NHS Talking Therapy Vs. Private Practice, What's the difference?

Saleha Choudhury
Feb 25, 2024
3 min read

Updated: Sep 26

When seeking therapy in the UK, one of the first decisions is whether to go through NHS Talking Therapies (IAPT) or choose a private counselling practice. Both routes can offer valuable support, but they differ significantly in cost, waiting times, therapist choice, and flexibility.

In this article, we’ll compare NHS Talking Therapy with private counselling, highlight the pros and cons of each, and help you decide which might best fit your needs.

2 people in a counselling session talking about stress, anxiety and depression.

What Is NHS Talking Therapy?

NHS Talking Therapies (previously known as IAPT – Improving Access to Psychological Therapies) is a free service provided by the NHS to help people manage common mental health problems such as anxiety, depression, OCD, and stress.

empty chairs for group counselling session that happens via NHS talking therapy

How to Access It

You can self-refer through your local NHS Talking Therapies service Find your local NHS service.
A GP can also refer you if they feel it’s suitable.

Benefits of NHS Talking Therapy

Free of charge
Delivered by trained professionals
Evidence-based approaches (often CBT)
Widely available across England

Limitations of NHS Talking Therapy

Long waiting lists (sometimes weeks or months)
Limited choice of therapist or therapy approach
Often short-term, time-limited treatment
Focused mainly on “common” mental health conditions

A clock highlighting how long you have to wait for on the NHS to get seen by a therapist

What Is Private Counselling?

Private counselling involves working with a therapist or counsellor outside the NHS system. Sessions are paid for directly by the client, or sometimes through private health insurance.

How Private Counselling Works

You can choose your therapist and approach (CBT, person-centred therapy, integrative therapy, etc.)
Flexible scheduling and frequency of sessions
Confidential, tailored, and often more personal support

Costs of Private Counselling

In the UK, sessions usually range between £40–£100 per hour (sometimes higher in London).
Some practices (like ours) offer discounted sessions or sliding scales.

A Counsellor taking notes whilst doing a counselling session with client with trauma

NHS vs Private Counselling: Key Differences

Here’s a quick comparison:

Factor	NHS Talking Therapy	Private Counselling
Cost	Free	£40–£80 per session (average)
Waiting Time	Weeks–months	Usually within days
Choice of Therapist	Limited	Full choice
Therapy Types	Mostly CBT	Wide range
Flexibility	Restricted	Flexible scheduling
Confidentiality	Standard NHS protocols	Often more personalised privacy

pound coin, symbolising the cost of counselling and therapy

Pros and Cons

Pros of NHS Talking Therapy

✅ Free and accessible

✅ Backed by NHS standards and research

❌ Long waits

❌ Less flexibility

Pros of Private Counselling

✅ Choice of therapist

✅ Immediate access

✅ Flexible session length & frequency

✅ Wider therapy options

❌ Cost can be a barrier

Which Option Might Be Best for You?

If cost is your main concern, NHS Talking Therapies are the obvious starting point.
If you need help quickly, prefer a specific therapy, or want more choice, private counselling may be worth the investment.
Some people even start with NHS therapy and then continue privately for ongoing support.