Every year one in four people suffer with a mental health issue, struggling to cope with emotional problems that they can’t find a way out of on their own. The good news is that whatever your age, gender, education, ethnicity or sexuality, talking therapies can help*1.
What are talking therapies?
They are a range of therapies which involve talking to someone specially trained to help you work through your issues. These can be a great way of exploring your feelings, discovering where they come from and pinpointing ways to think or act differently to make some positive changes.
However, as recent reports highlight that NHS services are under increasing pressure and unable to cope with demand*2, how do you access talking therapies?
It’s a good question and one that came to light when I got a call from an old work colleague, who had been on an NHS waiting list for some time. We hadn’t spoken for years but she knew I worked as a private counsellor and psychotherapist, so rang me for some advice. Feeling very down, stressed and not very resourceful, she wasn’t best placed to go and find more information for herself. I realised that other than talking to her GP, she had no idea where she could find help or support and that many other people must be in the same position.
I believe passionately in the value and effectiveness of talking therapies and in empowering people to help themselves. There are lots of services and options available, some on the NHS and some which you can access privately.
The diagram below gives you an overview of some different routes into talking therapies.
NHS ServicesYou’re probably aware that NHS-funded talking therapies are available but services vary. In some areas you’ll need a referral from your GP, in other areas you can self refer – you can usually find this information via your GP, surgery or website. The options may include face-to-face, telephone or group sessions, are usually provided free of charge and the number of sessions will vary.
Once you’ve been referred (or self referred), you’ll generally be assessed then allocated the next available therapist. As the NHS Choices website warns, due to high demand on these services there may be a waiting list or you may have to travel for treatment.
GPs can also refer you on to other primary care services and again, what’s available will depend on what has been commissioned in your local area. Some of these services can be quite innovative, or targeted at specific groups of people or age ranges. For example, Kooth.com is a well-established, ethical, well-moderated website that provides online counselling and peer support for young people. This is available free of charge in a number of areas where it has been commissioned by the NHS, but it is not universally available. You can check on the Kooth website to see if you can access it in your area.
GP practices linked to a college or university may also be able to refer students to dedicated student support services, or students may be able to self refer, depending on the university.
In Nottingham, for example, there are two large universities and a few times a year I am contacted by parents who are worried about their son or daughter who is studying away from home and struggling with emotional issues. Being so far away from your child when they are unhappy can be difficult and distressing for the parents, particularly if their child is unwilling to talk about exactly what’s going on for them. Often it’s easier for them to talk to someone outside the situation, so talking therapies are a good option.
Universities usually offer a range of support services tailored to students’ needs, which may include face-to-face counselling, website resources, factsheets, telephone support or group therapy sessions. They may also run workshops on related topics, for example The University of Nottingham Counselling Service also offers workshops on ‘Procrastination and Perfectionism’, ‘Staying Calm and Being Effective’ and a group on ‘Managing Depression, plus information on common issues like homesickness or exam anxiety. A search for ‘counselling service’ on the university website should help you to find details of services available and who to contact. Demand on these services is high so, again, there may be a waiting list.
As the diagram shows, GPs also have access to a wide range of other primary and secondary care services as well as other agencies such as Social Services and can refer to these where appropriate for further assessment or support. This is more likely to happen if someone is in crisis or has specific, more complex issues that require a higher level of support or intervention.
But as we know, demand on services is high and resources are extremely stretched. Paul Farmer, Chair of the We Need to Talk coalition and Chief Executive of mental health charity Mind, commenting on new data on talking therapies from the Health & Social Care Information Centre, said: “These latest annual statistics echo our own investigation… showing huge variation in access to talking therapies depending on where a person lives. We know that in some parts of the country investment in IAPT and other models has transformed lives but far too many people face unacceptably long waits or are struggling to even get a referral, which just isn’t good enough. While waiting, many become more unwell and one in six people attempt to take their own lives.”*2
Private Therapy ServicesIf you’ve been referred for NHS talking therapies by your GP, you may have fallen foul of the waiting times and decided to look at alternatives. Private therapy provides a good option, but comes in different forms from different providers so some people are less confident of how to access it. The main options are:
Employee Assistance Schemes
Many employers now fund short-term talking therapies for their employees, as part of their overall benefits or wellbeing package. Schemes vary from company to company, so if you’d like to look at this option, visit your company website or contact your line manager or HR department for more information. Some packages will only cover the employee but others will include counselling for other family members as well, so check the small print.
Large companies often have a contract with an Employee Assistance Provider (EAP) company who administer the scheme. Fees are usually paid directly by the employer to the EAP company who then pay the therapist, so under these circumstances you won’t need to pay. Other schemes may require you to pay and claim the fee back, but this is rare. Sometimes you can access the scheme via your manager or HR department, but more often it is set up so that you can call direct. In most cases you’ll remain anonymous and your company won’t need to know you’ve used the service unless you tell them.
As well as making employees feel more valued and supported, it makes sense financially from the employer’s perspective – they would rather have their staff back to work than off with long term stress or other mental health issues. So if your company has a scheme, don’t be afraid to use it.
Usually a company will ask for an initial assessment session and, based on this, fund a short course of weekly therapy sessions. The length of treatment depends on the issue and the contract agreed with your employer. You may only get four, six or eight sessions, but although that might not sound very many you can make a big difference over that time and it’s a good opportunity to see how talking therapy works for you.
Private Medical Insurance
There are a number of Private Medical Insurance (PMI) providers and whether talking therapies are covered and to what extent will depend on your policy. If they are available then your provider will be able to tell you exactly what you’re covered for and how many sessions you can have.
Your insurer may ask you to select from a list of pre-approved therapists, or they may pay for a therapist you’ve found yourself. Usually the therapist will be paid directly by the insurance company, but there may be a policy excess to pay so check this with your provider. Once your sessions have been authorised, the insurer will usually write to you and your chosen therapist to confirm and clarify the terms.
Accessing Private Counsellors and Psychotherapists Directly
There are many counsellors and psychotherapists working in private practice providing affordable talking therapies in all areas of the country. Many people don’t realise this or, if they do, perhaps don’t feel confident of what they need to look for in a therapist or how to go about finding one. A recommendation from a friend or relative is often helpful, but you can also easily find therapists in your area via a number of online directories.
Private counsellors and psychotherapists vary in the way they work, the areas they specialise in and the fees they charge. You’ll have the flexibility and choice of what suits you best, so it’s worth spending some time to find the therapists who appeal most to you. It’s a good idea to make a shortlist, then contact them directly and see how you feel when you meet in person. And if one therapist or type of therapy doesn’t suit you, don’t be afraid to try another, as you could have a very different experience. The therapeutic relationship you have with your therapist will influence how successful your therapy will be, so trust your instincts whether someone is right for you or not. I often ask clients, “Why me?” when we are having our initial conversation and the answer can be as simple as, “I liked your photo – you looked like someone I could talk to,” or, “I liked the way you write…,”.
However the Professional Standards Authority’s Accredited Voluntary Register (AVR) scheme provides assurance that accredited registers are well run and achieve its high standards in:
- Setting standards for registrants
- Education and training
- Managing the register
- Complaints and information
The two main professional organisations for counsellors and psychotherapists in the UK are the British Association of Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP). Members of these organisations commit to high standards of ethics, professional practice and ongoing professional development which is audited regularly. Other professional organisations exist, but these are the biggest and most well recognised. Both the BACP and UKCP operate an AVR for their members.
You can search for BACP and UKCP registered members on their websites via the links below:
There is also a very good commercial directory called Counselling Directory which you can search by area or postcode and speciality. This isn’t linked to any one professional organisation, but anyone applying for a listing has to provide evidence to verify their level of qualification, membership of professional bodies, accreditation and insurance:
Low-Cost Counselling Organisations
Not everyone can afford to fund their own talking therapies, so some organisations provide low-cost talking therapies. These organisations may ask you to pay a contribution towards your counselling based on an assessment of your income and personal circumstances, and they would usually agree a fee with you at the assessment stage.
Availability will vary from area to area and demand on these low-cost services is always high, but an internet search or a visit to your local library will help you to find them.
Specialist Support Organisations
Free or low-cost specialist support is also available from organisations focussing on specific groups or issues, either at local or national level. These are usually as charities or non-profit making organisations. They will normally have a website giving information and details of the support that they can offer, which may include talking therapies. Here are a few examples:
There are many organisations providing invaluable help for specialist areas and you can find them via internet search or asking at your GP surgery or local library.
I opened by quoting the statistic ‘every year one in four people suffer with a mental health issue’ and I invite you now to really think about it. Consider the people behind the statistic – your family, friends and work colleagues as well as the people you live near and see around you every day.
For some of them you will know a bit about what’s happening in their lives, for many you won’t; most of them will appear to be just fine yet one in four of them will be struggling emotionally, even if it doesn’t show on the outside.
Many people still suffer in silence – they feel confused or ashamed, maybe worry about being judged, don’t believe anyone can help, or they could be deploying the British ‘stiff upper lip’ and bottling it up so as not to be a bother to anyone. It can feel very risky confiding in someone about how you feel, even someone close, but it’s usually the first step to getting help.
So it can only be a good thing if more of us know how to access help and can pass that knowledge on to others when they need it…
*1 NHS Choices website.
*2 We Need to Talk coalition investigation (info is on the Mind website)
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