What would you expect and want if you went to see a private clinical psychologist?

[Buccabucca]

Hi, I hope it is OK to post here. I am a clinical psychologist who is considering starting a private practice. I am just trying to scope what people may want, need, expect if they were to see a psychologist privately. I currently work in the NHS and see many clients there so I have knowledge of what people may expect from a service but I'm just wondering if there is anything different if you went private?

For example, waiting times are an issue in the NHS in addition to the length of time you may be seen for. Would you say that's fair to say? Anything else that is important for you in choosing to go private? Eg, where you're seen, what the therapist is like, what interventions are offered etc?

Many thanks for your feedback, it's to help me consider all the things that are important when setting up a practice and hopefully give people the best help possible.

I've had private counselling and NHS psychotherapy. With the former I expected more flexibility with appointments, evening appointments - these were offered as a matter of course. I also didn't have to wait long to see them.

Help with filing insurance claims. Appointments pretty much when I needed them, rather than a long wait, longer appointments (for a while I had 2 hour appointments every week), and honestly someone who was a "better" therapist / psychologist than I found in the NHS.

Maybe it was just me but both my private therapists were much more effective and responsive than anyone I saw on the NHS.

Thanks for the replies so far. Can i ask, Jen- how long did you have to wait privately? Hearts- can you pinpoint what made the private therapist 'better?'

I've had extensive psychotherapy with a consultant clinical psychologist on the nhs.

Privately I think I'd like shorter waiting times (though my waiting time was only a few weeks as I was very unwell) and possibility of emergency phone consultations if needed. Have to say the 2+ years of therapy I had was second to none.

i didn't really like my appointments with the psychiatrist, i preferred to work with a counsellor. now i work in counselling myself. the main problem i felt was that they didn't give you very much time, and they were focused on medication, with more of just a 'chat' about any other aspects in your life. i would have liked to see more help strategies discussed rather than just basically going in, telling them what was happening, and them deciding what to do about my medication. good luck :)

Had private counselling, not psychology.

Clear and transparent pricing is helpful.

My private counsellor offered a few later slots for working people, most helpful and choice of 2 locations.

Very clear from the start about whether any contact in between sessions, and what that involves.

I did not mind waiting, as private waits were shorter than NHS. The better ones I found were usually busy anyway!

I would love the option of private psychology, as the only real help that I have had were the few sessions with a great NHS psychologist. But the sessions with the not so helpful psychologist were not helpful - so I think the relationship and the type of treatments offered make all the difference not just the qualification. In the NHS no choice of type of intervention - for me the psychodynamic model did not work but that is all the person did!! So if you work one particular way, worth advertising this and ensuring it suits the clients.

Can I ask some more questions if that's ok?

How much were you charged per session and did you think that was reasonable? And how did you find your private therapist? Eg, gp referral, self referral via advertising, word of mouth (and where was it advertised)

Just bumping for any more replies, thanks!

I'm having therapy with an NHS clinical psychologist. I can't remember how long I was on the waiting list for, but it was in terms of months rather than weeks, which I'm sure would be shorter in the private sector. I was seen for a block of 16 sessions, although that's been extended.

Other issues with the way NHS therapy is offered (haven't had private therapy so can't compare, but others who have tell me it is much better):

• I can't email the psych but I have problems with making/receiving phone calls, so communication is difficult! And the psych is often in sessions, but the receptionist doesn't have his diary in the office, so I can't rearrange appointments with her. Often it ends up with him sending me a new appointment by post, which I end up having to cancel by leaving a phone message, but not being able to rearrange a new one at the same time. My CMHT has a policy that no emails can be sent between any staff and patients.
• The local CMHT centre is a pretty depressing venue. The actual counselling room is just plain but the reception is behind glass (because they do get violent patients) and you have to ring the buzzer to be let in/to exit. And the reading material is quite depressing, lots of very low level help groups (gardening/cooking groups), welfare advice, free papers.
• I've had other therapy on the NHS before, I saw one therapist for two years on a weekly basis. So not all of it is short term. But she refused to tell me her previous experience or training/ethos, when I asked she just turned the question back on me and questioned my need to know. I thought that was quite condescending. When I asked for my medical notes (which I regularly request from all sorts of authorities) she took it very personally and seemed offended that I was delving into her personal notes about me.

-I was a single parent when getting counselling but was offered appointments at 9am, and told that I seemed to be avoiding therapy because it's virtually impossible for a single parent to travel to an appointment an hour away from their child's primary school!

• when I asked my therapist to complete a section on my DLA claim form (with factual information), they spent a full session querying why I was using my mental illness as an excuse not to work (despite the fact that DLA is not an out of work benefit).
• I once asked my therapist in the past to intervene with an issue with my housing provider which was directly related to my MH. She did call them but very reluctantly and didn't really make an effort to explain how the issue was related to my MH or to use her authority as a professional. I would expect a professional working with a vulnerable client to support them appropriately, especially when there are procedures that she could have followed, but perhaps didn't want to do the extra work, or felt that I was deliberately making the situation worse myself.
• I've had friends who have really rated their private counsellors, tell me they have phoned them in a crisis, had tearful but insightful sessions, been able to tell them things that they've told no one else. I don't think I relate to any of that, I just don't seem to have developed a relationship with any therapist I've had and the idea of crying in a session or them being the first people to call is a strange one to me. Although I'm not sure that's the kind of relationship I'd like, I do like things to be kept professional.

I found my private counsellor by recommendation by someone who realised how much distress I was in. They phoned their old counsellor who knew someone nearer where I lived. I would also look at websites. I think having a web page is helpful, with key details on: specialisms, models of working ( can you offer EMDR, ACT, CFT, psychodynamic etc etc), your code of ethics, your usual working practice ( length of sessions, do you do short term or longer term work, individuals, couple, family therapy), length of a session, membership of professional organisations and anything else relevant.

I have paid between 30-50 for a psychotherapist.

ah yes sorry i wasn't reading the thread properly and thought you had said psychiatrist...apologies!

the main problem with the NHS counsellors i had was that they were too directive, CBT CBT CBT thats all they cared about, didn't matter what had gone on in my past they didn't even ask or want to listen. being flexible and adaptable in your approach will be very good.