Choosing Therapy
Both routes can be useful. The right question is not which one is better in the abstract, but what kind of help you need, what you can afford, and how much choice or continuity matters.
NHS Talking Therapies can be the right place to start, especially if cost is a barrier or you want structured short-term help.
Private therapy can make sense when you want to choose the therapist and approach yourself, when you are looking for more continuity, or when the problem feels less like a single symptom and more like a pattern that keeps returning.
I am a private psychodynamic therapist in Croydon. I am not part of NHS Talking Therapies or Croydon Talking Therapies. That matters because the two routes are organised differently, and it would be misleading to blur them together.
The NHS page on talking therapies is the best place to check current NHS guidance, eligibility and self-referral routes.
With NHS Talking Therapies, the main strengths are access without direct session fees and a stepped-care pathway that can work well for anxiety, depression and related difficulties. The tradeoff is that you may have less choice over the therapist, the therapy type, the number of sessions, and how quickly work begins.
With private therapy, the main strengths are choice and continuity. You can choose the therapist, ask about their approach, meet in a regular weekly slot, and continue for as long as the work remains useful. The tradeoff is cost, and that cost is real. Private therapy is not the right answer if paying for it would create another pressure.
For some people, the NHS route is enough. For others, it is a beginning. Some people try structured work first and later look for a more open-ended psychodynamic space because the same patterns keep returning.
NHS Talking Therapies may be a good fit if you want free help, if your difficulty is fairly specific, if you are open to CBT or other structured psychological therapies, or if you want a service that can assess what level of care is appropriate.
It is also the route I would usually encourage you to check if you are unsure what you need, if you need help that sits closer to NHS mental health services, or if private therapy would be financially unsafe.
If you are in crisis, feel at risk of harming yourself, or need urgent support, private weekly therapy is not an emergency service. Contact your GP, NHS 111, a local crisis line, 999, or A&E depending on the level of urgency.
Private psychodynamic therapy may fit if you want to understand the roots of anxiety, depression, relationship difficulties, low self-esteem, shame, anger, grief, or patterns that seem to repeat across jobs, friendships and relationships.
It may also fit if you have already tried short-term work and found it useful but incomplete. Sometimes coping strategies help, but the underlying emotional pattern remains intact. Psychodynamic therapy is interested in that pattern, including how it appears in the therapy relationship itself.
My individual therapy sessions are weekly, in person in Croydon or online if you are not based in the USA or Canada. Couples therapy is in person only.
If cost is the deciding factor, start with the NHS route. If urgency or risk is high, speak to NHS services or your GP. If you want structured symptom-focused work, NHS Talking Therapies may be the more obvious first step.
If your main question is why the same thing keeps happening, or if you want a longer-term space with a therapist you have chosen, private therapy may be worth considering.
You do not have to make this a moral question. Choosing private therapy does not mean rejecting the NHS. Starting with NHS Talking Therapies does not mean you are settling for less. It is a question of fit, timing, and what you need the work to do.
Common questions when comparing NHS and private therapy routes.
Local mental health resourcesUse the NHS talking therapies page for current national guidance and self-referral information, then follow the route it gives for your area.
If you are comparing options, you can read more about individual therapy in Croydon, psychodynamic therapy, or my more opinionated blog post on Croydon Talking Therapies.
If you want to ask whether private therapy with me would be a sensible fit, you can send a message.