Counsellors in the National Health Service: A mixed‐method study of efficacy and satisfaction from the counsellor perspective

Ryan, Gemma; Duncan, Charlie and Moller, Naomi P. (2019). Counsellors in the National Health Service: A mixed‐method study of efficacy and satisfaction from the counsellor perspective. Counselling and Psychotherapy Research, 19(3) pp. 338–348.

DOI: https://doi.org/10.1002/capr.12221

Abstract

Background: It is difficult to know how many counsellors work in the UK’s National Health Service (NHS). At a time when the British Government is pledging an expansion of the mental health workforce it is important to understand both the opportunities and barriers for counsellors to work in the NHS.
Aim: To understand counsellors’ job roles, pay, perceptions of services, workplace stress, and reasons for leaving the NHS.
Method: An online survey was advertised to members of the British Association for Counselling and Psychotherapy (BACP); just under 2,000 counsellors responded. The sample was majority female, white and had completed training. Mixed methods were utilised to analyse the data which incorporated use of thematic analysis.
Findings: The data suggest that, as a workforce, counsellors are prone to being ‘squeezed’ out of the NHS workforce, that they are comparatively ‘underpaid’, are ‘pressurised’ by high level of work demand and are consequently experiencing concerning levels of workplace stress, and that they perceive themselves to be, in multiple ways, ‘under-valued’. Despite this, members reported high adequacy of therapist qualifications and supervision quality within NHS services.
Conclusions: Counsellors have expressed a desire to undertake more work in the NHS and are a potentially cost-effective mental health workforce in comparison with other types of professionals. However, this study has evidenced significant structural, cultural and pay and promotion-related barriers that are pushing counsellors out of the NHS. Of particular concern is what appears to be a broad under-valuing of counsellors as a professional group.

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