Counselling is one of those things that most people have a rough sense of without quite knowing what it involves in practice. There's a widespread idea that it means lying on a couch and talking about your childhood, which puts some people off before they've even considered it properly. The reality is considerably more ordinary and, for many people, considerably more useful than that image suggests.
A counsellor is a trained professional whose job is to listen, to help you understand what's going on for you, and to support you in finding your own way through it. They don't give advice in the way a doctor does. They don't tell you what to do. What they offer is something that turns out to be rarer than it sounds: undivided, non-judgmental attention, over a sustained period of time.
The different types
Person-centred counselling is one of the most common approaches in the UK. It works from the premise that people have the capacity to understand themselves and find their own direction, given the right conditions. The counsellor's role is to create those conditions: a relationship that is warm, honest, and genuinely accepting. This approach is less structured than others, and many people find it suits them well when what they need most is to feel understood.
Cognitive Behavioural Therapy (CBT) takes a more practical, structured approach. It focuses on the connection between thoughts, feelings, and behaviour, and works with the patterns that tend to sustain low mood, anxiety, or other difficulties. CBT tends to involve more exercises and between-session work than person-centred counselling. It's particularly well-evidenced for anxiety and depression, and is often available through the NHS for these difficulties.
Integrative counsellors draw on more than one approach, adapting their practice to the person in front of them rather than working from a single model. Many experienced counsellors work this way, and some people find it a good fit, particularly if their needs shift over the course of working together.
There are other approaches too, including psychodynamic counselling, which pays particular attention to how past experiences shape present patterns, and solution-focused therapy, which concentrates on what you want to move towards rather than examining what's held you back. It's worth having a sense of what might suit you when choosing a counsellor, though an initial consultation is often the most useful way to work that out.
"Many people describe their first session as a relief. Not because anything was resolved, but because they finally said things they hadn't found a way to say elsewhere."
What actually happens in a session
Sessions typically last 50 minutes to an hour and usually take place weekly, at least in the beginning. You'll sit, talk, and the counsellor will listen, ask questions, and reflect back what they're hearing. Some sessions feel productive and energising; others feel slower or harder. Both can be useful. The relationship builds over time, and many people find that the first few sessions feel a little uncertain before things find their shape.
Your counsellor will usually ask about what's brought you to see them, a little about your background, and what you're hoping for. They won't push you to talk about anything you're not ready to discuss, and the pace is yours to set.
How to know if it might be worth exploring
A useful indicator is whether you've been carrying something, whether that's a persistent low mood, a period of anxiety, a relationship difficulty, a life change, or simply a sense of being stuck, without feeling like you've been able to make sense of it or move through it. Counselling tends to be most useful when there's something you want to understand better, or when you've felt that talking to people in your life, however kind they are, hasn't quite reached the thing you need to address.
You don't need to be in crisis to see a counsellor. Many people find it useful as a regular support during ordinary but demanding stretches of life.
If you're considering counselling, look for someone registered with the British Association for Counselling and Psychotherapy (BACP) or the UK Council for Psychotherapy (UKCP), both of which maintain registers of accredited practitioners. Most counsellors offer an initial consultation, which is a good opportunity to get a sense of the person and whether the approach feels right. Welvow can help you find a registered counsellor in your area.
Find your practitioner →The first step is usually the hardest. After that, most people find they're glad they went.