In January last year, Pia was navigating a difficult breakup. As she did, she came across advertisements on social media for a man who claimed to be an expert in helping clients get over relationships. In various profiles online, he also described himself as a marriage counselor.
Pia, who asked to be identified by a pseudonym for this story, was already seeing a therapist but decided to reach out to the online counsellor too. “I really wanted to come out of my breakup,” she said. “The reels were very attractive, and the content was relatable. I thought, not everything needs to be completely formal.”
Pia signed up for an initial consultation with the counsellor, paying Rs 2,500 for a one-hour session. She felt that the advice he gave was generic, the kind she would expect to receive from a friend with little emotional insight.
“He told me to just forget my ex, move on and find somebody new,” she said. The session did not in any way help her process her pain. She found one suggestion from him particularly strange – that she find a foreigner to date at her new workplace.
Despite her scepticism, Pia recounted, she found the counsellor’s demeanour persuasive. And so, when he told her that attending group sessions that his company organised would benefit her, she agreed to do so.
Pia paid around Rs 6,000 for a series of these sessions, held over six months, which, she explained, also gave her access to “self-help modules” online. She paid an additional Rs 10,000 for four private sessions with the counsellor.
There was no fixed format to the group sessions – they would sometimes begin with a game or meditation or even an exercise in which participants imitated animal sounds. After this, the participants would talk about their problems, and the counsellor would offer them suggestions. While Pia found the sessions occasionally soothing, she also often felt they were awkward and unhelpful.
Further, she grew concerned at what she believed was superficial advice that the counsellor and other facilitators sometimes gave to participants in the group sessions, even in response to serious problems.
“They would often suggest that people should play mind games with others in their lives,” she said. “I don’t think this advice would help if someone was facing severe mental health issues.”
For instance, she recounted that the counsellor advised one woman who was facing domestic violence from her husband to just avoid him for a few days. “I felt that was a legal case, and maybe a therapist would have given better advice,” she said.
Pia also found the one-on-one sessions less than reassuring. “He tried to convince me that my ex was having an affair with a friend whom I saw in his photos,” she said. Pia did not think this was likely, but the counsellor refused to accept her point of view. She recounted that he said, “Girls don’t understand, but this is how all guys are. Guys and girls cannot be just friends.”
Pia was troubled by the advice, and after attending three private sessions, decided against attending the fourth, even though she had paid for it. “I felt he would again tell me that my ex cheated on me, and I should just forget about him,” she said.
Often, Pia also felt that the counsellor and the other facilitators were too focused on comforting participants, when in fact, in her view, some needed professional counselling. “In therapy, sometimes you have to hear things that you don’t want to hear, but are good for your mental health,” she said.
Pia’s experience casts light on a larger problem with the field of counselling in India – the country’s laws do not recognise and regulate a sufficiently wide range of mental health professionals. One of the results of this is that those who seek help run the risk of finding themselves in the hands of untrained and unqualified individuals.
The primary law that deals with mental healthcare in the country is the Mental Healthcare Act of 2017.
While the law recognises several kinds of mental health practitioners, including psychiatrists, and those from fields such as ayurveda and homeopathy, when it comes to psychologists, the only kind it acknowledges are clinical psychologists.
These are typically practitioners who work in clinical settings alongside psychiatrists, and help patients tackle mental illnesses.
Among those the law recognises as clinical psychologists are individuals who have an MPhil in clinical psychology from an institution affiliated with the Rehabilitation Council of India, a government body that oversees matters such as training programmes for professionals who deal with people with disabilities.
Clinical psychologists also have to be registered with the council to be recognised under the law. (Psychologists noted that changes are currently underway in these regulations – in line with the National Education Policy of 2020, the MPhil in clinical psychology stands to be discontinued after 2026, and will be replaced by other courses.)
In contrast to clinical psychologists, counselling psychologists typically work outside clinical settings, with those in mental distress. They usually have a master’s in psychology with a specialisation in counselling.
Those in the field explained that in many ways these distinctions are technicalities – clinical psychologists also use counselling as a tool, and counselling psychologists also often help with the diagnosis of conditions that are formally classified as disorders. But the law makes no formal reference to any other kind of psychologist.
“The act provided only a small subset of psychologists with due recognition,” said Rupa Chaubal, counselling psychologist and president of the advocacy group Psychologists Collective.
Chaubal explained that this lack of formal recognition for the larger field of psychologists has led to confusion among the public about the professional qualifications required for an individual to practice as a therapist or counsellor. This often results in situations where people find themselves consulting insufficiently qualified counsellors.
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It is not only those seeking help online who run the risk of encountering unqualified or under-qualified counsellors.
In 2022, Asha, a psychology student in Delhi began facing difficulties in college which led her to miss classes. A concerned professor suggested she approach an NGO based in New Delhi, for counselling. As a student with a limited budget, Asha was relieved to learn that the organisation offered free counselling services. She decided to avail of the services and donate some money to the organisation after her sessions were completed.
Asha visited the organisation’s office and was assigned a counsellor, a woman who, by her estimate, was in her fifties. “Ideally, I should have asked her qualifications, especially as a psychology student, but I forgot,” said Asha, who asked to be identified by a pseudonym.
From the very first session, Asha realised that she did not feel at ease with her new counsellor.
There were several reasons for this. For instance, though Asha had explained to the counsellor in the first session why she was seeking counselling, the counsellor failed to remember the information and at several sessions, would recall it incorrectly, forcing Asha to correct her. “I would end up feeling judged at the beginning of every session,” Asha said.
There were also constant distractions during their sessions, though ideally, a therapist should ensure that sessions are uninterrupted. Often, people in the office would peep into the room to ask the counsellor questions, and she would step out of the room to talk to them.
This felt to Asha like a violation of her privacy. “I didn’t want anybody to see me inside the room, deep-diving into a whirlpool of emotions,” she said.
Further, the counselling sessions were unhelpful. “Instead of working with me, it felt like the counsellor was there to collect gossip about me,” said Asha. She recounted that when she shared painful experiences with the counsellor, she often responded in ways that seemed aimed at invalidating Asha’s feelings.
One time, for instance, when Asha complained about a friend treating her poorly, instead of speaking about Asha’s emotions, the counsellor reminded her of a time when the same friend had helped Asha out. “She made me question myself, not in a useful way,” Asha said. “A good therapist would help you figure out your feelings and not give you instructions. I often felt bad about myself.”
It was only in their third session that the question of the therapist’s qualifications arose. At the session, Asha mentioned a theoretical concept from psychology, and asked the therapist if she had studied it. The therapist said that she had not studied psychology.
Asha was shocked to hear this and probed further. She recounted that the therapist said, “I’m only a counsellor and not a psychological counsellor. It’s not necessary for a counsellor to study psychology.” Further, the therapist said, “You just need to be trained, and I got my training in Gestalt psychology,” referring to a school of thought that originated in Germany in the 20th century.
“I thought, how did I end up here?” Asha said.
Scroll emailed the NGO to seek its response to the criticism that its counsellor was not sufficiently qualified. The organisation’s director responded, “We have a stringent process to select our Volunteer Counsellors. They are required to attend an orientation in person, fill a detailed form, followed by an Interview and a Group Discussion. We look for qualities such as availability, empathy, sensitivity, warmth, lack of judgement etc. The selected Volunteers are then trained experientially in a combination of classroom and on the job training for 6 months.”
The director said it “came as a surprise” that anyone would have been unaware that one of their counsellors had not studied psychology. “We have disclaimers everywhere in our centre prominently displayed that our Counsellors are Volunteers and NOT Professionals,” she wrote. “Our website also clearly indicates the same.”
After attending two more sessions, Asha decided to stop seeing the counsellor. She was busy with her coursework at the time, and so did not complain to the organisation about her dissatisfaction. The experience left her with the realisation that there was a serious need for better regulation of the profession. She stated that she was left confused “even though I was a psychology student”.
She added, “Just the label of therapy is not enough, you also need to find out about your therapist’s qualifications and work experience,” she said.
While inadequately qualified therapists exist both online and offline, data and conversations with professionals in the field indicated that the quick attention that social media users can gain, and the benefits that can accrue from it, have led to a sharp increase in conversations about mental health online, as well as the number of individuals online offering mental health support.
An Economics Times report stated that, “According to data from Qoruz, an influencer analytics and marketing firm that evaluated nearly 500,000 creators in India, Instagram accounts discussing mental health and wellness surged nearly 70% from 5,062 to 8,562 between 2022 and 2023 and have now reached 11,894.”
These include trained therapists. Psychotherapist Rhea Gandhi, who has a public account on Instagram with more than 22,000 followers, explained that there had been a cultural shift in expectations about whether therapists should have an online presence. “I was trained to think that as a therapist, I should be hidden and not be accessible to the public, so that it allows clients to have a very private relationship with us,” she said. “Earlier, therapists would be shamed for having public social media accounts as it was seen as unethical. But that has changed, and now there’s pressure to have such accounts.”
In fact, Gandhi was spurred to start her account by misinformation about mental health that she saw being spread online, which included posts that she felt were diagnostic in nature, as well as posts that offered quick fixes. “Instagram is not therapy,” Gandhi noted in her very first post from her account. “#MentalHealthAwareness is one thing, reducing our inner worlds to a bite sized nugget is another. If working through our emotional life was easy, we wouldn’t spend years and years learning about how to help ourselves and others do it.”
Gandhi does not consider her account as crucial to her practice, but rather as a tool of education. “I personally think it is absolutely unessential for therapists to have an online presence,” she said.
Like Gandhi, many others in the field also worry about the rise of mental health influencers and coaches online. “Mental health influencers are the bane of our existence,” said Ruchi Brahmachari, assistant professor of psychology at St Xavier’s College, Mumbai. “Lots of people are using mental health jargon for everything without having a proper understanding of these terms. They offer quick-fix solutions in the form of online courses and sessions.”
SnehaJanaki, a counselling psychologist from Mumbai, noted, “People who have done short-term training are offering magical and miraculous things. But anyone who has undergone some kind of training of the mind would represent themselves congruently.”
In other countries, such as the United States, “where the title of a psychologist is protected, people like life coaches have absolute clarity that they can’t diagnose and treat mental health concerns”, said Chaubal. “But this clarity is lacking in India.”
SnehaJanaki explained, “You have a whole range of people to choose from and there is no regulation in most of these fields. For consumers that’s a confusing trend.”
Indeed, once I began looking up mental health content online for this story, social media algorithms responded by showing a variety of mental health-related content in my feed. Some of this content was educational in nature, but much of it comprised advertisements for online workshops and sessions, which made a wide range of promises.
One post noted that in 28 days, I could learn how to “murder … anxiety” so that it “never comes back”. Another, that by paying as little as Rs 199, I could attend a “mindset reset bootcamp” and “cut ties with stressful, anxious and negative feelings” and “enhance abundance”. Yet another, that for Rs 1,200 I could say “bye bye to money trauma”. One post, incredibly, offered to train me in just six weeks to become a certified trauma healer myself.
Gandhi believes that clients and consumers need to be more aware of potential pitfalls when they navigate content they come across online. “People need to realise that the online space is not for research but for sharing opinions,” she said. “Consumers need to be responsible and do their research because the online space is like the wild wild west for misinformation and disinformation.”
In some cases, those claiming to offer counselling can develop into almost predatory figures in the lives of those seeking help.
Such was the case with Sai, a 31-year-old trans person who suffers from a painful genetic disorder that causes extreme flexibility in various joints. Sai, who asked to be identified by a pseudonym, was, in fact, seeking specialised physiotherapy for the condition, and not mental health support.
Since Sai is based in Ahmedabad, and the physiotherapist is based in Hyderabad, their sessions together were conducted on WhatsApp video calls.
In one of their early sessions, the physiotherapist told Sai that she was also a lifestyle coach and a health and lifestyle guru. In a separate podcast interview, she stated that she practiced cognitive behavioural therapy. The physiotherapist told Sai that counselling was a part of her sessions, and was intended to motivate clients to battle their illness.
At first, Sai did not pay much attention to these assertions.
Once their sessions began, however, he realised that most of the their time together was spent in talking, while the actual physiotherapy lasted for only between 10 and 15 minutes.
As sessions progressed, the physiotherapist asked Sai more questions relating to intimate details of his life and personal history, including about his gender identity.
For a few weeks, on Sai’s recommendation, his mother too saw the physiotherapist for separate sessions for her own problems related to nerve pain.
As the sessions progressed, Sai was puzzled to note that his parents, who had always struggled to understand his identity, began to exhibit some transphobia – they would, for instance, share transphobic content with him.
Meanwhile, the physiotherapist began to show signs of territorial behaviour. When she learnt that Sai was seeing a therapist in parallel for mental health support, she enquired about the fees he was paying, then brought up the matter in sessions with Sai’s mother. Sai recounted that his mother told him that the physiotherapist said, “I charge way lesser than the therapist, why does he need to go to another person?”
In October, Sai was aghast to learn from his sister that the physiotherapist had been feeding anti-trans content to his parents. She had, for instance, told Sai’s parents that Sai had been brainwashed when he was in university and he had embraced a trans identity because he had a history of sexual abuse.
“This was the cheapest, most basic and flawed psychoanalysis that people use to pathologise transness,” said Sai.
The physiotherapist invoked paranoia in Sai’s parents and convinced them to write “letters” detailing Sai’s life – saying that he was “okay” when he was younger but was now “crazy and took drugs”. She told them that writing the letters would be a step towards improving Sai’s condition.
When Sai confronted the physiotherapist about revealing confidential information to his parents, she claimed that in instances where a patient was mentally ill, she was bound to inform their next of kin. Sai argued that the physiotherapist had never asked him to list an emergency contact and that if she had, he would have listed his sister. But the physiotherapist deflected any conversation about the matter by talking about how Sai’s mother also suffered from mental health problems.
Eventually, after Sai confronted his parents, they apologised to him, and the family cut all contact with the physiotherapist.
Confusion in the field of counselling is exacerbated by the fact that India does not have a regulatory body for all psychology professionals – as a result, finding coordinated solutions to problems remains a challenge. Chaubal noted that such a body, which can ensure the “standardisation of professional recognition”, exists for doctors and nurses, but that psychologists have “never had one”.
She explained, “In the medical profession there’s always been a statutory body for recognising doctors, but this is where we have lost out. The standardisation of curriculum, requirements for professional recognition, are to be defined by the relevant statutory body of a particular profession.”
The Indian government sought to introduce some clarity into fields allied to healthcare, such as psychology, with the introduction of the National Commission for Allied and Healthcare Professions Act in 2021. The law proposes the setting up of a national council and state councils for various such professions, including paramedics and dieticians. These bodies are to be tasked with setting minimum standards for education, training and examinations, and enforcing codes of conduct and ethics for the professions. The state bodies are supposed to maintain registers of all such licensed healthcare practitioners in the state.
But psychologists are unsatisfied with some provisions of the law.
They note, for instance, that the law envisages professional councils to represent the different professions that it deals with. But, Chaubal noted, while professionals such as physiotherapists were categorised separately under the law, psychologists were clubbed into the category of “Community Care, Behavioural Health Sciences and other Professionals”, which included others such as diabetes educators, lactation consultants and podiatrists.
The law states that the council shall have representatives from all the professions in each category, and that the president “shall rotate biennially amongst the professions in the recognised category”.
Chaubal noted, “The American Psychological Association lists more than 55 specialisations. How can you dump us all under one title and not even give us a distinct council?”
The clubbing of psychologists with other professionals affects their representation in the higher state council. Under the law, that council has two representatives from each category. In effect, members of the other fields could end up in a position to represent psychologists in the state council. “I am not okay with a podiatrist deciding things for me as a psychologist,” Chaubal said.
Chaubal’s Psych Collective has been carrying out advocacy work to try and ensure that psychologists receive some form of recognition by state authorities. After failed attempts to move the Rehabilitation Council of India, in 2023 they began work with the State Mental Health Authority in Maharashtra to have existing psychologists registered at the state level. The collective hopes to expand this work to other states.
Chaubal believes that the rise in the number of unqualified counselors is tied to the messy landscape of regulation for psychologists in India.
“If we are struggling so much for regulation, then who will keep others in check?” she said. “When a profession is left unregulated for a long time, it’s obvious that anybody is going to do what they think is right.”
She added, “I want the people of India to know they deserve better mental health services. This all boils down to the larger public not receiving adequate or good quality mental health services.”
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