NHS Talking Therapies: A Care Staff Guide to Referral and Support

Many people struggling with low mood, worry or past trauma do not realise how easy it can be to get help from the NHS. Talking therapies are available in most areas, and for common problems such as anxiety and depression, people can often refer themselves without seeing a GP first. Care and support staff are often the first to notice that someone is struggling, so knowing how the service works helps you point people in the right direction.

This guide explains what NHS Talking Therapies is, who it is for, how to refer, which therapies are offered and how staff can support someone through the process. It draws on the NHS page on NHS Talking Therapies for anxiety and depression, last reviewed in November 2025.

What is NHS Talking Therapies?

The NHS describes talking therapies, also called psychological therapies, as talking with a trained professional about thoughts, feelings and behaviours.

Who is it for?

According to the NHS, talking therapies can help with common problems such as low mood, worry, depression, anxiety, phobias, obsessive compulsive disorder, post-traumatic stress disorder and body dysmorphic disorder. They can also support people living with long-term conditions such as irritable bowel syndrome or chronic pain. The NHS stresses that a person does not need a diagnosed mental health condition to use the service.

For some conditions, a GP referral is usually needed instead. The NHS lists eating disorders, bipolar disorder, personality disorders, psychosis and drug or alcohol problems in this group. If someone you support has one of these, speak to their GP or mental health team about the right route.

For more on the common conditions that talking therapies treat, see our guides to generalised anxiety and panic disorder, post-traumatic stress disorder and obsessive compulsive disorder and body dysmorphic disorder.

How to refer

The NHS says there are two main routes:

• Self-referral: for anxiety and depression, a GP is not needed. The person must be registered with a GP and aged 18 or over (16 or over in some areas). Under-18s use a separate children and young people's route.
• Through a GP: if the person is unsure whether to self-refer, or may have more specialist needs, the GP can advise on local options.

Staff can help by finding the local service, supporting the person to complete the referral form if they wish, and checking that they are registered with a GP. The decision to refer should be the person's own.

Types of therapy offered

The NHS lists a range of options:

• Guided self-help: a workbook or online course, often offered first.
• Cognitive behavioural therapy (CBT): practising skills between sessions.
• Counselling.
• Interpersonal therapy and dynamic interpersonal therapy.
• Couples therapy.
• Eye movement desensitisation and reprocessing (EMDR): for trauma.
• Mindfulness-based cognitive therapy.

People with a personality disorder may be able to get dialectical behaviour therapy. They should speak to their GP about it. If guided self-help does not help, another therapy may be offered.

What to expect

Therapy can be in person, by video or phone, or online, and may be one-to-one or in a group depending on availability. The NHS page does not state waiting times. People should be prepared for the possibility of a wait, and staff can help them find self-help guides and tools on the NHS mental health pages while they wait.

Not everyone is comfortable with talking therapy at first. It can feel hard to talk about difficult feelings, and CBT in particular asks people to practise skills between sessions. Encouragement from staff, with no pressure, often makes a difference.

Private therapy

The NHS notes that talking therapies are sometimes available for free through employers, universities and charities, and that private therapy is possible. If someone chooses private therapy, check that the therapist is registered with an accredited body approved by the Professional Standards Authority.

How care staff can help

The NHS page does not cover carers or support workers, so the points below are general good practice rather than NHS guidance.

• Listen first. Offer a calm, private conversation if someone says they are struggling.
• Share information, do not push. Explain that self-referral is possible and let the person decide.
• Remove practical barriers. Help with access to a phone or computer, appointment reminders and transport.
• Respect confidentiality. Share details with the therapist or service only with the person's consent.
• Know when it is urgent. Talking therapies are not a crisis service. If someone is in immediate danger, call 999; for other urgent concerns, follow your organisation's procedure and contact NHS 111 or the person's GP or mental health team.

Training and CPD

Staff who understand the mental health pathway can signpost with confidence. Record your learning in your CPD log, discuss real examples in supervision, and browse the options on our CPD pages.

Key points to remember

• NHS Talking Therapies offers guided self-help, CBT, counselling, EMDR and other therapies.
• People can self-refer for anxiety and depression if they are registered with a GP and aged 18 or over (16 or over in some areas).
• Eating disorders, bipolar disorder, personality disorders, psychosis and drug or alcohol problems usually need a GP referral.
• A diagnosed condition is not needed to use the service.
• It is not a crisis service; use 999 or 111 when needed.

Frequently asked questions

Does someone need a GP referral?

Not for anxiety and depression. The NHS says people can self-refer. For some other conditions, a GP referral is usually needed.

Is talking therapy free?

The NHS says talking therapies are sometimes available for free through employers, universities and charities. For the NHS service itself, check the cost and referral details with the local NHS Talking Therapies service.

What if the first therapy does not work?

The NHS says that if guided self-help does not help, another therapy may be offered.

This guide is for general information and is not a substitute for clinical advice or your organisation's policies.