10.1 Introduction
A career as a therapist can provide you with a unique, fulfillingmopportunity to make an appreciable difference to the lives of others. In this module, you will learn what you will need to consider if you are interested in pursuing this path. You will learn about the training options open to you, your legal obligations and the most common settings in which therapists work. It is also important that you understand the risks that can accompany a job in this field, so this module also sets out what you need to consider in terms of personal safety and how to ensure that you manage your stress levels.
10.2 How do People Train as CBT Therapists?
First, you'll need a degree related to social care and/or mental health to be able to pursue a post-graduate degree in CBT therapy.
Some course choices would include:
-Social work
-Mental health nursing
-Counselling
-Psychology
-Art therapy
Volunteering experience also counts for credits. You can contact the voluntary services co-ordinator with the local NHS trust near you. You can also apply for loans, funding and studentships.
The following skills help you become a competent CBT therapist:
-Ability to empathize and show compassion
-Active listening skills
-Strong communication skills that help you deal with clients, colleagues, peers and organisations
-Strong organisational skills to keep your office, payments, appointments and schedules in order
-Good relationship building skills
-Reliable problem-solving and planning skills
In the UK, professional therapists should be registered with either the British Association for Counselling and Psychotherapy (BACP), the UK Council for Psychotherapy (UKCP), or both. These bodies serve as a quality control process. When a client or organisation works with a therapist who has been accepted as a professional member, they can be sure that the therapist has received an appropriate level of training and has agreed to follow an ethical code of practice. These bodies hold their members accountable. If they fail to conduct themselves in accordance with standards of competent and ethical practice, they can be removed or suspended from the register.
In order to join the UKCP or BACP, you must be able to demonstrate that you have undertaken suitable training to graduate level or equivalent. If you are looking to be registered as a therapist with the skills required to work with children or families, you will need to undertake in-depth additional training through a recognised provider. The UKCP's official website advises people looking to train as therapists that 'the usual requirement is the completion of a masters-level course in psychotherapy, or an accredited course in psychotherapeutic counselling'.
A therapist typically trains for four years on a part-time basis. Training consists of classroom learning, role play, placements and personal therapy. You will need to prove that you have accumulated 450 hours of practice, skills and theory. Although the total cost of training will vary according to region, you should expect to pay at least several thousand pounds. You will need to cover the cost of the course fee, textbooks, personal therapy and professional supervision. To find suitable courses, you can check the relevant pages at bacp.co.uk and psychotherapy.org.uk(the website of the UKCP).
10.3 Further Development as a Therapist
Your professional development does not come to an end when you qualify as a therapist and gain a place on the register of your choice.
As a condition of membership, you will need to engage in a specific number of Continuing Professional Development (CPD) hours each year. CPD consists of activities that further build and consolidate your skills as a therapist, such as conferences, short courses and specialist workshops.
You can continue to build your skills as a CBT practitioner, or use your CPD hours to learn about more general aspects of therapy such as the role of the therapeutic alliance or latest developments in the field of mental health. Even if you work alone in private practice, your clients are likely to have interacted with other health professionals such as GPs and psychiatrists. Therefore, it is helpful to understand how and why mental illnesses are regarded and treated by the mainstream medical community. It is also important to work on self-development.
Therapists are not perfect individuals, but the greater their self-awareness and willingness to improve, the more likely they are to form meaningful relationships with their clients. You will need to undertake personal therapy as part of your training. This is for two reasons. First, it allows you to appreciate what therapy is like from the perspective of a client, which in turn will enable you to empathise with the people you work with at a later date.
However, it also allows you to gain insight into your own cognitions and alert you to any areas of vulnerability that could impact both upon your life in general and your work as a therapist.
For example
If you have yet to fully process residual childhood trauma, you may react with fear and anger when a client shares a similar account. Working through your own history allows you to focus on your client's reactions as opposed to your own. A therapist who starts to dwell on their own past and emotions during a session is not fully available to their client and this will damage the working relationship. One of the most exciting aspects of working as a mental health professional is the number of opportunities available for specialisation.
For example
You may work with individuals for a few years, but then decide that you would like to help couples with their relationship difficulties and subsequently complete a postgraduate qualification in relationship therapy. You do not have to adhere to one therapeutic paradigm. A therapist will usually train in one approach, but it is not uncommon to adopt an eclectic or integrative strategy that draws on techniques and interventions from a number of areas. Each client has their own unique set of problems and personality traits and the majority of mental health professionals believe that it is important to remain flexible when attending to a client's needs.
Activity: CPD Courses
Estimated time: 5+ minutes
Visit http://www.psychotherapyexcellence.com/events and browse the listings. There are lots of CPDevents available!
Which would you like to attend and why?
10.4 Working in the Private Sector
Many qualified therapists work in private practice. For some, this can be a lucrative and fulfilling approach but you will come up against challenges when setting up a practice. Issues you need to consider include the following.
Pricing
There are plenty of people who are willing to invest a significant amount of money in their mental health and wellbeing. The average price per therapy session is around £50-£100 and may be more in central London and other areas in which living costs are significantly higher than average. If you want to work in private practice, you need to be confident in asserting your own worth.
Assuming that you are appropriately qualified, there is no reason to apologise for setting a reasonable rate. Not only are you able to offer clients relevant qualifications and experience, but you will also need to factor in rental costs (if applicable), insurance and other expenses outlined in this module.
Some therapists operate a sliding scale model, whereby the client's fee is determined by their income. Whether you do this is down to personal choice and circumstances. Assess how much money you need to make to cover your costs and only consider offering low-cost therapy if it fits your philosophy and lifestyle.
Activity: The Price of Therapy in Your Area
Estimated time: 10+ minutes
Using Google, find a few private therapists working in your area. See if you can locate their prices.
Are they higher than the national average, lower, or roughly what you would expect?
Facilities
Some therapists work from home, whereas others hire treatment rooms. If you have a spare room at home, this can function as a therapy space. If this is not possible, or you would prefer to draw a clear line between your home and work space, hiring a space at a private clinic or treatment centre is a good option. Costs can vary considerably and you will need to factor in this expense when setting your prices. When choosing your location, think about accessibility (i.e. is it appropriate for clients with disabilities?) and ensure that the room is clean and safe. If you want to work from home, take a realistic look at your living situation.
For example
If you have children or pets, will it be easy to keep them away from the therapy space? If the people who live with you do not understand the importance of privacy and confidentiality in the therapeutic process, it is best to rent a room elsewhere.
Marketing
It may be tempting to accept business from any and all potential clients, but you will generally find it easier over the long term to attract business if you hone in on a niche and concentrate on reaching out to them. The task of marketing yourself can seem overwhelming. Start by submitting an accurate, up to date, well-written entry to respected counselling directories. Let prospective clients know who you want to work with and the type of problems you are most comfortable treating.
Advertising in local business magazines, attending networking events and offering to teach or speak at adult education classes can all help you gain exposure. Design some professional-looking business cards and flyers - this task can be outsourced at a relatively low cost - and pin them on community notice boards.
Prospective clients turn to the internet when looking for therapists in their area, so build a simple website, blog and social media presence. This allows people to follow and get to know you from a distance before reaching out to arrange therapy. If you are not familiar with Search Engine Optimisation (SEO), find a freelancer who can optimise your website so that you appear high up on the first Google results page for 'therapist in [YOUR TOWN]'.
Publishing blog posts (on both your own site and those run by other people) helps you build credibility as an authority in your field. You can also use your social media platform as a means of sharing useful mental health-related information such as articles with your followers and prospective clients. Cross-promotion is an effective way to spread the word about your services - and it is free! If you know any people who work in the health and wellbeing sector, such as a yoga teacher or a massage therapist, ask them whether they would be willing to promote your services if you will do the same for them. This does not have to entail much effort; you could perhaps mention one another's
businesses and services on your respective websites and social media profiles.
Supervision
As a condition of registration with a counselling body, you will need to undertake regular supervision. If you are a private therapist, you will need to hire a supervisor on a private basis. Therapists usually consult with their supervisors once or twice a month. The sessions can be carried out face to face, via the telephone, or via video chat. During a supervisory session, you will talk about any challenges you have recently faced in your professional practice and get feedback on your approach as a whole.
To recruit a supervisor, start by looking in the directories provided by your organising body. These are usually visible only to people who have joined the register. You could also ask your training provider to point you in the direction of therapists they know to be good supervisors. Once you have identified two or three candidates, set up an initial consultation with each before making your final choice. You need to choose someone you find approachable and empathetic. Remember, this person will be advising you if and when you come up against an ethical dilemma.
Professional indemnity insurance
Also known as malpractice insurance, indemnity insurance covers any costs you may incur should someone take legal action against you as a therapist.
For example
If someone were to sue you on the grounds that you have caused them significant psychological distress following a course of therapy, your insurance policy would cover your legal fees along with any damages you were ordered to pay to the claimant. In general, £1 million is considered a reasonable level of cover. The cost of insurance premiums depends on your circumstances. It is best to approach several providers to find a package that fits your needs. You can also get other forms of cover, such as insurance against non-payment of client
fees and insurance that covers you in the event that someone accuses you of libel and slander.
Tax and National Insurance contributions
As a self-employed person, you are responsible for filing your tax return every year. You can learn how to do this yourself using the resources provided by HMRC at https://www.gov.uk/government/organisations/hm-revenue-customs/contact/self-assessment. If you have a business turnover of more than £85,000 (2018), you will also have to register for VAT. For a simple, clear explanation of what you need to do when you begin to work for yourself, consult this online guide from HMRC https://www.gov.uk/working-for-yourself.
Data protection
In order to comply with the Data Protection Act, you will need to register as a data controller with the Information Commissioner's Office (ICO) and pay a fee of £35 per year if you keep any form of electronic records of client information. In registering, you are affirming that you intend to treat sensitive data with care, that you will not pass it to any third parties and that you will keep it for no longer than absolutely necessary.
10.5 Working for the NHS
Therapists employed by the NHS work with adults or children and their families to help them overcome a range of problems, including depression, eating disorders and other family difficulties such as traumatic divorces and breakdowns. They work in hospitals, local clinics, health care centres, within the community (i.e. in clients' homes), or within an Improving Access to Psychological Therapies (IAPT) service.
Child psychotherapists work within Child and Adolescent Mental Health Services (CAMHS). These teams are based in the community and work alongside staff from other children's services, including social services and education authorities. Whether they work with adults or young people, NHS therapists must be willing to work as part of a multidisciplinary team.
For example
A therapist treating a teenager with an eating disorder might need to liaise with a psychiatrist, a GP, the client's social worker and a representative from the client's local education authority. A qualified therapist can expect to begin on a salary of around £32,000, based on a standard 37.5- hour week. The NHS oversees supervision.
Fact
In 2017, 1.4 million people were referred to NHS therapy providers.
Source: www.nhs.uk
People working in the caring professions are at increased risk of compassion fatigue and burnout. Symptoms include a general inability to function, physical and mental exhaustion and cynicism towards your profession, your clients and life in general. It is vital that you acknowledge the demands your career places upon you and that you do not place yourself under too much pressure. Here are a few steps you can take to reduce your burnout risk.
Do not overload your schedule
The most important prevention strategy is to decide on an upper limit when it comes to the number of hours you work each week and stick to it! Bear in mind that you will need time between sessions to make any necessary notes, to have a break and to clear your mind before the next client. Take your personality and energy levels into account too - some people work best in the mornings, whereas others find they are better able to engage with clients in the afternoon and evenings.
Talk to your supervisor regularly
Supervision does not just act as a quality control check on a therapist's skills. It also helps the therapist maintain a healthy perspective on their career and life in general. If you have been feeling drained, there is no shame in mentioning it to your supervisor. They should have the knowledge and experience required to give you some sound advice.
Maintain good lifestyle habits
Eating well, sleeping properly and spending time with friends and family all act as buffers against the stress that comes with working as a therapist. It is normal to feel slightly overwhelmed from time to time, but your work should enrich your life.
Strive for a reasonable work-life balance.
It is inevitable that you will be forced to channel a lot of time and energy to one aspect of your life occasionally, but make it the exception rather than the rule.
Build an identity away from your profession
Working as a therapist can be highly rewarding. However, as is the case with any other career, it is essential to maintain an identity that does not revolve around your job. Otherwise, if you cannot work (whether or not you have to take a break due to burnout), you will be at risk of depression and burnout because you will have lost your key purpose in life.
Be honest with yourself
Therapists often emphasise the importance of self-awareness to their clients, but are not always so honest with themselves! Do not try to pretend that you are OK if your mental health is suffering.
Fact
567,000 people completed a course of NHS talking therapy in 2016/17, representing a 30,000 increase on the previous year.
Source: www.nhs.uk
Module Summary
The process of qualifying as a therapist takes approximately four years of part-time study at a college or specialist training institution. In order to qualify for registration with the UK's leading regulatory bodies, you will need to provide evidence of around 450 hours of training and experience. Once you have begun your career, ongoing supervision and CPD are compulsory to ensure that your clients receive high-quality treatment. CPD allows you to keep up with new developments in the field and will provide you with inspiration to incorporate new strategies into your practice.
As a therapist, you can work in the public sector, the private sector, or both. If you choose to set up a private practice, you will need to follow certain legal and professional obligations. These include registering as self-employed, learning how to deal with tax and related
financial matters and choosing a suitable location from which to practise. You will also need to create a marketing plan for yourself and price your services appropriately, which can be daunting if you have no prior business experience. Working as a therapist is rewarding, yet it can also be draining. The best protection against compassion fatigue and burnout is self-awareness combined with a healthy lifestyle and regular supervision.
.svg)
