NHS: GPs and specialist services
It is worth bearing in mind that treatments and therapies that work for one person may not work for
another. Some treatments work best in combination and some people prefer different treatments at different points in time.
What is clear is that given proper information you are in the best position to make the decision about what works for you.
While most of these treatments are given to you by others, it is you who is the expert in deciding on the 'tools' to help
For most of us our first contact with health services is through our doctor
(GP). Your GP should make a judgement based on how you are feeling and try to identify the right treatment for a pattern of
symptoms. The vast majority of mental health treatments stays with the GP (called Primary Care). However, in discussion with
yourself, your GP can refer you to be assessed by a specialist mental health service. This involves a short meeting
with mental health professionals where your situation will be assessed and a decision made where:
- You will be referred back to your GP who will support you in your care.
- You may receive short term support from mental health professionals and your GP.
- An appointment be made for you to see a psychiatrist or psychologist at an outpatients department.
- You will receive support from mental health professionals who work in community teams.
Talking therapies involve talking and listening. Most of us want somebody to talk to who listens and
accepts us, especially when we are going through a bad time. Sometimes it is easier to talk to a stranger than to relatives
or friends. People go for talking therapies for a whole range of reasons - because they have lost someone, because they
are depressed or worried, or unable to sleep or have become isolated. Talking therapies do not offer magic solutions,
it can be hard workand progress can be slow or painful.
Therapists are trained to listen and to help you find your answers without judging. Most therapists
will be happy to work with you if you are taking medication (for some people a combination of medication and therapy works
better). You should be given the option of talking therapy regardless of your diagnosis or your age, sex, social class or
ethnic group: everyone has an equal need to talk.
Talking therapies are available free on the NHS, either at your GP surgery, at a hospital, or from
a local community mental halth team. What is available on the NHS will vary a great deal from place to place and there will
often be a waiting list as NHS therapy is in short supply in many areas.
Ask your doctor or health worker what is available in your area. For example many charities provide
low cost or free counselling services, some employers provide counselling for their employees and student counsellors provide
a service at many colleges and universities. Many therapists work privately and, although they can be expensive, some will
offer a sliding scale based on your income. Talk to several therapists before you decide which one is right for you and
make sure they are members of a recognised body such as th UK Council of Psychoherapy or the British Association for Counselling
Counselling: helps you to look at issues you are facing
now and you are encouraged to talk about your feelings. Counselling on the NHS is usually short, medium or longer term and
can help with everyday issues to adjusting to major life events such as bereavement or loss. People who have used supportive
counselling say it can make you more aware and guard against too much stress in your life.
Cognitive Behavioural Therapy (CBT): aims to help you to change patterns of thinking
or behaviour that effects how you feel. It is a structured approach - you agree goals for treatment with your therapist and
try things out between sessions. Sessions are usually weekly and last an hour, with number of sessions ranging from 1 - 15.
Psychoanalytical and psychodynamic therapies: these involve
a therapist listening to your experiences, exploring connections between resent feelings and actions and past events. Therapists
have different approaches and different styles of working. Psychoanalytical and psychodynamic therapy may often continue for
a year or more but can sometmes be short term. It is usually one-to-one but sometimes groups are available where a therapist
aims to help group members understand themselves and others better.
NHS psychotherapists normally work in a hospital or clinic where you will see them as an outpatient,
while private psychotherapists often work from home. Psychoanalyic/psychodynamic therapy can help you to get to know
yourself better, improve relationships and get more out of life. It can be especially useful in helping you get to the root
of long-term or recurring problems. Most therapy will be on a one-to-one basis with just you and the therapist.However, you
may be offered couple therapy if you are having problems in a relationship or family therapy may be offered when the whole
family is in difficulty.
Do talking therapies work?
You may find big changes have taken place in the way you think and behave as a result of talking therapies.
You may undertand yourself betterand feel more able to deal with difficult times. Or, you might be disappointed, perhaps
even feeling worse than before. Talking therapies are more likely to work if you feel comfortable and at ease with your counsellor,
psychotherapist or group leader. So, finding the right person is as important as finding the right type of therapy Users of
talking therpies say that over and above just talking, they need to feel listened to, accepted and understood by their therapist;
feeling safe and believed is very important. Many people say that talking therapies do not make their problems go away, but
they feel better able to cope with them.