About Counselling

Why I charge the full fee for DNA’d sessions.

Different therapists will each have a different rationale for their counselling session fees, and what they do when a client does not appear for an arranged session,

With respect to a client not appearing for a session with me (giving no warning): I charge the full fee for that session (and charge a half-fee for sessions cancelled with notice).  This arrangement is put in writing at the beginning of the clinical work so that the client is informed.

Now, you may think that the absent client aught not to pay for a session that they do not/could not attend.   After all, the client was not actually there for that session.

But… I was still there for the session… the whole of it… and I stayed there with the absent client

Read on for a more full rationale that informs my approach for missed/DNA sessions…

Paying the full fee for sessions not attended.

In a client’s absence, I will still be working during the session:-

  • I will sit in the room with the client’s empty chair.

     Sometimes a cigar is just a cigar.

…apparently Sigmund Freud said this… but other sources say he didn’t 😉

What this phrase means that sometimes therapists who work with the unconscious may interpret evidence… when actually the interpretation is a bit of a miss and a literal understanding may be more appropriate.

Freud’s attributed quotation, above, is referring to how the cigar may be interpreted to represent (say) a penis. Sometimes this interpretation may be accurate (the man who always takes out a very large cigar from the box may be compensating for the small penis… or whatever the “penis” represents for him: lack power, potency, etc.) and sometimes the interpretation may not be accurate (the man simply likes large cigars).

So, baring this in mind…


  • I will contemplate my responses to the client’s absence (otherwise called “counter-transference”).

As human beings, we often effect other human beings.

Something we might say something like “he made me so angry” – and what we mean by putting it this way is that one person effected anger in the other.

It works a little bit like a dance (an actual one… two… three… physical dance): if you pull me towards you then I’ll feel that pull; your action resulted in my reaction.

It’s similar with emotions.

If I sit there and contemplate my emotions around the client’s absence (my “reaction”), this might help me understand what might be the client’s part in the dance (the client’s “action”).

Do I feel angry at this absence? Abandoned?

Am I feeling relieved? Was this following a difficult session?

Am I puzzled? Was I expecting this?

This pondering about my emotions can help me begin to appreciate maybe what the client’s “pull” on me may be asking of me… begging me… to understand. Something that, maybe, the client’s conscious mind cannot tell me.


  • I will ponder about what the absence might be (called unconscious communication).

Sometimes a DNA (“Did Not Attend”) might be about communicating something that could not be said in words.

Thinking this over can assist me in understanding a little about what might be happening for the client unconsciously (e.g. something that the client cannot put to me verbally, or if the client might be acting something out that wishes to be understood by someone).

Maybe the client became angry with something I said in the last session, but the client can’t tell me.

Maybe the client and I are going at a pace that’s too much for the client, but the client hasn’t been able to say “I want to slow down”.


  • I will look over my case notes.

It can be useful to read my notes from the day we started up to today’s session. Maybe there’s something I’ve not seen or have not been looking at since it appeared on the first day.

Perhaps the day of the absence is significant: could be an anniversary that’s important to the client, for example.

Maybe there’s a pattern forming with the client’s absence that the client and I have not paid attention to before.

  • From time to time, I’ll check my email & telephone messages…

… to see if the client has left a message for me about their absence or late arrival. Sometimes a cigar…


What I won’t do during a client’s session time…

  • I won’t telephone the client / chase them up.

Unlike some other therapists, I won’t telephone the client asking them where they are.

Behind my rationale for this is

(1) It’s likely that both of us already know that they’re not here.

(2) It’s true that the client might have forgotten about the session – but telephoning them during the session time isn’t going to change that.

(3) I believe telephoning during a session time can risk being quite persecutory or shaming.  It also breaks a boundary (that during this time we work in the room together). Telephoning goes contrary to my approach to unconscious communication (if a part of the client is needed to tell me something important by an absence, my approach is to understand/respond to the communication, not react to it).


  • I won’t email you/write a letter to the client.

 … for similar reasons to the item above.  I may draft some thoughts for inclusion in an email or a letter as part of trying to understand an absence, but I will leave the writing/sending to after the session.

So, in short, whilst you might not be present for your session, your session is still happening in your absence, and I’m still working for you.

Boundaries help us identify conversations to be had.

Setting boundaries help us – the client and I – to identify when a boundary has been stepped over.  Without boundaries being there, we cannot know when a boundary has been transgressed.

Transgressions are an invitation to conversation.

Whilst I may say that “if you miss a session without giving notice, I will charge for that session”, I’m also saying that this is open to a conversation too.

There will be exceptions to boundaries – and we can talk about those as they happen.

Boundaries aren’t meant to punish (although some of our childhood experiences will tell a different story); in counselling they’re there for safety, for containment and to help the counselling work.

Clearly, I may never receive the session fee for a client who has abandoned the work. If the client has left our counselling relationship they will have their own views and perspective about their absence, and we can’t talk about it of course (the client won’t be coming to see me any longer). So even through the client got a full session in their absence, I will be at a financial deficit and may well have to absorb that loss (rather than repeated chase up for it). It’s my position that containing this “loss” is an appropriate approach.

Reading Bion and Winnicott are helpful authors for a more detailed resource for my approach who are interested in learning more.

About Counselling Blog

Why are some Counsellors Charging Surprisingly Low Fees?

Unlike NHS counselling (which may be limited to just a few sessions, can only be accessed by visiting your GP, and may not be available until after a long waiting list) private therapy such as counselling isn’t limited to a set number of sessions (so it doesn’t cease mid-therapy), you don’t have to be referred by your GP (your GP doesn’t even have to know you’re visiting a counsellor if you want to keep matters private) and is usually available on-demand (no long waiting lists).

Private counselling also costs you a fee (actually, NHS counselling costs you a fee too but you pay for the fee through your National Insurance tax).

For some on a restricted income, it may seem as if private counselling may be a struggle to afford – but many (responsible) private-practice counsellors, such as Dean Richardson, will cater for this situation; some offer low fees across the board and some (like Dean) will offer to negotiate with you to find a rate that you can responsibly afford.

Because it’s ethical to assist the public in making an informed decision about which counsellor to choose, this article discusses some of the perfectly legitimate reasons for counsellors who charge much lower fees than other counsellors in your area.

Counsellors offering Low Rates.

Some counsellors offer cheap session fees because:-

  • The counsellor may not yet be qualified or is inexperienced. Sometimes we call a pre-qualified counsellor a “counsellor-in-training”.  The counsellor is working towards receiving their first qualification and is meeting regularly (eg weekly) with a supervisor whilst they are attending their training in counselling*.
  • The counsellor may have a qualification in another form of counselling, and they may be re-training in a new (to them) form of therapy … which is the counselling that you’re thinking about buying from them*.
  • The counsellor may require 450 practice-hours to apply for professional accreditation. Professional bodies (like the British Association for Counselling & Psychotherapy) have an application procedure that proves a counsellor’s competency (see  Counsellors working towards having sufficient hours within the set period (i.e. >=3 years <=6 years) may be offering lower fees to attract clients.
  • The counsellor may be working through a charity (which is funding the sessions with your counsellor).
  • The counsellor has no qualifications (and is not investing in any training nor ongoing competency).  The person isn’t a member of a professional body and is not attending regular monthly supervision. IN REALITY, there is no UK law preventing people from saying that they are a counsellor (“Counsellor” is not a protected title) , but it’s highly unethical practice. It would be wise to ask your counsellor about his qualifications during your first meeting (and judge for yourself how you feel about his response).

* In the training category, counsellors are usually required to obtain a number of practice hours before a qualification is awarded (eg 100 hours within two years). Offering cheap counselling rates may be one way an unqualified / in-training counsellor can get sufficient clients.

Working towards qualification or accreditation is an ethical way for a counsellor to improve their practice – and a low fee does not necessarily reflect on the quality or competency of the counsellor’s skills.

It can be helpful for you to ask the counsellor: “What is your qualification to practice counselling” or “Are you still in training?” and judge the answer for yourself.


Other counsellors may offer cheap rates because:

  • The counsellor may be just starting out in private practice, and has no (or very few) clients – they are trying to build up their practice and/or may be in competition with other more established / more experienced therapists in the area.
  • The counsellor is inexperienced in business, marketing or promoting their therapy service, believing that the only way to attract clients is by offering a low fee (counselling training doesn’t provide businesses training).
  • The counsellor may struggle with their own self-worth: often counselling training courses encourage counsellors to be humble and to focus on their humility. This can give the impression that counsellors are very kind, or even weak, but the training approach is to help counsellors show empathy and avoid being “too powerful” in their approach, particularly to sensitive situations (eg rape, abuse, addiction).  This can sometimes have an adverse effect on how ow the counsellor views their own “value” or “self-worth”; and this may be reflected in their struggle to charge anything but a very low fee for their services.
  • The counsellor may have been sanctioned by their professional body (eg the British Association for Counselling & Psychotherapy) and may require a number of supervised practice hours before they can re-apply for their accreditation status again.

It can be helpful for you to ask the counsellor: “Why are your fees so low” and judge for yourself how you feel about their response.

Compare Dean Richardson’s Approach to Lower Fees.

Dean Richardson Registered Member MNCS(Accredited Registrant) originally trained in a counselling charity which was offering a BACP Accredited diploma in counselling.

The charity did not turn people away from individual counselling due to not being able to afford it (though couple counselling, when introduced, had a minimum rate).  Clients were invited to offer their own a rate-per-session.

A significant number of people struggle to value themselves, though, and this can be reflected in the rate they offer for counselling (e.g. thoughts might include: “I don’t think of myself very much, so I don’t see why I would pay a much money for counselling”).

Dean learned a valuable lesson in discussing money with clients – to discuss a fee that the client can responsibly afford.

He continues this approach today in his private counselling practice. Whilst he has standard fees for each of his counselling services, he also have a number of places where he will discuss what a client can responsibly afford to pay for weekly counselling – to those whose income prevents them from accessing private counselling.

Click to to read more about How to Discuss a Lower Fee for Counselling with Dean Richardson.

When Finances change During Counselling.

Sometimes a client’s finances change during counselling.  Some clients choose to end their counselling without working towards the end. Others find ways to discuss with Dean how to renegotiate payments.

Discussing the fee might include:-

  • Reducing the weekly payment and keeping a tally of what is owed. The owed money are paid off weekly after counselling has finished until the amount is paid in full.
  • Renegotiating the fee to a level that the client can responsibly afford (and discussing this again when the financial situation improves).
  • Rarely, it may be appropriate to change the frequency of sessions (eg from weekly to fortnightly) but this isn’t like “taking the week off” and this change in approach will need to be carefully discussed.





NHS Waiting Times for Counselling

A recent report from the We Need to Talk coalition shows that half of the people waiting for counselling & psychotherapy on the NHS are having to wait for more than three months before their first session.

Even worse, one in ten of these people are waiting for a year or longer before their first session.

The coalition of mental health organisations: ‘We Need to Talk’ is campaigning for faster access to NHS Talking Treatments. You can read their findings in this PDF of their survey here.

With concerning information like this, it can be helpful to know that many private counsellors like Dean Richardson offer affordable private counselling to those on a limited income.

Whilst your counselling will not be free, you may be surprised about how affordable arranging a unique fee with Dean can be.

It won’t cost you anything to make contact today to ask about counselling… and until 31st January 2014 the first counselling session with Dean Richardson will be free of charge.


What does Counselling Cost?

Different therapists charge different rates for different forms of counselling, psychotherapy and other therapies.

Dean Richardson has broken down his fee structure so that you only pay for the counselling/psychotherapy service you need.

All fees have two parts: a standard fee (what the general member of public will be invited to pay) and a sliding scale (what a person with limited income can be invited to consider paying).

Click to read more about Dean’s costs for counselling.