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What happens in Psychological Therapy?

Dr Rosie Gilderthorp perinatal clinical psychologist thinking about how to explain psychological therapy

In this post I explain the terms you are going to see come up in google if you search for psychological therapy and answer some other questions about what meeting a therapist is really like.

Many people will be viewing this page with the ambition of tackling a lingering mental health problem that has been hanging over their heads for too long. After a the struggles of 2020 and 2021 there are loads of good reasons that people considering coming to psychological therapy. However, the VAST majority will not ever turn up at my door (or in my inbox). And here is why:

Terms like EMDR therapy, trauma therapy, CBT, CFT and ACT are really confusing! But they don't have to be.

The media, combined with the fact patient confidentiality means therapists never tell friends and family what they are doing at work, has led most of us to feel a bit of fear of the unknown when it comes to therapy. I completely understand this. It wasn’t until I started training to become a therapist myself that I realised how misguided my own preconceptions of therapy were. So I thought I’d help out anyone who is struggling to make that commitment to booking a therapy appointment due to fear of the unknown by summarising the different “types” of therapy you can sign up for. I’ve used the headings you are most likely to see when you type therapy near me into google.

Cognitive Behavioural Therapy (CBT)

The straight talker of the therapies. The idea is that what you think impacts on how you feel (emotionally and physically) and how you behave. CBT is about defining a goal you want to achieve and then changing one of those things at a time in the hope of breaking the vicious cycles of thinking, feeling and behaviour that hold us back from achieving that goal. You will like this kind of therapy if you like talking, communicating using diagrams and enjoy a linear, structured approach. It is very collaborative and active on your part. Your therapist will not ‘tell” you anything. They will help you discover answers for yourself and you will test things out (such as new ways of behaving) together. There is a great evidence base for CBT for the vast majority of mental health difficulties. As a Clinical Psychologist I find it an immensely helpful tool in my work. It doesn’t suit everyone though and it takes a highly skilled therapist to apply CBT to complex and longer term difficulties. Mindfulness and compassion focussed work are often integrated with CBT. This is called “third wave” CBT and is the way I often work with people.

EMDR and Trauma Therapy

There are several approaches to trauma therapy. The ones that are usually referred to as “trauma therapies” in search engines are EMDR and trauma focussed CBT. Both of these approaches are based on the idea that when something traumatic happens to us the brain stores the memory of the event in a different way to normal memories. This is because it is trying to make sure we never get into a dangerous situation again. Unfortunately however the result of this is that we often experience left over negative feelings, flashbacks and other nasty symptoms. Trauma therapies are about helping the brain to put the traumatic memories into the normal memory system so they stop causing problems. Both EMDR and CBT are shown to be highly effective. The main difference between the approaches is that EMDR is usually conducted over a shorter time frame (often only 6 sessions) and involves recalling the event (not necessarily out loud) while performing an activity which stimulates both sides of the brain (such as eye movements). In my experience EMDR is really good for people who have only had one traumatic incident or who don’t like to talk a lot. CBT usually involves verbally re-telling the event and is conducted over a long time period (perhaps 6 months) or a shorter but very intense programme.


This is a generic term that can refer to lots of subtly different types of therapy. Most of the time a psychotherapist is likely to be practicing psychoanalytic psychotherapy. It is worth checking this with them. This therapy is not necessarily focussed on a particular goal and so can go on for as long as you and your therapist feel is beneficial. It is more a journey of self discovery and can be a useful thing to do just to get to know yourself a bit better. This therapy is great for people who are very good at presenting as though they are all “sorted” and who struggle to really connect with their feelings.


Counselling is often used as a generic umbrella term to describe psychological therapies in general. Counselling however is actually a therapy in its own right. Counsellors tend to help people by allowing them to talk about thoughts and feelings that they might find difficult to discuss with people that are close to them in a safe and confidential environment. Sometimes talking and understanding your feelings in this way can be all it takes to resolve the issue that brings you to therapy. Sometimes a counsellor may also help you discover strategies or changes in your life you can make to help you feel better. Counsellors have variable levels of qualification and experience ranging from certificates up to doctorate level.

Clinical Psychology

Clinical Psychologists (like me) have a broad training at doctoral level. This includes experience of using lots of different types of therapy under expert supervision and working with different client groups (e.g. Children, adults, older people). This combined with the experience of the psychologist means we are able to draw on all of the approaches above to create a therapy plan that suits you. Clinical Psychology sessions therefore could look very different for different people! What all Clinical Psychologists have in common though is that we are members of a regulating body called the Health Care Professionals Council (HCPC). This body makes sure that we meet ethical and professional standards and that we all have a high level of academic qualification and professional experience. This is important as it means you can be assured that your psychologist will keep up to date with the latest clinical research and use it to work with you in the way that suits you best and is proven to be most effective. Other therapists do not often have this level of qualification and usually only offer one type of therapy. All the therapists we work with are qualified and registered psychologists with the HCPC.

What will happen in my first psychological therapy session?

The first step is to book a free consultation with one of our clinical psychologists. We will have a free 30 minute meeting with you to discuss your reasons for coming to therapy and your requirements including location and availability. We will then match you with the best therapist to meet your needs.

The first two full sessions you have with us will mainly focus on developing our shared understanding of your difficulties. We do not believe that a label, such as depression, gives us much information about your life and what you are struggling with so we will ask lots of questions about how your life is at the moment, how you would like it to change and the results you want to see from therapy. You will also have plenty of opportunity to ask questions about how your psychologist works. Together we will come up with a plan that will help you meet your goals. Often that will mean a course of therapy with us but sometimes we may recommend that you access an NHS service or take a different plan of action. If this is the case we will write you a brief letter/report that you can use to implement your plan.

How much does psychological therapy cost?

Therapy sessions with us cost £140. Sessions are usually 50 minutes in length.

How long will I need therapy sessions?

It is impossible to predict the length of therapy before we meet. That is why your first two sessions with your psychologist will be assessment sessions. This enables us to develop a plan together that will include an estimated length for your therapy.

How do I pay for psychological therapy?

You can pay up front via our online portal before each session or we can arrange weekly or monthly invoicing. Payment is due in advance of sessions. All major credit and debit crads are accepted. We also accept insurance referrals from AXA-PPP, Vitality and AVIVA so if you have insurance please let us know.

Where do therapy sessions happen?

We offer face to face therapy sessions in the heart of Tunbridge Wells but most of our clients prefer to work with us online so they can fit therapy around work, childcare or other commitments. When you have your free consultation with us we will ask you about your preferences and availability.

I hope that has helped answer some of your questions and that you can feel more confident about booking a session now. If you want to know more about therapy or to book a session with one of our psychologists then please contact us.

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