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Talking therapies for mental health

Talking therapies involve talking to a trained professional about your feelings. This may help you feel better if you’re going through a difficult time.

Counselling is one of the most common types of talking therapy. But there are also many others that you might not know about. Talking therapies can play an important role in treating mental health conditions, often alongside medicines.

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  • About About talking therapies

    Doctors use the term ‘talking therapies’ to group together a number of types of psychological therapies. All of them involve talking to a professional about your feelings. The professional may be called a counsellor or a therapist.

    Although the various types of talking therapy all have the same basis, they use different methods to help you. Some focus on helping you to change your behaviour. Others aim to help you change the way you think about things. Certain types are designed to help with particular mental health conditions.

    If you’re generally well and healthy but going through a difficult time in life, counselling may be the most helpful type of talking therapy. Counselling tends to help you explore your problems, understand them better, and work out how you will respond.

    Your GP or psychiatrist can help you decide which type of talking therapy would help you the most. Depending on your situation, they may also recommend taking medication.

  • Types Types of talking therapy

    Talking therapies can be categorised in a few different ways. These can include:

    • the school of thinking and theory behind them
    • who goes to the sessions – it might be individual or group therapy
    • whether the therapy aims to help with a particular issue – for example, bereavement therapy or sex therapy

    Don’t feel overwhelmed by all the different types of talking therapy, though. It’s really a positive thing that there are options available to suit different situations and problems. Talk to your doctor about what might work best for you.

    The following are just some examples of talking therapies that can help in particular situations. There are also types of psychological therapy that are not based on talking – such as art, music or drama therapy – which are not covered here.


    Counselling

    Counselling gives you a safe space to talk with someone who is trained to listen and provide emotional support. Your sessions may focus on one or two particular issues that you want to work through, or they can be more wide-ranging.

    Counselling can be a helpful chance to talk to someone who isn’t part of your family or circle of friends. It may help you to understand and express your emotions, and cope better with problems you’re facing.

    People have counselling for a variety of reasons, such as bereavement, divorce, or other life-changing situations. It’s often recommended for people who are going through a difficult time in life. It may also be helpful if you have mild or moderate depression or anxiety. If you’ve been diagnosed with a more severe mental health problem, your GP might recommend another type of talking therapy.


    Family therapy

    Family therapy helps family members communicate with each other. A therapist meets with your family in a safe environment (either individually or as a group) to help you explore each other’s points of view and relationships.

    Family therapy is designed to work with your family’s strengths to help you try different ways of behaving towards each other. This can help if there’s a particular problem or condition that a family member is dealing with.

    Family therapy can be used for:

    • relationship difficulties for couples
    • emotional or behavioural problems in children
    • eating disorders
    • alcohol dependence
    • schizophrenia

    Research has found family therapy to be helpful for a variety of situations and conditions.


    Cognitive behavioural therapy (CBT)

    CBT is a type of talking therapy that combines:

    • cognitive therapy – which focuses on the way you think about things
    • behavioural therapy – which helps with how you behave in response to your thoughts

    Common CBT techniques include:

    • challenging negative beliefs and replacing them with alternative ones
    • problem solving
    • developing coping skills

    CBT is proven to help people with a variety of conditions. For example, CBT can reduce the symptoms of anxiety disorders and mild-to-moderate depression. It may also help to reduce your risk of getting these conditions again. See our information on cognitive behavioural therapy for more details.

    You may also hear about an alternative to CBT called behavioural activation. Behavioural activation focuses on setting specific goals or activities to work towards. Behavioural activation is often used to treat depression. As a treatment for depression, behavioural activation doesn’t have as much proof to support it as CBT, but you may find it works for you.


    Dialectical behaviour therapy (DBT)

    DBT is based on cognitive behaviour therapy. But it focuses on balancing changes to your thoughts and behaviour with acceptance of who you are as a person. It also pays particular attention to helping you manage strong emotions. DBT has been used to help people with borderline personality disorder, but it may help with other mental health problems.


    Mentalisation-based therapy

    'Mentalisation' means thinking about your thoughts and beliefs, and reflecting on how those are linked to your behaviour. Some people find doing this difficult, so mentalisation-based therapy aims to help. Mentalisation-based therapy may help people who have borderline personality disorder.


    Interpersonal psychotherapy (IPT)

    IPT is used to treat depression. It works by helping you understand how your depression may be linked to your relationships and how they work. The therapy focuses on helping you strengthen relationships to improve your connections and experiences with others and helps improve your symptoms of depression. There’s strong evidence that IPT works for people who have depression.


    Short-term psychodynamic therapy

    Short-term psychodynamic therapy focuses on increasing your awareness about what’s happening in your life now, what’s happened in the past and how your feelings and thoughts are affected by your experiences. It gives you a regular time to talk to a therapist about your feelings towards yourself and others. It can help you change your thoughts and behaviours, and how you make decisions.

    Short-term psychodynamic therapy can be used to treat depression and social anxiety. Short-term means you are likely to have up to 25–30, 50-minute sessions over the course of six to eight months.

    This type of therapy doesn’t lend itself to scientific studies so there isn’t very much hard proof that it works. While some people find this type of therapy helpful, to date there is only a small amount of research to support it.


    Cognitive analytic therapy (CAT)

    CAT is where you work with a therapist to look at how your experiences in life have led to the problems in your life now. Your therapist will help you look at ways of coping and dealing with your problems so you feel better. There isn’t a lot of strong research that tells us for sure how well CAT works. NICE (the organisation that guides doctors) has suggested more research into whether it could help people with borderline personality disorder. There is some evidence that it may help to treat eating disorders.


    Eye movement desensitisation and reprocessing (EMDR)

    EMDR is one of several treatments recommended for post-traumatic stress disorder (PTSD). EMDR suggests that if you have experienced something deeply distressing, your brain might be overwhelmed by the memory and be unable to process it like a normal memory.

    EMDR involves talking with your therapist while using specific eye movements, sounds or finger taps to stimulate different parts of the brain. This is designed to help process the distressing or traumatic memories.

    There’s good evidence that EMDR works for treating PTSD and trauma-related problems.

  • Accessing services Accessing services

    You may be able to access counselling or talking therapy through:

    • a referral from your GP (if they agree it could be helpful)
    • a local Improving Access to Psychological Therapies (IAPT) service, if you have one – this allows you to self-refer for NHS talking therapy online or by phone
    • your workplace, university or school
    • a charity, some of which offer counselling or similar support – this includes Mind, Cruse Bereavement Care for bereavement, and Relate for relationships
    • having private therapy – websites allowing you to search for therapists in your area include the British Association for Counselling and Psychotherapists and the UK Council for Psychotherapy

    Talking therapies often involve meeting a specialist in person, but this isn’t always the case. Some counsellors and therapists also offer sessions over the phone, or online through messages and web chats. It’s really important though to check that any counsellor or therapist you contact is qualified. One way to do this is by searching for their name on the Professional Standards Authority register.

  • Other helpful websites Other helpful websites

    Further information


    Sources

    • Choosing a counsellor or psychotherapist. British Association for Counselling and Psychotherapy. www.bacp.co.uk, published February 2017
    • Talking Therapies ¬ Types of Therapy. Rethink Mental Illness. www.rethink.org, last reviewed February 2016
    • Making sense of talking treatments. Mind. www.mind.org.uk, published 2016
    • Psychotherapy. Oxford Handbook of Psychiatry. 3rd ed. Oxford Medicine Online. oxfordmedicine.com, published March 2013
    • Psychotherapy, counselling, and psychological treatment in the NHS. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed March 2018
    • How can I access a talking treatment? Mind. www.mind.org.uk, published February 2016
    • How to get therapy. British Association for Counselling and Psychotherapy. www.bacp.co.uk, accessed March 2018
    • Counselling in Primary Care. PatientPlus. patient.info/patientplus, last checked March 2014
    • Depression in adults: recognition and management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published April 2016
    • What is family therapy? Association for Family Therapy and Systemic Practice. www.aft.org.uk, accessed March 2018
    • Antisocial behaviour and conduct disorders in children and young people: recognition and management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated April 2017
    • Eating disorders: recognition and treatment. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published May 2017
    • Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published February 2011
    • Stratton, P. The evidence base of family therapy and systemic practice. Association for Family Therapy. www.aft.org.uk, published 2016
    • Cognitive Behavioural Therapy. Royal College of Psychiatrists. www.rcpsych.ac.uk, last updated July 2013 Bateman A, Fonagy P. Mentalization based treatment for borderline personality disorder. World Psychiatry 2010; 9(1):11–15
    • Dialectical behaviour therapy (DBT). Mind. www.mind.org.uk, published April 2017 Markowitz JC, Weissman MM. Interpersonal psychotherapy: principles and applications. World Psychiatry 2004; 3(3):136–39
    • Beale D. Behavioural activation for depression. Adv Psychiatr Treatment 2008; 14:29–36). doi: 10.1192/apt.bp.107.004051
    • Abbass AA, Kisely SR, Town JM, et al. Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD004687. DOI: 10.1002/14651858.CD004687.pub4 Social anxiety disorder: recognition, assessment and treatment. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published May 2013
    • Common types of psychotherapy. UK Council for Psychotherapy. www.psychotherapy.org.uk, accessed March 2018 Borderline personality disorder: recognition and management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published January 2009
    • Post-traumatic stress disorder: management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published March 2005
    • Anxiety and stress-related disorders. Oxford Handbook of Psychiatry. 3rd ed. Oxford Medicine Online. oxfordmedicine.com, published March 2013
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    Reviewed by Graham Pembrey, Lead Health Editor, Bupa Health Content Team, April 2018
    Expert reviewer Rahul Bhattacharya, Consultant Psychiatrist
    Next review due April 2021

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