The cost of living
I stopped using the term ‘working-for-free’ about the time that train fares doubled and I couldn’t get lunch for less than £5 in my workplace.
One of the things that keeps going round in my mind as I enter my sixth month of industrial action and wage deductions during a cost of living crisis is the evasion in the economic data of the real costs to us for not being paid/not being paid enough. I do have a habit of telling you things you already know but here’s another one I just want to say out loud which is that its not only that many of us are expected to work for free, its that this costs us and sometimes dearly.
On Saturday we held a discussion as part of National Counsellors’ Day organized by CTUK about the cost of living crisis and the impact on counsellors and psychotherapists - a follow up survey from the one we did in 2020/21. This first report was produced when we thought we were coming out of something rather than hurtling towards yet another financial and social crisis. For those of you with a political economy head this comes as no surprise, as the crisis we’re in now is hitting so hard in part because of the long history of austerity followed by the fallout of the pandemic peppered by the underlying shifts in work of automation and platformization putting the gig economy on steroids.
An unforeseen crisis combined with an old and predictable economic story are reflected in the results of this second survey. Key findings were:
49% worried about covering their costs of living this year
42% increased therapy workload to cover increased costs
59% of respondents earn their main income in counselling and psychotherapy
23% increasing work outside of therapy to cover costs
Reduction in part time work from 51% in 2020 to 41% in 2023
Significant reduction of unwaged work at 18% down from 36% in 2020
Significant reduction in earnings £0-99 per week to 17% in 2023 down from 30% in 2020
Shifting patterns of providing twice monthly instead of weekly sessions, losing clients early and having to introduce low/no fee systems
63% cut their professional costs: 46% cut CPD and 29% cut personal therapy
33% cannot see a future earning a living as a counsellor or psychotherapist
The demographics of the sector revealed a familiar picture of 76% women, 77% white British and ages clustered between 35-65 years with 70% of respondents 45 years and older. There is a high level of disability within the sector at 38% (28% in 2020), higher than the UK national average of 18%.
There has been mainly small shifts in income patterns since the cost of living crisis with many therapists continuing to earn low weekly wages. However, we are seeing a drop in people earning £0-99 per week from the 2020 figure of 30% to 17% in 2023. This may be in part due to people moving out of working in the sector or that people have increased their case loads as we see part time work go down from 51% in 2020 to 41% in 2023. Although we see slight increases since 2020 in weekly earnings across all categories still over 65% earn less than £600 per week (gross income) which is the median earning for employed people in the UK.
The very high levels of part time work convey a mixed picture of insecure income linked to insecure patient numbers. For many this is a situation of involuntary underemployment in private practice, supplemented by temporary work such as Employee Assistance Programmes (EAPs) and short term contracts with providers, increasingly online therapy providers.
We saw a reduction in the level of self-employment from 61% in 2021 to 44% in 2023 and NHS workforce static at 6%. We saw a fall in the percentage of people earning a living outside of counselling and psychotherapy at 21% down from 30% in 2020 with 59% of respondents earning their main living through counselling and psychotherapy work. In relation to debt we saw 55% (51% in 2020) of respondents went into debt while training and 36% while in work, up from 30% in 2020.
Most significantly unwaged work has fallen to 18% in 2023 down from 36% of respondents in 2020. The unwaged system of work has traditionally been part of most training courses, and is a way of gaining sufficient clinical hours for membership of the psychotherapy and counselling professional bodies. The therapists in both surveys worked across the range of public and private mental health employers, including services set up to respond to the Covid-19 impact on healthcare workers. Although the largest section of unwaged work continues to be relatively low at 1-4 hours per week this is likely to underestimate the real cost to counsellors and psychotherapists who will in addition have to attend supervision for these clients and, if clients are not seen in the same location on the same day, consist of working for free across a number of days and therefore reducing the possibility of maintaining paid work in other jobs.
Unsurprisingly then,16% (14% in 2020) of respondents receive income based welfare benefits with 4% accessing food banks while training and 3% while working as counsellors/psychotherapists, the same figures for 2020.
As a result of these financial realities, a high level of 33% (30% in 2020) of respondents cannot see a future earning a living as a counsellor or psychotherapist.
The combination of the post-Brexit rise in costs and fuel prices and sustained wage squeezes on top of decades of suppression of real wages has pushed already depleted working people into a genuine crisis. Although the cost of living crisis has exposed and deepened the inequalities of the labour market, the causes of this crisis go further back to the cumulative hit of austerity and the pandemic which further suppressed wages. When 57% of the families living in poverty are working families it underlines the nature of the problem of depressed wages and the gigification of working conditions and the subsequent growth in socio-economic inequalities. The UK increasingly has a two tier system with low income households experiencing the greatest hit in terms of wage suppression, increase in costs and reduction in government support. In this context it is hardly surprising then we are facing the longest period of sustained industrial action since the 1980s in an attempt to reignite collective wage bargaining in order to address the earnings crisis.
Within the psychotherapy and counselling sector we are beginning to see a similar two tier system of low income workers divided into those living in low income households and those who have access to additional family or spousal income. Although many in the sector are relatively protected from the crisis itself, we are seeing a rise in paid work and a fall in unwaged work across the sector. The fall in self-employment in the sector may relate to the insecurity of self-employed work which continuously underestimates the insecurity of income and the link to work intensification.
What the data shows is that the counselling and psychotherapy sector exhibits the precarious characteristics of the UK labour market such as wage insecurity and the growing degradation of wages and working conditions in the profession. Further, as the digitalization, automation and growth of online therapy platforms compounds the issues around working conditions and leads us into the important collective attempts to regulate platformisation.
It is this financial landscape that must now inform the current professional debates and negotiations about the future of therapy.
To read the full report click here.
ps I very rarely say this but I was blown away by the quality of the talking at National Counsellors Day on Saturday. If you missed it I strongly recommend you trot along to our gentle friends OnlineEvents and purchase yourself the recordings - from embedding politics in our therapeutic work to the politics of disordered eating its honestly worth your time.