Free Counselling — Who Pays?

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There’s a glaring contradiction involved in the way counsellors work with people to enable them to affirm themselves and the way they can appear — either as saviours from above and beyond the daily struggle, as martyrs sacrificing themselves for others, or just as well-meaning people with no sense of their own value.

I’ve been giving some thought to the practice of counselling in the UK recently. It is commonplace here for counsellors to work on a voluntary basis when recently qualified, and indeed for long after that. There are few paid counselling jobs available, so the options appear to be voluntary work or private practice.

This set-up can only reinforce a lack of confidence in the profession and its practitioners, which is unhelpful for any field but especially for this particular one — which is about building confidence in the people coming to us for help!

The argument that recently trained counsellors are not quite up to the job seems to me to be inappropriate. Trained nurses and doctors start to work immediately; that is after all the point of a qualification. Ongoing supervision is obligatory for all counsellors belonging to a professional association anyway. If we counsellors don’t appear to be quite sure how competent we are, we agree to the tacit message that there are two kinds of counsellor: the not so good ones who have to work for free or who are counselling as a kind of hobby, and the brilliant ones who charge a lot of money in private practice. This doesn’t inspire trust or confidence in what we offer.

If we are willing to routinely work without payment, what does this say about our attitudes to ourselves and the service we provide?

Few people can afford to work for free, and this creates a situation in which counsellors tend to be people who have money. The training is prohibitively expensive for most people anyway — hence the stereotype of the comfortably off ‘middle class’ counsellor who cannot really relate to the struggles most people face. This stereotype lives a life of its own, fed by the fact that counsellors obviously don’t generally disclose their financial situation to their clients! Counsellors who are struggling themselves financially may be caught up in their clients’ expressed or unexpressed anger over a power differential that may not even exist.

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The advice to keep on with the day job while counselling ‘on the side’, while speaking to practical necessity, is also a recipe for exhaustion. To do the job properly, it needs to be the main job, the real focus of attention. Somehow the mix of the clients in most need — say refugees, under fire in absolutely all areas of their lives — with counsellors who are working with them either as an ‘extra’ in their already full lives or because that is the only option they have to stay in the profession, seems to be the worst possible combination. Difficult work needs focus and recompense. You also cannot do too much of it; you need time to recharge. If after a full time job to pay the bills, a counsellor spends their free time seeing clients in severe need, it seems like a recipe for burnout at best.

It’s accepted in society that doctors for example have extensive training and high levels of knowledge and skill for which they are compensated financially. This isn’t a comparison game, but the fact that of all the professions counselling seems to be the one in which the value of the offering is written out of the game at the start is telling. It structurally expresses that counselling is something done primarily out of altruistic intentions, and not necessarily involving a high level of skill at all. Hence the stereotype of counsellors offering not much more than a sympathetic ear.

Of course, people in great need of counselling often can’t afford to pay for it and of course counsellors by the nature of the work and their choice to do that work, care about these people and want to help. This motivation though should not be the primary prism through which counsellors present themselves and are seen. Doctors also help people, but there is obviously a lot more to what they do than that.

There is such a glaring contradiction involved in the way counsellors work with people to enable them to affirm themselves and the way they can appear — either as saviours from above and beyond the daily struggle, as martyrs sacrificing themselves for others, or just as well-meaning people with no sense of their own value. These communications are embedded in the structure and energy of the situation in which we meet clients and can grow in power by not being part of the discussion, sometimes becoming a real elephant in the room, or causing counsellors to be in a state of active denial about their own discomfort in their working lives. This can be felt by clients, and without the necessary background information, it will be misinterpreted.

For person centred counsellors, who are following the three golden rules — empathy, congruence and unconditional positive regard — this is particularly jarring. How can one feel entirely congruent in these situations which really are dissonant, unclear and unfair?

The answer is really for counselling to be funded properly on an equal footing relative to other health care. But I think counsellors, if they put their heads together, might find some solutions as to how to provide affordable counselling to those in need without accepting the role of holier-than thou, martyr, or well-meaning person with low self esteem. I’d like to try!

All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

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