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Talking therapies for mental health


Expert reviewers, Dr Rahul Bhattacharya, Consultant Psychiatrist and Dr Adrian Raby, General Practitioner
Next review due October 2023

Talking therapies are psychological treatments which involve talking to a trained professional about your thoughts and feelings.

If you have problems with your emotional or mental health and wellbeing, talking therapies can help you to feel better and learn ways of coping. They can play an important role in treating mental health conditions, often alongside medicines.

Two people talking

About talking therapies

Doctors use the term ‘talking therapies’ to group together a number of types of psychological therapy. You may also hear these therapies referred to as ‘psychotherapies’ or even just ‘counselling’.

Talking therapies all involve talking to a professional (called your counsellor or therapist) who listens to you carefully without judging you. They can help you understand what might be causing your problems, and explore ways of helping you deal with them.

You may have one-to-one therapy or, depending on the problem, therapy may be with your partner, your family or in a group. Some types of therapy can be undertaken online.

The various types of talking therapy use different methods to help you. Some focus on helping you to change how you think, feel and behave. Others explore issues in childhood that may be affecting you. Certain types may be especially helpful if you have particular mental health conditions.

If your problem is related to a particular event such as a bereavement and you’re otherwise in good mental health, a short course of therapy may be enough. If you have more complex problems, you may need longer-term therapy. Talk to your therapist about how many sessions would be best for you in your particular circumstances.

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 you take medication.

If you need help now

This page is designed to provide general health information. If you need help now, please use the following services.

  • Samaritans
    116 123 (UK and ROI) This helpline is free for you to call and talk to someone.
    www.samaritans.org
  • NHS Services has a list of where to get urgent help for mental health.
  • Mind website. Click on the yellow ‘Get help now’ button at the top left of the page. This is a tool that is designed to help you understand what’s happening to you and how you can help yourself.

If you think you might harm yourself or are worried someone else might come to immediate harm, call the emergency services on 999.

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Types of talking therapy

Talking therapies can be grouped together in different ways. These include:

  • the school of thinking and theory behind them
  • who goes to the sessions – for example, individual or group therapy
  • whether the therapy aims to help with a particular issue – for example, help with your marriage or with a traumatic event

This means that there are lots of different, and sometimes quite complicated, names for the different talking therapies. Try not to feel overwhelmed by this. It’s good that there are lots of 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 – for example, art, music or drama therapy. These are not covered here.


Counselling

Some people may refer to all talking therapies as ‘counselling’, but the term really describes one specific type of talking therapy.

Counselling can be a helpful chance to talk to someone who isn’t part of your family or circle of friends. Rather than aiming to change you as a person, counselling aims to help you be clearer about your problems and to come up with your own answers.

Counselling may be helpful if you’re generally well and healthy but going through a difficult time in life. This might include bereavement, loss of a pregnancy, divorce or other life-changing situation. Counselling might also be helpful if you have mild or moderate depression or drug or alcohol problems.


Family therapy

Family therapy helps family members communicate with each other. A therapist meets with your family in a safe environment (individually or as a group) to help you explore each other’s point 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 in a variety of situations, including:

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

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a type of talking therapy that combines:

  • cognitive therapy – which focuses on the way you think about things
  • behavioural therapy – which helps you cope with problems by changing how you behave

CBT focuses on dealing with problems in the present rather than looking back at your past or childhood. Common CBT techniques include challenging negative thoughts you have and replacing them with more helpful and realistic ones. You’ll probably be given some ‘homework’ to do between sessions to practice these techniques.

CBT can help people with a variety of problems including anxiety, depression, phobias, obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

With guidance from a therapist, you can do a form of CBT on your computer at home or from self-help books. Your GP or local mental health services may be able to guide you to the best resources.


Dialectical behaviour therapy

Dialectical behaviour therapy (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.


Interpersonal therapy

Interpersonal therapy (IPT) helps you understand how your mental health problems (such as 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 so help improve your symptoms.

IPT is a treatment for depression, including postnatal depression, but may also be helpful for a range of other problems including panic disorder, bereavement, social phobia and insomnia.


Psychodynamic therapy

Psychodynamic therapy was developed from psychoanalysis, which is a long-term therapy. Psychodynamic therapy involves fewer sessions and the total course of therapy is shorter than psychoanalysis.

Psychodynamic therapy helps you think about how your experiences in the past may affect what’s happening in your life at the moment. It gives you a regular time to talk to a therapist about your feelings towards yourself and others. It can help you make future decisions based on what is good for you, not what your past experiences drive you to do.

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.


Cognitive analytic therapy

Cognitive analytic therapy (CAT) involves working with a therapist to look at how your past experiences have led to the problems in your life now. Your therapist helps you look at the ways of coping that you’ve developed to deal with problems. They then help you think about how to change these ways of coping so that you feel better and coping becomes easier.

Your therapist may put all this in writing at the start and help you to map out your problems on paper. At the end, they’ll give you a letter which summarises your therapy. You may be asked to keep a diary, and to do some work at home between sessions.

CAT can be used for a wide range of mental and emotional problems including eating disorders, anxiety, depression, personality disorder and drug or alcohol dependency.


Eye movement desensitisation and reprocessing

Eye movement desensitisation and reprocessing (EMDR) is one of several treatments recommended for post-traumatic stress disorder (PTSD). Rather than relying on talking with a therapist, in EMDR you’re asked to make rhythmic eye movements while recalling the traumatic event. It’s not certain how this works, but it might change the way you process memories, rather like what happens during sleeping. This allows you to reprocess an unpleasant or traumatic memory so that you can recall it without feeling the original emotional impact each time.

Accessing services

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


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 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.



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Related information


    • Psychotherapy. Oxford Handbook of Psychiatry. Oxford Medicine Online. www.oxfordmedicine.com, published online June 2019
    • Psychotherapies. Royal College of Psychiatrists. rcpsych.ac.uk, published April 2015
    • Psychotherapy, counselling, and psychological treatment in the NHS. Royal College of Psychiatrists. rcpsych.ac.uk, accessed July 2020
    • Talking therapy and counselling. Mind. mind.org, published June 2018
    • Cognitive and Behavioural Therapies. Patient. patient.info, last edited April 2014
    • Depression. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2020
    • Depression in adults: recognition and management. National Institute for Health and Care Excellence (NICE), 2009. www.nice.org.uk
    • Post-traumatic stress disorder. National Institute for Health and Care Excellence (NICE), 2018. www.nice.org.uk
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    • Social anxiety disorder: recognition, assessment and treatment. National Institute for Health and Care Excellence (NICE), 2013. www.nice.org.uk
    • Arts and creative therapies. Mind. mind.org, published November 2018
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    • Introduction to counselling and psychotherapy. British Association for Counselling and Psychotherapy (BACP), 2020. bacp.co.uk
    • How to get therapy. British Association for Counselling and Psychotherapy (BACP). bacp.co.uk, accessed July 2020
    • What is family therapy? Association for Family Therapy & Systemic Practice. aft.org.uk, accessed July 2020
    • About CAT. Association for Cognitive Analytic Therapy Ltd. acat.me.uk, accessed July 2020
    • Can I get free therapy or counselling? NHS. www.nhs.uk, last reviewed August 2018
    • EMDR: The basics. EMDR UK. emdrassociation.org.uk, accessed July 2020
    • O’Hara MW, Stuart S, Gorman LL, et al. Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry. 2000; 57(11):1039–45. doi:10.1001/archpsyc.57.11.1039
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, October 2020
    Expert reviewers, Dr Rahul Bhattacharya, Consultant Psychiatrist and Dr Adrian Raby, General Practitioner
    Next review due October 2023

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