Seeing the GP: Advice and tips for young people

Counselling and other talking therapies for mental health

Here, people talk about:

•   what is counselling?
•   being referred by the GP for counselling
•   referral to other services
•   counselling services at college and university

What is counselling?

Mental health issues can be treated in several ways, including with medication and talking therapies, such as counselling. Some people we talked to were referred for counselling by their GP. Others saw a counsellor at school, college or university. Counselling is about talking to someone who understands depression and other mental health issues and what can help. Counsellors are professionally trained to work with people on their personal and emotional issues, including anxiety, depression, eating disorders, and self-harm. All counselling sessions are confidential. The counsellor won’t tell the GP what has been said, unless they feel someone’s at serious risk.

A GP explains when a patient might be referred for counselling.

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Sometimes a GP refers a patient to counselling services, in what situations does that occur?

So if a patient comes with an emotional problem, a psychological problem, it may be that what that patient needs is a time and space to explore those problems with a sympathetic listener, a counsellor, and often those counsellors will work in the same place as the GP, so the patients will prefer to come back to the same place just to spend some more time talking to someone about what’s going on. And helping, it will help them come to their own decisions about what needs to happen next.

Okay and how long would the patient have to wait for these counselling sessions or is it done straight away after the GP’s appointment?

It varies hugely in different areas. Often there’s quite a long wait for counsellors. It may be a couple of weeks, it may be as much as two or three months.

And having said that, would you, if the problem was ongoing, would you advise the patient to come back and see you each week for a GP appointment or just wait around for the time to see a counsellor?

Again it depends a little bit with what’s going on. I would usually want to see the patient in the meantime just to make sure they’re okay.

Being referred by the GP for counselling

Some GP practices (surgeries or health centres) have an onsite counsellor and people may be referred to them by the doctor, though waiting lists vary. If counselling or therapy isn't available at the surgery, the GP may refer the person to a local psychological therapies service. Aphra was referred for counselling by the GP and waited 3 weeks before her first appointment. She was also taking antidepressants. Before this, she’d had counselling several years earlier at school.

Aphra saw the first counsellor for 6 sessions at her local surgery. She’s now seeing a second therapist in town and feels ‘like I’m in control’ again.

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When I'd finished with that therapist, because the only catch was is that it was limited to six sessions. And I remember thinking at the time going, 'Oh six sessions, I won't need all of those, I'll be fine in no time.' I was really kind of confident in that I would bounce back out of it all, and actually you know I'm on my second therapist. I'm just about to finish with her, and now I feel like I'm in control.

Did you…so you were seeing the GP, and the GP was prescribing the antidepressants?

Yeah.

And separately then you were seeing the counsellor?

Yeah. So the therapist I was seeing through the GP again stays confidential. So the GP only knows how many sessions you’ve had, or if they think there's a problem then actually they tell you, and it's up to whether you talk to your GP about it or not. Which came up after I'd had my six sessions with the first therapist. She thought I could benefit from a higher level therapist which would mean that I'd have to travel, but only into the town centre to their actual kind of head office as it were.

And that took a couple of months to come through, probably almost three months before I could see somebody there. But those sessions were every week and they were an hour long, so it's a lot more intensive and it's all cognitive behavioural therapy. So it feels really practical and like you're taking steps to fixing yourself as it were rather than just talking about how low you still are.

Was that how it was at the GP's surgery?

The GP's surgery had some cognitive behavioural therapy, but there was a lot more talking as well involved; it was a kind of mix of the two. And but those sessions were only half an hour and they were every couple of weeks, so there was a lot more time in-between. And I kind of see it almost like the ones I had at the GP's surgery was a triage kind of thing. So it was about making sure that I was eating and making sure I was sleeping and paying attention to what kind of activities I was doing.

Nikki and Sophie, like Aphra, had seen counsellors at school before they got other help. When Sophie was feeling very low, tired, and had little motivation for friends, study or the things she normally enjoyed, she also spoke to a school counsellor. The counsellor had a four week waiting list, which was disappointing. After around eight sessions, the counsellor advised Sophie to see the GP.

Sophie didn’t know what to expect of counselling and felt it wasn’t for her. She wishes she’d known that counselling was only one of several options for depression.

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The first time I kind of chatted to her [the counsellor], yeah, she was a very kind of like welcoming and she arranged an appointment with me. But because like my school is quite big and, because there were so many students, she had a waiting list for, I think it was like four weeks. So that was a bit disheartening because obviously you want to be seeing someone quite quickly.

So, yeah, that was kind of disappointing. So I think, you know, the schools need to be making kind of like a conscious effort to make sure that they’ve got enough counsellors for the amount of students they have.

So, yeah, that was the first time I'd ever met her, but then… yeah my first appointment. I mean it's difficult because it was… like counselling isn't for everyone and it's just kind of one way of, you know, being helped. And so I think at first I… I didn’t know what to expect. I didn’t really know how to respond because I… in my head I thought that’s the only way, like that’s the only kind of form of treatment really, where obviously I was really wrong. But so when it…when I found it wasn’t all that like effective for me and I just felt it was kind of just bringing up problems that I just didn’t want to be talking about.

I felt it wasn’t, it wasn’t really working for me but I…I think I should have known that there are other ways and it was alright if it wasn’t working for me. But, so yeah, I mean they were good in the sense of it was good to be able to have a space to talk to someone and know that if I did want to speak to her I could. But at the same time I think it was… it was difficult because it did feel a bit like it was either that or nothing, so yeah.

Shane had informal counselling with his GP after he’d taken an overdose. He saw her weekly for five months, which was very helpful, but he disliked going to the chemist afterwards to get his medication. He had 30 minute sessions with the GP and said it felt good to be doing something to help himself. Shane’s GP also told him about local counselling services and charities that he could contact.

It was good ‘offloading’ and Shane felt better after seeing his GP. But it felt ‘wrong’ going to the chemist with bandages on his arms.

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I always felt that I was helped when I left the doctors straight away, just because I had released some of the stuff that I was keeping to myself, which was a good point I guess. But I also felt wrong with myself in a way because, after the doctors, I made it a routine to go to the pharmacy directly afterwards. And later on I felt wrong in doing so because of the hospital incident, and I had to go and pick up medication with bandages on my arms for a mental health disorder in which everyone in the pharmacy could clearly tell it was for the self-harming and stuff.

If someone's in the same situation how could that have been easier because you went for counselling and then you went to the pharmacy.

Hm mm

Is there anything that could have helped there?

I guess with people in that situation actually having the pharmaceutical, I guess, goods in a way, having them with your doctor so at the end of your counselling or session or appointment, they can give you said medications and stuff like that, just because they…if they think it's good for you, they’ll give it to you. And if they don’t it…they won't, or at least talk to you about it. And just because they know you a lot better than the person behind a desk at the pharmacy.

So what the doctor was going to prescribe after she spoke to you, if she could have written the prescription, somebody could have fetched it while you wait in the waiting room or something?

Yeah just stuff like that so that it's a lot more like you're not being moved around in a sense.

So for five months you went to see her. Can you tell me what, you know, you said some of the good things was that sometimes you felt like you talked about things that you'd kept to yourself. Can you tell me the good points about going to see her, and then the things perhaps that weren't so good, please?

OK. Well one of the good points was the offloading and stuff, but also I guess the…it was the sense that I was finally beginning to help myself which, for me, was a rarity among anything just because, as I said, I prefer to help others than myself. So that was a good thing about it.

I guess also the fact that I…I felt like I was being I guess like specialised in a way because normal people have fifteen minutes and stuff like that, and I ended up with half an hour which I feel like I cheated other people in a sense just because I was given double their time, but also happy and glad because I had that extra time.

The bad things was probably I guess the moving around of doctors when she was not present I guess. So that was a bad thing. Another was with the going to the doctors I had – before the hospital incident – I was missing a lot of college days which brought me even further behind.

Referral to other services

Other mental health professionals that a GP might refer a person to include a psychotherapist, clinical psychologist, and psychiatrist. Other services include Child and Adolescent Mental Health Services (CAMHS).

CAMHS is an area of the NHS dedicated to supporting children and young people with emotional, behavioural and mental health issues, in both in-patient (hospital) and out-patient (day-care) services. CAHMS offer assessment and treatment to young people up to the age of 16 or 18, depending on the local service. The most common way to get an appointment is through the GP, but teachers and school nurses might also be able to make a referral.

Lucy was referred to CAMHS by her GP because of anxiety. She started feeling anxious around the age of 13 when she was at school. She often had to leave lessons because of it and later found it hard to go to most lessons. Her teachers suggested that she talked to a doctor. Being used to 10-minute GP appointments, she was surprised when the counselling session lasted an hour, which she liked. She felt uncomfortable in one of her sessions, though, because her dad wanted to sit in with her and then talk to the counsellor alone. After five sessions of individual counselling, she tried adolescent group psychotherapy.

Lucy knew she could start trusting the counsellor when she had problems finding the building. The counsellor was understanding and made her feel comfortable.

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Lucy knew she could start trusting the counsellor when she had problems finding the building. The counsellor was understanding and made her feel comfortable.

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I think at first I felt a bit uncomfortable cos of my dad going in there. And especially the time my dad was like, “Oh I just wanna talk to, you go outside for a sec.” Cos that made me think like, “Oh they’ve probably said something about me.” Cos I felt like I don’t want stuff about me to have been said if it, if I’ve said it to her confidentially. So that sort of bothered me. But then as soon as my dad stopped going in on the sessions, it was, it felt a lot better.

And there was this time, cos they moved buildings. And when they moved buildings, the first time I had to go there, I had to go by myself cos I didn’t, like my dad was doing something. I didn’t really have any idea where it was or where I was meant to get off the tram or anything like that.

So I got off the tram and it was chucking it down. And I think I walked about a mile in the wrong direction. And then I had to walk back and it was just all really horrible. I was like crying. And so I had to phone them like three times to find out where it was. And I finally found it. And then the appointment that I was even going for wasn’t even meant to be with her. It was meant to be with the group of people, to make sure I was definitely gonna go.

But then she saw me. She was like, “Oh, God, are you all right?” And I was like, “I’ve just gotten lost and it was really horrible.” And so she like took me into her office, found a blanket and gave me that and made me a cup of tea. So I think from that moment I was like, “This one’s all right. I trust this one. She makes me tea. It’s fine.” But, yeah, before that, when it was just my dad going all the time, I was like, “No, I don’t like this.”

Sophie was disappointed when individual counselling at school didn’t seem to make any difference. She thought that one-to-one counselling was the only option for depression but later learnt about group therapy and mindfulness meditation. She was referred by her GP to group psychotherapy through CAMHS. The sessions helped her see that she wasn’t alone in having and needing treatment for depression. Talking to people of different ages also helped her see that people can have depression at any age.

Talking to ‘really understanding’ people at group therapy helped. Sophie now finds it easier to talk to friends and family too when something’s wrong.

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Talking to ‘really understanding’ people at group therapy helped. Sophie now finds it easier to talk to friends and family too when something’s wrong.

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It was held in I think it was…it was like a mental health centre. I think it must have been about like twenty miles away from my house. I got the bus there. And it was…my first appointment I was…I was kind of nervous because I had no clue what to expect. But it was really friendly, really welcoming, and there were about seven or eight of us I think. And we did literally sit in a circle and we introduced ourselves. And there was two…two, no, three specialists there who were kind of, you know, encouraging us to speak and stuff. And I think it was just…it just worked really well in the sense of it was the first time I felt that I wasn’t alone in it and that there were other people out there who were kind of needing the same kind of treatment as I was.

So that was the group therapy; did your parents know?

Yeah, yeah.

And you went there. Was it mainly people of your age group, or different age groups?

Different age groups yeah that you…I think I was…I wasn’t the youngest but I was the second youngest and there were some older people there too.

So older people as in over twenty or something, over thirty?

Yeah, yeah, which I was surprised about because I thought, because it was through CAMHS [Children and Mental Health Services], well I thought it was through CAMHS, but it turned out I…if I wanted to do a CAMHS group therapy, I would have had to do a different thing. But I didn’t…I wasn’t fussed by the fact that it was…I thought it worked well because it was different age ranges – I thought that worked really well.

So, when you say different age ranges, so people…well you were the second youngest?

Yeah

And then were there people over forty/fifty/sixty?

Yeah, I think no-one was…probably no-one over sixty, but yeah I'd say like there were some middle aged people there.

And you said the age group and the age difference – that helped?

Yeah [coughs]. I think it helped because it did just show that no matter who you are, you can struggle with the same things, you know, whatever your age you still might struggle with the same thing so.

And you said it helped you feel that you weren't alone.

Yeah.

So the very first time you went there, did you notice a difference at all in how you were feeling?

Yeah, it made me much more kind of open in the sense of I didn’t know these people but they were really understanding. And it kind of made me think that I was able to speak to other people in my life because, you know, they’ll probably be just as understanding. So, yeah, I think it really made a difference in that sense and the fact that I was…I then felt that way and the more I talked about it, kind of, the more people understood that it made things a lot easier.

Lucy also went to a psychotherapy group through CAMHS and liked that she didn’t have to talk about serious things every time. She went for about a year and later had a few one-to-one counselling sessions.

Different people in the psychotherapy group talked about their problems every week but Lucy never really knew why they’d been referred.

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Then she [the counsellor] put me in the teenage psychotherapy group which, so I got put in that. And that was once a week and it was two hours I think. There wasn’t many of us. I think there was me and like four or five other people. And that was all right cos you didn’t always have to talk about serious stuff. And sometimes you could literally just go, have a bit of a break. And I quite liked that. And then she was like, “Oh, we’ll still keep on seeing you through this.” And I was like, “Oh, right, okay.” I think I went to the teenage psychotherapy group for about a year and didn’t have an appointment with her.

And then I think I really then ended up wanting an appointment cos I was feeling really like low and everything was like really bad. And sometimes like at the group thing, I ended up becoming sort of like the clown. Like, people were down, it was always me that had to cheer them up and I’d have to be the loud, funny one. It was like, yeah, so I never really felt like I could talk there. So this appointment, I think we had about two or three more appointments and that was really about it.

And in the psychotherapy group, were there other people with the same kind of issues, problems, issues that, did it feel comfortable being with people?

Well, I dunno, cos I didn’t really fully know their problems. It would sort of be more like one week someone would have a bad week. Like, someone’s nan would die and then they’d talk about that and they’d be really upset. And then, I think for me one week like my dad was ill, so I was upset about that. But you never really, you never really knew why people had started CAMHS [Children and Adolescent Mental Health Services] and stuff like that.

Was there someone leading the group?

Yeah, there were two members of staff and they were really nice.

What’s right for one person might not be right for another. Sarah disliked the idea of group psychotherapy and Aphra felt that peer support had its pros and cons – it was helpful for some people but had the potential to make others feel worse rather than better.

Auberon was referred to CAMHS by his GP too. When he turned 18, though, he had to move from CAMHS to adult services and had a long wait for CBT (Cognitive Behavioural Therapy). He was also under the care of a psychiatrist and only saw his GP when he needed to talk about his medications or get a repeat prescription:

Auberon had been having counselling and later spent a month in hospital. He had to wait 2 years for therapy when he moved to adult services but feels it’ll help.

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Regarding my mental health issues, I was in the hospital for a month which is where I was first diagnosed with mental health problems and all my diagnoses took place. And then…But before then I was seen under CAMHS [Children and Adolescent Mental Health Services] just as a counselling service, if you know what I mean; just as like a support and just talking service. But then after I'd been put into this hospital for a month, then I'd been referred to the adult mental health service team, so yeah.

Was there a big difference between that transition to the adult mental health team from the, you know the children's or young people's?

Yes, it was, because I was getting cognitive behaviour therapy at the time, and unfortunately my therapist got ill and unfortunately she couldn’t do it anymore. But they said they would…they said as it was so close to that change…between that period of change over, between the CAMHS and the adult, they said that…they said it would automatically start up again when you come in the adult. But things didn’t work out and I'd been on the…I'd been in the adult mental health services for almost two years and I'm finally getting my first CBT appointment next week.

So you’ve been waiting for a good…?

Two years, almost two years yes.

Have you been able to access any similar services at all in any other way?

I've been …no, not really. I've been…my care co-ordinator's great, but she's not a therapist really. She's just like a care co-ordinator because she gives more practical advice on what to do and how to cope and stuff, but therapy is, I think, everyone says it's a way forward, so yeah, so...

So the care co-ordinator – is this through the GP or the hospital?

It's through… I first start…well I was in a CAMHS mental health unit when I was in hospital, so then I was diagnosed, so I had a formal psychiatrist up there, and when I got out and everything. But then my psychiatrist switched me to adults because I was over eighteen, I was getting to the age of eighteen, and so yeah so....

Some people we spoke to said that their GP told them that their problems weren’t serious enough or high priority enough to be referred to CAMHS, including Siobhan. When Siobhan was diagnosed with depression and anxiety, her GP prescribed medication and told her about local services she could find out about. She chose to have online CBT.

Siobhan’s uncomfortable with talking about her feelings. The online CBT sessions are 40 minutes each and all she needs is internet access.

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Siobhan’s uncomfortable with talking about her feelings. The online CBT sessions are 40 minutes each and all she needs is internet access.

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And you mentioned that, was it through the doctor that a counsellor got in touch with you and said, “Do you want to do the online CBT (Cognitive Behavioural Therapy)?”

Yeah, the doctor said that there’s an onsite counsellor who they were gonna send me to. But that took a few weeks to get the appointment cos she only works Tuesdays till like 4 o’clock and I have school. So I had to book it for holiday times. And I went to see her and she like gave me the leaflet about IAPTs [Improving Access to Psychological Therapies] and what options there are and stuff like that, about what I can do. And just told me about different types of CBT, like face to face, online, like workshops that you can do in town and things like that.

Did you only see her the once then?

Yeah, I’ve not seen her since.

So she just told you about all the different options?

Yeah, then she just called me to ask me what I wanted to do.

And you felt that the online would be best for you?

[mhm] Yeah.

Would you like to try any of the others? Or do you think, “No, this is the one that’s best for me”?

I think the online one’s one of the better ones for me. Cos I’m not very good at just like when people go, “And how did that make you feel?” I’m like, “Well, I don’t know.” So, and like with the workshops, it’s a big group and having to just blurt it out. It would be like, “No, I’m not going to a support group. I’m not going to bloody ‘self-harmers anonymous’.”

And the online, can you do that any time or..?

Yeah, as long as I’ve got an Internet connection I can do it. But you’ve got to have headphones cos it talks. But it takes like about 40 minutes, so obviously I’ve got to have that chunk of time free.

Auberon, Nikki and Fran had all had care from psychiatrists in the past. Auberon had depression and had self-harmed. Fran had had psychosis at a younger age and her GP had referred her to hospital. Psychosis is a mental health issue that causes people to perceive things differently from those around them. This might involve hallucinations (hearing, seeing and, in some cases, feeling, smelling or tasting things that aren’t there) or delusions (believing things that are untrue – for example, thinking that there are devils in the room). Over the years, Fran had seen good and bad psychiatrists:

Fran disliked one of her psychiatrists and thought he was only interested in making money. Another one, though, was kind, jolly and like ‘a really sweet grandad’.

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My psychiatrist, he’s, he’s not, he’s a really arrogant man. He’s just like so arrogant. And it’s like he thinks he’s right.... And it’s almost like, he’s got this smirk like, “I’m not here to help you. I’m here to fill my bank account.” It’s like, “Then why are you, can’t you go and do something else to fill your bank account and like not mess with . . ?” yeah. Psychiatrists, I’ve had a couple of good ones. I’m not a massive fan of them.

What were the good ones like?

Kind. And really like, it’s like there was a doctor called Dr [remove name] and it’s when I was on the ward. And I couldn’t really talk to like anyone. I was, and I used to go out and smoke and he used to come out and smoke his pipe with me and just have a chat. And I was like, I’ve never had a grandad. And he was like this proper, he was that old, he was like a proper, really sweet grandad. Like he just really engaged with his patients.

And I’m not sure, like I’m never really sure what the role of a psychiatrist is, to be honest. Cos it seems to be the psychiatric nurses do all the work. Probably the psychiatrists just have such big caseloads or whatever. But he was just really nice and jolly. And he sat down with me and he was like, “All I need you to do is explain what’s going on in your head.” And I did that. And without really, so, yeah, he was an exception.

Counselling services at college and university

Counselling is usually available free of charge to students who are at college or university. When Susan found out about university counselling services, she was pleased that she could see a counsellor quickly and didn’t have to pay for it. Like Vinay, she was reluctant to see a GP about mental health as she didn’t want to speak to a different doctor every appointment. Being a medical student, she was wary of what other health professionals would think about her having counselling. She also felt that GPs weren’t the best professionals to talk to about mental health. Counselling turned out to be very different to what Susan had been expecting – she thought she’d be talking about the stress caused by an eye condition she’d had but ended up discussing many different things:

Susan talked about tough times she’d had during childhood. It made a big difference and she found it ‘amazing’. It does take time, though, and isn’t ‘a quick fix’.

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It was quite a weird experience, I didn’t…it wasn’t quite what I expected actually. So I had quite a few things in my childhood that were quite tough, but I'd never realised they'd affected me. And that was almost the first thing she talked about, and I had gone in wanting to talk about how stressed I'd been at university and how I'd had this awful condition in my eyes. And this was all making me sad. And that’s what I'd been expecting to talk about, and it wasn’t quite that.

And it was really hard to realise kind of how things in the past had affected you. And so yeah it surprised me, and part of me felt very uncomfortable with it. But once I'd overcome that initial phase, it just made such a difference, yeah it was amazing actually.

So would you recommend counselling to other people around your age group who are feeling anxious, stressed, maybe not talking about it, keeping busy?

Definitely, because I mean, I thought that I had a…I thought I was fine and I thought that there was no need for it, and that I was just being silly. And actually it helped me so much.

Can you talk about some of the ways it helped?

Yeah. So I think the main thing was just admitting to myself that there was something wrong. Because I was in denial for a long time and you just kind of live with it, and you think, 'No, this is normal, you know it's OK, I can carry on like this.' And every time you kind of reach almost a crisis point you think, 'That’s it I'm going to do something.' And then it passes and you think, 'No, no it's nothing, I'm fine.' So I kept putting it off, I kept telling myself I was fine, yeah.

But talking to her, looking at things in a different way.

Yeah

How did the feelings of anxiety, were they there still a lot more at first, or how…you know, because you weren't expecting to talk about some of the things, how did it go over the sessions – were you allowed to have as many as you like, or was it like six or?

Yeah, so she was very good, she said I could have as many as I'd like. And actually she never really said the number of sessions, it was more like, she would leave me after a session and just let me get in touch. And I felt that was really good because it did take a long time, and it was not a quick fix at all. And I think just realising that early on that actually you're not going to go in and feel great after the first one. It really takes a long time and I think she gave me kind of bite sized amounts of things that I could do to make things better.

And that was all I could really cope with, and I think just changing that expectation to, 'OK, I'm just going to do these small bits at a time.' And gradually just I changed things about my lifestyle. Things, the way I saw things, and it does give you strategies, and I feel like they’ll stay with me forever. And I, maybe I'll slip into bad things in the future but I think now I'm so much more aware, I won't kind of put them to the background, yeah.

Vinay had spoken to the university mental health advisor and hoped that he could have more sessions after the summer holidays. It was helpful ‘having someone to vent to, and that’s what she promoted, was just the venting it and getting off your chest. And promoting this sort of energy sort of perspective about being positive and just calming.’ Sarah also used the counselling services at her university but ‘hated it, but I don’t think they were bad....It wasn’t that it wasn’t helpful, I just really hated it. But I don’t think that’s a sign that they were a bad counselling service.’

Sarah dislikes talking about personal things to people she doesn’t know. She found it hard to open up but felt that the counsellor was good.

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Sarah dislikes talking about personal things to people she doesn’t know. She found it hard to open up but felt that the counsellor was good.

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And how did you feel about the counselling service?

I really hated it but I don’t think they were bad. Like I didn’t think it was, it wasn’t that it wasn’t helpful, I just really hated it. But I don’t think that’s a sign that they were a bad counselling service. So yeah...

Did you have one particular counsellor that you –

Yeah.

So were you able to see the counsellor quite regularly?

So I think you got five sessions and I think it was once, I want to say once a week. It was either once a week or once every two weeks, but I think it was once a week. Yeah.

And can you tell me what you liked and didn’t like about the counselling and then we’ll talk about maybe other things that might have helped or things that you might advise other people. So were there any good things about the counselling that you can remember?

Yeah. I think there were probably definite, there were definitely good things. I guess talking about things that you don’t want to talk about is probably a good thing in some ways. But yeah and they were, they were good and helpful and whatever, I just don’t think, I don’t know, I think I get quite, I don’t know, I don’t really enjoy it. But that doesn’t mean it’s not helpful and good. So yeah....

A few people also mentioned that. Some people found it helpful but other people felt it wasn’t for them at all.

Yeah.

Can you talk a little bit about why, why perhaps you didn’t like it or didn’t feel comfortable because maybe there’s something that,

Yeah.

…you know a service that maybe is better for younger people.

I don’t really know what the other options would be. Like I didn’t like it because I don’t particularly like talking to people that I don’t know about things that are quite personal. But that is the whole point of counselling so I’m aware of that and that’s a bit of a stupid opinion. But I don’t know what the option, other options would be for young people because if you want to talk to someone and you want to know about, if you need to talk about things, then you have to talk about them. So yeah I do think, I don’t know what the options would be.

So with that particular counsellor, you had five sessions, did you feel you could open up or did you feel it was really difficult and maybe you couldn’t because,

Yeah I didn’t but that was me, not her. She was good.

Some people prefer not to speak to a counsellor face-to-face but to email instead. This form of counselling allows people to take the time to think through what they’d like to discuss, and many find physically writing their issues down therapeutic. Sarah felt that email or telephone counselling might have been more helpful. She also felt that some form of talking therapy focused around an activity such as walking and talking might have helped more than sitting in a room and talking. Online counselling also offers people the chance to take their time to think and to be anonymous. Siobhan had online CBT and found it helpful. It was hard for to talk about her feelings and occasionally she texted the Samaritans. When Sophie finished her group therapy, she felt a lot better. Every now and then, when she felt she needed to, she phoned the Samaritans. Texts and phone calls are confidential.

The counsellor told Sophie about the Samaritans. She prefers texting to phoning so she can think about and get her words right. She got a reply 10 minutes later.

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The counsellor person who I saw, she gave me the texting number for Samaritans, which has been helpful.

Oh that’s good. A few people have mentioned that actually. So with the Samaritans, did you phone them or..?

I text them for that. Cos again it’s talking. I don’t like doing it. So I’d rather send a text so I can get my words right. Cos Autocorrect tells me what word I want.

That’s a really good point.

Yeah.

So you just text them. And did someone text you back straight away?

It were about a 10 minute delay but they did text back. But they said to me like the phone calls get priority over the text number, but they will get back to you.

And so you could text what you were thinking and --

[mhm] Yeah.

-- then someone would, would --

Yeah, they’d say like, “How can I help you? It’s completely confidential etc.” Like you then explain and they say like, “Oh, that’s really shit” or whatever. “What’s been going on to make you feel that way?” And things like that.

And would they actually give advice or suggestions or anything?

I think they’re more just someone to talk to over a text like. Rather than going, “Well, you could do this, you could do that.” Just like, “That’s shit.” And then they’d go. Just someone to like let your problems out to and who were just confidential. And they’re like volunteering to do it, so you know that they want to listen.

As well as using counselling or other talking therapies for depression, the young people we talked to also said that a change in circumstances helped too. For Lucy, leaving school and going to college helped. Nikki recalled how moving house and going to a college where she made new friends made a big difference, as well as volunteering to raise awareness of mental health issues. Vinay said playing the guitar and writing songs was a positive ‘catalyst’, and he encouraged other young people ‘to channel their emotion and their feelings into some creative outlet’.

More young people talk about their experiences of low mood and depression here.