Psychotherapy 

Introduction 

Attitudes to mental health

Four people who've had mental health issues, including bipolar disorder, paranoid schizophrenia and personality disorder, talk about the negative reactions they faced and how they overcame them.

Media last reviewed: 29/08/2013

Next review due: 29/08/2015

Self-help

If you have a problem, such as mild anxiety or depression, which you feel you may be able to improve yourself without professional treatment, there are many self-help books available.

These are mainly based on cognitive behavioural therapy (CBT). The websites of charities involved in your condition can also be useful resources.

The Department of Health recommends two software programs you can access on the internet, which may be useful if you're considering self-help. They are:

NHS Choices also has a number of useful mental health podcasts dealing with issues such as anxiety, low mood, low confidence, and panic attacks.

Free audio guides to boost your mood

Eight Moodzone mental wellbeing audio guides designed to help you better understand the problems you may be facing in your life

Psychotherapy is a type of therapy used to treat emotional problems and mental health conditions.

It involves talking to a trained therapist, either one-to-one, in a group or with your wife, husband or partner. It allows you to look deeper into your problems and worries and deal with troublesome habits and a wide range of mental disorders, such as depression and schizophrenia.

Psychotherapy usually involves talking but sometimes other methods may be used – for example, art, music, drama and movement.

Psychotherapy can help you to discuss feelings you have about yourself and other people, particularly family and those close to you. In some cases, couples or families are offered joint therapy sessions together.

A therapist will treat sessions as confidential. This means you can trust them with information that may be personal or embarrassing.

Read more about how psychotherapy works.

Psychotherapists

Psychotherapists are mental health professionals who are trained to listen to a person's problems to try to find out what's causing them and help find a solution.

As well as listening and discussing important issues with you, a psychotherapist can suggest strategies for resolving problems and, if necessary, help you change your attitudes and behaviour.

Some therapists teach specific skills to help you tolerate painful emotions, manage relationships more effectively or improve behaviour. You may also be encouraged to develop your own solutions. In group therapy, the members support each other with advice and encouragement.

What is psychotherapy used to treat?

Psychotherapy can be used to treat a wide range of mental health conditions, including: 

Types of psychotherapy

There are several different types of psychotherapy that have been proven to be effective and are offered on the NHS. These are described below.

  • Psychodynamic (psychoanalytic) psychotherapy – a psychoanalytic therapist will encourage you to say whatever is going through your mind. This will help you to become aware of hidden meanings or patterns in what you do or say that may be contributing to your problems.
  • Cognitive behavioural therapy (CBT) – a form of psychotherapy that examines how beliefs and thoughts are linked to behaviour and feelings. It teaches skills that retrain your behaviour and style of thinking to help you deal with stressful situations.
  • Cognitive analytical therapy (CAT) – uses methods from both psychodynamic psychotherapy and CBT to work out how your behaviour causes problems and how to improve it through self-help and experimentation.
  • Interpersonal psychotherapy (IPT) – looks at the way an illness can be triggered by events involving relationships with others, such as bereavements, disputes or relocation. It helps you cope with the feelings involved as well as working out coping strategies.
  • Humanistic therapies – encourage you to think about yourself more positively and aim to improve your self-awareness.
  • Family and marital (systemic) therapy – therapy with other members of your family that aims to help you work out problems together.

If you have psychotherapy, you will meet your therapist regularly, usually once a week. However, in some cases, more frequent sessions may be needed.

A short-term course of psychotherapy may involve anything between 6 and 20 sessions, with individual sessions lasting about 50-60 minutes. Group sessions are often longer.

Read more about how psychotherapy works.

How can I get psychotherapy?

If you're interested in psychotherapy, the best place to start is with your GP.

In 2010, the government announced plans to make psychological therapies more widely available on the NHS because they have been recognised as effective treatments for common mental health conditions.

If your GP or another healthcare professional refers you to a qualified psychotherapist, you will receive psychotherapy through the NHS free of charge. However, psychotherapies are not always available on the NHS and you may need to pay for private treatment.

The cost of private psychotherapy will depend on the type of therapy and the individual psychotherapist. Ask how much each session will cost and agree on a price beforehand. Typically, a 50 minute one-to-one session can range from £40 to £100.

Read more about the availability of psychotherapy.

Finding psychotherapy services

When looking for a psychotherapist, make sure they're fully qualified and if appropriate, they have experience in treating your specific condition. 

Find counselling and psychological therapy services in your area.

The British Association for Counselling and Psychotherapy (BACP) can also help you find a therapist, as can the UK Council for Psychotherapy (UKCP).




Page last reviewed: 22/05/2013

Next review due: 22/05/2015

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Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

BirdsEleven said on 02 July 2014

CBT has not worked for me I've been going through it for a year and I'm just getting worse, I don't know what I can do now.

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alive84 said on 12 May 2014

Cont. from previous comment.
Her manner of doing this along with the fact that she has a very impersonal manner generally makes me feel incredibly uncomfortable. How are you supposed
to make any progress in any sort of therapy when the therapist is basically cutting off any input that you are bringing to the session?
I realise that CBT is a pretty strict model of working, but I'm sure that it allows for greater flexibility than this woman is currently delivering.
I have to take into account that when I had CBT previously I found it to be considerably effective. I also remember being given varied exercises and reading to do inbetween sessions, filling in a diary was only part of the process, not the only thing! I was actually prescribed a book which I had to get out of the library which I had to work through in my own time, and I got the most help from this. Along with that I found the therapist very easily to get along with, a very friendly and 'human' person, who could relate to me as a person and did not treat me like I was something on a conveyor belt, which is the feeling I get from the current therapist.
I can only conclude it is the 'teacher' that is the problem and not what is being taught, so to speak.
I thoroughly believe that having psychology qualifications is not enough to ensure that someone is suitable to be a therapist. It takes a certain type of person to be effective at any type of therapy, and sadly very unsuitable people are being employed and are doing patients a huge disservice.
I also think there should be a comments system where patients can give descriptions of their experiences such as I have done, which then go to
management including the therapist's managers and human resources. Currently all patients can do is make official complaints, and I don't think this route is appropriate in cases where people are just badly suited to their jobs and are failing patients for this reason but haven't done anything specifically
wrong.

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alive84 said on 12 May 2014

I underwent CBT in 2006 for low self esteem and depression, and I remember finding it quite effective. Since certain life events have happened to me I have returned to CBT through the IAPT team for treatment of anxiety. So far I have to say I am finding it dreadful. I am four sessions in, which is halfway through - all I have been asked to do is keep a record of anxiety-provoking situations, note the thoughts occurring around the situation and how I feel, then try to come up with 'more helpful thoughts' to counter the original thoughts. This apparently is supposed to cure anxiety?
First of all, which I pointed out to the 'therapist' (use the term loosely), my anxiety does not occur as a result of thoughts. Thoughts occur as a result of the anxiety, but as the table is laid out as it is, I have to write it down as if the thoughts are causing the anxiety, which they are not. Anxiety occurs sometimes in certain situations, sometimes totally out of the blue for no reason while I am by myself minding my own business. The reasons for it are likely to be complicated, but no doubt rooted in my childhood and other life experiences. But the 'therapist' insists on sticking inflexibly to this model, which I have already pointed out to her is not at all helpful to me.
Secondly, I find the 'therapist' herself impersonal and robotic. Currently one of the most anxiety-provoking situations I have to endure is my sessions with her. Not least of the reasons for why she causes me anxiety is that she is completely unable or unwilling to take account of anything I say to her which does not agree strictly to this inflexible model. Basically in response to anything I say she then undergoes a speech during which she will twist what I have just said to make it seem like it is in line with the model!!! I sit there baffled thinking, did she really just do that?! She will literally turn whatever I say on its head to make it seem like it is supporting the model when it is the exact opposite!

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ceedling said on 25 August 2013

"Having been through CBT myself for depression I can tell you that it works and It does not treat just the symptoms...CBT actually has incredibly high success rates for Depression, anxiety and OCD."

Unfortunately CBT has a 50% success rate, which is not very high. I have also been through CBT for depression and didn't find it particularly helpful at all. I was taught how to deal with stressful situations, but it was all really obvious advice that I could only follow if I was in the right mindset. There should be more therapies widely available on the NHS for those who don't respond well to it.

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scottdjp said on 15 June 2013

Having been through CBT myself for depression I can tell you that it works and It does not treat just the symptoms.
The example of when you "blush and cannot speak in social situations" and that CBT would not examine the causes is totally wrong. Your therapist would examine the core beliefs and thoughts underneath this. For example, you have the belief "I always make mistakes and people reject me for them" so your thoughts in the situation would be "I'm going to make a mistake and these people will think im stupid and reject me" and then you would blush and not be able to speak. CBT would help you change your problematic and untrue thought pattern and also to analyse and replace your core belief with a more fitting, realistic and positive one.
CBT actually has incredibly high success rates for Depression, anxiety and OCD. Although I'm sure it has good rates for other disorders and problems as well.
If your doctor suggests CBT, you might want to give it a shot.
Dave

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susan 99 said on 09 August 2012

Cognitive Behavioral Therapy is not really psychotherapy and many trained psychotherapists are actually against it, viewing it as fundamentally unethical.

CBT is a process which equates the symptoms with the problem - e.g. a CBT practitioner would say that if you blush and cannot speak in social situations, then your 'disease' is blushing and not being able to speak in social situations, and would then provide strategies for overcoming the blushing and not speaking.

However a 'proper' psychotherapist would look at the underlying causes (in one patient this maybe the result of low self-confidence, in another paranoia) and then treat these, differing, causes accordingly.

The government wants to market CBT as psychotherapy because it is cheaper and claims to cure you in around six sessions. The evidence however is that it has a very low success rate and patients - unless dealing with a very, very specific phobia like getting on a plane say, frequently lapse.

Know what means what and then kick up a fuss! Refuse anti-depressents, refuse CBT, or a vague what-are-their-actual-qualifications conseller and demand to see a real therapist who might actually be able to help you.

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cuttysark said on 26 April 2011

This article is generally good information, albeit brief, but this may be deliberate as too much detail on this page might be unhelpful. I liked the succinct descriptions on different types of psychotherapy, and was interested to discover "person-centred psychotherapy", as I had never heard of this before. It is a very good idea to have the glossary terms at the end as it clarifies relevant words used.

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