Counselling involves regular confidential conversations with a counsellor. Counsellors don’t prescribe medication, but counselling, medication and other types of support can be used alongside each other. It can take various forms, including face-to-face, telephone, video, message-based or email. You can see a therapist on your own, as a couple, with a family member or friend or as a group. In this post, we’ll focus on therapy that involves a one-to-one conversation rather than messages or email.

Counselling can be very useful, as it is an opportunity to discuss your concerns in confidence with an impartial professional who isn’t someone you know in your day-to-day life. You may find it difficult to fully share your thoughts and feelings with family and friends, for example because you don’t want to worry them or are afraid that they wouldn’t understand. In a therapy session, you don’t have to filter what you say because of how it might affect the other person.

Counselling sessions usually last for 50 minutes and happen weekly. You can talk to your counsellor about any concerns that you have, including your situation, thoughts, feelings and actions. They will explore with you how these are affecting your life and any changes that might help you.

A therapist won’t offer you their own opinions or advice. The aim of the process is to support you to find the right solution or approach for you. They may, for example, ask questions to help you to find a different perspective or ask you to do exercises such as keeping a journal or practising saying something in the therapy session that you want to say to someone in your life. You can find more information about counselling here and via the NHS website here.

There are several different types of counselling, and many therapists are trained in more than one approach. For example, you may have heard of cognitive behavioural therapy (‘CBT’), which focuses on the connection between our thoughts, feelings and actions. CBT helps us to recognise how we can become stuck in cycles in which negative thoughts influence our feelings, which leads to unhelpful actions. By working with the therapist, we can learn to prevent or interrupt the cycle. CBT is often available on the NHS via the IAPT programme (see below) or through your GP. You can find out more about CBT here. 

If you are very anxious about the possibility of cancer recurring, you may find that counselling with CBT helps to manage anxiety more effectively so that it no longer affects day-to-day life in the same way.

Other kinds of therapy may explore in more depth what the source of difficult thoughts and emotions might be, for example how you may have learned through early life experiences to respond to situations in a certain way. Some people find that understanding this helps them to cope better with the present situation. You can find more information about the different types of therapy here.

There are different ways to access therapy. Some hospitals offer a psycho-oncology service, which is specialist psychiatric and psychological support for people diagnosed with cancer, for example ''What is Psycho-oncology?' and Imperial College Healthcare NHS Trust, Psycho-oncology. You can ask your team whether there is a psycho-oncology service in your area that they can refer you to.

Some cancer support charities and hospices also offer counselling. For example, Maggie’s Centres have psychologists available. Again, you can ask your team for information about any counselling services in your area. If you would like us to research local services for you, please get in touch with us.

If you’re registered with a GP, you can refer yourself to an NHS psychological therapies service through the Improving Access to Psychological Therapies (‘IAPT’) programme. You can do this online. Depending on the service capacity in your area, you may have to wait for a therapist to become available and be limited to a certain number of sessions and/or a certain type of counselling, such as CBT. You can also speak to your GP about how you’re feeling and ask them to refer you to a local service.

If you would like to find a therapist for yourself rather than being referred via the NHS or a cancer centre, you can see a counsellor privately. Depending on where you live and the service that you access, sessions can cost between £10 and £70 each. The British Association for Counselling and Psychotherapy has a directory of qualified and accredited therapists, which you can use to find a therapist in your area who works with people affected by cancer.

When you meet with a therapist for the first time, they will usually give you an introduction to how they work with their clients, including the types of therapy they offer, their fees, their cancellation policy and how they keep your information confidential. They will invite you to tell them about the concern that you would like their help with and to ask any questions that you have. If you decide that you would like to see them again, you can start to talk about how you will work together to achieve your goals.

Unless you’re limited as to how many sessions you can have, you can access therapy for as long as you find it helpful. As with any form of support, after a while many people feel ready to stop using it or to access it less often. If you think that therapy is no longer helping you, or is keeping your focus on your diagnosis more than you feel is right for you, you can tell your therapist that you’d like to stop.

Depending on how they work, the therapist may ask you to have an ‘ending session’ for you both to reflect on your progress and how you will continue to incorporate what you’ve learned from therapy into your everyday life. If at any time you feel that you would benefit from further therapy, you can arrange to return to the same therapist or see someone new.

If you would like to share your experiences of counselling or have any tips for someone thinking of having it for the first time, please comment on this post. If you would like information or support, please contact our Support Line on 0800 008 7054 or email [email protected]