Mental health professional associations in the UK are monetising. As a result, I believe that within 5 years, British-based practitioners will have to turbocharge their pricing. Also, privacy will take a huge hit and may vanish.
Spoiler: I'm not playing, so if you are my client, you will not be affected. However, I think I will be one of the exceptions.
Forewarned is forearmed. In this post I'll explain what's going on. My aim is to help you make informed decisions so you can secure therapy services while maintaining privacy and without paying a fortune.
Big Shock: Professional Associations Can Be Predatory
If you're not sure who's who, it makes sense to check if your therapist belongs to a professional association. You may even look first at the accredited members, thinking those must be the best qualified.
Those assumptions can be problematic.
Professional associations shout about their commitment to standards. However, they are businesses. As businesses, they have one objective: making money. This impacts on your privacy (and also on the fees you pay).
Here's how that works.
Professional associations make money by selling memberships and professional development content. The big ones also sell conferences and run journals that (surprise!) you pay to publish in.
But mental health professionals aren't super rich. It costs £20,000 to £50,000 for a Masters Degree, never mind the cost of the basic Degree. We're not keen to splash out more money.
|Al Capone in 1930|
As Al Capone once said, "'You can get much further with a kind word and a gun than you can with a kind word alone." Successful professional associations work on that principle, and they aim to have all the weapons.
In order to make us sign up, professional associations manoeuvre themselves into a position where they get to gatekeep the profession.
Professional associations try to trademark or control a title, like "counsellor". Others lobby politicians to pass laws so that mental health professionals can only work in schools or hospitals if they belong to their club. Clever ones do both!
In many countries you can pay for and complete a Degree and a Masters in Psychology or Counselling but be barred from working until you pay money to the local professional association.
Yup, we're just like the Mafia!
Professional Associations Monetise Through Accreditation
In addition, professional associations monetize membership ranks within the organization.
You can join up and get a basic membership. However, to get special badges and super listings in their advertising directories, you pay to be an accredited member.
This is where privacy comes in.
Mental health professionals who want that accredited badge, share their client notes and information with a supervisor – a fellow therapist – who then paid to check the work to make sure it's up to standard.
Typically, your client notes are emailed to the supervisor, with your name removed, and then your therapist and the supervisor have a long chat about your case.
I'm a privacy advocate, I know how ridiculously easy it is to identify people, especially if the client, therapist and supervisor are all in the same town, and so this whole supervision business gives me the icks.
But that's me. About half of my clients depend on privacy to stay safe, so for me this is a huge deal. I freely admit that when it comes to privacy, I wear a tinfoil hat.
Devastating Divisive SCoPed Initiative
In the past, qualified counsellors and psychotherapists joined UK professional associations as members, and a select few chose to be accredited.
However, many UK associations are now adopting SCoPed, a system that ranks membership by grades A/B/C and guess what? Your qualifications don't get you the super grade; you have to go for accreditation.
listings were announced a week or two ago, we found that the lady with a Masters and 11 years in
practice, and the bloke with the Masters and 24 years in practice, both also
contributors to literature, are listed as Column A which is for fresh grads with their first Diploma.
I'm Column A too. My basic Degree, first-class Masters, writing contributions and experience mean nothing to my associations. I'm ranked on the same level as Diploma fresh grads.
From the email, we can pay £230 for them to upgrade us to Columns B and C which is where the adults work. However, we can't get there unless we agree to become accredited members. Also, we have to pay the monthly fee to stay there.
SCoPEd effectively cancels our training. It means we can become qualified but we can't stay qualified. To stay qualified, we have to pay and pay and pay.
The Other Cost of Accreditation
Aside from privacy issues, eagle eyes will have noted that mention of fees 😊
Typical accreditation takes a minimum of 1.5 hours of supervision a month. At universities and some companies staff do swapsies, but if you're private like me, you have to pay full professional fees.
Accreditation costs run at £50 to £100 an hour and you have to pay 1.5 hours of supervision a month for basic accreditation.
Currently, I pay £300 a year for membership and conferences. If I were to junk my principles, my annual costs would go to £1200-£2100 a year.
Eye-watering, right? And these costs will be passed on to clients.
Predicting UK Therapy Services 2024 Onwards
There are numerous resignations and protests about SCoPEd, including this one by Michael Golding, a senior and well respected practitioner.
However, therapy is big business and big business attracts sharks. I believe the sharks are now in charge.
I think many UK practitioners will want to sit in columns B and C. They will pay to play because they'll be afraid they won't get any business if they're column A.
I believe therapy prices will skyrocket. Again, mine won't.
Also, as supervision will become standard, you will need to think more about privacy.
How To Discover How Confidential or Private Your Therapy Sessions Are
Discussions about privacy should take place
before you sign up. Therefore, before you decide if you're going to work with a
therapist, they should talk to you about the nuts and bolts of how sessions and
My first free chat takes 15-20 minutes and it's mostly about privacy.
If they don't have that first chat, here are the questions I would ask:
· What is your confidentiality policy?
· Under what circumstances do you break confidentiality? Also, who would you alert?
· How and where do you store my information?
· Who has access to my therapy records?
· Do you use case consultations or supervision? If yes, will you ask my permission first? Can I say no? If you insist, how is my identity protected? Who is the person you share this with? (in case you know the supervisor) How do they store my information? Who do they share my information with?
Also, here is a short list of green and red flags
Making Choices When You're Disempowered
If you go to a hospital, charity, or some big organization, you may find yourself in a position where your notes will be shared routinely without your knowledge or consent.
Maybe you don't have a choice beyond yes/no.
If that's so, here are some green flags that signal your therapist is a good egg.
- They talk about de-identification, including altering details about you like saying you're a gardener instead of a marketing professional, and they remove your birth date and place of birth.
- They tell you who the supervisor is, so that if you know them, you can warn them of the extra privacy issues.
- They give you a heads-up each and every time they share your information.
I'm sorry, it sucks. But I'm afraid that privacy in mental health is a serious problem, particularly in the West.
If you are cautious about privacy, don't assume that associations and practitioners share your concern. See past the presumption of touchy-feely goodness and remember that it is a business.
Tip Tip: a professional has academic training, practical training and experience. Check where we went to school and see how we are when you talk to us. Then make up your own mind.
And speaking of business, hire me.
- I'm sensible, super private, and I work online internationally.
- I work alone.
- I do all my own paperwork.
- I absolutely refuse to share any information about my clients.
- I keep all my client notes offline.
- I show you your client notes – or I won't take any if you prefer.
- I'm not paying all kinds of extra fees, so I'm nice and affordable.
While I am not keen on professional associations, I have various memberships because I love to learn.
My memberships are the bog-standard basic ones where they give me access to conferences, journals, and educational materials.
However, I'm column A and that's where I stay. Your privacy is my priority.