Counselling & Psychotherapy Services in LondonLacap (London) was formed in September 2000 as a London counselling and psychotherapy service with three ideas in mind. These have a weight on how this counselling service charges for counselling and psychotherapy in the London area. (1) Those of us who were working as counsellors or psychotherapists in the NHS and charitable agencies realised something had gone wrong! The auditors and accountants had won, and the space for proper clinical counselling, psychotherapy and psychoanalytic work was being constricted. Everything is now audited – including ‘happiness’. Auditors and accountants wanted to see if counselling & psychotherapy treatments in London were delivering ‘value for money’. What psychotherapy could deliver ‘happiness’ in the quickest time and for the least money? How do you find that out? (How can the government save money on counselling service provision?) Cognitive Behavioural Therapy finds that out every session, by directly asking the patient’s to mark the psychotherapist or counsellor’s performance, and to comment on whether they feel better. And even better, CBT treatments only take some twelve meetings to implant supportive ‘good ideas’ into the patient’s minds! So, you can audit CBT……..because patients do try to feel better, and try to make the counsellor feel good too by telling the counsellor what a wonderful person they are. No counsellor or psychotherapist using the psychodynamic model would entertain such a procedure. Psychodynamic psychotherapists do not think that ‘happiness’ can be audited, and shrink from the idea that a good outcome for a counselling is that you are just the same as everybody else! So, as the NHS and charitable models increasingly use CBT and deviant variations of psychotherapy-counselling that promotes ‘short-term’ work – Lacap was formed as a space where psychotherapist and counselling clinicians can carry on doing real work. (2) The second good idea is historical. Psychoanalysis is said to be the ‘purest’ kind of psychotherapy or counselling. It has been the preserve of the rich and educated. In London, it is vastly over-represented in the NW post codes. Psychotherapy fees in excess of £100 per meeting and psychotherapy session frequencies of five times per week ensure that psychoanalysis stays that way. There are many 'hobby' psychotherapists, who shrink from the realities of 'coal-face' clinical counselling work. Lacap wanted to address that problem, and is orientated to provide quality counselling and psychotherapy services in London irrespective of the ability to pay, taking into account that practically five counselling sessions per week is not possible, and not supposing that a level of education is indicative of the ability to be a ‘good counselling patient’. (3) Everything in the NHS and the charities counselling work is now about protecting yourself against litigation. Patients are supposed to be ready and willing to sue counselling and psychotherapy services at a drop of a hat! In London and the UK, what this means is that counselling imperatives are subordinated to management needs, as the management regulate and standardise counselling & psychotherapy practice to ensure that nothing exciting ever happens! Management don’t understand psychotherapy principles, and like modern school headmasters prefer that the children they suppose the counselling patients to be are happy rather than challenged (and possibly failing those challenges - like a psychotherapy can be unsuccessful). Management concerns are that counselling treatment outcomes are, like the ‘dumbed down’ exams for our children, always achievable and ‘happy’ outcomes. No-one can fail, anymore - let's lower the bar! This also involves the NHS counsellor and psychotherapist, like our teachers, increasingly doing less interesting, challenging, and actual counselling session work, as they compile the reports and attend the counselling supervision meetings that let management rest easy at night! Counselling & Psychotherapy London – at lacap(1) Lacap management are all veteran psychoanalysts themselves. Lacap is geared towards letting the counselling & psychotherapy clinicians have FULL clinical independence, and counselling-psychotherapeutic imperatives always take precedence over the ‘happiness’ of the management. So, this is not a bunch of London businessmen employing counsellors to make money, because counselling imperatives are not about making money! (2) We decided to be financially independent. This means that we do not have to compile reports for audited counselling outcomes for the next years ‘funding round’ like most charities do. This means that we do not have to sacrifice counselling and psychotherapy to ‘short-termist’ outcomes. (3) The fees are arranged on a sliding scale of £6.00 to £80.00. This ensures access to London counselling & psychotherapy services is based on a desire to do a counselling or psychotherapy rather than an ability to afford it. It ensures a ‘level playing field’ for access to counselling and psychotherapy services in London. (4) The frequency of counselling sessions is decided by a mix of what is practical, and what is clinically advisable. We do not force five counselling sessions per week because it is a ‘good idea’, and we do not have to restrict the psychotherapist to offering once-fortnightly or once-monthly counselling because we cannot justify the budget. Psychotherapists can offer frequencies commensurate with the difficulties. (5) We support access to counselling & psychotherapy services in London for those in unwaged or reduced income circumstances by effectively ‘taxing’ those who can afford to pay more. The cost of providing a counselling or psychotherapy session on our low-fee scheme is around £40.00 per hour (against £60.00 in the NHS). We take 23% part of the session fee, for the 1st 35 sessions, for those that pay standard rate counselling fees, and pass that over to the low-fee counselling and psychotherapy service. We can therefore both fund that area of work AND remain independent. (6) We are precisely located in Aldgate, London. Where we are is the dividing line street between the Corporation of London – the City’s business sector – and Tower Hamlets, where local GP’s refer into our practice. To the north is Spitalfields and Old Street, with the newer ‘tech’ businesses and artists and artisans. So, we hope that our geography permits a wide access to counselling & psychotherapy services in London |
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