Are you looking for counselling for someone else?

Seeing someone you care about struggle with their mental health can be challenging. It can be difficult to know how to best help, and the effect of someone’s ill health on the people around them is greatly underestimated. It can sometimes be that our attempts to help inadvertently exacerbate their challenges. 

Mental health concerns affect one in four adults and one in 10 children (NHS England).  What's more, 89 million antidepressants were prescribed in the UK in 2023/24 (NHS Business Services Authority). Access to effective care and therapeutic treatments is critical.

One of the more common enquiries is from someone seeking to help a person close to them. It may seem obvious to you that someone is struggling and should seek professional help, but there are a number of reasons why the subject of your concern may be reluctant to engage in treatment.

How can you best support a loved one?

Approaching someone to talk about their well-being can be fraught with difficulty. Will they take offence? What if I make them feel worse? How and when do I speak to them?

As with counselling, conversations with friends or family about their mental health should take place in a private, safe space, where they feel free from judgment. It's important to listen with empathy, offering a caring ear without rushing to provide solutions or fix their problems. This creates an environment where they can open up, feel truly heard, and explore their thoughts at their own pace.

After picking an opportune moment, ask simple questions such as, “I’ve been worried about you; would you like to talk?”, or “Is everything OK? It looks like you’ve been going through a difficult time recently”. You may find the person receptive to your concerns, or equally, they may be immediately dismissive. Let the person know you’re there to talk to them should they want to, and don’t be afraid to ask questions.

It is important that shows of care and support are consistent and empathetic. You may be frustrated by someone’s lack of interest in getting help or dismissal that they need it. Try and remember that the person struggling with their mental health may feel ashamed, or wish to deny or hide their condition. Empathy and patience are key, and being too focused on solutions or ‘fixing’ someone, can be experienced as dismissive.

Should a friend turn to you for help, it can also be tempting to seize this moment to immediately refer them to a professional. Remember, even if they decide to reach out to a counsellor, they may have to wait for therapy to begin, it may take some time before they find someone suitable for their needs, and it is likely that they will attend for just an hour a week. The support network of those around them is equally important, especially if the therapeutic process brings up difficult emotions.

Can you arrange a therapy session for someone else?

Yes and no. Ownership is a really important component of the therapy framework and process, and while I often arrange appointments indirectly – with partners or parents of my clients – I would always ask that the client directly confirm their attendance. During the initial consultation, while informing a client about the confidentiality of their sessions, I would then also inform them that from this point onwards, all communication is with them alone, unless they provide written permission otherwise.

Can I pay for someone else’s counselling/can someone else pay for me?

What does it mean for my confidentiality if they do?

While someone else can pay for an individual’s counselling session, it does raise some important considerations for counsellors around their client’s confidentiality and boundaries, and this should be addressed in discussions between counsellor and client during an initial meeting.

Counsellors in the UK are bound by strict confidentiality rules under professional ethical guidelines (e.g., BACP, UKCP) which protect clients even in the event someone else is paying.

Discussions between counsellors and clients should be confirmed in writing and include:

• What the person paying knows: That the payer may only be informed about logistical matters – session dates, receipts and/or invoices for sessions, or cancellation policies – and not the content of your sessions.
• Exceptions to confidentiality: As with any counselling, where confidentiality may be broken, usually only in cases where there’s a serious risk of harm to you or others, or if required by law.

Can you refer someone else for counselling?

You are unable to directly refer or ‘force’ someone into counselling, but referrals can be made through a few sources:

• Self-referral: by using directory sites such as the Counselling Directory or internet search engines.
• GP referral: in which conversations about their mental health with GPs can assess needs and refer them to NHS counselling or other mental health services.
• Employer or school referrals: if available, via Employee Assistance Programmes (EAPs), employee private healthcare plans, or school counselling services.
• Referrals for children or vulnerable adults: via NHS Child and Adolescent Mental Health Services (CAMHS) or social services and other mental health-focussed charities such as Mind.
• Crisis situations: if someone is in immediate danger or experiencing a mental health crisis, speak to emergency services (999), a local crisis team, or charities like the Samaritans (116 123).

Can you go to a therapy session with someone else?

In short, no. It’s vitally important that the person attending counselling has the opportunity to explore their thoughts and feelings in a safe, confidential environment. While asking to attend may be driven by your care for the affected person, they may have a version of themselves they present to those around them – sometimes referred to as ‘masking’ – which may be vastly different from how they feel inside.

A counsellor’s training emphasises the need to be a non-judgemental and caring listener, but non-directive and not invested in their clients’ choices. This is crucial; it allows the client to be more authentic without a need to impress or without outside influence or opinion.

Can you invite someone to your therapy session?

This may depend on your counsellor’s individual approach and/or governing principles.

My instinctive response to this question when posed in discussion with clients is to explore the ‘why’ – it could be pressure from a partner, a sense of discomfort in our sessions, or being able to talk about something important or particularly sensitive about themselves or the other person in a safe environment.

To protect the sanctity of the sessions with my client, I have a blanket rule that if sessions begin with an individual, they can’t later change to couples’ sessions or family therapy, and my training tells me that these boundaries are there to protect my client and our work. However, other counsellors and other approaches may have different rules – for some family counsellors or counsellors who work with younger people, it can be quite a natural part of their work to have individuals occasionally present.

It’s entirely natural to be nervous or apprehensive about seeing a counsellor, even after a few sessions. A therapeutic relationship is like any other, and it can take some time to settle into. Talking about these feelings with a counsellor can be extremely useful, and could be about more than immediately obvious. It could be that the counsellor reminds you or begins to represent someone from your past, or it could be that you and this counsellor simply aren’t a good fit. Not being a ‘good fit’ doesn’t necessarily mean the conversations have no value – an exploration of why you aren’t a good fit can be beneficial in itself, and the counsellor may be able to recommend another practitioner or form of counselling which is more suitable.

Seeing someone close to you in pain can be difficult, and it can be frustrating to see someone refuse or be unwilling to get help. The workings of someone’s internal world are totally unknown to anyone except those experiencing it. It can be tempting to make assumptions about what is happening to someone, what they should do, or what is causing their ill health.

Remember that no one can be hassled or convinced into therapy, and therapy only works when someone chooses to go. Offer care, concern, and patience. Remind them that help is available, but please also remember this – seeking help is only the beginning. Not only must the person find the right therapist and the right type of therapy, but that therapy is a process and can take some time.

Further help

• Worried about someone's mental health?