Counselling in Newcastle upon Tyne

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Photo of Sadie Mavarani, Psychotherapist, MUKCP
Sadie Mavarani
Psychotherapist, MUKCP
Are you tired of holding it all together? Of putting on a brave face when there’s so much beneath the surface that nobody can see? You go to work, you do your job, and to everyone around you, you seem “fine”. They don’t see the pain you’re carrying or the anxiety that creeps in late at night. They have no idea of the doubt you grapple with or the pressure you’re under. I’m a qualified psychotherapist who helps people manage the impact of stress, anxiety and trauma. I’m also down-to-earth, deeply empathetic and know how hard it can be to share those more vulnerable parts of ourselves we keep hidden.
Are you tired of holding it all together? Of putting on a brave face when there’s so much beneath the surface that nobody can see? You go to work, you do your job, and to everyone around you, you seem “fine”. They don’t see the pain you’re carrying or the anxiety that creeps in late at night. They have no idea of the doubt you grapple with or the pressure you’re under. I’m a qualified psychotherapist who helps people manage the impact of stress, anxiety and trauma. I’m also down-to-earth, deeply empathetic and know how hard it can be to share those more vulnerable parts of ourselves we keep hidden.
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Photo of Anastasia Melachroinou, Psychologist, MSc, GMBPsS
Anastasia Melachroinou
Psychologist, MSc, GMBPsS
Online Only
You might be feeling overwhelmed, emotionally stuck, or unsure why certain thoughts, feelings, or patterns keep repeating. You may want relief, clarity, or simply a space where you can speak freely and feel understood, without pressure to have everything figured out. Sessions are collaborative and adapted to your pace, with attention to what feels most meaningful and supportive for you.
You might be feeling overwhelmed, emotionally stuck, or unsure why certain thoughts, feelings, or patterns keep repeating. You may want relief, clarity, or simply a space where you can speak freely and feel understood, without pressure to have everything figured out. Sessions are collaborative and adapted to your pace, with attention to what feels most meaningful and supportive for you.
0191 743 2614 View 0191 743 2614
Photo of Katy Scott, Psychotherapist, MUKCP
Katy Scott
Psychotherapist, MUKCP
1 Endorsed
Waitlist for new clients
UKCP registered Psychotherapist, Clinical Supervisor and Trainer with 14 years experience. I work with people who have/are experiencing difficulties with any type of relationship such as romantic, family, work, peers, and people experiencing emotional abuse/coercion and control in relationships. I work with people struggling with compulsive sexual behaviours-sometimes known as porn/sex addiction, and I offer therapy to individuals, couples and groups.
UKCP registered Psychotherapist, Clinical Supervisor and Trainer with 14 years experience. I work with people who have/are experiencing difficulties with any type of relationship such as romantic, family, work, peers, and people experiencing emotional abuse/coercion and control in relationships. I work with people struggling with compulsive sexual behaviours-sometimes known as porn/sex addiction, and I offer therapy to individuals, couples and groups.
0191 917 9498 View 0191 917 9498
Photo of Finn Martin Boanas, Psychotherapist, MSc, MBACP
Finn Martin Boanas
Psychotherapist, MSc, MBACP
Thanks for checking out my profile. Life can bring all kinds of challenges. Perhaps you are feeling overwhelmed or have a feeling of being stuck. Perhaps you have a specific hurdle that you are struggling to overcome. Perhaps there are events in your past that you would like to process and move on from. I believe you can find a way through these challenges and would like to help you to do so.
Thanks for checking out my profile. Life can bring all kinds of challenges. Perhaps you are feeling overwhelmed or have a feeling of being stuck. Perhaps you have a specific hurdle that you are struggling to overcome. Perhaps there are events in your past that you would like to process and move on from. I believe you can find a way through these challenges and would like to help you to do so.
01661 525158 View 01661 525158
Photo of Stephanie Kelly - Safe Space Psychology - Dr Stephanie Kelly, Psychologist, HCPC - Clin. Psych.
I am a Clinical Psychologist with experience working with clients struggling with relational difficulties, trauma and other emotional and other psychological difficulties such as complex grief, low mood and anxiety. Working with male, female and non-binary clients, my aim is to personalise all therapeutic approaches to each individual client's specific needs. Over the years, I have worked in a wide variety of settings including acute and secure hospitals, community mental health services as well as in custodial settings with experience supporting adults, adolescents and families.
I am a Clinical Psychologist with experience working with clients struggling with relational difficulties, trauma and other emotional and other psychological difficulties such as complex grief, low mood and anxiety. Working with male, female and non-binary clients, my aim is to personalise all therapeutic approaches to each individual client's specific needs. Over the years, I have worked in a wide variety of settings including acute and secure hospitals, community mental health services as well as in custodial settings with experience supporting adults, adolescents and families.
0191 743 0381 View 0191 743 0381
Photo of Rachel Thomlinson, Psychologist, PsychD, HCPC - Clin. Psych.
Rachel Thomlinson
Psychologist, PsychD, HCPC - Clin. Psych.
I provide support across the lifespan and can support with a wide range of difficulties, including anxiety, low mood, trauma and relationship difficulties. I have specialist experience working with Children and Young People, and will work systemically with you, as well as individually with your child, to support your child's social and emotional development. I also provide parent/carer support, from pregnancy through to adolescence. I will support you to adopt a parenting approach that will enhance your child’s social and emotional development, and will work with you to understand any triggers that might get in the way.
I provide support across the lifespan and can support with a wide range of difficulties, including anxiety, low mood, trauma and relationship difficulties. I have specialist experience working with Children and Young People, and will work systemically with you, as well as individually with your child, to support your child's social and emotional development. I also provide parent/carer support, from pregnancy through to adolescence. I will support you to adopt a parenting approach that will enhance your child’s social and emotional development, and will work with you to understand any triggers that might get in the way.
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Photo of Tabitha Appleby, Psychotherapist, MBACP Accred
Tabitha Appleby
Psychotherapist, MBACP Accred
Online Only
I am BACP Accredited Psychotherapist, EMDR Practitioner Accredited with EMDR Association, BACP Accredited CBT Therapist and BACP Couples Therapist. I am only working online. I feel that therapy is relational and as such I always offer a free telephone call in which you can get a sense of me and how I work, and we can find out if I am the right therapist for you.
I am BACP Accredited Psychotherapist, EMDR Practitioner Accredited with EMDR Association, BACP Accredited CBT Therapist and BACP Couples Therapist. I am only working online. I feel that therapy is relational and as such I always offer a free telephone call in which you can get a sense of me and how I work, and we can find out if I am the right therapist for you.
01798 304026 View 01798 304026
Photo of Dan Entwisle, Counsellor, MBACP
Dan Entwisle
Counsellor, MBACP
Online Only
I bring more than just academic qualifications to counselling. I also bring my experience from my previous career as a broadcaster to create a unique therapeutic offer. As an integrative therapist I am ready to guide you on your personal path to wellbeing. My style is informal and welcoming. I don't just hear what you have to tell me, I listen and help you find your path by fostering a creative and positve theraputic alliance.
I bring more than just academic qualifications to counselling. I also bring my experience from my previous career as a broadcaster to create a unique therapeutic offer. As an integrative therapist I am ready to guide you on your personal path to wellbeing. My style is informal and welcoming. I don't just hear what you have to tell me, I listen and help you find your path by fostering a creative and positve theraputic alliance.
01661 523724 View 01661 523724
Photo of Karen Barr - Solace Psychology, Psychologist, HCPC - Clin. Psych.
Solace Psychology
Psychologist, HCPC - Clin. Psych.
Is low mood making it difficult for you to connect with the people and activities that matter to you? Are you struggling at school, university or work? Perhaps anxiety or stress is making life more challenging? If you want to understand your difficulties and learn how to help yourself I can offer a psychological therapy service that aims to empower you with the tools, skills and insight to improve your wellbeing and move you towards your goals for living a more meaningful and satisfying life.
Is low mood making it difficult for you to connect with the people and activities that matter to you? Are you struggling at school, university or work? Perhaps anxiety or stress is making life more challenging? If you want to understand your difficulties and learn how to help yourself I can offer a psychological therapy service that aims to empower you with the tools, skills and insight to improve your wellbeing and move you towards your goals for living a more meaningful and satisfying life.
0191 743 4970 View 0191 743 4970
Photo of Emma Smith, Counsellor, MNCPS Acc.
Emma Smith
Counsellor, MNCPS Acc.
Online Only
Hello, my name is Emma and I’m a therapist and trainee Counselling Psychologist. And over to you. Do you feel stuck in patterns in your life that you are struggling to shift? Or would you like to explore certain life events with someone who is not family or a friend? We all have our ways of behaving and seeing the world that have developed over time, and perhaps been useful once, but no longer serve us. I believe that we repeat and relive what we have not processed. These repetitions show up in our relationships, work, choices, and symptoms, but it is very difficult to get out of these behaviours and thinking loops on your own.
Hello, my name is Emma and I’m a therapist and trainee Counselling Psychologist. And over to you. Do you feel stuck in patterns in your life that you are struggling to shift? Or would you like to explore certain life events with someone who is not family or a friend? We all have our ways of behaving and seeing the world that have developed over time, and perhaps been useful once, but no longer serve us. I believe that we repeat and relive what we have not processed. These repetitions show up in our relationships, work, choices, and symptoms, but it is very difficult to get out of these behaviours and thinking loops on your own.
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Photo of Dr Anna Day, Psychologist, PsychD, HCPC - Clin. Psych.
Dr Anna Day
Psychologist, PsychD, HCPC - Clin. Psych.
2 Endorsed
Hi, I'm Anna, a Clinical Psychologist and EMDR therapist with over twenty years experience working in the NHS and private practice. Life can be challenging, and I'm here to offer a nurturing and safe space to help you move forward in the way that you would like. I support people with depression, anxiety, trauma, complex trauma, low self esteem, burn out, adjustment to physical health conditions, and attachment and relational difficulties. After suffering with chronic illness myself, I also specialize in supporting people with chronic illness, including ME/CFS, Long Covid and Chronic Lyme's.
Hi, I'm Anna, a Clinical Psychologist and EMDR therapist with over twenty years experience working in the NHS and private practice. Life can be challenging, and I'm here to offer a nurturing and safe space to help you move forward in the way that you would like. I support people with depression, anxiety, trauma, complex trauma, low self esteem, burn out, adjustment to physical health conditions, and attachment and relational difficulties. After suffering with chronic illness myself, I also specialize in supporting people with chronic illness, including ME/CFS, Long Covid and Chronic Lyme's.
01661 520453 View 01661 520453
Photo of Holly Lynn, Psychotherapist, MUKCP
Holly Lynn
Psychotherapist, MUKCP
Many people live with sexual or intimacy difficulties for years before reaching out. As I am currently undertaking a diploma in psychosexual therapy, I am able to offer an accessible, low cost psychosexual therapy to individuals and couples. People often come to psychosexual therapy feeling confused, frustrated or quietly worried about their sex life, whether that is loss of desire, anxiety around intimacy, painful or unfulfilling sex, or a sense of disconnection from themselves or their partner. You might not have the words for what is wrong, only a feeling that something is isn’t working or not as you had hoped.
Many people live with sexual or intimacy difficulties for years before reaching out. As I am currently undertaking a diploma in psychosexual therapy, I am able to offer an accessible, low cost psychosexual therapy to individuals and couples. People often come to psychosexual therapy feeling confused, frustrated or quietly worried about their sex life, whether that is loss of desire, anxiety around intimacy, painful or unfulfilling sex, or a sense of disconnection from themselves or their partner. You might not have the words for what is wrong, only a feeling that something is isn’t working or not as you had hoped.
0191 743 1815 View 0191 743 1815
Photo of Sarah Shuib - Sarah Shuib In The Moment Counselling, Counsellor, MBACP
On the outside, you’ve got it together. On the inside, your brain doesn’t seem to switch off. You’re a professional who’s used to being capable, reliable, and the one others turn to. But behind the scenes, it can feel relentless, overthinking everything, running on empty, and never quite switching off, no matter how hard you try. At some point, pushing through stops working. I offer a real, down-to-earth space where we cut through the noise and get to what’s actually going on. No overcomplicating, just honest conversations that help you understand yourself, set clearer boundaries, and feel more in control of your time and energy.
On the outside, you’ve got it together. On the inside, your brain doesn’t seem to switch off. You’re a professional who’s used to being capable, reliable, and the one others turn to. But behind the scenes, it can feel relentless, overthinking everything, running on empty, and never quite switching off, no matter how hard you try. At some point, pushing through stops working. I offer a real, down-to-earth space where we cut through the noise and get to what’s actually going on. No overcomplicating, just honest conversations that help you understand yourself, set clearer boundaries, and feel more in control of your time and energy.
01661 520213 View 01661 520213
Photo of Lorna Evans - The Mind Movement - Somatic - Neuroaffirming, Psychotherapist, MSc, MUKCP
Hello, I’m Lorna. I've been working with clients for over 15 years. I work from my clinic in Jesmond and online, offering therapy to clients worldwide. I bring warmth, care and a human approach to explore with you both past and present challenges affecting your mental, emotional and physical health. Areas I focus on are Trauma, PTSD, Anxiety and Depression. People come to therapy for many reasons. Sometimes there’s a clear issue to work through; other times it’s just a feeling that something isn’t quite right. We’ll explore what’s going on for you and what you would like to work on together to create change in your life.
Hello, I’m Lorna. I've been working with clients for over 15 years. I work from my clinic in Jesmond and online, offering therapy to clients worldwide. I bring warmth, care and a human approach to explore with you both past and present challenges affecting your mental, emotional and physical health. Areas I focus on are Trauma, PTSD, Anxiety and Depression. People come to therapy for many reasons. Sometimes there’s a clear issue to work through; other times it’s just a feeling that something isn’t quite right. We’ll explore what’s going on for you and what you would like to work on together to create change in your life.
0191 917 2252 View 0191 917 2252
Photo of Dr Mariam Majid - Psychology Newcastle - Dr Mariam Majid , Psychologist, PsychD, HCPC - Clin. Psych.
Psychology Newcastle - Dr Mariam Majid
Psychologist, PsychD, HCPC - Clin. Psych.
Thank you for visiting my profile. My name is Mariam and I am a registered Clinical Psychologist with over 15 years of experience working with adults with mental health problems. I am also trained in Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation Reprocessing (EMDR) both of which are evidence based psychological approaches to treat a wide range of emotional, behavioural and psychological difficulties including anxiety, depression, complex trauma, Post-Traumatic Stress Disorder (PTSD), adjustment difficulties, self esteem etc. I also work with couples.
Thank you for visiting my profile. My name is Mariam and I am a registered Clinical Psychologist with over 15 years of experience working with adults with mental health problems. I am also trained in Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation Reprocessing (EMDR) both of which are evidence based psychological approaches to treat a wide range of emotional, behavioural and psychological difficulties including anxiety, depression, complex trauma, Post-Traumatic Stress Disorder (PTSD), adjustment difficulties, self esteem etc. I also work with couples.
019467 60712 View 019467 60712
Photo of JAMES P POOLE, Counsellor, MBACP
JAMES P POOLE
Counsellor, MBACP
Many of my clients feel overwhelmed–by anxiety, stress, low self-esteem, grief, identity challenges or a sense of not belonging. They may be exhausted from holding everything together or struggling to understand why they feel the way they do. My ideal client wants a space where they can slow down, explore their emotions safely, and make sense of their experiences. They’re looking for clarity, relief, and a more grounded way of living—and they want to feel genuinely seen, heard, and understood.
Many of my clients feel overwhelmed–by anxiety, stress, low self-esteem, grief, identity challenges or a sense of not belonging. They may be exhausted from holding everything together or struggling to understand why they feel the way they do. My ideal client wants a space where they can slow down, explore their emotions safely, and make sense of their experiences. They’re looking for clarity, relief, and a more grounded way of living—and they want to feel genuinely seen, heard, and understood.
0191 743 7178 View 0191 743 7178
Photo of Billy Signey - Relief Counselling, Counsellor, BACP
Relief Counselling
Counsellor, BACP
1 Endorsed
Hello, My name is Billy Signey, MBACP, BA honours. I work in an integrative way offering a safe, confidential environment for my clients, enabling them to understand their feelings and emotions in this ever-changing and demanding world. I have worked with problems such as PTSD, Depression, Abuse, Sexual and Physical, Historical/Childhood issues, Neglect, Anxiety, Panic attacks, Suicidal ideation, Phobias, avoidance, etc. Please text me for a free 10-minute no-obligation chat and I will do my best to find the best way forward for you. I have an extensive list of client testimonials that can be viewed on request.
Hello, My name is Billy Signey, MBACP, BA honours. I work in an integrative way offering a safe, confidential environment for my clients, enabling them to understand their feelings and emotions in this ever-changing and demanding world. I have worked with problems such as PTSD, Depression, Abuse, Sexual and Physical, Historical/Childhood issues, Neglect, Anxiety, Panic attacks, Suicidal ideation, Phobias, avoidance, etc. Please text me for a free 10-minute no-obligation chat and I will do my best to find the best way forward for you. I have an extensive list of client testimonials that can be viewed on request.
0191 743 0523 View 0191 743 0523
Photo of Viv Houghton, Counsellor, MBACP
Viv Houghton
Counsellor, MBACP
Hi, My name is Viv, My role as a therapist is to provide space for you to explore your difficulties at your own pace, within a safe and non- judgemental relationship. I am deeply passionate about the work I do and I would feel privileged to accompany you on your path towards healing, growth, and resilience. People come to counselling for a variety of reasons, to help cope with the stresses of everyday life or following a major life change, bereavement or perhaps to understand themselves better.
Hi, My name is Viv, My role as a therapist is to provide space for you to explore your difficulties at your own pace, within a safe and non- judgemental relationship. I am deeply passionate about the work I do and I would feel privileged to accompany you on your path towards healing, growth, and resilience. People come to counselling for a variety of reasons, to help cope with the stresses of everyday life or following a major life change, bereavement or perhaps to understand themselves better.
07761 660755 View 07761 660755
Photo of Lucy Slesser, Counsellor, MBACP
Lucy Slesser
Counsellor, MBACP
1 Endorsed
I specialise in working with adults experiencing anxiety, whether that’s constant overthinking, relationship worries, or a deeper sense of feeling stuck or unsettled. Alongside my private practice, I work within the NHS as a Psychotherapeutic Counsellor, supporting clients with more complex and long-standing emotional difficulties and trauma. This has shaped a way of working that is both grounded and effective.
I specialise in working with adults experiencing anxiety, whether that’s constant overthinking, relationship worries, or a deeper sense of feeling stuck or unsettled. Alongside my private practice, I work within the NHS as a Psychotherapeutic Counsellor, supporting clients with more complex and long-standing emotional difficulties and trauma. This has shaped a way of working that is both grounded and effective.
07476 572407 View 07476 572407
Photo of Anita Wan, Psychotherapist, UKCP Trainee
Anita Wan
Psychotherapist, UKCP Trainee
1 Endorsed
Hi, I’m Anita, a UKCP Therapist-in-Advanced Training. I believe the very heart of relational psychotherapy is a caring, deeply human meeting between two people. My approach is collaborative, inclusive, compassionate and curious. I offer a warm and caring presence and a safe, confidential space where together we can explore all that you may wish to bring at your own pace. Our earliest relational experiences create a blueprint for our future relationships, informing our needs and wants, how we feel about ourselves and how we expect to be treated. Therapy can help us to grow and step into our true selves more fully and with less shame.
Hi, I’m Anita, a UKCP Therapist-in-Advanced Training. I believe the very heart of relational psychotherapy is a caring, deeply human meeting between two people. My approach is collaborative, inclusive, compassionate and curious. I offer a warm and caring presence and a safe, confidential space where together we can explore all that you may wish to bring at your own pace. Our earliest relational experiences create a blueprint for our future relationships, informing our needs and wants, how we feel about ourselves and how we expect to be treated. Therapy can help us to grow and step into our true selves more fully and with less shame.
0191 743 0290 View 0191 743 0290

See more therapy options for Newcastle upon Tyne

How does your Counsellor compare?

Number of Counsellors in Newcastle upon Tyne

200+

Average cost per session

£65

Counsellors in Newcastle upon Tyne who prioritize treating:

92% Anxiety
85% Depression
84% Self Esteem
80% Stress
79% Relationship Issues
72% Trauma and PTSD
62% Bereavement

Average years in practice

11 Years

Top 3 insurances accepted

73% Aviva
68% AXA PPP
67% Bupa

How Counsellors in Newcastle upon Tyne see their clients

77% In Person and Online
23% Online Only

Gender breakdown

78% Female
20% Male
2% Non-Binary
FAQs - About Therapy and Counselling

How can I find a therapist in Newcastle upon Tyne?

Search for nearby therapists or counsellors by inputting your city, postcode, or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or postcode into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

Counsellors and Psychotherapists listed in the directory are members of the main professional associations, mainly the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP). Most Psychologists in the directory are accredited members of the British Psychological Society (BPS) and/or are registered in the Health and Care Professions Council (HPCP).

Providers whose professional membership or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Given that professional memberships are not a statutory requirement for psychotherapists and counsellors in the UK, certain qualified professionals or organisations may choose not to maintain such memberships despite possessing the necessary qualifications. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counsellor?

Counsellors, psychotherapists and psychologists can all provide counselling or talking therapy and have credentials and experience that enable them to do so in the UK. Psychologists have earned a degree in psychology and many are members of the British Psychological Society (BPS) and have completed a postgraduate qualification in a specialism. Counsellors and Psychotherapists are not required to have a psychology degree, but to belong to a professional organisation such as the BACP or UKCP, they are required to have completed a training course as well as clinical and supervision hours.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the UK could be between £30 - £60 when seeing a counsellor and £60 - £150 and up when seeing a clinical psychologist. If you have private insurance, your plan may cover some if not all of your sessions. You should contact your insurance provider to determine if they provide coverage for therapy sessions and to determine what, if any, requirements they might have in order for your sessions to be covered, such as a referral from your GP or medical specialist.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

If you are struggling to access therapy due to budget constraints, you could also consider public funded mental health services. The NHS Talking therapies programme offers free of charge counselling for common mental health problems like anxiety and depression. The service is available to anyone registered with a GP, though you do not necessarily need to be referred by your GP and can refer yourself directly to a Talking therapies service. The service will provide different solutions, including group and individual therapy, for a limited number of sessions which are generally up to six.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your postcode.

Are therapy sessions confidential?

Therapists who are part of a professional organisation such as the BACP, the UKCP, or BPS are bound by an ethical framework that requires them to uphold a confidentiality agreement. Confidentiality is a crucial part of the therapeutic relationship and only under specific circumstances, such as when there has been participation in a criminal act or act of terror, or if there is potential or known harm to the client or others, will a therapist be obligated to break the agreement. These exceptions to the confidentiality agreement are usually discussed during the initial consultation.