Private therapy… where to begin?

Therapy sessions can be available for free through the NHS.  You can visit your GP for a referral or self-refer through your local IAPT (Improving Access to Psychological Therapies) website.  Currently, best practice is for treatment to begin 6-18 weeks after referral.  In most cases, the therapy offered will be Cognitive Behavioural Therapy (CBT) and you will usually have 6 to 10 sessions. 

If you are able to explore private therapy, you would have more flexibility around practitioners, location, length of treatment and start date… but where do you begin?

How do I choose a private therapist?

First and foremost, you should choose a counsellor or psychotherapist who is registered with a professional body.  The term ‘therapist’ is not regulated, so anyone can use it, regardless of their qualifications.

The British Association of Counsellors and Psychotherapists (BACP) and the UK Council for Psychotherapy (UKCP) are a great place to start.  Both professional bodies have a searchable directory of therapists who are registered with them, having reached the required level of qualifications and training.  Therapists must work within their Ethical Framework and are committed to ongoing professional development.



What is the process of beginning therapy?

Once you have found a therapist that you would like to work with, you can contact them directly if you have their details or via their directory listing.  You can usually expect a prompt response, within their working hours. 

The therapist may ask you if you would like to arrange a telephone call so that you can introduce yourselves and decide from this initial conversation whether you would like to book an appointment for a full consultation.  Most therapists will charge their standard rate for a consultation meeting in person.  At this meeting, they will discuss their terms and conditions and let you know how they work, how they bill and what their cancellation and holiday policy is.  You can use this meeting to ask any questions that you may have to ensure that you are comfortable before committing to beginning your therapy. 

You will also be asked to share some information about why you have decided to explore counselling, and whether you decide to proceed with this therapist or not, this information will be confidential.  If the therapist thinks that their type of therapy does not suit what you are looking for, they may signpost you elsewhere and make an alternative recommendation.

How long are the sessions?

Most therapists work in 50-minute sessions. These are usually held at the same time each week, but a routine that works for you can be discussed in your initial consultation.

How does confidentiality work?

Everything that you discuss together will be confidential and will not be shared.  There are only two exceptions to this, which your therapist should discuss with you. 

  • If they are concerned that you, or someone else, is at serious risk of harm, they may need to seek additional support from your GP or other healthcare professional.
  • Therapists are required to have supervision where they can discuss issues that arise through their work with a qualified supervisor.  This ensures you are being treated appropriately and the therapist is taking care of their own mental health.  Supervisors are under the same duty of confidentiality as your therapist.

How does online counselling work?

Since the Covid-19 pandemic, many therapists offer online counselling as an option, and some work exclusively online.  Some clients prefer face-to-face work, but the ability to meet online makes therapy more accessible for others.  It may also be possible to do a combination of both if occasional online appointments make it easier to attend regularly.  Your therapist should always provide the same level of privacy and care that they would in a face-to-face appointment.  My top tip would be to switch off ‘self-view’ mode.  Watching yourself in a therapy session is distracting and can really get in the way of the work.  You should expect your therapist to host the call, email you the link to join and never record the session, unless this is something that you have discussed.

How many sessions will I need?

There is no simple answer as no two therapy journeys are the same.  It may take 6-8 sessions to establish a therapeutic relationship and begin to explore the presenting issue in some depth, but it depends on the issue and type of therapy you are exploring.  If your budget is limited, discuss this with your therapist at the beginning so they know that the work could be short term as their approach may be different and it will avoid a sudden end to the work.  If you are working long term, it is a good idea to review at regular intervals too.

How much will it cost?

There is no straight forward answer to this.  Your therapist will discuss their rate with you at the beginning so you will be able to figure this out before you start.  It is possible to find lower cost therapy options by working with newly qualified therapists or students.  If the student is training on a course that is accredited by the BACP or UKCP they will have passed assessments to be fit to practice and will be receiving a high level of clinical supervision, so do not be put off by their student status.  Some therapists will offer a concessionary rate for certain industries or age groups, so it is always worth asking.  There may also be a charity that offers free or discounted rates based on either the presenting issue or the client demographic, such as young carers, victims of sexual assault, LGBTQ+ clients, cancer patients and their families.  An internet search will lead you to the relevant service or charity page, where you may also find a wealth of other information that could be helpful.

If you begin therapy and feel strongly that the therapist you have chosen is not the right fit for you, please discuss this with them.  This process should be transformational for you and is a huge commitment on your time and finances, so you need to be comfortable with it.  You will go through periods where it is difficult, and this is where the real work is happening, but you should still feel that you are in the right place to do that work, with a therapist who you can connect with.


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