I used to work for the Consumer Credit Counselling Service (five years ago, mind) in Leeds (UK) which is originally an American charity. From what I could make out it is the only decent ethical firm which consolidates debts, funded, oddly enough, by the creditors themselves, plus the interest they earn briefly keeping clients’ cash before the negotiated reduced payments are made to the often numerous unsecured debts.
A lot, if not all, of the other debt consolidation firms either charge the debtor to negotiate reduced payments on their behalf (which the debtor could frankly do by themselves, simply by furnishing their creditors with a financial statement outlining their hardship) or worse, convert debtors’ unsecured debts into one huge one secured against their house, leaving them ripe for repossession.
Many unscrupulous companies are willing to cash in on people’s shaky money management, ultimately leaving the debtor in a worse position.