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SHRINKING RETURNS

The emerging counseling industry in China has attracted a large number of followers but many find that becoming a qualified psychotherapist is an endless and expensive journey

By NewsChina Updated Jun.1

Counselors hug each other to enhance mutual trust among participants

Xiao Li, an intern counsellor in Beijing Jiandan Psychological Consulting, an online platform providing counseling services, sees an average of four clients per week. At the same time, she told NewsChina that she has to spend two or three days a week and pay more than she actually earns for the mandatory supervision process so she can be a fully accredited counselor.  

In 2017, experiencing a midlife crisis, Xiao realized she wanted a new direction in life, so she decided to retrain as a psychotherapist.  

Xiao’s story reflects the experiences of many new psychotherapists in China. Over the past decade, the counseling industry has developed quickly due to a surge in demand for therapy.  

Initially, many people approach therapy either as clients or out of personal interest. But the desire to become a counselor has seen many become addicted to training courses, which may not be recognized as a professional qualification due to the lack of a standardizing body in what is a relatively new field in the Chinese mainland.  

High Cost 
Xiao Li had been interested in a psychology-related career for a long time, although she did not study it at university. After the national psychological counselor qualification examination was launched in 2002, she passed the exam and obtained a level-three (highest is level two, lowest is level four) counseling certificate in 2007.  

The rapid development of the mobile internet and social media fostered the growth of counseling in China. Huang Weiqiang, who studied psychology, founded Yi Psychological Counseling, an online platform. According to Huang, the platform has around 25 million users, with nearly 100,000 people having participated in training courses. Total revenue from a popular online course can reach 4 million yuan (US$610,000). 

In 2015, as social media platforms such as WeChat took off, Xiao saw that the counseling industry was becoming more popular. As online training courses multiplied, she predicted a boom.  

Even so, when she decided to become a counselor, she found gaps in her knowledge. In her three years on the platform, she took at least 10 courses, each costing from 1,000 to 2,000 yuan (US$152-305). She attended offline courses and workshops, like those offered by psychology Professor Zhu Jianjun of Beijing Forestry University, which run to 5,000 yuan (US$762) a year.  

Still she found her knowledge was lacking. She knew a lot of theory but not how to perform proper consultations. In 2017, she spent another 30,000 yuan (US$4,572) on a two-year program from Jiandan Psychology. Xiao told the reporter the program is comprehensive, and after completing it many of her classmates practiced methods from different schools of psychotherapy.  

But Xiao still felt it was not enough. She explained that the psychoanalytic school initially founded by Sigmund Freud has since developed into many sub-branches, so if she wants to specialize, it would take two more years to sharpen her skills. In the past three years, she has spent at least 80,000 yuan (US$12,192) on counseling training.  

Generally in China, there are two main motivations to pursue psychological counseling: interest or to resolve personal issues. Many people become “trapped” in the learning process, taking more and more courses in their desire to become a psychological counselor.  

According to a survey conducted among more than 1,200 counselors across the country, women account for nearly 79 percent of trainees, and nearly 76 percent are in their 30s or 40s, mostly living in economically developed cities such as Beijing, Shanghai, Guangzhou and Shenzhen.  

Like Xiao Li, many have invested huge amounts of time and money in training programs. Liu Qian, a would-be counselor who studies with Yi Psychological Counseling, has spent around 80,000 yuan (US$12,192).  

According to self-reported data from the Jiandan Psychology platform, more than 50 percent of beginners have backgrounds in finance, internet or education, and nearly 50 percent have graduate degrees. Liu told the reporter that a classmate had spent over 200,000 yuan (US$30,480).  

The longer they study, the more psychotherapists spend on the study programs, which are forever offering upgrades and options. According to data from Yi Psychological Counseling, with a consultation experience of less than 100 hours, the average cost of training is around 46,000 yuan (US$7,010). With consultation experience ranging from 100 to 500 hours, the average cost is 84,000 yuan (US$12,802). With consultation experience of over 5,000 hours, the cost could soar to 240,000 yuan (US$36,576).  

Li Songwei, a well-known psychotherapist in China with a doctorate in psychology from Peking University, told NewsChina that he has seen many therapists study for a decade or more before they start practicing.  

Who Is the Patient? 
In June 2019, Liu Qian spent 9,000 yuan (US$1,372) studying hypnosis at a Shanghai-based psychology education organization, and another 4,000 yuan (US$610) on courses on marriage and family counseling. After her coursework was finished, Liu qualified for a Certification of Hypnosis issued by the American Hypnosis Association and a Certificate of Marriage and Family Counselling Instructor issued by the Popular Science Committee of the Chinese Psychological Society. But she still paid US$152 and a couple of hundred yuan for the two certificates.  

Nearly 100 different counseling and therapy certificates have emerged over the past three years. Some 30,000 people annually sit the basic training qualification exams from the Institute of Psychology, Chinese Academy of Sciences. More than 300 exam prep organizations are already listed and over 1,000 more are on the wait list for eligibility. But Lin Chun, vice chairman of the Working Committee of Psychological Counselor of the Chinese Psychological Society, told NewsChina that the course is not much more than “an introductory module to popularize mental health awareness.”  

The Committee of Standards and Research Services of the Chinese Psychological Society organizes counseling certification exams, but as a secondary body the committee is not qualified to issue certificates.  

Another practical concern for Liu Qian is her eligibility to register as a counselor on the platform after completing her training courses.  

“If you want to register as a counselor with a quality platform, you’d better be a student with it first. Training classes can make up what you might need as a counselor,” Xiao said. For this reason, Xiao registered for a two-year comprehensive course with Jiandan Psychology. A respected platform in the industry, Jiandan Psychology’s two-year course includes an internship program. Xiao must log 20 hours of case consultation before she can be promoted to internship counselor and be eligible to list on the platform.  

The amount of consultation hours is not only an important threshold for joining the platform, but also a key indicator for promotions within the counseling system. According to Jian Lili, founder of Jiandan Psychology, billable consultation hours should not be a decisive criterion, but because of the lack of an authoritative and fair evaluation system, the organization has to fall back on this. Some mandatory requirements highlighted by Jian include over two years of systematic training and a minimum 400 hours of paid consulting experience.  

Liu Qian spent nearly 20,000 yuan (US$3,048) for an advanced counseling course on Yi Psychology. After she finished, she registered as a consultant-in-training on the platform and started to offer cheap services at 99 yuan (US$15) for 10 sessions lasting 50 minutes to an hour. She feels that accumulating experience in counseling matters, and more importantly, joining the platform has given her a sense of belonging.  

In Li Songwei’s opinion, a counseling platform gains industry influence as it attracts more would-be therapists. Over the past few years, the pool of new therapists has grown, which has attracted more organizations that muddy the industry and lower standards.  

An anonymous expert from the Chinese Mental Health Association told NewsChina that some top trainers who are not qualified counselors can make hundreds of thousands or even millions of yuan from training programs that only last a few days. “Training organizations boast that the market is lucrative so they attract more followers,” said the source: “But in reality, only the organizations and trainers make a real profit.”  

Lin Fang, a counselor with five year’s professional experience, told the reporter that “the driving momentum of the industry development is weird,” – in other words, it is making money not from counseling, but from the pockets of new counselors.  

A group meditation event in Shenzhen, September 21, 2018

‘Endless Road’ 
Liu Qian now participates in three supervised sessions a week, two group and one personal. Personal supervision is one-on-one, where a supervisor advises a counselor by reviewing notes from sessions. Group supervision is where a supervisor guides a team of some 10 counselors to discuss and analyze cases.  

The seemingly authoritative supervision process works like an apprenticeship, Li Songwei said. Usually, after a year, the counselor can practice independently. When taking on difficult cases, counselors can seek additional help from supervisors.  

Qiao Zhihong, secretary of the psychology department of Beijing Normal University, told NewsChina that in the US, those with doctorates in psychology must work full time for one or two years under supervision of an advisor before qualifying to sit an exam for a psychotherapist’s license.  

Previously there were no requirements or rules as the industry was so new in China, but now supervision is mandatory for almost all organizations. Jiandan Psychology, which started in 2014, now requires counselors registered with the platform to undergo regular one-onone reviews. Jian Lili said higher levels of counselors require more logged supervised hours. Xiao Li’s supervision began after becoming an intern at Jiandan Psychology in July 2019. Xiao charges clients 150 yuan (US$23) per session, but pays about 500 yuan (US$76) for a one-on-one review. So far, she has conducted 20 hours of consultations, meaning she has to pay 7,000 yuan (US$1,066) out of pocket rather than making any money from her work.  

To graduate to novice counselor, Xiao must complete 400 consultation hours. The internship platform requires a review session once every four consultations, meaning she has to spend 40,000 yuan (US$6,096) for 100 reviews. “I’m against the requirement that everyone has to be supervised for a few years before becoming eligible to provide consultations,” said Li Songwei, who inferred that the platforms are just using these conditions as another means to make money from would-be counselors. “First, you have to figure out what the purpose of the supervision work is,” he said.  

Li said after he started working as a therapist, he asked for assistance with two difficult cases. Li favors a peer review model. He has a fourmember peer review team, which he believes is more cost-effective.  

The expert from the China Mental Health Association who asked for anonymity added that there is a shortage of experts with supervision capability in China.  

According to statistics from Yi Psychology, counselors with under 500 hours of consulting experience make less than 50,000 yuan (US$7,620) per year, while those with over 5,000 hours can make over 300,000 yuan (US$45,720) annually. Most start breaking even after 500-1,000 hours of consulting.  

Liu Qian does not plan to make a living as a psychotherapist in the next two years, as she plans to finish the long reading list assigned by her supervisor. “If you go into counseling, you’ll find that you’re on an endless road. You have to keep on with the process of self-discovery and read more books,” Liu said. “At least so far I am happy with the process.”  

Liu Qian said her son often asks her when her coursework will end. But she enjoys the learning process. “I don’t think I’m normal, but many people in this profession are like me,” she said. 

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