Counselling

Counselling is a type of talking therapy that allows a person to talk about their problems and feelings in a confidential and dependable environment.

A counsellor is trained to listen with empathy (by putting themselves in your shoes). They can help you deal with any negative thoughts and feelings you have.

Sometimes the term "counselling" is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right.

Other psychological therapies include psychotherapy, cognitive behavioural therapy (CBT), and relationship therapy, which could be between members of a family, a couple, or work colleagues.

Read more about other psychological therapies.

What is counselling used for?

Talking therapies such as counselling can be used to help with many different mental health conditions, including:

depression
anxiety
borderline personality disorder (BPD)
obsessive compulsive disorder (OCD)
post-traumatic stress disorder (PTSD)
long-term illnesses
eating disorders, such as anorexia and bulimia
drug misuse

How counselling can help

Counselling aims to help you deal with and overcome issues that are causing emotional pain or making you feel uncomfortable.

It can provide a safe and regular space for you to talk and explore difficult feelings. The counsellor is there to support you and respect your views. They won't usually give advice, but will help you find your own insights into and understanding of your problems.

Counselling can help you:

cope with a bereavement or relationship breakdown
cope with redundancy or work-related stress
explore issues such as sexual identity
deal with issues preventing you achieving your ambitions
deal with feelings of depression or sadness, and have a more positive outlook on life
deal with feelings of anxiety, helping you worry less about things
understand yourself and your problems better
feel more confident
develop a better understanding of other people's points of view

Counselling can often involve talking about difficult or painful feelings and, as you begin to face them, you may feel worse in some ways. However, with the help and support of your therapist, you should gradually start to feel better.

In most cases, it takes a number of sessions before the counselling starts to make a difference, and a regular commitment is required to make the best use of the therapy.

What to expect from counselling

During your counselling sessions, you'll be encouraged to express your feelings and emotions. By discussing your concerns with you, the counsellor can help you gain a better understanding of your feelings and thought processes, as well as identifying ways of finding your own solutions to problems.

It can be a great relief to share your worries and fears with someone who acknowledges your feelings and is able to help you reach a positive solution.

Counselling can take place:

face to face
individually or in a group
over the phone
by email
using a specialised computer programme

You may be offered counselling as a single session, as a short course of sessions over a few weeks or months, or as a longer course that lasts for several months or years.

Trusting your counsellor

A good counsellor will focus on you and listen without judging or criticising you. They may help you find out about how you could deal with your problems, but they shouldn't tell you what to do.

For counselling to be effective, you need to build a trusting and safe relationship with your counsellor. If you feel that you and your counsellor aren't getting on, or that you're not getting the most out of your sessions, you should discuss this with them, or you can look for another counsellor.

If you're seeing an NHS counsellor attached to your GP surgery, your GP may be able to arrange for you to see another NHS counsellor. Alternatively, you could pay to see a private counsellor. Many counsellors and counselling organisations offer a sliding scale of fees where the more sessions you have, the cheaper it becomes.

Who provides counselling?

As counselling involves talking about sensitive issues and revealing personal thoughts and feelings, your counsellor should be experienced and professionally qualified.

Different healthcare professionals may be trained in counselling or qualified to provide psychological therapies. These include:

counsellors – trained to provide counselling to help you cope better with your life and any issues you have
clinical and counselling psychologists – healthcare professionals who specialise in assessing and treating mental health conditions using evidence-based psychological therapies
psychiatrists – qualified medical doctors who've received further training in diagnosing and treating mental health conditions
psychotherapists – similar to counsellors, but they've usually received more extensive training; they're also often qualified applied psychologists or psychiatrists
cognitive behavioural psychotherapists – may come from a variety of professional backgrounds and have received training in cognitive behaviour therapy; they should be registered and accredited with the British Association for Behavioural & Cognitive Psychotherapies (BABCP)

Availability

In 2010 the government announced plans to make psychological therapies widely available on the NHS. This is because they've been shown to be effective treatments for common mental health conditions. The programme is called Improving Access to Psychological Therapies (IAPT).

As a result of the IAPT programme, evidence-based psychological therapies can now be accessed through:

GP surgeries
the workplace – most workplaces now offer access to a counselling service, sometimes in-house but more often through an Employee Assistance Scheme
universities, schools and colleges – UK universities and many further education colleges provide an in-house counselling service for their students; school-based counselling is universal in Wales and Northern Ireland, but provision is more patchy throughout the rest of the UK
some voluntary and charitable organisations

IAPT services offer a range of psychological therapies, including individual and group-based therapy. While a group may seem a bit intimidating at first, many people find that once they've overcome this worry, they really benefit from sharing and meeting with other people.

If you're referred for counselling or another psychological therapy through the NHS, it will be free of charge. However, your choice of the type of therapy may be limited. If you have a preference for the type of therapy you receive, or the time or location of your appointments, you may choose to look for a private therapist.

If you decide to pay to see a private therapist, make sure they're qualified and you feel comfortable with them. The cost of private counselling can vary considerably. Depending on where you live, a session can cost between £10 and £70. Some therapists may be willing to adjust their fees in accordance with your income.

Many private counsellors offer an initial free session and concessionary rates for students, job seekers and those on low wages. You should ask about charges and agree a price before starting a course of counselling.

Charities and voluntary organisations

Some charities and voluntary organisations also offer counselling. These organisations usually specialise in a particular area, such as couples counselling, bereavement, or family guidance.

Charities that may offer counselling include:

Cruse Bereavement Care – provides bereavement advice and support
Relate – offers relationship advice and counselling
Rape Crisis – for women and girls who've been raped or sexually abused
Victim Support – provides victims and witnesses of crime with help and support

You may also be able to access support groups through your local community, church, or social services.

Finding a qualified counsellor

Most reputable counsellors will be registered with a professional organisation that has been accredited by the Professional Standards Authority (PSA) (a government body), such as the British Association for Counselling and Psychotherapy (BACP) or The National Counselling Society.

Counselling and clinical psychologists must be registered with the Health & Care Professions Council (HCPC), and may also be chartered with The British Psychological Society (BPS). The British Association for Behavioural & Cognitive Psychotherapies (BABCP) maintains a list of accredited CBT practitioners.

Therapists registered with a professional association have met the PSA's high standards for governance, standard setting, education and training, information, management and complaints. They must also maintain high ethical and professional standards. This gives the public greater protection, and guarantees a minimum level of training and continuing professional development.

You can find a therapist near you by using the postcode search on the BACP website.

Attitudes to therapy

In 2014 the BACP carried out some research to find out more about people's attitudes towards counselling and psychotherapy. Some of the key findings included:

28% of people have consulted a counsellor or psychotherapist (up from 21% in 2010)
54% of respondents said that they, a family member, friend or work colleague have consulted a counsellor or psychotherapist
69% of people think the world would be a better place if people talked about their feelings more

Read more about the key findings of the BACP research (PDF, 134kb).