Accessing therapy

Talking therapy is becoming more widely available on the NHS and will continue to do so over the next few years.

It's estimated that around half the GP surgeries in England provide counselling services and support.

Access to NHS talking therapy will improve over the next few years. It's government policy to make counselling and other talking treatments, including cognitive behavioural therapy (CBT), more easily available on the NHS.

The Improving Access to Psychological Therapies (IAPT) programme, which is rolling out between 2008 and 2015, is putting thousands more trained therapists into GP surgeries. The scheme will provide easy access to talking treatment on the NHS to everyone who needs it.

If you want to try a talking therapy, ask your GP, who will be aware of what's available locally.

On the NHS

Your GP can refer you for talking treatment that is free on the NHS. This will usually be a short course of counselling or CBT from the GP surgery's counselling service.

If counselling or CBT aren't available at the surgery, your GP can refer you to a local counsellor or therapist for NHS treatment.

You may also be able to refer yourself for counselling. The IAPT programme means that more and more primary care trusts (PCTs) are introducing the option of self-referral.

Self-referral means that people who prefer not to talk to their GP can go directly to a professional therapist (though where possible, and unless there's a specific reason not to, it's better to discuss it with your GP first). The service is already available in some parts of England. To find out what's available in your area, search for psychological therapy services

Going private

If you can afford it, you can choose to pay for your therapy privately.

The cost of talking therapy varies and a one-hour session can cost between £40 and £100.

In the first instance, ask your GP if they can suggest a local private therapist. If you still need help, you can find a private therapist using the internet, the library or the Yellow Pages.

There are no rules governing who can advertise talking therapy services, so it’s essential to check that the therapist is listed on one of the registers of approved practitioners. Talk to several therapists before you decide which one is right for you. See You and your therapist for more advice.

The following organisations have approved therapists:

Charities

Some charities offer cheap or free talking therapies. These include:

  • Cruse for bereavement care
  • Beat for eating disorders
  • Mind for mental health problems 
  • Relate for relationship counselling

Some employers provide counselling for their employees and many colleges and universities offer free therapy to students who need it.

Difficulties accessing therapy

The availability of services varies depending on where you live. In some parts of England, especially rural areas or small towns, NHS therapy is limited. You may have to wait a long time or travel to find something suitable.

Your GP’s personal views about talking therapy can also affect your access to it. Some GPs are more likely to refer you for therapy than others. According to an online survey by the Mental Health Foundation, only 42% of people who visited their GP with depression were offered counselling, although 82% of them would have been willing to try it.

If your GP is unwilling to refer you for talking therapy, you may have to find out for yourself what’s available in your area and push hard to get it. Alternatively, you can change to another GP who's willing to refer you.

Facing discrimination

Some groups, such as black and elderly people, can find it more difficult to get talking treatment on the NHS, even though they're just as entitled to it and as likely to benefit from it as anyone.

Whatever your background, you have the right to be offered talking treatment if it could help you. You can expect NHS services to do everything they can to improve your access to talking treatment. Ask your GP for a referral for talking treatment if you think it could help you.

Last reviewed: 14/09/2011

Next review due: 14/09/2013

Comments are personal views. Any information they give has not been checked and may not be accurate.

ellenGB said on 07 April 2012

The aims are laudable and there are lots of good psychologists who want to help. However, as a very senior member of the profession, I was taken aback by two clinics in my borough who refused treatment to a disabled person because her illness meant that she was often housebound. They refused therapy by phone or Skype. In short, she was not able to access any treatment on the NHS. Her MP has been informed and the PCT is aware and I'd recommend that people ring PALS in their area if they come across poor practice.

CBT is a comparatively short treatment that can alleviate the psychological symptoms of a large number of conditions. The waiting times used to be about 14 weeks in some areas, which is ridiculous. Additional recources have reduced that. I agree, however, that the services are patchy and that there is plenty of room for improvement.

We're not doing the best we can. Psychologists are able to offer a variety of treatments, not just CBT. We should have the freedom to provide tailor-made programmes to suit needs and preferences. The NICE guidelines are just guidelines.

People should not have to go private for specialist interventions and the discrimination against the disabled and elderly is totally unacceptable. However, much has to do with the attitude of the local administrator.

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Lisa907 said on 04 April 2012

I think psychological services on the NHS are shameful. I suffered from mental health problems for a long time, had numerous admissions to a&e where I saw both psychiatric nurses and psychiatrists.On one occasion I was admitted as an inpatient. I kept being told I could and would be helped but all I got was an appointment to see a psychiatrist every 3-6mths which in the state I was in was very much inadequate. I got given medication that made me feel awful but that was the only thing that seemed to be on offer. Finally, even though it was very expensive I went privately. I tried CBT but I didn't find it helpful at all so I changed and went to see a dynamic psychotherapist. It was even more expensive but it was the best investment I ever made. I had sessions once a week for 2 years and i feel better than I ever imagined would be possible. The problem is no one would ever get that on the NHS. Even the IAPT program is in my opinion flawed. It focuses on CBT (because it is quicker and cheaper than other forms of therapy) and that might work for some people but it's not the answer to all problems. They need to wake up to the fact most mental health problems take a long time to cure and a cheap/quick form of therapy isn't going to help everyone. It might just be because of my experience but I think if you are going to rally get to the bottom of a problem you need to put the time and effort into it and long term therapy is what gives you the best chance of recovery.

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Gadget001 said on 03 November 2011

It's all well and good saying these services will arrive by 2015, but what do people who can't afford reduced prices of £25 a session privately? What about the people who were let down in the first place by the system and now they are still being let down because they have to still live with it, with nowhere to turn? It seems a postcode lottery determines if you get to deal with your problems. The areas with no counselling service at all, or that only offer 6 weeks, need grants to charities that can offer free counselling while things are being set up in those areas. if no charities exist those places need attention sooner. I know my area has a long waiting list for 6 sessions, and after that it's goodbye, unless you have a mental illness. I don't live in a rural area, there is no reason that a counselling service could not exsist we have a closed down a&e hospital, there is the space. We pay taxes and ni for NHS services it's about time we received them.

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