A primer for those considering retraining as a therapist or healer.
The sustained economic and financial turmoil of the last few years has seen many people laid off and made redundant; bringing out a reconsideration of their career options and the possibility of retraining in another field. Apart from seeking more fulfilling work and the opportunity to control their financial future, many people receive some form of supportive help or counselling during these tough transitions. Quite often the kindness of a trained therapist and an improved emotional coping ability ignites the idea of training as a therapist them self.
You may have already been asking yourself questions such as:
- “what are the job prospects for therapists?”
- “how much can a therapist earn?”
- “what is it like working as a therapist?”
Although working in a helping profession can be a very rewarding and altruistic experience, there are some very serious issues that will impact your future livelihood year after year that need to be carefully considered before enrolling in any therapy school. That way you will have appropriate expectations, avoid disappointment and give yourself the best chance of success.
This article is directly relevant to those wishing to study and work in the United Kingdom (UK) and draws upon a knowledge of such, however the issues presented are broad enough to have a much wider applicability. However do ensure you check specific details in your own country and state as necessary.
The word ‘therapy’ is of Greek origin (‘therapeia’) and literally means “to attend to”.
Given this definition, it’s easy to see how the therapy field is very broad and encompasses many different types , from the very conventional and mainstream to extremely alternative (and often controversial) forms of therapy. Some practitioners work with touch and their hands on the body such as Reiki, Craniosacral Therapy and Osteopaths; others use strictly verbal methods of relating and rely on a certain level of client insight such as counsellors and psychotherapists; some practitioners include more spiritual and energetic beliefs and techniques in their work; and then there are the beauty therapists who need to be mentioned as well for completeness.
It’s not my intention to list every type of therapy (suffice to say there are many – a comprehensive list of therapies is usually obtainable from an insurance company catering for complementary practitioners), but to indicate how broad and varied the options for retraining are.
Ultimately your choice of therapy will have a large impact, and many knock-on effects to things later on, and as such should not be a decision made lightly. Take some time and consider the following items before proceeding to individual school selection:
- Is this new skill going to be a profession or just an interesting hobby for you?
- What is your annual income required for 1) basic survival? 2) a rich and fulfilling lifestyle?
- Will your future anticipated income level change? (eg. significant life event, birth of a child)
- Is your desired therapy regulated (voluntarily or by law) with minimum training and ongoing supervisory requirements?
- Do you wish to work privately by yourself, in a clinic with other therapists, or in a much wider multi-discipline health setting such as a hospital or outpatient service?
- Are you good at, or wish to learn how to be self-employed? (including advertising, managing finances and running a business)
- Is having a university qualification (and being deemed a “professional”) more important to you than a certificate or college diploma?
- Is your working title (eg. Osteopath, Chiropractor, Psychotherapist) protected by law so members of the public are prevented from using it as well?
- Is your desired therapy backed by good quality research or clinical trials substantiating any medical or health claims commonly made?
[This is an important point, as a finding by the Advertising Standards Agency (ASA) against your marketing can potentially cause reputational damage. See these complaints upheld against the Craniosacral Therapy Association and also Being in Stillness (run by Amanda Biggs, tutor at College of Craniosacral Therapy CCST at the time of writing this article originally) – although it must be said that the lack of clinical evidence does not necessary mean the treatment is ineffective.]
- Are you happy touching people you don’t know, or would you wish to work hands-off or verbally instead?
The sad fact of the matter is that most therapists cannot survive on good intention and altruism alone (although a lucky few do seem to manage!). Almost all therapists need to offer a good value service which is wanted, meets the needs of the general public, and encourages referrals and repeat business. Many therapy schools seem to forget or not mention this important point, being more focused on the finer therapy techniques rather than the bigger picture.
Most professional therapy associations will either explicitly state or provide guidelines as to how many clients should be seen per week. Usually the number of 20 (x 1 hour appointments). This is important as the helping professions can be very draining with a high burnout rate, so the idea of limiting client facing time is to ensure the therapist can attend to self care, supervision and close contact with friends and family (especially important when working by yourself). All this helps the therapist remain impartial and able to offer safe, effective help to their clients.
Understand that most “full-time” therapists are actually what they call ‘portfolio workers’; seeing a number of clients in possibly different settings (eg. GP surgery, home, clinic) with the rest of the week spent doing something else to supplement their income and/or provide personal growth or fulfilment of social needs outside the consulting room. Painting professionally or teaching at a therapy college are both good examples of other portfolio activities.
Most complementary and alternative therapies will not allow you to obtain a PAYE, salaried 9-to-5 job working for someone else. So find out the average hourly rate of the therapy you’re interested in studying, in the area you’d like to practice. Multiply that by 20 (maximum clients per week) and then by 48 (working weeks per year). The answer is the gross amount you will make from seeing clients (ignoring all costs and tax for simplicity). It most likely won’t be as high as you’d like. Any shortfall from your desired annual income will need to be made some other way in your portfolio work.
If this kind of thing is not for you, then consider studying for either a Doctor of Psychology (Clinical or Counselling) or as a physiotherapist. Both are well recognised in the public and private healthcare system, regulated with standard pay scales and conditions that you can find out easily, and offer a professional career path with the opportunity to progress into management.
A Comment About Counselling and Psychotherapy in the United Kingdom
My understanding is the profession has a huge number of practitioners, several different professional associations which accredit and recognise different standards of training, and is rapidly becoming well known by the health service and general public at large.
The British Association of Counselling Professionals (BACP) seems to be the most widely known and accepted standard for base level counselling training, and any counselling course you decide upon should confer automatic BACP membership. It will most likely be a Diploma of Counselling which has taken 3 years to complete (1 standalone foundation year granting a Certificate in Counselling Skills, and then 2 further years granting a Diploma setting out minimum standards for personal therapy, client hours and supervisory contact). A psychotherapy training recognised by the United Kingdom Council for Psychotherapy (UKCP) will mandate this counselling qualification firstly, and then take another 2 years of in-depth study allowing you to work with psycho-pathologies, mental illness and extreme relational difficulties (5 years of training in total from no experience).
The Health Profession Council (HPC) is the official government body enacted in law to oversee some health professions such as Physiotherapy and Osteopathy, and has been looking to bring together the various counselling and psychotherapy associations into a single accreditation. This process has been in consultation with bodies such as the BACP and UKCP for approximately 8 years now and it’s unsure which and what levels of training the HPC will recognise, however I have heard anecdotally a good quality masters degree is the best assurance against any of these future changes, with an added benefit of being the most transferrable between different countries (please indicate if my understanding is incorrect in any these matters if you are better placed to comment).
Make no mistake, therapy training is big money for the schools, universities and associations involved in this industry. Standards, industry recognition and accreditation varies widely (along with cost) and it’s very much in your interest to pick a training that allows your own goals to be thoroughly met.
A weekend course in Reiki for example will allow you to start offering a nice service, but will in no way be thorough enough to deal with the ethical and boundary issues you will face when dealing with the general public and serious mental and relational difficulties (and to make use of your power in the “therapist” role and offer your own “advice” in such matters would be deemed unethical). To work at that level would take a course of many years (counselling for example) under close and continuous supervision to iron out your blind spots and ensure a professional service to the client. It will also give you a level of recognition needed to receive GP referrals and potentially work in the health service. Due to the largely unregulated nature of the profession, many therapists are poorly/minimally qualified to deal with the issues they advertise for (my personal opinion is that NLP and life coaches are often skirting this boundary).
University: Maybe the biggest decision you will make is whether to go to university (or a college accredited by a recognised university). Given the current desire for research based, substantiated outcomes it could be wise to consider Ph.D programs or B.Sci degrees from strong universities rather than B.Art qualifications. The advantages being a robust, professional training recognised by government and private employers across continents, potentially giving you skills to apply in other work settings such as corporations and management consulting. Universities have the further advantage of credit point transfers and recognition of prior learning (RPL) between other higher educational institutions. However, university courses are also often long, costly and often don’t offer flexible contact/part-time modes of study for those working or with family commitments. Some people also find higher education courses “too academic”, perhaps more suited to vocational training instead.
Private College: There are some very compelling reasons to consider attending a private therapy college or school; small class size, high tutor to student ratios, personalised training, and perhaps a more holistic or spiritual approach are some of them. Furthermore, it’s very appealing to cut out the corporate bureaucracy and be truly free to arrange your self-employed business affairs as you wish upon your graduation from a complementary therapy training.
However, private colleges are also dime a dozen and can range from a ‘one man, dogmatic, charismatic guru surrounded by devotee tutors’ type setup to very highly professional outfits which have decided to self-accredit for some reason. It’s very much a situation of buyer beware, and it’s even more important to do your due diligence now that colleges are advertising aggressively to try and stop falling student numbers due to economic woes.
It’s a good idea to ask the college if they run an open evening or introductory workshop you can attend prior to making any financial commitment. All therapy training can bring up strong emotions and it’s important to feel comfortable and safe at your place of learning. Some things you may wish to clarify with the college at one of these open days are:
- Contact times and mode of teaching delivery (eg. online, face-to-face, tutor lead).
- Total financial obligation (including personal therapy, supervision, course materials and the opportunity cost to you from any required placements and work experience) often not clearly indicated in the course prospectus.
- The remaining financial obligation to the college and what their cancellation or termination fees are should you wish to stop studying. Some colleges will expect payment in full and may even enforce the debt through the legal system.
- Whether their courses are recognised by, or confer accreditation with well known industry standards (eg. Register of Exercise Professionals REPS, National Qualifications Framework NQF, ITEC, British Association of Counselling Professionals BACP)
- Ask if you can talk to any prior graduates who are now working. This is important. Remember the 20 recommended clients per week (discussed previously) that we used to estimate our income. It’s quite possible this number is too high for the specific complementary therapy we have chosen. Speak to previous graduates to get a more realistic number based on the actual demand from the general public.
Some of the major areas where problems can arise when attending a private therapy college or school are:
- It can be very difficult to transfer to another college and have your completed work recognised (you may have to start again).
- They often lack an independent, student complaints and appeal process arbitrated outside of the college without bias to your assessment.
- Some colleges mandate a required number of therapy sessions with college tutors prior to graduation and at personal cost to the student (dual roles and major conflict of interest).
- It can be difficult obtaining a student loan and financial assistance. The same is potentially true for student visas for international students.
- A high quality of teaching and assessment is not assured if there is no outside accreditation and periodic review process.
- Your qualification may necessitate self-employment (as discussed previously), however many colleges provide minimal or no business skills and marketing training, nor ongoing support.
Given the information in this article and your own due diligence and hard work, you should be able to evaluate and plan a realistic therapy training that suits your needs and personal situation, ensuring both a sustainable and deeply fulfilling career as a therapist or healer. Some people may decide the overall cost and commitment to training (and subsequent self-employment) are more than they initially expected, and others may need the help of a career counsellor or life coach to explore specific retraining issues further.
Ask any project manager about the key to their success, and they will say that delivering a project is often more like a "dark art" or by chance, than a predictable science.