Your Complete Guide to NHS Talking Therapies (IAPT)
Taking the first step towards looking after your mental health can feel daunting, even overwhelming. The simple act of acknowledging you need support is a monumental achievement in itself. For millions of people in England, the next step in that journey is a service called NHS Talking Therapies for anxiety and depression, a programme that has fundamentally changed the landscape of mental healthcare.
This service, which you might also know by its original name, IAPT, offers a lifeline. It’s designed to be accessible, effective, and free at the point of use. But what is it, really? How does it work, and could it be the right choice for you? This comprehensive guide will walk you through everything you need to know, demystifying the process and empowering you to make an informed decision about your mental wellbeing.
What Exactly is NHS Talking Therapies (IAPT)?
NHS Talking Therapies for anxiety and depression is a programme delivered by the National Health Service in England. It provides evidence-based psychological therapies, primarily for adults experiencing common mental health difficulties like anxiety disorders and depression.
The programme was originally launched in 2008 under the name Improving Access to Psychological Therapies, or IAPT. The name was officially changed to "NHS Talking Therapies for anxiety and depression" in 2023 to make it clearer to the public what the service offers. You will still see the term IAPT used by professionals and in some literature, but they both refer to the same vital service.
What is the main goal of this service?
The primary goal of the programme is to make effective psychological treatments more accessible to the general population. Before its inception, access to talking therapies on the NHS was often inconsistent, with long waiting lists and a lack of standardised, evidence-based care. The service aims to solve this by providing timely, effective, and scientifically supported therapies.
It operates on a foundational principle that mental health is just as important as physical health. By offering treatments like Cognitive Behavioural Therapy (CBT) and other proven methods, the service helps people develop coping skills, manage their symptoms, and work towards a lasting recovery. It’s about empowerment, giving you the tools to understand and improve your own mental health.
Who is this service designed for?
This service is specifically designed for adults, aged 18 and over, who are registered with a GP in England. It focuses on treating what are often called ‘common mental health problems’. This includes a wide range of anxiety disorders and different types of depression.
These conditions include, but are not limited to, generalised anxiety disorder (GAD), social anxiety, panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). It also treats depression, low mood, and phobias. The service is not typically designed for severe and enduring mental illnesses, like psychosis or bipolar disorder, which require more specialist, long-term psychiatric care.
How Does the IAPT Process Actually Work?
The process is designed to be as straightforward as possible, beginning with a simple referral and moving through a structured pathway of assessment and treatment. The entire journey is built around a ‘stepped-care’ model, ensuring you receive the most appropriate level of support for your specific needs.
From the moment you reach out, the system is geared towards understanding your difficulties and matching you with a therapy that has been proven to help with the problems you are facing. It’s a systematic approach that has been refined over more than a decade to help as many people as possible.
How do I refer myself for treatment?
You do not need a diagnosis or a formal letter from a doctor to access this service. Most local NHS Talking Therapies services accept self-referrals, which is the quickest and most common way to get help. You can typically refer yourself by filling out an online form on your local service’s website or by calling them directly.
To find your local service, you can search online for "NHS Talking Therapies" along with the name of your town, city, or borough. If you prefer, you can also speak to your GP. They can discuss your symptoms with you and make a referral on your behalf, sending the relevant information directly to the service for you.
What happens during the initial assessment?
After you refer yourself, the next step is an initial assessment. This is usually a telephone conversation with a trained practitioner, often called a Psychological Wellbeing Practitioner, or PWP. The call typically lasts between 20 and 45 minutes and is a crucial part of the process.
During the assessment, the practitioner will ask you questions about your current difficulties, your mood, and how your symptoms are affecting your daily life. They will use standardised questionnaires to help measure the severity of your anxiety or depression. This conversation is completely confidential and helps the service understand your situation, confirm that they are the right service for you, and decide which type of therapy would be most beneficial.
What is the ‘stepped-care’ model?
The service uses a ‘stepped-care’ model to organise treatment. This model ensures that you receive the most effective, yet least intrusive, treatment for your needs. Think of it as a series of steps on a ladder of support.
Most people start on the lower steps, which involve ‘low-intensity’ treatments. These are highly effective for mild to moderate depression and anxiety and include things like guided self-help and psychoeducational courses. If your difficulties are more severe, or if a low-intensity treatment isn’t effective enough, you can be ‘stepped up’ to ‘high-intensity’ therapy, which involves more traditional one-to-one counselling sessions.
What Types of Therapy Are Offered Through IAPT?
A core principle of the programme is its commitment to evidence-based practice. This means that the therapies offered are not just random talking cures, they are specific, structured treatments that have been rigorously tested in scientific studies and proven to be effective for particular conditions.
The type of therapy you are offered will depend on the outcome of your assessment, the nature of your difficulties, and clinical guidelines. The service provides a range of options, from highly structured self-help to in-depth, one-to-one sessions with a qualified therapist.
What are low-intensity treatments?
Low-intensity treatments are often the first step in the stepped-care model and are delivered by Psychological Wellbeing Practitioners (PWPs). These treatments are based on the principles of Cognitive Behavioural Therapy (CBT) and are designed to be accessible and efficient. They are not a ‘lesser’ form of therapy, they are highly effective for many people.
One common form is guided self-help, where a PWP supports you as you work through a specialised workbook or online programme. You’ll have regular, brief support sessions, usually over the phone, to review your progress and troubleshoot challenges. Other options include attending structured psychoeducational group courses on topics like managing anxiety or stress, or using a specific type of computerised CBT (cCBT) programme.
What are high-intensity treatments?
If your assessment indicates more severe difficulties, or if low-intensity treatment hasn’t been sufficient, you will be offered high-intensity therapy. These treatments are delivered by fully qualified high-intensity therapists, such as CBT Therapists or Counselling Psychologists, and involve regular, structured sessions, typically lasting around 50 minutes each.
The most common high-intensity therapy is Cognitive Behavioural Therapy (CBT). Other therapies offered can include Counselling for Depression, which is a specific form of person-centred therapy, Interpersonal Psychotherapy (IPT) for depression linked to relationships, and Eye Movement Desensitisation and Reprocessing (EMDR) for post-traumatic stress disorder. Couples Therapy for Depression may also be an option if relationship factors are central to the issue.
Will I get to choose my therapist?
Generally, you do not get to choose your specific therapist within the NHS Talking Therapies service. You will be allocated a practitioner or therapist based on your clinical needs as identified in your assessment, the type of therapy recommended, and staff availability at that time.
The focus of the service is on providing the correct evidence-based treatment model rather than matching you with a specific individual. While you may not choose the person, you can be assured that all therapists working in the service are fully trained, accredited, and receive regular clinical supervision to ensure they are providing high-quality care.
What Are the Benefits and Drawbacks of Using IAPT?
Like any large-scale public health initiative, the NHS Talking Therapies programme has a distinct set of strengths and limitations. Understanding both sides of the coin can help you manage your expectations and decide if this is the best route for your personal mental health journey.
It is a service that has helped millions, offering a structured and proven pathway to recovery. However, its specific focus and operational model mean it may not be the perfect fit for everyone or for every type of problem.
What are the main advantages?
The most significant advantage is that the service is free. For many, the cost of private therapy is a major barrier, and this programme removes that obstacle entirely. Secondly, all therapies offered are evidence-based, meaning you are receiving a treatment that has been scientifically proven to work for your condition.
Another key benefit is accessibility. The option for self-referral makes it easy to get the ball rolling without needing to go through your GP first. The service has also done a great deal to reduce the stigma associated with seeking help for mental health, normalising it as a common and treatable part of the human experience.
Are there any potential disadvantages?
One of the most frequently cited drawbacks is the waiting list. While the service has targets for how quickly patients should be seen, high demand in many areas means you may have to wait several weeks or even months between your assessment and your first therapy session, particularly for high-intensity treatment.
The therapy offered is also time-limited, typically between 6 and 20 sessions. This structured, short-term model is highly effective for many common problems but may not be sufficient for those with more complex, long-standing, or deeply rooted issues. Finally, the focus on specific, manualised therapies means there is less flexibility and choice compared to private practice.
How long will I have to wait for treatment?
Waiting times are one of the biggest variables in the service and can differ significantly depending on where you live in England and the level of demand in that area. The NHS has set national targets for the service, including that 75% of people referred should start treatment within 6 weeks, and 95% should start within 18 weeks.
After your initial assessment, the service should be able to give you an approximate waiting time for the type of therapy you have been recommended. Waits for low-intensity treatments are often much shorter than those for high-intensity, one-to-one therapy. It’s always a good idea to ask about the expected wait so you can manage your expectations.
How Can I Make the Most of My IAPT Therapy?
Engaging in therapy is an active process, not a passive one. The more you put into it, the more you are likely to get out of it. Whether you are starting guided self-help or one-to-one CBT, your active participation is the key ingredient for success.
Being prepared, open, and committed can transform your experience from simply attending sessions to truly collaborating on your recovery. Think of your therapist as a guide, but remember that you are the one walking the path.
What should I do before my first session?
Before your therapy begins, take some time to think about what you want to achieve. What are the main problems you’re facing? How do they affect your life? Having a few clear, simple goals in mind can provide a powerful focus for your treatment.
You don’t need to have all the answers, but reflecting on what a successful outcome would look like for you is a great starting point. It can also be helpful to jot down some notes about your symptoms, feelings, and any specific situations you find difficult. This will help you communicate clearly with your therapist during your sessions.
How can I be an active participant in my therapy?
Active participation is crucial. This means being as open and honest as you can be with your therapist, even when it feels difficult. Therapy is a safe, confidential space to explore your thoughts and feelings without judgment.
Most importantly, do the work between sessions. Many evidence-based therapies, especially CBT, involve tasks or ‘homework’, such as keeping a thought diary, practicing new behaviours, or reading materials. This is where much of the real change happens, as you begin to apply the skills you are learning to your everyday life.
What if I feel the therapy isn’t working for me?
It is perfectly normal to have sessions where you feel stuck or to question if the therapy is really helping. If you feel this way, the most important thing you can do is talk about it with your therapist. They are trained to handle this feedback and will want to know how you are feeling.
Voicing your concerns gives you and your therapist a chance to review your goals, adjust the approach, or explore what might be getting in the way. Sometimes a small tweak is all that’s needed. If, after discussion, it still feels like the wrong fit, your therapist can discuss other options with you, which might include trying a different approach or being referred to a different service.
Frequently Asked Questions
Is IAPT counselling completely confidential?
Yes, the service is confidential. Your therapist is bound by professional and ethical codes of conduct, meaning what you discuss in your sessions stays between you and the service. The only exception is if they have a serious concern that you or someone else, particularly a child or vulnerable adult, is at risk of significant harm. In these rare situations, they have a duty of care to share information with other relevant services, like your GP or social services, to ensure everyone’s safety.
Can I use IAPT if I am already taking medication?
Yes, absolutely. Many people who use NHS Talking Therapies are also taking antidepressant or anti-anxiety medication prescribed by their GP. Psychological therapies and medication can be a very effective combination for treating depression and anxiety. Your therapist will likely ask you about any medication you are taking as part of the assessment, and it is important to be open about this. They will not, however, advise you on your medication, as this should always be discussed with your GP or psychiatrist.
What happens when my sessions end?
As your planned course of therapy comes to an end, your final one or two sessions will focus on consolidating what you have learned and creating a ‘relapse prevention’ or ‘staying well’ plan. This is a collaborative plan you create with your therapist to help you continue using your new skills and manage any future challenges independently. Your therapist will also signpost you to other resources in the community that you might find helpful for ongoing support.
Is this service available outside of England?
The IAPT programme, now known as NHS Talking Therapies for anxiety and depression, is specific to the NHS in England. However, the other UK nations have their own similar services designed to improve access to psychological therapies. In Scotland, the approach is often delivered through local health boards. In Wales, there is the ‘Mental Health Measure’, and in Northern Ireland, similar services are provided through Health and Social Care Trusts. While the names and structures differ, the goal of providing accessible, evidence-based talking therapies is shared across the UK.
Your journey to wellbeing is a personal one. The NHS Talking Therapies service provides a vital, evidence-based, and accessible starting point for millions in England, offering the tools and support needed to manage common mental health challenges. It is a testament to the power of structured, compassionate care.
Sometimes, however, your path may require a different approach. You might be looking for support with life challenges not covered by the service, seeking faster access without a waiting list, or feel that having the choice of your own therapist is an important part of your journey. At Counselling-uk, we believe in honouring that choice. We are dedicated to being a safe, confidential, and professional place to find help with all of life’s challenges. If you are ready to explore your options and connect with a qualified professional who fits your unique needs, we are here to support you. Your mental health matters, and the right support for you is out there.
