What Is Therapy and How Does It Work?

Why Consider Therapy?

Expressing our thoughts and feelings is incredibly powerful for enhancing our mental wellbeing. Suppressing them can lead to increasing levels of mental distress and unhealthy coping behaviours in the long run.

Therapy can help you:

  • Understand and enhance your mental wellbeing
  • Improve your relationships with others
  • Take greater control of your life
  • Make sense of how your past influences your present
  • Feel more confident
  • Feel a stronger sense of purpose and direction
  • Exceed in your professional life
  • Overcome your fears
  • Improve your physical health
  • Reduce unhealthy coping behaviours such as overeating, alcoholism, sex and love addiction, co-dependency and gambling

Talking with a friend, family member or mentor can often be very helpful. However, in some cases, you’d benefit more from speaking to a trained professional.

When to Access Therapy?

If you’re committed to personal development, it's likely you’d benefit from therapy even if you have a well-developed mental wellbeing toolkit.

Therapists can help us develop our mental resilience for future challenges, cultivate happiness, and generally help us become the best version of ourselves.

If you’re experiencing any of the following situations, therapy may be especially beneficial:

  • Your thoughts, feelings, or behaviours are affecting your quality of life (e.g. you’re not sleeping well, you’re using unhealthy coping behaviours, or you’re avoiding things you usually like doing)
  • You feel as though your poor mental wellbeing is starting to affect your relationships with your friends or family
  • Your friends or family members have told you they’re concerned about you
  • You have a variety of physical complaints such as headaches, digestive issues, breathing difficulties, muscle tension, fatigue, or generally feeling run down
  • You feel as though you're at risk of exhaustion or burnout
  • Improving your performance quickly could help you meet professional goals (e.g. your levels of mental distress are affecting your performance at work, or you’re an entrepreneur)

What is Therapy?

Therapy involves talking to someone who is trained to help you deal with difficult thoughts, feelings and behaviours.

A therapist can work with you to help you understand what might be causing these difficulties, and how to overcome them.

There are many types of therapeutic approaches, including:

  • Cognitive behavioural therapy (CBT): CBT is a time-limited therapy that focuses on the ‘here and now’ rather than your childhood. It examines the relationship between our situation, mindset, thoughts, emotions, behaviour, and physical reactions. It trains you to automatically question whether or not your thoughts are facts, which slows down your reaction time and helps you feel more emotionally stable. CBT is ideal for people who want a therapy that works towards solutions, with clear goals, and practical techniques.
  • Counselling: a counsellor can help you find ways to deal with your difficulties and understand how you’re feeling. Counselling can be particularly useful for people who are going through a difficult time such as bereavement, relationship problems, work-stress or other life-changing situations.
  • Mindfulness-based therapies: these therapies focus on teaching you to become the observer of your thoughts and feelings. Variations of mindfulness-based therapies include:
    • Mindfulness-based stress reduction (MBSR) – an 8-week workshop aiming to address prolonged periods of stress, incorporating techniques such as meditation, gentle yoga and mind-body exercises.
    • Mindfulness-based cognitive therapy (MBCT) - integrates mindfulness techniques such as meditation, breathing exercises, and stretching, with cognitive therapy approaches to help break the negative thought cycles associated with recurrent depression.
    • Acceptance and commitment therapy (ACT) – focuses on six core principles: cognitive defusion, acceptance, contact with the present moment, the observing self, values, and committed action.
    • Dialectical behavioural therapy (DBT) – tailored for people who have difficulties managing intense emotions, and problems with unhealthy coping methods such as binge eating and self-harm.
  • Humanistic therapy: humanistic therapies use a range of theories and practices to help you understand and enhance your mental wellbeing. This approach suits people interested in exploring their lives and looking at their issues from a wide range of angles. Variations of humanistic therapy include:
    • Integrative psychotherapy
    • Person-centred counselling
    • Gestalt therapy
    • Transpersonal psychology
    • Existential psychotherapy
    • Transactional analysis
    • Psychosynthesis
    • Body psychotherapy
    • Psychodrama
    • Personal construct therapy
  • Behavioural activation (BA): BA focuses more on our behaviour and environment than our thoughts and feelings, encouraging us to plan behaviours and address activities we may have been avoiding.
  • Interpersonal therapy (IPT): IPT focuses on you and your relationships with others and is based on the idea that poor mental wellbeing is rooted within our interpersonal relationships.
  • Psychoanalytical and psychodynamic therapies: these therapies focus on helping you understand how your unconscious and past experiences might be influencing your current behaviour. This kind of therapy is best suited for people interested in self-exploration who are willing to devote lots of time and energy to it.
  • Cognitive analytical therapy (CAT): CAT is a time-limited therapy that brings together elements of CBT and psychoanalytical therapies, focusing more on interpersonal dynamics than CBT—CAT looks at your patterns of relating with others, and the impact your usual behaviour patterns have on your relationships and life in general. It emphasises the therapeutic relationship itself as a tool of change. It is a NICE recommendation for the diagnosis of borderline personality disorder and eating disorders.
  • Schema therapy: schema therapy helps you understand the behaviour patterns that are holding you back and focuses on developing your trust towards others. ‘Schemas’ refer to the beliefs and patterns of behaviour we develop as a result of our childhood. For example, if you adopt the ‘abandonment schema’, you hold beliefs that everyone will eventually leave you. To protect yourself, you may develop a pattern of overreacting and/or self-sabotaging your relationships. 
  • Mentalisation-based therapy (MBT): mentalisation is the ability to think about thinking. MBT aims to help people improve their mentalisation abilities, and is particularly helpful for people who experience long-term difficulties in their relationships, overwhelming emotions, and self-destructive behaviours. It can also help you develop your trust towards others.
  • Eye movement desensitisation and reprocessing (EMDR): EMDR is a way of stimulating the brain through eye movements which appear to make distressing memories feel less intense. EMDR is used for a range of traumas, including past sexual, physical or emotional abuse, accidents and injuries, phobias, addictions and fear of performing in public. NICE recommends for the diagnosis of post-traumatic stress disorder (PTSD).
  • Trauma-informed Therapies: as well as EMDR, other therapies experts recommend for trauma survivors include: Somatic Experiencing, Sensorimotor Psychotherapy, Pesso Boyden System Psychomotor, therapists trained in The Comprehensive Resource Model, Internal Family Systems Therapy and Tension, Stress and Trauma Release. More details on these can be found here.

How to Access Therapy?

You may be able to access therapy through:


Private Therapy

If you choose to go private, you’ll likely experience a shorter waiting time and more choice. Unfortunately, the cost can be an issue for many.

The cost varies a lot. Some therapists offer reduced fees for people on low incomes—you can ask the therapist if they offer this. Some therapists may also have cheaper initial assessment appointments which allow you and the therapist to see if you will get on together.

A session can cost from £20 to £100 an hour. The average cost is around £50 an hour.

If you don’t feel you would work well with the therapist, you are under no obligation to see them again.

Your GP may be able to recommend a local private therapist.

You can also find a therapist online through the following websites:

If you’re thinking about using a private therapist, it’s important to consider their qualifications. Therapists can get a certificate or accreditation, which shows that they meet certain standards. By registering with accredited bodies, therapists agree to be checked to see if they are following professional standards. It’s important to check that your therapist is registered with an accreditation body. For example, having appropriate training and qualifications working to a code of ethics.

How Does It Work?

A therapy session usually lasts 50 minutes to an hour.

At the start of therapy, the therapist will ask you about your reasons for accessing therapy. In your first few sessions, you’ll probably do most of the talking, as the therapist will be asking you questions to determine your personal needs and the appropriate therapeutic approach.

You and your therapist should agree on:

  • What you expect from one another,
  • Your commitment to the therapy,
  • How to end the therapy.

Therapy can be one-to-one or group-based. Sometimes therapists use a combination of the two. The duration of therapy varies depending on the type of therapy and the personal needs of the client.
self-help tools

Want Practical Self-Help Tools to Complement Therapy?

Be sure to check out The Mental Wellbeing Toolkit.

Users say:
“This toolkit took me from depressive with no hope for the future to blossoming, with good relationships, goals and better habits for success. This toolkit is like 10 therapy sessions in one.”
"It was like all the knowledge I had accumulated over the last decade was neatly organized and easy to understand all in one place.”

People Share How Therapy Helped Them

"I used to have anger issues before I went to therapy, and it's really helped me have a more calm demeanor."

"Therapy helped me see how a combination of abusive experiences from my past all came together in the perfect storm, causing me to make a really unhealthy relationship decisions in adulthood. I was able to understand that what happened to me really was abuse and wasn’t just “normal”, like I was raised to believe in my family, I got perspective on what normal, healthy behavior really does look like, and I’ve had a lot of support from my therapist to practice and establish healthy boundaries."

"It's been helpful to have someone objectively listen to me and not tell me that I'm wrong or whatever for feeling whatever it is that I feel. It also helps give me tools that will in turn help myself in the long run.

It's good to be able to get some of those emotions out and not have them boil over and learn how to ultimately understand myself a little better."

"I have been talking to the same counselor for almost 6 years now. I had some really bad experiences with therapy in the past so reaching out to this one took a lot of courage.

It's helped me to regulate my mood and understand why I have the reactions I do. It's taught me to be mindful and name my emotions. It's not an easy road, but believe it's well worth it if you find a good one."

"So I tried therapy once before and it was terrible. The guy said "what was your week like, oh ok that is cool, see you later." It was a complete waste of time I couldn't help but think how the hell is this dude actually going to help me get over my PTSD, depression, and anxiety. He had no interest I felt like in helping me just kinda a guy to ask me what I did. It was equivalent to my wife asking me what I did at work today.

Fast forward five years later and I tried therapy again. This time the guy gets it. He gets my issues and gets why I have them. Intead of just asking me what my week is like he starts with "tell me something that happened to you this week that was positive" then we get into the session.

During the session he doesn't validate my feelings but helps me understand why I feel that way. He is trying to help me not erase my memories of my trauma but find the "good" in what happened. Like yeah it sucks such and such happened but how has that experience helped in someway? Rewrite the endings because you can't rewrite the past and don't allow your past control you but allow it to teach you.

He also helps me understand why I feel certain ways and if why it may not be rational to think that way now. Such as "you have a fear of someone doing a home invasion on you because it happened when you were a child and is a violent memory but you aren't in that situation anymore. Could it happen yes but the chances of it happening are much smaller now that you are out of what your mother put you in."

This has been huge for me."

"It helped me realize that a major part of my trauma I was blaming myself for. It showed me the reality that what happened could happen to anyone and I wasn't to blame."

"I was forced into therapy as a teenager and I hated it. My mom and the therapist would gang up on me and would basically try to convince me that I was selfish for not accepting my new stepdad. I stopped going as soon as I moved out.

When I started having panic attacks during college, I decided to give therapy another try and I always felt a bit awkward talking to my then 50 year old proper lady therapist about drugs, drinking, sex, and other such topics and I never felt like I could be completely genuine.

I felt like I had to put on somewhat of a face for her. She also had me do different therapy methods that seemed very structured and I hated going through these really unnatural motions.

I stopped going after a few years. I figured therapy just wasn't for me and I got accustomed to my panic attacks that would happen multiple times per day.

Then a few years ago, while in my professional career, I thought maybe it'd be good to have someone to talk to about the stresses at work because surprisingly not many people want to hear about a day in the life of an accountant.

I met my current therapist and now I understand what therapy can do for you if it's the therapy that best fits you with a person that you feel you can connect with.

My therapist lets me have the floor. Somedays I go in and we have plenty to discuss and work on and somedays I just want to talk to someone about how dumb a season finale for a TV show was.

The most important thing for me is that it's one place that I feel completely in control, I have no barriers, I say whatever I want and I say it however the fuck I want to say it. After so many years of being a prisoner to my own mind, I finally get a chance to feel free and it is so empowering.

Besides getting to talk about whatever I want, my therapist also helps me understand things from another perspective. I'm always quick to forgive others and to put them on a pedestal but punish myself and think that everything is my fault. He helps me see situations objectively and helps me learn how to analyze my anxious thoughts and see the root of where they're coming from.

I think that therapy can be a magical thing as long as people can be patient enough to find the type of therapy/therapist that best suits them and their needs."