How do talking therapies work and are they effective?

Talking therapies, also known as psychological therapies, have become a cornerstone of modern mental health care. Whether it’s dealing with anxiety, depression, trauma, or even chronic pain, these therapies help people navigate their thoughts and emotions in a structured and supportive way.¹

What are talking therapies?

Talking therapies involve structured conversations with a trained professional to help individuals process thoughts, emotions, and behaviours.¹ Unlike a casual chat with a friend, these therapies follow evidence-based techniques designed to help people manage mental health conditions and improve their overall wellbeing.¹

Different types of talking therapies exist, and they each have their own unique approach. The most widely used include:²

• Cognitive Behavioural Therapy (CBT): A practical, problem-solving therapy that focuses on changing negative thought patterns.

• Psychodynamic therapy: Explores deep-rooted emotions and past experiences to understand current behaviour.

• Interpersonal Therapy (IPT): Helps people improve relationships and communication.

• Behavioural activation: Using pleasant activities combined with social skills training to activate positive behaviours.

Each of these therapies is tailored to different needs, whether someone is dealing with a short-term crisis or long-term emotional struggles.

How do talking therapies work?

At their core, talking therapies work by changing thought patterns, processing emotions, and developing coping strategies.¹ Here’s how:

1. Understanding thought patterns

Our thoughts shape how we feel and behave. CBT, one of the most researched and widely used therapies, helps people identify negative automatic thoughts—those unhelpful beliefs that pop up without us realising.¹

For example, if a friend walks past without saying hello, someone with social anxiety might think, “they must not like me.” CBT teaches individuals to challenge these thoughts, consider alternative explanations (e.g. “maybe they didn’t see me”), and ultimately reduce emotional distress.

2. Breaking the cycle of negative thinking

CBT also tackles cognitive distortions—common errors in thinking that fuel mental health struggles. These include:

• Catastrophising: Always expecting the worst outcome.³

• Mind reading: Assuming others are thinking negatively about you.⁴

• Black-and-white thinking: Viewing situations as all good or all bad.⁵

By recognising and reframing these patterns, therapy helps people see situations more realistically and manage emotions more effectively.

3. Processing and expressing emotions

For many, simply putting thoughts into words is therapeutic. Psychodynamic therapy, for instance, encourages deep exploration of past experiences to understand how they shape present-day emotions and behaviours.⁶

IPT, on the other hand, focuses on relationship dynamics. By addressing unresolved conflicts or communication breakdowns, individuals can improve their connections with others—something that is vital for mental health.⁷

4. Building coping strategies

Therapy isn’t just about talking; it’s about learning practical tools for managing stress, anxiety, and depression.

For example, someone with panic disorder might learn breathing exercises to regain control during an anxiety attack. Those dealing with chronic pain might use mindfulness techniques to reduce stress and improve their quality of life.

The goal? To equip people with long-term skills that help them handle challenges outside of therapy sessions.

Are talking therapies effective?

The effectiveness of talking therapies is backed by decades of research. Studies show:^1,8

• CBT is as effective as medication for many anxiety and depression cases.

• Combining therapy with medication is more effective than either treatment alone for conditions like chronic depression.

• Talking therapies can reduce the risk of relapse in mental health conditions.

• They are also effective for non-psychiatric conditions like chronic pain, irritable bowel syndrome, and insomnia.

Additionally, therapy provides a safe and confidential space to talk about personal struggles without judgment. This alone can be incredibly healing.

What to expect in therapy

Therapy sessions typically last 45-60 minutes and follow a structured approach. While different types of therapy have their own methods, a typical CBT session might look like this:

1. Checking in: Reviewing mood and discussing any updates since the last session.

2. Setting an agenda: Deciding which issues to focus on.

3. Working through challenges: Identifying negative thoughts and learning new coping strategies.

4. Summarising and setting homework: Practicing new skills in daily life.

Therapy usually lasts 8-12 weeks, but some people benefit from longer-term support.

The best part? Almost anyone can benefit from therapy. While talking therapies are often associated with depression and anxiety, they can also help with:¹

• Post-Traumatic Stress Disorder (PTSD)

• Obsessive-Compulsive Disorder (OCD)

• Eating disorders

• Substance abuse

• Attention Deficit Hyperactivity Disorder (ADHD)

• Relationship issues

• Low self-esteem

Even those without a diagnosed mental health condition can benefit, as therapy can help manage stress, build resilience, and improve overall wellbeing.

How to access talking therapies in the UK

In the UK, talking therapies are widely available through the NHS (albeit with a lengthy waiting time), private therapists, and charities. The NHS Talking Therapies programme (formerly IAPT) offers free therapy for anxiety and depression, with self-referral available in many areas.⁹

For other conditions, a GP referral may be needed. Private therapy offers quicker access but comes at a cost, typically £40-£100 per session. 

Extra help for those struggling

If you’re struggling with your mental health, know that you’re not alone—help is available. Whether you’re feeling overwhelmed, anxious, or just need someone to talk to, these organisations offer free and confidential support:

• Samaritans – Available 24/7 for anyone in distress. Call 116 123 for free or visit www.samaritans.org.

• Mind – Provides advice and support for mental health challenges. Call 0300 123 3393 or visit www.mind.org.uk.

• CALM (Campaign Against Living Miserably) – Focuses on suicide prevention and mental wellbeing, particularly for men. Call 0800 58 58 58 (5 pm–midnight) or visit www.thecalmzone.net.

If you’re in immediate danger or need urgent help, please contact 999 or visit your nearest A&E. You’re not alone, and support is always within reach.

The numan take

Talking therapies aren’t just about talking, but more so about understanding yourself, breaking unhelpful patterns, and building resilience. Whether it’s CBT for anxiety or mindfulness-based therapy for stress, there’s a talking therapy to suit everyone. If you’re struggling, don’t hesitate to reach out to a loved one and a healthcare professional. Therapy could be the first step towards a healthier, happier you. 

References

1. Chand SP, Kuckel DP, Huecker MR. Cognitive behavior therapy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.

2. Barth J, Munder T, Gerger H, Nüesch E, Trelle S, Znoj H, et al. Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A network meta-analysis. PLoS Med [Internet]. 2013;10(5):e1001454. Available from: http://dx.doi.org/10.1371/journal.pmed.1001454

3. Pike AC, Serfaty JR, Robinson OJ. The development and psychometric properties of a self-report Catastrophizing Questionnaire. R Soc Open Sci [Internet]. 2021;8(1):201362. Available from: http://dx.doi.org/10.1098/rsos.201362

4. Wang B, Zhao Y, Lu X, Qin B. Cognitive distortion based explainable depression detection and analysis technologies for the adolescent internet users on social media. Front Public Health [Internet]. 2023;10. Available from: http://dx.doi.org/10.3389/fpubh.2022.1045777 

5. Sanivarapu S. Black & white thinking: A cognitive distortion. Indian J Psychiatry [Internet]. 2015;57(1):94. Available from: http://dx.doi.org/10.4103/0019-5545.14853

6. Opland C, Torrico TJ. Psychodynamic therapy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.

7. Cuijpers P, Donker T, Weissman MM, Ravitz P, Cristea IA. Interpersonal psychotherapy for mental health problems: A comprehensive meta-analysis. Am J Psychiatry [Internet]. 2016;173(7):680–7. Available from: http://dx.doi.org/10.1176/appi.ajp.2015.15091141

8. DeRubeis RJ, Siegle GJ, Hollon SD. Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms. Nat Rev Neurosci [Internet]. 2008;9(10):788–96. Available from: http://dx.doi.org/10.1038/nrn2345

9. England NHS. NHS England » NHS Talking Therapies, for anxiety and depression [Internet]. Nhs.uk. [cited 2025 Jan 30]. Available from: https://www.england.nhs.uk/mental-health/adults/nhs-talking-therapies/