What is intensive therapy for PTSD and who is it for?

Over the past decade there has been increasing interest in intensive models of PTSD treatment, particularly for people whose work exposes them to repeated or prolonged trauma. While traditional weekly therapy remains effective for many, it can be slow, fragmented, and difficult to sustain for individuals with demanding roles or complex occupational pressures.

Intensive PTSD therapy has emerged as a clinically grounded alternative, offering trauma-focused treatment delivered over a shorter, more concentrated period. For the right individuals, it can provide a safe, effective, and time-limited route to recovery.

What is intensive therapy for PTSD?

Intensive therapy for PTSD refers to trauma-focused treatment delivered more frequently than the traditional once-weekly session. This may involve extended sessions lasting longer than the standard 50 minutes, or multiple therapy sessions per day delivered over consecutive days.

By concentrating therapeutic work in this way, treatment-focused time is optimised. Less time is lost to repeated introductions, re-caps, and session endings, allowing for greater continuity and depth of work. Research shows this structure helps build therapeutic momentum and reduces the disruption that often accompanies stop–start therapy.

For many people with PTSD, interruptions such as sickness, annual leave, operational demands, or family commitments can significantly slow progress. Intensive therapy aims to reduce these interruptions by delivering treatment within a defined and protected timeframe, often condensing what might otherwise take months or years into a matter of days.

The problem with stop–start therapy for PTSD

PTSD treatment is particularly vulnerable to disruption. Breaks between sessions can lead to re-triggering, symptom escalation, and emotional destabilisation, especially for individuals who remain exposed to stressful or trauma-related environments.

In practice, a planned course of 12 weekly sessions can easily extend to six months or more due to cancellations, holidays, and competing demands on both clients and therapists. During these extended gaps, valuable session time is often spent managing crises or re-stabilising rather than processing trauma itself. This can contribute to frustration, prolonged distress, and higher dropout rates.

Trauma-focused therapies are challenging by nature. When progress feels slow or repeatedly interrupted, some clients disengage before meaningful change can occur. Intensive models were developed in part to address these challenges by reducing delays and maintaining therapeutic focus.

Why the Mitland Plan was developed

The Mitland Plan intensive programme was developed from Dr Butler’s doctoral research into clients’ experiences of intensive therapy for post-traumatic stress, and was designed in response to repeated clinical observations while working with serving military personnel. Over four years of doctoral study, Dr Butler interviewed clients and analysed qualitative data exploring how intensive trauma therapy was experienced in practice. This research was informed not only by academic study but by extensive exposure to best practice internationally. Dr Butler visited Combat Stress, the UK veterans’ charity, and Psytrec in Utrecht, an NHS-equivalent inpatient service delivering intensive trauma treatment. She also developed links with organisations in Ireland, including The Ely Centre, which supports families and survivors of the Troubles, and with public service facilities in the USA providing intensive therapy for victims of crime. Alongside this, she spoke with hundreds of practitioners and clients about their experiences of intensive therapy for trauma and PTSD.

Clinically, it was observed that standard weekly therapy was frequently disrupted by public holidays, annual leave, operational demands, and long waiting lists. Personnel were often downgraded for extended periods while waiting for treatment, and in many cases symptoms deteriorated rather than improved. Weekly sessions were often insufficient because clients were repeatedly re-triggered by their environments between appointments, meaning therapy became focused on managing immediate distress rather than addressing underlying trauma. Preparation for treatment, including stabilisation, could take many weeks and at times delayed trauma processing rather than supporting it.

At the same time, there were many effective and well-validated trauma treatments available, including EMDR, Trauma-Focused CBT, and Narrative Exposure Therapy. While evidence-based, these approaches were often diluted by low session frequency. There was no clear clinical rationale for trauma therapy needing to be delivered once per week; this model largely reflected historical practice and practical constraints rather than therapeutic necessity. Intensive delivery offered a way to use these treatments more effectively, reduce delays, and provide timely intervention for individuals whose symptoms were worsening while they waited for care.

How intensive therapy works

Our intensive programme combines structured self-learning resources with live, one-to-one trauma therapy sessions. Treatment typically takes place over three to six consecutive days, with additional time available if clinically required.

Sessions are delivered online, allowing clients to access specialist trauma expertise nationally while remaining in their own environment. This format also improves accessibility for individuals who may find travel difficult or disruptive.

All therapy is delivered individually rather than in groups. Following the intensive phase, clients receive a follow-up session to support integration and consolidation of the work completed.

This high-level structure allows for focused, contained treatment while maintaining flexibility to respond to individual clinical needs.

Who is intensive therapy for PTSD for?

Intensive PTSD therapy is particularly suitable for people who are limited by time and do not wish, or are unable, to engage in months or years of weekly therapy before meaningful recovery begins.

It is well suited to:

• Individuals with occupational PTSD

• First responders and blue light workers

• Military personnel and veterans

• Shift workers

• Senior professionals

Because the work is concentrated and emotionally demanding, clients need a degree of stamina, motivation, and readiness to engage with treatment. All clients are screened for suitability using validated assessment tools to ensure that an intensive approach is appropriate and safe.

Who intensive therapy for PTSD unsuitable for?

Intensive PTSD therapy is not appropriate for everyone. It is not suitable for individuals who are currently in crisis, living in unstable circumstances, or who lack adequate personal or professional support.

It is also not indicated for people who:

• Are at elevated risk of suicide

• Are experiencing severe alcohol or drug misuse

• Are in the early stages of substance recovery

• Have another condition that is primary and requires alternative treatment first

• Are seeking to avoid therapy rather than actively engage in it

Careful assessment and clinical judgement are essential to ensure that intensive treatment is used ethically and appropriately.

Clinical principles underpinning the programme

The programme is grounded in established trauma-informed principles. These include:

• A phased-based approach

• Evidenced-based treatment

• Delivered by licensed, specialist professionals

• Attention to safety and containment throughout treatment

• Integration work to consolidate gains following trauma processing

These principles guide both the pace and depth of the work and ensure that treatment remains safe, ethical, and clinically robust.

What do clients typically experience?

Clients often describe intensive therapy for PTSD as challenging but worthwhile. Many experience the consecutive structure as containing and supportive, allowing them to focus fully on treatment and recovery without repeated disruption.

Clients frequently report that the programme builds momentum and provides a rare opportunity to “deep dive” into trauma work in a safe and protected space. The concentrated format can make it easier to stay emotionally engaged and complete trauma processing that might otherwise be repeatedly interrupted in weekly therapy.

Why intensive therapy for PTSD matters to services and referrers

From a service perspective, intensive therapy for PTSD offers several potential benefits. It can reduce the impact of waiting lists, limit deterioration while individuals await treatment, and form part of a structured return-to-work plan.

By delivering effective treatment within a defined period, intensive models may help people re-engage with family life and occupational responsibilities more quickly, while avoiding prolonged periods of long-term therapy.

Intensive PTSD treatment models are well established in countries such as the Netherlands, Denmark, and the United States. In the UK, some NHS and charitable services are beginning to adopt similar approaches. There is a growing body of research demonstrating that intensive trauma therapy can be safe, effective, and acceptable to clients. For example, Police Care UK has recently announced a randomised controlled feasibility study in collaboration with Dr Sarah Butler and the University College London, examining the effectiveness of intensive therapy for police officers with complex PTSD.

When to consider intensive PTSD therapy

Intensive PTSD therapy is not a replacement for all trauma treatment. However, for the right individuals, it offers a focused, ethical, and time-limited alternative to traditional weekly therapy.

For referrers working with trauma-exposed populations, it provides an additional option when standard delivery models are proving too slow, disruptive, or poorly matched to occupational realities. As with all trauma work, careful assessment and suitability screening remain central to ensuring safety and effectiveness.

If you are a charity, public service, corporate organisation, or commissioning body working with people exposed to repeated or high-risk trauma, please get in touch.