Therapist

How to speak to a therapist nhs

Talking therapies, or psychological therapies, are effective and confidential treatments delivered by fully trained and accredited NHS practitioners. They can help with common mental health problems like stress, anxiety and depression.

You can access talking therapies for free on the NHS.

You can refer yourself directly to an NHS talking therapies service without a referral from a GP, or a GP can refer you.

NHS talking therapies services are also known as Improving Access to Psychological Therapies (IAPT) services.

These services are still open and accessible during coronavirus (COVID-19). Help is available in person, by video, over the phone or as an online course.

Information:

There are also simple steps you can take to look after your mental health.

The Every Mind Matters website offers expert advice to help improve your wellbeing, as well as practical tips on sleep, coping with money worries and self-care.

Important:

Urgent help in a crisis

If you or a loved one are having a mental health crisis, you can call a local NHS mental health helpline for 24-hour advice and support:

Find a local NHS urgent mental health helpline

You can call for yourself, your child, your parent or someone you care for.

If someone’s life is at risk or they cannot be kept safe, call 999 or go to A&E.

What are talking therapies?

Talking therapies can help with common mental health problems like stress, anxiety and depression.

Which therapy you are offered depends on which one has been shown to be most helpful for your symptoms.

Here are a few examples:

  • Guided self-help – where a therapist coaches you as you work through a self-help course in your own time, either using a workbook or an online course.
  • Cognitive behavioural therapy (CBT) – based on the idea that thoughts, feelings, what we do, and how our bodies feel physically, are all connected. CBT works to help us notice and challenge patterns of thoughts or behaviours so we can feel better.
  • Counselling for depression – a type of counselling developed for people with depression.

Talking therapies are offered in different ways, including:

  • using a self-help workbook with the support of a therapist
  • as an online course
  • one-to-one in person, over the phone or through video consultation
  • in a group

See more about talking therapies

What can talking therapies help with?

You do not need to have a diagnosed mental health problem to refer yourself to an NHS psychological therapies service (IAPT).

Getting support as soon as you start having difficulties can help to reduce their impact.

You may be:

  • feeling anxious
  • feeling low and hopeless
  • having panic attacks
  • finding it hard to cope with day-to-day life
  • struggling with flashbacks and nightmares
  • feeling stressed

Perhaps you’re finding it hard to cope with work, life or relationships.

Other things that talking therapies can help with include:

  • worrying
  • obsessive thoughts or behaviours
  • fear of social situations
  • trouble sleeping
  • phobias

If you’ve already been diagnosed with a mental health condition you can still refer yourself to an NHS psychological therapies service (IAPT), or a GP can refer you.

Talking therapies can also help if you have mental health problems resulting from other conditions, such as diabetes, cancer, long-term pain or irritable bowel syndrome (IBS).

What happens when you refer yourself

  1. Contact your local NHS psychological therapies (IAPT) service.
  2. Someone from the service will get in touch, usually within a few weeks.
  3. They’ll ask for more details about the problems you’re having. This is known as an assessment.
  4. If the service thinks they can help you, they’ll recommend a therapy for you. This is based on your symptoms and how severe they are.
  5. Waiting times for the first session vary. The service will tell you what to expect.

Information:

While you wait for your assessment or therapy to start, you can access expert advice and practical tips on the Every Mind Matters website.

Who can have talking therapies on the NHS?

Anyone who is registered with a GP can get talking therapies on the NHS, but you do not need a referral from a GP.

You can refer yourself directly to an NHS psychological therapies service (IAPT) online.

If your first language is not English, talking therapies can be delivered in your chosen language through multi-lingual therapists or confidential translators. Talking therapies are also available in British Sign Language (BSL) through SignHealth Psychological Therapy Service.

Young people

You need to be aged 18 or over. Some services offer treatment for young people aged 16 and 17, but you need to check this with individual services.

Children and young people who are not able to access adult talking therapies can get support with mental and emotional problems from their local children and young people’s mental health service (CYPMHS).

Pregnancy and new parents

If you’re feeling anxious or depressed during pregnancy or after becoming a parent you can also access NHS psychological therapies services.

Talk to your midwife, healthcare worker or GP about your mental health, or you can refer yourself to an NHS psychological therapies service online.

Older people

Talking therapies have been shown to be very successful and beneficial for older people.

Find out more about how talking helps on the Age UK website

Does my GP need to know?

Talking therapies services normally let your GP know that you are getting support. Your talking therapy team will explain what information will be shared confidentially with your GP and why this is important.

If there is anyone else you would like your information to be shared with, or if you have any concerns about what will be shared, talk to your therapy team.

Other places that offer free help

Some employers provide free counselling for their employees. Ask your HR department.

Most colleges and universities offer free counselling to students who need it. Read a blog about what to do if you’re a student and it’s all getting too much from Professor Prathiba Chitsabesan, National Clinical Director for Children and Young People’s Mental Health.

Some charities offer helplines, cheap or free talking therapies or group support.

Video: Psychological therapies for stress, anxiety and depression

Animated video explaining self-referral to psychological therapies services for stress, anxiety or depression.

Counselling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues.

Sometimes the term “counselling” is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right.

What can counselling help with?

Counselling can help you cope with:

  • a mental health condition, such as depression, anxiety or an eating disorder
  • an upsetting physical health condition, such as infertility
  • a difficult life event, such as a bereavement, a relationship breakdown or work-related stress
  • difficult emotions – for example, low self-esteem or anger
  • other issues, such as sexual identity

What to expect from counselling

At your appointment, you’ll be encouraged to talk about your feelings and emotions with a trained therapist, who’ll listen and support you without judging or criticising.

The therapist can help you gain a better understanding of your feelings and thought processes, and find your own solutions to problems. But they will not usually give advice or tell you what to do.

Counselling can take place:

  • face to face
  • in a group
  • over the phone
  • by email
  • online through live chat services (learn more about online tools for mental health)

You may be offered a single session of counselling, a short course of sessions over a few weeks or months, or a longer course that lasts for several months or years.

It can take a number of sessions before you start to see progress, but you should gradually start to feel better with the help and support of your therapist.

Can you get free counselling on the NHS?

You can get free psychological therapies, including counselling for depression, on the NHS.

You do not need a referral from a GP.

You can refer yourself directly to a psychological therapies service.

Or you can get a referral from a GP if you prefer.

Find out more about free psychological therapies on the NHS

Private counselling

If you decide to pay to see a private therapist, make sure they’re qualified and you feel comfortable with them.

The cost of private counselling can vary depending on where you live, with a session costing anywhere between £10 and £70.

Many private therapists offer an initial free session and lower rates for students, job seekers and those on low wages.

You should ask about charges and agree a price before starting a course of counselling.

Charities and voluntary organisations

Some charities and voluntary organisations also offer counselling. These organisations usually specialise in a particular area, such as couples counselling, bereavement or family guidance.

You do not need a referral from a GP for an appointment for these services, but you may have to pay a fee to cover the cost of your sessions.

Charities that may offer counselling include:

  • Cruse Bereavement Care – for bereavement advice and support
  • Rape Crisis England & Wales – for women and girls who have been raped or sexually abused
  • Relate – for relationship advice and counselling
  • Samaritans – for people to talk about whatever’s troubling them at any time
  • Victim Support – for victims and witnesses of crime

You may also be able to access support groups through your local community, church or social services.

Finding a qualified therapist

As counselling involves talking about sensitive issues and revealing personal thoughts and feelings, your counsellor should be experienced and professionally qualified.

Reputable therapists will be registered with a professional organisation that’s been accredited by the Professional Standards Authority (PSA). This means they have met the PSA’s required professional standards to practise.

You can find a qualified therapist in 3 simple steps on the PSA website

Other talking therapies

As well as counselling, there are many other types of psychological therapies (or talking therapies) that involve talking to a therapist about your feelings or problems.

Read more about other talking therapies and how they can help

Video: Psychological therapies for stress, anxiety and depression

Animated video explaining self-referral to psychological therapies services for stress, anxiety or depression.

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