This is a question I get asked a lot and I thought a blog post may help. I should add a health warning - this is my opinion, and I am really aware other people may think about this differently.
First and foremost, I believe counselling and psychotherapy SHOULD be free at the point of use via NHS or Public Health services. This would allow everyone, regardless of financial means to access such a valuable service.
As part of this, therapists should be paid a fair rate of pay for the services they provide. Some people will argue this is unrealistic and that boundaries need to be put in place given this is public money.
As a result of public budgetary considerations, we have free services in the UK which are often limited in scope. The bar will sometimes be high to qualify for the service in the first place. If your problem is deemed mild or moderate, you may not be offered any service at all.
Services will then often place a limit on the number of sessions a person can access. Some services offer 6 sessions, others are more generous (generally it falls between 6 and 20 in my experience).
Some services will be online or on the telephone only, some will offer face to face sessions. You will often get no choice in the therapist you work with, or at most will be offered a choice of male or female.
Waiting lists are common in public counselling services. This will depend where you are in the country. There may also be a gap between your initial consultation and treatment.
The type of therapy you will receive is also very often non-negotiable. Whilst the NHS is using NICE guidelines to determine the type of therapy offered, the reality is that short term, less costly interventions are preferred. The current government scheme called IAPT (Improving Access to Psychological Therapies) dictates interventions that are largely CBT led (Cognitive Behavioural Therapy). Let's be clear here, whilst CBT has a fantastic evidence base, there is plenty of evidence to show other approaches can be just as effective.
In contrast, private therapy can be more flexible.
Firstly, there will be a therapist for you and very often you can choose someone who has a niche that meets your requirements. You can browse numerous practitioners' websites or online profiles, and you can find someone who you think might be a good fit. You can use sites such as Counselling Directory, Psychology Today, UKCP, NCPS or BACP to locate the right therapist for you.
However, one thing I am aware of is that often successful therapists are full, and may themselves offer a waiting list. Good therapists will offer potential clients a recommendation to an alternative practitioner in these circumstances. I believe that getting the right therapist for you is essential. The strength of the therapeutic relationship can offer the best chance of change, so don't be afraid to make enquiries of a few different therapists.
Being in the driving seat, you can also choose a therapeutic approach that suits you - you are not necessarily restricted to CBT. I offer a mixture of Transactional Analysis (TA) which sits alongside Neuro Linguistic Programming (NLP). These are also combined with a modicum of common sense, experience and improvisation!
There is not usually a limit on the number of sessions you can have with a private therapist. Some choose to work with a limit, but most are happy to continue for as long as you need. Many people value longer term therapy, and I leave this as a matter for the client's autonomy. My rule of thumb is 'you can continue for as long as you believe you are receiving value for money.'
You can also choose a therapist who is happy to work in a way that suits you, face to face, online or a combination of both. I find that most people get the most from face to face sessions, although I have also worked very successfully with clients online. I prefer not to work on the telephone, as I think so much information is missed without the visual cues and body language.
Cost, of course, is a factor with private therapy. This often varies geographically and can range from £40-£150 per session. I personally believe that therapy having a cost often leads to clients wanting to get the most value for their money, and they engage much more with the process. I should say that price may not reflect how good a therapist is.
Make sure you ask a potential therapist some key questions, to see if they are the right person for you:
Are you insured to practice?
Have you completed a supervised placement to get your counselling qualification?
What ethical codes do you choose to follow?
Are you a member of any professional organisations, and are you accredited?
What would you approach be to help me?
Is your work supervised regularly?
Note that these questions will not always give you a true picture. Trust your gut. The main question to ask yourself is 'do I think we will work well together?'
If you have any further questions, I am happy to anser them. Drop me an email or use the contact details on the website.
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