Talking Treatments

This factsheet aims to explain talking treatments. You will find descriptions of the various forms of talking treatments available. If you are considering or undergoing one of these treatments you will find information on what to expect from it, what it involves and how you can get the best from this type of help.

What are talking treatments?

Talking treatments are a psychological method of relieving emotional distress and helping people to change their attitudes or behaviour patterns. They work by providing you with an opportunity to explore issues with a trained professional, gain a better understanding of yourself, and develop coping strategies in order that you can lead a more positive lifestyle.

Talking treatments alone can be effective in treating mental health problems for some people, for others a combination of talking treatments and drug treatment may be the most effective treatment. Drug therapy tends to work by treating the symptoms of a mental health problem, whereas talking treatments aim to address the underlying causes of the problem.

When are talking treatments suitable?

Psychological treatments can help you if you are experiencing anxiety, panic attacks, obsessions, phobias, depression and also other less serious illnesses, where you do not lose touch with reality. The aim is to examine, with the therapist's help, possible origins of your problems and to gain understanding which may help you to overcome your illness

In treating schizophrenia, manic depression or other major mental health problems, counselling can have a very valuable role in association with antipsychotic drug treatment by helping to overcome some of the consequences of the illness, for example by improving social skills, or by coming to terms with things that cannot be changed

A wide variety of talking treatments are available, ranging from counselling and psychotherapy to cognitive behaviour therapy. These are explored in more detail below.

What are the different types of talking treatments?

Counselling
Counselling can help you make sense of your life and resolve specific problems. It can also help you to make decisions, deal with mental health problems and many other issues affecting your emotional and mental well-being. Counselling is provided in a safe environment and the content of what you talk about should be kept confidential. The aim of the counsellor is to help you, and they can do this in many different ways. They may just listen, as speaking out loud about your problems can help you put your thoughts in order. The counsellor will not tell you what to do, and you will be left to make your own choices. Some counsellors, however, may go through a whole list of options, and examine the pros and cons of each option, so that you can make informed decisions. Counselling is generally face-to-face, but can also take place over the telephone or via the internet. Counselling may be offered as a one-off session, for a limited period of weeks, or on an ongoing basis for several months or years.

Cognitive behaviour therapy
Cognitive behaviour therapy combines two very effective kinds of psychotherapy — cognitive therapy and behaviour therapy.
Behaviour therapy helps you weaken the connections between troublesome situations and your habitual reactions to them, such as fear, depression or rage, and self-defeating or self-damaging behaviour. It also teaches you how to calm your mind and body, so you can feel better, think more clearly, and make better decisions. Cognitive therapy teaches you how certain thinking patterns are causing your symptoms — by giving you a distorted picture of what's going on in your life, and making you feel anxious, depressed or angry for no good reason, or provoking you into ill-chosen actions. When combined into CBT, behaviour therapy and cognitive therapy can provide you with very powerful tools for stopping your symptoms and getting your life on a more satisfying track. CBT is normally practiced by psychologists, and is most often offered in the form of a series of weekly sessions for a period of 8 – 12 weeks.

Mindfulness-based Cognitive Therapy

Mindfulness-based Cognitive Therapy (MBCT) combines two kinds of psychotherapy-cognitive therapy and mindfulness.

Mindfulness encourages patients to take a different perspective towards negative thoughts by concentrating the mind on those small shifts in mood which if uncontrolled can lead to catastrophic mental breakdown. It has been shown in patients with three or more previous episodes of depression to reduce the recurrence rate over a year by 55%.

Mindfulness is usually taught in classes where participants learn to observe thoughts and feelings, both pleasant and unpleasant, accepting them as ‘weather patterns of the mind’ which arise, stay a while and dissolve in time. This mental training can help people to be less fearful and trapped in old habits of anxiety, chronic unhappiness and self-destructive cycles of relapse. It was recommended in December 2004 by the National Institute of Clinical Excellence (NICE) as a primary treatment for preventing relapse in depression.

Psychotherapy and psychoanalysis
Psychotherapy and psychoanalysis are processes of discovery that aim to eliminate or control mental or emotional distress. They also can be used to help a person overcome a specific problem or to stimulate overall emotional growth and healing. In regularly scheduled sessions - usually 45-50 minutes in length - a person works with a therapist to identify, learn to manage and, ultimately, overcome emotional and mental problems. Psychotherapy and psychoanalysis are active processes requiring concentration, energy, and commitment by both parties. You may agree a particular timescale for therapy with your therapist, for example 8 weeks, or the therapy may be open-ended and continue for several years.

Group therapy
In group therapy approximately 6-10 individuals meet face-to-face with a trained group therapist. Interaction between group members is highly encouraged and provides each person with an opportunity to try out new ways of behaving; it also provides members with an opportunity for learning more about the way they interact with others. It is a safe environment in which members work to establish a level of trust that allows them to talk personally and honestly. Group members make a commitment to the group and are instructed that the content of the group sessions are confidential. It is not appropriate for group members to disclose events of the group to an outside person. When people come into a group and interact freely with other group members, they usually recreate those difficulties that brought them to group therapy in the first place. Under the direction of the group therapist, the group is able to give support, offer alternatives, and comfort members in such a way that these difficulties become resolved. During group therapy, people may begin to see that they are not alone and that there is hope and help. It can be comforting to hear that other people have a similar difficulty, or have already worked through a problem that deeply disturbs another group member.

Relationship counselling and family therapy
During a lasting relationship, a couple can face a series of important decisions and turning points. For example, whether to get married, how to adjust to pregnancy and the birth of a baby, problems with health, sexual issues, work-related issues and problems as the couple grow older. Relationship counselling enables the couple to examine and decide how best to cope with these difficulties in a private and safe environment with the help of professional counsellor. The ending of a marriage or a long relationship is generally a slow and painful process. Counselling can help people going through this to overcome emotional difficulties and develop the confidence to rebuild their lives. Particular emphasis is placed on helping parents achieve stable and workable arrangements for their children. Family therapy works in the same way, only with the entire family attending.

Support Groups
Support groups are a way of empowering people to help themselves, and others, on the path to recovery. Participation in a support group can end the painful isolation of suffering alone with a mental health problem that is disruptive and debilitating for the individual and those people around him/her. An effective group will help members achieve recovery through mutual support as well as provide them with updated information about causes and treatment, eliminating some of the myths about mental illness.

Self-help groups
Many people find it helpful to meet other people in a similar position. It can be very useful to share experiences with other people who may be going through the same thing you are. There are opportunities for mutual support, and you may get ideas of what things other people have found helpful to them. Above all, it is an opportunity to help you realise that you are not alone in how you are feeling.

Which treatment may be right for me?

Individuals respond to different treatments in different ways. What works well for one person may not work well for another. Speaking to your doctor will help you weigh up the pros and cons of the different treatments available. Your doctor should be able to provide you with information on how treatments work and how effective they are. Talking treatments alone may be extremely effective for some people, others may find a combination of drug treatment and talking treatments works best for them.

How can I access talking treatments?

A referral for talking treatments can often be arranged by your doctor. However, frequently there are long waiting lists for these types of treatment on the NHS. Free or low-cost counselling is also provided by a number of charities and voluntary organisations, and for those who can afford to pay, there are many private practitioners. Your local health centre may have information about local counselling services, notice boards in hospitals and community centres may have useful contacts. Otherwise, you could try speaking to your local social services department or Citizens’ Advice Bureau. If you are looking for a private practitioner you could contact one of the professional bodies listed below – they should be able to provide you with details of local services.

What should I look for in a counsellor or therapist?

At the moment there is no government-regulated body for counsellors or psychotherapists. In order to ensure that someone is appropriately trained and works within a professional code of ethics, it is wise to check if they are registered with a regulatory body such as the British Association of Counselling and Psychotherapy or the United Kingdom Council for Psychotherapy. These organisations aim to regulate standards of training, supervision and professional practice. It is important that you feel comfortable with your counsellor or therapist, and that you feel able to develop an open, honest and trusting working relationship with them. Without this, no talking treatment is likely to be successful.

Where can I find help and support?

There is a wide a range of services available that can help provide care, support and information to people experiencing mental health problems, their friends, relatives and carers. You may find some of the following useful:

SANEline / SANEmail
1st Floor Cityside House, 40 Adler Street, London, E1 1EE
helpline:0845 767 8000, fax: 020 7375 2162
email: sanemail@sane.org.uk
web:www.sane.org.uk
SANEline and SANEmail offer emotional support and information to those experiencing mental health problems,
their families and carers.

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Victoria Buildings, 9 – 13 Silver Street, Bury, BL9 0EU
tel.0161 797 4484, fax: 0161 797 2670
email: babcp@babcp.com
web: http://www.babcp.com/
The full directory of psychotherapists is available online.

British Association for Counselling and Psychotherapy (BACP)
BACP House, 15 St John’s Business Park, Lutterworth, Leicestershire, LE17 4HB
tel. 0870 443 5252
email: mail@psychoanalytic-council.org
web: http://www.bacp.co.uk/
See website or send A5 SAE for details of local practitioners.

British Psychoanalytic Council
West Hill House, 6 Swains Lane, London N6 6QS
tel. 020 7267 3626, fax: 020 7267 4772
email: mail@bcp.org.uk
web: http://www.bcp.org.uk/
A linking body of psychoanalytical psychotherapist societies.

Carers UK
20–25 Glasshouse Yard, London EC1A 4JT
carers line: 0808 808 7777, tel. 020 7490 8818, fax: 020 7490 8824
email: info@carersuk.org
web: http://www.carersonline.org.uk/
Information and advice on all aspects of caring.

Nafsiyat
262 Holloway Road, London, N7 6NE
tel: 020 7686 8666
email: enquiries@nafsiyat.org.uk
web: www.nafsiyat.org.uk
An inter-cultural therapy centre for people in greater London

PACE (Project for advocacy, counselling and education)
34 Hartham Road, London, N7 9JL
tel: 020 7700 1323
email: info@pacehealth.org.uk
web: http://www.pacehealth.org.uk/
Free counselling service & private psychotherapists for lesbians and gay men.

Relate
Herbert Gray College, Little Church St, Rugby, CV21 3AP
tel: 01788 573 241
email: enquiries@relate.org.uk
web: www.relate.org.uk
Offers counselling for adults with relationship problems

Samaritans
The Upper Mill, Kingston Road, Ewell, Surrey KT17 2AF
helpline: 08457 90 90 90, fax: 020 8394 8301
email: jo@samaritans.org
web: http://www.samaritans.org/
24-hour telephone helpline offering emotional support for people who are experiencing feelings of distress or despair, including those that may lead to suicide.

United Kingdom Council for Psychotherapy (UKCP)
2nd Floor Edward House, 2 Wakley Street, London, EC1V 7LT
tel. 020 7014 9955, fax: 020 7014 9977
email: ukcp@psychotherapy.org.uk
web: http://www.psychotherapy.org.uk/
Umbrella organisation for psychotherapy in UK. Regional lists of psychotherapists are available free.

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