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Counselling and therapy

When we're struggling with our mental health, counselling and therapy can help us to process what’s going on in a safe environment. Find out what happens during counselling and therapy and how it can help you feel better.

What is counselling/therapy?

Counselling and therapy (sometimes called ‘psychotherapy’) are both types of talking therapy, which can be a source of support if you’re struggling with something.

As the name suggests, ‘talking therapy’ often involves talking about your feelings, thoughts and experiences. This can help you to make sense of what’s going on in your life, and give you a safe place where you can talk about difficult feelings, get things off your chest, and find ways of coping when things are difficult.

Counselling or therapy may be offered to you as a treatment for a specific mental health problem, but you don’t need to have a diagnosed mental health condition, or even a specific ‘problem’, to do talking therapy.

Counselling and therapy (sometimes called ‘psychotherapy’) are both types of talking therapy, which can be a source of support if you’re struggling with something.

As the name suggests, ‘talking therapy’ often involves talking about your feelings, thoughts and experiences. This can help you to make sense of what’s going on in your life, and give you a safe place where you can talk about difficult feelings, get things off your chest, and find ways of coping when things are difficult.

Counselling or therapy may be offered to you as a treatment for a specific mental health problem, but you don’t need to have a diagnosed mental health condition, or even a specific ‘problem’, to do talking therapy.

The first session was the scariest, I had so many questions racing through my mind: would I get along with my therapist? Could she really talk to me without judgement? Am I in control of the session? The answer to all of these was yes! The first step into therapy is often the hardest but, for me, it was the most rewarding.
Eleanor, 18

How can therapy or counselling help me?

Different people may find therapy or counselling helps them in different ways – it’s important to remember that everyone’s experience is different. Sometimes it can be helpful just to talk to somebody confidentially and without judgement. This can help us feel less alone, or it may just be a relief to talk about what we’re going through with someone who will listen.

You might find it scary or hard to reach out for support from the people around you, like your family or friends. They might not understand immediately, or they might react in a way that feels unhelpful for you. If this is the case, you might find it more helpful to speak to a therapist or counsellor.

For some of us, talking therapy can be a really helpful way to understand our problems better, which can help us change how we deal with difficult situations and other people so that we manage these things in a more positive and helpful way.

Therapy and counselling can also help us find practical solutions to the problems we are facing - for example, how to manage anxiety.

Everyday life is so hectic and fast-paced that we could all do with a weekly space where we stop and reflect on how we are doing, really.
Therapists answer your questions about therapy

Concerns about getting professional help

It’s normal to have some concerns about whether professional support is right for you. You might be worried about being discriminated against, particularly if this hasn’t happened to you before. Or you might be worried your therapist or counsellor won’t understand part of your identity. 

There are lots of reasons you might be nervous or uneasy about getting professional help. Here are just some examples:

  • being judged
  • being misunderstood
  • having to explain or justify your beliefs
  • having to explain or justify your culture
  • getting advice that isn’t relevant to you
  • being told your way of life isn’t right
  • feeling like you can’t be completely open or that you have to hide details about your life
  • feeling worse as a result

If you’re not able to see someone else, that doesn’t mean the therapy or counselling won’t work. You won’t know if something is going to work for you until you give it a try. However, if your therapist or counsellor ever makes you feel unsafe, it’s important to say something – see our section on what to do if you’re unhappy with your therapist or counsellor below.

If private counselling and therapy is an affordable option for you, you’ll have more choice on who you get support from. We have more information on this further down the page.

The right support for you

It is important to remember that NHS mental health professionals are trained to be non-judgemental and open-minded. But every individual therapist or counsellor is different.

Some will make you feel comfortable and understood, and some will share your background, or have lots of experience working with young people who are a lot like you. But others might not be able to help you for different reasons, such as not having the level of awareness, skill or ability to relate to you and understand you in the way that you need.

Unfortunately, you don’t always get much choice when seeking a counsellor or therapist through the NHS, but if you think you’d find it easier to talk to someone from your background, it’s worth asking your GP or the person in charge of your care.

At the time I was told to keep therapy a secret, but now I am proud to say I have been in therapy for the last eight years. This is where I started to learn who I really was, where my issues were and not necessarily how to get rid of them, but how to cope with them and embrace them.
Danny

What happens during therapy or counselling sessions?

In your first session or ‘consultation’, you will discuss what you can expect from the sessions. Your counsellor or therapist will explain practical details like how many sessions you have, or what to do if you can’t attend a session. This is a good opportunity to ask any questions you have - for example, you might want to know more about the type of therapy or counselling they practise, how they can help you, or you might want to hear more about confidentiality (whether they will tell anyone else what you tell them).

After the first session, you will normally see your therapist or counsellor once a week, although they may suggest you see them more often if they think it is necessary.

What you discuss will depend on what you’re struggling with and the type of therapy or counselling you are doing.

It might feel scary or difficult, but it’s important to try and be as honest with your therapist or counsellor as possible so they can help you in the best way. But, if there is anything you don’t feel comfortable talking about, that’s okay – just let them know. This is your therapy, so it is important it feels right for you.

A young Black woman in a wheelchair talking to an older Black woman on a bench in the park.

Difficult feelings during and after sessions

You may find that doing therapy or counselling brings up some difficult emotions for you. This does not mean that you are doing it ‘wrong’. In fact, it is often a sign you are dealing with important problems. However, if you are feeling overwhelmed by your emotions during a session, it’s okay to let your therapist or counsellor know and take a break if you need to. Together you can think about what might help make it easier, or what you can do after a session to look after yourself.

Some people also find that they feel physically drained after sessions too. For this reason, it can be a good idea to make sure you have some time after your sessions to relax and do some self-care.

It’s important to remember that there is no ‘right’ way to experience talking therapy or counselling. However, you deserve to be treated fairly, and your therapist or counsellor should make you feel safe and comfortable to open up and talk about difficult feelings, without judgement.

If a part of your identity – for example, your gender, sexuality, race, faith, physical health – feels important for you to talk about, it’s okay if you want to talk about them with a therapist or counsellor that shares this element of your identity. Some young people have told us that it has really helped them to find a therapist or counsellor from the same cultural background as them, for example. For more information on this, see our section on ‘How to access therapy’.

You might also feel conflicted about seeing a therapist or counsellor if it’s something that people close to you, such as your family, friends or your community, don’t agree with or understand. Although this can be hard, you should never feel guilty or ashamed for looking after your mental health by reaching out for professional help. It’s important to tell your therapist or counsellor if you feel this way so that they can support you.

If you’re worried that your sessions are not working for you, talk to your therapist or counsellor. It is their job to listen to this and talk it through with you so that they have a better idea of how to support you in future.

  • I know that it is daunting to open up to somebody who you do not know, but trust me you will feel the benefits if you put the work in.
    Laura
  • Creative therapy has helped challenge my perfectionism and the high expectations that I put on myself, and instead has helped me to stop judging my art, or other creative expressions of my emotions.
    Elsie
  • Therapy helped me to gain a better understanding about how I was feeling and it allowed me to learn how to cope with my emotions without getting overwhelmed by them.
    Laura
  • A counsellor won’t push you to talk about something that makes you feel uncomfortable - you only have to talk about things that YOU want to talk about. And just as you can do in a regular situation, you can say you’re uncomfortable with the topic and move on.
    Caitlin

Real stories about counselling and therapy

Common types of talking therapy

There are several types of talking therapy that you might be offered. A doctor or psychiatrist might suggest what they think is best for you, but it is important you feel comfortable with the therapy you choose.

CBT is a type of talking therapy used to help you understand how you think about things and to change any behaviours that aren’t helping you. It is normally very practical, and your therapist may ask you to put into practice what you discuss in your sessions. You might then report back to your therapist about how you found it . The aim is to help you apply the skills you’re learning in your daily life to help you manage your problems.

A course of CBT normally lasts between 12 and 20 sessions.

Studies show that CBT works for a variety of mental health problems, including:

DBT is similar to CBT in that it is about helping you understand your feelings and change unhelpful behaviour, but it also helps you learn to accept yourself. DBT is done for a bit longer than CBT – normally around six months. It also often involves working with groups.

The focus is to identify unhelpful behaviours, understand why you might have developed them, and learn new coping strategies that are more helpful in the long term.

DBT is most often recommended for people with borderline personality disorder (BPD), but it can be helpful for anybody who feels emotions very intensely.

IPT focuses on helping you address problems in your relationships with important people in your life. It is normally suggested for people struggling with depression who have already tried other types of treatment. The theory behind IPT is that having poor relationships in your life can cause you to feel depressed.

In IPT sessions, you will explore relationships you have, what difficulties you have in these relationships, and try to find solutions.

A course of IPT normally lasts between 12 and 16 sessions.

EMDR is used to help people process distressing memories and reduce their emotional impact. It is a relatively new form of therapy, but it is increasingly being used to help people with post-traumatic stress disorder (PTSD).

Dealing with or talking about trauma can be very difficult and distressing. EDMR involves doing repetitive side-to-side eye movements while you explore a trauma. We don’t fully understand how this works yet, but there is evidence to suggest that it does, and many people find it helpful.

A course of EMDR normally lasts between eight and 12 sessions.

Creative therapies like art, music or drama therapy can be used to help people express difficult feelings. These types of therapy are often done in groups, but can be done individually. Normally in creative therapy sessions, you will use a form of expression like art or music to explore your feelings, then discuss the outcomes.

Take a look at Elsie's blog to find out more about creative therapy.

How creative therapy has helped me

There are many other types of talking therapy available to you. If you are unsure or have questions, you can ask your GP. The important thing is to find the therapy that works for you.

Being introduced to CBT practices has helped me develop some new coping techniques, and I feel better prepared to cope with shifts in my mental health.
Natasha

How to access therapy

If you think you would like to try counselling or therapy, a good place to start is by talking to your GP. They can let you know what services are available in your area and how to access them. You can also tell your GP if you want a particular service, such as wanting to speak to someone from the same race, ethnicity, gender or religion. Unfortunately, it might not always be possible, but your needs are valid and it’s okay to ask for what you think will help you best.

Have a look at our page on how to speak to your GP about mental health for more information and tips.

If you are 18 and over and live in England, you can also refer yourself for psychological therapies on the NHS without a doctor. For more information about what services are available in your area and how to self-refer, look on the NHS website.

If you are under 18, you can access psychological therapies on the NHS through Child and Adolescent Mental Health Services (CAMHS). For more information about CAMHS and how to access their services, have a look at our CAMHS page.

You can also get counselling or therapy privately if you are able to pay. The cost will depend on who you see, what type of counselling or therapy they offer and where they are based. Many therapists or counsellors offer a free session to begin with, so it can be a good idea to meet with a few different therapists to see who feels right for you before you start paying. Some counsellors and therapists also have reduced prices for students, people who are unemployed or people on low wages. If you are seeking therapy or counselling privately, it’s important to confirm the cost before you begin.

You can search for therapists or counsellors that work specifically with young people, or search by therapists who work on specific conditions or problems. You can also have a say in who you receive support from, which can be helpful if you’d prefer to speak to someone who can relate to particular aspects of your identity, such as your race, ethnicity, religion or gender.

It is also very important to make sure any therapist or counsellor you speak to is fully qualified, so that you are getting support that is helpful and safe. There are a few websites you can use to find qualified therapists who are registered with a professional body, such as:

Many schools and universities offer free counselling or other forms of talking therapy.

If you are a student, it is a good idea to talk to whoever is in charge of student welfare at your school, college or university. You can also talk to a teacher that you feel comfortable with, and they can help find out what is available at your school.

  • Write things down beforehand, in case you get flustered and forget what you need to say. It’s not as bad as your brain is telling you it will be.
  • It is okay to not know what to say. A counsellor is there to support you so they will know that you are anxious.

Will my therapist/counsellor tell anyone what I say?

Anything you say in counselling and talking therapy sessions is confidential. But, your therapist or counsellor may have to tell someone if they think you or someone else might not be safe. Usually they will try to let you know first.

They may also discuss what you tell them with a supervisor (the person who helps them think about how they can best support you), but this is only to ensure you get the best treatment possible, and their supervisor also has to keep your information private and confidential.

If you are doing group therapy, the therapist leading the sessions should discuss confidentiality with the group before you begin.

  • I didn’t think that group therapy would be for me, but I’ve definitely been pleasantly surprised by how useful I found it.
    Amrit
  • It’s important to remember that your counsellor is working in your best interest, even if you may doubt that at times.
    Caitlin

What to do if you're not happy with your therapist/counsellor

Remember that therapy and counselling has to work for you. It can take time to build trust when receiving support and some sessions may bring up difficult emotions. The important thing is that you find someone you feel able to talk openly with.

If your therapist or counsellor makes you feel uncomfortable, it might help to speak to them about how you are feeling. It is their job to understand how they can offer you the best service. There may be limitations in their knowledge and understanding - such as with culture and faith - that they need to address. It’s not your responsibility to educate them on these subjects.

If you don’t feel comfortable talking to your therapist or counsellor, you can speak to your GP or CAMHS team. They can help you with the problem or arrange a different therapist or counsellor. However, if your therapist or counsellor makes you feel unsafe or stressed, it’s important to stop seeing them and speak to someone you trust, your GP or your CAMHS team.

Every mental health professional has a duty of care to provide you with the best support they can. If you feel you have been treated unfairly by a counsellor or therapist, or any member of NHS staff, you are entitled to make a complaint. To make a complaint about treatment in the NHS, follow these steps:

  1. If you're unhappy with how your treatment is going but you don't want to make a formal complaint, speak to the clinician treating you, or contact your local PALS (patient advice liaison service) at your hospital for confidential advice and support.
  2. Check the complaints process. Every NHS organisation has its own process, but they must all follow the same NHS rules. If you can't see the complaints process online, call or email the complaints department.
  3. Find out who to complain to. It will either be the service you used, or the commissioning group who paid for the service. The gov.uk website can help you find out where to send your complaint.
  4. Send your complaint verbally, in writing, or by email and wait for a response. Your complaint should be acknowledged within three days, with details of what happens next.
  5. If you need help with making a complaint, you can contact your local NHS Complaints Advocacy Service. This is a free and confidential service, independent from the NHS. Contact your local council to find out who the advocacy provider is in your area.
  6. Need to take it further? If you're not happy with the results of your complaint, you can contact the Parliamentary and Health Service Ombudsman.

If none of this works, you can write to your MP who can complain on your behalf.

You deserve the best treatment possible for you, so if something isn’t working, please don’t worry about speaking out! People want to provide the best support for you and so letting them know what isn’t working is important for you and them.

More information and support

Get help now

  • Samaritans

    Whatever you're going through, you can contact the Samaritans for support. N.B. This is a listening service and does not offer advice or intervention.

    Opening times:
    24/7
    Samaritans

  • Childline

    If you’re under 19 you can confidentially call, chat online or email about any problem big or small.

    Sign up for a free Childline locker (real name or email address not needed) to use their free 1-2-1 counsellor chat and email support service.

    Can provide a BSL interpreter if you are deaf or hearing-impaired.

    Hosts online message boards where you can share your experiences, have fun and get support from other young people in similar situations.

    Opening times:
    24/7
    Childline

  • Muslim Youth Helpline

    Provides faith and culturally sensitive support for young Muslims. 

    Online chat service available during opening hours.

    Opening times:
    4pm - 10pm, 365 days a year
    Muslim Youth Helpline

  • Youth Access

    Provides information about local counselling and advice services for young people aged 11-25.

    Put in your location and what you need help with into their 'Find help' search, and see what services are available in your area.

    Youth Access

  • Mind

    Offers advocacy services, as well as information and signposting on mental health difficulties, via the Mind Infoline.

    Also hosts Side by Side, an online community for those aged 18 and over to connect with others who are going through, or have been through, similar experiences.

    Opening times:
    9am - 6pm, Monday to Friday (except for bank holidays)
    Mind

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