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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 http://www.bacp.co.uk/accreditation/).  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.

 

 

 

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FAQ

Will my Doctor/GP be told I’m in Counselling?

When we begin our assessment for counselling,  I will talk with you about confidentiality and what it means with respect to your privacy and law. 

I have strict rules that protect your confidentiality: that where the law does not over-ride me, I will not discuss our work with anyone (other than my obligatory clinical supervision).

This means that I will not inform your doctor/GP about your counselling as a matter of course.

 

Let’s highlight a couple of potential exceptions:-

  • If you wish me to write to your doctor/GP, we will discuss this in session before I agree to do so.
  • If your health (physical or mental) appears to warrant intervention from your doctor/GP, in rare circumstances I may request your permission to write to your doctor/GP, but we will discuss this in session before I take any action.

So, when you come to me for counselling I will not automatically inform your doctor that you are receiving therapy from me.

My counselling practice is independent of NHS primary care services.

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FAQ

Do I ask my Doctor/GP to refer me for Private Counselling?

No – you are not required to ask your doctor/GP to refer you to Dean Richardson for private counselling.

As a BACP Accredited counsellor/psychotherapist with his own private practice in Portsmouth (Hampshire) and via video conference through Skype, Dean is fully qualified and experienced to work with individuals, couples and groups.

Dean offers individual the following services:-

… all are in his private practice in Portsmouth & Southsea and online through the Internet via Skype video conference.

You can make your own appointment for counselling to discuss your options for counselling with Dean Richardson – you do not need to seek a referral by your GP (general practitioner / doctor) and your doctor is not automatically informed of any decision you make to enter counselling.

Dean is qualified to make his own judgements & recommendations to you on suitability for counselling through a process called the “counselling assessment”.  This assessment session is a 50 minute appointment for individuals (or individuals wishing to join a therapy group), and 4×50 minute sessions for couples. What you need from counselling will be discussed to help you identify the focus for counselling work before any counselling begins (although many find the assessment process therapeutic too).

If counselling may not be a suitable therapy for you (or your partner when considering couple relationship counselling) other options can be discussed including referrals to therapies and therapists who may be more appropriate for your needs.

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FAQ

Can I ask my Doctor/GP for Counselling?

Counselling can be made available to you on the NHS via your GP.

There is often “stepped” process involved – including a waiting list to begin treatment depending on your presenting issues.

An illustrative example would be:

  • Initially, your doctor may first ask you to come back again in a few weeks time to see if things are better.
  • If things don’t feel better then next you may next be given access to reading material – a form of self-guided self-help therapy.
  • If this doesn’t help you may be offered access to a computerised [tooltip text='Cognitive Behaviour Therapy (CBT) is a form of talking therapy that is focussed on helping a person change the ways they think, how they feel, and their behaviour, in a stepped process. CBT has a reputation for being a manualised treatment (patient is diagnosed and a matching treatment prescribed) which is how computer-based CBT treatments have been created.
    http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy'] CBT [/tooltip] treatment.  This may help you identify and deal with your problems through suggestions the computer may offer based upon your responses to questions.
  • If these “self-guided” therapies remain ineffective, a referral to a low-level  (trained & qualified) therapist may be the next step – involving a waiting list of several weeks or months.
  • If the low-level impact fails to help you, you may be referred to another therapist for further treatment.

Low-level impact treatments are cost effective to the NHS because of their being no need to train highly skilled therapists.

The initially-mild interventions offered to you should be overseen by a therapist who should have an initial qualification, adequate experience & appropriately supervised (i.e. newer (lower-cost) therapists are more commonly used early low-impact intervention stages of a patient’s NHS counselling).

You may later be offered a fixed number of sessions of face-to-face counselling if the previous therapeutic intervention didn’t work for you. You may be offered to meet with a more experienced psychotherapist or psychiatrist if the previous experiences of therapy are ineffective.

Why CBT/Stepped Process?

This NHS stepped process is partially due to costs and partially due to new procedures introduced called IAPT (read more).

CBT is a treatment that GP’s can understand – it principally works on a diagnoses/prescription modality, where several treatments can be normalised (i.e. the CBT therapist follows someone’s recommendations/instructions for treating a particular ailment).  Of course, one would not take a prescription from an unqualified GP, so one would not be prescribed a form of therapeutic treatment from an unqualified CBT therapist – but there are various levels of experience & qualifications.

IAPT originally only offered CBT (cognitive behavioural therapy).  Mild forms of CBT can be offered by minimally trained therapists using a form of manualised therapy (e.g. you may be diagnosed and a therapist may refer to a set of therapeutic interventions that are recommended for your form of diagnosis).

Whilst CBT can be effective for certain issues it is not a fix-everything therapy and not everyone likes to feel like they are responding to a manual-of-therapy.  If you can be helped by the processes then this will be beneficial – albeit that to get to the higher forms of treatment the previous experiences of treatment may have to have failed first.

Private Counselling – Your Choice of Treatment.

Unlike NHS Stepped-Treatment, private counselling with Dean Richardson begins with the FULL service.

There is no tiered/stepped process with Dean. You start immediately with full 50-minute weekly sessions working with Dean face to face.  No computers giving you questionnaires.  No books to read.

You and Dean will begin with an assessment session (meeting to talk about what you need from counselling, and discussing what counselling may and may not be able to help with).

You and Dean will meet weekly (usually the same day, same time, same location – which helps many people manage their commitments elsewhere).

With Dean’s assistance you might decide to discuss choose how many counselling sessions you wish to attend (such as brief/focal counselling) or you may with to work with Dean until the focus of the needs for counselling have been fully addressed.

No waiting lists – no maximum number of sessions.

It’s a very personal counselling service that aims to create a therapy that works for you and your needs.

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FAQ

How Long is a Counselling Session?

Length of a Counselling Session.

Counselling sessions with Dean Richardson – both individual & couple counselling – face-to-face or Skype sessions – last for 50 minutes and occur weekly.

Couple Counselling sessions have the option to be extended to 90 minutes (prearranged) weekly.

Because each appointment time is reserved exclusively for a particular client, if you arrive late for your appointment our time cannot be extended to make up the the time. Similarly, if you arrive early the session will still begin at your appointment time.

Unlike many GPs, you won’t be kept waiting for your appointment to begin.

Length of a Group Session.

Group therapy sessions with Dean Richardson last for 90 minutes and occur weekly.

Because the group start together, if you are late you may or may not be allowed to join (depending on what the group has previously agreed about late starting).  The group always ends at the agreed ending time – is not extended for any reason.