Starting therapy
Thinking about therapy? Start here
Deciding to seek support is rarely a single moment — it's usually a slow build of wondering whether things should feel this hard. This guide brings together everything worth knowing before you begin, from recognising the signs to understanding what your first session will actually be like.
Where to begin
You don't need to be in crisis to deserve support
One of the most common things people say in a first session is some version of *"I probably should have done this sooner."* Many wait until things feel unbearable, partly because it's hard to know how bad is bad enough — and partly because the whole process can seem opaque from the outside. What will it cost? Who am I even supposed to see? What if I get there and can't explain what's wrong?
None of those questions need answering before you reach out. But if you'd rather understand the landscape first, the articles below work through it in order — from noticing something isn't right, to choosing the right professional, to knowing what happens once you begin. Read what's useful and skip the rest.
Step one
Is it time to seek support?
Recognising that something needs to change is usually the hardest part — and rarely as obvious from the inside as people expect.
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5 subtle signs it's time to start therapy
The quieter indicators that often go unnoticed, long before things reach breaking point.
Read the article2
Busting 5 therapy myths
Therapy isn't only for crisis, and it isn't a sign you've failed to cope. What's true, and what isn't.
Read the articleStep two
Choosing who to see
Counsellor, psychotherapist, clinical psychologist, psychiatrist — the titles sound similar and the differences are rarely explained.
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Clinical psychologist, counsellor or therapist?
What the titles mean in the UK, which are protected by law, and which tends to fit what you're facing.
Read the article2
How evidence-based therapy works
What it means for a therapy to be evidence-based, and why it matters when choosing.
Read the article3
Online therapy in a digital age
How video sessions work in practice, and who tends to find them a good fit.
Read the articleStep three
What happens once you begin
Knowing the shape of the work removes a good deal of the anxiety about starting it.
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The first session: what to expect
What actually happens when you meet a psychologist for the first time.
Read the article2
The therapeutic relationship
Why the relationship between you and your therapist predicts so much of whether therapy helps.
Read the article3
Making the most of therapy
Practical ways to get more from the work, both in sessions and between them.
Read the article4
Ultimate guide to CBT
The key principles and core components of cognitive behavioural therapy, explained plainly.
Read the article5
Third-wave therapies: CFT, ACT and mindfulness
Compassion-focused and acceptance-based approaches, and what they add to traditional CBT.
Read the article6
From coping to thriving
How therapy builds resilience that lasts beyond the end of the work.
Read the articleThe practical side
Cost, insurance and how to book
Therapy is £120 per session (up to 60 minutes, online), with a longer 90-minute session available at £180. The introductory call is free and carries no obligation — see the fees page for everything in one place, including the cancellation policy.
If you hold private health insurance, your sessions may be funded by your insurer. Kayleigh is a recognised provider for Bupa, Aviva and WPA — see how insurance-funded therapy works.
Common questions
Questions people ask before starting
- How do I know if I need therapy?
- There's no threshold you have to cross. People commonly seek support when something has been persistent rather than passing — difficulty sleeping, dread that doesn't lift, avoiding things that used to be manageable, or the sense of not feeling like yourself. If you're weighing it up, the subtle signs it's time to start therapy is a good place to start. You don't need to prove things are bad enough.
- What's the difference between a psychologist, a counsellor and a therapist?
- "Clinical Psychologist" is a title protected by law — only someone registered with the Health and Care Professions Council (HCPC) may use it, following a psychology degree and a three-year doctorate with supervised NHS placements. "Counsellor" and "therapist" are not protected in the same way, though many hold strong training and accreditation with bodies such as the BACP or UKCP. Counselling often suits a specific, present-day difficulty; clinical psychology tends to come into its own with complexity, trauma, or where previous therapy hasn't helped. There's a fuller breakdown in clinical psychologist, counsellor or therapist: which one do I need?
- How much does private therapy cost?
- Across the UK, private therapy commonly ranges from about £60 to £150 per session, with clinical psychologists generally at the higher end. Sessions with Kayleigh are £120 (up to 60 minutes), or £180 for a 90-minute session. The introductory call is free. Full details are on the fees page.
- Can I use my private health insurance?
- Often, yes. Kayleigh is a recognised provider for Bupa, Aviva and WPA, and many other policies allow you to see an HCPC-registered Clinical Psychologist of your choosing. Most insurers ask you to obtain an authorisation number before your first session — see how it works.
- How long does therapy take?
- It depends on what you bring. Focused work on a specific difficulty is often shorter; long-standing patterns, trauma or several difficulties together usually take longer. Rather than fixing a number at the outset, goals are agreed early on and progress reviewed regularly, so you can see whether it's working and decide whether to continue.
- Does online therapy work as well as in person?
- For most common difficulties, research over the past two decades has found outcomes comparable to in-person therapy, and the working relationship tends to be rated similarly in both. What you need is a private space and a reliable connection. More on the benefits of online therapy.
- I'm on an NHS waiting list — can I start privately too?
- Usually, yes. Being on an NHS waiting list doesn't normally prevent you from seeing someone privately, and starting private therapy doesn't automatically remove you from the list. It's worth telling both the NHS service and your GP what you've arranged, so everyone involved in your care knows what support you're receiving.
- What happens in the first session?
- The first session is mostly about understanding — what brought you, what's been happening, and what you'd like to be different. There's no requirement to have it neatly explained beforehand. You can read more about what to expect when meeting a psychologist.
If you need help now
This page is for general information and isn't a substitute for advice about your own health. If you need support urgently, please contact your GP, call NHS 111 and choose the mental health option, or call Samaritans free on 116 123 at any hour. In an emergency, call 999.
Ready when you are
Still not sure? That's a good enough reason to talk
The introductory call is free, lasts fifteen minutes, and carries no obligation to continue. It's simply a chance to say what's going on and find out whether working together feels right.