ISTDP in the NHS: Can early-career therapists do it safely?

A 2025 study suggests yes. Among 26 patients with chronic and complex difficulties, engagement was strong (24 completions, 89% attendance), no serious adverse events were reported, and symptoms showed moderate improvement on CORE-OM and BSI. The implications for training and supervision are promising.

February 18, 2026

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Reference: Malda-Castillo, Rigby & Diamond (2025), Journal of Contemporary ISTDP, Issue 04.

The big question: Is ISTDP safe + effective when delivered by an early-career clinician in NHS secondary care?

Short answer: YES — and the results are pretty exciting.

Quick stats (from the study):

  • Moderate symptom improvements on CORE-OM and BSI
  • 26 NHS patients with chronic/complex difficulties
  • 24 completed treatment (super low dropout)
  • 89% attendance among those who started
  • No serious adverse events reported

What the numbers looked like:

Engagement was high (completion + attendance).
Symptoms improved (moderate effect sizes).
Outcomes: most improved; very few worsened.

Why this matters:

This study suggests ISTDP can be taught + delivered safely in real NHS services — even by early-career clinicians — as long as training and video-supervision are in place.

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