The NHS and Private Treatment - Which One is For You?

by Harley Therapy
Reviewed by Dr Sheri Jacobson

Confused about the difference between a NHS therapist and private treatment?

For some people, going through their GP to try therapy is a perfect solution. For others, it’s just not the best option.

Here are the questions to ask yourself when deciding between going through the NHS or booking a counsellor or psychotherapist privately.

How long do you want to wait before you see a therapist?

The NHS, particularly in city centres, has extensive waiting lists. Some people in London boroughs report waits of over a year to see a therapist. This is absolutely no help at all if you are suffering from anxiety or depression and need to talk to someone right away. Private therapy, on the other hand, is very quick. In fact booking on our platform can mean you speak to someone as soon as the next day.

How many times do you want to go through your issues and concerns?

If you decide to see a psychotherapist on the NHS there is quite a process to go through. First, you explain things to your GP. Then, in most cases, you will receive a call from a mental health practitioner who puts you through a phone assessment where you must answer very personal questions. Several weeks, months, or over a year later, you will be booked with a therapist. And you will have to explain all your issues and mental health history again.

How private do you want your mental health issue to be?

If you go through the NHS you might be asked to go to a group ‘introduction’ session after your phone assessment. This involves going to a local health centre and sitting in a room with several therapists who work for the NHS who explain a bit about mental health and therapy and allow you to ask questions. Which is all very useful except if you are a private person. The other people in the room will live in your community. You might see them when you are out and about.

Do you want to actually work with a person, or just take a course?

The NHS now offers those suffering from anxiety or mild depression access to an online course. You work through the course yourself instead of attending therapy sessions. It's been shown useful for many people. But if you want to actually talk to someone, this might be disappointing for you. You have had the courage to see your GP about your low moods only to be offered a 'do it yourself' course.

Do you want to choose your own therapist?

If you are lucky enough to pass the NHS assessment and be given a session with a practitioner, then you must take the therapist you are paired with. If there is a real issue you are of course free to complain. With private therapy, you are free to do your research and book a counsellor or psychotherapist you feel an affinity with. And if after several sessions you don’t feel you are a match, you have the choice to end working with them then try another therapist.

Do you want to choose the type of therapy you try?

The NHS only offers certain types of therapy, and they are generally therapies that are evidence-based (backed up by research) and cost effective. This does not mean they are the best therapy for your issue, or that they are better than other sorts of therapy. Therapy, like anything, sees trends. And when a therapy is seen as trendy it will receive all the research budgets. Currently the NHS mostly offers cognitive-based therapies like CBT. If you want to research the different types of therapy and try the one that seems best suited to you, you are better off with a private therapist.

Do you want your mental health issues on public record?

If you go to your doctor for help with your mental health, it will be on your health record for the rest of your life. For some people this is not a problem. For others, if they are planning to work for an company that requires access to medical records, or are thinking of adoption in the future, they might not want their mental health on a public record where it can be misconstrued and used against them (sadly, stigma against mental health is still alive and well). If you book privately, then your issues remain private unless you share information of illegal activities.

Do you have an issue that is recognised as treatable by the UK mental health profession?

The UK does not necessarily recognise or prioritise the same mental health issues as other countries might. And the treatment offered by the NHS might be very different than that you can find in places like America. ADHD is a case in point here. Adult ADHD has only recently begun to gain attention in the UK, and even now many Britsh GP’s refuse to see it as a real condition and will not refer you to a psychiatrist. Even if you do manage to get a referral, the waitlists are very long, and the medication the NHS offers might be limited.

Do you want a therapist with a lot of experience?

There are many very experienced therapists working for the NHS. In fact many top therapists work part time in the NHS and the rest of the time privately. This enables them to see and help a wider variety of people and expand their skillset. But again, with the NHS you don’t get to choose what therapist you see. If you want to be sure of the amount of experience your therapist has, you have to book privately.

Do you want to pay, or do you prefer therapy to be free?

If you want free therapy, you have to go through the NHS and see your GP. That said, nowadays there are several ways to find low cost counselling. This might be working with a trainee therapist, for example. Or check our roster of therapists, several of whom offer appointments at a very reasonable rate.

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