Understanding Therapy
“Therapy” gets used as an umbrella term for a lot of different things — and the differences matter. The right kind of support depends on what you're dealing with, not just personal preference. Here's a plain-language guide to the approaches we use at Well Balanced Minds, and how they compare to counselling more broadly.
Counselling vs High Intensity Psychological Therapy/ Psychotherapy
Counselling is usually non-directive — a space to talk, be listened to, and explore feelings and experiences, generally without a fixed structure or specific target for each session. It's genuinely valuable, and often the right first step for a life adjustment, bereavement, general low mood, or simply wanting space to think things through.
Psychological therapy — what we specialise in — tends to be more structured.
Each approach has a specific model of why a difficulty developed, a plan for addressing it, and clear goals we track together. It's often better suited to more entrenched difficulties: trauma, longstanding anxiety, burnout, or patterns that haven't shifted with talking alone.
Neither is “better” — they're different tools for different needs. Working out which one fits is part of what happens at your first appointment.
Cognitive Behavioural Therapy (CBT)
What it is: Looks at the links between thoughts, feelings, behaviours and physical sensations, and works to change the unhelpful patterns that keep a difficulty going.
Well suited to: Anxiety, panic, low mood, phobias, work-related stress, unhelpful thinking patterns.
What sessions look like: Structured, often with agreed tasks between sessions, working toward specific, measurable goals.
A note on qualifications: “CBT” is a widely used term, and elements of it are taught, in varying depth, across many different training routes — some brief, some far more substantial. Full accreditation as a Cognitive Behavioural Psychotherapist with the British Association for Behavioural and Cognitive Psychotherapies (BABCP) is a distinct, higher bar: it requires a core professional qualification in mental health (or recognised equivalent), at least 100 hours of specific, university-validated CBT training, ongoing clinical supervision, and adherence to BABCP's Standards of Conduct, Performance and Ethics — verified through listing on the CBT Register UK and Ireland. If a previous course of “CBT” didn't feel like it helped, it's a completely reasonable question to ask any practitioner whether they hold BABCP accreditation — you can check anyone's status for free on the CBT Register.
Compassion Focused Therapy (CFT)
What it is: Developed by Professor Paul Gilbert, CFT draws on evolutionary psychology and neuroscience to explain why some people get stuck in high self-criticism and shame. It works with three emotional regulation systems — threat, drive, and soothing — and focuses on building the capacity to activate a genuine, felt sense of safety and self-compassion, not just a change in thinking.
What sessions look like: Often blends cognitive and behavioural techniques with more experiential work — compassionate imagery, soothing-rhythm breathing, and sometimes chairwork — aimed at building an internal sense of warmth rather than harsh self-judgement.
Evidence base: A growing evidence base, particularly for difficulties where shame and self-criticism play a maintaining role — increasingly used alongside CBT rather than as a stand-alone replacement for it.
Well suited to: Burnout, self-criticism, perfectionism, shame, and difficulties that haven't fully responded to more traditional CBT.
A note on qualifications: CFT is a newer field than CBT or EMDR, and — unlike BABCP or EMDR Europe — there isn't yet a single overarching accrediting register. Training ranges from short introductory workshops through to substantial postgraduate diplomas (ours took ten months, via the Compassionate Mind Foundation, the organisation founded by Paul Gilbert). It's worth asking any practitioner what level of CFT training and supervised experience they've completed, since the range genuinely is wide.
Counselling vs High Intensity Psychological Therapy/ Psychotherapy
Stepped Care Model
If you've spent time around NHS or HSC mental health services, you may have come across the idea of “stepped care.” It's the framework used across Health and Social Care in Northern Ireland — developed following the Bamford Review and set out in the regional “You in Mind” care pathway — to match the level of support offered to the severity and complexity of what someone's dealing with, starting with lighter-touch options and stepping up to more specialist input where needed.
We're an independent private practice, not part of the statutory HSC system — but we think the stepped care idea is a genuinely useful way to explain what we do, and just as importantly, what we don't.
EMDR (Eye Movement Desensitisation and Reprocessing)
What it is: A structured, phased therapy that helps the brain reprocess distressing or “stuck” memories, using bilateral stimulation (commonly guided eye movements) alongside the memory itself — based on the idea that the brain has a natural capacity to process difficult experiences, which can get blocked when a memory is especially distressing.
What sessions look like: EMDR follows a clear phased structure, starting with history-taking and building coping resources before any processing work begins, and doesn't require talking through every detail of what happened out loud. Many people find it a more contained way of working with trauma than talking therapy alone.
Evidence base: Recommended by NICE and the World Health Organization as an effective treatment for PTSD, with a substantial and growing evidence base for other trauma-related presentations.
Well suited to: PTSD, single-incident trauma, workplace incidents, and other distressing or “stuck” memories — including trauma that's hard to put into words.
A note on qualifications: EMDR training is only open to practitioners who are already accredited mental health professionals with existing one-to-one therapy experience, so the basic entry bar is relatively high. Even so, there's a real difference between someone who has completed the standard training course and an EMDR Europe Accredited Practitioner, who has gone on to complete a substantial number of further supervised cases under an accredited EMDR Consultant. It's a fair question to ask any EMDR practitioner what level of accreditation they hold.
The steps, in plain terms
Step 1 — Self-directed help & wellbeing support
Psychoeducation, self-help resources, lifestyle and wellbeing changes. Often enough on its own for mild, everyday stress.
Step 2 — Primary care talking therapies
Lower-intensity talking therapy — often what's meant by “counselling” — a supportive, exploratory space, usually shorter-term and less structured. A good fit for mild-to-moderate difficulties, life adjustment, or simply needing to talk things through with a trained professional.
Step 3 — Specialist psychological therapy
Structured, evidence-based approaches like CBT, EMDR and CFT, usually delivered by accredited psychotherapists or chartered psychologists. This is for more complex, entrenched, or severe difficulties — trauma, longstanding anxiety, burnout that hasn't shifted, or presentations that need a specific therapeutic model rather than general support.
Steps 4–5 — Specialist & high-intensity mental health services
Condition-specific specialist teams, multidisciplinary input, or crisis and inpatient care — beyond what any private, community-based practice, ourselves included, is set up to provide.
Where we sit — and why we don't offer generic counselling
Our team's qualifications and accreditations — BABCP-accredited CBT & EMDR, BPS Chartered Psychologist, postgraduate CFT training — are built for Step 3-type work: structured, evidence-based psychological therapy for difficulties that need more than a supportive conversation.
That's a deliberate choice, not a judgement on counselling. Counselling is valuable, and for some people it's exactly the right fit — often more accessible, and well suited to mild difficulties or a need for a general talking space. But it's a different service, usually delivered by practitioners trained specifically in that model, and it isn't what our qualifications or way of working are built around. Offering it alongside structured psychological therapy would mean doing neither well.
If, at your initial assessment, we think counselling — or a different kind of support altogether — would suit you better than what we offer, we'll tell you plainly and help point you in the right direction.
What this means in practice
• Dealing with trauma, PTSD, longstanding anxiety, burnout, or difficulties that haven't shifted with talking alone? → Structured psychological therapy (what we offer) is likely to be a good fit.
• Mainly need a supportive space to process a recent life event, or dealing with milder, more situational difficulties? → Counselling may be a better — and often more affordable and accessible — starting point, and we're glad to help you think that through.