Can anyone explain to me why a large proportion of counselling psychologists work in private practice ?

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Can anyone explain to me why a large proportion of counselling psychologists work in private practice ?

Post by ryan95 » Sun Jul 26, 2020 8:09 am

I have been looking at paid positions in the NHS and the variance in pay scales between clinical and counselling psychology is very evident, I am aware that clinical psychologists have more emphasis on psychometric assessment and are granted greater exposure to clinical settings. Just thought that counselling psychology seemed to be more my thing but from looking at potential career earnings and progression there does not seem to be as greater scope for any of this as there does with clinical psychology, which is disheartening given the length of training and experience needed to obtain a doctorate in counselling psychology. Is it a service issue that so many counselling psychologists are working privately or is it a problem of not being as sought after within the clinical community since counselling psychologists have to do additional training in order to carry out psychometric assessments.

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Re: Can anyone explain to me why a large proportion of counselling psychologists work in private practice ?

Post by hawke » Sun Jul 26, 2020 5:33 pm

I have seen plenty of counselling psychologists working at a high level in the NHS - certainly at 8a and 8b, and in child/adult services where therapy is the main form of intervention. Many jobs now will advertise for counselling or clinical psychologists.

Although you are right, there are roles and services that require skills (like psychometric assessment) covered in the clinical course but not the counselling course. My impression is also that clinical psychology training involves more of a systems and leadership component (e.g. training in consultation, or service evaluation and development) whereas counselling psychology focuses much more on individual work. It's those skills that are selected for at higher bandings, which (if my impression is right, and please someone correct me if it's not) might mean a counselling psych would struggle to progress as easily.

In my very anecdotal experience, many counselling psychs seem to find the NHS is not a very good fit for them, and find their values are better matched to third sector and private organisations. I've seen many say they feel stifled in the NHS, not able to work in the way they would like to with clients. I've also seen counselling psychs shake up the system in a wonderful way, but that has been the minority. Many clinical psychs will only have worked in the NHS, and so don't know any different and have been trained/selected to fit with NHS systems.

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Re: Can anyone explain to me why a large proportion of counselling psychologists work in private practice ?

Post by Spatch » Sun Jul 26, 2020 7:09 pm

I don't have any robust evidence about the reason for this, although I there are counselling psychologists at all kinds of levels within the NHS. However, when I was doing my DClinPsy, I spent quite a bit of time with the DCounPsy trainees at the same university and observed the following:

- Whereas ours were all emebedded in NHS services, the Counselling Psych trainees were exposed to a lot of different contexts, which possibly expanded their horizons about what was out there beyond the NHS Band 7 onward ladder.

- Private and independent working wasn't really raised in our training, and I felt tacitly discouraged, whereas DCounsPsy were taught by lecturers who worked privately and more accepting of this method of working.

- As they paid for their own training, and many were from other countries, some didn't feel they had the same loyalty or obligation to the NHS.

- Person centered and Psychodynamic was far more integral to their training than ours, and in my experience these tend to be offered more in private contexts, whereas the evidence based therapies/ CBT focus of the DClinPsy meant we automatically leant towards the NHS services that pushed these.

I may be wrong, and there could be other reasons. I think Hawke makes some excellent points, but would be good to hear from some of the CounPsy folk that are on here.
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Re: Can anyone explain to me why a large proportion of counselling psychologists work in private practice ?

Post by hs577 » Sun Jul 26, 2020 9:09 pm


As a counselling psychologist I personally chose to work in the nhs and have worked in the nhs for over 10 years. I qualified 2017 in counselling psychology and am currently an 8a in a split role of working age adult services.

Regarding psychometric tests it depends on the course as some incorporate some specialist workshops in it. I was a research assistant so did lots of neuropsych tests in this role. I don’t think theyre a major contributing factor since there is some training you can do afterwards in respect of your question and the pay difference. It’s just that counselling psychologists didn’t exist when the tests were developed so wouldn’t have been included.

Our course covered research, service evaluation and consultation. However it didn’t cover leadership in as much depth. So again it can be what you make of it, individual reasons and there are again post qualifying workshops etc

I’ve published 4 papers and have a couple more on the go and would say my research is rigorous. The Counselling psychology course has a focus more on qualitative but I’ve done both types plus mixed methods.

They do push you towards the voluntary sector and private practice plus nhs posts. My personal impression is those who never worked in the nhs before found it stifling. I worked for iapt a few years prior and during the course so was used to the associated NHS targets. Im also aware of current changes like the power threat meaning framework.

There is a lot more individual preferences/ pre qualification differences in Counselling psychology and more differences in placements. (For example it might be you do one of your placements for 3 years in a niche area which wouldn’t be possible in clinical psychology which would cover breadth and possibly a year specialism). Or your experience as a counselling psychologist could have lots of breadth. Often people may have family, caring and likely need to due to this prioritise paid work commitments sometimes Outside of the course making it more complicated to gain breadth. Quite frequently counselling psychologists have paid work which may not enable much time for more placements. For example in terms of what I was willing to do I could only allocate a day and two evenings to placement. I had a 22.5 hour job which increased to 30 hours in my final 2 months. Thus restricting my breadth to accommodate my job plus caring commitments.

As spatch says they likely don’t have the same allegiance to the nhs with not having their funding from them. The courses covered 1 or 2 lecturers in private practice.

I know one of our cohort doing is private practice and I wouldn’t rule it out for myself either in the future.I’m constantly told I’d be good in private practice but don’t want to at this point.

Thus I think a lot of this could be individual reasons and choices why some are private practice. I know most of our cohort are nhs, followed by lecturer and/or research positions then some in the voluntary sector.

Like anything else its what you make of it and carefully thinking about what you want to do with it.

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Re: Can anyone explain to me why a large proportion of counselling psychologists work in private practice ?

Post by miriam » Mon Jul 27, 2020 3:23 am

Clinical courses are NHS-funded training, with placements in NHS services. Trainees get inside knowledge of services that are recruiting, and NHS job adverts are circulated to local courses. Meanwhile I can't take a trainee on placement in my service or advertise a post to trainees on most courses as it isn't NHS. Most CoP trainees are self-funding, and take placements that relate to their interests or where they can get paid employment, which is almost always in the private sector - and there are major private employers who sponsor practitioner doctorates outside of the NHS funded clinical courses (eg St Andrews). It also means the outcome of training is more individual, rather than covering the breadth of client groups required in the clinical doctorate. For example, when I've been recruiting to NHS CAMHS posts, CoPs may not have the types of placements that give a grounding in child and family work, or an awareness of the way different public sector agencies work together, as all their placements may have been through a single employer, or focused on direct therapy work.

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Re: Can anyone explain to me why a large proportion of counselling psychologists work in private practice ?

Post by hettie » Fri Aug 21, 2020 3:10 pm

I would echo what many ahve said... On certain CoP training course you could probably do all the required clinical placements without an nhs placement at all. Lots of course insist on one NHS placement and many trainees choose to do nearly all their placements within the NHS, some don't though.....
As an aside psychometric test training is included in most CoP training programmes now and Counsellign Psychologists can go on to do the Neuro training if they so wish...
In my leadership role within the NHS I would hope to be one of those Counselling PSychs shaking up the system in wonderful way :D ...But then I trianed systemicaly before my doctorate and have gone onto to get very into systems thinking and leadership. I chose counselling over clinical because of some of my perceptions of how stifling the clinical pathway/NHS was and have ended up fidning a happy home challenging from within

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