Counselling in London

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Photo of Harriet Elsom, MBACP, Counsellor
Harriet Elsom
Counsellor, MBACP
Verified Verified
London W4
Hello, I am a therapist working in practice with clients in Hammersmith W6, Chiswick W4 and online. I offer a sensitive, reflective space and work with a broad range of issues and concerns both short and long-term. These may be anxiety, depression, grief and loss, anger and relationship issues for example, or people may come with more of a general sense of longing, disquiet or stuckness. It isn't necessary to know what is wrong, it is enough to know that you wish for something to be different.
Hello, I am a therapist working in practice with clients in Hammersmith W6, Chiswick W4 and online. I offer a sensitive, reflective space and work with a broad range of issues and concerns both short and long-term. These may be anxiety, depression, grief and loss, anger and relationship issues for example, or people may come with more of a general sense of longing, disquiet or stuckness. It isn't necessary to know what is wrong, it is enough to know that you wish for something to be different.
020 7046 0186 View 020 7046 0186
Photo of Enas Ismail, MA, MBACP Accred, Psychotherapist
Enas Ismail
Psychotherapist, MA, MBACP Accred
Verified Verified
London SW13
I am a qualified and experienced Psychotherapist in private practice. I have experience in working with depression, low self esteem, anxiety, relationship problems, gender and sexuality issues, abuse, eating disorders and mental health problems. I have worked with people from a wide range of ethnic backgrounds.
I am a qualified and experienced Psychotherapist in private practice. I have experience in working with depression, low self esteem, anxiety, relationship problems, gender and sexuality issues, abuse, eating disorders and mental health problems. I have worked with people from a wide range of ethnic backgrounds.
020 3962 1210 View 020 3962 1210
Photo of Davina Naik, MBACP, Counsellor
Davina Naik
Counsellor, MBACP
Verified Verified
1 Endorsed
London SE24
I am a qualified TA (Transactional Analysis) psychotherapeutic counsellor. I offer therapy to individuals, couples and groups. I work with clients from different ethnic and cultural backgrounds, of different genders and ages. I offer a safe, non-judgemental and confidential space for us to work together, to help you find a way forward; exploring your current concerns in a way that feels comfortable for you. We go at your pace.
I am a qualified TA (Transactional Analysis) psychotherapeutic counsellor. I offer therapy to individuals, couples and groups. I work with clients from different ethnic and cultural backgrounds, of different genders and ages. I offer a safe, non-judgemental and confidential space for us to work together, to help you find a way forward; exploring your current concerns in a way that feels comfortable for you. We go at your pace.
020 4538 8795 View 020 4538 8795
Photo of Hazrath Khan
Hazrath Khan
Verified Verified
London EC3R
I am an award winning holistic therapist based in London, UK (Prestige Award winner, Global Recognition Award winner) with expertise in 9 modalities. Most common issues I can help are anxiety, depression, phobias, fears, physical conditions, relationships issues, infertility, improving your confidence and self-esteem, energy healing, belief changes, money blocks, fulfilling life purpose
I am an award winning holistic therapist based in London, UK (Prestige Award winner, Global Recognition Award winner) with expertise in 9 modalities. Most common issues I can help are anxiety, depression, phobias, fears, physical conditions, relationships issues, infertility, improving your confidence and self-esteem, energy healing, belief changes, money blocks, fulfilling life purpose
020 4538 6129 View 020 4538 6129
Photo of Elliot Nelson, MBACP, Counsellor
Elliot Nelson
Counsellor, MBACP
Verified Verified
1 Endorsed
London W1U
We all have a story that needs to be told, and I want to give you the gift of therapy that will equip you and move you towards being your most authentic self, whatever that looks like for you. As an Integrative Counsellor, my work considers your whole story in context, the historical value of experiences and the present-day application. The individuals I work with come from various backgrounds, so I work with a culturally sensitive and accommodating trauma-informed approach. They want to work on relational difficulties, sexual addictions, shame, unprocessed loss, transitioning to adulthood, and midlife crisis.
We all have a story that needs to be told, and I want to give you the gift of therapy that will equip you and move you towards being your most authentic self, whatever that looks like for you. As an Integrative Counsellor, my work considers your whole story in context, the historical value of experiences and the present-day application. The individuals I work with come from various backgrounds, so I work with a culturally sensitive and accommodating trauma-informed approach. They want to work on relational difficulties, sexual addictions, shame, unprocessed loss, transitioning to adulthood, and midlife crisis.
020 3376 8282 View 020 3376 8282
Photo of Manuela Sapochnik, PsychD, HCPC - Clin. Psych., Psychologist
Manuela Sapochnik
Psychologist, PsychD, HCPC - Clin. Psych.
Verified Verified
London N22
I have 20 years experience as a child and family Clinical Psychologist. I see individuals, couples and families. I worked in multiple NHS settings for 18 years and moved to full time private practice 2 years ago. I am trained in CBT, ACT, CFT, EMDR, EFT, Mindfulness and family therapy. I have extensive experience with mental and physical health issues and I believe they are deeply connected. I am passionate about delivering good therapy, tailored to each persons unique life and needs. The linking thread in all my work is recognising the lasting impact of traumatic experiences (large and small) on how we feel and function right now.
I have 20 years experience as a child and family Clinical Psychologist. I see individuals, couples and families. I worked in multiple NHS settings for 18 years and moved to full time private practice 2 years ago. I am trained in CBT, ACT, CFT, EMDR, EFT, Mindfulness and family therapy. I have extensive experience with mental and physical health issues and I believe they are deeply connected. I am passionate about delivering good therapy, tailored to each persons unique life and needs. The linking thread in all my work is recognising the lasting impact of traumatic experiences (large and small) on how we feel and function right now.
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Photo of Millicent R Martin-Lebert - Repercia Therapeutic Counselling Services, MBACP, Counsellor
Repercia Therapeutic Counselling Services
Counsellor, MBACP
Verified Verified
London SE16
Repercia Therapeutic Counselling Services do not believe in ‘One size fits all’. because everyone is unique in their thoughts, feelings, behaviours, illness, attitude, appearance and the way they view the world. We have over ten years' experience helping people cope with and eventually overcome their mental health problems. Rather than struggle through difficult times on your own, don’t hesitate to reach out. We provide the place, space, and pace for you to feel safe in a therapeutic environment. Relationship will be build on respect, openness and trust with a robust adherence to confidentiality
Repercia Therapeutic Counselling Services do not believe in ‘One size fits all’. because everyone is unique in their thoughts, feelings, behaviours, illness, attitude, appearance and the way they view the world. We have over ten years' experience helping people cope with and eventually overcome their mental health problems. Rather than struggle through difficult times on your own, don’t hesitate to reach out. We provide the place, space, and pace for you to feel safe in a therapeutic environment. Relationship will be build on respect, openness and trust with a robust adherence to confidentiality
020 3870 2479 View 020 3870 2479
Photo of Henrik Lynggaard, PhD, HCPC - Clin. Psych., Psychologist
Henrik Lynggaard
Psychologist, PhD, HCPC - Clin. Psych.
Verified Verified
London W1W
I work as a psychoanalytic psychotherapist and I have consulting rooms in Central London and North London. I have more than 30 years’ experience of working in the NHS as well as in independent practice. In my experience people seek therapy for many different reasons. They may be facing a predicament, be anxious, depressed or confused, or feel stuck in repeating patterns of thoughts and behaviour that have adverse effects on their lives. They may have relationship difficulties or questions about their sexuality; they may be finding it difficult to deal with the loss of a person, a position or an identity.
I work as a psychoanalytic psychotherapist and I have consulting rooms in Central London and North London. I have more than 30 years’ experience of working in the NHS as well as in independent practice. In my experience people seek therapy for many different reasons. They may be facing a predicament, be anxious, depressed or confused, or feel stuck in repeating patterns of thoughts and behaviour that have adverse effects on their lives. They may have relationship difficulties or questions about their sexuality; they may be finding it difficult to deal with the loss of a person, a position or an identity.
020 3984 8911 View 020 3984 8911
Photo of Matt Wotton - Highgate Therapy Online, MSc, MBACP, Psychotherapist
Highgate Therapy Online
Psychotherapist, MSc, MBACP
Verified Verified
London N10
If you’re ready to take an in depth look the issues facing you, we’re a group of experienced practitioners, committed to helping you achieve change. We work online to provide flexibility about when and where you access help - including at the weekend or evening. You decide whether you want long-term help as you transition through life, or whether you’re looking for short-term help to deal with a particular, pressing problem. Either way, we will make sure you feel safe, understood and helped to achieve the change you seek. We are fully insured, highly trained and registered with the largest professional body of therapists in the UK.
If you’re ready to take an in depth look the issues facing you, we’re a group of experienced practitioners, committed to helping you achieve change. We work online to provide flexibility about when and where you access help - including at the weekend or evening. You decide whether you want long-term help as you transition through life, or whether you’re looking for short-term help to deal with a particular, pressing problem. Either way, we will make sure you feel safe, understood and helped to achieve the change you seek. We are fully insured, highly trained and registered with the largest professional body of therapists in the UK.
020 3917 4110 View 020 3917 4110
Photo of Richard Backes, BPC, Psychotherapist
Richard Backes
Psychotherapist, BPC
Verified Verified
London W1W
My name is Richard Backes, I'm an experienced and qualified Psychoanalytic Psychotherapist based at 25 Margaret Street, W1W 8RX, 5 mins from Oxford Circus Underground. I provide psychotherapy in Central London. I provide a confidential and safe setting for us to explore past and present feelings and relationships. By understanding more about yourself, and by developing a greater self-awareness, the aim is to find different ways of thinking about and dealing with painful situations.
My name is Richard Backes, I'm an experienced and qualified Psychoanalytic Psychotherapist based at 25 Margaret Street, W1W 8RX, 5 mins from Oxford Circus Underground. I provide psychotherapy in Central London. I provide a confidential and safe setting for us to explore past and present feelings and relationships. By understanding more about yourself, and by developing a greater self-awareness, the aim is to find different ways of thinking about and dealing with painful situations.
020 3835 3284 View 020 3835 3284
Photo of Mischa Richards, MA, BPC, Psychotherapist
Mischa Richards
Psychotherapist, MA, BPC
Verified Verified
London SE1
Looking for help, enhanced quality of life and to realise your potential? Along life’s course, suffering can prevent us from living the life that is ours. With empathy and interest, I will support you to discover your truth and freedom.
Looking for help, enhanced quality of life and to realise your potential? Along life’s course, suffering can prevent us from living the life that is ours. With empathy and interest, I will support you to discover your truth and freedom.
020 7870 6643 View 020 7870 6643
Photo of Kelsey Wiemer, MSc, MBABCP, Psychotherapist
Kelsey Wiemer
Psychotherapist, MSc, MBABCP
Verified Verified
London SW15
Life is hard and full of unsuspected challenges. Often the more we journey toward where we want to go, the bumpier the road gets. The impact of past experiences, present stressors, and worries about the future threaten to keep us stuck in an unhelpful loop. We repeat old, conditioned patterns and behaviours simply because we're on autopilot and maybe haven't had the space to reflect. By increasing our awareness, bringing our attention to the present, detaching from old stories, and focusing on what's helpful we make meaningful choices.
Life is hard and full of unsuspected challenges. Often the more we journey toward where we want to go, the bumpier the road gets. The impact of past experiences, present stressors, and worries about the future threaten to keep us stuck in an unhelpful loop. We repeat old, conditioned patterns and behaviours simply because we're on autopilot and maybe haven't had the space to reflect. By increasing our awareness, bringing our attention to the present, detaching from old stories, and focusing on what's helpful we make meaningful choices.
020 3974 1472 View 020 3974 1472
Photo of Pashmina Nanwani, DCounsPsych, MBACP, Counsellor
Pashmina Nanwani
Counsellor, DCounsPsych, MBACP
Verified Verified
London W14
My name is Pashmina, I am an experienced Relational Counsellor and Psychotherapist. I am Indian by origin, and have lived in Africa, Spain, Middle East and the UK. With my experience and London being so ethnically diverse, cultural and social differences play a huge role in my practice and continues to be an area of focus. I have gained experience of working with anxiety, trauma, depression, relationship issues, and many other issues. I continue to work with clients at a centre affiliated with the NHS and as well as clients in my private practice. I offer both short-term and open ended therapy.
My name is Pashmina, I am an experienced Relational Counsellor and Psychotherapist. I am Indian by origin, and have lived in Africa, Spain, Middle East and the UK. With my experience and London being so ethnically diverse, cultural and social differences play a huge role in my practice and continues to be an area of focus. I have gained experience of working with anxiety, trauma, depression, relationship issues, and many other issues. I continue to work with clients at a centre affiliated with the NHS and as well as clients in my private practice. I offer both short-term and open ended therapy.
020 4538 6596 View 020 4538 6596
Photo of Marek Julian Mironski, MA, COSRT Accred, Psychotherapist
Marek Julian Mironski
Psychotherapist, MA, COSRT Accred
Verified Verified
2 Endorsed
London SE1  (Online Only)
Psychosexual therapy is a form of talking therapy that helps you to understand, manage and overcome any sex related difficulties you may have been experiencing. Those difficulties can arise through physical, psychological, emotional and situational aspects affecting our sexual wellbeing. I offer therapy to individuals and couples who might experience difficulties such as: •Erectile dysfunction •Rapid and delayed ejaculation •Painful sex •Sexual health issues (HIV; herpes or anxiety)•Issues relating to intimacy, sexuality and Chem Sex •Low libido •Inability to orgasm• Relationship issues •Compulsive sexual behaviours and more.
Psychosexual therapy is a form of talking therapy that helps you to understand, manage and overcome any sex related difficulties you may have been experiencing. Those difficulties can arise through physical, psychological, emotional and situational aspects affecting our sexual wellbeing. I offer therapy to individuals and couples who might experience difficulties such as: •Erectile dysfunction •Rapid and delayed ejaculation •Painful sex •Sexual health issues (HIV; herpes or anxiety)•Issues relating to intimacy, sexuality and Chem Sex •Low libido •Inability to orgasm• Relationship issues •Compulsive sexual behaviours and more.
020 3872 2506 View 020 3872 2506
Photo of Christopher Brown - Click Therapies, MSc, GMBPsS, Psychotherapist
Click Therapies
Psychotherapist, MSc, GMBPsS
Verified Verified
London SE7
Click Therapies are a small team of UK accredited therapists, nurses and doctors. We are a dedicated online psychological wellbeing service that meets the challenges of the 21st century. We work collaboratively with all our clients to offer a personalised therapy experience to achieve the best recovery outcomes for you. Our service is flexible to meet your needs needs. You can access therapy, anytime, anywhere at your convenience . We deliver evidence based treatments in line with National Guidelines and World Health Organisation. Why not connect with us for your FREE 15min consultation, you have nothing to lose...
Click Therapies are a small team of UK accredited therapists, nurses and doctors. We are a dedicated online psychological wellbeing service that meets the challenges of the 21st century. We work collaboratively with all our clients to offer a personalised therapy experience to achieve the best recovery outcomes for you. Our service is flexible to meet your needs needs. You can access therapy, anytime, anywhere at your convenience . We deliver evidence based treatments in line with National Guidelines and World Health Organisation. Why not connect with us for your FREE 15min consultation, you have nothing to lose...
0117 456 2766 View 0117 456 2766
Photo of Prof Mihai Brindusa Covaci - Akademos Learning / 9462-9755 Quebec, PhD, MUKCP, Counsellor
Akademos Learning / 9462-9755 Quebec
Counsellor, PhD, MUKCP
Verified Verified
London WC2H
We provide effective support in the listed specializations, at a reasonable price. For more information, please visit www.orcid.org - 0000-0002-6007-8489 and 0000-0002-0713-1068, www.akademoslearning.space, www.cbmuniversity.org or www.udemy.com (user "mihai-covaci-3"). We are members of psychology societies, such as UK Council for Psychotherapy, Association for Business Psychology, Manitoba Psychological Society (Canada), Christian Counselors Association of Australia, College of Psychologists in Romania (Europe), and others. Our customers are satisfied with the services offered by us. Our clients are happy and fulfilled.
We provide effective support in the listed specializations, at a reasonable price. For more information, please visit www.orcid.org - 0000-0002-6007-8489 and 0000-0002-0713-1068, www.akademoslearning.space, www.cbmuniversity.org or www.udemy.com (user "mihai-covaci-3"). We are members of psychology societies, such as UK Council for Psychotherapy, Association for Business Psychology, Manitoba Psychological Society (Canada), Christian Counselors Association of Australia, College of Psychologists in Romania (Europe), and others. Our customers are satisfied with the services offered by us. Our clients are happy and fulfilled.
020 4538 0621 View 020 4538 0621
Photo of Andrew Ballance, MBACP, Counsellor
Andrew Ballance
Counsellor, MBACP
Verified Verified
London E8
I work with adults of all ages and young people mainly here in East London and also online. If you find yourself stuck, having a difficult time, or maybe unclear about who you are or what to do, I believe I can support you in taking the next steps forward.
I work with adults of all ages and young people mainly here in East London and also online. If you find yourself stuck, having a difficult time, or maybe unclear about who you are or what to do, I believe I can support you in taking the next steps forward.
020 8103 3974 View 020 8103 3974
Photo of Heather Page, MBACP, Psychotherapist
Heather Page
Psychotherapist, MBACP
Verified Verified
London EC1Y
You may come to therapy to speak about issues that make you angry, afraid or unhappy or that simply don't make sense. Understanding that we are all unique, with our own strengths, qualities and interests, as well as challenges, is hugely important for our well-being. We also know that through having a balanced view of ourselves, we can feel better equipped to cope with difficult emotional and psychological experiences and make positive connections with others. In our sessions, we will have the chance to explore whatever is troubling you to help you identify and confront such issues and feel more confident about yourself.
You may come to therapy to speak about issues that make you angry, afraid or unhappy or that simply don't make sense. Understanding that we are all unique, with our own strengths, qualities and interests, as well as challenges, is hugely important for our well-being. We also know that through having a balanced view of ourselves, we can feel better equipped to cope with difficult emotional and psychological experiences and make positive connections with others. In our sessions, we will have the chance to explore whatever is troubling you to help you identify and confront such issues and feel more confident about yourself.
020 3870 4185 View 020 3870 4185
Photo of Zehra Ali, MA, MBACP, Psychotherapist
Zehra Ali
Psychotherapist, MA, MBACP
Verified Verified
London W8
I am Zehra, a registered psychotherapist working in private practice. My approach to therapy is pluralistic/integrative where I tailor our work according to your therapeutic needs and goals. I specialise in working with loss and grief which includes bereavement and death but also loss of self/identity through significant life changes such as the end of a relationship(s), changes in physical and mental health due to chronic illness and life transitions such as moving countries or settling into university or work. Other sub-specialisations of mine include working with anxiety, depression and relational trauma (childhood and adult).
I am Zehra, a registered psychotherapist working in private practice. My approach to therapy is pluralistic/integrative where I tailor our work according to your therapeutic needs and goals. I specialise in working with loss and grief which includes bereavement and death but also loss of self/identity through significant life changes such as the end of a relationship(s), changes in physical and mental health due to chronic illness and life transitions such as moving countries or settling into university or work. Other sub-specialisations of mine include working with anxiety, depression and relational trauma (childhood and adult).
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Photo of Rebecca Jones, BACP, Counsellor
Rebecca Jones
Counsellor, BACP
Verified Verified
London N8
In life, we all encounter moments of uncertainty, challenges, and emotions that can leave us feeling overwhelmed. If you've found yourself here, it's likely you're seeking support and guidance through such times, and I want to extend a heartfelt welcome to you. Whether you're struggling with bereavement, relationship issues, self-esteem challenges, neurodiversity, exploring difference or simply seeking greater self-awareness and personal growth, I am here to walk alongside you with unwavering support and guidance.
In life, we all encounter moments of uncertainty, challenges, and emotions that can leave us feeling overwhelmed. If you've found yourself here, it's likely you're seeking support and guidance through such times, and I want to extend a heartfelt welcome to you. Whether you're struggling with bereavement, relationship issues, self-esteem challenges, neurodiversity, exploring difference or simply seeking greater self-awareness and personal growth, I am here to walk alongside you with unwavering support and guidance.
020 4538 8446 View 020 4538 8446
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See more therapy options for London

How does your Counsellor compare?

Number of Counsellors in London

3,000+

Average cost per session

£75

Counsellors in London who prioritize treating:

90% Anxiety
85% Depression
83% Self Esteem
81% Relationship Issues
78% Stress
66% Trauma and PTSD
62% Bereavement

Average years in practice

9 Years

Top 3 insurances accepted

68% Aviva
63% AXA PPP
55% Vitality

How Counsellors in London see their clients

74% In Person and Online
26% Online Only

Gender breakdown

75% Female
24% Male
1% Non-Binary
FAQs - About Therapy and Counselling

How can I find a therapist in London?

Search for nearby therapists or counsellors by inputting your city, postcode, or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or postcode into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

Counsellors and Psychotherapists listed in the directory are members of the main professional associations, mainly the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP). Most Psychologists in the directory are accredited members of the British Psychological Society (BPS) and/or are registered in the Health and Care Professions Council (HPCP).

Providers whose professional membership or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Given that professional memberships are not a statutory requirement for psychotherapists and counsellors in the UK, certain qualified professionals or organisations may choose not to maintain such memberships despite possessing the necessary qualifications. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counsellor?

Counsellors, psychotherapists and psychologists can all provide counselling or talking therapy and have credentials and experience that enable them to do so in the UK. Psychologists have earned a degree in psychology and many are members of the British Psychological Society (BPS) and have completed a postgraduate qualification in a specialism. Counsellors and Psychotherapists are not required to have a psychology degree, but to belong to a professional organisation such as the BACP or UKCP, they are required to have completed a training course as well as clinical and supervision hours.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the UK could be between £30 - £60 when seeing a counsellor and £60 - £150 and up when seeing a clinical psychologist. If you have private insurance, your plan may cover some if not all of your sessions. You should contact your insurance provider to determine if they provide coverage for therapy sessions and to determine what, if any, requirements they might have in order for your sessions to be covered, such as a referral from your GP or medical specialist.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

If you are struggling to access therapy due to budget constraints, you could also consider public funded mental health services. The NHS Talking therapies programme offers free of charge counselling for common mental health problems like anxiety and depression. The service is available to anyone registered with a GP, though you do not necessarily need to be referred by your GP and can refer yourself directly to a Talking therapies service. The service will provide different solutions, including group and individual therapy, for a limited number of sessions which are generally up to six.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your postcode.

Are therapy sessions confidential?

Therapists who are part of a professional organisation such as the BACP, the UKCP, or BPS are bound by an ethical framework that requires them to uphold a confidentiality agreement. Confidentiality is a crucial part of the therapeutic relationship and only under specific circumstances, such as when there has been participation in a criminal act or act of terror, or if there is potential or known harm to the client or others, will a therapist be obligated to break the agreement. These exceptions to the confidentiality agreement are usually discussed during the initial consultation.