Talking Therapies

A Guide to Talking Therapies

Troubled by mental health problems like depression, phobias or anxiety? Use this guide to talking therapies to find the right treatment.

Most of us want somebody to talk to, who listens and accepts us, especially when we are going through a bad time. Talking can help with all sorts of problems, from depression, anxiety, obsessions and panic to bereavement and phobias.

Sometimes it's easier to talk to a stranger than to relatives or friends. Trained therapists listen and help you find your own answers, without judging you, and research has found that talking therapies can help with a wide range of problems.

Why go to therapy?

People choose talking therapies for different reasons. It may be that somebody has died or left, or that you have become depressed or isolated. You may be unable to sleep or are having panic attacks. Perhaps you have had a psychiatric diagnosis and are already having treatment. Or you may simply be trying to understand yourself better.

Who can you ask for help?

Your GP can be the first place you go when looking for help, and there are different types of talking therapies they may recommend.

You can ask your GP for talking therapy regardless of any diagnosis you have been given or medication you are on. Some research has found that a combination of drugs and therapy works better then either on its own.

Many talking therapists work privately. They can be expensive, but some will offer a sliding scale based on your income so ask about this. Talk to several therapists before you decide which one is right for you. Make sure they are members of a recognised professional body.

Some therapists will aim to find the root cause of your problem and help you deal with it, some will help you change your behaviour or negative thoughts, and others simply aim to support you.

Telephone helplines run by specialist charities may also be useful.

Here is a guide to the main types available:

Counselling

Counselling is the most basic form of talking therapy and your GP surgery may have its own counsellor. Counselling helps you to look at problems you are facing now. It may focus on a specific problem such as postnatal depression, disability or bereavement, or on a decision or life crisis. It involves talking to a counsellor who supports you and sometimes offers practical advice.

In counselling, you are encouraged to talk about how you feel about yourself and your situation, and find ways to tackle your problems. Counselling on the NHS is usually short or medium term. Longer-term counselling may go deeper and be more like psychotherapy. Counselling can help you stay well and prevent mental health problems.

Cognitive behavioural therapy (CBT)

Cognitive behaviour therapy (CBT) aims to help people change patterns of thinking or behaviour that are causing problems. Changing how you think and behave changes the way you feel. In CBT you set goals with your therapist and try things out between sessions.

Cognitive behaviour therapy is usually provided by an NHS psychologist, but doctors, nurses, counsellors and social workers may also use it. Sessions are usually weekly and last an hour.

CBT typically involves between six and 15 sessions and unlike a lot of other talking therapies focuses on the 'here and now' rather than looking for causes of your symptoms in your childhood or past.

It is widely used in the NHS today for anxiety, phobias, agoraphobia, depression, panic attacks, eating disorders, obsessive compulsive disorder (OCD) and post-traumatic stress disorder.

Many GPs use computer-based CBT (CCBT), with patients using online programmes called Fear Fighter and Beating the Blues to help them challenge anxiety and depression.

Psychotherapy and psychoanalysis

Psychotherapy and psychoanalysis involves a therapist listening to your experiences and exploring connections between present feelings and action and past events. It aims to help you understand more about yourself and improve your relationships. Some therapists may seem detached and analytical while others are friendly and supportive.

Psychotherapy can be one-to-one talking, or can be done in a group. It often goes on for a year or more. There is some evidence that it can help depression and some eating disorders.

NHS psychotherapists normally work in a hospital or clinic, where you will see them as an outpatient. Private psychotherapists often work from home.

Psychiatry

A psychiatrist is a medical doctor with psychological training. As well as talking about your problems, psychiatrists can also prescribe medications, such as antidepressants and tranquillisers.

Family or couples therapy

Anorexia, depression, sexual problems or schizophrenia are often helped by family or couples therapy, where you talk to a therapist with your partner or family. The idea is to resolve arguments in a safe environment and improve the way you understand each other.

Group therapy

Group therapy is a useful way for people who share a common problem to get support and advice from one another. It helps many people to recognise that they're not alone in their experiences. It's often recommended for people with obsessive compulsive disorder (OCD) or eating disorders, and children and young people with mild depression.

Specialist clinics

If you suffer from an eating disorder, OCD or an addiction, you may be referred to a specialist clinic such as an eating disorders unit or a detoxification or rehabilitation clinic.

Motivational counselling

This kind of life coaching focuses on hopes and aspirations for your life and career, and avoids confronting you on issues you may be sensitive about.

Art/drama therapy

Art, drama and other kinds of creative psychotherapies can be especially helpful for people who find it hard to express their emotions or thoughts verbally, and children.