NHS vs. Private CBT: What Are the Differences?

A note on the waiting time figures

The NHS's own published standard is that 75% of people should start treatment within 6 weeks of referral, and 95% within 18 weeks. NHS England's most recent national figures (2024–25) report 91.6% accessing care within 6 weeks, which sounds strong, but that figure covers everything NHS Talking Therapies offers, including higher-volume, lower-intensity options like guided self-help. In practice, this usually means longer waiting times specifically for structured 1:1 CBT, and how much longer depends a lot on where you live. If you want an accurate picture for your area, your GP practice or local NHS Talking Therapies service can tell you their current wait.

None of this is a knock on the NHS route. It's free, it uses the same evidence base, and for a lot of people it's the right choice. The private route mainly buys you certainty: you know the cost upfront, you know who you'll be seeing, and you know roughly when you'll start.

A note on session flexibility

NHS England's own guidance says the number of sessions offered "should never be restricted arbitrarily," with up to 14 to 20 recommended depending on the problem. In practice, that's not always what people experience. OCD-UK, a patient charity, has documented services offering as few as 6 to 8 sessions, and some requiring a wait of several months before someone can request further treatment; OCD-UK say NHS England has confirmed that wait isn't the national policy, just how some local services are running it. Working privately, that flexibility sits with us directly: if the programme needs to run longer, we agree it together in session, not through a separate request or wait.

A note on what happens after treatment ends

The 12-session structure is the same idea whether you're on the NHS or working privately with me; the difference shows up around the edges of it. NHS Talking Therapies doesn't routinely collect data on how people do after they're discharged, and the research that does exist suggests a large proportion of people see symptoms creep back within the first year. Once your agreed course ends, there isn't a standard, built-in way to check back in. Working privately, that flexibility is part of the offer: if 12 sessions turns out not to be enough, we can agree to extend rather than ending abruptly, and if you'd find it useful, we can arrange a follow-up session around 3 months after treatment ends, to check how things have held and troubleshoot anything that's slipped.