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 talking therapies, including counselling for depression, on the NHS.
You do not need a referral from a GP.
You can refer yourself directly to a talking therapies service.
Find a talking therapies service in your area
Or you can get a referral from a GP if you prefer.
Find out more about free talking 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: Talking therapies for stress, anxiety and depression
Animated video explaining self-referral to talking therapies services for stress, anxiety or depression.
Therapy: it’s a word that’s slipped into conversations more and more in the past few years – perhaps that’s a positive sign of the stigma lessening, indicative of more people needing help for mental illness, or both. Either way, it’s a crucial form of treatment for almost one million people every year.
While therapy is free on the NHS, accessing it is easier said than done. Laura Peters, head of advice and information at Rethink Mental Illness, told HuffPost UK there are a number of hurdles facing patients: not all therapies are available everywhere, waiting times can be lengthy, and there are only a set number of sessions available. So if you don’t feel you received all the help you needed, it’s back to the drawing board – and possibly another year-long wait.
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People in England can access a number of therapy treatments freely through the NHS. The Improving Access to Psychological Therapies (IAPT) programme provides evidence-based treatments for people with anxiety and depression and is accessed by more than 900,000 people each year.
According to the NHS, 75% of people referred to IAPT services should start treatment within six weeks of a referral, and 95% should start treatment within 18 weeks of referral, but some people are having to wait much longer. Adam Bradford, for example, had severe depression and suicidal thoughts – he was told by his GP there would be a 12-18 month wait for counselling. He returned home with a prescription for antidepressants and promises of future support.
So what’s the best route to take?
How To Access Therapy
The most effective way to access free psychological therapies for common mental health problems in the UK is to discuss it with your GP, who will most likely refer you on to your local IAPT service. In some areas, it’s also possible to self-refer to IAPT. There were 1.6m IAPT referrals in 2018-19 and 70.2% of these were self-referrals, rather than through a GP.
The therapies you can access through IAPT are evidence-based and aimed at people with common mental health problems including depression, generalised anxiety disorder, phobias, post traumatic stress disorder, panic disorder and obsessive-compulsive disorder.
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While there are many talking therapies available, cognitive behavioural therapy (CBT) is most commonly offered – though this picture varies in Scotland, Wales and Northern Ireland, where the IAPT programme is not currently available.
Therapy Options Available
It’s important to stress that therapy isn’t for everyone – as some people find it doesn’t help. Others, however, reap the benefits.
The type of therapy a person is offered will depend on the severity of their condition, as well as the cause of their symptoms – and it’s possible they’ll have to try more than one therapy to find the right one.
Talking therapy is one of the most common forms and involves you meeting a trained therapist for a fixed number of sessions, explained Peters. “This can either be as a one to one, or it can be with a group of people,” she said. “Whilst this is the most common form, there are other options like art or drama therapy, and you should talk with your GP to see what options are open to you.”
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Other Ways To Access Therapy
If you’re faced with a mammoth waiting time for therapy on the NHS, there are other routes to try which lead to the same path: free, professional help.
The first is through work. “Many employers are recognising the importance of promoting staff wellbeing by implementing initiatives such as Employee Assistance Programmes (EAPs),” said Rachel Boyd, information manager at mental health charity Mind.
EAPs enable staff to access confidential 24-hour telephone support, and it’s often possible to access a limited number of therapy sessions through them. Boyd said they typically have a shorter waiting time than through IAPT. If you’re unsure whether you can access EAPs through your work, speak to HR.
There are also charities – including local Mind, Rethink Mental Illness or Turning Point branches – which offer free or low-cost therapy treatments, although the availability of these can vary significantly between locations. Mental Health Matters (MHM) offers a telephone counselling service and talking therapies in some areas.
Some counselling services may be free or low-cost for members of the lesbian, gay, bisexual and transgender (LGBT+) community. You can find these by searching online or by asking your local LGBT+ service. The LGBT Foundation is a charity based in Manchester offering mental health services and resources to the gay community. This includes befriending, free counselling and a support helpline. London Friend is an LGBT+ charity which offers a telephone support service, as well as low-cost counselling, social and support groups. You can find more support here.
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For students, many colleges and universities also have free counselling services. Boyd explained this can usually be accessed without having to go through academic tutors or a GP. Students might also be able to get reduced rates for private therapy.
Going Private
The obvious drawback with private therapy is that you have to pay for it – and for a lot of people, that’s not an option. The cost of going private can vary depending on where a person lives, with a single session typically costing anywhere between £10 and £100.
One of the perks is that you can choose the type of therapy you need, whereas with free therapy on the NHS it can be quite limited. Boyd said it’s helpful to ask: how much the counsellor charges per session, whether they offer a free introductory session, if they offer reduced rates for people on low incomes, and whether or not they charge for missed appointments.
She also advised looking for a therapist using the online search function of reliable websites like the Counselling Directory or the British Association for Counselling and Psychotherapy (BACP). That way, you can have peace of mind that your therapist is a qualified professional.
Advice For People On A Waiting List
:: Mental health experts advise practising self-care and adapting lifestyle changes to help manage symptoms and prevent problems from developing or getting worse.
:: You might find it useful to meet others willing to share their experiences, through support groups or an organised activity – online spaces like Elefriends can also be useful for those who find it difficult talking face-to-face.
:: Physical activity has been proven to boost mental wellbeing, as does spending time outdoors.
:: For more personalised tips on managing mental health and wellbeing, check out Every Mind Matters.
:: Practising mindfulness is also recommended – this involves making an effort to notice what’s happening in the present moment (in your mind, body and surroundings) – without judging anything. “It can help by increasing your awareness, managing unhelpful thoughts, and by developing more helpful responses to difficult feelings and events,” said Boyd.
Useful websites and helplines:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI – this number is FREE to call and will not appear on your phone bill.)
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email: [email protected]
- Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.
