Before we launch into exploring the various options, I have one suggestion for you: take your time. Unless you are in a state of crisis and need help immediately, I would encourage you to properly consider the different choices and weigh their pros and cons, rather than impatiently rushing into a decision. Your choice will have an impact on your mind, emotions, and mental wellbeing, and ultimately will decide whether your counselling sessions are beneficial or not. Regard this first step as the beginning of your healing process rather than just an annoying necessity you have to go through.
The first question is whether your financial situation allows you to pay for counselling or not. Below are the pros and cons of the two options:
Even though the government severely cut the funding for the mental health services in the UK, it is still possible to get free support either on the NHS or through one of your local mental health charities. The obvious benefit of this choice is that it won’t cost you a penny (aside from the travel cost associated with getting to your appointments). The other positive is that if you choose to participate in group sessions, you might meet new people and feel less isolated.
Due to constrained budgets, the free mental health services are time-limited (it is very common to be offered a maximum of six sessions on the NHS, depending on the severity of your presentation) and the waiting lists are long (four to eight weeks is not unusual). Non-HNS mental health charities can sometimes offer more sessions but here the waiting lists are often also long.
Harder to choose a therapist and type of therapy
One considerable problem with free NHS services is that in most cases the client can’t choose which practitioner they want to work with – patients are matched with mental-health professional through the referral system and if your counsellor happens to be an inexperienced trainee or somebody you don’t get on with, you can’t do much about it. Another limitation is that NHS mental health services have a very defined way of working and will use only certain therapies (for example CBT is the ‘treatment of choice’ for depression and anxiety). It is therefore possible that if you find CBT too prescriptive or rigid, the sessions will have a limited benefit for you. Non-NHS counselling charities might then be your choice because they do not rely so heavily on CBT.
The final negative aspect of free counselling points to something I observed during my career in the NHS mental health services. Paradoxically, offering free mental health services (in order to increase access to as many individuals as possible) makes some people less motivated to attend the sessions, because they don’t have to invest anything and therefore have nothing to lose. When people are asked to contribute (even a very small amount), they often feel more motivated to commit to sessions and consequently get more out of counselling.
If you are in a position of being able to pay for counselling, your range of options increases. You can search for a professional in your area in order to limit travel time, you can choose whether you want to work with a man or a woman, and you can do a search based on your particular issue and the type of therapy you resonate with.
The other positive is that if you decide to work on a deeper issue, you don’t have to worry about ending due to a limited number of sessions and can relax into the therapeutic process. This is called an ‘open-ended contract’ and it means that as long as you find your sessions useful, the therapist carries on working with you.
Therapy is costly. The average fees for a counselling session in Bristol range currently from £35 to £60 but some specialist clinics will charge much more. This can be a real obstacle to many people and is something which makes private therapy inaccessible for a large part of the population.