly improved remission rates at post-treatment, sustained at 12 months follow-up (Salzer et al, 2018)
Adults PP Outcomes for Anorexia Nervosa and Bulimia Nervosa
- Significantly increased BMI in AN at end-of-treatment, and up to 12-months follow-up (Zipfel et al, 2014).
- Significantly higher recovery rate in AN at 12-months follow-up in between-group analysis (compared with optimised treatment as usual) (Zipfel et al, 2014)
- Improvements from both CBT and PP at the end of treatment, at 2 years’ follow up, 44% in the CBT and 15% in the PP group had stopped binge eating and purging.
Adult - Anorexia - Rating: 5
Best available evidence for PP in the treatment of AN includes an RCT that evaluated the effectiveness of focal psychodynamic psychotherapy in adult outpatients with anorexia nervosa (Zipfel et al, 2014). It included 242 females, aged 18 years or over, with AN or subsyndromal AN, and BMI of 15.0 to 18.5 kg/m2. FPT was delivered in 40 sessions over a period of 10 months. The study was conducted in Germany. A systematic review identified two RCTs that evaluated psychodynamic psychotherapy for BN (Steinert et al, 2017). Both papers compared PP to CBT. One RCT had 50 participants and the other 70 participants.
Outcomes
Adults PP Outcomes for Anorexia Nervosa and Bulimia Nervosa
- Significantly increased BMI in AN at end-of-treatment, and up to 12-months follow-up (Zipfel et al, 2014).
- Significantly higher recovery rate in AN at 12-months follow-up in between-group analysis (compared with optimised treatment as usual) (Zipfel et al, 2014)
- Improvements from both CBT and PP at the end of treatment, at 2 years’ follow up, 44% in the CBT and 15% in the PP group had stopped binge eating and purging.
Adult - Bulimia - Rating: 4
Best available evidence for PP in the treatment of AN includes an RCT that evaluated the effectiveness of focal psychodynamic psychotherapy in adult outpatients with anorexia nervosa (Zipfel et al, 2014). It included 242 females, aged 18 years or over, with AN or subsyndromal AN, and BMI of 15.0 to 18.5 kg/m2. FPT was delivered in 40 sessions over a period of 10 months. The study was conducted in Germany. A systematic review identified two RCTs that evaluated psychodynamic psychotherapy for BN (Steinert et al, 2017). Both papers compared PP to CBT. One RCT had 50 participants and the other 70 participants.
Outcomes
Adults PP Outcomes for Anorexia Nervosa and Bulimia Nervosa
- Significantly increased BMI in AN at end-of-treatment, and up to 12-months follow-up (Zipfel et al, 2014).
- Significantly higher recovery rate in AN at 12-months follow-up in between-group analysis (compared with optimised treatment as usual) (Zipfel et al, 2014)
- Improvements from both CBT and PP at the end of treatment, at 2 years’ follow up, 44% in the CBT and 15% in the PP group had stopped binge eating and purging.
Adult - Depression - Rating: 5
Some of the best available evidence for Short-term PP in adult depression management includes meta-analytic studies. These are described below.
- Lindegaard et al (2020) conducted a meta-analytic study to determine the effectiveness of internet delivered interventions based on psychodynamic therapy models on mental health conditions. The review included 7 studies, involving 1,080 participants. Primary mental health issues targeted in these studies included depression, anxiety disorders, return to work, and transdiagnostic focus (i.e. targeting both depression and anxiety).
- Cuijpers et al (2020) conducted another meta-analytic study to determine the effectiveness of psychological therapies in adult depression management. The review included 309 RCTs that involved 385 comparisons. Of these, 12 comparisons (i.e. 3%) involved psychodynamic therapy.
- Lilliengren et al (2016) also conducted a meta-analytic study to determine the effectiveness of Experiential Dynamic Therapy (EDT) (a subgroup of short-term psychodynamic psychotherapy) in the management of psychiatric conditions. The meta-analysis included 28 studies involving 1,782 adult patients presenting with depression, anxiety, personality, or mixed disorders. Seven of these studies primarily targeted depression. EDT was delivered in individual, group or guided self-help formats, over 20 sessions, delivered once weekly.
- Driessen et al (2015) conducted a meta-analytic study to determine the efficacy of short-term psychodynamic psychotherapy (short-term PP) for depression management. The meta-analysis included 54 studies involving 3946 participants. Participants were adults (aged at least 18 years), who met diagnostic criteria for major depressive disorder, another mood disorder, or presented with elevated depression scores. Interventions were classified as STPP if they were founded on psychoanalytic theories, were time-limited from the onset, and applied verbal techniques.
- A Cochrane review by Abbass et al (2014) was conducted to determine the effectiveness of Short-Term Psychodynamic Psychotherapies (short-term PP) in the management of mental health disorders. The meta-analysis included 33 studies with 2173 participants. Participants were adults (aged 17 years or over) diagnosed with common mental health disorders including anxiety, depression, and somatoform disorders. Eighteen studies with 1415 participants were included in determination of depression outcomes in the short-term (i.e. less than three months). Interventions were classified as STPP if they were psychodynamic in nature, and delivered over 40 sessions or less, with each session lasting 45-60 minutes.
- An RCT of long-term psychoanalytic psychotherapy for treatment resistant depression (Fonagy et al (2015) assesses outcomes during 18 months of treatment and at 24, 30 and 42 month follow up.
Outcomes
Adult Outcomes for Depression
Compared to control groups (including waiting list, care as usual, placebo), the following outcomes were observed:
- Significantly reduced depression symptoms at post-treatment (Cuijpers et al, 2020; Lindegaard et a, 2020; Lilliengren et al, 2016; Driessen et al, 2015), sustained at up to 6-months after treatment (Abbass et al, 2014), at more than 6-months follow-up (Lilliengren et al, 2016; Driessen et al, 2015) and at long-term (42 month) follow up (Fonagy et al 2015).
- Significantly reduced anxiety symptoms at post-treatment (Lindegaard et al, 2020; Lilliengren et al, 2016; Driessen et al, 2015), sustained at more than 6-months follow-up (Lilliengren et al, 2016; Driessen et al, 2015)
- Significantly improved interpersonal functioning and general psychopathology at post-treatment, sustained at more than 6-months follow-up (Driessen et al, 2015)
- Significantly improved quality of life at post-treatment (Lindegaard et al, 2020; Lilliengren et al, 2016; Driessen et al, 2015), sustained at more than 6-months follow-up (Driessen et al, 2015)
Significantly reduced general psychiatric symptoms and interpersonal problems at post-treatment (Lilliengren et al, 2016)
Adult - Panic Disorder - Rating: 5
Some of the best available evidence for PP in the treatment of PD in adults come from systematic reviews and meta-analysis/ network meta-analysis, and one Randomised Controlled Trial (RCT).
- Papola et al (2021) conducted a network meta-analytic study to evaluate the efficacy of psychotherapies for the treatment of acute phase of panic disorder with or without agoraphobia. The study included 103 RCTs (N=7352) of studies that compared any kind of psychotherapy (including short-term psycho-dynamic therapy) in adults (≥18 years). Adults diagnosed with panic disorder and other comorbid disorders were also included. Delivery formats of psychotherapies were wide ranging and included individual or group formats, face-to-face or remote delivery, and guided/ unguided self-help or therapist delivered interventions. There were no limits set for duration of treatment or number of treatment sessions.
- Keefe et al (2014) conducted a meta-analytic review to evaluate the effectiveness of psychodynamic therapies for anxiety disorders including PD, GAD, and social anxiety. 14 RCTs with1073 adults were included in this review, and PP was delivered in individual or group formats, over the short or long term.
- Svensson et al (2021) conducted a Randomised Controlled Trial (RCT) to evaluate the effectiveness of PFPP or CBT. The study was conducted in Sweden and included 221 adults with panic disorder with/without agoraphobia. PFPP comprised of 19– 24 individual sessions completed in 10–16 weeks, with 2 sessions per week.
Outcomes
Adult Outcomes Achieved for Panic Disorder
Compared to treatment as usual, wait-list control, or control group who received minimal support, the following outcomes were observed in participants who received PP;
- Significantly reduced panic symptoms (Papola et al, 2021)
- Significantly reduced severity of panic disorder at post-treatment, with continued reduction observed at up to 24 months follow-up (Svensson et al, 2021)
- Significantly reduced anxiety symptoms at post-treatment (Keefe et al, 2014)
Adult - Social Anxiety Disorder (SAD) - Rating: 5
Some of the best available evidence for PP in the management of SAD include meta-analytic studies. These are described below.
- Recently, Zhang et al (2022) conducted a meta-analytic study to determine the efficacy of psychodynamic therapy in the management of social anxiety disorder. The study included 12 RCTs that involved 1,213 participants diagnosed with SAD or social phobia. Mean ages of participants in the included studies ranged from 17-43 years. The review included psychodynamic therapy delivered in various formats including individual, group, short-term, and long-term.
- Mayo-Wilson et al (2014) conducted a network meta-analytic study to determine the effectiveness of psychological and pharmacological interventions for SAD management in adults. The meta-analysis included 101 trials (n=13,164 participants) involving 41 interventions or control conditions. Psychodynamic therapy was evaluated in 3 studies (n=185). Participants in the meta-analysis were adults aged at least 18 years who met the diagnostic criteria for SAD.
Keefe et al (2014) conducted a meta-analytic study to determine the effectiveness of psychodynamic therapies for anxiety disorders. The meta-analysis included 14 RCTs involving 1073 participants (aged 18 years or over) with one or more specific class of anxiety disorder (e.g., GAD, panic disorder or SAD). SAD/ social phobia was the most frequently studied anxiety disorder as it was examined exclusively in 4 studies. The review included psychodynamic therapy delivered in different formats including short term, long term, individual and group.
Outcomes
Adult Outcomes for SAD
Compared to inactive controls the following outcomes were observed:
- Significantly reduced symptoms of SAD/ anxiety at post-intervention (Zhang et al, 2022; Mayo-Wilson et al,2014; Keefe et al, 2014). Effect of psychodynamic therapy on was similar to other active treatment at post-intervention (Zhang et al 2022; Keefe et al, 2014), at follow-up up to 1 year (Keefe et al, 2014).
Need
Comparable Population
PP has been shown to be effective in adults with depressive illness and a range of anxiety disorders (including PD, GAD, and social anxiety) as well as adults, children and adolescents with anorexia and bulimia nervosa. There is limited available evidence demonstrating its effectiveness in adults with borderline personality disorder and co-occurring substance use disorder or antisocial personality disorder.
Desired Outcome
PP is associated with significant reduction in depression and anxiety symptoms at post-treatment, significantly improved interpersonal functioning and quality of life post-treatment and at more than 6 months follow-up. In adults with panic disorder, continued reduction in symptoms were observed at 24-months follow-up. PP is also associated with significantly reduced alcohol misuse, parasuicidal behaviour, and institutional care at 12-months post-treatment initiation. Available evidence also shows significant increases in BMI at post-treatment and up to 12 months follow-up in adults with anorexia nervosa.
1 - Does Not Meet Need
The intervention has not demonstrated meeting need for the identified population
2 - Minimally Meets Need
The intervention has demonstrated meeting need for the identified population through practice experience; data has not been analysed for specific subpopulations
3 - Somewhat Meets Need
The intervention has demonstrated meeting need for the identified population through less rigorous research design with a comparable population; data has not been analysed for specific subpopulations
4 - Meets Need
The intervention has demonstrated meeting need for the identified population through rigorous research with a comparable population; data has not been analysed for specific subpopulations
5 - Strongly Meets Need
The intervention has demonstrated meeting the need for the identified population through rigorous research with a comparable population; data demonstrates the intervention meets the need of specific subpopulations
Fit
Values
Psychodynamic Psychotherapy (PP) is used in treatment of adults, children, and adolescents with a range of mental health diagnoses, including depression, anxiety, anorexia, panic, and somatoform disorders. Founded on core psychoanalytical concepts, it focuses on psychological roots of emotional suffering in order to help patients achieve a more coherent and functional sense of self, which may lead to the reduction of symptoms.
Priorities
PP focuses on psychological roots of emotional suffering in order to help patients achieve a more coherent and functional sense of self, which may lead to the reduction of symptoms. PP can be delivered as individual therapy or in group format, over the short or long term.
Existing Initiatives
1 - Does Not Fit
The intervention does not fit with the priorities of the implementing site or local community values
2 - Minimal Fit
The intervention fits with some of the priorities of the implementing site, but it is unclear whether it aligns with local community values and other existing initiatives
3 - Somewhat Fit
The intervention fits with the priorities of the implementing site, but it is unclear whether it aligns with local community values and other existing initiatives
4 - Fit
The intervention fits with the priorities of the implementing site and local community values; however, the values of culturally and linguistically specific population have not been assessed for fit
5 - Strong Fit
The intervention fits with the priorities of the implementing site; local community values, including the values of culturally and linguistically specific populations; and other existing initiatives
Capacity
Workforce
PP is delivered by qualified mental health practitioners from a range of professional backgrounds with a postgraduate training in psychoanalytic / psychodynamic therapy.
PP can be delivered face-to-face or remotely, in individual or group format.
The length of therapy is determined by the complexity of the patient’s difficulties, the short-term therapy delivered weekly over 6-12 months and the longer-term therapy delivered weekly over a number of years. Individual sessions last 50 minutes and group sessions last 1.5 hours. Groups usually consist of 8-10 participants and are facilitated by 1 or 2 therapists.
Technology Support
PP can be delivered without access to technology but access to video platforms for remote delivery can be useful.
Administrative Support
PP is delivered weekly over the short or long term, with face-to-face delivery within specialist Psychotherapy Departments.
Administrative support is needed to manage appointments, collate and input outcome measures and format clinical letters.
Financial Support
Financial support for training is available for Psychiatry Higher Trainees specialising in Psychodynamic Psychotherapy during Medical Psychotherapy training. Financial support for non-medical staff needs to be discussed with the NHS Board where they are employed. Start up costs can range from £6000-9000 per year of training, additional costs apply for supervision, personal psychotherapy, accreditation and CPD.
1 - No Capacity
The implementing site adopting this intervention does not have the capacity necessary, including a qualified workforce, financial supports, technology supports, and administrative supports required to implement and sustain the intervention with integrity
2 - Minimal Capacity
The implementing site adopting this intervention has minimal capacity necessary, including a qualified workforce, financial supports, technology supports, and administrative supports required to implement and sustain the intervention with integrity
3 - Some Capacity
The implementing site adopting this intervention has some of the capacity necessary, including a qualified workforce, financial supports, technology supports, and administrative supports required to implement and sustain the intervention with integrity
4 - Adequate Capacity
The implementing site adopting this intervention has most of the capacity necessary, including a qualified workforce, financial supports, technology supports, and administrative supports required to implement and sustain the intervention with integrity
5 - Strong Capacity
Implementing site adopting this intervention has a qualified workforce and all of the financial supports, technology supports, and administrative supports required to implement and sustain the intervention with integrity
