How to find a therapist (in the UK).
One of the things I’m hoping to do with this blog is to help demystify the world of counselling and psychotherapy and to make it easier to understand and eventually access. There is so much technical and psychological language to navigate when someone starts researching about therapy, so many acronyms and abbreviations! It can feel like there is no clear path to starting the process of finding a skilled and well-matched therapist.
To make things more tricky, there are lots of differences between the lingo of the USA and the UK, with different definitions and standards in each region further complicating the task of understanding the information online.
I hope to write a series of these articles but today I’ll be starting with my attempt to simplify and collate the main ways in which people can access therapy in the UK. This won’t be an exhaustive list, but I will provide a brief overview of how to access therapy via the three main routes (NHS, community/charity and private) and the pros and cons of each route.
Therapy via the NHS.
The first stop for most of us here in the UK when we have a health problem is the NHS, and this can be the same for mental health as well. Mental health is a very active part of our national conversation at the moment with seemingly endless pledges of intent to increase funding and improve the accessibility of services. Alongside this, there is a constant stream of criticism that the provisions aren’t where they need to be. Whilst this may give the impression that the NHS isn’t a viable option, this most certainly isn’t the case, and many people are successful in receiving suitable and effective support. Horror stories about never-ending waiting lists certainly do exist, but these vary wildly based on factors such as location and time of year that you refer. When things go well, you can expect to be seen quickly by a suitably qualified therapist, with good knowledge of local specialist services to involve should that be necessary.
However, the number of sessions you may be offered is likely to be low as the NHS struggles to meet the challenges of high demand. The type of therapy you will be offered may also be restricted to specific techniques, with CBT being the most commonly offered therapy, and often people are offered group therapy rather than one to one.
You will also be required to go through an assessment process and many people find that they are assessed as too severe or not severe enough to be eligible. It is also unlikely that you will have much say on which therapist you are paired with (although you should vocalise a preference if you have one, just in case). If you are unhappy with your therapist, you may find that the process of being re-allocated is time-consuming and complicated.
To access therapy via the NHS, you could either speak to your GP, or if you are uncomfortable doing this, you can visit the NHS find a therapy website (your GP won’t be informed that you are accessing therapy via this route).
Pros: Available nationwide, free, no need to check your therapist credentials, can be quick (but depends).
Cons: Often long waiting lists, a limited number of sessions offered, limited/no choice over the type of therapy or therapist, may only be offered group therapy.
How to access: Via your GP or NHS website
Therapy via the community charity sector.
There is a thriving network of charitable and community organisations in the UK offering therapy at either low or no cost. These organisations offer a vital contribution to mental health support in the UK and often find themselves filling in the gaps when other state-funded mental health services are affected by budget cuts. You may find you are able to access services specifically designed for either a demographic you belong to (race, age, sexuality etc.) or for a specific type of situation you may have experienced (such as domestic violence or abuse).
Like the NHS, you can be confident that the organisation has vetted the therapists they work with for both a required standard of training and to ensure there are no safeguarding concerns present (known as a DBS check). There may also be a greater variety in the type of therapy available and the number of sessions offered. However charities in the UK are also under a lot of pressure and will also be limited in what they are able to offer. Waiting times can also be very long (but as above can vary wildly).
Charities are usually funded by grants from corporate or local authority sources, and these often specify the demographic and location of the people who are eligible. This can add additional frustration in accessing services via this route. For instance, finding an ideal service for you but then discovering that you live a couple of streets away from the area served. There is also not a centralised referral route, so you will have to spend time researching your local services and completing the referral documents for each one - although often your local council will provide a list/directory of the services available locally.
Pros: A large number of available organisations with specialised services available, sometimes greater flexibility than NHS, either free or reduced cost.
Cons: As with NHS, long waiting times and limited sessions are common, restrictions on who can access, and lengthy process of applying to each organisation.
How to access: Researching local services and applying individually to each - often local authority can provide a list of available services locally.
Accessing therapy privately.
The first thing to do in this section is to acknowledge my obvious bias, i.e. this website and blog are for my own private therapy practice, and I am therefore likely to paint this route in a positive light! To address this I shall start by talking about the downsides of this option.
The most obvious is the cost involved. Whereas the NHS is free and the charity sector either free or low cost, the private option most certainly isn’t. I’m writing from London where the average cost for private therapy ranges from about £50-£80 per hour, depending on where in the city you are. Prices are lower outside the capital but finding a therapist who will charge less than £40 may still be challenging. This, unfortunately, poses a significant obstacle for many people hoping to start therapy - although it should be noted that some therapists (including me) offer a limited number of appointment slots at a reduced rate.
The other significant challenge of finding a private therapist is that counselling and psychotherapy are unregulated in the UK - and this means that anyone can legally claim to be a therapist, whether they are suitably qualified or not. Whereas in the NHS/charity sectors, the organisation will have ensured you are working with a trained professional, in the private sector this responsibility unfortunately falls to each individual client. The most important thing to do is to check that your therapist is registered with a recognised professional body, such as the BACP, UKCP or NCS - this information is usually displayed prominently on therapists’ websites. Another option is to search via a professional database that vets members before they can advertise there. Two brilliant options are the BACP directory and Psychology Today.
`If for you, the financial cost is not prohibitive, private therapy can be a great option, providing greater choice and flexibility than the low or no-cost options. You will be able to choose the therapist you feel comfortable working with and who practices the type of therapy that you want. You will also be able to agree both the length of therapy with your therapist based on your individual needs. Finding therapy outside of office hours will also be easier - whereas many organisations will usually only offer session times between 9-5.
Pros: Choosing your therapist and type of therapy, more flexibility in scheduling sessions around your life, not limited in the number of sessions offered.
Cons: Expensive (sometimes prohibitively so), and you will want to check your therapist’s credentials.
How to access: Contacting individual therapists directly, using directories such as BACP or Psychology Today is a great place to start.
Some final thoughts.
I hope this article has been helpful but it’s worth saying that this is by no means an exhaustive list of the options available - although it does cover the main routes. There are, for instance, several specialist services available in the NHS not covered here, several companies and educational institutions may offer counselling services that are also worth exploring. There is also something of a blurring of the boundaries between the NHS and charity sectors, with many charities running contracts NHS services, this shouldn’t however affect the ways in which you access the service.
The featured image is copyright of Nick Younson and licensed under creative commons.