Counselling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues.
Sometimes the term "counselling" is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right.
Other psychological therapies include psychotherapy, cognitive behavioural therapy (CBT), and relationship therapy, which could be between members of a family, a couple, or work colleagues.
What can counselling help with?
Counselling can help you cope with:
- a mental health condition, such as depression, anxiety or an eating disorder
- an upsetting physical health condition, such as infertility
- a difficult life event, such as a bereavement, a relationship breakdown or work-related stress
- difficult emotions – for example, low self-esteem or anger
- other issues, such as sexual identity
What to expect from counselling
At your appointment, you'll be encouraged to talk about your feelings and emotions with a trained therapist, who'll listen and support you without judging or criticising.
The therapist can help you gain a better understanding of your feelings and thought processes, and find your own solutions to problems. But they will not usually give advice or tell you what to do.
Counselling can take place:
- face to face
- in a group
- over the phone
- by email
Find out more information on Mental Health and Wellbeing.
You may be offered a single session of counselling, a short course of sessions over a few weeks or months, or a longer course that lasts for several months or years.
It can take a number of sessions before you start to see progress, but you should gradually start to feel better with the help and support of your therapist.
People across Wales can now access free online therapy without needing to go through their GP. People aged 16 and over experiencing mild to moderate anxiety, depression or stress can sign-up for a 12-week course of SilverCloud online therapy via their smartphone, tablet, laptop or desktop computer.
Private counselling
If you decide to pay to see a private therapist, make sure they're qualified and you feel comfortable with them.
The cost of private counselling can vary depending on where you live, with a session costing anywhere between £10 and £70.
Many private therapists offer an initial free session and lower rates for students, job seekers and those on low wages.
You should ask about charges and agree a price before starting a course of counselling.
Charities and voluntary organisations
Some charities and voluntary organisations also offer counselling. These organisations usually specialise in a particular area, such as couples counselling, bereavement, or family guidance.
Charities that may offer counselling include:
- Cruse Bereavement Care – provides bereavement advice and support
- Relate – offers relationship advice and counselling
- Rape Crisis – for women and girls who've been raped or sexually abused
- Victim Support – provides victims and witnesses of crime with help and support
You may also be able to access support groups through your local community, church, or social services.
Finding a qualified counsellor
As counselling involves talking about sensitive issues and revealing personal thoughts and feelings, your counsellor should be experienced and professionally qualified.
Most reputable counsellors will be registered with a professional organisation that has been accredited by the Professional Standards Authority (PSA) (a government body), such as the British Association for Counselling and Psychotherapy (BACP) or The National Counselling Society.
Counselling and clinical psychologists must be registered with the Health & Care Professions Council (HCPC), and may also be chartered with The British Psychological Society (BPS). The British Association for Behavioural & Cognitive Psychotherapies (BABCP) maintains a list of accredited CBT practitioners.
Therapists registered with a professional association have met the PSA's high standards for governance, standard setting, education and training, information, management and complaints. They must also maintain high ethical and professional standards. This gives the public greater protection, and guarantees a minimum level of training and continuing professional development.
You can find a therapist near you by using the postcode search on the BACP website.
Other psychological therapies
As well as counselling, there are many other types of psychological therapies, including psychotherapy and cognitive behavioural therapy (CBT).
Psychotherapy
Like counselling, the term "psychotherapy" is sometimes used to refer to talking therapies in general. However, psychotherapy is also a specific type of therapy. It may also be described as psychoanalytic or psychodynamic.
Psychotherapy is a more in-depth form of therapy than counselling, and it can be used to address a wider range of issues.
A psychotherapist can help you explore your thoughts, feelings and beliefs, which may involve discussing past events, such as those from your childhood.
They'll help you consider how your personality and life experiences influence your current thoughts, feelings, relationships, and behaviour. This understanding should enable you to deal with difficult situations more effectively.
Depending on your problem, psychotherapy can be short or long term. Adults, young people and children can all benefit from psychotherapy. Sessions can take place on a one-to-one basis, in couples, families, or in groups whose members share similar problems.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking therapy that helps you understand the links between thoughts, feelings and behaviour. This allows you to manage your problems by helping you change the way you think and behave.
CBT doesn't remove your problems, but helps you manage them in a more effective way. It encourages you to examine how your actions and thoughts can affect how you feel.
It's based on the idea that the way you think about a situation affects how you feel and act. In turn, your actions influence the way you think and feel. It's therefore necessary to change both thinking (cognition) and action (behaviour) at the same time.
CBT is an active therapy, and you'll be expected to work on your problems between sessions, trying out different ways of thinking and acting, as agreed with your therapist. The aim is for you to develop the skills to become your own therapist.
CBT is usually a short-term treatment. For example, a course may consist of between 6 and 24 one-hour sessions.
The National Institute for Health and Care Excellence (NICE) recommends the use of CBT for:
CBT is widely available on the NHS for treating depression. If you feel CBT may be helpful, you should first discuss it with your GP.
Private therapists are also available. Before starting CBT with a private therapist, you should check the therapist is accredited by the British Association for Behavioural & Cognitive Psychotherapies (BABCP).
Computerised CBT (CCBT) packages are also available. CCBT is delivered in a series of weekly sessions and should be supported by a healthcare professional. NICE recommends CCBT for some people with depression.
Humanistic therapy
Humanistic therapy incorporates your body, mind, emotions, behaviour, and spirituality. It encourages you to think about your thoughts and feelings, and take responsibility for your actions.
A humanistic approach provides a distinct method of counselling and focuses predominantly on an individual's unique personal potential to explore creativity, growth, love, and psychological understanding.
Group therapy
Group therapy aims to help you find solutions to your problems by discussing them in a group setting. Sessions are led by a facilitator who directs the flow of conversation.
As well as group therapy, many people find psychoeducational groups or courses very helpful. These provide information and skills without having to discuss personal problems in-depth.
NICE recommends group therapy for people with obsessive compulsive disorder (OCD), and for children and young people with mild depression.
Many people are initially anxious about attending a group, but find they benefit from meeting people who share the same experiences and work together to overcome them.
Relationship therapy
Relationship therapy is where people who are having relationship difficulties work with a therapist to resolve their problems. It can be used to help couples, family members, or work colleagues.
NICE recommends relationship therapy for people who've tried individual therapy without success.
Family therapy can be used for children with depression, or where a family member has a mental health condition, such as anorexia or schizophrenia.
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. Techniques such as yoga, meditation and breathing exercises can also be incorporated.
NICE recommends mindfulness-based therapies to help people avoid repeated bouts of depression.
Eye movement desensitisation and reprocessing (EMDR)
Eye movement desensitisation and reprocessing (EMDR) is a treatment that uses eye movements to stimulate the brain. It's been shown to make distressing memories feel less intense.
EMDR can help a person deal with traumatic memories, such as those that occur after an accident, or after sexual, physical, or emotional abuse.
In particular, NICE recommends EMDR for treating post-traumatic stress disorder (PTSD).
Telephone counselling
Samaritans provides a confidential listening service for people who would like to talk about whatever is troubling them. Everything is off the record and without judgement.
The Community Advice and Listening Line - CALL is a Wales wide mental health telephone helpline service providing emotional support over the phone. They can be contacted on 0800 132737.