To wonder how people afford counselling privately?

[MedianRange]

Counselling where I live starts at £40 per hour 50 minutes with some charging £50 or £60. Concessions for unwaged are minimum £35 per hour.

The average salary where I live is £19k.

How do people afford it??

I am unsure how much benefit people get if they are not working but I'm pretty sure they are unlikely to have £35 left over a month let alone each week or fortnight.

I'm also thinking that most people who would require counselling have had life issues that has probably impacted their earning potential.

But then if the counsellors get very few clients at these rates, it would make sense that they would charge less so I am honestly confused.

Any ideas anyone??

The thing is to say 'for people with severe difficulties' is speculative at best and who would 'judge' the need, where would be the cut off?

If people are hurting/worried/whatever it is real for them, disrupting of life and then they get told that their difficulty is not great that surely would create more worries/problems. It would be unfair and even dangerous to make that judgement.

So hard and agree lots of people wont need therapy, a good therapist will pinpiot the need, know what sort of therapy is needed be that CBT, DBT, humanistic, psychodynamic etc and work or signpost in the right direction.

MinceSpy the colleges don't offer the counselling themselves. Their diploma students are on placement with different organisations, usually charities like the one I chair.
In our case, we accept diploma students on placement after application and interviews. They then do a 20 hour bereavement and Loss course and have to pass that. They're then allocated a client. Our counsellors have to attend a minimum of 12 hours free training out of 28 offered during the year and group Supervision monthly. The organisation funds this.
Clients get the service for free but we welcome donations.
Our service is funded by the CCG - until next year at least. If people want better services it's their local CCG they need to lobby. Otherwise they are dependent on private services.
Kim you are self employed. You wouldn't offer your services free because they're not easy to afford. It's the CCG who need to be made aware of the needs of people in distress, not the counsellors ' fault for running a business.

Alibabsandthe40Musketeers The issue of NHS counselling being woefully underfunded is a different one. We should not, IMO, be expecting the private sector to pick up the slack by undercharging.

This.

I've had private counselling at a time when I really couldn't afford it but it was invaluable allowing me to work. I was very stressed by financing it ironically. It did focus me on making it very effective so I worked hard to get the most from it

It's not speculative. People are assessed. There is a clinical basis to a lot of therapy.

I'm not suggesting that all people don't work hard because it's free but when you can't afford it, you have to make it work in as fast a time as possible so it does change how you view it.

Sorry kim cross post there.

It's not expensive in comparison to other privately purchased health services. That is my point.

The issue here seems to be that some people think anyone should be entitled to fully funded, free counselling, whatever severity of their difficulties.

YABU for saying the average salary where you live is £19k - how would you know?

Because government statistics state this :)

And actually my income is higher than average and my outgoing are probably lower than average and its still not realistic for me. Yes I have always recognised that there are people with more income/resources than myself (and therefore can afford more expensive things). I just didn't appreciate there are enough people with that kind of spare money to keep the many therapists in my area busy at £40 - £60 an hour. Now I accept that.

None of the therapists I have looked at state that they offer a free first session, and although I could have initial e-mails/phone calls to get a first impression, it would be only when I went into my details more that I could gauge whether their approach/response would be helpful. To go into detail would only be appropriate within a session. So in theory I could spend £240-£300 just finding the right one if that makes sense.

BallsToThat I totally get where you are coming from and glad you have met a therapist who is helping you. What would your tips be about finding the right one? I have no-one who can make a recommendation so I would be approaching the therapists from a blank slate. Tbh, their profiles all seem to say a similar thing so no-one jumps out at me.

You could do some reading around the different counselling models and see if you can decide what might suit you.
Look for registration with a recognised professional society - BACP is the most common and most will have voluntary accreditation at least (a requirement from 2016)
Cross reference between web sites, counselling directory and BACP site. For example I have my own website and am on Counselling Directory but although my BACP registration and accreditation are searchable I don't pay to appear on their directory.

Oh and many counsellors use social media too. I have a Facebook business page and twitter profile as do many counsellors I know.

MedianRange I know that on this thread there are many stories of peoples' crap experiences with the NHS but I wanted to check that you had properly investigated what is available in your area. Do you have a local IAPT (improving access to psychological therapies service) in your area, (if you're in England you should have)? Most of these services offer counselling and cognitive behavioural therapy and many offer slightly longer (up to around 20 sessions) of other therapy models such as Interpersonal Therapy, Eye Movement Desensitisation and Reprocessing and Dynamic Interpersonal therapy. If you've investigated this and feel you've been fobbed off or offered something that isn't suitable then I'd urge you to try again, ask what they provide and push for what you think would suit you best from that menu of services. Good luck I hope you get the help you need.

I would like to see those government stats. And as I said, if it is median average earnings, half of people will earn more than that so in fact many people are likely to be able to afford private counselling. Anyway who says you have to go every week?

I negotiate with clients some if whom come fortnightly.

I agree it is not practical for all therapy to be funded by the NHS.

Also, I have read very positive stories about successful therapy but what about the unsuccessful? I daresay that having a 6/8 session limit may have actually made some people worse - opened up some wounds and left people hanging so to speak. When therapy is free some people have it even if its not really helpful (the clients just hope it will be).

There is a wide range of models and a client may not instinctively know which model would work best for them. There are even differences within them - one therapist's CBT may be different to another therapist's CBT for example so its not as easy as saying I need x model.

As with any profession, there are high and low quality. I have read many stories on the Internet where despite having registrations, qualifications and extensive experience, some therapists are not professional, e.g. have inappropriate boundaries, regularly cancel clients appointments, take calls whilst in session, break confidentiality etc. Obviously there is no way of knowing how common this is. Obviously clients are vulnerable and may continue with therapy despite these shortcomings; its not like they have anything to compare/contrast and they would have already invested their time/money/emotion. They may think its not helping because they are not working hard enough. If not then there's always other clients who have no knowledge of how they work before engaging with them. Because of confidentiality therapists can't show potential clients examples of their work.

Many therapists would also find it difficult to appreciate some people's difficulties, e.g. poverty. Most therapists I have looked at list a wide range of issues they can support with but I doubt they have extensive experience in all of them. And it doesn't necessarily follow that lots of experience = good and low experience = not so good.

Local therapy is a very small world in my experience. I'm not disputing the veracity of the negative stories but I don't know any counsellors in private practice who behave like that.
I have counselling friends spread wider geographically who don't behave like that either.

MedianRange you make lots of very valid points. I think often the most significant factor in whether therapy helps is the therapeutic alliance and there's no easy way of judging which therapist you'll have that with before meeting them. Whilst I take your point that the experience of say CBT could be very different when delivered by different therapists you can do a bit of research into the approaches on offer and see what you think would be the best fit for you. The examples you give about unethical practice, repeated cancellations, breaking confidentiality and taking calls in session are appalling, any of those actions warrants a formal complaint albeit I appreciate that's harder to do with a self employed therapist than one working within the NHS. Also with regards to the hypothetical 6/8 session limit for counselling I understand that for some people that will do more harm than good by opening up issues that can't be addressed in that time frame, NICE guidelines do recommend short term counselling but only for mild to moderate presentations, if your difficulties are more severe then I'd suggest you push for something longer, the NHS operates a stepped care model in most places where they will try and offer people the lowest appropriate intensity intervention however sometimes the appropriate bit gets lost and they try and funnel everyone through the shorter interventions regardless of whether that will meet their needs.

Trainee therapist and teacher here :)

Median you sound like you are unsure about the benefits of therapy. Why not put yourself on a waiting list with your gp or mind and go to some free or low cost sessions with an open mind and see how it goes? Research has shown many clients are happy with 7 sessions on average hence the time limited model. If you got time limited cbt for example on the nhs you could use it to work on a fear or phobia rather than trying to look at your whole life. Dipping a toe in could feel a bit safer and give you a clearer idea of whether you think counselling is for you.

I'm never going to earn as much as a counsellor as I do as a teacher but I find it far more rewarding. It has cost me far more to train as a counsellor than as a teacher and the placements are not comparable. I can see having to work for free for a couple of years to get enough hours to become accredited - never had to do that in teaching :)

YANBU. i live overseas and a session costs...wait for it....

129 quid.

needless to say, i haven't been very often.

Today's Sunday Times has several articles on this and indeed is behind a campaign for more NHS provision for mental health. i am an interloper on this thread as a lawyer who charges £240 an hour and thinks £100 an hour is cheap (in comparison) although of course all expensive things are hard to afford even on average pay whether that's a new car or massage or IVF. I never see anyone free for initial appointments but some lawyers do.

For those unable to pay anything do keep on at your GP as they do pay for some sessions (my father and brother were/are psychiatrists (not psychologists) and I have an interest in the area).

handbag's advice above is good. know my father always suggested patients should have pills plus therapy - the best combination and often referred people to qualified clinical (now chartered) psychologists and suggested they took up new hobbies outside (as fresh air, sun shine, moving, exercise never do most of us any harm unless people of course feel so dreadful even leaving the house is difficult).

The other thing I meant to say is whilst you may have found examples of people who have appropriate qualifications and registrations who behave in unprofessional ways I think you are so much better at going to a therapist who has these (or if you are seeing a trainee then one who is working under appropriate supervision arrangements). It really isn't the case that because there may be anecdotal evidence of poor practice by accredited therapists that accreditation counts for nothing. Counsellors should be accredited by the BACP, CBT therapists by the BABCP, psychologists by the HCPC. Accreditation is more important than qualifications as I think it's very hard for members of the public to judge whether a qualification is industry standard or micky mouse and also someone could have qualifications but have been stuck off for unprofessional practice, accredited practioners will have the appropriate qualifications anyway. Having said all of that I want to reiterate that therapists on the whole are compassionate and professional and work in this field because of a genuine desire to help others so please don't let negative stories on the internet deter you from seeking help.

Someone above posted about counselling being an investment in yourself and I agree with this. I have only just started and am paying the £50 per week from savings, after worrying about how I would finance it or whether to leave the savings for something else.

Mine is for anxiety, bereavement and relationship issues and I should have done it a few years ago, I think. I have just hit a point where I need to work through a number of issues. I don't know how long it will take and am fortunate to have the finances to do so.

I agree that there should be wider access to low-cost counselling, but the points made here by professionals about what the fees have to cover and the work involved in preparation etc have been very useful to read.

Of course private psychiatrists do it the other way round, and charge more for an initial assessment appointment than they do for subsequent ones

Does anyone else not think that it's a bit silly that they'll hand out so many anti-depressive drugs free on the nhs, which imo don't work except as a placebo (and I've seen various scientific reports to back that up), yet therapy and counselling which really could help is so limited?

Why shouldn't it be available on the nhs? The harm and abuse that leads to therapy needs are social failings, why shouldn't society pay for it? If it doesn't, those of us in need of it are in danger of perpetuating and exacerbating the problems, extending them through more circles.

The defensive (not a criticism btw, I know they're true) comments about the amount of unpaid work therapists have to do merely shows where the scale of the problem lies. Why do we ask all professionals to do this when their skills will benefit society?

I should be asking politicians these questions.

The fact is that sadly any provision the NHS offers for bereavement and relationships isn't likely to be adequate.
Most of my bereavement charity's referrals are from GPs and the average waiting time is 4-5 weeks for assessment. A bigger charity is commissioned for this I'm the next big city and AFAIK the waiting time is a lot longer.
Hence why people seeking help with these issues often have to do so privately. The NHS doesn't provide them directly because they're complex in an individual sense and outcomes are difficult to measure.