Elitism in counselling and psychotherapy

Mel Ciavucco
9 min readJul 19, 2020

A trainee counsellor’s perspective

By Mel Ciavucco

I’ve worked in a counselling organisation for over seven years, five years of which as the office manager. I was taken on as a temporary receptionist and I told the manager at the time that I thought I might be interested in training to be a counsellor in the future. He told me I was way too young… I was almost 30. Every time the idea of training popped into my head, I pushed it aside. I knew it wasn’t really about my age, it was more about waiting until I’d had more personal counselling and felt ready… but is anyone ever really ready?

It’s maybe a stereotype that counsellors are mostly white middle-aged women… but that’s the group of people I’ve mainly worked with through my seven years in the industry. As a temp receptionist, I held our wonderful counsellors up on a pedestal. Administrators hold the whole system together yet are often paid minimum wage, seen as unskilled. I just couldn’t see how I would fit into the counselling world — I thought I was too immature, too unstable, too quirky… and too common. I hadn’t seen any working-class fat therapists with pink hair. I thought I’d have to put that identity aside if I wanted to start training. I’d also have to find A LOT of money, which seemed quite impossible on a low wage in the charity sector. I had four jobs at one point and still wasn’t bringing a lot of money in. Helping jobs don’t pay well.

This is no criticism of the middle-aged white women in the industry, but without representation of all different people, different genders, ethnicities, abilities, shapes and sizes, how do we expect to give the message to the general public that counselling is for everyone? When the doors are closed for trainees who aren’t affluent enough to access it, we reinforce the idea that therapy is only for white, middle-class people, delivered by white, middle-class people.

Last year, at 36-years-old, I took the first tentative step towards a career in counselling. I did a 10-week Listening Skills (introduction to counselling) course and loved it, but I already knew the hurdle that was coming — the cost of courses. Counselling training options are super confusing — there are levels and certificates, diplomas and degrees and foundation degrees. Seems like there should be a lot of ways in, right? Well, often it’s not down to choice.

Technically, counselling isn’t regulated in the UK (though there are membership bodies) but that means anyone can sign up to a £12 Wowcher “counselling” course and set up a website, with the obligatory picture of a few stacked up stones, and call themselves a counsellor. These courses are not valid counselling courses and are not accredited (there’s a petition against them HERE). Even if they say they’re accredited it’s normally just by a generic online course provider which has nothing to do with therapy. These online courses are irresponsible and potentially pose a huge risk to the general public.

It didn’t help when Prince Harry and Megan Markle posted on Instagram earlier this year, ‘If you’re home and feeling bored, you can digitally train to be a counselor and HELP someone who really needs your support!’ Many counsellors and organisations called them out on this for being misleading. Their post was referring to organisations which provide text and phone support (not counselling) but they hadn’t made this clear. Counselling isn’t something you can train to do cheaply or quickly and it involves a lot of hard-going emotional stuff. To imply that you can just become a counsellor if you fancy it when you’re bored is completely disrespectful to our industry.

It’s clear that there desperately needs to be better regulation for the industry, which is what SCoPEd (Scope of Practice and Education) is trying to do. In the recent draft of the guidelines (July 2020) they split counsellors and psychotherapists into three different bands — A, B and C, though it’s pretty clear what the hierarchy is. Here’s my take:

A — foundation degree from a crap college, better luck next time

B — oh, you thought you did a lot of work on that MA? Sorry mate, still not enough to get to the top

C — trained for 35 years, with 3 million placement hours, costing £2 billion, whilst still being able to pay the mortgage on the house and the holiday home. Good enough.

Okay, I’m being silly but you get the point. It’s hugely reinforcing the elite hierarchical nature of counselling training.

I was just about able to do my Foundation Certificate at the same college as the listening Skills Course. They’re seen as one of the “best” colleges in my area. I felt like I tricked my way in somehow. I knew I wasn’t going to be able to continue my training there as I’d already spent over £4,500 on that one year alone including the 35 mandatory sessions of counselling. It was an amazing course and I’m privileged to have been able to do it. Their Psychotherapy course is five years, the kind that likely gets you into band C. That’s a very, very expensive five years.

These “best” colleges are the ones that help you find good placements, that look great on your CV and have the good reputation needed to help you get a decent job or set up in private practice. These courses are accredited by the “best” membership bodies. But no finance options to help, these are only accessible for certain socio-economic groups… you guessed it — predominately white middle-class people.

Most university tuition fees are now £9,000 per year, but if you’ve already used student loans they often don’t allow more. Advanced Learner Loans can be an option, but only for certain types of courses — the general rule according to Student Finance is that Advanced Learner loans are for further education such as diplomas and courses at local colleges (but I couldn’t get one for my Certificate) and Student Loans are for higher education (ie university).

One of my local universities changed their diploma to an MA, meaning it isn’t accessible for people like me who don’t have a degree. I applied for an undergraduate degree, which will mean travelling further (costing even more money), in the hope that I could access student finance. But here’s the next problem — I went to university in the early 2000’s and had quite major mental health problems. I battled through, not telling many people, not even the university or my doctor. I was so ashamed of dropping out of university and was scared that if I admitted to having mental health problems, that it might affect my job prospects (in any industry). I’m glad we’ve moved on a bit since then but we’ve still got a way to go. So currently, I’m not eligible for student finance, unless I can prove I had mental health problems almost 20 years ago. Fun. I’ve just attempted this appeal (once I’ve had an outcome I’ll post an update at the end of this article). If this isn’t successful, there will be no other option than to try to raise the £9000 tuition myself, so if I start saving now I might have enough by the time I’m ninety-five.

From online counselling groups I’m part of, it seems many students are turning to online course options as they’re cheaper and more accessible. But online courses often aren’t recognised by some membership bodies. Even at local colleges, many courses no longer meet the BACP (British Association for Counselling and Psychotherapy) accreditation requirement. So now, with SCoPEd (Scope of Practice and Education) underway, is it even worth it?

I knew I wouldn’t get into this industry without some hurdles, it’s all part of the journey. But I want us to consider that if I’m struggling to access counselling training, with my various privileges (white, non-disabled, cis-gender), then how much harder must it be for people in minority groups? There were no people of colour, trans or non-binary people, or people with disabilities on my foundation course.

Only the privileged win in this game. The “best” colleges don’t need to take a chance — their greatest source of income is from stable middle-class white people, who are likely already educated and easily accessed their own therapy. Why would they open the doors to anyone else? The industry is being maintained as elitist because they rely on wealthy people to keep them going. The working class seemingly are a risk. There’s no doubt that mental health difficulties are more prevalent in working-class and minority communities, and there are not only financial blocks but also stigma and normalization of trauma which impact people accessing counselling (and people training to be counsellors). I passed off the traumatic incidents in my own life as just “normal stuff” and wouldn’t ask for help because I didn’t think therapy was for people like me. It was for the posh kids. Then I thought I couldn’t train to be a counsellor because it was only for the posh people. I realise the conditions in my own life which has caused this thinking, but I wasn’t wrong. Now I’m determined to get into the industry for this reason, because we need to make a change.

There needs to be a way for people to access high-quality training based on their ability, experience and self-awareness instead of socio-economic factors. We don’t need a band C that is only accessible for a small percentage of elite people. This hierarchy is only going to make the white, middle-class nature of therapy worse, which will reinforce the stigma and barriers around accessing counselling. We should be normalising counselling for everyone, especially now following lockdown and COVID-19. We need mental health support more than ever, from a wide range of people, to help a wide range of clients. I’m all for regulation of the industry but only if there’s going to be equal access to training courses. Maybe SCoPEd could start with tackling those pesky £12 Wowcher deals instead?

This is bigger than the colleges and universities of course. This is about how we view mental health as a society. This is about who our society (mainly the people at the top) deem “good enough” to be a counsellor. I’m aware that I have my own battles to fight about my own self-worth, and I’m privileged to be able to work on my own self-awareness. Self-actualization is a privilege. It’s political. It’s about classism, racism, transphobia, fatphobia… I could go on. It’s about our unconscious biases. It’s about the division, stigma and shame on which a capitalist society thrives.

When our mental health services are over-stretched, under-funded and therapy is seen as a luxury, we are stuck in the cycle of the middle-class people becoming counsellors, offering sessions to middle-class people who can afford to pay for it. We are failing the people who need it the most — the minority groups and working-class people having to deal with austerity, discrimination and inequalities on a daily basis. We need to keep talking about mental health, keep pressuring the government to fund services properly. We need bursaries and financial help for trainee counsellors. We need to change the content of training courses to be inclusive instead of just throwing in a day of learning about “diversity” to tick a box. When we make race, gender, sexuality (etc) a separate “thing” we only reinforce stigma and the message that there’s the “norm” and there’s the “other”. The industry has to prove that courses are genuinely accessible to everyone and that means making the “othered” people feel safe enough to be there.

We need equal access to all levels of training, based on ability and suitability instead of wealth. An important aspect of being a counsellor, in my opinion, is the ability to self-reflect and understand/recognise your privilege and use that, with compassion and empathy, to be able to support others. We need options for low cost/free counselling for anyone who needs it, whilst not reducing the quality and standard of training for counsellors.

This isn’t just important, it’s crucial now. The world is in crisis, but it’s an opportunity for change.

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Mel Ciavucco

Integrative counsellor, trainer and writer. Interests in eating disorders, body image, weight stigma, and domestic abuse. https://melciavucco.com