Counsellors, psychotherapists
Both are trained to listen, giving people time and space to explore important issues. They're not there to find answers to your problems but to allow you to find your own answers through guided discussion.
Community mental health nurses, community psychiatric nurses
These are psychiatric nurses who work in the community rather than in hospitals. They may be attached to GPs' surgeries, community mental health teams, mental health centres or psychiatric units. They may also visit you in your home.
Their role includes offering emotional support and helping you explore ways of living with your problem and anxiety management techniques, and administering psychiatric drugs.
General practitioners
A GP is many people's first point of contact when seeking help. Everyone has the right to the services of a GP and a sizeable proportion of their work is related to emotional or psychological problems. GPs all have different expertise and ideas when it comes to mental distress, but in general they can:
- Talk through your problems with you
- Prescribe short-term medication, such as antidepressants and tranquillisers
- Refer you for specialist NHS treatment in hospital or in the community
- Refer you for counselling, psychotherapy or complementary therapy
Psychiatric nurses
Nurses who have specialist training in mental health, they work with hospital inpatients on psychiatric wards and with patients attending day hospitals and psychiatric units.
Psychiatrists
These are medically qualified doctors who have specialised in the diagnosis and treatment of mental illness. A consultant psychiatrist is the senior member of the psychiatric team, with overall responsibility for a patient's assessment and care.
Psychologists
Clinical psychologists have specialist postgraduate training but they're not medical doctors and do not prescribe drugs. They can help with a variety of problems connected with health and wellbeing, including depression, sexual or relationship difficulties, eating disorders, the effects of trauma and problems with alcohol or drugs. They normally offer psychological talking treatments.
Social workers, approved social workers or mental health officers (Scotland)
They can carry out mental health 'needs assessments', and they're involved in the management and planning of care. They may help with benefits problems or arrange daycare services, supported housing and residential care. They can also arrange breaks for carers.
Approved social workers have undergone additional training and, along with mental health professionals, help to assess whether a person should be compulsorily admitted to hospital, and consider the alternatives.
Occupational therapists
Occupational therapists (OTs) help people with mental health problems develop skills, support and strategies so they're better able to manage their particular condition. The aim is to enable patients to live their lives as freely and independently as possible.
They may work in hospitals, but mental health OTs frequently work in other settings, including community and social care teams, prisons, vocational rehabilitation, condition management programmes and independent or private practice.
OTs must be registered with the Health Professions Council and most are accredited to the standards of their professional body, the College of Occupational Therapists. Once qualified, they often undertake further studies leading to specialist and extended roles within the mental health care team.
Art therapists
Art therapy is a form of psychotherapy that uses painting and creative activities to communicate with participants. Qualified, registered art therapists help to treat children, young people and adults for a wide range of conditions, including:
- Learning or physical disabilities
- Depression
- Anxiety
- Brain injury
- Neurological conditions
Art therapy sessions are run for groups or individuals. It's not a recreational activity or an art lesson, and participants don't need to have any previous experience or expertise in art.
The sessions offer the opportunity for expression and communication through art and creativity and can be particularly helpful to people who find it hard to express their thoughts and feelings verbally.
Music therapists
Music therapy is another form of psychotherapy. It uses mainly improvised music to form a relationship between the client and therapist.
Rather than teaching the client to sing or play an instrument, a qualified, registered therapist encourages the use of instruments and voice to create a musical language of their own. By responding musically, the therapist is able to support and encourage the patient, which is particularly useful for those who have difficulty with verbal expression.
Music therapists work with adults and children of all ages, individually or in group sessions.
Dramatherapists
Dramatherapy is a form of psychological therapy/psychotherapy which uses the performing arts as an integral part. It’s not a recreational activity or a drama lesson. Dramatherapists are registered with the Health Professions Council and treat children, young people and adults for a wide range of conditions, including:
- Learning or physical difficulties
- Eating disorders
- Physical or emotional trauma
- Mental health conditions
- Addictions
- Social exclusion
It’s particularly helpful to those who find it difficult to express themselves verbally, or want to use action methods in addition to talking.
Dramatherapists work in a wide range of settings including the NHS, schools, prisons and communities.
Qualifications
The range of psychotherapies available, and the number of different qualifications, is bewildering. In the UK there's no compulsory regulation of psychotherapists and counsellors. Anyone can put a brass plate on their front door with their name on and the word 'psychotherapist' underneath it and start charging people.
Most trained professionals, and quite a few people seeking help, find this frightening. However, once you know which qualifications to look out for, which professional bodies you can contact and what kind of behaviour should set alarm bells ringing, you'll have some idea of whether you're dealing with a Freud or a fraud.
Formal qualifications
BACP acc - this stands for British Association for Counselling & Psychotherapy Accredited, and usually means the person has undertaken up to 450 hours of supervised practice (in which their work with clients is checked for a minimum of 11 and a half hours each month) or 200 hours of training and 250 hours of practice. If they do something you believe to be wrong, you can complain to the BACP.
C Psychol - this stands for chartered psychologist. There are several kinds but each must take a first degree or postgraduate diploma in psychology followed by up to three years' full-time specialist training. If they do something you believe to be wrong, you can complain to The British Psychological Society.
- clinical psychologists - they can apply a wide variety of psychological tests, as well as engage with patients in different forms of psychotherapy.
- counselling psychologists - according to The British Psychological Society, they help people improve their wellbeing, resolve crises and increase their ability to solve problems and make decisions for themselves.
FRCPsych or MRCPsych - fellows or members of the Royal College of Psychiatrists are qualified doctors with at least three years' rigorous postgraduate training. They can prescribe drugs and diagnose, and usually work in a team with other health professionals. If they do something you believe to be wrong you can complain to their employer or the General Medical Council (GMC).
RMN - registered mental nurses have taken a three-year course. If they qualified in the past ten years, the training was probably at a university with some general nursing included. Before this, the RMN qualification was obtained by a three-year course at a mental health unit and was mostly practical.
An RMN qualification doesn't make someone a psychotherapist or counsellor, but it's considered to be a good basis from which to take further training, which is what many nurses now do. If they do something you believe to be wrong, you can complain to the Nursing & Midwifery Council (NMC).
UKCP - this stands for United Kingdom Council for Psychotherapy, an umbrella organisation incorporating many schools of psychotherapy and insisting on high standards of training and ethical conduct. Most psychotherapists with this qualification have taken about four years' postgraduate training. They're also registered with one of the UKCP's member organisations.
Things that should worry you
If you're concerned about your therapist's behaviour, you can speak to another healthcare professional about it, terminate the professional relationship and/or contact any of the organisations mentioned above. In particular, you should be alarmed if your therapist:
- Makes you feel humiliated
- Talks more about their own life or problems than yours
- Invites you out
- Invites you to their home, unless that's where they practise (in which case, it's a good idea to let someone else know the address)
- Gives you a gift
- Gets irritated when you ask about their qualifications
- Makes a sexual advance towards you