A below the line contributor to the Guardian website asserted that, ‘Therapy should be as easily available and prescribable as medication is at the moment’.  I replied:

Fine words, but your response ignores the reality:

1   There are simply not enough trained therapists to deliver this level of support.

2   I believe that, even if the money for training were available, there aren’t enough people wanting to be trained to be counsellors, therapists etc—and with the appropriate attitude—for us to end up with a large enough pool of practitioners, across the country.

3   Further, while ten hours is probably enough when the problem is well defined, contained and amenable to a particular type of therapy (which, in effect, was designed for that sort of problem), there is a wide range of intractable problems which require far longer—like five times as long or more. Just allow the word “abuse” to come to mind see that.

4   The wide range of seriousness of presenting issues (to say nothing of the underlying issues) means that not all therapists are qualified or able to handle all cases

5   There is a bewildering range of ‘genres’ of therapy: psychodynamic, gestalt, TA, CBT, integrative, group, NLP, for a start—and then there need to be special approaches for children, those with learning difficulties and so on. How does the controller of the approved list mentioned assess the skill levels (not the qualifications—one can be qualified to to high heaven and still be useless) of the many practitioners who might be potentially included on the list?

6   How low would ‘NHS specified rates’ be? While I’m sure that there are therapists in private practice who could do with more work, and would therefore lower their rates in return for a predictable supply, in reality most therapists will endeavour to lower their rates for those who need them to.

7   On the other hand, if therapists are going to be expected to work for a pittance, they won’t be able to meet the costs of their supervision from their own pockets. So this is an extra cost in this hypothetical scheme. And recruiting more therapists to allow for those doing all the extra supervisory work will be a headache

8   If millions of people annually are going to receive thousands of pounds of care (including the cost of the NHS managing the provision of the service), all to be paid for by the NHS, where is the money going to come from?

© 2019 Jeremy Marchant . image:  Free image
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