Overdiagnosed or overlooked? Why therapy is more than a diagnosis

Recent headlines sparked by Health Secretary Wes Streeting have cast a sweeping shadow over private practice therapists, suggesting that they are "overdiagnosing" mental health conditions due to the unregulated nature of the industry (The Guardian, 2025). This is a provocative and misleading statement that fails to recognise the nuanced and individualised approach of private practice therapists. Rather than simply labelling and diagnosing, we are dedicated to supporting people through their mental health and suffering, helping them make sense of their experiences in their own language.

Why private practice therapy is more than a diagnosis

The core of therapeutic healing lies in the therapeutic relationship, not in rigid diagnostic categories. Private practice therapists are not beholden to a one-size-fits-all model of treatment within a fixed department budget; instead, we work collaboratively with our clients to co-create an approach that is responsive to their unique emotional needs, experiences and neurobiology. We understand that every brain is wired differently and that a particular way of therapeutic working may not work for everyone. By having the freedom to tailor our approach, we can help and support our clients in finding meaningful and manageable coping strategies for their mental health and well-being, rather than simply slotting them into predefined boxes.

The accusations levelled against private practice therapists for "overdiagnosing" mental health conditions are not unfounded. While the proponents of private practice therapy argue that their approach is more nuanced and tailored to individual needs, the reality is that the lack of regulation in this industry can lead to a concerning trend of over-pathologising normal human experiences (Santhouse, 2025). Furthermore, the privacy and confidentiality of private practice therapy allows clients to open up more freely, without fear of judgement or future healthcare implications. This is a crucial aspect of the healing process that is often overlooked in the public discourse.

Private practice therapists listed on the Counselling Directory website (where they are always verified prior to being listed) are highly trained professionals who have dedicated years to their craft, and they are committed to providing compassionate, individualised support to their clients, not just hastily applying diagnostic labels. Private practice therapists explore and question any diagnostic labels with clients first to understand their relevancy and meaning in the client's emotional processing, as clinical diagnoses are not within the remit of their standard professional practice. Any supporting letters written to the client's GP are done so following their client's request, after thorough exploration of any mental health label for their client. 

Therapy isn’t a diagnosis - it’s the relationship that heals

The core of therapeutic healing lies not in labels, but in therapeutic connection. While diagnoses can be helpful in some settings - particularly for coordinating NHS care or accessing certain services - private practice therapists aren’t beholden to a tick-box model of treatment. We’re not here to slot people into categories. We’re here to bear witness to our clients' life experiences and sit beside them in their pain and help them make sense of it, in their own language, with empathic support.

For many of us in private practice, particularly those trained under rigorous governing bodies like the UKCP, therapy is not just about what’s “wrong” with a person. It’s about what’s happened to them, how they’ve survived, and what kind of support they need to grow and develop from where they are now. Therapy allows for this process to occur within a professional empathic, non-judgemental and trusting safe space, at a time limit that has been set by the client and not by the organisation providing the therapy.

Brains are like snowflakes: The neuroscience of individuality

Every single brain is wired uniquely. Thanks to cutting-edge research in neurobiology, we now understand that mental health cannot be treated as a one-size-fits-all formula. Our neural pathways are shaped by our environment, attachment experiences, trauma history and even our epigenetics (Weisz et al., 2023). This is why a single intervention like those used within the NHS, e.g. CBT - while helpful for many - simply won’t work for everyone.

Private practice therapists have the freedom to co-create a therapeutic approach that’s genuinely responsive to the client sitting in front of them - not a theoretical construct. As a therapist, I often collaborate with clients to find self-soothing strategies that are meaningful and manageable for them. This might mean exploring sensory regulation for someone with complex trauma, or practising embodied grounding exercises with a client whose anxiety lives in their body. How I work with a client will always depend on the therapeutic relationship I have with my client and this means it is always individually tailored to my client.

The NHS, by contrast, must operate within standardised pathways. You might get assigned to a therapist, like you would a dentist or a physio. But the reality is, the fit matters. And deeply. And when you don’t feel safe or connected with your allocated therapist, the healing process can stall - or even re-traumatise you.

Client voice: Choosing your own therapist matters

Let me illustrate this with composite client examples, using pseudonyms for confidentiality. 

Sarah, in her mid-30s, was struggling with panic attacks and sought help through the NHS. She was assigned a therapist with whom she shared no cultural background, no therapeutic preference, and no relational spark. Despite her best efforts, her therapy sessions felt mechanical. She dropped out after four sessions, internalising the belief that “therapy doesn’t work for me.”

Contrast that with James, a client who contacted me privately. We had an initial call, during which he asked questions, shared his concerns and genuinely got to choose whether I felt like the right fit. We worked together for nine months. His panic attacks subsided - not because he was told what to do, but because we explored his nervous system together. We co-authored a roadmap for his safety, his nervous regulation, and his life meaning that belonged to him.

Mental health support is not a luxury - it’s the foundation of your life

When some people say, “I can’t afford therapy,” I always hear that with compassion. Life is expensive. And I gently invite people to reflect on how much they may already be spending on for their short-term relief. Alcohol. Gambling. Recreational drugs. Shopping. Endless self-help books that gather dust. Nights out to ‘numb the week’. What if that money could be redirected toward understanding the root of your distress, rather than soothing the symptoms of it?

Therapy isn’t a splurge. It’s a recalibration for you and your life. An investment in the most important and intimate relationship you’ll ever have - the one with yourself. And let’s be clear: you can have a beating heart and working lungs, but if you don’t have a healthy thinking brain, your mental health will be shattered and everything else will feel hollow. Without a clear, relaxed thinking brain and emotional stability, your life shrinks.

Therapy that doesn’t follow you around

Here’s something else people often don’t realise: In private practice, your therapy is private and confidential. Your records don’t automatically feed into your medical file. There is no diagnostic label to follow you through life. This privacy allows clients to open up more freely, without fear of judgement, future insurance implications or stigma.

When you access private therapy with an accredited professional - like those trained under UKCP, BACP or equivalent - you're working with someone who has often undergone years of postgraduate training, personal therapy (there are many mental health professionals in the NHS who haven’t ever had personal therapy), clinical supervision, peer supervision and continuous development. These aren’t weekend courses. These are life-long vocations.

Debunking the myth: Are private practice therapists overdiagnosing?

To say that private practice therapists are “overdiagnosing” is to misunderstand our role entirely. Most private practice therapists do not diagnose - because that’s not our function. We listen. We explore. We validate. We hear. We see. And when we notice signs of a more serious mental health condition that may not be within our professional competency - psychosis, for instance - we don’t ignore it. We refer. We collaborate. We act ethically. To reduce our work to “overdiagnosis” is not only a professional misrepresentation, but it also silences the thousands of people who have found life-changing support through private practice therapy - support they may never have received through the stretched, underfunded NHS system.

The bigger picture: A call to empathy and nuance

Wes Streeting’s remarks speak to a broader societal discomfort. The mental health crisis is spiralling and someone needs to be blamed. And placing private practice therapists in the crosshairs misses the point. We are not the problem. We are part of the solution. And while NHS mental health services are essential, they are simply not equipped to offer the flexibility, depth and client-led focus that many people need to truly heal. Both sectors matter. But they are not the same. And there is immense value in both being available to everyone who wants their right to choose.

Practical solutions for you

So, if you're wondering whether therapy is right for you - or worth the money - here are a few mindset shifts and ideas:

• Audit your spending: Could you redirect just £10-£20 a week from another area into your mental health and well-being?
• Think long-term: What would it mean to really understand yourself, not just patch yourself up?
• Shop around: Private practice therapy gives you choice. Use it. Speak to a few therapists and see who feels right.
• Understand your biology: Your nervous system isn’t broken - it’s trying to protect you. Learn how to work with it.
• Know your rights: A private practice therapist can’t diagnose you without your knowledge. We’re accountable to work with you safely and ethically, not according to algorithms.

Private practice therapy is not about placing a mental health label on you. It’s about working through what’s happening for you and peeling any labels off - one by one - until your true authentic self can breathe safely again.

References

Bailin, A., Cho, A., Sternberg, A., Evans, S.C., Hollinsaid, N.L., Bearman, S.K., & Weisz, J.R. (2023). Principle-guided psychotherapy for children and adolescents (FIRST): Study protocol for a randomized controlled effectiveness trial in outpatient clinics. Trials, 24:682. https://doi.org/10.1186/s13063-023-07717-y

Santhouse, A. (2025). No More Normal: Mental Health in an Age of Over-Diagnosis. The Times. https://www.thetimes.co.uk/article/no-more-normal-mental-health-over-diagnosis-alastair-santhouse-review-zdh920qcz

The Guardian. (2025). Wes Streeting: there is overdiagnosis of mental health conditions. https://www.theguardian.com/politics/2025/mar/16/wes-streeting-there-is-overdiagnosis-of-mental-health-conditions

Weisz, J.R., et al. (2023). Lab for Youth Mental Health - Publications. Harvard University. https://weiszlab.fas.harvard.edu/lab-publications