Haydn Williams, executive chairman of the British Association for Counselling and Psychotherapy, has an expert’s view of the stages that have brought us here. “Cultural change doesn’t happen immediately. The reasons for this go back a long way. Twenty years ago, organisations like the BACP began to champion counselling in schools, which means seeking help is normalised for younger people. Now in their 20s and early 30s, they have benefited from this counselling, so they feel it is a normal thing to do.
“There is also greater discourse about therapy, how it works, and its success rate. Evidence-based therapy styles such as Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) mean that far greater numbers of people are aware of its efficacy,” he adds.
It is not just celebrities who are openly embracing therapy. BACP research illustrates the surge in popularity: in 2010, 21 per cent of people said they had consulted a counsellor or psychotherapist; by 2021 it was 33 per cent, while 85 per cent of people, across the age groups, agree that “it is a good idea to seek counselling or psychotherapy for a problem before it gets out of hand”. In other words, therapy has become mainstream.
Williams reports that 71 per cent of BACP therapists have seen an increased demand for therapy sessions, and that is also true at welldoing.org, the therapist-matching service I founded in 2014. But there have been some noticeable trends within these changes. For example, there are many more parents seeking help for adolescents. Couples looking for therapy, and university students seeking support (we have a cohort of therapists offering them cut-price therapy) are also strong areas of growth.
Natasha Wellfare, who sees clients in Essex, believes that the rise in therapy’s popularity is in part down to the fact that so many young people are educating their parents about mental health and wellbeing. “Teenagers are so open to talking. They are normalising the subject, taking the conversations they see on social media and educating their parents. It’s a bottom-up approach.”
Nicholas Malik, who sees clients in north London, describes his practice as snowed under. “There’s been a huge expansion, with the combined effect of Covid, moving away from the EU and an uncertain economic climate producing such anxiety that a lot of people are seeking therapy because they feel like they are tiptoeing on shifting sands.”
Helping clients deal with general depression and anxiety means Malik is doing a lot more short-term work, with a high turnover of people who are ready to finish seeing him after only three to four months. “In my practice I have never seen that before. People are very, very anxious.” He believes the demand for therapists in the next 12 months will be “higher than we’ve ever seen.”
Malik explains that the pandemic meant that any unprocessed personal issues were intensified. “It’s actually quite normal for things to start breaking down in a pandemic. Isolation is terrible, so it’s important for people to come out and not be isolated. One of the reasons people want to see a therapist is they have felt locked away for a year.”
Arti Kashyap-Aynsley, 39, is a good example of this. She gave birth to her first child at the beginning of the Covid period. “I was identified as having post-partum depression, but all the support I needed was cut off. My family was in Canada, and I really struggled. My therapy journey started, I think, as a result of all of these things coming together, so to say the pandemic has impacted my mental health is an understatement.”
As the global head of health and wellbeing for the Ocado Group, Kashyap-Aynsley knows a lot about therapy and mental health. Even so, she recalls: “I myself went back and forth on it and I definitely contemplated that sense of failure of not being able to ‘fix’ the situation on my own. It is such a vulnerable thing to seek and ask for help. But I also need to do what is right for me, and if therapy is that thing then I want to wear that with pride, though I also know that isn’t the same view for everyone.”
Covid has meant that more clients and therapists are happily using video calls for their sessions. Other recent changes include mental health apps approved by the NHS, and online services such as BetterHelp and Thrive. There is a growing market for technology in mental health support but clients and therapists agree that they are simply not the same as having a dedicated person to see, hear and understand you every week. Malik explains: “Apps are helpful and improve access. But problems in life are created by human beings and are better solved by humans.” While Kashyap-Aynsley says: “I need to know there is a real person on the other end, not a robot or algorithm.”
Bob Deakin, 64, is a project manager who first saw a therapist via the NHS following a cancer diagnosis. “That therapy experience was very good at helping me with anger,” he says. “For the past couple of months I am back seeing a therapist, and I’m not ashamed about it. Therapy helps you identify some of your behaviours that don’t serve you well. You might spend £50 on eating out; for me, it’s better spent on my mental health.”
Deakin likens the impact of therapy to going to a gym to stay physically healthy. “The difference is that at the gym, progress is easy to measure. That’s the challenge with therapy. It requires some faith on behalf of the client.”
However, although things have changed a lot, many people think we still have a long way to go when it comes to some people accepting therapy as a normal part of life. Sarah Niblock, chief executive of therapist organisation UKCP, told me that she’d love therapy to be as normal as “going to the gym or dentist but we are still a long way from that. Our data show that many people are still deterred from seeking mental health due to stigma. We ran a joint survey of more than 2,000 people with YouGov, which showed that despite the escalation in mental health issues during the pandemic, 23 per cent of those experiencing problems didn’t think they were serious enough to seek help, 14 per cent felt embarrassed or ashamed, and 13 per cent didn’t know how to talk about the issue. Some mentioned they were fearful that reporting a mental health issue could impact their employability.” In spite of this residual stigma and shame, all of the therapy platforms report higher traffic and requests for sessions since March 2020.
But while deciding to see a therapist is one thing, finding the right one is another. Even those people who want to embrace therapy can feel flummoxed and deterred when faced with web pages showing hundreds of counsellors and therapists trained in a wide range of modalities. For this reason, therapy client-turned-trainee psychotherapist Jo Love wrote Therapy is… magic: An essential guide to the ups, downs and life-changing experiences of talking therapy.
Her tips to find the right person include the usual checking on membership, qualifications and so on, but focus more on finding the right fit.
“The relationship you have with your therapist is so important to the outcome you’re going to get from therapy, so it’s OK to try different people out. At the end of the day, therapy is about two humans coming together, and if you don’t click that doesn’t mean you’ve failed or therapy isn’t right for you – it’s just that you need to find someone who works for you.”
