People often spend a long time deciding whether to start therapy. Months, sometimes years. The hesitation is rarely about money or scheduling, though those reasons get used as cover. More often it is a quieter set of questions: am I bad enough to need this, am I making too much of it, will the therapist think I am being dramatic, can I sort this out on my own, what if it does not work. These questions are reasonable. They are also, in my experience, almost never resolved by more thinking. The most reliable way to answer them is to have a conversation with someone who does the work, which is what a free consultation is for. Before that conversation, though, there are a few things worth considering.

The thresholds that genuinely matter

The clinical thresholds for diagnosable conditions exist for good reasons, but they are not the only useful threshold for thinking about therapy. The thresholds I find more useful in practice are about impact rather than intensity.

The first is whether the difficulty is interfering with the things you actually want to do. If anxiety is making you turn down work opportunities, or low mood is shrinking your social life, or perfectionism is keeping you from finishing things you care about, the difficulty has crossed a threshold worth taking seriously. The intensity might still be moderate, but the cost is real.

The second is whether the difficulty has become a stable feature rather than a passing state. A bad week is a bad week. A bad three months that is not getting better, despite the things you have already tried, is something different. The pattern matters more than the worst day.

The third is whether the strategies you would normally use are still working. Most people have a small toolkit they use for managing ordinary stress — exercise, sleep, certain people they talk to, certain things they do to recover. If those tools are still doing their job, the difficulty is probably within the range of normal life. If those tools have stopped working, or if you have noticed yourself using them more without getting the same effect, that change is worth paying attention to.

If any of these thresholds describe what is happening for you, therapy is the kind of intervention that is likely to help, regardless of whether you would meet criteria for any specific diagnosis. You do not need to be unable to function in order to benefit from structured help.

“Other people have it worse”

The single most common reason people give themselves for not starting therapy is that other people have it worse. Variations include: friends with more serious problems, news stories about genuine catastrophes, the conviction that what you are dealing with is small in the grand scheme. This argument is offered to me regularly in early sessions, and I find it worth pushing back on directly.

The question is not how your difficulty compares to other people’s. It is how your difficulty compares to your own ordinary functioning. If something is making your life noticeably harder than it would otherwise be, that is sufficient reason to address it. The fact that other difficulties exist in the world does not make yours less real, and the absence of starvation in your life is not a reason to live with insomnia.

The “I should be able to do this on my own” version

A close second is the belief that you should be able to handle this on your own. Sometimes this comes from a personal value about self-reliance. Sometimes it comes from a family culture in which getting help was framed as failure. Sometimes it is a more diffuse sense that needing therapy is somehow a character flaw.

The most useful response is not to argue with the belief but to examine it carefully. Would you apply the same logic to a physical problem? Would you refuse to go to a physiotherapist for a back injury because you should be able to fix it yourself? Would you decline to see a dentist because needing one was a sign of weakness? The answer in most cases is no. The application of a different standard to the mental side is usually a holdover from older cultural assumptions that have not held up well to scrutiny.

The second thing worth saying is that working with a therapist is not the opposite of doing the work yourself. The work is still yours to do. The therapist is the structured support around the work — someone who knows the territory, has a clear method, and can help you make sense of what you are experiencing. If you are unfamiliar with what that actually involves, how CBT works explains the method in plain terms. This is closer to working with a coach or a tutor than to having someone fix something for you.

What therapy is not

Therapy is not a place where someone tells you how to live. Most CBT therapists, including me, will not give you direct advice about your relationships, your career, or your major life decisions. That is not what we are good at, and it is not what you actually need. What we are good at is helping you make sense of your own thinking and your own behaviour, and developing tools that you can use to make better decisions on your own.

Therapy is also not, despite some of the imagery, mostly about your childhood. CBT in particular is much more focused on what is maintaining a difficulty now than on where it came from originally. Your history is relevant, and we will discuss it when it matters, but the work is largely about the present and the immediate future.

Therapy is not something that should drag on indefinitely. Most CBT courses are between six and twenty sessions, depending on the difficulty. The aim is for you to leave with a clearer understanding of your patterns and the practical skills to work with them, not to be in therapy permanently.

What a free consultation is for

If you are still uncertain after reading the above, the consultation is the right next step. Fifteen minutes, no charge, no commitment. The purpose is to give you a sense of what working together would actually be like, to talk through what you are dealing with, and to figure out whether CBT is the right approach for what you are experiencing. Sometimes the answer at the end of the consultation is yes, let’s book in. Sometimes it is no, this is not quite the right fit, and here is what would be a better starting point. Both of those answers are useful.

You do not need to know exactly what to say in the consultation. You do not need a polished version of your difficulty. You can arrive with a half-formed sense that something is not quite right, and we will work it out together.

When therapy is not the right next step

In a small number of cases, the right next step is something other than therapy. If you are in immediate crisis — actively suicidal, unable to keep yourself safe, in the middle of a severe mental health emergency — therapy is not the appropriate first port of call. The right contact is your GP, NHS 24 on 111, or A&E, depending on the urgency. If your difficulty is primarily about grief in the first six months after a significant loss, structured CBT may not be the best first step (though it can become useful later). If you are dealing with active addiction, specialist substance services are usually the right starting point. None of these mean CBT cannot help you — they mean it should not be the first thing on the list.

If you are reading this article and recognising the patterns it is describing, the answer to the question in the title is probably yes. A free consultation is the simplest way to find out.