BABCP submission to Senedd Cymru Priorities for the Health and Social Care Committee
The British Association for Cognitive and Behavioural Psychotherapies (BABCP) is the lead organisation for Cognitive Behavioural Therapy (CBT) in the UK and Ireland. Our mission is to support the development of CBT, and those who deliver it, to improve the mental health of people across the UK and Ireland.
As a professional body with over 27,000 members, and around 500 members in Wales, we are committed to promoting the highest standards of CBT practice, training, and supervision. We hold all our members to the highest professional standards, which they commit to by adhering to our Standards of Conduct, Performance, and Ethics. We hold the CBT Register UK and Ireland jointly with the Association for Rational Emotive Behaviour Therapy (AREBT). The Register is accredited by the Professional Standards Authority (PSA) and is the only officially recognised register of BABCP and AREBT accredited CBT therapists, supervisors and trainers. Our Register also includes sections for other NHS England-recognised occupations using CBT informed approaches. These are Evidence-Based Parent Trainers, (EBPTs) Psychological Wellbeing Practitioners (PWPs), Children’s Wellbeing Practitioners (CWPs) and Education Mental Health Practitioners (EMHPs). These registration schemes are approved by NHS England.
Given the nature of our organisation, we will be focusing on areas related to the provision of mental health and other areas of health and social care where there is an established evidence base for psychological therapies such as CBT.
Response
Do the Welsh Government's health and care priorities reflect the most significant challenges facing communities across Wales?
Yes
BABCP agrees that the Welsh Government’s health and care priorities reflect the most significant challenges facing communities across Wales. We particularly welcome the strengthening of mental health services in Wales.
We believe that it is important that in its aim to strengthen mental health services in Wales, the Government should prioritise ensuring that communities have access to a choice of evidence-based, effective psychological therapies such as CBT, as recommended by Cymru and the National Institute for Health and Care Excellence (NICE). CBT is one of the most effective and evidence-based types of talking therapies. It is recommended in NICE Guidelines as well as Matrics Cymru as an intervention and often treatment of choice for addressing various conditions, including anxiety disorders, depression, OCD, eating disorders, personality disorders, amongst other conditions.
Investing in CBT would allow the Government to expand community care and move towards prevention. Intervening promptly with accessible, evidence-based and brief treatments not only reduces distress and improves mental health, it also improves cost-effectiveness of services. Implementation of stepped care models in Canada, Australia, New Zealand and Norway – see for example, https://link.springer.com/article/10.1186/s12888-018-1838-0 in addition to England, (https://pubmed.ncbi.nlm.nih.gov/29350997/) have demonstrated that using evidence-based psychological therapies for mild to moderate common mental health conditions can prevent escalation of mental health problems across the life-span. Treating anxiety and depression using low-intensity CBT interventions, while ensuring that it is accessible in local communities and delivered by trained and registered practitioners improves health outcomes and is highly cost effective.
The Welsh Government should consider a similar model to enhance mental health in Wales by investing in the CBT workforce to provide local, community-based, accessible stepped care, with evidence-based, cost effective psychological interventions.
Access to evidence-based psychological therapies, such as CBT could also save NHS money. A recent study by the London School of Economics, found that for with every pound spent, NHS Talking Therapies generates an 4 benefit of £5.50 for the economy5.
Are any important priorities missing?
No
BABCP believes that the Government has identified the right priorities but as expressed in our response to the question above, it is crucial that the Government focuses on increasing access to evidence-based psychological therapies for children, young people and adults and expanding the workforce that can deliver evidence-based therapies such as CBT.
The CBT workforce would be well-placed to allow the Government to expand community provision and promote prevention, and as expressed in the response above, also to tackle the waiting lists. Additional resources, such as training and expanding the workforce that can deliver those interventions would be an effective approach to reducing waiting times, which are worrying. A Freedom of Information request placed by Mind in 2024 revealed that around 2,000 adults with severe mental health problems were waiting more than six months to access specialist psychological therapies, with a further 750 waiting more than one year. Early assessment and diagnosis by suitably trained and qualified practitioners and early intervention is crucial to decrease the likelihood of deterioration while on a waiting list.
What are the main barriers to delivering these priorities and measuring progress?
BABCP believes that the greatest barriers include workforce shortages, particularly of adequately trained and accredited CBT psychotherapists that can provide evidence-based interventions. This can be a barrier to many of the Government’s priorities – reducing waiting times, community provision, strengthening mental health services or reducing inequalities.
Investment is needed in training, supervision and retention of accredited CBT practitioners and other psychological therapists.
Ensuring that services across Wales have the resources and the workforce to deliver the best evidence-based interventions to the people and communities that need them will address some of the barriers that currently exist to making progress.
What should the Committee focus on to make the biggest difference?
The biggest difference will be achieved by focused investment in the psychological therapies workforce, particularly in ensuring that fully trained and accredited CBT practitioners can meet the needs of local communities across Wales. Accessible evidence-based psychological interventions in educational settings, local communities, health care and specialist provision will be the most effective way for the government to achieve their aims, as this will reduce waiting times, strengthen mental health services, expand community-based care, move towards better prevention and reduce health inequalities.
There is strong evidence that CBT reduces incidence and severity of mental health problems when used as an early intervention or as a preventative measure. A 2026 study in the US confirmed that Digital CBT reduced the prevalence of having anxiety, depression and/or an eating disorder through 2 years of follow up and substantially increased service utilisation: https://www.nature.com/articles/s41562-026-02460-1 .
The introduction of CBT-informed approaches delivered at low intensity in the community and in education settings will be beneficial if adequately resourced.
The Government should also consider increasing the provision of Internet-Based Cognitive Behavioural Therapy (CBT-i) and CBT-informed self-help: https://pmc.ncbi.nlm.nih.gov/articles/PMC9896353/. https://readingagency.org.uk/get-reading/our-programmes-and-campaigns/reading-well/
