Do you want extra help with your dental fears or phobia? Getting support from a qualified psychologist or therapist can be a great idea. This can also be really useful if you have other mental health issues that are making things harder for you, for example depression (which often results in a lack of self-care, including not being able to look after your dental health), general health anxiety, or emetophobia.
How do I get help in the U.K. on the NHS?
Here’s how to navigate your way through the British mental health services:
The core person for you, as a potential user of mental health services in the UK, is your general practitioner (GP). The GP acts as the hub in the network of your care. They should be informed about what is available for you in your local area.
This system works well when you have a trusting relationship with your GP. Unfortunately, different GPs have different levels of interest in getting involved with people with mental health problems, or there may be a personality clash. In that case, you have every right to change your GP. You can do this by writing to the GP practice and explaining that you want to change your GP. You don’t need to give any reasons.
If you are in England, you can also skip the GP route altogether and self-refer to many psychological therapies (IAPT) services: go to the NHS choices Psychological therapies location search page to find a service near you that accepts self-referrals.
There’s a lot that you can do to improve the chances that you will get what you want from your GP:
- If you have a complicated problem (as mental health problems often are) it may be worthwhile trying to book a double appointment so the GP is less rushed than usual.
- Some people find it helpful to write a list of the difficulties they are experiencing as it can be difficult to remember things you wanted to say in the rush of an appointment.
- It is often useful to go with a friend or relative who knows you well, so that they can help you ensure that the story you want to tell gets told.
After talking to you, your GP may feel they need to get some advice from a specialist service about how best to proceed, in which case they will write to the appropriate specialist service asking them to get in touch with you.
In England, there are 2 main components to specialist mental health services which GPs are able to refer patients to:
- the “Improving Access to Psychological Therapies” (IAPT) services and
- community mental health teams (CMHT).
IAPT services are generally aimed towards people with “common mental health disorders” i.e. depression, anxiety, phobias and stress. Depending on the nature of your difficulties your GP may feel that referral to this service would be appropriate, particularly if you express an inclination towards talking therapies rather than medicines.
CMHTs tend to work with people more serious problems whose mental health problems may result in a risk to themselves (through suicide or self-harm) or risk to others. They also work with people with psychotic illnesses (i.e. illnesses associated with unusual ideas or hearing voices).
If you are seeking help for dental phobia related issues in England, then you would be referred to IAPT services.
Psychological Therapies (IAPT)
IAPT is a central government initiative which aims to make psychological therapies much more widely available than was previously the case (before 2008).
IAPT services offer a variety of psychological interventions, some conducted one-to-one, some in groups. Generally people start at the simpler types of intervention and proceed to more complex interventions, such as longer term therapy, if necessary. Typically, people receive 6-8 sessions of cognitive-behavioural therapy (CBT).
You can see what is available in your area by using the NHS Choices IAPT services search page.
If you feel that the person or the type of therapy you’ve been referred to isn’t working out for you, let your GP know asap so that an alternative can be found.
Services in Scotland, Wales, and Northern Ireland
In Scotland, Wales, and Northern Ireland, the process is similar to the above – you go to your GP to get a referral. The equivalent to IAPT in Scotland is called “Psychological Interventions and Therapies for Adult Mental Health” (PITAMH), but they have no search page for service users.
Seeing a therapist privately
If you don’t mind paying for treatment privately, you don’t need a referral.
Beware – in many countries, working as a therapist or counsellor is unregulated. This means that anyone can hang out a shingle and call themselves a therapist or counsellor. Your safest bet would be to see a qualified psychologist.
Which brand of psychologist?
Psychologists come in two basic flavours: clinical psychologists and counselling psychologists.
Clinical psychologists help with mental health problems, such as anxiety problems including panic and agoraphobia, OCD, specific phobias, post-traumatic stress disorder, and social phobia. Of course, they also help with other mental health conditions like depression.
Counselling psychologists focus on helping you resolve relationship, family or work issues, offer bereavement counselling, or can help with self-esteem issues – they help with “everyday” problems.
Which type of psychologist you choose depends on your specific issue. If you are looking for help with a mental health condition – including anxiety, panic disorder, emetophobia (fear of vomiting), or post-traumatic stress disorder – then a clinical psychologist may be best.
The British Psychological Society has a Directory of Chartered Psychologists which you can search online.
What other mental health professionals are there?
Psychiatrists are medical doctors who specialise in mental health. They generally use medication as their treatment method, because that is their area of specialty.
Other therapists and counsellors: It can be quite difficult for the layperson to figure out if a therapist is well-qualified. Sometimes, an impressive-sounding string of letters behind their name may mean nothing more than participation in a weekend course. You should not hesitate to change therapists if you feel you’re not making progress. Of course, there are great therapists out there who are not necessarily qualified psychologists. You should choose someone who is registered with a reputable body such as the British Association for Counselling and Psychotherapy (BACP). In order to qualify for registration with the BACP, a therapist has to have completed a recognised training course and have on-going supervision. The BACP also operates a code of ethics and a complaints procedure, so there is some protection for clients.
How do I know if the therapist is right for me?
If for some reason you don’t like the psychologist (or you feel you’re no longer making any progress), don’t hesitate to see someone else instead.
If you are paying for therapy yourself, it is generally a good idea to interview more than one psychologist or therapist on the phone or in person before making a final decision. Think about the kind of questions you may want to ask, for example, what experience the psychologist or therapist has with the type of problems you are experiencing.
Many thanks to Dr Andy Montgomery, MbBChir, PhD, MRCP, MRCPsych (General Medical Council registration number: 3616932 / Royal College of Psychiatrists: 13163) and to the Mental Health Forum for allowing us to use some of the information on this page.