NHS Waiting Lists for Therapy: When Private CBT Makes Sense

The reality of NHS mental health services in 2026

I’m going to say something that might sound self-serving, given that I run a private therapy clinic. But it needs saying.

The NHS is failing people who need mental health support. Not because the clinicians aren’t good. They are. The psychologists, therapists, and mental health nurses working in the NHS are some of the most dedicated people I’ve ever met. The problem is that there aren’t enough of them, the demand is overwhelming, and the system was never built to handle the volume of need that exists right now.

In the North West, waiting times for NHS talking therapies through the IAPT system average 8-12 weeks for low-intensity support. For high-intensity CBT, the kind you’d need for moderate to severe anxiety, depression, PTSD, or OCD, you’re looking at 4-6 months in many areas. In some parts of North Wales under the Betsi Cadwaladr health board, waits can stretch beyond a year.

For children needing CAMHS input, the picture is worse. Eighteen-month waits are common. Two years is not unheard of.

I’m not saying this to sell my services. I’m saying it because if you’re sitting on a waiting list right now, you deserve to know what your options are.

What you’re actually waiting for

Here’s something most people don’t realise. When you’re referred for NHS therapy, you’re often not getting the same thing you’d get privately.

The IAPT model prioritises throughput. Step 2 (low intensity) usually means guided self-help, computerised CBT, or group workshops. These can be useful for mild difficulties, but they’re not the same as sitting in a room with an experienced therapist working through your specific problems.

Step 3 (high intensity) is closer to what private CBT offers: one-to-one sessions with a qualified therapist, typically 12-20 sessions. But this tier has the longest waits, and you usually have to go through Step 2 first, even if it’s clear from the start that you need more intensive support.

The assessor who triages you might be excellent. But they’re working within a system that has limited resources and strict criteria for who gets what.

When private therapy makes sense

I’m not going to pretend private therapy is the right choice for everyone. It costs money, and not everyone has it. I charge £60 per session, which is towards the lower end of the scale for qualified CBT therapists in the North West, but it’s still a significant expense.

Here’s when I think it’s worth considering:

You’re getting worse while waiting. If your anxiety or depression is escalating and you’re months away from NHS support, waiting isn’t a neutral act. Your mental health can deteriorate significantly in the time it takes to reach the front of a queue.

You’ve tried the low-intensity stuff and it wasn’t enough. Guided self-help books and online courses have their place. But if you’ve done those and you’re still struggling, you probably need proper one-to-one therapy.

You want to choose your therapist. On the NHS, you get whoever is available. You can’t choose someone with specific experience in your condition, or someone whose approach suits your personality. Privately, you can.

Your work or daily life is significantly affected. If your mental health is costing you productivity, relationships, or opportunities, the maths of paying for therapy often works out in your favour over the medium term.

You need specialist help that’s hard to find on the NHS. Primitive reflex integration therapy isn’t available on the NHS at all. For specialist CBT for certain conditions, NHS provision can be patchy.

What private CBT actually costs

Let’s talk numbers, because vagueness helps nobody.

At my clinic, CBT sessions are £60 for 50-60 minutes. I offer concessions for military veterans, serving personnel, and blue light workers.

A typical course of CBT for anxiety might be 8 sessions. That’s £480 total. For depression, 8-12 sessions: £480-£720. For PTSD, 12-20 sessions: £720-£1,200.

Those are real numbers, and I understand they’re not trivial. But compare them to the cost of months off work, or the impact on your relationships, or what you’re spending trying to manage the problem yourself, and the picture shifts.

Some private health insurance policies cover CBT. It’s worth checking if you have cover through work.

Using both systems

Going private doesn’t mean you can’t also use the NHS. Plenty of my clients stay on the NHS waiting list while doing private therapy. If the NHS appointment comes through and you’ve already improved, you can decline it. If you’d like additional support, you can take it.

Your GP should still be involved. They can monitor medication if you’re on any, and having your therapy recorded in your medical notes creates a useful paper trail.

I always encourage clients to tell their GP they’re seeing me. Good care is joined-up care.

What to look for in a private therapist

If you’re going to pay for therapy, make sure you’re getting someone qualified. Here’s what to check:

Qualifications. A minimum of a postgraduate diploma in CBT from an accredited institution. My qualifications are a BSc in Psychology, a Diploma in CBT, and a PgDip in Mental Health Science.

Experience. Ask how many years they’ve been practising and whether they have specific experience with your condition. I’ve been doing this for 13 years.

Accreditation. Look for registration with a professional body like the BABCP (British Association for Behavioural and Cognitive Psychotherapies). This means they’re meeting ongoing standards of practice and supervision.

Insurance and DBS. Any therapist working with vulnerable people should be DBS checked and professionally insured. Ask if you’re unsure.

A free initial conversation. Any decent therapist will offer a brief phone consultation before you commit to anything. If they won’t, that tells you something.

The bottom line

The NHS is struggling, and pretending otherwise doesn’t help anyone. If you have the means to access private therapy and you’re suffering now, it’s a legitimate option. Not instead of the NHS, but alongside it or while you wait for it.

If you’d like to talk through whether private CBT might be right for your situation, give me a call. The initial phone consultation is free, takes about 15 minutes, and there’s no pressure to book anything.

07469 870 295 or use the contact form.