Talking therapies explained

The term 'talking therapy' covers all the psychological therapies that involve a person talking to a therapist about their problems.

For some problems and conditions, one type of talking therapy may be better than another. Different talking therapies also suit different people.

Below is a brief explanation of some common talking treatments and how they can help. Your GP or mental health worker can help you decide which one could be best for you.

Counselling

Counselling is probably the best-known talking therapy and the one most likely to be available on the NHS at your GP surgery.

Counselling on the NHS usually consists of 6 to 12 sessions, each an hour long. You talk in confidence to a counsellor, who helps you to think about your situation.

Counselling is ideal for people who are basically healthy, but need help coping with a current crisis, such as:

• anger
• relationship issues
• bereavement
• redundancy
• infertility
• the onset of a serious illness

Cognitive Behavioural Therapy (CBT)

The aim of CBT is to help you think more positively about life and free yourself from unhelpful patterns of behaviour.

In CBT, you set goals with your therapist and may carry out tasks between sessions. A course typically involves around 6 to 15 sessions, which last about an hour each.

Like counselling, CBT deals with current situations more than events in your past or childhood.

CBT has been shown to work for a variety of mental health problems. This doesnt mean it's better than other therapies, just that the evidence base is more robust for CBT at this time.​

In particular, CBT can help with:

• depression
• anxiety
• panic attacks
• phobias
• obsessive compulsive disorder (OCD)
• post-traumatic stress disorder (PTSD)
• some eating disorders, especially bulimia

CBT is available on the NHS for people with depression, anxiety and other mental health problems that it has been proven to help.

There are also self-help books and computer courses based on CBT to help you overcome common problems like depression.

Psychodynamic psychotherapy

Unlike counselling and CBT, psychodynamic psychotherapy involves talking more about how your past influences what happens in the present and the choices you make. It tends to last longer than CBT and counselling. Sessions are an hour long and can continue for a year or more.

There are different types of psychodynamic psychotherapy, but they all aim to help you understand more about yourself, improve your relationships and get more out of life. Psychodynamic psychotherapy can be especially useful for people with long-term or recurring problems to find the cause of their difficulties.

There's some evidence that psychodynamic psychotherapy can help depression and some eating disorders.

NHS psychodynamic psychotherapists normally work in a hospital or clinic, where you'll see them as an outpatient. Private psychodynamic psychotherapists often work from home.

Family therapy

In family therapy, a therapist (or pair of therapists) works with the whole family. The therapist explores their views and relationships to understand the problems the family is having. It helps family members communicate better with each other.

Sessions can last from 45 minutes to an hour-and-a-half, and usually take place several weeks apart.

You may be offered family therapy if the whole family is in difficulty. This may be because one member of the family has a serious problem that’s affecting the rest of the family. Family therapists deal with lots of different issues, including:

• child and adolescent behavioural problems
• mental health conditions, illness and disability in the family
• separation, divorce and step-family life
• domestic violence
• drug addiction or alcohol addiction

Relationship counselling

Relationship counselling, or couples therapy, can help when a relationship is in crisis (after an affair, for example). Both partners talk in confidence to a counsellor or therapist to explore what has gone wrong in the relationship and how to change things for the better. It can help couples learn more about each other's needs and communicate better.

Ideally, both partners should attend the weekly hour-long sessions, but they can still help if just one person attends.

Group therapy

In group therapy, up to around 12 people meet, together with a therapist. It’s a useful way for people who share a common problem to get support and advice from each other. It can help you realise you’re not alone in your experiences, which is itself beneficial.

Some people prefer to be part of a group or find that it suits them better than individual therapy.

Interpersonal therapy

This is a talking treatment that helps people with depression to identify and address problems in their relationships with family, partners and friends.

Behavioural activation

Behavioural activation is a talking therapy that encourages people to develop more positive behaviour, such as planning activities and doing constructive things that they would usually avoid doing.

Mindfulness-based therapies

Mindfulness-based therapies help you focus on your thoughts and feelings without becoming overwhelmed by them. They can be used to help treat depression, stress, anxiety and addiction.

Mindfulness-based stress reduction (MBSR) incorporates techniques such as meditation, gentle yoga and mind-body exercises to help people learn how to cope with stress.

Mindfulness-based cognitive therapy (MBCT) combines mindfulness techniques like meditation and breathing exercises with cognitive therapy. The National Institute for Health and Care Excellence (NICE) recommends MBCT to help people avoid repeated bouts of depression.

Read more about mindfulness.