NHS England » NHS Talking Therapies, for anxiety and depression (2023)

The NHS Talking Therapies, for anxiety and depression programme (formerly known as Improving Access to Psychological Therapies, IAPT) was developed to improve the delivery of, and access to, evidence-based, NICE recommended, psychological therapies for depression and anxiety disorders within the NHS.

From small beginnings in 2008, the programme has steadily grown so that nearly 1.2 million people were able to access services in 2021/22. This expansion was the result of training and deploying thousands of new psychological therapists and practitioners, as well as providing additional training modules for existing therapists. Taken together The Five Year Forward View for Mental Health and The NHS Long Term Plan commit the NHS to further expand the NHS Talking Therapies, for anxiety and depression programme so that 1.9 million people per year will be able to access services by the end of 2023/4.

Details of local NHS Talking Therapies, for anxiety and depression services are available on the nhs.uk website: Find an NHS psychological therapies service.

What are NHS Talking Therapies, for anxiety and depression services?

NHS Talking Therapies, for anxiety and depression services are characterised by three key principles:

  1. All psychological therapies offered are evidence-based and delivered at the appropriate dose: where NICE recommended therapies are matched to the mental health problem, and the intensity and duration of delivery is designed to optimise clinical outcomes.
  2. All within the clinical workforce are appropriately trained and supervised: high-quality care is provided by clinicians who are trained to an agreed level of competence and accredited in the specific therapies they deliver, and they receive weekly outcomes focused supervision from senior clinical practitioners with the relevant competences to support continual improvement.
  3. Routine outcome monitoring via standardised measures is used on a session-by-session basis, so that the person having therapy and the clinician offering it have up-to-date information on the person’s progress. The outcomes of all NHS Talking Therapies, for anxiety and depression services are published so that the sector can learn from variation in outcomes and public transparency about the benefits and limitations of the services is maintained. This helps guide the course of each person’s treatment and provides a resource for service improvement, transparency, and public accountability.

Services are delivered using a stepped-care model, which works according to the principle that people should be offered the least intrusive intervention appropriate for their needs first.

(Video) Treatment for depression and anxiety | NHS Talking Therapies

For more information on how the services work, please see the NHS Talking Therapies, for anxiety and depression manual.

Who are NHS Talking Therapies, for anxiety and depression services for?

NHS Talking Therapies, for anxiety and depression services provide NICE recommended psychological interventions for adults and older adults with anxiety disorders and/or depression. This can be standalone or in the context of a long term physical health condition where this can be managed effectively in a uni-professional service. Evidence-based therapies are delivered by trained clinicians, with or without concurrent pharmacological treatment.

NHS Talking Therapies, for anxiety and depression services provide treatment for people with the following common mental health problems:

  • agoraphobia
  • body dysmorphic disorder (BDD)
  • depression
  • generalised anxiety disorder
  • health anxiety (hypochondriasis)
  • mixed depression and anxiety (the term for sub-syndromal depression and anxiety, rather than both depression and anxiety)
  • obsessive-compulsive disorder (OCD)
  • panic disorder
  • Post-traumatic Stress Disorder (PTSD)
  • social anxiety disorder
  • specific phobias (such as heights, flying, spiders etc.).

In addition to evidence-based talking therapies for the common mental health problems listed above, NHS Talking Therapies, for anxiety and depression services also provide employment advice in many areas of England, to support people to reach their employment goals.

(Video) Bernie's story: Improving Access to Psychological Therapies

Aligned with the Long Term Plan and the Advancing mental health equalities strategy, NHS Talking Therapies, for anxiety and depression services are working to reduce health inequalities, ensuring services meet the needs of all in the population that they serve. Our work on advancing equalities focuses on improving access, outcomes and experiences for specific populations and under-represented groups.

How are NHS Talking Therapies, for anxiety and depression services accessed?

Referral pathways have been specifically developed to promote access and equality. They include:

  1. self-referral into every service (find an NHS psychological therapies service – www.nhs.uk)
  2. community or voluntary service referral
  3. primary care referral
  4. secondary care referral (including both mental health and physical health care services).

What does NHS Talking Therapies, for anxiety and depression involve?

All talking therapies involve the patient and therapist, or practitioner, working as a team to understand problems, overcome current difficulties and achieve identified goals. Therapy involves talking, but usually also involves doing practical exercises and tasks both in and outside of sessions. It is an active process, and the therapist or practitioner will regularly check in with the patient to ensure progress.

Talking therapies are provided in different ways, including:

(Video) Help! | Talking Therapies | NHS | BSL version

  • using a self-help workbook or website with the support of a therapist
  • one-to-one in person, over the phone or through video consultation
  • in a group.

If a patients first language is not English, talking therapies can be delivered in their chosen language through multi-lingual therapists or confidential translators. NHS Talking Therapies, for anxiety and depression are also available in British Sign Language (BSL) through SignHealth.

What types of therapy are offered in NHS Talking Therapies, for anxiety and depression services?

The following are the NICE recommended talking therapy options for depression, anxiety and post-traumatic stress conditions. You can find out more about these options on the NHS website’s Types of talking therapy page.


  • Guided self-help based on cognitive behavioural therapy principles
  • Cognitive behavioural therapy (CBT)
  • Interpersonal therapy (IPT)
  • Couple therapy for depression (CTfD) or behavioural couple therapy (BCT)
  • Dynamic interpersonal therapy (DIT)
  • Counselling for depression (PCE-CfD).
  • Mindfulness-based cognitive therapy (MBCT)

Anxiety which can include disorders such as panic, phobias, obsessive compulsive disorder, and generalised anxiety disorder:

  • Guided self-help based on cognitive behavioural therapy principles. This is not advised for social anxiety disorder or post-traumatic stress disorder
  • Cognitive behavioural therapy (CBT)

Post-traumatic stress disorder

  • Trauma-focused cognitive behavioural therapy (TfCBT)
  • Eye movement desensitisation and reprocessing (EDMR)

Social anxiety disorder

  • Cognitive behavioural therapy (CBT)

How are NHS Talking Therapies, for anxiety and depression services delivered?

Services should offer a choice of in-person or remotely delivered therapies. Most of the in-person therapy is provided in local settings that are as easy for people to access such as GP practices, physical health clinics, community settings and voluntary organisations. In recent years, expedited by the pandemic, more people are opting to have therapy remotely (via video platform, telephone or text talk). Alongside these options, services are also offering digital treatment (digitally enabled therapies, DET), provided via the internet. Such platforms encourage learning through patient self-study, reinforced and supported by a suitably trained therapist. As well as maximising the geographic reach of the NHS Talking Therapies, for anxiety and depression programme, delivering treatment via digital platforms means that treatment can be accessed anywhere and at any time. It can also help promote access to treatment for people who may be less likely to engage with more traditional face-to-face therapy appointments. Other people prefer in person therapy and can choose this. It is a matter of choice.

(Video) Digital talking-therapy treatments for anxiety and depression approved by NHS England

How are NHS Talking Therapies, for anxiety and depression services commissioned?

Services are commissioned by local integrated care boards (ICBs) and are overseen by NHS England on a regional and national basis.NHS Talking Therapies, for anxiety and depression services will also work closely with community mental health services for people with severe mental health problems (also referred to as severe mental illness) to ensure people are able to receive support from the right service for their needs.

NHS Talking Therapy for Anxiety and Depression services need to develop strong relationships with professionals across a broad range of mental and physical health care pathways, as well as social care, to ensure that people with needs that are either not appropriate or are too complex for NHS Talking Therapy for Anxiety and Depression services receive the necessary care in the right place.

Patient and public participation is an essential part of the NHS Talking Therapies, for anxiety and depression programme. The knowledge and expertise of those using services is key to driving all aspects of our programmes development.

Psychological therapies for severe mental health problems (adults and older adults)

Psychological therapies for people with severe mental health problems (also referred to as severe mental illness) are a key part of the new integrated offer for adults and older adults, as set out in the NHS Long Term Plan. Severe Mental Health problems include psychosis, bipolar disorder, ‘personality disorder’ and eating disorders. All areas of the country are seeking to increase availability of these therapies as part of a wider transformation of adult and older adult community mental health services. For more information on community mental health services please see our community mental health services page.

(Video) Treating anxiety and depression - www.slam.nhs.uk


How do I access NHS therapy? ›

You can access talking therapies for free on the NHS. You can refer yourself directly to an NHS talking therapies service without a referral from a GP, or a GP can refer you. Help is available in person, by video, over the phone or as an online course.

What is another name for talk therapy that people with anxiety and depressive disorders attend? ›

Psychotherapy (sometimes called talk therapy) refers to a variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviors. Most psychotherapy takes place when a licensed mental health professional and a patient meet one-on-one or with other patients in a group setting.

Which type of psychotherapy is most effective for anxiety and depression in general? ›

Cognitive behavioral therapy (CBT) is the most widely used evidence-based intervention for treating anxiety.

How long is the wait for CBT on NHS? ›

Almost 200 people now wait for more than a year for DP, while the wait for CBT, under IAPT, is three weeks. There's also evidence that people needing CBT wait longer when more unwell.

Is therapy free in the UK NHS? ›

You can get free talking therapies, including counselling for depression, on the NHS. You do not need a referral from a GP. You can refer yourself directly to a talking therapies service. Or you can get a referral from a GP if you prefer.

How to get free NHS treatment? ›

Hospital treatment is free of charge for people who are ordinarily resident in the UK. This does not depend on nationality, payment of UK taxes, National Insurance contributions, being registered with a GP, having an NHS number, or owning property in the UK.

What two types of therapy can be an effective treatment of both depression and anxiety? ›

Because cognitive therapy and behavioral therapy work well together to treat depression and anxiety disorders, the two are often combined in an approach called cognitive behavioral therapy (CBT).

What type of therapy is often recommended for treating many anxiety and depression disorders? ›

Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness.

What two types of psychotherapy are most commonly used to treat anxiety disorders? ›

While many different types of therapy are used to treat anxiety, the leading approaches are cognitive behavioral therapy (CBT) and exposure therapy.

Which therapy is most successful in the treatment of anxiety disorders? ›

A form of psychotherapy known as cognitive-behavioral therapy (CBT) is highly effective at treating anxiety disorders.

What therapy is most successful in treating depression? ›

Cognitive behavioral therapy (CBT) is one of the most well researched therapy approaches for depression, and is proven to be effective in treating people with depressive symptoms.

Which therapies are most successful in the treatment of anxiety disorders? ›

Cognitive behavioral therapy (CBT) is the most effective form of psychotherapy for anxiety disorders. Generally a short-term treatment, CBT focuses on teaching you specific skills to improve your symptoms and gradually return to the activities you've avoided because of anxiety.

How long is NHS mental health waiting list? ›

The maximum waiting time for non-urgent, consultant-led treatments is 18 weeks from the day your appointment is booked through the NHS e-Referral Service, or when the hospital or service receives your referral letter. However, your right to an 18-week waiting time does not apply if: you choose to wait longer.

What happens in NHS therapy? ›

Counselling on the NHS usually consists of 6 to 12 sessions, each an hour long. You talk in confidence to a counsellor, who helps you to think about your situation. Counselling is ideal for people who are basically healthy, but need help coping with a current crisis, such as: anger.

Does NHS provide CBT? ›

You can get talking therapies, including CBT, on the NHS. You can refer yourself directly to an NHS talking therapies service without a referral from a GP.

How much does one session of therapy cost in the UK? ›

How Much is Private Counselling and Therapy in the UK? Costs and Prices
In-person Private Therapy£50-£80/hourNo additional fees
BetterHelp (15% Off Here)£48 – £72/week, billed monthlyNo additional fees
Calmerry (20% Off. Code: “CARE”)£41 per week, billed monthlyNo additional fees

How do people afford therapy UK? ›

You can get some therapy sessions for free on the NHS. These services are usually called talking therapy or psychological wellbeing services. If you live in England you might be able to refer yourself - or you could ask your GP to refer you.

What are the 3 types of counseling? ›

So, what are the three main types of counseling? Psychodynamic, humanistic, and behavioral approaches are the most common and each support different individual therapies.

Can a US citizen get free healthcare in UK? ›

IMPORTANT: Anyone in the UK can receive treatment at an NHS facility, no matter their residency status. However, tourist visitors to the UK do not typically qualify for free NHS treatment. Any care beyond emergency treatment and certain other services will likely incur a fee.

What does the NHS not cover? ›

Examples of non-NHS services for which GPs can charge their NHS patients are: Accident / sickness insurance certificates. Certain travel vaccines. Private medical insurance reports.

What services are not free on the NHS? ›

Patients often need to pay towards the cost of:
  • prescriptions.
  • dental care.
  • eye care.
  • wigs and fabric supports.

How do I access my CBT NHS? ›

You can get talking therapies, including CBT, on the NHS. You can refer yourself directly to an NHS talking therapies service without a referral from a GP. Or your GP can refer you if you prefer. If you can afford it, you can choose to pay for your therapy privately.

How long is the waiting list for therapy in the UK? ›

One of the stated targets of the IAPT programme is that for referrals finishing a course of treatment in the month, 75% enter treatment within 6 weeks, and 95% within 18 weeks5. These are based on the waiting time between the referral date and the first attended treatment appointment.

How do I get access to therapy notes? ›

If you would like to access these notes, discuss it with your therapist. Talking about your reasons for wanting to read these notes can help your therapist understand your request. It can also help you understand some of your therapist's concerns about releasing these confidential records.

How much does CBT cost the NHS? ›

The average direct cost of the CBT intervention was £910 per person. There were no clear differences between the groups in terms of other NHS costs, personal expenditure or lost productivity.

Is there a long waiting list for CBT? ›

waiting times for initial assessment were reported to be less than four weeks although in 14 per cent of cases people were reported to typically wait more than 12 weeks to be seen.

Can you apply CBT to yourself? ›

A client has asked me, 'can I do CBT for myself' and the answer is yes; we call it self-directed Cognitive Behavioural Therapy or guided CBT. Self-help therapies are psychological therapies you complete at your own pace and in your time.

How can I speed up my NHS waiting list? ›

You can do this by using the NHS e-Referral Service (the information comes up in a drop down menu called 'Services Near You') or by checking hospital websites – many update their waiting times at least weekly and it can be a good way to see which hospital has the capacity to see you sooner.

What is the maximum waiting time for NHS? ›

Your right to non-emergency care

The waiting time ends on the date you receive treatment for the condition for which you have been referred. If you wait longer than 18 weeks, the NHS should take all reasonable steps to offer you a range of suitable alternative providers.

Can I ask to read my therapists notes? ›

Your clinical notes are considered a medical record, which you have a right to see. Some therapists keep separate personal notes with questions and thoughts they have during sessions, and you're not guaranteed to see those. You can always ask, of course.

Can my therapist record me? ›

This is frequently known as the “two-party consent” rule and with regards to psychotherapy services, requires that both the patient and the therapist consent to the recording.

What do therapists write in their notes? ›

Your therapist uses what's in your current treatment plan to determine what they put in their notes. Progress notes are supposed to show how what you did in any given session addressed one or more of the goals on your treatment plan and whether you're making progress on them.

Why is it so hard for me to open up in therapy? ›

There are a few things that might contribute to this: you may not have developed the level of trust you need to feel safe with the therapist you are working with, you may be fearful of being judged by the therapist, or maybe you are afraid that opening the pain of the past might be too much to handle.

Why do therapists ask where you feel something in your body? ›

Scanning our body for tightness, emotion, specific sensations such as a sinking gut can help provide insight into how we experience the world and provide direction for steps going forward. A therapist is not a keeper of all the right answers and does not intuitively know what is best for you.

What should I tell my psychologist? ›

6 Things To Tell Your Therapist
  • Your strengths and things you are good at. ...
  • Any problems you have with sleep. ...
  • Medications you take and any changes in medication. ...
  • Major physical health concerns. ...
  • The most stressful periods of your life…even if they happened a long time ago. ...
  • Anyone you want us to talk to.
Apr 16, 2023


1. Anxiety and depression - www.slam.nhs.uk
(Maudsley NHS)
2. It’s Movember: come forward and talk about your mental health (Full)
(NHS England )
3. Online depression and anxiety therapy greenlit for NHS to use in England 🧠
(Birmingham Live )
4. Managing Time Boundaries in NHS Talking Therapies Webinar
(SBK Healthcare)
5. Mental health stories | NHS
6. The Anxiety and Depression Network - Oxford AHSN
(Oxford AHSN)


Top Articles
Latest Posts
Article information

Author: Gov. Deandrea McKenzie

Last Updated: 09/14/2023

Views: 6035

Rating: 4.6 / 5 (46 voted)

Reviews: 85% of readers found this page helpful

Author information

Name: Gov. Deandrea McKenzie

Birthday: 2001-01-17

Address: Suite 769 2454 Marsha Coves, Debbieton, MS 95002

Phone: +813077629322

Job: Real-Estate Executive

Hobby: Archery, Metal detecting, Kitesurfing, Genealogy, Kitesurfing, Calligraphy, Roller skating

Introduction: My name is Gov. Deandrea McKenzie, I am a spotless, clean, glamorous, sparkling, adventurous, nice, brainy person who loves writing and wants to share my knowledge and understanding with you.