In this issue
Here and now
News feature: Who needs a diagnosis? (free article)
Are counsellors and psychotherapists becoming over-reliant on psychiatric diagnoses? Catherine Jackson reports
The big issues
Counselling survivors of sex trafficking
Cate Harding-Jones describes her work in a safe house for sex-trafficked women.
Working therapeutically with chronic fatigue syndrome
Rosie Driffill offers some pointers for good practice.
How do we detox toxic masculinity?
Nick Duffell explores the benefits of long-term therapeutic groupwork.
Pluralistic counselling and psychotherapy: 12 years on
John McLeod and Mick Cooper review the pluralist approach.
Let’s all get uncomfortable
Pretish Raja-Helm and Shammi Kohli challenge the absence of cultural diversity in training.
When do you raise your fees?
Might I be putting my client at more risk by reporting safeguarding concerns?
Siri Sat Nam answers our questionnaire.
Maggie Pettifer 1948-2018
Prompted by my research for the article on the use of diagnoses in counselling in this issue, I started to look more critically at the content of Therapy Today and to wonder what it would be like if we expunged every diagnostic reference from its pages.
It would be a tough task. Whole articles, like that on obsessive compulsive disorder in the last issue, would be almost impossible to publish, and certainly not in so few pages. I’ve also become more sensitive to how much the language of diagnosis has crept into our everyday conversations – words like ‘depressed’, ‘OCD’ and ‘on the spectrum’ have replaced ‘psycho’ and labels such as ‘mongol’ that used to be common parlance. But are these any more respectful and any less stigmatising and judgemental? And how do psychiatric diagnoses really serve the person given them, other than, as Pete Sanders says, to ‘make them think sick’? Are they not essentially about convenience for the professional and the health and social care system? Truly, is your curiosity opened up or closed down by the label your client offers you, or that precedes them, when they walk through the door?
Last year was the year of the #MeToo movement – a massive, worldwide phenomenon that challenged men’s use of sexual harassment to demean and control women. It has changed women’s lives, hopefully forever. But what about its impact on men? Nick Duffell starts what I hope will be a continuing discussion in these pages about the role of counselling and psychotherapy in helping ‘detox’ masculinity and redefine what it means to be a man today.
How much are you worth? How much should clients pay? Two very tricky questions.
In one of my training placements we volunteers were asked to discuss and agree with our clients how much they could afford for their therapy. The only guideline was that sessions should be between £10 and £40, but the more the better as far as the charity was concerned. I dreaded those first-session conversations because it felt untherapeutic, disempowering and downright rude to assess someone’s financial position when we’d only just met.
Today, I still think long and hard before introducing a price increase and about how best to do it. It’s difficult to make a living as a therapist unless we charge a viable amount, but many of us are reluctant to raise our fees, or even to raise the subject. Perhaps we fear being challenged or appearing greedy, or maybe it brings up issues for us around our own self-worth? If you’d like to know how other therapists do it, turn to this month’s Talking Point.
Rachel Shattock Dawson