When it comes to accessing therapy, timing can make all the difference. For some, the motivation to seek support comes in a moment of real need and waiting weeks or months can feel unbearable. For others, the reassurance of a trusted service like the NHS provides a sense of safety, even if it means a longer wait. Both options have their strengths and limitations and understanding them can help you make the choice that feels right for you.
The reality of waiting lists
NHS and charity services are vital, but they are often stretched. According to NHS Talking Therapies performance statistics, the target is that 75% of people should access services within 6 weeks, and 95% within 18 weeks of referral. In reality, waiting times vary greatly depending on location and demand.
“For some, weeks of waiting can feel like months. For others, the wait feels worth it to access trusted NHS care.”
In my own experience, the difference has been striking. Back in 2014, when I was referred for therapy while struggling with prenatal anxiety, I was seen quickly. Within 3 weeks I had an assessment and my first session. At that time, I was referred to a charity specialising in pregnancy and the speed made a huge difference to how supported I felt.
Fast forward to 2022 and when I accessed NHS talking therapies again, it was 14 weeks from referral to my first session. During that wait I was assessed and had built a connection with one therapist, only to be reassigned when it came time to begin therapy properly. While I did go on to build a strong relationship with my assigned therapist, my first reaction was panic at the change, something that many clients find unsettling. In private practice, clients have the ability to choose the therapist they feel is the right fit for them.
The advantage of instant access
Private therapy offers the possibility of starting support when motivation and need are at their highest. Situations where instant access can make a real difference include:
- Experiencing acute distress or crisis and needing a safe space immediately.
- Processing a recent trauma or significant life event.
- Experiencing frequent panic attacks or escalating anxiety.
- Managing workplace stress or relationship difficulties affecting daily life.
“Sometimes, the difference between starting therapy today or six weeks from now is the difference between coping and feeling overwhelmed.”
Accessibility concerns: cost vs. value
Cost is a real and valid consideration for many people. Many therapists, myself included, feel the discomfort of charging for therapy when free services exist. But the reality is that offering therapy as a paid service allows us to provide:
- Faster access
- Consistent, high-quality sessions
- Manageable caseloads, ensuring each client receives the attention they need
It’s not about replacing NHS or charity services, both are invaluable, but offering an alternative for those who need or want to begin right away.
The booking system debate
Technology has made therapy more accessible in practical ways. Online booking systems, such as Fresha, make arranging sessions simple, eliminating the stress of phone calls or lengthy email exchanges. Seeing a confirmed date and time in front of you can be reassuring and empowering.
That said, there are ethical considerations. Booking therapy should never feel like booking a haircut. Therapy is deeply personal and requires a proper assessment to ensure the support offered is safe and appropriate and while I do think booking a haircut is also a very personal decision (no one knows my hair texture like my stylist!), the depth and sensitivity of therapy makes it something that needs a different process.
Pros of online booking:
- Immediate clarity and confirmation
- Empowerment for clients to manage appointments
- Reduces the stress of negotiating times and prices
Cons of online booking:
- Risk of skipping a proper initial assessment
- Therapy should never feel transactional
- Clients may book without understanding whether the therapist is the right fit
“Booking therapy should never feel the same as booking a haircut.”
Balancing accessibility with care
For me, it’s about finding a balance. I want therapy to be accessible, timely and empowering, but never at the expense of safety, ethical practice or suitability. That’s why I always begin with an initial assessment, a space to:
- Explore your goals and needs
- Discuss any risks or challenges
- Ensure the therapy offered is appropriate for you
By combining accessibility with responsibility, clients can feel both supported and empowered from the very first step.
Practical tips for choosing the right option
If you’re deciding between NHS and private therapy, consider:
- How urgent your need feels right now
- Whether cost is a barrier for you
- The importance of choosing a therapist who feels like a good fit
- Whether you want short-term support or longer-term exploration
- Membership in a professional body (e.g., NCPS/BACP) for accountability and adherence to ethical practice.
Final thoughts
Waiting lists can feel disheartening, but support is out there. Whether accessed through the NHS, a charity or privately, what matters most is finding a therapist who feels safe, consistent and attuned to your needs.
Quick access can be life-changing, but the quality of the relationship matters just as much. Ultimately, the best option is the one that empowers you, not the one that rushes you.
“Having experienced both NHS and private therapy myself, I believe there’s no single ‘right’ choice, only the one that feels right for you.”
