Psychotherapy / talking therapy

What is psychotherapy / talking therapy?

Psychotherapy, or talking therapy, is treatment that helps through listening and talking. A trained therapist gives you a safe, confidential space to understand difficult feelings, patterns, relationships or experiences, and to find healthier ways to cope. 'Counselling' and 'psychotherapy' overlap; counselling is often shorter and focused on a current problem, while psychotherapy may go deeper or last longer.

There are many types. Some, like cognitive behavioural therapy (CBT), are structured and focused on the present. Others, like psychodynamic psychotherapy, explore how past experiences and relationships shape how you feel now. Interpersonal therapy focuses on relationships; couple and family therapy involve more than one person. Different approaches suit different people and problems.

Talking therapies can help with depression, anxiety, trauma, grief, relationship difficulties, low self-esteem and many other struggles — and simply with making sense of a hard time. They are not only for severe mental illness.

An honest expectation: therapy is rarely a quick fix. It takes openness, time, and a good fit between you and the therapist. It can also feel uncomfortable at points, because facing difficult feelings is part of how it helps. The relationship with your therapist matters as much as the method.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Counselling versus longer-term psychotherapy

These overlap rather than being sharply separate. What matters most is the right approach for you and a therapist you can work with.

Preparing for your programme

• Think about what you want from therapy and what 'better' might look like, even if it is hard to put into words.
• Ask about your local NHS or HSC psychological-therapies service. In England this is often called NHS Talking Therapies and you may be able to refer yourself; in Scotland, Wales and Northern Ireland the service names and referral routes differ, so your GP can point you the right way. Longer-term therapy is often private.
• If going private, confirm the therapist is on a register accredited by the Professional Standards Authority (such as BACP, UKCP or BPC).
• Expect an initial session to explore your difficulties and check the fit and approach.
• Allow time and emotional energy for the process; therapy can be tiring as well as helpful.
• It is fine to ask about the therapist's training, the type of therapy, fees and how long they expect it to take.

What happens

Therapy usually begins with an assessment or first session. The therapist asks about what has brought you, how it affects your life, and what you hope for, then discusses which approach might suit and how you might work together.

Sessions are typically 50–60 minutes, often weekly. What happens in them depends on the type of therapy: in more structured approaches you may work on specific goals and try things between sessions; in more exploratory approaches you talk openly and reflect together on feelings, patterns and relationships. The therapist listens without judging and helps you make sense of things at your own pace.

The length varies widely — from a handful of sessions of counselling to longer-term psychotherapy over many months. Some difficult feelings may surface along the way, which is a normal part of the work, and a good therapist helps you manage this safely.

What you share is confidential, with the usual exception that a therapist may need to act or share information if there is a serious risk to you or someone else. They should explain these limits at the start.

Is this programme right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The therapeutic relationship matters as much as the technique, so a poor fit or an inadequately trained therapist are the main risks. In the UK 'counsellor' and 'psychotherapist' are not fully protected titles, so it is important to choose someone on a register accredited by the Professional Standards Authority (such as BACP, UKCP or BPC). If therapy feels unsafe, unhelpful after a fair try, or the relationship is not right, it is reasonable to raise this or change therapist.

Published figures to discuss

Talking therapies are low-risk, and outcomes vary with the person, the problem, the type of therapy and the fit with the therapist. Many approaches have good evidence of benefit, but none works for everyone or guarantees a result, and change is usually gradual. Because reported outcomes differ widely across therapies and conditions, it is more honest to say many people benefit than to attach a single percentage.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. 'Afterwards' is about applying what you have learned, expecting feelings to fluctuate, and noticing change build over the course of therapy.

• Feeling emotionally tired or tender after sessions
• Ups and downs rather than steady improvement
• Difficult feelings surfacing as you work through things
• A gradual sense of understanding yourself and coping better

Aftercare

• Keep using what you have learned in therapy in everyday life.
• Be patient with yourself; integrating change takes time.
• Notice early warning signs of difficulty and act on them.
• Stay connected with supportive people.
• Return for further sessions if you feel you need them; therapy can be revisited.
• Tell your GP if your mood drops or symptoms return.

• Notes or reflections on what helped you most
• A plan for handling future difficult periods
• Contact details to arrange further sessions if needed
• GP aware, if relevant, of how therapy went
• Supportive people you can turn to
• Early warning signs noted, so you can act promptly

⚠ Get urgent help if…

• Mood dropping markedly, or feeling hopeless, during or after therapy
• Any thoughts of suicide or self-harm — if at immediate risk call 999 or go to A&E anywhere in the UK; for support call Samaritans 116 123 or text SHOUT to 85258. For urgent mental-health help you can also call 111 and choose the mental-health option in England, Scotland or Wales, or in Northern Ireland call Lifeline on 0808 808 8000 or your GP out-of-hours service
• Feeling overwhelmed by emotions or memories stirred up in therapy, with no plan to manage them
• A therapist behaving unprofessionally, crossing boundaries, or making guarantees
• Discovering your therapist is not on a recognised, accredited register
• Symptoms clearly worsening over time rather than improving

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

A good course of therapy often means you feel better, understand yourself more, and cope more healthily with difficulties — sometimes with lasting change. Many talking therapies have good evidence of benefit, though outcomes vary with the person, the problem and the fit with the therapist.

Therapy cannot guarantee a particular result or that difficulties will never return. What it offers is a supported way to work through hard times and to build understanding and resilience you carry forward.

For many people the benefits of therapy last, and the understanding gained continues to help over time. Some return for further work at later points in life, which is entirely normal. As circumstances change, what you need from therapy may change too.

Related tests, treatments or support

Talking therapy is often combined with medication (for example for moderate or severe depression or anxiety), and different therapies can be used at different stages. For specific problems, a structured therapy such as CBT or EMDR may be recommended; for others, longer-term exploratory work may suit better. Your GP or therapist can help you decide what fits.

Follow-up & long-term care

Endings in therapy are usually planned rather than abrupt, and some therapists offer a review or occasional follow-up. You can arrange further sessions later if needed. If you were referred by a GP or specialist, a brief note on progress may be shared with them with your agreement; you can ask what is shared and with whom.

• Keep applying the insights and skills from therapy
• Stay connected with supportive people
• Return for further sessions if you feel you need them
• Look after sleep, activity and stress
• Tell your GP if symptoms return or worsen

Repeat, follow-on and what comes next

• If the therapist or approach is not the right fit, you can change.
• A different therapy may be tried if there is no benefit after a fair attempt.
• Returning for further work at a later stage is common and not a sign of failure.
• The plan and approach are reviewed as your needs change.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Planned, worked-through endings rather than abrupt stops
• An easy route back for further sessions if needed
• Clear handling of confidentiality and any sharing with your GP
• Signposting to urgent help should a crisis arise
• Support to keep applying what you have learned in everyday life

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The type and length of therapy (short-term counselling versus longer-term psychotherapy)
• The therapist's training, accreditation and seniority
• Session length and how often you meet
• Format: in person, online or by phone
• Whether individual, couple, family or group therapy
• Any reports or letters to a GP or referrer

• The therapist's accredited register (BACP, UKCP or BPC) and relevant experience
• Fee per session and how often sessions are expected
• An estimate of how long the work might take, and that it can be reviewed
• Whether an initial assessment is charged separately
• Cancellation policy and notice required
• What happens, and what it costs, if you need further sessions later

On the NHS? Some talking therapies are available free through the NHS or HSC. Access is through your local psychological-therapies service: in England this is often called NHS Talking Therapies and may allow self-referral, while service names, eligibility and referral routes differ in Scotland, Wales and Northern Ireland. Longer-term or specialist psychotherapy is more often accessed privately, with some available on the NHS where clinically indicated.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• Which type of therapy do you think would suit me and my situation best?
• What are your qualifications, and which accredited register are you on (BACP, UKCP or BPC)?
• How long do you expect the work to take, and how will we review progress?
• What are the limits of confidentiality?
• What happens if the therapy doesn't feel right or isn't helping?
• Can I return for further sessions later if I need to?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my programme, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this programme not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for psychotherapy / talking therapy

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Counselling Royal College of Psychiatrists — About psychotherapy BACP — types of therapy UKCP — UK Council for Psychotherapy Mind — types of talking therapy NHS — NHS Talking Therapies (self-referral) nidirect — urgent and emergency care services (NI) nidirect — GP out-of-hours service (NI) NHS England — 111 mental-health crisis support NHS inform — urgent mental-health help (Scotland) NHS 111 Wales — mental health and wellbeing nidirect — mental-health emergency / Lifeline (NI) NHS — find NHS Talking Therapies (England) NHS inform — psychological therapies (Scotland) NHS 111 Wales — counselling nidirect — mental-health care professionals (NI)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.