According to recent research, the number of people who identify as having a mental health condition has increased significantly during the past ten years, particularly amongst adolescents and young adults. However, this doesn’t necessarily mean that more people are experiencing mental health issues. The increase could in part be related to the number of media campaigns endorsed by well-known celebrities including the British royal family, that are raising awareness and de-stigmatising mental health conditions. As a consequence, people are more likely to recognise when they have a problem, and take positive steps to do something about it, than they did previously.

Treatments

Selective serotonin reuptake inhibitors (SSRI’s) such as Citalopram, Fluoxetine, and Sertraline have been the most popular form of treatment for common mental health disorders since the 1990s, but recently there have been concerns that these medications are being prescribed too readily to people with only mild symptoms. So during the past ten years, the National Health Service (NHS) in the UK has doubled its provision of talking therapies, and plans a further 50% increase in the next five years. First-line treatment is now usually by a combination of medication and talking therapy. The former for mood stabilisation, and the latter to discover the cause and explore pathways to recovery.

What are talking therapies?

The term 'talking therapy' covers all the psychological therapies that involve a person talking to a therapist about their problems, and is also known as counselling or psychotherapy. It can be undertaken as an individual, as a couple, with other family members, or as part of a group of people having similar difficulties. It takes place in a supportive, non-judgemental environment where people are able to relax and talk openly about their experiences. It may be time-limited, meaning the therapy will come to an end after a set number of sessions, or open-ended, meaning it can continue for as long as it’s needed. It's common for sessions to be held once a week. One-to-one sessions typically last around an hour, but group sessions can sometimes be longer. 

What can talking therapies do?

Talking therapies give people the chance to explore why they have negative thoughts and feelings, and the effect that they’re having on their mood and behaviour. It helps them to think and act differently, take greater control of their lives, and make positive changes.

Do talking therapies really work

• Strong evidence from England and Norway shows that patients referred to talking therapies for anxiety and depression have a recovery rate of around 50%. Read the report here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813743/

• Research shows that cognitive behaviour therapy (CBT) strengthens specific connections in the brains of people with psychosis, and that these stronger connections are associated with long-term recovery. Read the report here: https://www.sciencedaily.com/releases/2017/01/170117101436.htm

• CBT is equally effective at treating major depressive disorder as SSRI’s. Read the report here: https://www.bmj.com/content/351/bmj.h6019

Choosing a therapist

It’s key to a successful outcome that the patient likes and trusts their therapist, and that they feel comfortable discussing their innermost thoughts with them. A therapist should be trained and certified, and although they may differ in their educational background and style of delivery, it’s important to ensure that they’re a registered member of a professional body so that they meet certain recognised quality standards.

Different types of talking therapies

Therapies are usually divided into several broad types:

• CBT: challenges thought processes and develops coping strategies.

• Creative: uses art/drama/music to explore and communicate difficult or confusing feelings.

• Dialectic behaviour therapy: helps patients develop skills to cope with unstable emotions.

• Humanistic: focuses on the individual as a whole, including mind, body, and soul.

• Mindfulness based: develops awareness of current thoughts and feelings.

• Person-centred: focuses on using personal insight to encourage personal growth.

• Psychoanalytic: focuses on unconscious, deep-rooted thoughts that often stem from childhood.

• Psychodynamic: explores how unconscious thoughts affect behaviour.

• Solution-focused: focuses on the future, rather than past experiences.

Getting the most out of therapy

Positive steps to get the most out of therapy:

• Be prepared to talk honestly about your thoughts, feelings and behaviours.

• Write down what you want to achieve from therapy.

• Ask about the type of therapy you're getting. 

• Use the sessions to talk about what's most important to you.

• Tell your therapist what's working and what isn't. 

• Take a comforter (e.g. small soft toy) into the session to help you relax.

How will you feel after a therapy session?

It's common to feel a range of emotions after a session. You might feel:

• Relieved, if you've shared something important and felt heard and understood.

• Inspired, if you've started to understand something new about yourself or set yourself a new goal to work on.

• Exhausted, if you've found the session stressful.

• Frustrated, if you haven’t made progress, or haven't felt heard or understood.

• Upset or overwhelmed, if the session has brought back difficult memories or feelings.

What can you do if therapy isn't helping?

Usually, the purpose of therapy is to bring about change. So if you’re afraid of change, you’re unlikely to make progress. If you have trust and confidence in your therapist, be brave, and be truthful. Talk to them about any problems you’re having; ask if they can offer you a different type of therapy; if there is another therapist you can work with; or if an alternative treatment would be more suitable for you.

Thank you for reading this blog post. If you have any thoughts to share, or ideas for future posts, please do let me know. I would love to hear from you.