Talking therapies for mental health

Talking therapies are psychological treatments that involve talking to a trained professional about how you think, feel and behave. If you’re struggling with your mental health and wellbeing, talking therapies can help you to better understand your problems and learn healthy ways to cope. They have an important role in treating mental health conditions, and are often used alongside medicines.

Some types of psychological therapy aren’t based on talking – for example art, music or drama therapy. These aren't covered here.

About talking therapies

Doctors use the term ‘talking therapies’ to group together several different psychological therapies. You may also hear these therapies referred to as psychotherapies or 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. They’ll also explore how to help you deal with these problems.

What you share in your therapy sessions is confidential. Your therapist won’t share your information without your consent unless it’s for your safety or care. They may discuss your situation with their clinical supervisor or your GP to make sure you receive appropriate support. These exceptions are usually explained clearly at the start of your therapy.

Depending on the reason why you’re seeing a therapist, you may have:

• one-to-one therapy (in person or online)
• therapy with your partner or your family
• therapy in a group

Talking therapies use different methods to help you. They may focus on:

• helping you to change how you think, feel, and behave
• exploring how issues in the past may be affecting you now

Talking therapies can be useful for a wide range of issues, including anxiety, depression, trauma, grief, and relationship problems.

Short-term therapy may help with a recent bereavement or stress. If you have more complex problems or ongoing difficulties, you may need longer-term therapy.

Your GP, psychiatrist or therapist can guide you to the best type of talking therapy for you. Depending on your situation, they may recommend a combination of therapy and medicines.

Types of talking therapy

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

• the school of thinking and theory behind it
• who goes to the sessions – whether you’re on your own or with a group
• if the therapy aims to help with a particular issue such your marriage or a traumatic event

Some psychotherapists use a combination of approaches to suit you and your situation. Talk to your doctor about what might work best for you. Having a good relationship with your therapist is more important than the type of therapy you have. You need to be able to trust your therapist so that you can talk about your feelings comfortably.

The following are some examples of talking therapies that can help in particular situations. Some talking therapies have quite complicated names. Try not to feel overwhelmed by this.

Counselling

Counselling is generally short-term and helps you manage specific life challenges such as grief, stress or divorce. It’s often used when someone is psychologically well overall, but is going through a tough time. You may be able to see a counsellor at your GP surgery. Counselling might also be a helpful talking therapy for depression or drug or alcohol problems.

Family therapy

Family therapy helps families, couples or children communicate better with each other. It’s useful in managing conflict. 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 your relationships.

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 how you think about things
• behavioural therapy – which helps you cope with problems by changing how you behave

CBT helps you understand and change unhelpful thoughts and behaviours. The sessions are structured and often include practical exercises. You’ll probably be given some homework to do between sessions to practise these techniques. A course of CBT can last from six weeks to six months.

CBT can help with a variety of problems including:

• anxiety, including social anxiety
• depression
• phobias
• obsessive compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD)

You can also 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 a type of CBT that focuses on regulating your emotions, managing distress and using mindfulness. DBT was originally designed to help people with borderline personality disorder. But it’s also helpful in other situations involving strong emotions.

You’ll usually have regular sessions over a year to 18 months. This will be a mixture of individual and group sessions.

Interpersonal therapy

Interpersonal therapy (IPT) is a structured therapy. It can help to improve communication and resolve relationship issues.

IPT is often used for depression, including postnatal depression and grief-related depression. But it may also be helpful for a range of other problems including panic disorder, social anxiety and insomnia.

Psychodynamic therapy

Psychodynamic therapy helps you make connections between the past and the present. You and your therapist may talk about:

• what’s happening in your life at the moment
• what’s happened in your life in the past
• how your past experiences may be affecting how you think, feel and behave in the present
• your feelings towards yourself and others, especially your family and people you’re close to

This can help you make future decisions based on what’s good for you, rather than what your past experiences drive you to do.

Short-term psychodynamic therapy can be used to treat depression, social anxiety or medically unexplained symptoms such as chronic pain.

You’ll usually have 50-minute psychodynamic therapy meetings once a week but more often if you need them. How long you need to continue with psychodynamic therapy varies. You may need only a few weeks or months of therapy, but you may need longer if your problems are more complicated. Psychodynamic therapy is often one-to-one, but you can also attend group therapy. Group therapy usually lasts for around 90 minutes, and you go once or twice a week.

Cognitive analytic therapy

In cognitive analytic therapy (CAT), you’ll work with a therapist to look at how your early life experiences influence your current behaviour.

Your therapist uses written summaries and diagrams. At the end, they’ll give you a letter that summarises your therapy. They may ask you 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. These include:

• eating disorders
• anxiety
• depression
• personality disorder
• self-harm, including drug or alcohol dependency

You’ll usually have 8, 16 or 24 sessions of CAT.

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 talking with a therapist, in EMDR you’re asked to focus on distressing memories while making specific eye movements. This can reduce the emotional impact of those memories. This is similar to what happens when you sleep.

Accessing services

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

• your GP surgery or a GP referral if they agree it could be helpful
• a local NHS Improving Access to Psychological Therapies (IAPT) service, if you have one – this allows you to self-refer for NHS talking therapies online or by phone
• the local Child and Adolescent Mental Health Service (CAMHS) is for children and teenagers who are too young to use the IAPT service (under 16, 17 or 18 depending on where you live)
• your workplace – through an Employee Assistance Programme (EAP)
• your school, college or university
• a charity that offers counselling or similar support – for example, Mind for mental health, Cruse Bereavement Support for bereavement, and Relate for relationships
• your private health insurance
• self-referral to a qualified private therapist – websites allowing you to search for therapists in your area include:


• British Association for Counselling and Psychotherapists
• UK Council for Psychotherapy
• British Association for Behavioural & Cognitive Psychotherapies

Therapy may be in person, over the phone or online (through messaging or video sessions).

It’s very important to check that your therapist is registered with a recognised professional organisation. One way to do this is by searching for their name on the Professional Standards Authority register.