Counselling 

Introduction 

Mental and emotional health: talking therapies

Learn about different talking therapies that can help people overcome a range of problems, from depression to stress. Tip: check with your GP whether there are any IAPT services (Improving Access to Psychological Treatment) in your area.

Media last reviewed: 11/07/2013

Next review due: 11/07/2015

Attitudes to therapy

In 2010, the British Association for Counselling and Psychotherapy (BACP) carried out some research to find out more about people's attitudes towards counselling and psychotherapy.

Some of the key findings included:

  • 95% thought that it's a good idea to seek counselling or psychotherapy for a problem before it gets out of hand
  • 91% thought that it was more acceptable to talk about emotional problems than it was in the past
  • 88% thought that people might be happier if they talked to a counsellor or psychotherapist about their problems

Read more about the key findings of the BACP's research (PDF, 906kb).

The types of therapy

A guide to the different types of talking therapy and how they can help you

Counselling is a type of talking therapy that allows a person to talk about their problems and feelings in a confidential and dependable environment.

A counsellor is trained to listen with empathy (by putting themselves in your shoes). They can help you deal with any negative thoughts and feelings that you have.

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

Other psychological therapies include psychotherapy, cognitive behavioural therapy (CBT) and relationship therapy (which could be between members of a family, a couple or work colleagues).

Read more about other psychological therapies.

What is counselling used for?

Talking therapies, such as counselling, can be used to treat many different health conditions including:

How can counselling help?

Counselling aims to help you deal with and overcome issues that are causing pain or making you feel uncomfortable.

It can provide a safe and regular space for you to talk and explore difficult feelings. The counsellor is there to support you and respect your views. They will not usually give advice, but will help you to find your own insight and understanding of your problems.

Counselling can help you to:

  • cope with a bereavement or relationship breakdown
  • cope with redundancy or work-related stress
  • explore issues such as sexual identity
  • deal with issues that are preventing you from achieving your ambitions
  • deal with feelings of depression or sadness, and have a more positive outlook on life
  • understand yourself and your problems better
  • feel more confident
  • develop a better understanding of other people's points of view

Counselling can often involve talking about difficult or painful feelings and, as you begin to face them, you may feel worse in some ways. However, with the help and support of your therapist, you should gradually start to feel better.

In most cases, it takes a number of sessions before the counselling starts to make a difference, and a regular commitment is required to make the best use of the therapy.

What to expect from counselling

During your counselling sessions, you will be encouraged to express your feelings and emotions freely. By discussing your concerns with you, the counsellor can help you to gain a better understanding of your feelings and thought processes, as well as identifying ways of finding your own solutions to problems.

The counsellor may encourage you to identify issues and, if appropriate, take personal responsibility for them. They will be able to help you recognise the effects of other people and their actions, and explore alternative ways of coping with them.

It can be a great relief to share your worries and fears with someone who acknowledges your feelings and is able to help you reach a positive solution.

Trusting your counsellor

A good counsellor will focus on you and listen without judging or criticising you. They may help you find out about how you could deal with your problems, but they should not tell you what to do.

For counselling to be effective, you need to build a trusting and safe relationship with your counsellor. If you feel that you and your counsellor are not getting on, or that you are not getting the most out of your sessions, you should discuss this with your counsellor.

If the situation does not improve, or your counsellor is dismissive or unwilling to discuss the issue, it is perfectly acceptable to look for another counsellor with whom you feel more comfortable.

If you are seeing an NHS counsellor who is attached to your GP surgery, your GP may be able to arrange for you to see another NHS counsellor. Alternatively, you could pay to see a private counsellor. Many counsellors and counselling organisations offer a sliding scale of fees, where the more sessions you have, the cheaper it becomes.

Who provides psychological therapies?

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

Different healthcare professionals may be trained in counselling or qualified to provide psychological therapies. These include:

  • counsellors – trained to provide counselling to help you cope better with your life and any issues you have
  • clinical and counselling psychologists – healthcare professionals who specialise in assessing and treating mental health conditions using evidence-based psychological therapies
  • psychiatrists – qualified medical doctors who have received further training in diagnosing and treating mental health conditions
  • psychotherapists – similar to counsellors, but have usually received more extensive training; they are also often qualified psychologists or cognitive psychiatrists
  • behavioural psychotherapists – may come from a variety of professional backgrounds, and have received specific training in cognitive behaviour therapy; they should be registered and accredited with the British Association for Behavioural & Cognitive Psychotherapies (BABCP)

Counselling formats

Many different types of counselling are available in a range of formats. For example, counselling can take place:

  • face-to-face
  • individually or in a group
  • over the phone
  • by email
  • using a specialised computer program

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

Availability

In 2010, the government announced plans to make psychological therapies more widely available on the NHS. This is because they have been shown to be effective treatments for common mental health conditions (see above). The programme is called Improving Access to Psychological Therapies (IAPT).

As a result of the IAPT programme, evidence-based psychological therapies can now be accessed through:

  • GP surgeries
  • the workplace
  • universities, schools and colleges
  • some voluntary and charitable organisations

If you are referred for counselling, or another psychological therapy through the NHS, it will be free of charge.

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

The cost of private counselling can vary considerably. Depending on where you live, a session can cost between £10 and £70. Some therapists may be willing to adjust their fees in accordance with your income. 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.

Charities that may offer counselling include:

  • Cruse Bereavement Care – a charity that provides bereavement advice and support
  • Relate – a charity that offers relationship advice and counselling
  • Rape Crisis – a charity for women and girls who have been raped or sexually abused
  • Victim Support – a charity to help victims and witnesses of crime

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

Page last reviewed: 20/11/2012

Next review due: 20/11/2014

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Comments

The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

User907252 said on 27 September 2014

I think this is a good overview and that the points you make about having the courage to change to a different therapist if you don't feel comfortable with them is very relevant.
The costs you suggest on this page seem more representative of the majority, than the fees of upto £100, which are quoted on your front page and may put people off looking further.
I think picking your way through the many different kinds of psychological help, let alone understanding what it means in practice is more than most of us can manage let alone if we're feeling really down or panicky.
I also wondered why G.Ps. don't offer therapy? Do referrals cost a lot or don't they believe it might help? It doesn't seem fair and most people really believe that their doctors know best.

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AppleBobbing said on 30 June 2014

It is worthwhile to note that the major counselling bodies are now moving towards registration schemes (voluntary accredited registers). These usually stipulate that the counsellor follows a code of ethics, is insured and is still developing their practice.

For instance:

http://www.bacpregister.org.uk/

or for a longer list search for counsellors on here:

http://www.professionalstandards.org.uk/voluntary-registers/the-accredited-registers-directory

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kizgoth said on 07 February 2014

I have been let down by the NHS for the past few years. Trying to get counselling has been nearly impossible. I have now been forced to pay for my counselling. I am on benefits because I am too unwell to work, and will now be living hand to mouth day to day because of having to pay for private counselling.
The NHS has let me down and I am ashamed to have ever thought highly of the NHS.

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smileytigger said on 19 September 2012

It’s hardly surprising Counsellors feel marginalised within the NHS hierarchical structure if the people within the structure misunderstand and mis-communicate its purpose and value. Which itself raises some questions – is counselling perceived as secondary to the more familiar – and lets not forget more easily performance managed therapies - simply because they are more familiar or because counselling is so misunderstood?

Having experienced several forms of therapy as a client and a practitioner I personally find the most rewarding therapy to be person centred counselling, one of the reasons for this is the empathy that is present in the relationship.

For clarity and in the hope that someone somewhere in the NHS will rectify their miscommunication about what counsellors provide:

Sympathy – (often found in friends, colleagues and family) is when a person acknowledges your discomfort and provides reassurance.

Empathy – (found in good well trained counsellors) goes beyond sympathy and is when a person understands (note the subtle difference here) what you are feeling because they are able to put themselves in your shoes, thereby allowing them to relate to you on a much deeper level.

There is more I could add, such as sympathy often comes with judgement whereas empathy does not …but then I’d be sharing all my training and experience but let’s face it, the NHS doesn’t value it so what’s the point.

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smileytigger said on 19 September 2012

It’s hardly surprising Counsellors feel marginalised within the NHS hierarchical structure if the people within the structure misunderstand and mis-communicate its purpose and value. Which itself raises some questions – is counselling perceived as secondary to the more familiar – and lets not forget more easily performance managed therapies - simply because they are more familiar or because counselling is so misunderstood?

Having experienced several forms of therapy as a client and a practitioner I personally find the most rewarding therapy to be person centred counselling, one of the reasons for this is the empathy that is present in the relationship.

For clarity and in the hope that someone somewhere in the NHS will rectify their miscommunication about what counsellors provide:

Sympathy – (often found in friends, colleagues and family) is when a person acknowledges your discomfort and provides reassurance.

Empathy – (found in good well trained counsellors) goes beyond sympathy and is when a person understands (note the subtle difference here) what you are feeling because they are able to put themselves in your shoes, thereby allowing them to relate to you on a much deeper level.

There is more I could add, such as sympathy often comes with judgement whereas empathy does not …but then I’d be sharing all my training and experience but let’s face it, the NHS doesn’t value it so what’s the point.

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User590313 said on 06 September 2011

"Counsellors are trained to listen sympathetically" - well, as a counsellor I'd have to disagree slightly with this last line in the first paragraph above. I think it would be more accurate to say "Counsellors are trained to listen with empathy". There is a subtle but huge difference between the sympathy and empathy. If you want sympathy you can go and see a family member or friendly neighbour. If you have a deep issue to work through empathy will enable deeper understanding to be realised.

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