Irattling Opening a shop in the UK, claiming to be a doctor of medicine, and being reported, you may regret it. “Doctor,” along with other professional health titles from “art therapist” to “hearing aid dispenser,” are protected by law. Pretenders face unlimited fines. However “therapist” (including “psychotherapist”) is not. Anyone can take a weekend counseling session — or don’t bother attending at all — and accept paying patients.
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Policing the field is difficult because therapy encompasses many practices from crystal healing to psychoanalysis. But calls for the government to try are growing because private therapy is booming. Quantifying the size of the market is tricky, but two points point to rapid growth.
One is the long queues for the National Health Service (National Health Insurance System). The charity Mind says 1.6 million people are on the waiting list for mental health treatment (with a further 8 million people with less serious problems who would benefit from treatment). Many who could afford it turned to privatization. Glenys Parry, a clinical psychologist and psychotherapist and emeritus professor at the University of Sheffield, said it was likely that “more people suffering from severe depression, anxiety and distress in their relationships are now seeking private therapy division”.
Another sign is the growing demand for personal development treatments—helping people become happier or more successful—that is being met entirely by private supply. More and more companies are offering therapists as an employee benefit. Therapeutic terms (“boundaries,” “triggers,” “trauma”) have entered everyday language. The increased use of online meeting platforms during the pandemic has made talk therapy more accessible.
Many private therapists are registered with respected bodies such as the British Association for Counseling and Psychotherapy, which has training requirements and complaints procedures for its members. But the onus is on the patient to check whether the therapist is on such a list—they may not think about it because they are too frustrated or too trusting. Regardless, the lack of regulation limits the protections such associations can offer. If someone gets kicked off the register, there’s nothing stopping them from continuing to practice and pocket it.
Helen Ritzema, a child and adolescent psychotherapist, says that even some professionals have trouble deciphering what someone has been trained to do.She worries about some schools and National Health Insurance System The trust has hired therapists to work with children, although they have only been trained for adults. This has the potential to lead them to misinterpret children’s behavior, confusing them with the behavior of adults with personality disorders.
What might regulation entail? There is a limit to how many hoops, if any, a lifestyle therapist has to jump through. But Dr Ritzema argues that the titles “psychotherapist” and “child psychotherapist” should be protected by law (titles used by psychologists, including “clinical” and “educational,” are already protected). The Netherlands, Sweden and Switzerland insist on six years of training to call themselves a psychotherapist. This title is also protected in Finland and France.
However, tighter regulation does not guarantee better outcomes. Some forms of treatment do not work for everyone. Miguel Farias, a psychologist at Coventry University who has studied the adverse effects of mindfulness meditation, said about 8% of people experienced a worse mental state after undergoing mindfulness meditation.He describes mindfulness groups (by National Health Insurance System) is like “a mental health assembly line.” People with mental health issues often need one-on-one care, he said.
Bad experiences can also stem from a simple mismatch between therapist and patient. One business owner described seeking therapy after failing to start a business. The therapist was recommended by a friend. “I was in a horrible, anxious state with growing insomnia and panic attacks,” he said. “I described it all to the therapist, and he said: ‘Tell me about your relationship with your father.’ I told her it was great, thank you, and then never went back.”■
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