Abstract
Purpose
Psychological therapies have positive effects on mental health. The National Health Service, England (NHSE), commissioned a suite of training programmes in psychological therapies to upskill clinicians and increase availability of treatments. Between 2021 and 2022, 1,575 training places were offered. The purpose of this study was to complete a training evaluation, commissioned by NHSE in 2022 / 23.
Design/methodology/approach
A two-phased mixed-method evaluation was conducted. Phase one assessed training provision from the perspective of trainees, managers, course teams and clinical leads against Kirkpatrick’s framework. Phase two explored the factors influencing retention and the causes and scale of attrition from training. The total data set included a trainee survey (n = 235) and qualitative interviews with trainees, educators and managers (n = 89).
Findings
Significant benefit was derived from the national programme. Trainees were highly satisfied and motivated by their training, describing client benefits and changes in therapeutic practice. However, many experienced challenges which impacted wellbeing and the likelihood of course completion. Respondents acknowledged struggling with academic requirements and busy clinical workplaces, insufficient study time plus personal issues that could “push” trainees towards attrition. Equally, key “pull” factors encouraged trainees to persevere (e.g. enjoyment, supportive managers, effective supervision and increased competence).
Originality/value
To maximise investments in training programmes for the delivery of psychological therapies, addressing the needs of trainees and causes of attrition is key. The authors present a new model of the push−pull factors that promote training retention and prevent attrition in this context.
Psychological therapies have positive effects on mental health. The National Health Service, England (NHSE), commissioned a suite of training programmes in psychological therapies to upskill clinicians and increase availability of treatments. Between 2021 and 2022, 1,575 training places were offered. The purpose of this study was to complete a training evaluation, commissioned by NHSE in 2022 / 23.
Design/methodology/approach
A two-phased mixed-method evaluation was conducted. Phase one assessed training provision from the perspective of trainees, managers, course teams and clinical leads against Kirkpatrick’s framework. Phase two explored the factors influencing retention and the causes and scale of attrition from training. The total data set included a trainee survey (n = 235) and qualitative interviews with trainees, educators and managers (n = 89).
Findings
Significant benefit was derived from the national programme. Trainees were highly satisfied and motivated by their training, describing client benefits and changes in therapeutic practice. However, many experienced challenges which impacted wellbeing and the likelihood of course completion. Respondents acknowledged struggling with academic requirements and busy clinical workplaces, insufficient study time plus personal issues that could “push” trainees towards attrition. Equally, key “pull” factors encouraged trainees to persevere (e.g. enjoyment, supportive managers, effective supervision and increased competence).
Originality/value
To maximise investments in training programmes for the delivery of psychological therapies, addressing the needs of trainees and causes of attrition is key. The authors present a new model of the push−pull factors that promote training retention and prevent attrition in this context.
| Original language | English |
|---|---|
| Pages (from-to) | 427-442 |
| Number of pages | 16 |
| Journal | The Journal of Mental Health Training, Education and Practice |
| Volume | 21 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 21 Jul 2026 |
Bibliographical note
Publisher Copyright:© 2026 Emerald Publishing Limited
This author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BY-NC 4.0) licence. This means anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. For commercial reuse, please contact the publisher [email protected].
You may deposit your author accepted manuscript at any point, but it must not be made publicly accessible until official publication
Funding
This work was commissioned and funded by NHS England. The authors are grateful for the support provided throughout the development and delivery of this evaluation. The views expressed in this publication are those of the authors and do not necessarily reflect the official policy or position of NHS England or the wider National Health Service. The authors would also like to extend their sincere thanks to all participants, including trainees, educators, and stakeholders, whose time, insights, and experiences made this study possible.
| Funders |
|---|
| NHS England |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
-
SDG 3 Good Health and Well-being
Keywords
- Psychological therapies
- Clinical training
- Education
- Evaluation
- Attrition rate
- Retention
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