Talking therapies

Talking therapies can help you deal with negative thoughts and feelings and make positive changes.

*Last updated: 21 September 2021

Talking therapy involves talking to a trained professional about your thoughts, feelings and behaviour. Describing what’s going on in your head and how that makes you feel can help you notice any patterns you may want to change. It can help you work out where your negative feelings and ideas come from and why they are there.

Understanding all this can help you make positive changes, take greater control of your life and improve your confidence.

This page uses the word ‘talking therapy’, but you may also hear it referred to as talking treatment, counselling, therapy, psychotherapy or psychological therapy.

Who can benefit from talking therapy?

Talking therapy can help with:

  • difficult life events such as bereavement or redundancy
  • relationship problems
  • events from your past that still cause you distress – consciously or unconsciously
  • difficult feelings such as anger, shame or low self-esteem
  • mental health problems
  • some long-term physical health conditions.

It doesn’t have to be a last resort or something you turn to in a crisis. If you think you could do with talking to someone in a safe space who won’t judge you, then it’s ok to try it.

How do I know which kind of therapy is right for me?

There are many different approaches when it comes to therapy. Therapists may train in one approach or use a number of different methods. Some use specialist techniques – for example, an art therapist would use art to help you explore your feelings. Others offer specialist treatment for specific issues such as addictions or eating disorders.

It can be easy to be overwhelmed by the number of different types of talking therapy out there. Don’t let that put you off. We go through some different types below, but the most important thing is the relationship you have with your therapist. Trusting them and feeling comfortable opening up means you will get the most from your sessions, no matter what approach they use.

Different types of talking therapy

There are many different types of talking therapy, although your choice may be limited depending on where and how you access it.

The National Institute for Health and Clinical Excellence (NICE) recommends certain therapies for certain problems, but other therapies might work for you just as well.

Here are some of the main kinds of talking therapy.

Cognitive behavioural therapy (CBT)

This looks at how your thoughts and beliefs affect your feelings and behaviour. By changing how you react to your thoughts (for example, challenging negative thoughts) and how you behave (for example, trying new activities), you can start to feel better.

What’s unique about it?

CBT tends to be short-term – often between six and 12 sessions – and takes a more structured approach than other therapies. It looks at specific problems rather than how you feel more generally. You’ll often have tasks to do between sessions such as keeping a diary or practising the skills you’ve learned in therapy.

What can it help with?

CBT can help with a range of problems including depression, anxiety, obsessive compulsive disorder, managing long-term illnesses, eating disorders, post-traumatic stress and schizophrenia.

Our page on cognitive behavioural therapy has more information.

CBT was amazing - it was so simple. My diagnosis is bipolar disorder and I had very low self-esteem and lack of confidence in my future. I had about 15 sessions over a year. The psychologist showed me how to notice what I was thinking and then how I felt afterwards, and to realise you can choose your own thoughts. I thought they were just random thoughts there to make my life a misery. But I learnt that at any time I could stop and say: 'Why am I thinking that?'

I had a CBT therapist but I think she probably used lots of different things - in fact it didn't feel like she was 'using' anything - it felt like a natural process rather than anything very medical or clinical.

Dialectical behaviour therapy (DBT)

DBT is an adapted form of cognitive behavioural therapy (CBT) that can help people who experience emotions very intensely. It teaches you how to live in the moment, cope with stress, regulate your emotions and improve your relationships.

What’s unique about it?

‘Dialectical’ comes from the idea that bringing together two opposites – acceptance and change – can make a bigger difference than either one alone. Accepting yourself and changing your behaviour might sound like a contradiction, but your therapist will help you understand how this can bring about positive shifts in your life.

What can it help with?

It was originally designed to treat borderline personality disorder but now it’s also used for eating disorders, addiction, depression and problems such as self-harm or suicidal feelings.

Mind has more information on DBT.

Psychodynamic therapy

Psychodynamic therapy explores how your childhood experiences and unconscious mind influences your current thoughts, feelings, relationships and behaviour. Your therapist may use techniques such as:

  • free association – where you talk freely about whatever is on your mind, no matter how silly or illogical it might seem, to let your true feelings come to the surface
  • transference – where feelings you experienced in other relationships, especially from childhood, are unconsciously projected onto your therapist. By recognising this, you can start to understand these feelings and past relationships
  • interpretation – your therapist will sometimes offer a new perspective on what you’re talking about, aiming to help you broaden your self-awareness and self-knowledge.

What’s unique about it?

Psychodynamic therapy focuses more on your past and on your unconscious mind – the feelings and thoughts that you’re not aware of but that affect your choices and actions in the present day. It’s often relatively long-term, lasting from several months to many years.

What is it helpful for? 

Depression, anxiety, post-traumatic stress, long-term physical health problems, eating disorders and addictions. NICE recommends psychodynamic therapy for people experiencing depression alongside other complex illnesses.

I was quite severely depressed as a teenager. I tried various antidepressants and some CBT-based stuff, but nothing was helping. Finally, my GP suggested that I try psychotherapy at my local mental health unit.

At first I was sceptical. I couldn't see how sitting in a room with a stranger was going to help. I was quite a nightmare, trying to prove to my therapist and myself that the therapy would fail. But with psychodynamic therapy, the therapist is prepared to sit and wait out that part with you. She started helping me link the way I was thinking, feeling and behaving to what might have gone on when I was younger and that really made sense.

Humanistic therapy

Humanistic therapy lets you explore your whole self rather than just specific problems. It aims to help you grow, live your life to the full and be true to yourself. Your therapist will offer you empathy, warmth and genuineness to help you make these changes.

Person-centred therapy, Gestalt therapy and transactional analysis are all examples of humanistic therapy. The British Association for Counselling and Psychotherapy (BACP) has more information about them.

What’s unique about it?

Humanistic therapy focuses on all of you. It’s based on the belief that we are all capable of growth but that life experiences may have blocked us from reaching our potential. Your therapist can help you identify and remove those blocks.

What is it helpful for?

Anxiety, depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), personality disorders and more. A humanistic therapist will work with any issue causing difficulties in your life.

I was referred to a unit that deals with people who turn to alcohol because of psychological problems. I was in a state of constant panic and had been drinking to keep those feelings at bay. There wasn't a set formula to the sessions. We'd just go and get a cup of coffee and I'd talk about what was bothering me. With person-centred counselling the therapist steers you through finding out more about yourself and developing confidence.

How do I find a therapist?

You can find a therapist in different ways, although not all types of therapy will be available everywhere.

Through the NHS

Your GP or another health professional may refer you to a qualified therapist or you can self-refer if you live in England. The therapy will be provided free on the NHS.

In many places there are long waiting lists and you may not have much choice who you see.

The National Institute for Health and Clinical Excellence (NICE) advises which treatments doctors should prescribe. NICE recommends certain therapies for certain problems and these may be easier to get on the NHS than others.

Go private

If you can afford it, you can choose to pay for your own therapy. Therapists may charge anything from £35 an hour and more depending on where you live, although some offer reductions to people on a low income.

To find a private therapist, it’s a good idea to search via a website that only lists therapists who are registered with a professional body such as:

Through your place of work or education

Some workplaces have Employee Assistance Programmes (EAPs) which may offer a limited number of free therapy sessions. Many colleges and universities offer free therapy services.

Other organisations

Some charities and community organisations offer talking therapies free or at low cost, sometimes by using trainees. Ask your GP if they know anywhere local, contact local counselling training centres, or try one of the following.

What happens in talking therapy?

Sessions usually last 50 minutes and take place at regular, planned times. They can be face-to-face, on the phone or online. How often you see your therapist and how many sessions you have will depend on the type of therapy you’re having and your personal circumstances.

You might see a therapist on your own, in a group, as a couple or as a family.

In group therapy you don't just talk about yourself, you're listening to other people - that takes the burden off your problems. You realise you're not the only one.

During a session you might talk generally about how you’re feeling or you might go through specific exercises, depending on your therapist’s approach. What you talk about could include your childhood, your relationships, past and present life events or stressful situations, for example.

Your therapist will listen to you without judging you and help you explore your thoughts and feelings. They won’t tell you what to do but will help you understand yourself better and think about the changes you may want to make.

Talking therapies are not therapies that are 'done' to you by someone else. You play an active part. That can be empowering at a time when you may feel you have lost control over part of your life. If you’re determined to get the most from your therapy, it’s more likely to work.

You need to be honest with yourself in therapy and that can be difficult. It may mean facing up to your fears, recalling distressing memories or talking about intimate topics and private thoughts and feelings. Think about whether you’re ready to open up and talk to your therapist if you’re feeling overwhelmed. Sessions should always go at your pace so you don’t feel rushed.

How do I choose a therapist?

You may already have questions to ask yourself or your therapist. Here are some to consider.

Questions you could ask yourself before you choose a therapist

  • What kind of therapy might suit me?
  • How much time and money do I have for therapy?
  • Do I want a particular therapist – eg a man or woman, someone who shares my racial background or sexuality, someone my own age?

Questions you may want to ask a therapist

  • What are your qualifications?
  • What other training have you done?
  • Do you belong to a professional organisation?
  • What experience do you have of working with people with my particular issue?
  • What happens at a typical session?
  • How many sessions would I have?
  • What is the cost for each session? Do you offer any reductions?

When you meet a therapist for the first time (sometimes called an assessment), they will be working out if they can help you. That’s your chance to find out about the therapist too. The British Association for Counselling and Psychotherapy (BACP) has an information sheet on what happens in your first session.

Ask yourself:

  • Do I feel comfortable talking to them?
  • Would I be able to trust and work with them?
  • What's my gut feeling about them?

It might take a few tries before you find a therapist you connect with. Take your time to find someone who feels right so that you can get the most from your sessions.

What makes a good therapist?

Your relationship with your therapist is really important. A good therapist will listen to you, have your best interests at heart and help you learn how to change. They will check you’re getting what you want from therapy and refer you to someone else if they can’t help with your particular issue.

What I found really good was being able to talk about what was happening and have someone who was listening - she was really good at giving me space, listening to what had happened and discussing what might have caused it - not in a deep way but trying to help me piece the whole picture together.

A good therapist concentrates on you – what is important in your life, what you want to achieve, what steps you could take to get there. They shouldn't tell you what to do. Your therapist may be highly trained and very experienced, but you are the expert on you.

Remember therapy is a two-way process. If you have any questions, ask them. A good therapist will help you deal with your worries and work out how you will manage when therapy comes to an end.

What if I’m not happy with my therapist?

It can take time to build a relationship with your therapist and start to open up. You may feel sad or frustrated after sessions at times depending on what you’ve talked about. But if you’re not happy with how the sessions are going, you can:

  • talk to your therapist to try and resolve any problems
  • ask your therapist if they can try a different approach
  • go back to your GP or referral service to ask if you can see someone else
  • find another private therapist.

If you need to make a complaint

If you have a serious concern about your therapist, you can make a complaint.

You can contact the professional body your therapist is registered with and follow their complaints procedure. You can ask your therapist who they’re registered with or see if it’s mentioned in your contract, if you have one. For example, you can complain about a BACP member or a UKCP member by following the steps on their websites.

The BACP has a ‘get help with counselling concerns’ service you can contact by phone or email. They can help you make sense of what you think has gone wrong and work out your next steps.