Self-help guide
What is counselling and who might find it helpful?
Counselling (often referred to as therapy) provides a safe and confidential space for you to talk to a trained professional about your issues and concerns. Your counsellor can help you explore your thoughts, feelings, and behaviours so that you can develop a better understanding of yourself and others.
A counsellor should not give you their opinion, offer advice, or prescribe medication. Instead, they should endeavour to help you find your own solutions — whether that is making effective changes in your life or finding ways of coping with issues that you choose to bring to therapy.
Anyone can access counselling and potentially benefit from it. There is likely to be a charge for the service, which you should check upfront.
A reputable and experienced counsellor should be used to working with a range of different clients and be trained in using different techniques so that they can find an approach which suits you. You can find more about various different approaches on the Counselling Directory website.
Finding a counsellor
The title ‘counsellor’ or ‘therapist’ is not a protected title — anyone can advertise counselling or therapy services. However, trained and reputable counsellors will be registered with a professional body that is accredited by the Professional Standards Authority (PSA). Accreditation should indicate that the PSA is able to assure the public that any counsellor on their voluntary register meets certain criteria for training, continuous professional development, appropriate supervision of practice, and ethical working.
Avma recommends choosing a counsellor who is a registered member of a body accredited with the PSA. The PSA independently assesses organisations who register practitioners who are not regulated by law, working both within and outside the NHS. Any counsellor who is registered with an organisation who is a member of the PSA can be expected to meet standards of proficiency and ethical practice. Relevant organisations registered with PSA include:
- the Association of Child Psychotherapists (ACP),
- the Association of Christians in Counselling (ACC),
- the British Association for Counselling & Psychotherapy (BACP),
- the British Association of Play Therapists (BAPT),
- the British Psychoanalytic Council (BPC),
- the CBT Register UK, a joint register of all Association of Rational Emotive Behaviour Therapy (AREBT) and British Association for Behavioural and Cognitive Psychotherapies (BABCP) accredited members,
- COSCA (Counselling & Psychotherapy in Scotland),
- the Human Givens Institute (HGI),
- the National Counselling & Psychotherapy Society (NCPS),
- Play Therapy UK (PTUK), and
- the UK Council for Psychotherapy (UKCP).
All these professional bodies agree standards for education and set criteria for entry on to the register and for counsellors to stay on the register. Some set additional criteria that experienced counsellors can meet to demonstrate their range and length of experience.
Registered members must agree to comply with the terms and conditions of entry to register and to stay on it. These include committing to continuing professional development and working to an ethical framework, including having a complaints process in place and being appropriately registered to work with your data via the Information Commission (ICO). These bodies ensure that their registrants continue to meet the standards by asking them to commit to terms and conditions each year they renew their membership.
There are several directories online that can help you search for a counsellor in your area and consider what kind of counselling you prefer. Two examples are the Counselling Directory and the BACP database search.
Most counsellors can offer face-to-face sessions or online via a platform such as Zoom. We suggest you review the profiles of the possible counsellors and do not be afraid to contact them to ask further questions if you have them.
Many counsellors have experience of working with trauma, bereavement, loss or disability, but very few counsellors have extensive experience of working with people who have been harmed by healthcare. A good counsellor will want to learn about your experience and support you in working through it.
Who else can offer support?
Support may be offered by your local healthcare provider, who may have a bereavement or psychological wellbeing service. These services may include counsellors as well as psychologists. Alternatively, you may want to request support via your GP, who could refer you to the local NHS services. However, you may prefer independent support not connected to NHS services.
You may be able to access support via a charity that is focused on a particular issue and may provide counselling or other kinds of support. A list of these can be found at the end of this self-help guide.
If you are employed within an organisation that has an employee assistance programme, you may be able to access counselling free of charge or at a low cost through them. Similarly, your occupational health assessor (if you have one) may be able to help. These services are confidential — your line manager will not be notified that you are attending counselling and no information will be shared with them about your sessions.
What should I expect from counselling?
Most counselling takes place in planned, regular sessions which last for around 50 minutes or so each. How often you see your counsellor and how many appointments you have will depend on your individual circumstances and will be agreed between you and your counsellor.
During a session, your counsellor may take you through specific exercises designed to help with your problem, or you might have more general discussions about how you are feeling. What you talk about will vary depend on what you want help with and the counsellor’s approach.
Your counsellor should be impartial but understanding. They should listen to you without judgment and help you explore your thoughts and emotions. They may offer information, but they will not tell you what you should think or do.
What might you expect in the first session?
Most counsellors will begin by introducing themselves, establishing some boundaries for the sessions, and telling you a bit about the way they tend to work. They may ask you to talk about why you are there and what you would like to work on with them. You should feel free to ask your counsellor anything you want to know about how things will work in each session.
The cost of counselling
The cost of counselling varies. Counselling can be accessed free of charge via your NHS services. If you are unable to access counselling on the NHS, private counsellors will charge a fee which you will be responsible for. The cost of counselling varies and can typically range from £50 to £100 per session. The rate may depend on the area in which you live and the kind of counselling you want to access. With the advent of online sessions, you may have more flexibility in who you decide you would like to work with.