The Privacy Price of Accreditation: How professional associations are trading client confidentiality for control and cash.

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 the accreditation game, 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

Al Capone in 1930

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.

 

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 monetise 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. 
 

When SCoPed listings were announced a week or two ago, we found that the lady with a master's degree and 11 years in practice, and the bloke with the master's degree 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 Bachelor of Science with Honours in Psychology and my Masters with Distinction in Counselling, 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. But, as so-called accredited members, we have to pay huge fees 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 arrange for swapsies. They hand each other some client notes, maybe have a chat, and accredit each other. Nice, easy, cheap - and you get to look super professional. Call me cynical but I have seen this done by colleagues.

 

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. If you're very busy like me, that may be 2 or 3 hours per month.
 

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 2025 Onwards

I'm not the only person disgusted by this. There have been numerous Board resignations and protests about SCoPEd, including this one by Michael Golding, a senior BACP official 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 

If you require good privacy for your personal safety or to safeguard your high octane career, understand how organisations deal with your information. 

 

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 confidentiality work. 
 

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 
 

How Private Are Sessions? A check-list by Ellen Whyte

 

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. 

Bottom Line 

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 keep my fees down

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. 

Finding Strength in Therapy: Navigating Sexual Violence Recovery without Reliving the Details

"I'm a victim of sexual violence. Do I need to share details about the attack in therapy?" 

 

No.

 

That was easy, right? So here's the long answer.

 

Almost everything you've seen on TV about sexual violence counselling is wrong.

 

On TV, people who have been attacked go into therapy and are forced to detail the experience.

 

It's bunk. Reliving the details is traumatising. In sessions, we don't do this.

 

History Factoid

The first mental health professionals working in the early 1900s thought that reliving trauma was healing. They talked about bringing it to the surface and healing through pain.

 

Turns out that was a major mistake.

 

A terrific resource

By the 1950s, mental health professionals realised they were on the wrong track. They emphasised compassion.

But it was  Judith L. Herman's book "Trauma and Recovery" published in 1997 that redirected crisis and trauma counselling into a modern direction. 

 

Her principles are to empower with support, care, and information. 

 

I take my cue from her and work to Trauma-Informed Care standards. 

 

Compassionate counseling for adult survivors is not cut and paste because every client has unique experiences and goals. So there's no step-by-step blueprint.

 

But the values for safe and supportive counseling for survivors are always the same.

 

Trauma-Informed Care standards. Compassionate Counselling For Adult Survivors

So if you've had a bad time, please don't think that going to therapy means reliving the details.

 

Television writers stick to those scenes because audiences get a thrill from the horror of the retelling.

 

In trauma recovery through therapy, the focus is on empowerment, care and positive change.

 

If you're looking for support for healing from sexual violence, drop me an email ellen.whyte@gmail.com or text.

When Suicide Is A Crime – Seeking Help In Difficult Times (includes Podcast version)

Overcoming Challenges: Dealing with Suicide in Criminalized Countries

 

I'm excited because Malaysia is decriminalizing suicide.

 

 

Click to hear the podcast version

 

I live in Malaysia, and up until now, dealing with suicide was tricky.

We had an old law, left over from colonial times I think, that criminalised suicide.

Malaysians are compassionate. In a crisis, most police, doctors and medical staff would help and not say a word.

But there were exceptions. Every now and again, suicide survivors rescued by their family and friends would be arrested, hauled up in court and fined.

 

Between 2014 and 2018, 11% of those facing suicide were arrested and taken to court. Penalties included fined and up to a year in jail.

There would always be protests about this. And thankfully, increasing outcry pushed politicians to finally change that law.

It's not quite a done deal yet, but ever since the process started, there has been a change in how emergencies are managed.

It's wonderful!

 

Seeking Therapy in Criminalized Countries

Sadly, many of my clients live in countries where suiciding remains a criminal act. When seeking therapy, this poses some problems.

So I'd like to discuss these a bit further and describe an approach that my clients and I use.

I have two aims here.

First, if you're stuck in this situation, I'm hoping that this will help you reach out more safely.

Second, if you are supporting a friend or loved one, this may be useful to you.

There is always help

About Penalties for Suicide

Okay, so first thing is to know that in places where suicide is a crime, penalties vary.

Typically, courts impose fines and jail sentences. Some countries add flogging.

You might lose your job, have your kids taken away, or be divorced. The social stigma is huge.

In corrupt countries, a suicidal episode can also result in the police and other authorities demanding bribes.

Also, although it's not talked about much, abusive family members will use an incident in order to extort money or exert emotional blackmail.

About Barriers

As a result, people who are suicidal are too frightened to say so. They worry that asking for help will invite disaster.

This fear creates a considerable barrier. Sometimes, even close loved ones don't realise when someone is in trouble.

Second, being proactive and looking for help before you get to a crisis stage can be tricky.

Not all therapists take on suicidal clients. It's intensive work, risky, and so it's not everyone that's up for it.

And in countries where a crisis invites legal troubles, it's even harder to find someone who will take you on.

So, is it all doom and gloom? No. Absolutely not!

Sourcing Support

Finding support is perfectly possible, but it takes a bit of prep.

First, the law is an ass but there are many people who very quietly stick up two fingers to nasty rules.

You are never alone!

However, the key to finding your way is to be accountable.

You cannot throw the burden of care on to others. You are an adult and that means being responsible for yourself.

This is a challenge, especially when you're down, but it is essential. Make it a core principle.

Once you have that fixed in your mind, look for a mental health professional who can help provide support.

The most likely candidates are those who deal principally with depression and trauma.

Also, it's worth trying people who are LGBTQ affirming. I say this because many of the countries that criminalize suicide, also criminalize nonheterosexuality.

Second, before you start, ask about privacy. Specifically, ask who has access to your notes.

You don't want a fabulous therapist who then shares your notes with their boss, their staff, or a database that can be accessed by others.

Stay Safe! Safety Plan

Third, kick off therapy by deciding how you will deal with emergencies.

When you're upset, it's hard to think straight. A safety plan covers all the steps you should follow in a crisis.

• Start with noting down what you have done in the past that helped.
• Then ask, what exercises from sessions are helpful?
• What will you tell yourself as alternatives to the dark thoughts?
• What would you say to a close friend who was feeling this way?
• What could others do that would help?
• Who can you call? At this point, you list three trusted people you can reach out to.
• What is a safe place you can go to?
• And if you still feel suicidal and out of control, do you know a discreet doctor? Or perhaps there is a clinic that will quietly help you out? Write down the contact details.

You may want to rehearse a short cover story. For example, I am upset at a breakup. I would never hurt myself because that would be illegal but I am VERY UPSET.

Plan for a friend or relative you trust to come with you for this.

With a safety plan to back you up, enter counselling. Hopefully, you can get into a happier place.

Some Final Thoughts

Please know that you are not alone. There are millions of people who face suicide.

It is never easy. In films, they go to a hospital where there are trained staff to look after them.

They make it look so simple. So available.

In truth, there may be some rich big cities that have that service, but in most of the world, it simply isn't available.

It takes a dedicated ward and several shifts of trained staff to work 24/7. That's expensive! Most countries just don't have the resources.

Most people who are troubled, lean on friends and family to help them through rough times.

Life can be very difficult and silly laws can make it harder, but you can do this.

So make your list and reach out. 

Photo Credit: Image by Mohamad Hassan on Pixabay