A beginner’s guide to therapy ( because it is a thing you can do) a

Think it might be time to talk to someone, but aren’t sure who? Here’s the lowdown on what’s available…

ccording to the charity Mind, 40% of all GP appointments are now about mental health. But how do you know what the right treatment for you looks like, especially when you’re in the midst of a dark cloud? There’s an abundance of choice out there, from hypnotherapy to group meetings, so we’ve decoded all that’s on offer before you make the leap or part with any hard-earned cash. Remember, no matter what route you take, that therapists don’t have a magic wand and it’s important to approach the process with a willingness to work if you want to see the best results. Timing and motivation are also crucial. Go because you want to, not because someone else has told you that you should. Not sure where to start? Here’s what’s available…

1 HYPNOTHERAPY

What is it? Forget swinging pocket watches. Sessions involve being guided into a relaxed state, imagining various scenarios (ranging from those that evoke an extreme response in you to you picturing a “safe place”) and listening to your hypnotherapist’s suggestions. You’ll remain in full control throughout. “Your hypnotherapist will ease you into focused concentration, similar to meditation, and though people talk of ‘going under’, you won’t be ‘under’ for the whole session,” explains Darren Marks, hypnotherapy instructor for the International Association Of Counselors & Therapists. “It has a wave-like quality – you’ll be deeply absorbed one minute, distracted

the next.” By this point, your brain should be more adapted to change.

Who should get it? Anybody hoping to quit smoking or conquer a phobia. The British Medical Association also once described it as the “treatment of choice” for dealing with anxiety and stressrelated disorders. There have been trials suggesting it can help with physical issues like irritable bowel syndrome, too – with 71% of patients responding positively in one study.* It can also help with chronic pain and some sleep disorders.

Best for? Those looking to break a bad habit. Any downsides? By law, hypnotherapists aren’t required to have any specific training – so be sure to do your homework before booking in and look for someone with a healthcare background who’s accredited by the Professional Standards Authority. It’s also unsuitable for anybody suffering from psychosis or certain personality disorders. How much and how many? Private sessions start from £50 and last up to two hours; the number required varies from person to person. Find a reputable hypnotherapist on the British Society Of Clinical Hypnosis database (Bsch.org.uk).

2 COGNITIVE BEHAVIOURAL THERAPY ( CBT)

What is it? “In CBT we look at how the way someone thinks and behaves may be causing or exacerbating a particular difficulty and how to change those patterns,” explains Dr Victoria Galbraith,† a registered counselling psychologist. After your first consultation session, your therapist will set clear goals with you and work out the best way for you to achieve them by breaking problems down into: situations, thoughts, emotions, physical feelings and actions. You’ll learn a series of coping techniques and may be given worksheets to complete in your own time.

Who should get it? Anybody concerned with how they’re thinking and acting in the present day, including those experiencing an eating disorder, depression and panic attack sufferers, rather than those attempting to resolve past issues. Exposure therapy is also a form of CBT, helpful for those with OCD and severe phobias, and involves you facing your fears in manageable ways (eg if your fear is spiders, your therapist may suggest you read about them, then later show you pictures). As CBT is structured around the individual’s targets, a course of it can be completed in a relatively short time, so it may be a more suitable approach if you’re self-funding.

Best for? Stopping negative thought patterns and cycles. Some coping techniques you’ll learn could also be applied to other problems that arise in the future.

Any downsides? There’s homework – such as noting down your feelings in between sessions and practising techniques – so you need to really commit to see a change. It’s not always a long-term solution either, and you may need more sessions later on. How much and how many? If you have one-on-one CBT, you’ll usually meet with a therapist between five and 20 times, with each session lasting up to an hour. It’s available on the NHS, or privately from £40 to £100 a pop. Seek out someone recognised by the British Association For Behavioural & Cognitive Psychotherapies (Babcp.com).

3 GROUP THERAPY

What is it? An umbrella term for working with a therapist in a group of other people who are experiencing similar issues. While you’ll be encouraged to talk, there’s no requirement to.

Who should get it? Find the idea of a one-on-one session a bit intense? This could be the right route for you. Plus, there’s the added bonus of potentially bonding with others facing parallel difficulties.

Best for? As well as anxiety and depression, group therapy can be especially good for people with quite specific problems, such as addiction. It may also be cheaper than individual private sessions.

Any downsides? The idea of sharing your problems with a host of unfamiliar faces might feel a bit daunting and intimidating at first, but the majority of participants open up after the first few sessions. How much and how many? Costs vary depending on the group you’re joining (Alcoholics Anonymous, for example, passes a collection pot around during meetings to cover running fees, but nobody is expected to donate if they’re unable to). Some group CBT courses and workshops are available on the NHS (for example those focused on stress, anxiety and depression). Your GP should be able to recommend local support groups for other issues.

4 COUNSELLING

What is it? Not to be dismissed as a wishy-washy chat over a cuppa, counselling is one of the more common solutions offered at GP surgeries. It’s a branch of talking therapy that involves finding ways to cope with emotional issues and better decipher your feelings, by

“The way that someone thinks may exacerbate their difficulties”

working with a trained therapist. Counselling is seen as shortterm, for current situations. Psychotherapy (which works in a similar style) delves into your past, to figure out why you might behave in a certain way.

Who should get it? The NHS recommends it for difficult life events, such as divorce or bereavement, as well as workrelated stress, sexual-identity struggles and upsetting physical health conditions, such as infertility.

Best for? Evaluating traumas, emotional problems and tackling challenging life events.

Any downsides? Depending on where you’re based, NHS waiting lists can be extremely long. Chemistry with your counsellor is important too and if you don’t gel, you’re well within your rights to raise your concerns with them during a session or look for another. How much and how many? Some charities offer free or lowcost counselling, particularly for students, job seekers and those on a smaller income. Alternatively, you can self-refer or go private, in which case it’s recommended you agree a price before starting a course of sessions, which can cost anywhere between £10 and £70 each. The course could last from a few weeks to years. You can check the credentials of counsellors via the British Association For Counselling And Psychotherapy (Bacp.co.uk).

5 MENTAL- HEALTH APPS

What are they? There are multiple new apps that claim to help with everything from learning breathing techniques to mindfulness (the practice of bringing awareness to the present and not allowing your thoughts to take over or spiral).

Who should get them? Those short on time or who live in remote areas (or places subject to long NHS waiting lists), making it difficult to access face-to-face treatments. Apps are also a good way of dipping your toe into therapy before committing to paid sessions.

Best for? Many apps focus on managing panic attacks (Beat Panic), the urge to self-harm (Calm Harm) or unhelpful thoughts (Chill Panda).

Any downsides? With so many apps out there, it can be hard to know which are worth your while – luckily, there’s a list of approved ones (which includes the three above) at Nhs.uk/apps-library. How much and how many? Most on the aforementioned list are free (including Thrive, which uses games to track your mood and to teach methods of dealing with stress and anxiety), but some have in-app purchases or require a GP referral. Ieso, free in some areas, even allows you to confidentially instant-message mental-health therapists. ◆

For immediate support, call the Samaritans for free on 116 123