Counselling and psychotherapy

Counselling and psychotherapy are talking therapies. You meet a trained professional who listens without judging, helps you make sense of what you're going through, and supports you to find your own way forward. Counsellors and psychotherapists in the UK are self-regulated through registers accredited by the Professional Standards Authority, each with a public search, so choosing one with confidence is quick and easy.

What happens in a first session

A first session is mostly about getting to know each other. Your counsellor will ask what's brought you, what you'd like to be different, and anything that's important for them to know. They'll explain how they work, how confidentiality works, and how long and how often you'll meet.

Sessions usually last 50 to 60 minutes and can be in a room together, by video or by phone. Some counsellors also work with couples, families or groups.

A counsellor doesn't usually tell you what to do. They listen closely, help you see things from new angles and support you as you work out what's right for you. Feeling at ease with them matters, so it's fine to have a first chat with more than one before you decide.

Counselling or psychotherapy?

The two overlap a great deal and many practitioners offer both. Counselling is often shorter and focused on something happening now, such as a loss, a change or a difficult patch. Psychotherapy often goes deeper and longer, looking at patterns that have built up over time.

There are many approaches, for example person-centred, integrative, psychodynamic, CBT (cognitive behavioural therapy) and human givens. Your counsellor will explain theirs, and many blend more than one.

What people come for

People most often see a counsellor or psychotherapist for:

• Stress and worry
• Low mood
• Bereavement and loss
• Relationships and family
• Work pressure and burnout
• Confidence and self-esteem
• Anger
• Big life changes
• Past experiences that still weigh on you

Recognised in NHS guidance. NICE, which advises the NHS, lists counselling among the treatment options people can talk through and choose from for a new episode of depression, alongside options such as CBT, behavioural activation and interpersonal psychotherapy. Your counsellor will talk you through how they can help with what you'd like to work on.

Alongside the rest of your care

Counselling sits comfortably alongside the rest of your care. If you're taking medicine for your mental health, or have symptoms that haven't been looked at yet, it's worth seeing your GP as well. Many counsellors work alongside GPs and will ask about this at your first session.

NHS Talking Therapies is another good route in England. You can refer yourself, without going through your GP, if you're 18 or over (16 or over in some areas). The service offers counselling and other talking therapies for anxiety and depression, and the NHS usually offers between 8 and 16 sessions. Some people use NHS Talking Therapies, some choose a private counsellor for more choice over who they see and when, and some do both at different times.

If you or someone you know ever needs urgent help, the NHS website explains where to get it, and in an emergency call 999.

How many sessions, and what it costs

It depends on what you're working on. Some people find six to twelve sessions is enough; others prefer to keep going for longer. Most counsellors meet weekly, at the same time each week, and review with you how things are going.

Most private counsellors charge somewhere between about £40 and £80 a session, depending on where they are, their experience and the type of therapy. Longer-term psychotherapy and couples work often cost a little more. Many offer a free first chat, and some keep a few lower-cost places for people on lower incomes.

Professional registers

Counsellor and psychotherapist are self-regulated titles. The profession has its own registers, accredited by the Professional Standards Authority (PSA), the body that oversees the UK's health regulators. Each register sets training standards, has a code of ethics and a complaints process, and has a public search. The NHS suggests choosing a private counsellor who is on a PSA-accredited register.

• BACP (British Association for Counselling and Psychotherapy), the largest, for counsellors and psychotherapists across the UK.
• UKCP (UK Council for Psychotherapy), for psychotherapists and psychotherapeutic counsellors.
• NCPS (National Counselling and Psychotherapy Society).
• BPC (British Psychoanalytic Council), for psychoanalytic and psychodynamic therapists.
• HGI (Human Givens Institute), for human givens therapists.
• ACC (Association of Christians in Counselling and Linked Professions).
• COSCA (Counselling and Psychotherapy in Scotland).

Letters such as MBACP, MBACP (Accred) or MNCPS (Acc.) show which body someone belongs to and their level of membership.

Psychologists. Titles such as counselling psychologist and clinical psychologist are protected by law. Everyone using them must be registered with the Health and Care Professions Council (HCPC), which has its own online register.

Choosing your counsellor

Counsellors are happy to talk about how they work. Good things to ask at a first chat:

1. Which register are you on?
2. What is your training, and which approach do you use?
3. Have you worked with people going through something like this before?
4. How often would we meet, and for how long?
5. What do you charge, and do you offer a free first chat?
6. Do you work in person, online or by phone?

Most of all, notice whether you feel comfortable with them. That sense of fit is one of the most important parts of counselling.

Want to look someone up? Check a practitioner's registration → every regulator and register in one place, with links to their public searches.

Common questions