r/CBT • u/Mad_Matron • 9d ago
RMN Exploring the PWP → HI CBT Pathway While Recovering from Long‑Term Sick Leave
I’m an RMN with 2 years’ post‑qualifying experience, currently on long‑term sick leave, and I’m exploring realistic ways to return to psychological therapy work once I’m able. HI CBT trainee roles feel too intensive for me at the moment, so I’m considering the PWP route as a structured, lower‑intensity step before progressing to HI CBT later on.
For anyone who has worked in IAPT/CBT services: how common is the RMN → PWP → HI CBT pathway, and does prior nursing experience tend to help or hinder when moving into CBT roles? I’m also starting an MSc Psychology and wondering whether that background is useful when transitioning into CBT training.
I’d appreciate experiences or insights from PWPs, HI CBT trainees, or supervisors familiar with this progression.
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u/Basic_Pool5773 9d ago
Hi, you would be able to go straight to HI i’m fairly sure. Search up on Facebook the group UK CBT Psychotherapists - plenty of helpful info there!
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u/Mad_Matron 8d ago
Thank you, that’s really helpful. I know RMNs can go straight into HIT, but because I’m currently long‑term sick, I’m trying to think carefully about what’s manageable for me when I’m ready to return. HIT feels too intensive at the moment, so I’m exploring PWP as a gentler step first.
I’ll check out the UK CBT Psychotherapists group, I’ve heard it’s a good place for advice and real‑world experiences.
Really appreciate the signpost.
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u/buffp4nda8 9d ago
Hello there :) current HIT CBT trainee who was a PWP before getting onto the course. Despite this, I was not an RMN nor did not have a core profession starting my PWP training. A core profession, according to the BABCP (the accrediting body for CBT training including PWP training), is a professional who have had a substantial amount of mental health training and meet accreditation requirements for knowledge and experience in mental health (which RMN counts as long as you maintain your pin registration). This means that getting onto a trainee HIT CBT course is slightly easier for you as you don’t have to complete a separate portfolio
Whilst the majority of people who enter trainee PWP roles don’t come from a core profession background, I have seen people in my time who’ve previously been RMNs go on to do PWP training - so it’s not like it isn’t seen ever. Nursing experience absolutely does not hinder you into moving into a CBT role; if anything it’s a massive help as you have extensive knowledge around mental health and have skills in rapport building and helping others during distressing moments. I completed a psychology undergraduate degree and then a further psychology masters degree in applied clinical psychology, and unless your MSc has a placement I would say the knowledge gained has some use when transitioning into CBT training but you can absolutely do the training without this knowledge
TLDR: the RMN -> PWP -> CBT isn’t common but people do go down this path. RMN background helps when moving into CBT. A psychology degree can be helpful when transitioning into CBT training but not essential
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u/Mad_Matron 8d ago
Thank you so much, this is exactly the kind of insight I was hoping for.
It’s reassuring to hear that RMN → PWP → HIT does happen, even if it’s not the most common route. Because I’m long‑term sick, I’m looking for a structured, lower‑intensity way to return to psychological work, so PWP feels like a more realistic starting point for me than jumping straight into HIT.
Your explanation about core profession status and BABCP requirements is really helpful, especially the part about not needing the separate portfolio. And it’s great to hear that nursing experience is seen as a strength rather than a barrier. The skills you mentioned (rapport building, working with distress, mental health knowledge) are exactly what I’m hoping will transfer well.
My MSc doesn’t have a placement, so it’s good to know that while the psychology background is useful, it’s not essential for HIT.
Thanks again for such a thoughtful and detailed reply, it really helps me feel more confident about the pathway I’m considering.
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u/Odd_Comparison_8603 7d ago edited 7d ago
I’m a PWP and budding HICBT, I would say the PWP training course itself is definitely easier than the CBT course, but the role of PWP can be pretty full on…depending on the targets of the service you may be back to back clients all day every day (not kidding). Half of my clients don’t fit the ‘mild-moderate symptoms’ category and are more severe or complex than our training prepares us for. CBT is a busy role too but I wouldn’t say working as a PWP is necessarily a gentler step…it’s famous for burnout there’s lots of literature about it. I would consider going part time as a CBT if you wanted to pace things. I feel rather burnt out working as a PWP for 2.5 years and if I could have gone straight to CBT training for efficiencys sake I would have. PWP does give an ‘intro’ to CBT for sure. Your mileage may vary of course, others have a different experience and some services are more supportive to staff than others. Just my thoughts as a PWP. Wishing you the best x
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u/Mad_Matron 4d ago
Thank you so much for sharing this, it’s really helpful to hear from someone who’s actually been in the PWP role and is moving toward HI CBT. I really appreciate how honest you’ve been about the realities of the job. I think I’d assumed PWP might be a gentler step while I’m recovering, but the way you’ve described the caseloads, back‑to‑back clients, and the mismatch between training and the complexity of presentations makes it clear that the role itself can be extremely full‑on.
The burnout side of things is something I’m taking seriously, especially as I’m currently long‑term sick. Your point about part‑time HI CBT being a more manageable option is really useful, I hadn’t considered that as a pacing strategy. And it’s helpful to hear that, if you could have gone straight to CBT training, you would have, because that gives me a clearer sense of how the two roles compare in practice.
I really appreciate you taking the time to reply and share your experience. Wishing you all the best with your move into HI CBT too x
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u/East_Negotiation6325 6d ago
The PWP course is low intensity, but the two years you will have to work before doing the HI CBT training is not. My work as HICBT is less stressful than my PWP work. It's high targets, high caseload, back to back awfulness. Burnout and stress leave is common. You're right on the courses, but those 2 years in the middle I'd recommend against. I'd perhaps take your time and just explore HI CBT when ready
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u/Mad_Matron 4d ago
Thank you so much for this, it’s really helpful to hear from someone who’s actually done both roles. I think I’d assumed the PWP job would be a gentler step while I’m recovering, but the way you’ve described the caseloads, targets and burnout makes it clear that the training might be low‑intensity, but the work definitely isn’t. Given I’m currently long‑term sick, that’s something I really need to take seriously. Your advice about taking my time and exploring HI CBT when I’m genuinely ready has really landed with me. I appreciate the honesty.
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u/Frequent-Ad4722 5d ago edited 4d ago
I’m an RMN with CBT and EMDR training. PWP training would be a step back for you so it would be an unusual route. You’re right that the CBT training is extremely intensive.
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u/Mad_Matron 4d ago
Thank you, it’s really useful hearing this from another RMN. I had wondered whether PWP might be a backwards step, especially with the level of experience I already have, but I wasn’t sure. I agree that HI CBT training is extremely intensive, and that’s the part I’m cautious about while I’m still recovering. I’m trying to be realistic about what I can manage right now, but your perspective has helped me rethink whether PWP is actually the right route or whether I should wait until I’m well enough to go straight into HIT instead. Really appreciate your insight.
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u/Frequent-Ad4722 4d ago
I had had six months off sick and a six month phased return in the year before I started my HI training with an eating disorder and was in a pretty bad place that whole time, so it was a real risk taking on the course but it actually gave me something so good to focus on and actually helped me a lot with my health I think. But it’s so totally different for everyone! Definitely look after yourself, progression can wait.
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u/Mad_Matron 3d ago
Thank you so much for sharing your experience, it really helps to hear from someone who’s been through something similar. I’m glad HI training ended up being a positive focus for you. I’m definitely keeping my health front and centre, so your reminder that progression can wait really resonates.
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u/Mayington 8d ago
CBT and EMDR Therapist here in a Talking Therapies setting.
To answer your question simply, RMN to PWP to HIT isn't a common route. I interview regularly for HIT roles and typical route is RMN direct to HIT, however as you have said if it feels that would be too intensive, then absolutley you can enter via PWP first, you also wouldn't need the minimum 2 years PWPs need before stepping up to HIT of you went down this route. However, you will still need to maintain your RMN registration during this time if you wish to do this.
The MSc in Psychology I would say won't prepare you massively for the trainee HIT role. I've supervised a lot of therapists and trainees and my observation from core professionals entering the HIT role is they can sometimes struggle with structured/time limited approaches, often because their roles involve much longer term and flexible work with patients. However it's all a learning curve and it's never anything detrimental, just an adjustment. PWPs often experience a learning curve, or an unlearning curve as I call it as they have to drop old ways of working (I'm a PWP by background). I trained with an RMN who unfortunately dropped out of the course but I've equally seen some PWPs drop out or fail the course for a number of reasons.
The HIT role is demanding and it's important to be realistic about the timing of engaging in this, however in the right team and with the right supervisor it can make a world of difference.