What is counselling and psychotherapy?

In this article, Hospital Support Worker Kate Firkins explains what counselling and psychotherapy are and what you can expect when accessing a talking therapy.

The most important part of accessing a talking therapy is that you have a good relationship with your therapist:

“Research has shown the relationship you have with your therapist is really important in how successful you find any talking therapy. Regardless of the type of therapy they practice, if you don’t like or trust that person, you are less likely to feel able to open up to them and are less likely to have a positive experience.”  – Mind.org.uk

Usually individuals choose to have therapy because they are experiencing difficulties and distress in their lives. Sometimes people can feel isolated, despite living amongst loving family and friends, as they feel it’s impossible to talk to those around them. This may be out of fear of being judged or criticised or it may be a fear of burdening people they love and care for. For these reasons it may be easier to speak to a qualified counsellor who is independent of friends and family.

It’s important to remember that you do not need to be in crisis, or on the verge of it, before choosing to have therapy. In fact, the earlier you seek help, the more effective the therapy may be.

What might someone choose to discuss with a therapist?

  • Living with a long-term illness/other health issues
  • Bereavement/trauma
  • Divorce/relationship difficulties
  • Redundancy/financial concerns
  • Bullying Anxiety Depression
  • Social media dependency

The most common way to access therapy is on a one-to- one basis face-to-face; however, at the moment, therapists are offering sessions via telephone or via the internet. Couples therapy is also an option for helping with relationship difficulties.

The NHS offer free counselling which can be accessed via your GP, or some health authorities allow self-referral—this service is known as IAPT (Improving Access to Psychological Services). This service also offers group therapy; the group members will focus on a difficulty common to them all, for example, eating disorders, depression, anger management, stress and anxiety.

What is therapy?

Therapy is time set aside by you and the therapist on an agreed date at an agreed place, which provides a safe, private space where you cannot be overheard or interrupted. The therapist will do their best to help you to look at your issues and to identify the right course of action for you, either to help you resolve your difficulties or help you find ways of coping. They will help you to make sense of things and understand yourself better.

What therapy is not

Therapy is not advice-giving or persuading the client to see the therapist’s point of view, nor is it just a friendly chat as you would speak with a friend.

Therapist qualities

A therapist is an impartial professional who is able to express warmth and empathy to assist you to talk openly about your feelings and emotions. They should be non-judgemental, fair, open and trustworthy to enable a respectful working relationship to develop between themselves and their client.

As mentioned above, having a sound relationship with your therapist is the most important element to the interaction; however, it is also essential that the therapist abides by an ethical framework set out by one of the two national regulatory bodies, BACP (British Association of Counsellors and Psychotherapists) or UKCP (UK Council of Psychotherapy). This framework includes confidentiality at its core. When you first meet your therapist, they should explain the terms of confidentiality and when this may need to be broken (e.g. if the client suggested they intend to harm themselves or someone else).


You may hear therapies being referred to as counselling, psychotherapy, psychological therapy or talking treatment. They are all broadly the same thing.

Different titles used by talking therapists


A psychiatrist is always a trained and qualified doctor who has specialist training in mental health problems. They are trained in the use of drugs for mental health disorders.

They usually work in a hospital.

Clinical psychologist

Trained in behavioural sciences to a minimum of degree level. This means they are able to help examine unwanted behaviours and explain how these might be changed. They also usually work in hospitals or NHS settings.


Trained to help clients explore and analyse in depth their own unconscious defences and internal conflicts. Once these are understood, then it is easier to change unwanted behaviours, or develop more useful ones. This type of therapy is quite intense, and the meetings will take place two to three times each week for a long period, perhaps years.

Counsellor and psychotherapist

They help clients understand themselves and their behaviours and relationships with others.

All therapists may train to work with specific problems such as addiction.

Different types of therapy

There are more than 50 types of therapeutic approaches—it’s worth asking your therapist to describe their approach to make sure it suits you. Most therapists use an integrated approach that combines various aspects of these approaches; they then customise the approach based on the client’s needs and preferences.

The most common approaches include:

Person Centred Therapy (PCT)

This approach focuses on the client and the therapist provides little direction, but offers subtle guidance and encourages the client to take control of the outcome. These therapists are less analytical and offer empathy as a core condition.

Cognitive Behavioural Therapy (CBT)

CBT treats dysfunctional thinking that leads to maladaptive behaviours, mental illness, negative emotions and focuses on thought patterns rather than the client as a person.

Psychoanalytical/ psychodynamic therapy

This approach explores unconscious feelings and thoughts and the impact of the past on the present. It is the oldest type of psychotherapy and closest to what Freud created.

How might this relate to the current situation?

Many people with a diagnosis of blood cancer have been advised to shield for the past few months to protect them from contracting COVID-19. For those who have followed this advice, they may now be feeling very anxious as the shielding period ends; they may start experiencing panic attacks when they leave their home, they may be constantly worrying about their health and they may have obsessive thoughts or exhibit excessive behaviours. Being in a stressful situation can cause a lot of different emotional reactions like anger, frustration, anxiety, regrets, second-guessing yourself, self-blame. These feelings are normal reactions to an abnormal situation; however, if these feelings continue, it may be advisable to seek therapy or speak to your GP.

In addition to these feelings of emotional fear, there may be other related issues that people have to cope with such as loss of a loved one, redundancy or financial hardship. Having spent a long period of time in the same home as a partner may have put a strain on your relationship, and we know that in some cases this has led to an increased incidence of domestic abuse. If you feel you may be in an abusive relationship, please call the National Domestic Abuse Helpline on 0808 2000 247 for confidential advice.

How can Leukaemia Care help?

Leukaemia Care can offer a grant up to the value of £400 or six counselling sessions. Your counsellor must be registered with either BACP or UKCP to ensure they are a qualified and regulated professional. This grant is available to patients with a diagnosis of leukaemia, MPNs and MDS and their relatives living in the UK.

For more information and to download the application form click here.

Health Technology Appraisals

This involves working with bodies such as the National Institute for Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC) and the All Wales Medicines Strategy Group (AWMSG) to ensure that the views of patients are taken into account when making decisions over access to drugs and treatments.

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