What is counselling?
Working with a professional counsellor to discuss your problems and feelings in a confidential and safe environment.
It's also known as Psychotherapy or Therapy.
What does counselling do?
Improves or stabilises
Who can have counselling?
Most NHS talking therapies are adults-only, with the specific age cutoff depending on the service
How long does counselling last?
Counselling may be as short as six sessions or may involve several years of work, depending on the counsellor and client.
Who might want counselling?
It is a normal thing to want or need help from counselling at some points in your life.
You may be experiencing distress or problems with your mental health due to not being sure who you are, what you want to change about yourself, or how other people will react to changes. Counselling can help you talk through these problems. Counselling is also useful if you are facing life changes and want support to stay well or talk through issues that may come up.
One in six people in the UK are experiencing a common mental health problem right now, and nearly half (43.4%) of all adults say they have experienced one 1. It is particularly common for people who experience gender dysphoria to also have mental health conditions, with transgender health services reporting that up to 38% of people attending their service have at least one “psychiatric disorder” (mental illness) 2, p.177.
The most commonly found problems are depression and anxiety 2, p.177. This can range from mild depression or anxiety to major conditions with a severe effect on quality of life. Other studies of people with gender dysphoria have shown that people may also have problems with social anxiety, addiction, and eating disorders 3;4. Counselling is one of the most effective ways of dealing with problems like these.
A large number of people with gender dysphoria (perhaps up to 20%) also have an autism spectrum condition 5. If you are one of these people dealing with emotional problems on your own without help can be even more complex and difficult.
How do I get counselling?
If you think you might need help, you can speak to your GP. They will often suggest that you try some kind of counselling, sometimes in combination with other approaches like medication or specialist assessments and treatments.
Counselling approaches are talking therapies: by discussing your problems in a safe environment with a counsellor you can gain a deeper insight into them. Counsellors do not “treat” or “heal” people like a doctor, nor do they give you general life advice. The counsellor instead helps you understand yourself and your problems so that you can move forward.
Your counsellor will be bound by rules of confidentiality which mean that they need to keep information you tell them private unless there is a good reason not to do so (for example, if they are required to by law, or if they believe you are at risk of killing yourself). Counsellors also normally have their own counsellors called “supervisors” who support them with the emotional challenges of their work.
What kinds are there?
Practitioners may be known by a number of names, including “counsellors”, “therapists”, “psychotherapists”, “clinical psychologists” and “psychiatric nurses”, depending on exactly what training they have and what their job involves 6. We’re using the word “counsellor” here for simplicity.
There are a variety of ways of working, including:
- Cognitive behavioural therapy
- Person-centred therapy
- Existential therapy
- Psychodynamic therapy
- Dialectical behaviour therapy
- Art and music therapy
You might find that some of these approaches are more suited to you than others. Don’t be discouraged if you don’t “get on” with the first few counsellors you try; it might take a while until you find a counsellor whose approach and personality are right for you. It might help to learn a bit about the different types of therapy and talk them through with a friend.
Where can I learn more?
You can read more about counselling on the NHS website.
How much will it cost?
The NHS provides counselling free of charge. You can often refer yourself directly to local organisations that provide counselling for the NHS, though it can be helpful to talk to your GP first as they may be able to offer you more options. If you are a patient with the NHS gender services, they may also be able to provide you with specialist counselling.
As the counselling provided by the NHS is usually limited to a small number of sessions, if you have more complex problems you may wish to explore other options for finding counselling:
- many LGBT+ organisations provide a counselling service, often at low cost or on a sliding scale where what you pay depends on how much you earn
- many counsellors will allow you to pay for your own treatment (private funding), and some offer a sliding scale system
The next sections describe these options in more detail.
Counselling from LGBT+ organisations
Many regional LGBT+ organisations offer counselling services for LGBT+ people. Many of these are free, low-cost, or operate on a sliding scale (are cheaper for people with low income).
Regional LGBT+ organisations that offer counselling services include:
Privately funded counselling
There are online directories you can use to find a counsellor offering private services:
- British Association for Counselling and Psychotherapy
- UK Council for Psychotherapy
- Pink Therapy
- Gendered Intelligence Therapists and Counsellors Directory
When searching for a counsellor, you should check they have been accredited by a professional body. Professional bodies ensure that your counsellor is properly trained and follows their rules and ethical framework.
You may find that choosing a counsellor can be difficult because they all offer differing approaches to counselling.
The BACP and UKCP both have guides to the different approaches.
You can also find advice on finding a counsellor on the UKCP and BACP websites.
- 1.McManus, S, Bebbington, P, Jenkins, R and Brugha, T (eds.) (2014) “Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014.” Link
- 2.Arcelus, Jon and De Cuypere, Griet (2017) “Mental Health Problems in the Transgender Population: What Is The Evidence?,” in Bouman, W. P. and Arcelus, J. (eds.), The Transgender Handbook: A Guide for Transgender People, Their Families and Professionals, Nova Science Publishers Inc, pp. 173–188. Link
- 3.McNeil, Jay, Bailey, Louis, Ellis, Sonja, Morton, James and Regan, Maeve (2012) “Trans Mental Health and Emotional Wellbeing Study 2012.” Link
- 4.Vries, Annelou LC de, Doreleijers, Theo AH, Steensma, Thomas D and Cohen-Kettenis, Peggy T (2011) “Psychiatric comorbidity in gender dysphoric adolescents.” Journal of Child Psychology and Psychiatry, 52(11), pp. 1195–1202. Link
- 5.Van Der Miesen, Anna IR, Hurley, Hannah and De Vries, Annelou LC (2016) “Gender dysphoria and autism spectrum disorder: A narrative review.” International Review of Psychiatry, 28(1), pp. 70–80. Link
- 6.Sanders, Pete (2002) First steps in counselling - a students’ companion for basic introductory courses 3rd edition, PCCS Books. Link
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