Psychotherapy

Psychotherapy has a long history and resolving issues through counsel and reassurance date back thousands of years, but the therapy known today can be traced back to the late 19th century when Sigmund Freud used 'psychoanalysis' to help patients suffering with hysteria and other mental disorders.

Freud's treatment involved association, analysis of dreams and transference to treat a patient. The patient could then express the repressed conflict that was causing them mental harm and slowly learn to overcome it. From Freud's pioneering work, physicians and scientists in the early 20th century developed the theories further.

Psychodynamic systems and behaviour modification therapy treated problems like phobias and became a strand of psychotherapy that was less focused on the internal struggles Freud was treating, concentrating more on external influences on the human condition. A third strand that involved a humanistic branch of psychotherapy was developed in the 1950s by Carl Rogers and centred on an approach of understanding the patient as an individual with unique needs.    

Psychotherapy is carried out with an individual or as a group and involves talking through a particular problem to find a cure. A psychotherapist will develop a rapport with the patient so they can explore emotions and experiences that are the cause of feelings such as anxiety and depression or serious mental disorder.

A psychotherapist will work with people, usually over a long period, to overcome psychological, behavioural and emotional problems. By understanding a patient's thoughts, beliefs and personal or childhood experiences, the psychotherapist will help the patient make changes to their way of thinking and behaviour.

Within psychotherapy there are different styles and different techniques. Cognitive behaviour therapy will involve work for the patient away from the face-to-face session. Psychodynamic therapy involves looking at past experiences while other techniques concentrate predominantly on the future.

Be prepared

When visiting a Psychotherapist (or indeed any therapist / practitioner) it is sensible to check they are a registered and accredited member of a professional association. Tthe British Association for Counselling and Psychotherapy (BACP), and the UK Council for Psychotherapy (UKCP) and the British Psychoanalytic Council (BPC) are the largest psychotherapy organisations in the UK. Members are expected to have high standards of training and abide by codes of ethics and practice. Psychotherapy is available on the NHS and will need a referral from your GP. It is subject to long waiting times and many people choose to find private practitioners.

Before your first appointment, write down what your problems are and what you hope to achieve with psychotherapy. Also write down any questions or concerns you have about the therapy as you may forget to ask them during the session. If you are taking prescription drugs, take them with you or make a note of what they are.

Your session will be confidential and usually take place in a quiet environment. Some therapists conduct sessions over the internet or via telephone but it is generally done face-to-face.

The psychotherapist will begin by trying to define your problem, asking questions about how long it's been going on and what steps you have previously made to prevent it. The therapist will try and learn more about you, any personal relationships you have and your work or interests. Be prepared to answer questions about your mental health and any previous problems or family history.

You will be given a treatment plan that lays out the direction of your therapy and what you are expected to do during your treatment. It is important to be honest and open-minded about your psychotherapy as forming a trusting relationship with your therapist is fundamental to your progress.

Should they be needed, your therapist may recommend medication or referral to another specialist. They will discuss this with you at your first appointment and throughout your therapy. Although confidential, there are certain legal exceptions that your therapist will discuss with you and you may also be required to sign an agreement for conducting your sessions.   

Psychotherapy appointments typically last an hour but your first session may last a little longer as your therapist assesses your problem. Expect follow-up appointments to be 45 - 60 minutes long.

Psychotherapy treatment costs vary but as a guide expect to pay £20 - £80 for a session depending on your location and practitioner's overheads. It is advisable to check these costs before making an appointment. Your GP will provide you with information about funded therapy on the NHS but this can be limited depending on your Primary Care Trust.

The number of sessions you will need with your psychotherapist depends upon the issues you have but between 6-15 sessions is normal and you will usually attend on a weekly basis. Your psychotherapist will discuss this with you during your first session. Some psychotherapists have an open-ended approach and will allow you to continue beyond your agreed number of sessions if you feel it would be beneficial.

Psychotherapy is available to anyone and can help with a variety of issues and disorders. Many people are worried about what will happen to them mentally should they start to explore their psychological make-up but your psychotherapist is trained to help you through this. Some people find they develop a reliance on their psychotherapy but again, your therapist is trained help you should this happen.

Should a psychotherapist decide that your particular problem needs a different specialist they will advise you of this and arrange for a referral.