Talking therapies or psychological therapies involve someone talking about his or her problems to a trained therapist. Talking therapies can be used alongside other treatments, for example medication.
Talking therapies seem to be more effective in treating some mental health problems than others, for example depression, anxiety and stress disorders. They also seem to be most effective when the person doing the talking and the person doing the listening establish a good relationship with each other. If you are the person doing the talking your own attitude is also important. If you are determined to make it work and you are completely honest with yourself the treatment is more likely to work.
Some talking therapies, such as counselling, may be offered through a variety of agencies including GP surgeries. Other talking therapies are usually only offered by appropriate professionals, for example psychodynamic psychotherapy is usually only offered by psychotherapists. Many talking therapies are not currently available via the NHS but an increasing number of practitioners are now offering online services.
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There are many psychological therapies each with its own adherents and practitioners. What follows is a list of some of the therapies currently in use.
Behavioural therapy
People are encouraged to learn new ways of behaving through gradual changes and exposure to feared situations. They are often asked to keep diaries to record their activities and to monitor their progress. It is particularly useful in the treatment of phobias and anxiety.
Cognitive therapy or cognitive behavioural therapy
Based on the fact that the way we feel is partly dependent on the way we think about events (cognition). It also stresses the importance of behaving in ways which challenge negative thoughts – for example being active to challenge feelings of hopelessness. Although it may sound like common sense, CBT is more than just positive thinking. Research suggests that it can be effective for people with both severe and moderate depression.
Computerised Cognitive Behavioural Therapy (CCBT)
A treatment based on CBT where the client works through a computer programme that aims to help them understand their problems and develop coping skills. CCBT can be used on its own or with a therapist and forms a treatment option alongside more established treatments. A course of CCBT usually lasts for 6 to 8 weeks.
Counselling
Involves the client talking about their difficulties with a counsellor, who plays a supportive role, and may sometimes provide practical advice on problem-solving. Counselling is offered by various agencies including via the NHS and non-statutory organisations such as the Samaritans.
Family and relationship counselling
In some instances, it is useful for couples or families to work together in a therapeutic setting to resolve their difficulties. The therapist encourages dialogue counselling between the participants, in order to improve communication between them. This technique is also useful because it helps the therapist to understand each person’s difficulties within the context of the group.
Group therapy
People who share a common problem (e.g. substance abuse or self harm) may be invited to participate in group therapy, using one or more of the therapeutic styles mentioned above in a group setting. Often people who participate in this therapy appreciate the support of others within the group who have actually experienced, or are experiencing, similar difficulties; it may help them to recognise that they are not alone in their experiences, and to discover new ways of coping with their distress. Carers may also benefit from this therapeutic setting.
Psychoanalysis
Intensive, long-term treatment which encourages the individual to ‘free associate’ (i.e. to explore whatever comes to mind and make links with events or feelings from earlier in life). It is not usually available within the NHS.
Psychoanalytic or psychodynamic psychotherapy
Similar to psychoanalysis except that the discussion concentrates on specific problems rather than ‘free association’. May be helpful with neurotic and personality types of problems, including childhood abuse. Not widely available within the NHS.
Psychotherapy
Sometimes used to describe all forms of talking therapies. Also used to describe talking therapies which are based on psychodynamic theory and practice.
Re-Evaluation Counselling
The process of ‘discharging’ painful emotion with the aid of a partner, usually indicated by the presence of tears, trembling or shaking, reluctant or eager talk, laughter, storming and raging, or yawning.
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If you are receiving treatment under the NHS you may not have a choice of therapist. However, if you are paying for your own treatment you should ask some key questions.
The most important questions to ask when choosing a counsellor or psychotherapist are:
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Do they have a recognised qualification?
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What other training have they done?
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Are they a member of a professional body with insurance, a complaints procedure and a code of practice they could give you?
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What approach do they use? Will I feel comfortable with it?
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How experienced are they?
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Can I develop a good relationship with them?
Registers of accredited practitioners:
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Written in 2000
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