top of page

NHS Talking Therapy Vs. Private Practice, What's the difference?

Choosing between NHS talking therapies and private counselling is a significant decision for individuals seeking mental health support in the UK. Both avenues offer valuable assistance but differ in various aspects such as access, cost, choice of therapists, and types of therapy available. This comprehensive guide aims to provide detailed insights to help you make an informed decision based on your personal needs and circumstances.

2 people in a counselling session

Understanding NHS Talking Therapies

NHS talking therapies, also known as Improving Access to Psychological Therapies (IAPT), are free services provided by the NHS to individuals experiencing emotional difficulties such as depression, anxiety, and stress. These services are available to adults over the age of 18 and can be accessed through a GP referral or, in some areas, by self-referral.


Cost: The most significant advantage is that it's free. There's no financial burden on the patient.

Quality Assurance: Therapists are accredited and services are regulated, ensuring a standard level of care.

Wide Range of Therapies: Offers various evidence-based therapies, including Cognitive Behavioural Therapy (CBT), counselling for depression, and more.

empty chairs for group meeting


Waiting Times: Can be lengthy, often several weeks to months, depending on the area and service demand.


Limited Choice of Therapists: Patients cannot choose their therapist, which might affect the therapeutic relationship.

Session Limits: There may be a limit on the number of sessions available, potentially affecting long-term care.

Understanding Private Counselling

Private counselling offers an alternative route for those seeking mental health support, with services provided by therapists and counsellors operating outside the NHS framework. Access does not require a GP referral; individuals can directly contact therapists.


Immediate Access: Shorter waiting times, with many therapists offering sessions within a week.

Woman taking notes

Choice of Therapist: Greater freedom in choosing a therapist who fits personal preferences, including specialization, approach, and personality.

Flexibility: Often more flexibility in session timings, frequency, and length of therapy.


Cost: The most significant barrier, with costs varying significantly but often ranging from £50 to £100 per session.

pound coin

Regulation and Quality: While many therapists are accredited, it's essential to verify credentials as the sector is less regulated than NHS services.

Insurance Coverage: Private therapy is not always covered by insurance, and even if it is, there may be limits on the number of sessions.

Making the Choice

When deciding between NHS talking therapies and private counselling, consider factors such as the urgency of your need for support, your financial situation, the importance of choosing your therapist, and the specific type of therapy you're seeking.

Immediate Needs

If you're in immediate distress or need support quickly, private counselling might be more suitable due to shorter waiting times. However, if you're in crisis, it's crucial to seek immediate help through your GP or emergency services.

Financial Considerations

For those with limited financial resources, NHS talking therapies offer a valuable service without the burden of cost. However, if you have the means or private health insurance that covers therapy, private counselling could offer more personalized and immediate support.

Therapeutic Relationship

The relationship with your therapist is a critical component of effective therapy. If you feel strongly about choosing a therapist with whom you feel comfortable and who has specific expertise, private counselling may offer more options.


Type of Therapy

Both NHS and private options offer a range of therapies. However, if you're seeking a specific type of therapy not widely available through the NHS, or if you require a longer-term therapy option, private counselling might be more appropriate.

Summary Table




£50-£100 per session

Access/Waiting Times

Weeks to months

Often within days

Choice of Therapist


Wide choice


Fixed session times and limits

Flexible timings and duration

Type of Therapy

Evidence-based, some variety

Wide range, including niche therapies


Highly regulated, accredited therapists, sometimes service provided by 3rd party, who could use trainees, and junior staff.

Less regulated, check membership such as BACP, and if accredited.

 The decision between NHS talking therapies and private counselling is deeply personal, depending on individual circumstances and preferences. Both paths offer valuable support for those struggling with mental health issues. The NHS provides a cost-effective, regulated service with a range of therapies but comes with longer waiting times and less choice. In contrast, private counselling offers immediacy, choice, and flexibility but at a financial cost.

It's essential to weigh these factors carefully, considering your immediate needs, financial situation, the importance of therapist choice, and the type of therapy that might best suit your needs. Ultimately, the best choice is the one that feels right for you and supports your journey towards mental well-being.

If you would like to self refer yourself to the NHS, please check this link: NHS SELF REFERAL

Other similar articles


15 views0 comments


bottom of page