Dr Jurai Darongkamas (She/Her)
Consultant Clinical Psychologist
If you’re on an NHS Talking Therapies waiting list, or waiting for a similar NHS psychological therapy service, you may be wondering whether you can see a private therapist in the meantime. Perhaps you’re concerned that doing so could affect your NHS appointment or mean losing your place on the waiting list.
It’s a perfectly understandable concern, particularly if you’re struggling now and don’t know how long you’ll have to wait for treatment.
The short answer is that you can consider private therapy while waiting for NHS treatment, but I would encourage you to check the arrangements with your local NHS service first. Policies can vary between services, particularly when it comes to receiving private and NHS psychological therapy at the same time.
There are also some important things I’d encourage you to think about when choosing a private therapist.
1. Your initial NHS appointment may not be the start of therapy
One thing that isn’t always clear when you’re first referred to NHS Talking Therapies is that your initial appointment may only be for an assessment.
This is an opportunity to talk about the difficulties you’re experiencing, how they’re affecting your life and what kind of help might be appropriate.
Depending on the outcome, you may then have a further wait before the actual therapy begins.
The type of therapy offered will also depend on the nature and severity of your difficulties, what the local service provides and what is considered most appropriate for you.
Having worked in the NHS for over 33 years, I’m very aware of how frustrating waiting lists can be, both for people needing help and for the clinicians trying to provide it.
Unfortunately, waiting times can vary considerably between services, and even between different types of therapy within the same service.
I would suggest asking how long you’re likely to wait for the initial assessment and, importantly, how long the subsequent wait for therapy might be. It’s worth knowing what to expect.
2. Can I have private therapy while on an NHS Talking Therapies waiting list?
For some people, having private therapy while waiting for an NHS appointment can be a sensible option, particularly if their difficulties are having a significant impact on their everyday life.
I can certainly understand why someone might not want to wait several months before receiving any help.
However, it’s important not to assume that every NHS Talking Therapies service has the same policy.
My suggestion would be to contact your local service and ask specifically about this; that way, you can make a more informed decision rather than worrying about what might happen.
3. Should I tell the NHS I’m seeing a private therapist?
My general advice would be to be open about any psychological treatment you’re receiving.
I appreciate that some people might worry that telling the NHS about private therapy could lead to them being removed from the waiting list.
However, from a clinical point of view, it’s helpful for the professionals involved in your care to understand what treatment you’re receiving, whether it’s helping and what approaches are being used.
For example, if you’ve already started working on particular difficulties with a private therapist, that information could be useful when planning any further treatment.
It may also help avoid duplication or potentially conflicting approaches.
Having said that, the NHS service’s own arrangements are important, so I would ask them directly how receiving private therapy might affect your referral.
I certainly wouldn’t want someone to feel they had done something wrong simply by seeking help while waiting, but I also wouldn’t want to give you false reassurance about a policy that may differ from one service to another.
4. Will I have to stop private therapy when my NHS treatment begins?
The answer is: it depends.
Some NHS services may ask you to choose between continuing private therapy and starting their treatment. Others may consider your individual circumstances.
There can be sound clinical reasons for avoiding two separate courses of psychological therapy running at the same time.
For example, the therapists might be working from different psychological approaches or focusing on different treatment goals. Without appropriate coordination, this could become confusing or, in some circumstances, unhelpful.
On the other hand, having more than one professional involved in someone’s care isn’t automatically a problem.
What’s important is that the treatment makes sense for your particular difficulties and that everyone involved has a clear understanding of what’s being worked on.
I would therefore suggest discussing this with both your private therapist and the NHS service before deciding what to do.
I’ve looked at published guidance from several NHS Talking Therapies services, and it illustrates why there isn’t a straightforward yes or no answer.
For example, NHS Talking Therapies in Camden and Islington states in its January 2025 guidance that it won’t work with people who are currently receiving talking therapy elsewhere. NHS Sheffield Talking Therapies also says it cannot offer treatment to people already receiving therapy elsewhere.
Lancashire and South Cumbria NHS Talking Therapies takes a slightly more cautious approach in its wording, explaining that the service may not be suitable for people already receiving therapy elsewhere.
These are examples of local service policies, rather than proof of a blanket national prohibition on private therapy while waiting for NHS treatment.
So, my advice would be to contact your own NHS Talking Therapies service and ask specifically about its arrangements. Ideally, get clarification in writing, particularly if you’re worried about losing your place on the waiting list.
5. Choosing a private therapist: please check their qualifications
This is something I feel particularly strongly about.
Private therapy can be expensive, and I completely understand why someone might look for a relatively inexpensive option, especially if they’re already facing a long NHS waiting list.
But I would encourage you not to make your decision on price alone.
Unfortunately, choosing a private therapist in the UK can be something of a minefield if you’re unfamiliar with the different professional titles, qualifications and training routes.
What many people don’t realise is that almost anyone can call themselves a therapist, counsellor or psychologist. These titles, on their own, aren’t legally protected.
This means you could come across someone who has undertaken several years of rigorous, accredited professional training, or someone whose training has been much shorter and less comprehensive.
That’s quite a difference when you’re entrusting someone with your mental health.
By contrast, Clinical Psychologist is a legally protected professional title. Clinical psychologists must undertake recognised professional training and be registered with the Health and Care Professions Council (HCPC) to practise under that title in the UK.
Of course, there are also many excellent, appropriately trained and experienced counsellors, psychotherapists and other psychological therapists working privately. I’m certainly not suggesting that everyone needs to see a clinical psychologist.
What matters is finding someone with the appropriate training, experience and therapeutic approach for the difficulties you’re experiencing.
Before deciding, I’d encourage you to ask:
- What professional qualifications and training does the therapist have?
- Are they registered with an appropriate professional or regulatory body?
- Do they have experience of working with the particular difficulties you’re experiencing?
- What kind of therapy do they offer, and is there good research evidence for its effectiveness for your difficulties?
- What is likely to be involved, how many sessions might be needed and what will it cost?
You can check whether someone is registered as a clinical psychologist through the HCPC online register.
For counsellors and psychotherapists, you can also look for membership of an appropriate professional register, including registers accredited by the Professional Standards Authority.
I’ve spoken with people over the years who felt that previous therapy hadn’t helped them, and some who believed that their difficulties had actually become worse following inappropriate interventions or advice.
That doesn’t necessarily mean the therapist was poorly qualified, as even well-delivered therapy doesn’t help everyone. However, it does illustrate why appropriate training, assessment and matching the therapy to the person’s needs matter so much.
Relatively inexpensive therapy can be excellent, and expensive therapy isn’t necessarily better. It’s the therapist’s competence, experience and suitability for your needs that are important.
6. Could a specialist clinical psychology assessment help?
Something else you might consider, particularly if your difficulties are longstanding, complex or haven’t improved with previous treatment, is having a specialist clinical psychology assessment.
This isn’t quite the same as simply arranging a course of therapy.
A clinical psychology assessment aims to develop a more comprehensive understanding of what’s happening for you.
For example, we might explore:
- What difficulties are you experiencing now?
- When and how did they begin?
- What experiences or circumstances may have contributed to them?
- What might be keeping the difficulties going?
- What’s making it hard to make changes in the direction you’d like?
- What strengths and resources do you already have?
- Most importantly, what might help?
An important part of this process is often developing what clinical psychologists call a psychological formulation.
That sounds rather technical, but I often explain it as putting the pieces of a jigsaw together.
Rather than looking at individual symptoms in isolation, we’re trying to understand how the different pieces of someone’s life, experiences, relationships, emotions, ways of thinking and coping strategies fit together.
When we begin to understand that bigger picture, it can help us identify which psychological approach, or combination of approaches, might be most helpful.
Sometimes a relatively straightforward assessment can be completed in one appointment.
For someone who has experienced difficulties for much of their life, perhaps involving childhood experiences, trauma or longstanding relationship difficulties, it may take two, three or even four appointments.
It depends entirely on the individual.
I also think it’s important not to rush these assessments. There may be a great deal to talk about, sometimes involving painful or sensitive experiences, and I don’t want someone to feel they’re being interrogated.
Some people choose to pay a bit extra for report writing time, to have a written clinical psychology report following their assessment. They may then wish to share this with their GP, NHS Talking Therapies assessor or another healthcare professional.
Such a report can bring together the assessment findings, psychological formulation and recommendations in a way that may be useful when considering treatment options.
However, I should emphasise that an NHS service is not obliged to follow recommendations made in a private report, and obtaining one won’t necessarily shorten an NHS waiting list.
A specialist assessment isn’t necessary for everybody, either.
There’s also the question of cost.
A comprehensive assessment can involve several appointments, and preparing a detailed written report takes additional professional time.
If you’re considering this option, do ask about the likely number and cost of assessment appointments, as well as the separate fee for preparing a written report. That way, you understand the potential overall cost before deciding whether to proceed.
7. What if I can’t afford private therapy?
This is something that concerns me a lot.
Private clinical psychology services, like many other professional services, are unfortunately beyond the financial reach of many people.
Yet the need for psychological help doesn’t depend on someone’s ability to pay.
During my years working in the NHS, I saw just how important accessible psychological services are, particularly for people whose difficulties have developed over many years or who are facing particularly challenging circumstances.
It can now sometimes feel like a postcode lottery, with access to services and waiting times varying depending on where someone lives.
I’m also concerned about the increasingly apparent divide between those who can afford to pay privately and those who have little choice but to wait.
If private therapy isn’t affordable, it’s still worth asking your GP or local NHS Talking Therapies service whether there are other sources of support available while you’re waiting.
Depending on your circumstances and local area, these might include NHS-supported self-help resources, charitable organisations, community services or lower-cost counselling.
Some people also find that appropriate, evidence-based self-help information can be useful while waiting, although it isn’t necessarily a substitute for individual psychological therapy.
And please, if your mental health is deteriorating while you’re on a waiting list, do let your GP or NHS service know. Don’t assume that you simply have to wait until your appointment comes around.
Final thoughts
If you’re on an NHS Talking Therapies waiting list and thinking about private treatment, there are three things I’d particularly encourage you to remember.
First, check with your local NHS service about its arrangements for private therapy while waiting, and what would happen when your NHS treatment begins.
Second, take care when choosing a private therapist. Qualifications, experience and the suitability of the therapeutic approach for your difficulties matter a great deal. Don’t assume that a higher fee automatically means better treatment, or that a lower fee means poorer treatment.
Third, remember that an initial psychological assessment and a course of psychological therapy aren’t necessarily the same thing. Sometimes, particularly when difficulties are complex or longstanding, taking the time to develop a fuller understanding of what’s happening can be a valuable starting point.
Above all, I hope you’re able to access the right support for your needs, without having to wait too long.
You deserve to understand your options and to feel confident about the decisions you make concerning your psychological care.
About the National Clinical Psychology Service (UK)
The National Clinical Psychology Service provides independent clinical psychology assessments, psychological therapy and specialist clinical psychology reports.
For people experiencing complex or longstanding psychological difficulties, an extended clinical psychology assessment and individual psychological formulation may help clarify their difficulties and inform appropriate treatment recommendations.
To find out more, please visit our home page, our Experienced Clinical Psychologists page, or Contact Us.
This article provides general educational information and does not constitute individual clinical advice. NHS service policies and clinical arrangements may vary.
Author: Dr Jurai Darongkamas (She/Her)
Consultant Clinical Psychologist
