For decades, psychotherapy was viewed in the UK as something self-indulgent and American, the stuff of Woody Allen jokes.
Now, of course, we’re all encouraged to talk about our feelings at the drop of a hat and have come to appreciate the benefits of therapy for everyone.
I’m trained in psychotherapy myself – and had to spend time ‘in therapy’ as part of that training. I found it transformative and liberating and would recommend it to anyone.
I’m pleased that the stigma around seeking talking therapy has diminished.
And yet… more and more people seeking help for their problems has had unintended consequences.
The fact is, we are seeing a surge in people who think they are mentally unwell when they aren’t. And it all stems from an explosion in poorly trained ‘therapists’ dishing out labels to people who frankly don’t qualify for them.
The demand means that qualified NHS psychotherapists can’t possibly keep up – waiting lists stretch on for many months, sometimes even years – and so understandably people turn to the private sector. But here, prices are soaring.
A psychotherapist in central London will now typically charge at least £130 an hour, and since many people need therapy for an extended period of time, it ends up costing an awful lot.
We are seeing a surge in people who think they are mentally unwell when they aren’t. And it all stems from an explosion in poorly trained ‘therapists’
Inevitably, a market has sprung up for cheaper therapists, many of whom are not well-qualified.
That means patients are getting a diagnosis that the therapist doesn’t understand and isn’t trained enough to give.
I’m not the only one concerned about this. Government officials are now planning to examine whether counsellors or therapists can start a business too ‘easily’.
Last month, Stephen Kinnock, the care minister, said he was ‘struck’ by how easy it was ‘to set yourself up as a counsellor or therapist and start charging for it within the next day’ in the UK – especially compared to other countries where you have to undergo many years of training before you’re allowed to practise.
At last! Someone in power has woken up and pointed out what so many of us working in mental health have been worried about for so long.
Many people do not realise that the term ‘therapist’ is not a protected one. This means anyone – and I mean anyone – can call themselves a therapist. They can rent a room and, with absolutely no qualifications, training or experience, go about seeing patients.
Yes, really. It’s terrifying.
Worst of all, I find, are the people who have managed to cobble together reputable-sounding qualifications but actually fall far short of the kind of expertise you need to be seeing vulnerable, mentally ill people.
This group are very hard to spot because their CV seems legitimate.
Yet all too often therapy training courses care more about whether you are able to pay the fees than whether you have the skills to be meddling in people’s minds.
Therapy is a broad term covering different types of talking treatment. Over the years, I have seen many patients who have wasted a lot of time and money seeing people in the private sector who simply aren’t suitable. Often the type of therapy they had wasn’t right for their problem.
One middle-aged woman had spent four years and thousands of pounds on therapy to treat her depression, but came to me in a state of some desperation.
Despite the time she had devoted to it, she felt no different – and actually felt worse because she started to see herself as a lost cause.
Yet the way she described her sessions didn’t seem right to me. They seemed more like a friendly chat each week, rather than a chance to address her actual symptoms.
Now, there’s a time and a place for a kind, supportive chat. But when you’re dealing with serious childhood trauma and suicidal depression, as she was, you need more than a furrowed brow and a sympathetic nod.
This woman had very worrying symptoms – she was hearing voices telling her to kill herself (a phenomenon called ‘command hallucinations’). Yet the therapist had failed to pick up on the seriousness of this and, when I looked them up, they were clearly way out of their depth and not experienced or qualified enough.
Thank goodness this woman had the sense to go and speak to her GP. He referred her on to mental health services where she received the proper psychiatric care she so sorely needed.
It’s a shame, because a lot of therapists are very good and diligent. But the problem is, the vulnerable person looking for help has no idea who is good and who is downright dangerous. The system is just too confusing and too easily gamed.
What should you do, given all of the above? As a general rule, I recommend seeing a qualified psychologist rather than someone just calling themselves a ‘therapist’.
Clinical psychologists have gone through years of intense training and have learned about a number of different types of therapy so they can adapt treatment to your specific needs.
Yes, it’s good to talk – but you must ensure you’re speaking to the right person to get the help you need.
Yet another fallout, Harry? 
It appears that the Duke of Sussex’s relationship with former ally Princess Eugenie, who even appeared briefly in Harry and Meghan’s Netflix docuseries, has turned sour
We all know the Duke of Sussex has become distanced from his family over the years. But he did manage to maintain one close relationship – with Princess Eugenie, who even appeared briefly in Harry and Meghan’s Netflix docuseries.
Yet now even that has soured, according to reports.
When Eugenie was pictured in 2023 coming out of a pub in London with broadcaster Piers Morgan, who has clashed with the Prince and his wife in the past, it was apparently enough to cast her out.
I do understand this might feel like a betrayal for Harry, but I am always wary of the idea of cutting contact with family members, especially when they have been loyal and caring, as Eugenie has. We can’t control who others associate with, nor expect them to take on our grievances as their own.
There also comes a point when someone has fallen out with so many family members, they have to ask themselves who the real problem is here.
The herpes zoster virus causes shingles, but has also been linked to dementia. Now a study has found that the shingles jab reduces
The herpes zoster virus causes shingles, but has also been linked to dementia. Now a study has found that the shingles jab reduces the risk of developing dementia by 20 per cent – a fascinating advance in our understanding of the disease.
The NHS is crumbling. Yes, waiting lists have spiralled, but I’m talking about the buildings.
A survey of staff shows the shocking state of many of them.
I did some of my training in a very old building which was part of an 18th-century workhouse at the back of St Pancras station in north London and, while it looked grand and imposing, there were cockroaches and rats, damp and peeling paint.
Many of the patients said it felt like a prison. Several colleagues refused to sleep there when on call and bedded down in their cars – an option not available to the patients, of course.
My current office is in a building which was the childhood home of Charles Dickens. It’s part of a walking tour of London and groups of tourists assemble outside my window every day. But inside it’s barely fit for purpose.
The rooms are tiny and it’s perishingly cold in the winter.
Even worse are the post-war blocks which I suspect were only ever intended to last a few years but are still here – and in a desperate state of disrepair – decades later.
Time to invest in a thorough upgrade, if we possibly can.