I read with interest This Life by Helen Waddell (19 September), and agree with her that a range of therapeutic options for people with particular mental health needs should be available alongside prescription drugs where appropriate. While I recognise the experiences Helen describes, I want to offer an alternative assessment of services I had when I required medication and therapy for clinical depression.

My alternative assessment may be due to a number of factors: that I accessed services in the mid 1980s; or that I had contact with a different group of professionals. My GP agreed to refer me to the clinical psychologist as well as prescribing anti-depressants. Although I had to wait for therapy, I didn't feel as if I had been abandoned to my symptoms, which didn't get worse while I was waiting.

The clinical psychologist, who was a talented and caring woman, assessed me and eventually we engaged in a productive client-centred relationship. Although she didn't always give me what I thought I needed (in terms of access to her) she always listened to me and offered me what Helen seems to have been denied: talking therapy over an extended period of time. Unlike Helen, I believe my drugs did work - they alleviated distressing symptoms when I was in crisis, while therapy helped me to cope.

Since then I have continued to manage my mental health and gone to a range of therapeutic groups, which I've paid to attend. I have also trained as a psychodrama psychotherapist - every year I run a therapy group for residents from a rehabilitation project who have misused drugs or alcohol and who are unlikely to have psychotherapy in the normal run of things. My experiences of helping those residents to access other therapeutic services have shown me how hard that is. Without such services it is difficult for people to continue the work they've started.

As Helen argues, choice is crucial if people are to use services that meet their specific needs. Without some sense of choice and voice, people requiring services are unlikely to feel empowered by systems or staff. There is always the thorny question of negotiating when client and staff assessments of what is needed differ, but the bigger issue, from my perspective, is the rise to dominance of particular therapeutic approaches, often due to attempts to offer services in organisations where budgets are limited and need endless.

The standardisation of therapy makes it less effective, yet the rise of "protocol therapy", which is rooted in the "managed care movement" and grounded in spurious notions of "evidence-based" effectiveness, dominates therapeutic service delivery. Until that changes, people will continue to have the sort of experiences Helen described rather than those I had.

Annie Huntington is a lecturer in the directorate of social work at the University of Salford.