22 Jan 2014

Koan Practice

Counselling & psychotherapy services in London: Our ethos

We are formed 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) Around the year 2000, 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 – this group counselling practice 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.
We wanted to address that problem, and are 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. Clients 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 clients 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

(1)  The management are all veteran psychoanalysts themselves. We are geared towards letting the counselling & psychotherapy clinicians have FULL clinical independence, and counselling-psychotherapeutic imperatives always take precedence over the ‘happiness’ of the management.

(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. Our low-fee work is funded by fees from higher income patients.

(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. 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). Because this scheme shares its costs with the senior therapists, it is able to operate independent of outside funding.

(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