Counselling Within a General Practice

What Is General Practice Counselling?

Counselling within a GP surgery sits within the primary care team and offers patients direct access to mental health support without needing a specialist referral in most cases.

A range of professionals may provide counselling in this setting, including trained counsellors and clinical psychologists. Some GPs engage in therapeutic conversations during appointments, though dedicated counsellors handle more structured work.

Many GP practices in England now offer some form of counselling service, though availability varies significantly by area and depends on local NHS commissioning arrangements and funding.

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Why Counselling Is Offered in GP Surgeries

A large proportion of patients visiting their GP present with problems that are psychological or social in nature rather than purely physical. Relationship difficulties, work stress, bereavement, anxiety and low mood account for a significant share of appointments.

Offering counselling within the surgery means patients can receive support closer to home. It can reduce waiting times compared with specialist mental health services, though this varies by region. The approach tends to suit people whose difficulties are mild to moderate rather than severe or complex.

This type of support can help patients with:

• Working through a specific problem or life event
• Making difficult decisions
• Improving communication and relationships
• Managing symptoms of anxiety or depression
• Adjusting to illness, loss or change

For more serious mental health conditions, a GP will usually refer patients to community mental health teams or specialist services instead.

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How Sessions Typically Work

Primary care counselling tends to be short term. Most patients are offered between six and twelve sessions, though this can vary depending on the service and the nature of the problem.

Sessions focus on a particular issue rather than open ended exploration. The aim is to help the patient understand their situation more clearly, develop coping strategies and move forward. This time limited approach can suit individuals seeking practical support without a long commitment, though it may not meet everyone's needs.

A GP will usually make the initial referral after discussing concerns with the patient. Some services also accept self referrals through the NHS Talking Therapies programme, previously known as IAPT, though availability varies by region. You can find local services through the NHS website.

Appointments may take place at the GP surgery, a nearby health centre or via video call or telephone.

Working as a Counsellor in Primary Care

Counsellors working in general practice need to adapt to a faster paced environment than private practice or voluntary settings. Sessions are often shorter and caseloads can be high.

Strong boundaries and clear communication matter in this role. Counsellors work alongside GPs, nurses and other health professionals. Effective teamwork and communication are essential, as is comfort with appropriate information sharing within the clinical team.

Qualifications required will depend on the employer. Many NHS positions require a diploma level qualification or above, along with registration with a recognised body such as the British Association for Counselling and Psychotherapy or the UK Council for Psychotherapy.

For those interested in this career path, the BACP website includes guidance on working in primary care settings. NHS Jobs lists current vacancies across the country.

The Next Step

Now that you have read through the advice above, you might want to put it into practice. Our Counselling Approach Finder lets you describe what a client brings to you and find out which counselling approach is most evidence based for their situation. Try it now →