The most useful thing to know about finding a therapist in London is that the title alone tells you almost nothing. In the United Kingdom the words therapist, psychotherapist and counsellor are not protected in law, so anybody may print them on a website, and the check that separates a trained practitioner from an untrained one takes about two minutes and almost nobody does it.
The second most useful thing is that the supply problem is not what people assume. London has an unusually dense concentration of practitioners. What stops people getting seen is the reply rate.
Check the register before anything else
This is the step to do first because it is the only one with a definite answer. Some titles are legally protected and some are not, and the difference decides which register applies.
Protected titles. Clinical psychologist, counselling psychologist, educational psychologist and several others are restricted by law. Using one without being on the statutory register is an offence, and that register is searchable by surname and shows registration status and any findings against the person. [hcpc-register-london] Two minutes, and it is the strongest single check available to you.
Unprotected titles. Therapist, psychotherapist, counsellor and psychoanalyst are not restricted. For these, the meaningful registers are voluntary but accredited, and membership requires an accredited training, supervision, insurance and a complaints route. The professional bodies most people are looking for are the British Association for Counselling and Psychotherapy, the United Kingdom Council for Psychotherapy, and the British Psychological Society. A practitioner who is on none of these is not necessarily bad. They are somebody you have no route to complain to, which is a different thing and matters most in exactly the situations where it would matter most.
Psychiatrists are separate again: they are doctors, they are on the medical register, and they are who you need if the question involves medication or a diagnosis rather than talking therapy. Our piece on psychiatrists and psychologists covers which one a given problem calls for.
What it costs, and what you get for the difference
Private fees in central London sit at the top of the national range. Sessions commonly run from about 70 to 150 pounds, with specialist and consulting-room practices above that. Two things move the number more than seniority does: postcode, and whether the session is online.
A schematic of the trade-off described in this article, drawn to show the shape rather than to report measured fees or waiting times.
The shape is the point. Money mostly buys speed and choice rather than quality, and the cheapest routes are slow rather than worse. A supervised trainee at a university clinic is being watched more closely than almost anybody in private practice, which is an argument in their favour that people rarely hear.
| Route | Roughly what it costs | What it is good for |
|---|---|---|
| Central London private practice | 70 to 150 pounds a session | Speed, choice of approach, evening appointments |
| Outer London or online | Often 20 to 40 per cent less | The same clinician, without the consulting-room rent |
| University training clinic | Sliding scale, sometimes free | Structured, closely supervised, long courses of work |
| Charitable and low-fee services | Free to about 30 pounds | People on low incomes, and specific communities |
| Group therapy | A third to a half the individual rate | Social anxiety, addiction, bereavement, and it is underrated |
| Publicly funded talking therapy | Free | Common problems such as depression and anxiety |
The publicly funded route is worth one specific note, because it is the one people get wrong. In England you can generally refer yourself for talking therapy for common problems without going through a doctor first. Many people wait months for an appointment in order to be told they could have referred themselves.
What a good therapist looks like in the first three sessions
Credentials get you a shortlist. The fit is decided in the room, and there are things to look for that are more reliable than how you feel after session one, which is often just relief at having started.
Good signs, in rough order of how much they predict:
- They ask what you want to be different, in concrete terms, and write it down.
- They can name what they do and why, and give a rough number of sessions rather than an open-ended arrangement.
- They say how you will both know whether it is working, and revisit it.
- They are comfortable being disagreed with, and do not treat your objection as material.
- The method matches the problem. For depression and the anxiety disorders there are approaches with a strong trial record, and guidance sets out which ones are offered first. [nice-ng222-london]
Warning signs are less about technique than about accountability: a practitioner who cannot say which register they are on, who is vague about method, who discourages you from talking to anybody else about the work, or who is unusually available in a way that starts to look like a friendship. Note also that the first therapist you meet is a sample of one, and changing after two or three sessions is ordinary rather than a failure. [apa-choose-therapist-london]
Is this the right therapist for you?
Tick anything true after two or three sessions. This is a reflection prompt rather than a test, and it produces no diagnosis.
0 of 6 ticked
Say it in the next session, in those words. A good therapist will treat that as useful information about the work. How they respond is itself the most informative thing you will get, and it is a reasonable basis for staying or leaving.
Pick the single item you ticked and put it on the table next session. Most of these are fixable and several are just conversations that have not happened yet.
The arrangement looks sound. Worth rereading at around session eight, which is where drift tends to show up rather than at the start.
The bottleneck is the reply rate, so send ten
This is the practical finding that changes outcomes more than any other advice on this page. People send one careful enquiry, hear nothing, and conclude there is no help available.
Send a short identical message to eight or ten practitioners in one sitting. Include what you want help with in one line, your rough availability, your budget, and whether you want online or in person. Expect roughly half not to reply and several to be full. That is not about you and it is not about London; it is what a caseload-based profession with no central booking looks like from the outside.
If money is the constraint, say so in the first message rather than at the end of a phone call. A meaningful number of private practitioners keep one or two reduced-fee places and simply do not advertise them, and the only way to find out is to ask.
While you wait
Waiting lists are the norm on the cheap routes, and the weeks in between are not empty. Structured self-help based on cognitive behavioural methods has a real evidence base for common problems, and it is the same material the early sessions would cover. Our guides to therapy for anxiety and finding the right therapy cover which approach fits which problem, and a self-assessment gives you a score to hand over at the first appointment, which is more useful to a clinician than a description written from memory.
When to seek help
Contact a doctor rather than waiting for a private appointment if you cannot work or care for people who depend on you, if you have not slept properly for weeks, if you are drinking more to manage, or if the low mood has lasted more than a month without moving. Those are the situations where the waiting list is the wrong instrument and a same-week appointment is the right one.
Ask by name for what you want. Naming an approach, whether that is cognitive behavioural therapy, a trauma-focused therapy or a specific medication review, changes what you are offered more than describing how you feel does.
Contact your local emergency services or a crisis helpline if you feel unsafe or have thoughts of harming yourself.
How MyFreud can help
MyFreud is a mobile app that helps you find solutions to problems that have affected your mind and productivity. Live coaching sessions are useful in the gap that this article is mostly about, which is the weeks between deciding to do something and getting an appointment, and each one ends with an actionable plan rather than a place on a list. Daily tracking gives you something concrete to bring to a first session, since a month of recorded days is a better account than the one you will manage to give under pressure. The notepad is where the shortlist of ten and their replies go, which is dull and is the part that actually gets people seen.
Download MyFreud and start today: App Store or Google Play.