Why I Don’t Keep a Waiting List

Waiting lists for counselling are often spoken about, particularly within the NHS, where waiting lists are prolonged, which can lead to worse mental health outcomes. As a therapist who works in an open-ended way, keeping a waiting list feels unfair, and with the indefinite way I work, I have to ask, is it morally and ethically to do so?

Years ago, I did keep a waiting list, especially for those requiring concessions; however, managing this became overwhelming with the need to constantly juggle the administrative side, manage expectations  and waiting a period of time to hear back, became a logistical nightmare. I stopped because if someone is reaching out to start therapy, they want to start as soon as possible!

It would be easy to say this doesn’t impact clients wishing to return to therapy with the same therapist!

Most therapists have a maximum number of people they can see per week, at times this could be dramatically reduce because:

• The therapist is carrying out additional training and to ensure they are meeting their course requirements they reduce client hours to avoid burnout

• Personal Circumstances, this could include family obligations, family emergencies or their own health

• Portfolio of client work - e.g. They have reduced client hours due to current client presenting issues and want to ensure ethical working and burnout

Although in an ideal world, if you are a returning client, a therapist will have space, unfortunately, this is not always the case, particularly when they work in an open-ended. Therapists know the maximum number of clients they can see, which will not be detrimental to their own health and well-being, and if they’ve reached that number, it would be unethical to work beyond their capacity.

So, new or old clients, when I have no availability, I will:

• Refer you to the centre I work at or a colleague

• Providing immediate resources, e.g. Helpline