What is it like to obtain CBT privately compared to the NHS?

Working for the NHS during the early stages of my career as a cognitive behavioural therapist proved to be very interesting. This provided a real insight into how psychological therapies can be delivered within an IAPT (improving access to psychological therapies) setting. Working in private practice since has allowed me to appreciate the differences between the two ways of offerings available in the UK.

Typically within an NHS setting, therapy is subject to time limited constraints. Unlike the private sector, the number of sessions administered within the NHS will be limited. This is understandable considering their budgetary constraints. Also, IAPT services offer cognitive behavioural therapy (CBT) on either a low or high-intensity basis. Low intensity is based on shorter sessions and is administered by a psychological well-being practitioner as opposed to a CBT therapist. It tends to be accessed more quickly and is more suited to mild psychological issues. It is difficult to find CBT offered at this level within the private sector. Convenience is another key difference. Therapists in the private sector tend to be more flexible in their working hours, offering more out of hours appointment availability.  

Furthermore, due to budgetary restraints restricting resources, the NHS is renowned for its waiting lists, and the IAPT system is no exception in this case. However, waiting times do vary from a few months to as much as a year. The NHS is trying hard to address this issue; some trusts are adopting innovative treatment methods which are proving helpful in this sense, e.g. by offering computerised and online CBT for example which can really help in providing effective therapy quickly.

The NHS still offers a great service, a free service which can be accessed by all. Without the NHS there would be many who would be unable to access any psychological health care. The IAPT service has achieved its goals of improving access to psychological therapy and plans to continue building on this success. It’s well trained and highly qualified staff are closely managed to provide an efficient service which treats millions of people.

My experience was indicative only of the local IAPT service, for whom I worked for providing face to face therapy at the time; it should be noted that providers change frequently and so too do their policies. Not all IAPT services will necessarily operate in the same way. The services themselves are not necessarily to blame for any of their shortcomings, much of which results quite simply from a lack of funding. Mental health remains the underdog as far as NHS funding is concerned. That said, thankfully, not long before the time of writing, the government announced plans to invest £1 billion into UK mental health services. Let's hope IAPT services receive a good proportion of this.

If you are struggling with your own well-being it is really important that you seek help as soon as possible. Whether that be privately or through the NHS. Your GP should ideally be kept informed regardless of the pathway you choose in this sense.