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Psychotherapy
What is psychotherapy?
Why might I seek psychotherapy?
How does it work?
How can it help me?
Myths about psychotherapy
Which form of psychotherapy should I choose?
Psychoanalysis
Psychosynthesis
Psychodynamic psychotherapy
Behavioural psychotherapy
Humanistic psychotherapy
Gestalt therapy
Rogerian therapy
Transactional analysis
Transpersonal psychotherapy
Psychotherapy for people who are lesbian, gay or bisexual or who are exploring/coming to terms with their sexuality
Culturally specific services
Therapy for more than one person:
Couples therapy
Family therapy
Group therapy
How do I find a psychotherapist?
Do psychotherapists have a professional code of conduct?
Useful contacts
Further reading
This factsheet is for people who want to find out about psychotherapy and who may be considering psychotherapy as a treatment option.
Psychotherapy is a talking treatment that aims to help you to find ways of coping with problems you may be experiencing. The overall aim of psychotherapy is to help you to understand why you feel the way you do, and what lies behind your responses to other people and to things that happen to you. Many people find that this understanding helps them to deal more successfully with problems and distress. Psychotherapy provides an opportunity for you to work towards living in a more satisfying and resourceful way by developing your understanding of yourself and the way you respond to others. The psychotherapeutic process goes deeper than counselling: you may be encouraged to look closely at your past, particularly your childhood, and your relationships with significant people in your life.
Psychotherapy is not the only form of talking treatment available. Other forms of talking treatment include counselling, cognitive behaviour therapy, self-help groups and support groups.
You may be experiencing emotional distress, feeling depressed, or going through a crisis; you may be feeling confused or wish to develop a greater degree of self-understanding. It may be that you need someone to talk to who is outside your family and your circle of friends and therefore has no preconceived ideas about you and may be able to give you fresh insights into how you feel and respond to things. You may feel that you need more support in terms of time, understanding and trust than your family and friends can offer you.
Psychotherapy involves talking to someone who is trained to listen. Psychotherapy can take a number of forms, but is generally longer-term than other talking treatments such as counselling or cognitive behaviour therapy. The expected time-scale for undergoing psychotherapy should be seen in terms of years rather than weeks or months. Psychotherapy can vary according to which school of thought the therapist adheres to, but the basic therapeutic principles of providing a safe environment where you can talk about what is troubling you and be listened to in an empathic manner remain the same.
Psychotherapy allows you to talk about your emotions in a safe environment. There is a healing value in having someone regularly listen to you, and display an understanding and acceptance of you. There are potential benefits such as gaining insight and self-knowledge which can lead to control over symptoms such as depression, anxiety or obsessive behaviour.
There is a myth that attending psychotherapy is a sign of weakness, that strong people maintain a "stiff upper lip" and have no need for psychotherapy. Exploring one's feelings and emotions with a view to leading a more positive way of life is a sign of courage rather than of weakness. Psychotherapy and counselling have also been seen as indulgent activities undertaken by the middle and upper classes with nothing better to do with their time and money.
Another myth is that psychotherapy is only for people who have mental health problems, that you have to be completely unable to cope to consider psychotherapy. This is untrue, many people find psychotherapy enables them to develop self-understanding. Many who attend psychotherapy are simply people who wish to work towards living a more healthy and positive lifestyle.
Psychotherapy has developed in many different ways and directions since the early days of psychoanalysis, and the choice of which form may seem daunting. Many people find that choosing a particular kind of psychotherapy may be less important to them than choosing a therapist whomthey feel comfortable with. Research studies have shown that different types of psychotherapy can be equally effective. Although most psychotherapists begin by training in one particular type of psychotherapy, many of them take an eclectic approach and do not rigidly stick to one particular approach in dealing with clients.
As well as psychoanalysis, there are three distinct schools of psychotherapy available in Britain: psychodynamic, behavioural and humanistic.
Psychoanalysis, developed by Freud, was the first type of psychotherapeutic treatment. Analysis aims to explore, in great depth, the root causes of symptoms you may be experiencing.The analyst allows you to confront aspects of your personality within secure boundaries. They will assist you to explore your unconscious and make it conscious. An important element of psychoanalysis is transference. Transference is the transferring of feelings that are attached to one person onto another, e.g. the feelings held towards a parent transferred onto the therapist. Through understanding the transference relationship, understanding of the earlier relationship can be gained. Generally, psychoanalytic psychotherapists will want you to attend 50 minute-long sessions between two and five times a week, and the therapy may continue for four or five years. It is generally considered to be the most intensive of the types of therapy.
Psychosynthesis has its roots in psychoanalysis. It follows the principle that the past can determine the quality of life in the present. Psychosynthetic therapists help clients to explore the past in a focussed way looking at particular life issues. Psychosynthesis recognises people's spirituality and the way this can influence their lives. The goal of this form of therapy is to foster a stable sense of identity which is free of unconscious complications.
This type of therapy is also based on the theories and techniques of analysts, such as Freud, Klein and Jung. Their aim is to help you to make sense of your inner world, to understand the usually unconscious conflicts which can cause symptoms such as depression or anxiety. Psychodynamic therapists look at your difficulties in terms of your whole life, not just how you are in the present. Psychodynamic therapy is interested in investigating connections between childhood experience and adult personality in order that you can gain a new insight into the way you have been influenced by what happened in your past.
You would expect to see the therapist for between one and three sessions per week, and although it tends to be fairly long-term, it is not as lengthy a process as analysis but is more often limited to an agreed and pre-set period of time.
This form of therapy is based on learning theory. Symptoms such as anxiety or agoraphobia are seen as the results of learned habits or ways of coping with situations or emotions, rather than as the result of unconscious processes. Part of the therapist's role is to help you to unlearn some of these learned habits. The therapist may assume a teaching role to help you to learn more suitable, less painful, ways of coping. This type of therapy is particularly helpful for people whose lives are disrupted by obsessive or phobic behaviour patterns.
A rational emotive
approach to behavioural therapy sees emotional distress as being largely determined by our perceptions of events rather than by the events themselves. This means that the therapist is primarily concerned with how individuals maintain their problems through their belief systems, rather than how these problems were acquired.
A solution-focussed
approach to behavioural therapy involves the therapist and client constructing specific behavioural and perceptual changes which can resolve the problem or difficulty the client is facing.
This approach has been developed by Fritz Perls, Carl Rogers and Eric Berne who were part of the ‘human potential movement’, which suggests that emotional problems arise when people are prevented by their circumstances from realising their full potential, and the aim of the therapy is to increase insight and self-development. In this therapy, the therapist encourages you to examine your past and present life, and to work towards change for the future. Put simply, in order to discover what you want to be, you need to understand what you are now. In order to do this, you need to look closely at aspects of your present life and relationships. This form of therapy may involve techniques such as psychodrama and role play. It includes Gestalt therapy, Rogerian therapy and transactional analysis.
This is a form of existential therapy which was developed by Perls. It aims to help the client to find out what stops them from being the person they feel they really are, and to make the changes that will help them to feel more genuinely themselves. ‘Real change occurs when people become what they are, not when they try to become what they are not.’ The focus of this type of therapy is on what is happening in the present, not what happened in the past.
This is also known as person-centred therapy. Carl Rogers believed that people were capable of growing and developing into what he called ‘the fully-functioning person’. He put great emphasis on empathy, non-possessive warmth and genuineness in therapists, and providing an atmosphere where the clients feel safe to explore their potential.
This is a way of analysing interpersonal relationships developed by Eric Berne and is used a lot in groups. It helps people to understand how they interact with others, how their role may change in different relationships, and how to change the way they interact with people if their relationships are causing problems. The main roles discussed are the ‘child’, the ‘parent’, and the ‘adult’, and people may unconsciously adopt these roles to a greater or lesser extent depending on who they are with. For example, someone may come to an understanding that they adopt a ‘child’ role in a relationship in which they should really be an ‘adult’, and changing this will put the relationship on a much better footing.
Transpersonal psychotherapy differs from other forms of therapy in placing a greater emphasis on the spiritual aspects of personality. It makes extensive use of intuition, dreams, and guided fantasy. Emotional problems experienced by the client may be explained by reference to memories of a previous existence or past life. In people who are open to the types of ideas that it encompasses this type of therapy can be very powerful, especially in helping with problems such as severe anxiety or phobias. A person undergoing this type of therapy needs to be very secure in their own identity, and this makes it unsuitable for treating some types of distress.
Some people want to know they are talking to someone who has had direct experience of coming out, of homophobia, or of managing dual identities etc. Others want acceptance of their sexuality, and to feel that they will be understood immediately without first having to explain their identity to the therapist.
Some lesbians, gay men and bisexual people have in the past been on the receiving end of damaging counsellors/therapists. There are examples of poor practice from members of LGB communities who have experienced naïve questioning and lack of understanding.
However, heterosexual counsellors and therapists can still be appropriate for gay people, providing they have understanding of the issues, are able to work in an affirmative way and have the necessary experience. For further advice and information contact PACE (see contact details at the end of this factsheet).
Culturally specific services
Some counselling and psychotherapy is culture-bound and psychotherapists are generally only able to work with people who are articulate in their language and who they see as having insight and being well motivated. This can mean that they only take people with a similar view of the world to themselves. In recent times however, there has been recognition that accessing the service has been difficult for people from the Black community. It has also been noted that those responsible for the commissioning and provision of services should monitor its accessibility, in order make it more responsive to various sectors of society, including Black people. For more information on culturally specific counselling contact Nafsiyat (see contact details at the end of this factsheet). You can also call MindinfoLine on 08457 660 163 (Mon–Fri 9.15am-5.15pm). Mindinfo Line staff can search for culturally specific services in all areas of England and Wales.
This type of therapy, as the name may suggest, is most appropriate where two people in a relationship are having emotional problems which they are unable to sort out between themselves.
This form of therapy is useful when families are experiencing difficulties in communicating with and relating to each other. Family therapists look at how the individual works as a social unit and emphasise the positive and negative contributions the individual makes. They make suggestions as to how family members might change the way they interact and help them gain an understanding of other members' points of view and issues.
Group therapy developed during the second world war as a way of helping the large number of traumatised men at a time when hospitals were short-staffed. It uses theory and techniques derived from several different types of therapy, and enables people to deal with inter-personal problems and develop self-awareness.
There are generally 8-12 people in the group who meet together regularly with a therapist, and people talk about their own concerns.The idea of group therapy may appear intimidating; however, most people find it reassuring to find that other people may be in the same position as themselves. It is also helpful for people to get other points of view on their concerns, the way they appear to others, and the way their behaviour comes across and affects others.
There is often a choice of mixed or single-sex groups and there are usually beginner, intermediate and advanced groups.
It is possible that your GP may be able to refer you to a psychotherapist from the NHS; however, this type of service is not available everywhere. Psychotherapy is also available from a number of voluntary agencies. The other option, if you can afford it, is to see a private psychotherapist. Some psychotherapists may offer a sliding range of fees depending upon your income; these are often trainees in the final stages of their training.
To find out about psychotherapists in your local area you could try contacting the following: the United Kingdom Council for Psychotherapy, the British Confederation of Psychotherapists, the British Association for Counselling, your GP, Community Health Council, local Mind group, or Citizens' Advice Bureau.
Psychotherapists undergo professional training, and there are a number of recognised qualifications. The United Kingdom Council for Psychotherapy and the British Confederation of Psychotherapists have both set up registers of therapists who are members of organisations which meet basic training criteria, have codes of ethical practice, complaints procedures and the means to remove therapists from their registers if a complaint is upheld.
The purpose of having registers for psychotherapists is to ensure the safety of people undergoing therapy. Clients may be in a vulnerable position where they could be taken advantage of by an unscrupulous therapist. Registers and codes of ethical practice are an attempt to ensure professionalism and to minimise any risk of abuse. POPAN, The Prevention of Professional Abuse Network, offers advice, information, support and advocacy to help people who may have been abused by therapists or other health and social care professionals.
British Association for Behavioural and Cognitive
Psychotherapies (BABCP)
The Globe Centre, PO Box 9, Accrington BB5 0XB
tel. 01254 875 277
web: www.babcp.com
Full directory of psychotherapists available online
British Association for Counselling and Psychotherapy (BACP)
BACP House, 35–37 Albert Street, Rugby CV21 2SG
tel. 0870 443 5252
web: www.bacp.co.uk
See website or send an A5 SAE for details of local practitioners
British Confederation of Psychotherapists
West Hill House, 6 Swains Lane, London N6 6QS
tel. 020 7267 3626
fax: 020 7267 4772
web: www.bcp.org.uk
The British Confederation of Psychotherapists is a linking body of psychoanalytic psychotherapy societies. It can give information on properly trained psychotherapists.
Nafsiyat
262 Holloway Road, London N7 6NE
tel. 020 7686 8666
An inter-cultural therapy centre; they may be able to assist in providing information about counsellors from black and ethnic minority groups.
Prevention Of Professional Abuse Network (POPAN)
52-53 Russell Square, London WC1B 4HP
Helpline: 0845 4 500 300
Fax: 020 7631 1122
email: info@popan.org.uk web: www.popan.org.uk
Provides information and support to those who have been abused in counselling or therapy.
PACE (Project for Advice, Counselling and Education)
34 Hartham Road, London N7 9JL
tel. 020 7700 1323
email: info@pacehealth.org.uk
web: www.pacehealth.org.uk
Provides counselling for lesbians and gay men, including counselling on HIV issues. May be able to offer free counselling for those on low wages or unwaged.
The Couple Psychotherapy Service
Studio House, Templewood Avenue, London NW3 7UY
tel. 0870 902 4878
web: www.couplepsychotherapy.co.uk
The Institute of Family Therapy
24-32 Stephenson Way, London NW1 2HX
tel. 020 7391 9150
fax: 020 7391 9169
email: clinical@instituteoffamilytherapy.org.uk
web: www.instituteoffamilytherapy.org.uk
Provides family therapy and accepts self-referrals.
United Kingdom Council for Psychotherapy
167-169 Great Portland Street, London W1W 5PF
tel. 020 7436 3002
email: ukcp@psychotherapy.org.uk web: www.psychotherapy.org.uk
(search for psychotherapists online plus other information about psychotherapy)
Provides information about properly accredited psychotherapists.
Women's Therapy Centre
10 Manor Gardens, London N7 6JS
tel. 020 7263 6200
email: info@womenstherapycentre.co.uk
web: www.womenstherapycentre.co.uk
Provides therapy to women by women. Has information on therapists in other parts of London. If you would like to discuss having psychotherapy with WTC, please telephone their Advice and Information line on 020 7263 6200 which is open Monday to Friday 10am-12 noon and 2-4pm. Out of these hours you are welcome to leave a message on the ansaphone.
Understanding talking treatments
Updated May 2004
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