Not a Radio gameshow, but NHS Talking Therapies practitioner’s felt responses to encountering clients who mention trauma, revealed in a paper by Kerr et al (2025) in the The Cognitive Behaviour Therapist. Psychological Wellbeing Practitioners (PWPs) are the gatekeepers into the Service, but in this study they report being out of their depth, unable to differentiate trauma responses. With no training in reliable diagnosis or trauma treatment. But clients are unaware of this. Whither transparency?
The authors of the paper are Oxford University researcher’s, they studiously avoid saying that the assessment process in NHS Talking Therapies is fundamentally flawed. To do so may scupper their access to data from the Service and embarrassingly, underline that the assessment process employed, originated with one of their colleagues.
I assessed John (some details changed to protect confidentiality) who fell from a ladder, and was unable to work as a painter and decorator for many months. He developed depression and panic disorder. John was routed via his GP to NHS Talking Therapies, where he had 7 sessions of ‘low intensity CBT’. He was deemed by the PWP to have ‘PTSD/like symptoms’ and put on a waiting list for ‘high intensity CBT’ , where he is currently languishing. John hadn’t been informed that he would likely have trauma-focussed CBT involving repeated reliving of his fall! There was no precision in the PWP’s assessment. The fall was undoubtedly a stressor, but it was very unlikely that it was the extreme stressor required for a diagnosis of PTSD. I conducted a standardised diagnostic interview for PTSD, enquiring about each symptom and whether each cleared a threshold for significant impairment. He quite definitely did not have PTSD.
But most people have experienced a trauma in their life, and those who go to NHS Talking Therapies will be no exception. If the gatekeepers, the PWPs, are at sea on this, the whole service is questionable.
Dr Mike Scott