How to Choose The Right Therapy in London
What so many types of therapy available in London, which one do you choose? It can be confusing and overwhelming. Read on to discover your options…
What bring’s you to therapy?
People look for a therapy clinic for a range of issues – anxiety, depression, problematic relationships, and just about anything that stops you enjoying life. Every therapy has its own pros and cons, and some are more suited to specific problems. Despite this, there’s lots of crossover between the different talking therapies, and sometimes the most healing component of therapy is being with someone you really resonate with.
If you’re looking for regular therapy sessions, London has a huge selection, so I’ve made some notes on the different therapies available in London. Once you’ve identified one which you feel might work for you, scroll down (here) to find out how to choose a therapist and what to do next.
Psychotherapy, deriving from the ancient Greek words psyche (soul) and therapeia (healing) is also known in the UK as talk therapy and talking therapy. Psychotherapy has roots in ancient cultures around the world, with the modern European approach developing from the end of the 19th century.
In the weekly therapy sessions, your psychotherapist will encourage you to open up about what’s troubling you. You’ll explore your past and how it’s influenced you in a confidential space. You’ll look at what’s present for you now, and fears of the future. As the work deepens, you might experience difficult emotions and upsetting thoughts which were previously kept at bay. Psychotherapists are trained to help you cope with this and will guide you through the process.
You’ll be encouraged to be open and honest, to be yourself. It’s a process that’s sometimes intense, sometimes joyful, but always rewarding. Psychotherapy can profoundly change the way you feel and think about yourself, other people, and the world. Through understanding yourself, you can learn to let go of unconscious behaviours which stand in the way of your highest potential.
Psychotherapy is very effective for the treatment of depression, anxiety and social anxiety. It is also used to treat specific trauma based conditions such as PTSD and CPTSD. Duration can be from a few months to several years, depending on your needs. There’s many psychotherapists in London, each with their own approach, but they can be grouped into five broad categories:
– Psychodynamic therapy
Also called psychoanalysis, this approach was developed by Sigmund Freud, but has since developed in many new directions. Psychodynamic psychotherapy takes your childhood experiences into account, and uses dreams and analysis to uncover unconscious motives and patterns of behaviour.
– Behaviour therapy
Behavioural psychotherapy is based on behaviours you’ve learnt, and how you’ve been influenced by the environment and the people around you. It’s based on two concepts:
- Classical conditioning – developed by Ivan Pavlov, who showed that dogs begin salivating as soon as they hear their dinner bell.
- Operant conditioning – shaping behaviour with reward and punishment
– Humanistic therapy
Humanistic psychotherapy assumes a basic goodness in everyone, and an innate drive to reach one’s fullest potential. The therapist believes everyone is unique, and that you’ll thrive in an empathetic, non judgemental environment.
Humanistic psychotherapy includes:
- Gestalt psychotherapy – an emphasis on being aware of the here and now
- Client-centred psychotherapy – provides a supportive environment, where you can be yourself
- Existential psychotherapy- helping you take responsibility and find meaning in your life
– Cognitive therapy
As a client, you’ll be encouraged to recognise dysfunctional thinking, and how it leads to problematic emotions and behaviours. Changing your thoughts can have a big impact on how you feel and act in your life.
A modern development of Cognitive therapy is a combination with behavioural therapy. CBT (more here), or cognitive behavioural therapy, is an effective short time therapy, currently offered on the NHS.
– Integrative therapy
Most experienced psychotherapists don’t limit themselves to one specific style of therapy. As they get to know you, they’ll draw from several psychotherapeutic modalities to tailor the therapy specifically for you, and what you need. I am an integrative psychotherapist, and have training in a range of approaches.
Counselling is a talking therapy, similar to psychotherapy. It’s more suited to a single issue which isn’t rooted in the past, or in the unconscious mind. This could be depression or anxiety from a recent event such as bereavement, stress at work or a physical health condition. Or it could be confusing feelings of anger or low self esteem.
A counsellor will listen to you without judgement, and support you as you go through a difficult time. They’ll explore your issues with you, and guide you towards a better understanding of your situation. Traditionally, counselling was face to face, but there are now possibilities of online, phone, email or live online chat counselling. Duration of counselling can be anywhere from one session to several months.
Some counsellors are trained for specific issues, such as sexual identity, addiction or eating disorders. In practice there’s lots of crossover between a psychotherapist and a counsellor, as most psychotherapists are also trained as counsellors.
Talk therapy, or talking therapy is any therapy in which talking is the primary activity. All of the therapies listed here can be classified as talking therapies, where you, the client, talk confidentially to a trained therapist. Every talk therapy is different, and ranges from short term CBT to long term psychotherapy. It’s suitable for both men and women, a range of mental health problems and for self-development.
It’s normal to feel low from time to time, especially if you’re going through a challenging period. In most cases, your mood will eventually improve, and there’ll be no need for any treatment. But sometimes a low mood or feeling of sadness can persist for weeks or months. There may be other symptoms too, such as anxiety, low self-esteem and general apathy. Depression also effects your physical state, and can cause low energy, mental confusion and problems with sleep.
If you recognise some of these symptoms, and they don’t seem to be going away, you may be suffering from depression. Depression is a common mental health problem which can be treated successfully with depression therapy.
For depression brought on by something in your life, such as the loss of a job or relationship, counselling can help you process your feelings, and provide you with empathic support. For depression without an obvious cause, hopelessness and suicidal feelings, psychotherapy can hep you get to the root of the problem.
It’s natural to feel anxious in response to certain situations. You might be going for a job interview, or waiting for the results of a medical test. But sometimes that feeling of anxiety can remain present when there’s nothing obvious causing it. It can pervade all areas of your life and be quite debilitating.
If you’re feeling worried all the time, or too restless to sleep or think clearly, you might be suffering from chronic anxiety, known as ‘generalised anxiety disorder’ in the NHS. General anxiety can come about for many reasons, and successful management and treatment is possible with therapy.
For anxiety with a clear cause, such as a health condition, or a history of drug misuse, counselling or CBT can be very effective.
Sometimes the cause of your anxiety or panic attacks will not be obvious, and a course of psychotherapy will help to explore the underlying causes. These can include traumatic experiences from the past, and current relationship difficulties.
Other conditions involving anxiety include PTSD, panic attacks and social anxiety.
Social anxiety therapy
Do you feel overly self conscious around other people? Or feel them judging or criticising you? Feelings like this can be so intense that it stops you from going out or attending social functions. Social anxiety can have a huge impact on the quality of your life. It tends to stem from teenage years, and often gets better as you get older. Sometimes it can get worse with age, and it’s necessary to get some help.
Social anxiety, also known as social phobia can be treated with psychotherapy, CBT and some of the therapies related to CBT, such as acceptance and commitment therapy. Group therapy can also be very effective, because it can give you the chance to express how you’re feeling within the group without fear of judgement and criticism.
If you tend to become overly invested in relationships, so much so that you’re sacrifice their own self care and needs to make the relationship work, you may have a codependent personality style. Codependents can easily become obsessed with what others think of them, making great efforts to appeal to them, while sacrificing their own needs.
The codependent personality tends to develop during childhood, shaped by early relationships with parents. It can stem from childhood abuse, emotionally immature parents, or having a codependent parent from whom you’ve inherited behaviours.
Trauma can take many forms – from one off physical events such as a car accident or assault, to sustained emotional and physical abuse over a period of years.
Everyone’s unique, and it’s common for people to respond differently to the same traumatic events. Symptoms related to trauma include:
- Always looking out for potential danger
- Sensitivity to loud noises and busy environments
- Difficulty getting to sleep or staying asleep
- Nightmares and disturbing dreams
- Intrusive memories of the trauma
- Feelings of anxiety and panic
- Low mood, sadness and low self esteem
- Irritability when you’re not in control
- Emotional disassociation from your feelings
- Avoiding people or places associated with the trauma
While many people recover from the effects of trauma within a few months, for some, trauma symptoms persist for years later. When this happens, we call it PTSD, or post traumatic stress disorder. PTSD can have a negative impact on relationships, and how fully you allow yourself to engage in life. Difficulty concentrating and forgetfulness, along with psychosomatic physical symptoms, like shallow breathing and stomach upsets are potential signs of trauma that need reprocessing.
The effects of PTSD are different for everyone, and will largely depend on your personality type, and your style of expressing emotion. There’s a few methods and therapies suitable for treatment of PTSD and C-PTSD.
Psychotherapy can help you come to terms with trauma from the past. You can learn to identify the fight or flight response which you may be stuck in. There’s also variations – the freeze, fawn and flop responses, which are all natural, but ultimately dysfunctional ways of dealing with PTSD.
Psychotherapy can also help you identify the different parts of yourself that make up your unified self. It’s natural for each part to have its own agenda, which can be in conflict with each another part. One part of you might want to go out and socialise, while another part needs to stay safe at home alone. By giving voice to our inner parts, we can come to a new clarity and understanding of our internal conflicts, and how to resolve them.
Childhood trauma therapy and CPTSD
Growing up in a challenging environment can have lasting effects, especially if the caregivers are not emotionally equipped to fully support a child’s needs. When parents are grappling with their own mental health challenges, it often impacts their child’s emotional and mental well-being, leading to a condition called Complex Post Traumatic Stress Disorder (C-PTSD).
If childhood trauma or abuse have been a part of your past, certain triggers or situations might unexpectedly take you back to those memories. Intense feelings of sadness, anger or anxiety can be overwhelming, and hard to understand.
You might experience emotional flashbacks, distressing dreams, or perhaps only recall fragmented memories, leaving you feeling uncertain about your past. These feelings can surface in unexpected situations or around specific individuals, causing a lot of distress.
Dealing with the effects of childhood trauma, whether emotional, physical, or sexual, can be challenging. Because it can be difficult to trust others, the therapeutic relationship becomes an important part of the healing process. A supportive therapist will accept you as you are, helping you to process past traumas in a safe environment.
Eye Movement Desensitisation and Reprocessing (EMDR) is a technique used by psychotherapists, counsellors and CBT therapists to reprocess traumatic memories. It starts with talking about your history, your life and relationships, before formulating a treatment plan. The treatment involves focusing on a traumatic memory while identifying an associated negative belief about yourself, along with emotions and body sensations.
The therapist moves a finger in front of you, which you follow to create a sideways eye movement. They’ll introduce a positive belief you’d prefer to have. With every movement, the memory becomes less disturbing.
CBT, or cognitive behavioural therapy is a method of identifying and changing your thought patterns. As you replace less negative thoughts with more helpful thoughts, it can have a positive affect on your emotions and behaviour.
Developed in the 1970s, is a cognitive therapy that draws on behaviour therapy. It’s commonly used in the NHS due to its efficacy and measurable results. It’s a practical short term therapy typically lasting between 5 and 20 sessions, where you set goals, and carry out homework between sessions.
CBT is an effective therapy for anything where modifying your thought patterns might help. Depending on the root causes, this includes many of the issues discussed above, including depression, anxiety, panic attacks, phobias, OCD (obsessive compulsive disorder), and PTSD (post-traumatic stress disorder).
There’s also several therapies derived from CBT, all accessible in London:
- MBCT (Mindfulness-based cognitive therapy)
Drawing on the ancient art of mindfulness and meditation, MBCT is offered over 8 weeks as a group process.
- ERP (Exposure and Response Prevention)
A good therapy for OCD, Exposure and Response Prevention teaches you to tolerate anxious feelings instead of carrying out compulsions
- DBT (dialectical behaviour therapy)
Effective for borderline personality disorder, and anyone prone to black or white thinking
- ACT (Acceptance and commitment therapy)
Learn how to accept and embrace your feelings, both negative and positive. And commit to actions which are consistent with your values and goals.
The ability to have close and harmonious relationships is crucial to leading a fulfilling and satisfied life. If you constantly find yourself in destructive relationships or are drawn to unsuitable partners, relationship therapy will help you to evaluate the way you’re relating to others, and to communicate in a style that fosters understanding and closeness.
All of the therapies listed here will help you to develop a healthy relationship with yourself and with others. Psychotherapy will dive deep into the underlying factors, from childhood traumas to deeply held, unconscious beliefs.
In most people, grief involves a range of feelings and emotions, which can come up at any time, including sadness, anxiety, despair and relief. There isn’t one way to go through the grief process, and bereavement therapy honours how you’re feeling at any given time.
The 5 stages of grief where identified by Elisabeth Kübler-Ross in the 1960. They’re not linear steps, and not everyone goes through all of them. In grief and bereavement therapy, they can be used as tools to help identify and validate your feelings.
If you have a partner, and you’re going through difficult times, relationship therapy can be a good option. Specialist couples therapy is available in many private therapy clinics throughout London, by psychotherapists and counsellors with the appropriate training.
Problems related to sex are common, but many people in London and the UK find sex embarrassing to talk about. Problems related to sex can have many causes, including physical, such as surgery, disability, illness or medication, and psychological, such as depression and anxiety or relationship problems.
Psychosexual therapists come from many disciplines, medical psychological and from within healthcare. They’ve taken further training to help people with physical intimacy, and will encourage you to talk freely and openly.
If you have a physical problem, your GP should be able to help, but sex therapy isn’t available on the NHS.
Finding a therapist in London
It’s really important that you find a therapist who’s a good match for you. Finding that connection and resonance can be just as important as which type of therapy you decide to have.
For therapy and counselling, check that your therapist is registered with either BACP or UKCP, as this will ensure an adequate level of training. During your initial session, ask about anything on you mind, and consider whether you’d feel comfortable working with them for a period of time. It’s fine to try another therapist if you think they’d be more suitable.
Once you’ve had a few sessions, you should be able to talk to your therapist openly and honestly about how things are progressing, and the best way forward.
How many therapy sessions will you need?
Short term therapies, like CBT and EMDR can take between 5 and 20 sessions, though some therapists might suggest more depending on the issue and how you’re responding.
It’s very difficult to say how many sessions you’ll need for counselling or psychotherapy. It depends on the root cause of the problem you come with, and to the depth you want to explore. Counselling tends to be between one and three months, whereas psychotherapy can last for between a few months and several years.
How much is therapy in London?
Therapy prices in London tend to be more than the rest of the UK, though there are some low cost options provided by charities and training institutions. This is the typical price range of ‘in person’ therapy sessions in London as of 2023:
- Private therapy £65 – £250
- Low cost therapy £10 – £65
- Couples therapy £65 – £250
- CBT therapy £100 – £270
If you’re working, your employer might have a scheme, or an in-house therapist. If you’re a student, universities and colleges in London and the UK always have a counselling department you can get in touch with.
If you’re on a low wage, there’s charities and organisations, or you can contact the NHS directly. If you have insurance, or you’re looking for private therapy, there are a host of therapeutic services throughout London at various price points.
NHS Therapy in London
The NHS offers a range of free psychological therapies, including short term counselling and CBT. You don’t need a referral from a GP – you can access the NHS Talking Therapies here.
You’ll normally be offered 6 or 8 weekly sessions, depending on which borough you live in. This can be good for short term treatment of depression or anxiety, and your counsellor might be able to suggest longer tern therapies available to you through local charities.
If you have a more complex mental health condition, it’s best to speak to your GP first who can arrange specialist care and medication if needed.
Low cost Therapy in London
There are several charities and organisations offering cheap counselling and therapy in London. Speak directly with them to see how much you would be paying – it may be a sliding scale depending on how much you earn.
London Charities offering therapy:
- The Caravan offers a free drop in counselling service in Central London
- Cruse Bereavement Care offers support if someone close to you has died
- Rape Crisis England & Wales is for survivors of sexual abuse
- FreshStart offers longterm psychotherapy for people on low wages
- The Samaritans over a compassionate listening service
How IN Therapy London can help
If you feel you could benefit from therapy, please book an initial consultation. You don’t have to prepare for this, just come as you are and we can look into how I might be able to help.