Psychological Therapies Spotlight Audit


The audit was led by a partnership between the Royal College of Psychiatrists and the British Psychological Society.

The audit looks at the quality of psychological assessment, formulation and therapy delivered by secondary care mental health services to people aged 18 and over. The audit includes an audit of practice (case note audit) along with a survey for therapists and feedback from service users.

Data were collected between October 2018 and January 2019.

The psychological therapies audit includes the following key areas of focus:

  • Equity of access
  • Shared decision making
  • Waiting times
  • Training and supervision of therapists
  • Measuring and monitoring service user outcomes
  • Provision of the NICE recommended therapies


Key Finding

The audit found that most adults who received psychological therapy rated their therapists highly and felt helped by the treatment they received, but access was poor with almost half of adults waiting over 18 weeks from referral to the start of treatment. Many service users also reported a lack of choice in key aspects of their therapy and outcome measures were not being routinely used to assess change.

Key Recommendation

All Mental Health Trusts should have a Trust-wide Psychological Therapies Management Committee. This will enable Trusts to co-ordinate different parts of psychological therapy provision, offering clear leadership, both professionally and managerially. This should include service user and carer representatives, the lead psychological professional for the Trust, direct representation at Board level and coordination of core tasks, including systematic data collection, waiting list management, outcome measures, service user involvement, care pathways, training and supervision.

  1. The service routinely collects data to assess equity of access.
  2. A person who is assessed as requiring psychological therapy does not wait longer than 18 weeks from the time at which the initial referral is received to the time that treatment starts.
  3. Psychological therapies are provided in line with relevant NICE guidance (type and number of sessions) for the service user's diagnosis/condition.
  4. Service users report being provided with information and choice about their treatment.
  5. Service users report a high level of satisfaction with the treatment that they receive.
  6. The service routinely uses validated measures (e.g. symptoms, level of functioning and/or disability) to inform and evaluate treatment.
  7. Therapists are providing therapy under supervision.
  8. Therapists have received formal training to deliver the therapy provided.
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