ABSTRACT
This chapter focuses on the virtues or otherwise of establishing managed counselling services within the National Health Services (NHS). It discusses the implications of such developments for the counselling profession, for other health and medical professions, for treatment approaches to mental health, and for the employment conditions of counsellors in the future. Counselling and psychotherapy are based on the movement of the individual to self-knowledge and autonomy and the medium for treatment is the therapeutic relationship. The effective use of counselling and psychotherapy may well have been growing steadily in the NHS and in particular in primary care since the 1980s. There are always constraints in the NHS – most notably that of money and consequently of staff – that put a time and money pressure on every resource. Counselling is very cost effective over the long term and when compared to other calls on primary care.
