NATALIJA HAYTERPSYCHOTHERAPY & COUNSELLINGStarting therapy
You do not need a polished explanation, a diagnosis or a crisis before asking for help.
Do I need a diagnosis or to be in crisis before starting therapy?
No. People often come because they feel stuck, low, anxious, burnt out or caught in difficult relationship patterns, even without a diagnosis or crisis. You do not need to wait until things become unbearable. The initial assessment is a chance to discuss what is happening and whether therapy may help.
What happens in the first session?
The first meeting is a 50-minute, £100 online assessment. It is an unhurried conversation about what brings you to therapy, what you would like to change and what kind of support may fit. You can ask questions and there is no obligation to continue.
What if I do not know what to say, or I freeze up?
That is very common and you do not need to prepare a polished account. Saying “I don’t know where to start” is enough. Natalija can help give the conversation structure, and silence can be part of the work rather than a failure to perform.
Will I have to talk about my childhood?
Only where it seems relevant and at a pace that feels manageable. Psychoanalytic and relational work may pay more attention to early experiences than CBT, but the purpose is to understand present patterns, not to force you into material you are not ready to explore.
How long does therapy take?
It depends on what you are working on and what you want from therapy. Some people benefit from focused work over a few months; others choose longer-term work. Goals, progress and the pace of therapy are reviewed together.
Approach and outcomes
The approach is chosen collaboratively and can be reviewed as the work develops.
Does therapy actually work?
Therapy can help many people, but no ethical therapist can guarantee a particular result. CBT has a strong evidence base for difficulties including anxiety and depression. Psychoanalytic and relational work can help people understand longer-standing emotional and relationship patterns. Across approaches, collaboration, clear goals, regular review and the quality of the therapeutic relationship all matter.
What is the difference between the approaches you use?
CBT focuses on thoughts and behaviours that may be maintaining a difficulty in the present and is often more structured and goal-focused. Psychoanalytic and relational therapy explores how emotional and relationship patterns developed and how they continue to operate. You do not need to choose in advance: the initial assessment helps identify a suitable starting point, and the balance can change over time.
Is it normal to feel worse before feeling better?
Some people feel temporarily more unsettled when difficult experiences come into focus. Feeling persistently worse, less safe or unable to cope should not simply be accepted as part of therapy. Tell Natalija so that the pace, approach and support plan can be reviewed. Use urgent services rather than waiting for a session if there is an immediate risk to safety.
What if I start and feel that therapy is not helping?
Please say so. Therapy should allow an honest conversation about what is and is not useful. Goals, pace or approach can be adjusted; a different service can be considered; or you can stop. The usual 48-hour cancellation terms still apply to appointments already booked.
Online sessions and practical questions
Clear arrangements help online therapy feel private, predictable and easy to attend.
How does online therapy compare with in-person therapy?
Online therapy can be effective for many common difficulties when it is clinically appropriate, and it can make regular attendance easier by removing travel. It is not the right format for every person or situation. Suitability depends on your needs, privacy, location and level of risk, and is discussed before ongoing work begins.
Is everything I say confidential?
Sessions are confidential within the usual professional, legal and safeguarding limits. Those limits, record keeping and practical steps for privacy during online sessions are explained clearly at the start.
How much does therapy cost?
The 50-minute initial online assessment is £100. Individual online sessions are £90, and couples or family sessions are £100. Cancellations within 48 hours are charged in full because the time has been reserved.
Do you accept health insurance?
The practice is recognised by several major insurers, including Bupa, AXA, Aviva and Vitality. Cover, excesses, session limits and cross-border reimbursement depend on your provider, policy and location, so please confirm authorisation directly with your insurer. Self-funding clients are welcome.
Can I have therapy in a language other than English?
Yes. Online sessions are available in English, Latvian and Russian.
Boundaries and urgent support
It is important to know what the practice can provide—and what to do when urgent help is needed.
What happens if I need support between sessions or I am in crisis?
Email and WhatsApp can be used for practical messages or brief, non-urgent contact, but they are not monitored continuously and this practice is not a crisis service. If you or someone else is in immediate danger, call local emergency services or go to the nearest emergency department. In the UK, call 999 for an immediate danger, call NHS 111 and select the mental health option for urgent help, or call Samaritans free on 116 123. Outside the UK, use the emergency or crisis service where you are.
Can couples or family sessions be mixed with individual work?
When therapy begins with a couple or family, Natalija will usually continue seeing them as a unit. This helps preserve neutrality and keeps the shared space open for honest dialogue. If separate individual therapy is needed, the boundaries are discussed in advance and a different therapist may be recommended.