1. Purpose and background
The engagement sought to understand current user experience of NHS Talking Therapies (TT) across Essex, and to identify what people value, what could be improved, and how an Essex‑wide Talking Therapies and Psychological Therapies for Severe Mental Health Problems (PT‑SMHP) service model can best meet local need. A mixed‑methods survey was used, combining closed questions, multiple‑choice responses and free‑text insight.
2. Who responded
A total of 118 people had used Talking Therapies in the past 12 months and form the basis of the analysis. Respondents represented a mix of service users, carers and those with dual perspectives:
- 63.6% service users
- 11.0% carers/family members
- 28.0% both service user and carer roles (combined experience)
Respondents reflected a broad demographic spread across:
- Council areas: Responses came from residents across Essex, with the highest representation from Southend. Geographical variation was noted highlighting the importance of establishing a consistent Essex-wide offer.
- Age: Responses ranged from 18 to 85+, with highest representation in the 35–64 age bands.
- Gender: Majority women (76%), with smaller proportions of men and very small non‑binary representation.
- Disability / LTC: 63.6% reported living with a disability or long‑term condition.
- Ethnicity: Most respondents identified as White British, with small numbers from minority ethnic groups (too small for firm conclusions).
This breadth helped ensure diverse perspectives were represented.
3. Overall experience of services
When asked to rate their experience of Talking Therapies in the last year:
- Experience scores averaged 3.04 out of 5, equivalent to “Fair”.
- Ratings ranged from Excellent to Extremely Poor, reflecting a range of experiences.
4. What people value about Talking Therapies
These following strengths reflect a strong foundation on which the future Essex‑wide model can build.
- Strong therapeutic relationships: People frequently praised clinicians for empathy, understanding and support.
- Skilled and compassionate staff: Many said therapy had a meaningful impact on wellbeing.
- Clear structure in sessions: Goal‑setting, explanations and well‑paced sessions helped people build confidence.
- Choice of therapy format: People valued being able to choose between telephone, online or face‑to‑face options when these were truly available.
5. Key challenges identified
The following challenges were raised in feedback showing areas that could benefit from further development.
Long Waiting Times (most dominant theme)
- Reported by 71% as a barrier.
- The largest qualitative theme (40 comments, 22%).
- Waits of 12–30 months were commonly referenced.
- Lack of updates intensified distress and left people feeling “forgotten”.
Limited Therapy Options and Personalisation
- 46.6% identified limited therapy choice (most often CBT‑only models).
- Many wanted trauma‑focused work, ND‑informed therapy, or deeper 1:1 psychological support.
Communication Difficulties
- People reported unclear information, difficulty contacting teams, or inconsistent updates — especially while waiting.
Continuity, Endings and Transitions
- People often saw multiple clinicians and described abrupt endings without follow‑up.
Desire for More Face‑to‑Face Options
- Telephone‑only offers felt impersonal or unsuitable for many, particularly those with trauma or neurodivergent needs.
Neurodiversity and Trauma‑Informed Practice
- Respondents emphasised the need for adjustments to communication, pacing, sensory considerations and therapeutic approach.
6. Opportunities for future service development
Based on what people shared, key opportunities include:
Support People While They Wait
- Regular updates, realistic timelines, and light‑touch wellbeing support.
Expand Therapy Choice
- A broader range of modalities (e.g., trauma‑informed, ND‑informed, counselling).
Improve Communication
- Clearer pathways, predictable updates, easy contact routes.
Strengthen Continuity and Transitions
- Minimising changes of therapist, clearer handovers, and optional follow‑up after discharge
Embed Inclusive Practice
- Neurodiversity‑informed and trauma‑informed adjustments.
Ensure Consistency Across Essex
- More equitable access, waiting times and therapy choice across localities.
Overall summary
The engagement paints a balanced picture:
- Therapy itself is highly valued, with strong therapeutic relationships central to positive experience.
- The journey into therapy remains the main challenge, particularly in relation to long waits, limited therapy choice, communication gaps, and inconsistent continuity.
- Demographic and locality analysis shows variation, highlighting opportunities for more inclusive, equitable and personalised support across Essex.
These insights offer a strong, person‑centred foundation for shaping the future Talking Therapies and PT‑SMHP model.