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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.

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If someone you care about is going through a hard time, our pages on how to cope when supporting someone else and helping someone else seek help give suggestions on what you can do, and where you can go for support.

How to get the most from therapy and counselling

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.

Tips for face-to-face therapy

If you have therapy face-to-face, these are some things you could try to make the sessions feel more comfortable:

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.

Tips for phone and online therapy

Many of us may have therapy over the phone or via an online, rather than face-to-face. If you have therapy remotely, you may worry that it will be harder to have an open and honest conversation. This may feel especially hard if you used to have face-to-face therapy but this is no longer possible. 

These are some tips to help make your sessions feel more comfortable:

Make a plan with your therapist

Before the session, try to talk to your therapist about:

  • whether you can choose between a phone or video call, and which one you would prefer
  • the confidentiality of your sessions. It’s the responsibility of the therapist to ensure that any digital platform they use is secure
  • what number you’ll be called from if you’re having your session by phone
  • who will re-start the call if you lose connection. This can be common, but usually only lasts for a short amount of time
  • any other worries you have about the session. Remember that your therapist may be getting used to working in this new way as well.

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, you could try using headphones for the session.

You might also find it useful to turn off any digital notifications such as email 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 a relaxing activity, such as listening to your favourite piece of music, before going back to your usual routine.

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. And remember that you may be able to have face-to-face sessions again in the future. 

Dealing with therapy coming to an end

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."

What to do if therapy isn't helping

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.

How to complain about therapy

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:

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.

If you want to reproduce this content, see our permissions and licensing page.

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