Talking therapy and counselling
Explains what talking therapies are, what happens during therapy, how to get the most from therapy and how to find a therapist.
Getting the most out of therapy can sometimes feel difficult, especially if you're offered a type of therapy that isn't right for you, or worry that you've not been offered enough sessions to make a difference.
These are positive steps you can take to get the most out of any type of therapy you are offered:
Make sure talking therapy is the right choice for you just now
It could help to ask yourself beforehand:
- Am I ready to explore my feelings and behaviour?
- Do I feel able to open up about things that are very personal or hard to talk about?
- Is there anything else I need to get help with first? For example, if you are struggling with housing issues or money issues, you may be able to find support with those issues elsewhere.
Decide what you want to achieve from therapy
It can help to set some small goals which you feel are achievable. Discuss this with your therapist so you can both aim to reach a shared goal.
Understand the type of therapy you're getting
Ask your therapist how they think this kind of therapy can help you, and what to expect from it. If they use terms you don't understand, ask them to explain. Our section on common terms used in therapy might help.
Talk about what's most important to you
Therapy sessions are your time, and you shouldn't feel pressured to talk about something you don't feel is important.
Tell your therapist what's working and what isn't
They might be able to change the sessions so that they suit you better.
Make the room feel more comfortable and safe
For example, you could ask to change where you sit, or adjust the lighting or the temperature of the room so you feel more relaxed.
Take something in with you to help you ground yourself
For example, this could be a treasured item or something you can fiddle with.
Have someone you trust nearby, if you want
It could help you relax if you know someone will be there to meet you when the session is finished.
Many of us may have therapy over the phone or online, rather than face-to-face.
Some of us prefer this, particularly if it’s difficult leaving the house or using transport. But some people worry that it will be harder to have an open and honest conversation if they have therapy remotely. If you feel like this, this may feel especially hard if you’ve had face-to-face therapy in the past but this isn’t currently possible.
These are some tips to help make your sessions feel more comfortable:
Make a plan with your therapist
Try to talk to your therapist before the session. These are some things you could discuss:
- Whether you can choose between a phone or video call, and which one you would prefer
- The confidentiality of your sessions, and how your personal data will be used. It’s the responsibility of the therapist to make sure that any digital platform they use is secure
- What number your therapist will call you from if you’re having your session by phone. Or whether the therapist will withhold their number. They sometimes do this to respect your privacy, for example if you don’t want their number showing on a shared phone bill
- Who will restart the call if you lose connection. This can be common, but usually only lasts for a short amount of time
- How long the session will last, particularly if you have problems looking at a screen for a long time
- Any reasonable adjustments you might need, for example if you would prefer to turn your camera off for a video call. Or if you would like to have someone you trust with you during the session
- Any other worries you have about the session
Ask for help with setting up your call
If you’re unsure about how to use video calling technology, ask a friend, family member or someone else you trust to help set this up. Age UK has a guide to using video calls, which may also help.
Think about where you'll have the session
If you can, try to find a place in your home where you won’t be disturbed. If you’re worried about being heard by people you live with, using headphones for the session may help with privacy. Or you could ask your therapist if it would be possible for you to talk to them while you’re out for a walk. Choose somewhere away from home, in a safe space for you.
It might also help to turn off any digital notifications such as social media or text messages, to avoid getting distracted.
Think about how to relax during the session
For example, you could hold a comforting object or take a moment to focus on your breathing.
Think about what you'll do after the session
Your session may bring up difficult emotions. To help manage this you could try and plan a relaxing activity, such as listening to your favourite piece of music, before going back to your usual routine.
If you’ve had your therapy session in your home, you might want to take some time away from the room where this took place. Spending some time in a different room may help you wind down after the session. Or go outside for a short while if you're able to.
You may want to let someone you trust know that you’re having the session, so that they can check in with you afterwards.
Be kind to yourself
It can take time to build trust and feel comfortable with a therapist. This could feel even more difficult when you’re not seeing them face-to-face.
Try to be kind to yourself if it takes time to get used to having therapy in this way. If you're finding it hard to feel comfortable, it may help to tell your therapist exactly how you're feeling. This might feel daunting, but it may help to increase your sense of connection because you've been able to be honest.
It's common to have a mixture of thoughts and emotions about finishing therapy. It's likely to depend on the experience you've had and the relationship you've formed with your therapist. There's no one particular way you're supposed to feel.
If you're worried about how you'll cope, tell your therapist how you're feeling. They might be able to help you plan things you can do after your therapy has ended to help yourself, think of alternatives to try, and work out your next steps.
Therapy can be frustrating at times, but as long as you are ready to look at your problems honestly it can be a really useful space to talk about what's bothering you.
Therapeutic relationships can be challenging. It can take time to build trust and feel comfortable with a therapist, and it's common to have times when you feel frustrated or upset after a session.
But sometimes you might find that, even after trying it for a while, you're really not happy with how it's going. In this case you may want to consider:
- Talking to your therapist about any problems you're having with them
- Asking your therapist whether they can offer you a different type of therapy
- Asking your GP or the NHS service if there is another therapist you can work with
- Finding another therapist, especially if you are accessing therapy privately
- Ending your therapy, or seeking alternatives to try instead
If you have a serious concern about any treatment you've received, you can complain.
Your therapist should tell you their complaints process if you ask them for it. If that doesn't feel possible you could ask your therapist what professional body they're registered with, then make your complaint through that body (all professional bodies should have a complaints procedure you can follow).
If you're unsure how you feel and want another opinion before making a complaint, these services can help:
- The British Association for Counselling and Psychotherapy (BACP) offers a services for you to get help with counselling concerns. This is a confidential telephone and email service for any questions or concerns you have about good and bad practice in therapy.
- The Clinic for Boundary Studies provides support services for people who feel they have been harmed by someone in a position of trust.
See our legal pages on complaining about health and social care for more information about your rights.
This information was published in June 2018.
This page is currently under review. All content was accurate when published.
References and bibliography available on request.
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