"Why Is Therapy So Expensive? And Do Your Bargain Rates Mean You Suck?" "Why Is Therapy So Expensive? And Do Your Bargain Rates Mean You Suck?" Breaking down therapy costs and how to figure out whether you are getting quality service for your money.

Therapy is wildly unregulated in most places. There are people who work for free or very low fees and others who charge a fortune.

We’re all careful with money, right? So you would be sensible to ask, why pay for therapy at all?

#1 Expertise Takes Training = Expensive. I’m a level 7 registered counsellor and psychotherapist, which is about the highest you can go; only a PhD is higher at a level 8.

My training consists of a Bachelor's degree, and a Master's degree. Aside from the classes, the Master’s degree included over 1,000 hours of unpaid internships, including 300 hours of therapy work supervised by other level 7s.

The training takes 6 to 7 years, and it costs a fortune. Part of the fees you pay goes to recoup my investment in my training. I also need to eat!

The upside for you is this: quality. 

Many charities and services offer mental health services but don't actually have anyone who is properly trained. As most countries allow anyone to practice, terms like 'our trained therapists' may mean someone who's read a book or taken a weekend course.  

Of course, some of these people can be very helpful some of the time! But there's also a dangerous downside. As they aren't trained, they will have trouble identifying issues and identifying evidence based best practice approaches.

Think of it in terms of plumbing. If you want to change a tap, you might be okay with a mate who has a spanner and who can read an instruction pamphlet. But would you let them install a new bathroom? Probably not.

I’m a quality plumber. The kind you trust to put in the bathroom complete with jacuzzi bath and fancy sink.  

#2 There’s Prep. You talk for an hour and stop. I put the notes together, invoice, and before we talk next time, I read the notes and prep. It takes time.

There’s other admin that comes with running a business, like doing my taxes, keeping my professional paperwork going and more, so your fees also contribute to paying for those overheads.

My professional memberships alone cost me £350 year, so the first 100 hours I work I don’t see a penny. I could drop them, but then it makes connecting with new clients harder.

#3 Training Never Stops. Every job involves constant learning but psychology is particularly intensive.

I do constant journal sweeps as well as reading new publications, attending lectures, and taking short courses. It costs money to stay current.

OK, So Why Are You Cheaper Than Your Peers?

Level 7s typically charge £70 to £100 for 50 minutes so I could charge a lot more and work fewer hours. Sadly, I have this pesky vision that mental health services should be reasonably affordable.

Therefore, I work on McDonald’s economic principles: lower margins but more people.  It means I work a bit more but I like my work so that’s okay.

I keep costs down by working online from home. I don’t have extra rent, a personal assistant, and I do my own marketing too.

When I’m older though, I plan to put up my prices and work a lot less. So hire me while I’m affordable 😊

Safe Dating: What to Know About Men Who Drug and Rape on Dates

Here’s a curious thing: it’s likely that your first IRL date is probably safe; it is your second date that’s potentially dangerous.

In the old days (pre-1990s!) dating was mostly conducted through friends or friends-of-friends. You might not know the person, but someone close to you would know their parents, whether they were single, where they worked, and so on.

Today we tend to work further from home and dating apps have us meet strangers.

Stranger-danger is a thing but when we are robbed, assaulted, or raped, it is more likely to be a relative or friend rather than a masked villain jumping out of a dark alley.

Many people who date online are normal, decent people. Flawed in human ways but inherently safe.  

A small percentage are extremely dangerous. If you’re online looking for love, this is one nasty way some predators work. Because forewarned is forearmed.

How Drug-Then-Rape Dates Work 

Predators hide their real selves

They’re warm and constantly sending photos of themselves and asking you about your day and your heart.  

When you meet, they’re sweet and you have a nice coffee or drink. Most likely, you’re happy when the date ends.

You text, you meet the second time – and then the coffee is spiked or maybe it was in your cocktail.

When you waken up, you don’t remember exactly what happened. Maybe you’re in a hotel. Maybe you’re at his place. Very often, he’s still around and he’s acting normally.

Many targets are completely confused at this point. They can’t believe they’re with a predator, so they try and ‘make sense’ of matters. They wonder if they were drunk. They wonder if they asked for sex.

They can’t believe the truth: that this is a regular occurrence because that ‘nice guy’ drugs his targets and then assaults them.

Note: most reports come from women attacked by men but men are also attacked – for sex and sometimes just for money.

If you report it, the rapist points at the texts you’ve exchanged. You’re good friends, you had a great time on that other date – and then he claims he’s the victim of a hysterical woman who was perfectly happy with a one night stand at the time but blah blah blah….  

How To Protect Yourself

First, awareness counts. Don’t accept drinks or food unless it comes straight from the bar or kitchen to you.  Don’t take your eyes off it.  If you’re uncertain, leave it.

Second, when you date strangers, always have someone collect you or check on you after the date. And tell your date up front at the start of the date that your brother/cousin/mum/father is collecting you or meeting you. Do this for the first six dates.

Finally, if anything feels off, leave.

Remember: tigers have stripes for a reason; it helps them blend in. Predators are tigers too, and they are very good at looking perfectly harmless. So be careful and don’t believe what people say about themselves; watch their behaviour to know who they are.

Image courtesy of HANSUAN FABREGAS from Pixabay

Looking For Therapy But Don’t Want To Tank Your IPO or High-Octane Career? Here’s What You Need To Know

When you’re dealing with a lot of stress, having a therapist on hand can be a valuable tool. Mental health practitioners are invested in privacy, however, clients are often unclear how our ethics codes work. Here are a few tips so you can make informed decisions.

Active Danger Negates Privacy

A vague, “sometimes I feel I want to vanish” is fine. Being very depressed is also fine. But if you share that you’re planning suicide, your therapist has a duty to save you. Similarly, if you share you plan to hurt someone else, your therapist will sound the alert.

To figure out where the boundaries are, read the agreement. It should state the exceptions clearly and state what action will be taken.

Organisations Will Share Your Information  

Therapists working in a hospital, medical practice or NGO will store client notes in a place where others can access them. This can be useful if you see different people, but you won’t know for sure who gets your information or what they do with it.

In a small organisation, your therapist can tell you who sees what. They typically won’t know in a large organisation because they don’t make those decisions.

The giant online platform BetterHelp was fined $7.8 million recently for selling private client information with major advertising platforms, including Facebook, Snapchat, Criteo, and Pinterest.

Know the difference between Registered and Accredited

A registered therapist belongs to an organisation. An accredited therapist shares your information with colleagues. They then talk about your sessions.

In theory, your therapist should anonymize your information. In practice this can be difficult, especially in smaller communities. Also, they may hand over their notes physically or send them via email.

Note: if your sole therapist is accredited, she may send your notes to a colleague at a hospital or university, and then nobody knows where those notes may end up.

Why does this happen? Mental health business practice has a lot of pyramid scheme or MLM mentality to it. (I know, I’m a cynic. But hang in there and you’ll see why.)

Someone figured out years ago that if you add in a fancy sounding title, unknowing customers will think you’re extra special.  

With ‘accreditation’ therapists pay each other to look over each other’s notes and sessions. The theory is that it promotes extra high standards. It may do, but it also means privacy risk for clients.

The UK’s biggest provider of workplace mental health services, Health Assured, is now being investigated for allowing strangers to "eavesdrop" on confidential calls by listening in to the helpline without the knowledge or permission of callers, in the service of ‘accreditation.’

Also, the cost of chatting about sessions is passed down to the client. A double whammy that really makes me see red, because I believe services should be affordable.

How To Keep Safe

Ask questions. Ask, “Who sees my notes?” and “Where do you store your notes?” and “How often in the last year have you discussed a client session with a third party?”

A quality therapist will tell you all this up front, before you start sessions and share private information. She will also detail exceptions. And finally, it will all be in the agreement–in simple language, not legalese.

So, when you want mental health support, I hope this helps you feel confident and empowered when you reach out. 

Note: with thanks to Chris Sansbury from Pixabay for the image.