A-Z

Depression and low mood (young people)

Talking treatments

Talking treatments are a common psychological method of processing distress, overcoming emotional difficulties and changing negative or destructive patterns of thinking and behaving. It can help someone gain understanding over their behaviour and aid positive and proactive change. Talking treatments cover a broad range of approaches from generic counselling to specific forms of therapy (such as psychotherapy and cognitive behavioural therapy).

Most of the young people we spoke with had received help from talking treatments for depression and low mood. For some, this had been a few sessions over a couple of weeks or months, others had received therapy for over a year or two. Most young people who received therapy had CBT (Cognitive Behavioural Therapy), while a few received behavioural therapy or psychodynamic therapy. Some had received generic counselling. As many people didn’t know, or talk about which kind of therapy they’d had, our focus here is on their experiences of talking treatments generally, rather than disseminating the pros and cons of the different approaches.

Many young people had initially seen their school counsellor, who had either seen them for a few sessions or referred them on for talking treatment elsewhere. Many felt that counselling provided through school wasn’t enough to deal with some of the problems they had and was more focused on exam stress, for example. Some said they felt the appointed school contact wasn’t experienced or skilled enough to counsel as they were for example a teacher or a tutor, not a trained counsellor. A few people’s first contact with counselling was through their college or university counselling services which many had found very professional and helpful.

Most people also had talking treatments through the NHS or community projects. A few people had therapy as a part of their inpatient care at a psychiatric hospital. One man said of the talking treatments provided by the NHS:

“A lot of people say the NHS is dead and everything like that. I just think, maybe you’re just complaining a bit too much. It’s free, you know.”

Several people felt that that the waiting lists for the NHS talking treatments were far too long and the number of sessions they could have too limited. A couple of people had had to go privately, to be able to get the kind of help they felt they needed, when they needed it. A couple of people really keen to have talking treatments were still on a waiting list which was hard and frustrating.

 

Cat has had to pay for private counselling which has been great but has “financially killed” her.

Cat has had to pay for private counselling which has been great but has “financially killed” her.

Age at interview: 23
Sex: Female
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I’m now undergoing CBT at [place name], which costs £117 per session, for the next week for the next six months. Three to six months. and that’s the difference in going private, is that there is no length of time, in CBT. In NHS you only get 10, private it’s as long as you need it. Which I feel is so much better because there is no pressure on; “you’ve got to be better by 10 weeks. You’ve got to be in recovery by 10 weeks”, that’s it, whereas I’m in session, well I’ll be coming up to session 3 and I’m nowhere near completion, nowhere near. So it’s like there’s no actual end, it’s, it ends when you feel it needs to end. but financially it killed me, it’s killed me financially already, but it’s been a choice between money or life. And what do you do if you can’t, you can’t choose it? But then as a result of me going private the NHS have pulled me off the list, they have pulled my family off that family counselling.
 
They sent us a very nasty letter to say that as a result of me going private they’d now cancelled the family consultation that we’ve been waiting four years for. Which I’m astounded by.

Most young people had been to individual (one-to-one) therapy and a few had been to group therapy. Among the benefits of attending groups were feeling under less pressure to take part and be active, regarding groups as “easier” than individual work and most importantly, meeting other people in a similar situation and learning from each other. The main disadvantage some people experienced was feeling uncomfortable in such a social situation. One man said it wasn’t “his thing” because; “we just sat there kind of with candles and spoke about our problems”.

 

Sarah found group therapy sessions “a relaxing environment” and it was great to be around people...

Sarah found group therapy sessions “a relaxing environment” and it was great to be around people...

Age at interview: 17
Sex: Female
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The best thing was about it is you’re with other people that are in exactly the same position as you are. You felt like you weren’t alone. I mean a lot of us swapped numbers and we keep in contact, and things like that, but, I think it wasn’t just the therapy that helped but the people, like meeting other people the same as me.
 
It really did help, because you could talk about it and it wasn’t weird, it wasn’t like, it wasn’t like they didn’t understand you, they understood perfectly like what you were, like how you dealt with things and it was really, it was nice like being in that environment with everyone. It was relaxing.
 
So how did you find, that it, that it was just a group counselling, rather than one to one. Was that good for you?
 
Yeah. I got, it was to a certain extent, it helped me sort of see how other people dealt with it as well. Like how the positive things they did to deal with it helped me pick up positive things to do with it. And like I don’t know, it was weird ‘cos you sort of, you were thinking, you weren’t even thinking “Oh my God I’m not going to be the only person like this, oh.” Like oh gosh you know like. Then you get in and when you’re with the people you start to feel more relaxed, you felt more like you were just like talking with your mates like you just felt like you were the same ‘cos you, you’d laugh and you’d make jokes about things and you’d just acted normal and because we all knew how each other felt it was easier for us to sort of click and get on. Like because we knew like, we, we trusted each other but I don’t think we entirely trusted each other if you know what I mean.
 
But the group therapy was much better because it was a much more relaxing environment like. You, you didn’t feel as nervous, because like there was other people there so, if you got upset there was somebody else there that would, you know. It wasn’t just you, they could move to focus on somebody else, like it wasn’t all on you constantly. It was nice how you’d go around in a circle and deal with things and it was just like a nice environment. It was easier.

People also talked about the process of therapy and what happened in their sessions. For most, the sessions were mainly focused on talking, the topics initiated by both themselves and the therapist. They described the process as a way of analysing and looking at their behaviour and thoughts from a different angle, to try to rationalise why they behaved in a certain way and to find alternatives.

For some, therapy was more focused on learning particular skills or techniques, for example managing stress or anger or learning relaxation techniques. Particularly for those who’d had CBT, sessions focused on developing particular strategies to alter their usual thought patterns and trying to find ways to break cycles of negative thinking. A couple of people had also learnt such strategies through CBT online resources.

 

Jennie says trying to learn new strategies and ways of thinking in CBT first felt like a chore...

Jennie says trying to learn new strategies and ways of thinking in CBT first felt like a chore...

Age at interview: 19
Sex: Female
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Like saying like, oh you’re like really patient with your brother, and it’s like, well no sometimes, I’d say, oh sometimes I’m so impatient with him, and it’s like well no, actually I am very patient with him, and you’ve just got to always, and I mean still now, that is the hardest thing to do, still conscious that I’ve got to do that. And apparently, like counsellors have said usually it is a conscious thing you do have to do for a long time before it comes natural, and even some people who are not depressed have to do it consciously.
 
Because every, like every week usually people have a bad day about, oh my hair looks a mess today, and they’ve got to consciously think that, “Oh well, it doesn’t matter, I can go out still.” Whereas when I was depressed it was, “Oh, I cannot go out, my hair,” or, “I just can’t go out today I can’t bear seeing people.” Whereas others would be able to get round that by thinking, “Oh well this, this is fine, and I can still go out,” whereas I’d sort of like hibernate in my room or at home where I knew it was a safe environment.
 
Yes. Do you think starting to kind of force yourself to say or to think those more positive things has actually made you then feel more positive as well?
 
Definitely. But it takes a while. At first it’s like a chore, because you’ve been, it’s like you’ve been given a task to do and you’ve got to do it, and it feels like a chore to carry on doing it, and being able to apply it all the time. But definitely you’ve, like my family, all my family have said that I am definitely a lot better, and I seem more positive about things I’m doing, and I’m getting involved in more things than I would have done before.
 

Edward describes how online CBT sites have helped him.

Edward describes how online CBT sites have helped him.

Age at interview: 18
Sex: Male
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The one that the National University of Australia does is like a questionnaire type thing, and you can fill in the log, the other one’s sort of, [university name] one just explains to you sort of why these things happen, and it gives you sort of I can’t remember all the buzz words now, ‘cos there’s loads of these buzz words. But it’s like sort of, look, you know analyse what you thought, look at what could be wrong with it, look what could the alternative thoughts of it, how true is your original thought, that kind of a-four-step-process so to speak. , and it also explained stuff like the symptoms, which is what I suffered from, I suffered from non-specific chest pain, which is also called psychosomatic chest pain. Very common in people with anxiety, and there was a guy on there, who was doing like a voice over and he was speaking about that, and it suddenly clicked that this was all, this was caused by stress, not by, I went to see the doctor about it but he said, non-specific chest pain is caused mainly by stress.
 
And when you, it, it helped a lot actually and you just start to sort of realise that if you can control the stressful situation you start to feel a lot more better about it, and that when you’re feeling really bad it’s anxiety causing the problem, not yourself sort of. So by externalising yourself and blaming the anxiety you feel a lot better about it really.
 
Benefits of talking treatments
The majority of people found talking treatments a positive experience and something which helped them. The benefits were wide-ranging. For many, it was an opportunity to be listened to; a regular slot just for them to air their feelings. Young people described therapy as an “outlet”, an opportunity to “let go”, to “vent anger”, “get weight off” their shoulders and “a release”. One man said it was “fantastic to finally let go”, another woman said “counselling makes you feel lighter”. Talking treatment functioned as a way for people to let out feelings which they might otherwise have bottled up and helped them cope better. For many, talking was helpful in itself. One woman described how free she felt to express herself in counselling:
 
“You don’t have to justify anything that you’re saying or feeling because anything and everything’s normal with depression. Anything that you are feeling is normal.”
 

Counselling is “one of the best things” that helped Emma-Jane. She says “suffering in silence is...

Counselling is “one of the best things” that helped Emma-Jane. She says “suffering in silence is...

Age at interview: 20
Sex: Female
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Counselling is probably one of the best things that I would recommend to other people. sort of before like you know medication or anything like, or sort of suffering in silence, suffering in silence is the worst thing you can do. because it does just trap you, and you just go round in this little vicious circle and there’s no way out.
 

Therapy was a good experience for Tina. It surprised her how open she could be and what she...

Therapy was a good experience for Tina. It surprised her how open she could be and what she...

Sex: Female
Age at diagnosis: 24
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Yeah, I was learning, and as much as she was learning from me, I was learning trying to understand myself a bit more. That I couldn’t always carry off a confident, face, a façade. I carried this face around for as far as I’m concerned, twenty four years. This false pretence of being somebody that I actually am not, because I believed it to be what other people expected. That’s wh- I was a character that everybody, that I thought everybody wanted me to be. I was a bubbly, lively person. I was probably one of the people you would never have thought suffered from depression. And, mainly because I hid it. And I hid it so well that it came natural to me. That, I wouldn’t necessarily open up to anybody. So, although it was all bottling up inside me, I’d had this session and I found some things come out that I wouldn’t talk to my best friend about.
 
Which I found really strange. I didn’t know how it had happened, and it made me, I suppose, crave more. See if the next session went like it. Or just see whether it would go how I expected it to.
 
And so I went back again. And, it panned out the same as the first one. And I thought, I you know, what’s going on? I don’t understand this. And I thought, well, obviously I’ve got this stuff that needs to come out. I’d love to know what she thinks about me. I’d love to know what her opinion is, I’d love to know what she’s trying to work out about me. I’d love to know how she perceives me to be.
 

Counselling has been very helpful for Jack and he says just going in made him feel “very strong”.

Counselling has been very helpful for Jack and he says just going in made him feel “very strong”.

Age at interview: 17
Sex: Male
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And I just thought this is just absolutely fantastic walking in and say hallo. And just talking, just just letting, letting it all go, I felt very strong sitting in that particular chair just thinking, “I think this is the reason for this, all my problems, and this is the reason.” And the psychotherapist would say “Okay, so,” and they are like, obviously the whole idea is, he didn’t tell you what to do, he asks you things so you can find out the answer within, the answer lies within, that’s obviously the big thing.
 
But you just, a lot of people say, “Oh what if you get dependent on it?” And you just think, on whether that be counselling or anything like that, and that’s not the idea really, you just think it’s it’s almost a release that the kind of emotional and, stuff like that, and it’s nice, it’s just... but it’s very very helpful anyway.
 

Cat says having CBT was “a changing point” for her. She was later refused CBT on the NHS because...

Cat says having CBT was “a changing point” for her. She was later refused CBT on the NHS because...

Age at interview: 23
Sex: Female
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Within a couple of weeks I then turned 18, on the 5th January and kind of moved over to the Adult Mental Health Services and kind of a few weeks later started CBT with a fantastic psychologist and we clicked from the moment I walked in there and it was the best thing anyone could have done. was to put me on CBT that was the changing point.

 

And I had CBT every week, it was supposed to be only 10 sessions, 10 points, 10 sessions on the NHS which I feel is disgusting on the NHS, the waiting list for CBT is beyond a joke. The length that you get it for is just unreal. Now I had supposedly for 10 weeks, but because of just this sheer amount of problems that the system and the Child Adolescent Care had left me with, that it was gonna take a lot longer. So it eventually went to 20 weeks, but it was then, it was every week for 10 weeks and then it was moved to every 2 weeks for the next 10, for the next 10.
 
And I was put on an eating programme, so my weight was checked, and I had to record what I was eating, when I was throwing up. and it was focussing on my thought processing and everything. And it really really did help. It’s one of the things I do recommend. It’s definitely something that I feel should be more available worldwide, nationally, locally, everywhere.
 
 
My social worker has got in contact with my psychiatrist and everything and we have been refused CBT on the grounds that I’d actually, ‘cos I’d had it when I was 18, I’m not allowed it again. And it all comes down to money at the end of the day. It does, it comes down to money. And even though the situations different, the issues are different, the age is different, no. They don’t seem to think I warrant CBT again. Even though my medical reports say different. We think different. 

This is how one woman described why CBT worked for her:

“This positive thinking really helps you to uplift your mood, which helps you then fight the depressions, whereas like the sort of the tablets that were given to me would uplift my mood, but not tackle the thoughts. So although my mood was uplifted I didn’t have the application to tackle the thoughts which were the things that kept on eating away at me. I think like the best thing for me was… to tackle my thoughts and it uplifted my mood.”
 
Another important benefit of talking treatment was getting non-judgemental and impartial support, advice and help. Many compared speaking to a counsellor or therapist to sharing their thoughts and feelings with friends or family and said it was often emotionally harder to share negative feelings with close people. Some also worried about burdening their friends too much, or that friends might not be balanced or rational in their response. One woman described how a therapist provided an “outsider’s perspective” that she could trust not to be biased or judgemental. Some felt that therapists were there to give advice, if they wanted it, but didn’t “force their opinions” so young people had the control over decisions they made.
 

Counselling has helped Loz to talk through things with someone who understands where he’s coming...

Counselling has helped Loz to talk through things with someone who understands where he’s coming...

Age at interview: 17
Sex: Male
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I think it’s [counselling] just helped me sort of talk things through with people, more times I’ve realised that I have someone to view my sort of like feelings to, without them sort of like having to like too much their own opinion. I mean if it’s like something like really sort of like shocking then yes he’ll voice his own opinion, but yeah apart from that it’s just really good to be with someone who knows the sort of things that you’ve gone through because he’s talked to other people, to children my age, well people my age, teenagers. I just think its more people that in that sort of situation to talk things through otherwise they feel isolated like I did. I thought no-one understood how I felt and finding someone that knew that made me feel happier I, that I could sort of like open my sort of like feelings up and say I’ve had a really shit day, I’ve thought of this, this, this, and I really just need to say it to you sort of thing.
 
I mean he, he just goes through why I’ve thought that and how it made me feel, what did you do after it, did you deal with it, or did you not, and I’ll be like, well I’ve thought about it but I didn’t do it, and that sort of thing like with the self harming, suicide obviously, ‘cos I wouldn’t be here, and that that sort of thing. That’s that’s my kind of sadistic humour coming out again, that’s the sort, the suicide thing. Not something to be joked about too much.
 

B really liked her counsellor who gave her advice but would never tell her what to do. (Read by...

B really liked her counsellor who gave her advice but would never tell her what to do. (Read by...

Age at interview: 19
Sex: Female
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It was really strange because I didn’t want to tell any of my friends except for the friend who had lost her mum to suicide as well because she was seeing her as well at the same time. So apart from her no-one else knew I was seeing the school counsellor because obviously I was scared of people thinking, “Oh she’s a nutter.” and stuff like that. And ‘cos you know how it is in upper school and stuff when people are always like that, and, so…
 
But the woman [counsellor] was really lovely. The woman I saw, she was really lovely, and she was caring, and I would just talk about whatever I wanted to talk about and she would give me a, like a advice on what I’d, what I’d do and stuff, but she’d sort of like didn’t tell me what to do which I really loved, because like with social services they were like, “You do this.” And like with the Mental Health Team they would, ‘cos I was at that age where they could tell me what to do, they told me what to do, which I didn’t really like and…
 
Like if I wanted to do something I had to go through my social worker, or I had to go through my Mum and they’d be sort of, I had to go through a lot of people and I sort of hated the fact of being told what to do, but I mean with the counsellor I would just sit there, and I would rant and row all I liked and say what I wanted to do, and she would say, “Oh you could do this, but you don’t have to if you don’t want to do it.” And sort of I sort of liked that and so; it’s just about really finding the right kind of help you want. ‘Cos everybody’s different, other people might like being told what to do, while other people don’t like being told what to do and stuff, so. It’s just different.
Many people felt talking treatments had boosted their confidence and feeling of self-worth, which many had struggled with. Similarly, it provided them with hope and helped them to gain a more positive attitude to their lives and recovery from depression.
 

School 'ordered' Helena to go to counselling which didn't help her. Later on, she found 'a...

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School 'ordered' Helena to go to counselling which didn't help her. Later on, she found 'a...

Age at interview: 19
Sex: Female
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As my problems were psychological and not physical the teachers and heads of year couldn’t understand what was wrong. In my school at that time there were no counselling services of any kind. I was ‘ordered’ (if I didn’t go it would be me refusing help) to see a counsellor out of school with my mum. She was a nice woman and really did try to help. The only problem was the main focus of each session seemed to be about getting me back into school, not the underlying issues. Also, I had to go with my mum and couldn’t talk freely on my own.
 
I left school with five GCSE’s and a huge amount of relief, I felt like an enormous weight had been lifted from my shoulders. I’d like to say that once I left everything got better, but it didn’t. My experiences in school had made me so anxious, the real world frightened me. After leaving school I started counselling (I had to get there by taxi with my mum as I was scared of buses) which helped me considerably. Getting help for my problems was probably the best thing I’ve ever done. With the help of my brilliant counsellor slowly my confidence built up and I started living again by joining a young advisory group and going to short college courses. I found I was passionate about film and writing and enjoy meeting new people. I’m currently enrolled on an Access Course and plan to go to University next year to do a Creative Writing or Film degree.

Learning skills and techniques for relaxation or managing anger was also something useful people could take away from talking treatments, and as one woman said, “apply it to all of my life”. A couple of people said they only had a couple of sessions but felt reassured by just knowing how to get help if they decided to go back. In this way, therapy or counselling enabled young people to cope better on their own and equipped them with skills to get by.
A couple of people pointed out how good just the act of going to counselling or therapy made them feel. One woman said she felt great because she knew she’d taken a positive step to help herself and make a difference to her life. Another said how going to counselling, and being taken seriously, made her feelings and experience of depression “validated”; to know things weren’t OK and she was “worthy” of support. One man said:
 
“It [benefit of counselling] was partly having someone to listen, but also partly just making the positive step, making that decision to do something about it made me feel a lot better.”
The counselling or therapy process wasn’t always easy and a few people emphasised that they had to be “willing” to get help and work through the issues themselves. One person described counselling as “a very active process” and another as “hard work”. One man said it was hard for him to accept he couldn’t deal with things on his own but once he got over that thought, he really benefitted from the sessions.
 
It is important to remember though that to find these types of therapy beneficial it can involve a lot of hard work and can take up a lot of time.
 
Finding the right therapy and the right therapist
Finding the right counsellor or therapist who “you click with” was really important. Among the qualities young people wanted from their counsellors were; being “down to earth”, “open”, “relaxed” and “inclusive” and “not being patronising”. A few people’s therapists had personal experience of mental health problems, something they found beneficial. It was essential that people felt able to trust their therapists and that they were impartial.
 

Stacey really likes her counsellor. They keep in touch by calling and texting.

Stacey really likes her counsellor. They keep in touch by calling and texting.

Age at interview: 17
Sex: Female
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She [counsellor] understands where I’m coming from when I say things. Helps me a bit, she does help me a lot out. She, well like we work when she won’t, when she needs me to do things like fill a sheet in, she explains it in a way I’ll understand, do you know what I mean? And I understand what she means, and she’ll ring me up, she’ll text me to see if I’m alright, and that’s nice, to make like, my phone will ring, Oh it’s [counsellor name], and she’ll be like, “Are you alright?” do you know what I mean. She’s a nice person, yeah.
 
Yeah. And it’s so important that you get on and like, on a…?
 
Yeah, ‘cos if I didn’t like her I wouldn’t go. Do you know what I mean? If I didn’t feel comfortable with her I wouldn’t go, but I did really like her when I first met her.

Some of the people felt that the type of counselling or therapy they had been to had been unhelpful and not suitable for their needs. Some found their therapist’s approach or attitude unsupportive or too focused on underlying causes rather than exploring methods of moving on. By contrast, others felt that counselling they had focused solely on getting them back to school, for example, without addressing the underlying causes of the problems. Finding the right type of talking treatment, suitable for the young person’s individual life situation was essential. Some found it helpful to change the therapist or counsellor when it hadn’t worked out in the first place.
 

Holly explains why therapy can be difficult for someone on the autism spectrum.

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Holly explains why therapy can be difficult for someone on the autism spectrum.

Age at interview: 18
Sex: Female
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So the process of sort of find, working out that I was depressed and getting it sorted might have been a lot shorter because you know the thing, like I went through CBT with the person that referred me and sort of things like, “Well how do you feel at this moment? And how do you change that?” Well I didn’t know how I felt at that particular moment to be able to change it. ‘Cos the, it was, it was alien to me, I didn’t understand, I could work out on the days when I wasn’t happy, and I could work out the days when I was, but I didn’t understand why or anything like that so.
 
Yes and I suppose because a lot of it is to do with emotions and feelings and depression and the mental health and counselling?
 
And when you’re autistic you don’t know your emotions and feelings and things so yeah. It was quite difficult. 
 

When Holly and her parents first went for family therapy with CAMHS, most of the time she wasn't...

When Holly and her parents first went for family therapy with CAMHS, most of the time she wasn't...

Age at interview: 18
Sex: Female
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The head of year that I said before was really quite nice suggested to my parents that I went to the doctors and said, “Look, this is the problem, and she’s having behavioural problems,” ‘cos I was deliberately getting myself kicked out of lessons. And obviously to do that you have to be behaving pretty badly, and so they said, “You know, can we see someone?” And so we were referred to the child and adolescent mental health service, called CAMHS, and they suggested it would be good to do some family therapy, which didn’t really work because it was just people arguing the whole time.
 
And so we stopped doing that because it wasn’t helping the situation. And so then they said, “Well okay, what about we have just your Mum and your Dad there?” And so for the majority of the time I wasn’t there at all, it was it was just them, a child and adolescent service trying to talk through their problems and things, which I thought was quite strange, and again that didn’t work. And so we discharged ourselves from the service and said, “Look, sorry but it’s not working.”
 
When I started sort of the self harming and the suicide attempts we obviously we were re-referred straight away and the person was different ‘cos we said we didn’t want to see the same people as before ‘cos it didn’t work. And the person that I went to see was actually really lovely, and she, she understood, she’d looked through the files from before and saw that there was a, a problem with the parents, and didn’t include them, and it was just sort one to one things, and, and getting to know me, and things like that.
 

Sara explains why she is wary of contacting support aimed for Muslim young people. (Read by an...

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Sara explains why she is wary of contacting support aimed for Muslim young people. (Read by an...

Age at interview: 20
Sex: Female
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I do know there options that are open, and there is something called, I think for like Muslims, there’s something called the Muslim Youth Help Line. Which is kind of like a Muslim based help line a bit like the Samaritans. But for example there’s kind of, my view of religion is very different from what I think everyone else thinks, and it’s quite, for example just one example, like sexuality, I don’t think there’s any problem with any kind of sexuality but the majority of Muslim I know won’t say that. And if you phoned up these help lines and you said you’ve got, they, they will just convince you that you, they will try to convince you that you’re wrong.
 
And I don’t like, actually that’s why I don’t like phoning up those places ‘cos I don’t feel like they actually will understand as much as they say they will. Like if you wanna bring up a problem, I mean I’m sure they won’t, definitely something like an eating disorder which is completely unrelated, they could probably help you, but I don’t feel comfortable phoning up places where I think they are close minded.
 
And kind of for the same reasons like I don’t like telling my friends because much as I might know them really well, there might be one thing that they’re very close minded about, and it might just happen to be something like eating disorders or self harm or, so I just don’t want to bring it up.

A few people felt talking treatment wasn’t flexible enough. A couple commented that sessions at pre-arranged times didn’t work because of their fluctuating moods. They would have preferred having the help there at the time when they needed it the most, or felt able to talk. One woman said she just “ran out of things to say” and didn’t feel her problems were helped by talking about them.
 

Tasha’s low mood was not caused by any “major life event” that she could process in counselling....

Tasha’s low mood was not caused by any “major life event” that she could process in counselling....

Age at interview: 18
Sex: Female
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First of all I tried, I tried counselling. I had an assessment but at the time it was quite, my mood swings were really fluctuating so I would be feeling really really good and then really bad. And I had my assessment for the, with the psychiatry unit on a day when I was feeling really good, so it didn’t come across that I had any problems and they just referred me to Relate, so I went there and every week I had counselling. But I don’t really feel like I have problems to talk about, I don’t feel like there was a major life event that brought it on so every week I was sort of sitting there, trying to fill an hour [laugh] of talking about what, how I was feeling, but there was only so much you can say when you’re feeling the same all the time.
 
And not enough was happening in a week to discuss that. And after the fourth or the fifth that we sort of went over everything we could and so they stopped because I didn’t feel like they were helping.

Some didn’t see the point in what they saw as the principles behind talking treatment. One woman described counselling as too “scripted” and “rehearsed” and not based on genuine rapport. Another person said that for her the idea behind talking treatment was “to think happy thoughts” and that recovery “didn’t work like that”.
 

Ruby found counselling “rehearsed” and “put on” and the counsellors “very patronising”.

Ruby found counselling “rehearsed” and “put on” and the counsellors “very patronising”.

Age at interview: 27
Sex: Female
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My experiences of counselling, and this is purely my experiences which are a dip in the ocean, I’ve not had a good experience, I’ve found counsellors very patronising. I’ve been told when I was suicidal that I should just concentrate on my university work, take my mind off it, why not have a bath, take up yoga, like you know. And I’m like, don’t patronise me, like almost again it’s like not being taken seriously is my main thing, but… but that’s just my experience, like a lot of people I know who’ve been for counselling or therapy, they’re all like, “Oh my Gold it’s totally worked,” so again, it might be like the medication, I’ve just not met, or been put in the right situation yet for it to work, you know. Which is my hope ‘cos I you know I’ll take anything to improve my situation and like you know, but , so that’s just my experience but then I’d say the same about medication if they hadn’t have found these, the good stuff that works for me. You know so maybe it’s just, but I just found it a bit patronising in that at 10 o’clock on a Thursday morning you had to switch on as to why your mother hates you. What? That’s all a bit scripted and rehearsed and I’m really not in the mood right now. What I need is at midnight when I’m shaking and crying, I need something now, not midday the next day when like you in and talk about why you were shaking and crying. Do you know what I mean like… I just found it a little bit, put on. But that’s just, that’s just pure, I would encourage anyone to give it a go.
 

Counselling hasn’t helped Sophie. She knows she has “loads of people willing to help” her but she...

Counselling hasn’t helped Sophie. She knows she has “loads of people willing to help” her but she...

Age at interview: 17
Sex: Female
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I had counselling and I had loads of things, but nothing seemed to actually stick in and help me. I wouldn’t, it’d just be a bar, and I wouldn’t be able to take it all in and, I still do it now really when I go to my counselling sessions, and I go to the hospital, yeah everybody can say things and say look it’s gonna be alright, and try and do this to help you stop, stop the self harm, but, it’s just nothing goes through, I don’t unders-, like I don’t, I listen, I can sit there and listen and that and I can sit there and talk, but I wouldn’t be able to do the things that people have advised me to do. ‘Cos it just won’t go through. And that’s what just depresses me more. But just have to carry on, just have to find something to get better. Like loads of people are willing to help me. ‘Cos they know that I’m a better person than just not being depressed all the time, ‘cos they know I have a laugh, and I do have my laughs and but I don’t know I think it’s just the fact that it depresses me more ‘cos I want to be with my Mum.
 
I can talk to people but it’s when they say, sit there and say, this is the advice they give you and I try and do it, but nothing helps. It’s like nothing can help. But I’m so negative about things, but I’d like, I’d like to be positive but I just can’t see anything happening.
 
But and it’s like I get depressed as well when you just sit there and you just want your Mum there. You just want your Mum to be there by your side, ‘cos that’s like one person that knows you well and, you just want that bit of love.
For some people, the particular type of talking treatment had been unsuitable, for example too childish or “boring”. A few of them had found therapy with CAMHS more suited to younger children and felt the focus wasn’t enough on “talking” which is what they had wanted.
 

Kirstie says counselling has been “boring” and not helpful at all. She found their approach...

Kirstie says counselling has been “boring” and not helpful at all. She found their approach...

Age at interview: 16
Sex: Female
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It’s [counselling] boring. I’ve been about three times so far, and the first time she drew some jugs, and said, now draw a line on how full your good mood is today. Now draw a line and show us how full your bad mood is today. Now draw a line and show us how full your good mood is on an average day, and how full your bad mood is on an average day. And she was winding me up so much I was like, “The jugs not big enough love, it’s really not for my bad mood.” And apart from that, then we did a test, I can’t remember what it was, but it’s like she shows you a picture and there’s something missing from the picture. Like it’s half an orange, and one of the segments, you know where there’s that little white bit that goes through the middle of the segments. It’s missing on one of them, so two of the segments are joined. And you have to point out, and she times how long it takes you and whether you get it right or not.
 
What about talking about stuff, is that helpful there at all?
 
No. ‘Cos I don’t go to talk about stuff.
 
You go to draw lines?
 
Yeah, I thought it was to talk about stuff, but apparently no it’s not. ‘Cos the best way to sort out my head is to draw lines, work out that I’m only as intelligent as a four year old, and then, oh wait, she got me to bring one of my friends, and then she observed us playing monopoly. To see how frustrated I got. And I was like, “Look.” She’s like, “You’re getting frustrated.” I went, “No I’m getting frustrated at you stood there staring at me.” I went, “If you want to observe, why don’t you play? Best way to observe if you play with us.” And she wouldn’t, and I went look that really annoyed me, just stood there staring at me. “Please stop it.” But she wouldn’t so.
 

Anger management hasn’t helped Kirstie. She says “writing down what makes me mad on a piece of...

Anger management hasn’t helped Kirstie. She says “writing down what makes me mad on a piece of...

Age at interview: 16
Sex: Female
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What happened there?
 
What in my anger management? We just do what, how I feel when I get angry, what like, how I notice I’m getting angry, like if I shake or something. And we had to write all this down. And then ten things that make me most angry. And then draw them on a thermometer, in order of how angry they make me. And then say whether they make me rage mad, just normal mad, irritated mad, or just annoyed. And then I have to write down about the ten things how I could deal with them in a positive way if they made me angry again. So I was like oh this is fun. And literally I’ve been there and I’ve done it about nine times now. It just doesn’t work. I’m not being horrible, but writing down what makes me mad on a piece of paper is making me mad.

A couple also had problems with their parents intervening too much or “controlling” the therapy process. They felt they couldn’t say what they wanted to say in sessions in case their parents found out. Confidentiality and trust were essential to establish for talking treatment to work.

Other types of therapy

Interpersonal Psychotherapy
(IPT) is based on the belief that for some people relationship problems play a big role in their depression. It is different from other forms of therapy in its emphasis on relationships and building interpersonal skills rather than focusing on the specific mental health problems of the individual.

Since these interviews were recorded, new techniques such as ‘Mindfulness’ are increasing being used to help.

Mindfulness Based Stress Reduction (MBSR)
Combines various meditation practices with modified yoga exercises and mind-body education. The idea behind mindfulness is that by being more aware of the present moment, including feelings and thoughts, your body and the world around you it can positively change the way people feel about life and how they approach challenges (see NHS Choices, Breathworks or Mind websites for more details on mindfulness).

Acceptance and Commitment Therapy (ACT)
Encourages people to re-evaluate their relationship with their experiences, including learning to develop a greater division between themselves and their thoughts. These changes are used to help people become more psychologically flexible changing the agenda away from controlling negative experiences and instead helps to focus on setting value-based goals.

We have not been able to interview anyone who has had these therapies. If you have experience of these treatments and you would like us to include your story on this website, please email us.

Last reviewed June 2017.

Last updated June 2017.

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