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Scenario

Dispensing assistant Megan has a question for technician Vicky.

“In my technician course, it mentions talking therapies alongside medication such as antidepressants for conditions like depression and anxiety,” Megan starts. “I thought that meant counselling, but when I googled it, a whole list came up!”

“Oh yes,” replies Vicky. “CBT, family therapy, interpersonal therapy, mindfulness, there are so many types.”

“But are they all basically the same thing? And if not, how? And when would each one be used?” Megan asks.

Answer

The term “talking therapies” covers a whole range of interventions:

Counselling is probably the best known and involves an individual talking to a specially trained counsellor to get their thoughts in order. It is particularly useful for people who are generally healthy but are experiencing a crisis, for example, a bereavement, serious illness, relationship breakdown or infertility

Cognitive behavioural therapy (CBT) aims to move individuals away from unhelpful behaviour patterns and into a more positive way of thinking. It is often advocated for mental health conditions such as depression, anxiety and post-traumatic stress disorder, as there is a significant amount of supporting evidence. It can be delivered in one-to-one sessions, via online courses, or there are many self help books on the topic

Family therapy involves one or more therapists working with a whole household so they better understand the problems being experienced by their loved ones – such as, substance abuse, separation, sudden or chronic illness and behavioural issues – and so are able to communicate and work through them

Relationship counselling, sometimes known as couples therapy, sees both partners talking about what has gone wrong between them, learning about what the other needs and working on changing things to improve the situation

Group therapy involves several people who have a problem in common – such as alcoholism – working with a therapist on a sessional basis to support and advise each other, and reduce the sense of isolation

Interpersonal therapy (IPT) is generally used for depression sufferers to help them identify and address problems that they are having in their close relationships

Behavioural activation encourages individuals, often those with depression, to adopt a more positive attitude and approach activities they are avoiding, for example getting into the habit of planning if this has been difficult and not doing so has held them back

Mindfulness supports people in focusing on their thoughts and feelings without becoming overwhelmed, and is helpful for a range of problems from depression and stress to anxiety and addiction. It is sometimes combined with CBT or techniques such as meditation. 

The bigger picture

A problem shared is a problem halved goes the popular saying, but sometimes it can be difficult to open up. Talking to a professional is a potential solution, bringing with it the benefits of a therapist’s experience and expertise, a non-judgemental and empathic listening ear with a degree of detachment, and, importantly, confidentiality. In some areas it is possible to self-refer for certain talking therapies on the NHS, with a referral needed otherwise. Waiting lists can be lengthy however, but there is usually an option to speed up the process by paying privately. 

Extend your learning

• Some forms of therapy can be accessed through online programmes and apps
• Read about the effectiveness of CBT in children and young people with anxiety in this Cochrane Review
• Many, but not all, therapists are registered with the British Association for Counselling and Psychotherapy
• Do you know the location of your nearest NHS talking therapies and the various referral processes?