How can psychological therapy help?
Psychological therapy offers more than somewhere to talk. It creates a relationship in which experiences that have felt confusing, overwhelming or difficult to put into words can begin to be understood. Therapy may help you recognise patterns, make sense of emotional responses and find different ways of approaching difficulties. Sometimes change is quite visible. At other times, it begins more quietly: a little more space to think, less feeling driven by anxiety, or a different understanding of yourself and your relationships.
Is there evidence that psychological therapy works?
Yes. There is a substantial body of research showing that psychological therapies can help with many emotional and psychological difficulties, including anxiety, depression, obsessive compulsive disorder and trauma. Research does not, however, offer a guarantee about what will help a particular person. The outcome also depends upon the nature of the difficulty, the approach being offered and the quality of the relationship with the therapist. Good psychological work is informed by evidence while remaining attentive to the individual person.
How does talking therapy work?
What kinds of difficulties can therapy help with?
How long will therapy take?
How do I know whether therapy is right for me?
You do not need to be in crisis or have a diagnosis to seek psychological help. You may know that something feels wrong without yet having the words for it. An initial consultation provides an opportunity to think about what has brought you, what you hope might change and whether I am the right person to help. Feeling sufficiently comfortable with the psychologist matters, although therapy will not necessarily feel comfortable at every moment.
Psychological therapy can help with anxiety, obsessive compulsive difficulties, low mood, trauma, grief, relationship problems, low self esteem, questions about identity and periods of significant change. With children and young people, distress may also appear through behaviour, withdrawal, school difficulties, physical complaints or conflict within relationships. The important question is not simply which symptom is present, but what that symptom may mean within the person’s wider life.
There is no honest answer to this before we have begun to understand the difficulty. Some people benefit from a relatively brief and focused piece of work. Others need more time, particularly when difficulties are longstanding, complex or rooted in important relationships. The purpose and progress of therapy should be discussed openly and reviewed regularly. Therapy should not simply continue out of habit.
Therapy is not simply a matter of receiving advice or being told how to think. It involves becoming curious about what is happening, why certain feelings or situations have become so difficult, and what may be keeping those difficulties in place. This can include thinking about present circumstances, earlier experiences, relationships and the ways we protect ourselves when something feels too painful or threatening. Understanding does not change everything overnight, but it can create the freedom to respond differently.
What is the difference between a clinical psychologist, psychiatrist, counsellor and psychotherapist?
What if therapy does not help?
Therapy does not help everyone in the same way, and sometimes a particular approach, therapist or point in time is not right. If you feel that the work is not helping, it is important that we can speak about this openly. We can reconsider our understanding of the difficulty, the aims of the work and whether something needs to change. Occasionally, the most useful decision is to pause or seek another professional opinion. A lack of progress does not mean that you have failed at therapy.
Do clinical psychologists only provide therapy?
No. Therapy is one part of a clinical psychologist’s work. A central task is developing a psychological formulation: a thoughtful account of how the difficulty may have developed, what it means and what may be keeping it going.
When working with a child or young person, I may also consult with parents, schools and other professionals. Sometimes the most helpful intervention is direct therapy with the young person. At other times, change is better supported through the adults and relationships around them. The outcome may be a period of therapy, a clearer shared understanding, practical recommendations, or a combination of these.
A clinical psychologist has completed doctoral level professional training in psychological assessment, formulation, research and therapy. Clinical psychologists consider not only symptoms, but also development, relationships, family life and the wider circumstances in which difficulties have emerged. The title Clinical Psychologist is protected by law, and practitioners must be registered with the Health and Care Professions Council.
A psychiatrist is a medically qualified doctor who has undertaken specialist training in mental health. Psychiatrists can diagnose mental health conditions, prescribe medication and consider the relationship between physical and mental health. Some psychiatrists also provide psychotherapy.
Counsellors are trained to help people explore emotional difficulties, relationships and life experiences. Their training and therapeutic approach can vary considerably. Counselling may be brief or continue for a longer period, depending upon the person, the difficulty and the setting. Psychotherapists usually undertake extensive training in a particular form of therapy. Their work often pays close attention to emotional development, relationships and patterns that may operate outside our immediate awareness. Psychotherapy can also be brief or longer term. It is therefore unhelpful to distinguish counselling and psychotherapy by length alone.
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