Working in the NHS

The NHS is the largest employer of systemic psychotherapists in the UK. It offers the opportunity to work in multidisciplinary teams, develop specialist expertise and progress into senior clinical, leadership and training roles.

As you can see below, roles can vary depending on the service you work in.

The most common roles

Qualified family and systemic psychotherapists often work in a range of settings including community mental health teams, hospitals and specialist therapy services. They:

• Provide therapy for families, couples or individuals
• Assess family relationships and dynamics
• Work as part of a multidisciplinary mental health team
• Provide supervision to other staff

Child and Adolescent Mental Health Services (CAMHS)

Family and systemic psychotherapists commonly work in CAMHS. They:

• Provide family assessments and therapy as part of a multidisciplinary CAMHS team
• Work with children and young people experiencing difficulties such as anxiety, depression, eating disorders, behavioural difficulties or trauma
• Work closely with parents and carers to support family relationships and communication

Adult mental health services

Family and systemic psychotherapists work in adult mental health services, including community mental health teams and hospital wards. In these roles, they:

• Provide family interventions for conditions such as psychosis, depression and bipolar disorder
• Support carers and family members of people experiencing mental health difficulties
• Run systemic case discussions with clinical teams

Specialist services

Family and systemic psychotherapists can also specialise in particular areas of mental health care, such as:

• Eating disorder services
• Perinatal mental health teams
• Personality disorder services
• Learning disability services
• Forensic mental health services

Senior roles

With experience, family and systemic psychotherapists can progress into senior or highly specialist roles within the NHS. In these roles, you might:

• Supervise therapists and trainees
• Lead systemic thinking in clinical teams and the wider Trust
• Help to develop services
• Train other professionals
• Carry out research or evaluate services

Clinical leads

Some experienced therapists move into consultant or clinical lead roles. In these positions, you might:

• Lead a psychological therapy service
• Carry out strategic planning for the service
• Manage clinical teams
• Teach and supervise colleagues
• Offer specialist consultations with clinicians, teams and managers to help develop the organisation

Teaching roles

Some family and systemic psychotherapists take on training and educational roles within the NHS. They might:

• Teach systemic therapy to other clinicians
• Supervise trainees on psychotherapy courses
• Run reflective practice groups for staff

What does progression look like?

Most qualified family and systemic psychotherapists start out in the NHS in band 7 roles, with salaries typically ranging from £49,387 to £56,515 per year. These are commonly based in community mental health teams, hospitals and specialist therapy services.

With experience, therapists can progress to highly specialist systemic psychotherapist roles, where they may supervise other therapists and lead systemic practice within teams. These roles are usually band 8a, with salaries between £57,528 and £64,750.

Some roles involve teaching and developing systemic thinking in a specialist service, such as an eating disorders service. These may also include research and evaluating a service and are often described as principal systemic psychotherapy roles. They are usually band 8b to 8c, with salaries between £72,719 and £97,746.

The most senior roles are clinical leads or consultant family and systemic psychotherapists, who lead services and take on additional management and leadership responsibilities. These roles are typically band 8d or band 9, with salaries ranging from £94,356 to £129,783.

• Find out more about NHS band pay scales on the NHS Employers website

Working in the NHS: Beccy’s experience

Beccy Holttum, our branches committee chair and Cornwall and Plymouth branch representative for the Association for Family and Systemic Psychotherapy (AFSP), says:

“I work 2 days a week for a children and young people’s eating disorder service in Wales and 3 days for one in Cornwall. Most of the work is helping families and wider systems come together to help, support and guide their young people. They cannot get better without the support of their families.

“I never take what I do for granted. It’s a privilege to be on the young person and family’s journey to recovery. Challenges include the lack of appropriate space, rooms, resources and staff. Plus being expected to do more work online.

“You will have amazing times and hard times as a family and systemic psychotherapist in the NHS. The difference you can make to young people and families, couples, individuals and organisations will make everything worthwhile.

“My advice is to seek support from other family and systemic psychotherapists. Use your local branch of AFSP and become active in the support systems around you.”

Working in the NHS: Caz’s experience

Caz Brown, chair of our professional affairs committee, says:

“I’ve been fortunate in my career to have had the opportunity to manage teams and develop eating disorder and self-harm services within the NHS. I have also worked with young people placed in specialist services, who have dangerous or risky behaviours, and their families to reintegrate them back home and into their local community.

“Senior family therapists have the opportunity to work in strategic roles within the NHS. These can allow systemic psychotherapists to influence policy or develop new services, which I have found both enjoyable and challenging.

“For a number of years, many NHS Trusts focused on employing and promoting psychologists. But, in my experience, this is now changing. However, I feel that people who are prepared to move around and apply for different posts are, generally, able to progress much quicker. Although, this exception may depend on whether you have developed specialist experience and skills.”