In our regular blog articles, ‘Making Head or Tail of…’, our Head of Services, Isabelle Dolis, shares her thoughts and reflections on a topic relevant to counselling and the services we offer at Cogwheel Counselling.
We live in a world where we all appear to have fewer and fewer resources to make life work. Our time is crammed with work demands, caring responsibilities and life admin in many forms. At times, this means that we end up rationing sleep, rest and play in order to try and manage. Our attention is incessantly hijacked by devices and social media notifying us; we will miss out if we don’t check this particular notification right now. Our income grows so much slower than the cost of living which becomes less and less manageable even when many are cautious and limit spending to bare necessities.
There is no doubt that our emotional wellbeing is under assault from many angles and more and more people notice their mood degrading and their levels of stress and anxiety rising. Paradoxically, it seems that the referrals to our service have slowed down recently. Our mission at Cogwheel is to offer affordable counselling yet, in order to run our service and pay a fair wage to our staff and counsellors and invest in quality support for all, our volunteers and trainees in particular, we have also needed to review our contribution levels. This creates a tension that some of our funders have helped us navigate up until now through the Cogwheel Counselling Support Fund which enables us to offer a supported rate for those on very limited incomes or subsisting on benefits. We have also been commissioned by a local NHS Primary Care Network to provide six sessions of counselling free at the point of delivery to their patients. Whilst our basic session rate set at £27 is much lower than the cost of private therapy, for many this is an amount they do not feel able to commit to therapy. Many are willing to try and do get in touch, yet, rent, food and heating quite understandably come first. Even our lowest rate of £10 has been a concern for many on a tight budget. I suspect that some of those who might, but do not get in touch may do so if the sessions were fully funded.
Yet, I believe this is only part of the picture. Many clients seem to prefer in person therapy, but there is more cost and additional time to consider. Over the last year, we have noticed a marked increase in the demand for sessions in the evening. People’s availability is increasingly more limited and it becomes harder to find a suitable allocation in a timely manner as many counsellors prefer to avoid evening times because of the demands on their own time. This is proving a particularly difficult conundrum to navigate from an organisational standpoint. The times we can offer do not always match well clients’ availability at a price they can manage and in a way that is right for them. Not enough money, not enough time, not enough mental space to afford pausing, looking at and working on issues and taking time for oneself. This may manifest in initial engagement yet offers are not followed through. Fear and avoidance are likely elicited when approaching issues becomes a reality.
Cogwheel therefore continues to look at how we can meet the needs of many individuals in the area in a way that works for them. Offering remote sessions certainly has facilitated seeking help for many. Further reducing the cost of sessions or offering free sessions for those in particularly difficult financial situations is something that we continue to consider. A number of clients have enquired about fortnightly sessions. This may mean a higher level of administrative complexity, but may ease the pressures in terms of time waiting and permit spreading the cost for clients. The frequency of sessions has so far been associated with best outcomes, however, if individuals cannot engage with therapy the way it is being delivered, then there are not outcomes to speak of. Training institutions can be very specific with their placement requirements, so conversations are needed to match textbook best practice and the realities of the service delivery frontline, particularly in third sector organisations. We continue to reflect on how we can effectively meet clients where they are.
