Croydon Talking Therapies: Understanding What's Actually on Offer

Your GP mentioned "talking therapies" and handed you a leaflet. The NHS website has reassuring language about "evidence-based psychological therapies." You're trying to work out what you've actually signed up for.

Here's what Croydon Talking Therapies actually offers:

• Low intensity CBT: 3-6 sessions, usually online or over the phone

• High intensity CBT: 6-12 sessions if you score high enough on their measures

• Counselling: 6 sessions maximum (provided by Care To Listen)

• Group therapy: Eight weeks sharing your struggles with strangers

• Guided self-help: CBT worksheets you do alone

That's it. That's the entire menu for South London's mental health provision through IAPT (Improving Access to Psychological Therapies), now rebranded as NHS Talking Therapies.

"Talking therapies" sounds comprehensive, doesn't it? Like there's real choice available. In reality, it's NHS code for "cognitive behavioural therapy in various doses."

What "Evidence-Based" Actually Means

When Croydon Talking Therapies says "evidence-based treatment," they mean:

• CBT (the main offering)

• Guided self-help (CBT you do yourself)

• Behavioural activation (CBT focused on activity)

• Group CBT (CBT with witnesses)

• Six sessions of counselling (just enough to open wounds they can't help you close)

What they don't mean is choice. What they don't mean is depth. What they don't mean is time to understand why you're here again.

The NHS says 95% of people access services within 18 weeks. But "access" means your initial assessment, not treatment. And if you need high-intensity CBT rather than guided self-help, you'll wait longer. If you score just below their thresholds, you might not qualify at all.

Why CBT Became the Default

CBT dominates NHS provision for one reason: it fits the system's needs, not yours. South London and Maudsley Trust, which oversees mental health services in Croydon, treats over 45,000 people annually through IAPT. That's 45,000 people getting essentially the same treatment regardless of what brought them there.

The same worksheets. The same thought diaries. The same six sessions.

CBT is measurable, manualised, and designed to get you functional enough to return to work. It works well for specific, surface-level symptoms - panic attacks with clear triggers, specific phobias, recent depression with obvious causes. For these issues, six sessions might help.

But here's what it can't touch: the patterns that keep bringing you back.

What Actually Happens in 6 Sessions

Here's the reality of those six sessions you waited seven months for:

Session 1: Assessment and goal-setting. You explain your entire history in 50 minutes. The therapist types while you talk.

Session 2: Psychoeducation. You learn about the CBT model. You're given your first thought diary.

Session 3-5: Technique practice. You challenge thoughts, test behaviours, fill in worksheets. The therapist checks you're doing it "right."

Session 6: Relapse prevention and discharge. You're given a folder of worksheets and wished well.

Three months later, you're back at your GP. Same anxiety, different trigger. Same depression, deeper this time. Same relationship patterns, new person.

The GP refers you back to Croydon Talking Therapies. Another assessment. Another six sessions. Another folder of worksheets you'll never look at again.

Eight sessions isn't enough for complex emotional patterns. In Croydon, you get even less.

What Six Sessions Can't Touch

Consider someone who repeatedly ends up with critical bosses, experiencing "generalised anxiety" at every job. They get referred for CBT. They learn breathing exercises. They challenge their thoughts. The anxiety returns with the next job.

What if the anxiety isn't the problem? What if they're unconsciously choosing critical authority figures because criticism feels familiar - like home, like love, like what they know? The anxiety is their nervous system recognising danger in patterns they keep recreating.

Six sessions of CBT couldn't touch this. How could it? The pattern is unconscious. The anxiety is the symptom, not the problem.

This is what's missing from NHS provision:

Psychodynamic therapy explores these unconscious patterns. It asks not just "how can you manage this anxiety?" but "why do you keep ending up in situations that make you anxious?"

Humanistic approaches focus on who you are beyond your symptoms, your capacity for growth that's been blocked.

Systemic therapy looks at the relationship dynamics keeping you stuck.

None of these are available through IAPT Croydon or through Mind in Croydon's NHS-funded services. Not because they don't work - the evidence base is solid. But because they can't be delivered in six sessions, measured on weekly questionnaires, or reduced to worksheets.

While the NHS does offer psychodynamic therapy for severe cases through secondary care (CIPTS), this is extremely difficult to access. For the average person engaging with Croydon Talking Therapies, these options are simply not on the table.

The Real Cost of "Free"

The waiting list might be 6 weeks or 18 weeks, depending on what you need and when you ask. In that time, you'll have repeated the pattern again.

Private therapy in South London typically costs between £60-120 per session. Expensive? Consider the real cost of staying stuck:

• The relationship you'll sabotage while waiting seven months for help

• The job you'll quit because the anxiety becomes unbearable

• The patterns you'll pass on to your children because you never understood your own

The question isn't whether you can afford private therapy. It's whether you can afford to keep managing symptoms while the cause remains untouched.

What Depth Actually Looks Like

Psychodynamic therapy doesn't measure progress through weekly questionnaires your iPhone could track. It doesn't discharge you after six sessions because that's all the funding allows. It doesn't treat your depression as a thinking error or your anxiety as a breathing problem.

Real therapy takes time. Time to build trust. Time to notice patterns. Time to understand not just what you do, but why you do it. Time to experience yourself differently in relationship.

When we meet weekly for as long as it takes, something different becomes possible. Not symptom management. Not coping strategies. But understanding the patterns that brought you here and choosing whether to keep running them.

Who This Actually Helps

If you're dealing with a specific phobia, recent trauma with clear symptoms, or mild depression with obvious causes, NHS provision might help.

But if you recognise yourself in any of these patterns:

• You've done CBT before and you're back with the same issues

• Your problems predate your current situation by years

• You keep choosing the same type of person, job, or situation

• You can manage the symptoms but they always return

• You feel like you're living someone else's life

Then you need more than what the NHS has decided you deserve.

The Productivity Problem

The NHS treats mental health like a productivity problem. Get people functional. Get them back to work. Get them off the waiting list.

But you're not a productivity problem. You're a person with patterns that make sense in context, struggling with problems that have roots, dealing with symptoms that have meaning.

Your anxiety isn't a glitch to be debugged. Your depression isn't just negative thinking. Your relationship patterns aren't cognitive errors.

They're communications from parts of yourself that need to be heard, not silenced with breathing exercises. They're evidence of struggles that need to be understood, not managed with worksheets.

The understanding you need is available. Just not from the NHS.

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Luke Row is a BACP registered psychodynamic therapist in Croydon and online. I work with people who've tried managing their symptoms and are ready to understand what's underneath.