As the rising cost of living burns a hole in our pockets, and disposable incomes continue to fall for many, what will the impact be on those of us who earn our living as therapists in private practice?
As overheads rise, what decisions will we make about whether to pass increasing costs on to our clients, in the form of fee increases? And what if doing so would then price us out of the market and result in a decline in new referrals? Or in existing clients, whose financial circumstances may become increasingly stretched, finding the cost of weekly sessions one they can no longer afford?
With rising costs and falling disposable incomes adversely affecting many, will the freedom to choose to see a therapist in private practice become even more rarefied? The privilege of the wealthy elite?
To a large extent, this is already the case, and – I will tie my colours to my mast here – I’m not among those who argue that therapy should be free at the point of use. I’m in the camp that holds that an exchange must take place between client and therapist to create a more equitable power dynamic. And that this monetary exchange should hurt a little, so that the client is acknowledging in their payment that the therapy has value to them and that they are choosing to making an affordable sacrifice in exchange for it.
That’s not to forget, however, that there will always be those for whom even a nominal fee will not be affordable, and it is right that therapy provision should be available to them at no cost. But – and here’s the rub – properly resourced and funded within the statutory sector. And not, as is currently so often the case, provided by unpaid, inexperienced and unqualified therapy students on placement.
Those most in need of therapeutic support but least able to pay often present with the kinds of complex traumas that only experienced senior clinicians can best provide. This is not to dismiss the good work that trainee therapists undoubtedly do – but we should not be in a position where the least experienced among us are at the coal face providing therapy to the most complex of clients, while the most experienced work in private practice because of the dearth of permanent therapist jobs in the statutory sector.
How often do we hear reports of the parlous mental health crisis our nation is in? Made worse by the pandemic, but resulting from inequalities endemic in British society that seem only to widen (despite the so-called ‘levelling up’ agenda)? And how often do these reports also suggest that there are insufficient therapists to meet the demand?
No; there is a vast army of qualified, experienced therapists (60,000 of them are members of BACP alone), many of whom have the capacity for more work, but are underused because the funds are simply not available to pay them. Other healthcare professionals are not expected to work voluntarily for no pay. I think we do our professional status a disservice by continuing to be prepared to do so, thereby letting central Government off the hook when it comes to providing the funds to properly resource mental health services across our four nations.
John Daniel, Editor