Psychotherapists in turmoil over plans to start regulation
Government aim to protect clients from abuse will 'stifle creativity', say opponents
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Independent Minds
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Demand for 'talking treatment' has soared in the UK as an alternative to drug therapy
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Their aim, as they put it, is to turn "neurotic misery" into ordinary human unhappiness. But now Britain's psychotherapists have heaped anguish on themselves with a damaging feud that has split their ranks.
The dispute has erupted over Government proposals for the regulation of the country's 50,000 therapists to protect their clients from abuse and exploitation. While some therapists accept the need for official monitoring of what they do, others are furious at what they see as a Government attempt to control how they talk to their patients.
Demand for "talking treatments" is booming as doctors and patients have recognised that they are more effective and safer as the first-line treatment for depression and anxiety in place of antidepressant drugs and tranquillisers. Fears of job losses and economic insecurity caused by the recession are driving increasing numbers to seek help.
Alan Johnson, the Health Secretary, announced last year that an extra 3,600 therapists would be trained to provide cognitive behaviour therapy – a technique for helping patients overcome negative thinking – on the NHS at a cost of £173m a year from 2010.
But every barrel contains bad apples. There is concern about therapists who abuse their position by, for example, having a sexual relationship with a client. Witness, a charity supporting those abused by health and social care workers, recorded 83 cases in 2005-06.
Under the proposals for the regulation of psychotherapists, published in February 2007, they would be required to register with the Health Professions Council, which regulates chiropodists and physiotherapists, and which has powers to investigate complaints and administer sanctions. Draft legislation to register psychologists was laid before Parliament last month. The plans are supported by the British Psychoanalytic Council which has condemned what it describes as "a strident campaign by a small group of therapists and counsellors against statutory regulation".
Peter Fonagy, professor of psychoanalysis at University College, London, said: "Most practitioners have come across individuals who have been inappropriately treated by fellow therapists. This kind of action must not be allowed to undermine public confidence in psychotherapy. Evidence shows increasingly clearly that therapy and counselling are among the most effective treatments for psychological disorder and are growing rapidly in popularity. We need a transparent and independent system which allows clients' voices to be heard if they feel their therapy has been inadequate or inappropriate."
Against this view, the Alliance for Counselling and Psychotherapy has attacked the Government's proposals as "singularly inappropriate" and claims they will "perpetrate net damage to the field". More than 2,000 therapists have signed a petition opposing the plans.
In a statement, the Alliance said regulation would "medicalise the field, rigidify training and inflate the cost of therapy, reducing access". Any attempt to make therapy conform to a "safety-first" culture would "degrade the quality of help offered".
Supporters of the Alliance include Professors Andrew Samuels of the University of Essex, Brian Thorne of the University of East Anglia and Haya Oakley, former honorary secretary of the UK Council for Psychotherapy.
In their statement, they say: "Many if not most practitioners see their work as more an art than a science. Any attempt to impose a quasi-objective framework of standards and competencies not only stifles creativity but also damages therapeutic work with the client. Applying a predetermined set of external principles means overriding the client's individuality. This is ethically unacceptable as well as therapeutically ineffective."
Psychotherapy has always been riven by schisms, since the split between Freud and Jung. An umbrella body, the UK Council of Psychotherapy, was established in 1982 to promote self-regulation but it has since splintered and is challenged by rival organisation the British Psychoanalytic Council.
Regulators have faced the daunting task of drawing up guidelines for therapy, to set a benchmark against which misconduct can be judged. The early efforts of a quango called Skills of Health, commissioned to make the first attempt, have not been encouraging. A draft of more than 450 rules produced last year included one requiring therapists to "identify the client's response to your use of silence", which is counter to the teachings of Freud and others. Another instructed therapists to seek "feedback" about the helpfulness or otherwise of an interpretation. One body, the Psychoanalytic Consortium, rejected that by declaring therapy was "not about making an evaluation of service, as in a pizza restaurant".
The regulators' difficulty is that they are attempting to police private conversations between two people which are freely entered into and which happen behind closed doors. Some professionals think they are foolish even to try.
The Health Professions Council said it was expected psychologists would be registered this summer and legislation to regulate psychotherapists would be introduced under a "further order".
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Comments
What's the motivation behind this nonsense.. isn't this mirepresentation really quite sinister?? Whilst it may be difficult (although not impossible) to apply guidelines for procedural aspect of counselling and therapy and to evaluate its effectiveness using a scientific methodology, the heart of regulation is about trying to root out the rogues and protect clients from abuse .Abuse - sexual, financial and emotional is known to occur not infrequently in all therapeutic contexts. Is it being "quasi-objective" and stifling of creativity to require that therapists do not engage in sexual relations with their clients, intimidate them or rip them off?
I tell you what, in the absence of regulation i would advise anyone looking for a counsellor or psychotherapist to avoid any of these 2000 odd practitioners like the plague
There is as much or more abuse hiding under the guise of regulated professionals as there is from the unregulated.
"Caveat emptor" is a much better protection than Government red tape.
I have no knowledge of the workings of psychologists but the reality of humanity is that there are rogue operators in every walk of life, whether it be police, politicians or therapists. That is however no excuse for making evreybody suffer, the REGULATORS are gradually stepping into every walk of our lives and eroding our freedoms of expression and it has to stop....!
It is not yet clear which would-be regulator would be more draconian.
I do not think counselling and psychotherapy should be professions. They are craft or art, more like poetry or religious belief than science.
Regulation by self interested trade associations like BACP and UKCP or the NHS is ethically wrong.
Most are just nosey bored housewives who want to poke their noses into others' lives. Some are pervs. ALL are self- righteous and sanctimonious.
Counselling in most cases is at best a waste of money and time and at worst totally damaging - and the american psychobabble culture we have has overprotected kids and conditioned them into thinking counsllors are necessary and helpful. They are neither.
I know people who have spent tena sof thousands on these con artists. Much better to have gone on a nice holiday surely than enrich these nosy egomaniacs. Most counsellors and therapists and psychologists and psychiatrists are abnormal themselves - why they go into the field in the first place. Read about some of them. And so the blind lead the partially sighted...
There is no evidence at all that counselling makes people better in any way - time does, money does, meidcation does soemtimes, having the benefit of resilience from childhood does too - but there is plenty of evidence that therapy makes people poorer.
By the way most counsellors do not want regulation because most are thick and uneducated and have ulterior motives.
In the right hands counselling and psychotherapy are life saving and life affirming tools far more about helping people live successfully in the here and now than the Freudian notion of excavating the subconscious. Of course therapy needs to be regulated...clients are vulnerable to abuse by definition. It is lack of regulation that led to the psychobabble of past life regression, re-birthing etc. The problem is who is to do the regulating and set the criteria for success in a such a complex and widely misunderstood field with so many differing approaches.
It should be a matter of personal conscience for client and counsellor alike.
I am curious what you find wrong about rebirthing. It has helped a lot of people.
Regulation is long overdue, especially when 'counselling' may be provided by social workers and others.
For example, I met one local government employee whose area of practice is complaints about breaches in client's expectations and rights, but who feels competent to hand out 'counselling' by means of a commercially produces CD Rom! This happens in the face of the views of the training provider in question that people who have just been for a day or half day session or who have simply bought the product are not 'qualified' to practice as counsellors.
As with other services provided by the state, counselling is already semi-privatised and there is a market in training and products, including books and CD Roms. This week's Panorama provided a timely reminder of the sort of cost cutting if not fraud that can result from pressure to obtain services at rock bottom prices.
I am quite disgusted to find that the AQA backed courses on counselling in FE colleges allow people to finish counselling training after just 100 hours experience of counselling, even if the full qualification only comes after 450 hours.
Make your own inferences here.
One of my psychotherapy students also trained in graphology.
I have recently been teaching A level psychology part time. It is mostly around research done over the last fifty years. Very little of it is good science.I am appalled that psychology has attained status as "science" largely by piggy backing human biology.
I was guest of honour at the British Psychology Society a few years ago (only as father of a daughter who won the UK Psychology A level prize). The scientific findings of psychology are trite.
I am not making great claims for graphology, just suggesting that it might be just as useful as psychology in assessing people.
The great statistics based psychologist Eysenck accepted that the best predicting of career test was the astrology chart.
Thousands of years observations behind that, after all.
People get ahead by boasting their moral and ethical and empirical superiority.
I find this is seldom justifiable.It is mostly just will to power.
In the US, Counseling and Psychotherapy is rigorously regulated with the result that clients can be assured of clear practice guidelines, supervised therapists and governed by visible ethics and government regulated guidelines.
Do we see creativity stifled there? On the contrary, the US produces some of the most innovative and ground braking therapies in the world today. Even if we cannot do any better let us at least respect the needs of people and make available monitored, supervised, regulated and good quality therapy.
I think you idealise the American situation. The HPC will not solve the problems you describe.
Time heals - a cold goes away by itself without anyone doing anything - it's the same with grief etc. What really annoys me is that some very vulnerable people are conned by the psychobabble industry into paying all-powerful counsellors huge sums of cash for precisely nothing of any use.
I have seen no evidence that counselling works - except perhaps for fromer addicts counselling alcoholics or drug users etc. I have seen plenty of evidence that counselling is very damaging and those who have it cannot seem to allow wounds to heal but keep picking ate them to make them bleed - those who have counselling recover more slowly or not at all. We MUST challenge this new orthodoxy that counselling is intrinsically good and necessary. It's not. And so many people and kids especially are not allowed to develop resilience these days but instead are constantly told how worderful they are - all justified by the worship of self-esteem in our culture.
People are toop self-obsessed - that's the problem here - and they have too much money and not enough to do. 90% + of all counselling in a waste of timke and money - but everything else is regulated (teaching, nursing, etc) so why not counselling? Especially seeing as the potential of abuse by an omnipotent counsellor is massive.
Now, I was a very good teacher before I did my official teacher training, but I needed that piece of paper to teach in state colleges. That is what regulation means. Quite frankly, those interested in being thrapists are often very damaged people, always want to make money, and enjoy access to vulnerable people's secrets and pain, far more so than teachers for example. Has there evr been a problem with teachers abusing pupils on a vast scale? No, it's very rare and yet all teachers need a CRB check. So why not unqualified people who have an interest (genuine or dubious) if counselling others?
By the way, I trust counsellors and therapits one hell of a lot less than politicians, so the hysteria here is uncalled for. No-one ever likes giving up total power - and that is what counsellors have. Most are not highkly educated or qualified and are now sh.. scared that now they'll have to get an education and pay for it too! This is the 21st century and if we must have mumbo-jumbo merchants then we need to wath them like hawks.
Look how it works for doctors and lawyers! Their registration system works to protect THEM, not us.
They close ranks and protect their own.
Secondly and very importantly, registyration gives the public a dangerous illusion they are protected. People have an exaggerated trust in certificates. Where they might otherwise be cautious, they are more likely to trust a certified practitioner more quickly.
What is needed is a public campaign to spread simple guidelines. Posters in libraries, GPs offices, chemists, youth clubs etc
Make it mandatory for every practitioner to display and individually supply these guidelines.
1. A therapist must never physically touch you without your consent.
You do not ever have to agree to being touched unless you wish it.
2. A therapist must never express sexual attraction for you.
Any physical contact must not touch sexual areas of the body (as normally covered by a bikini or nearby zones see diagram).
3. A therapist must act and speak in ways that increase your comfort and confidence. They should never act or speak to frighten you.
Where a therapist finds it necessary to speak or act coldly this must be explained on request.
4. A therapist must usually be truthful with you. Where they withold information they must always later explain this occurred and why.
5. A therapist may not narrate events from their own personal life unless this clearly acts to encourage or advise you.
Something like that. The problem is not registration but ignorance among the public as to the boundaries.
But psychotherapy and counselling do not offer diagnosis treatment or cure. They offer insight, compassion, understanding, tolerance, empathy.and relatedness.
It is like making a group of ballet dancers answerable to an army drill sergeant.
It is the state intruding into our last safe place, our inner life.
What is essential for psychotherapy and counselling is a place where it is safe to explore what is forbidden in the outside world, feelings of despair, suicide, murderousness, terror, sometimes in the face of a state that goes to war on innocent civilians with cluster bombs and white phosphorus and depleted uranium based on lies and deceit.
Under new state guidelines clients are already told they may not feel suicidal with their therapist or they will have the psychiatrist dragged in.
We can and should no longer trust the state. We no longer trust politicians. We can no more trust state regulation to protect us from corruption than we can trust the bankers to protect our money.
We already have remedy for abuse by psychotherapists. We have the common law. Sexual abuse by a therapist is assault, assault causing grievous bodily harm, or rape.
Making psychotherapy and counselling professions will hedge them round with excuses and protections from ordinary justice. Professions are arguably conspiracies against society.
What will be the outcome of the Governments plans? Ballet dancers marching about like squaddies under the protected titles, while the real work continues under another title.
What is in a couple of names.
You cannot stop people exploring the meaning and value of life together.
Or can you? Already we live in a surveillance society.
Big brother now wants to watch us everywhere.
It is time to say no further.
"We can and should no longer trust the state. We no longer trust politicians. We can no more trust state regulation to protect us from corruption than we can trust the bankers to protect our money."
Well I trust the state one million times more than any counsellor. State regulation does protect us from corruption. What have banker got to do with anything? You matey and getting hysterical and clutching at straws in your excuse-peppered rant.
"We already have remedy for abuse by psychotherapists. We have the common law. Sexual abuse by a therapist is assault, assault causing grievous bodily harm, or rape."
And the same can be said for teachers, nurses, doctors etc but people rightly expect more regulation for these people because of the potential for abuse.
"Making psychotherapy and counselling professions will hedge them round with excuses and protections from ordinary justice. Professions are arguably conspiracies against society."
Yes and you are arguably conspiring to cover up abuse. Utter piffle. You are abviously bricking it because regulation will expose people like you for what you are.
The would-be regulator, BACP had one of its ethical principles as "It is unethical to give advice" though it may have altered this now.
Now look up "counsellor" in a dictionary. It means an advisor.
It seems to me as if you have had unhappy experiences with counsellors. There is a lot of rubbish counselling about.
But if you think the Government is fit to evaluate what is good and what isn't you and I are never likely to agree.
The best person to judge what is useful to them is the client.
My advice to people would be to never ever waste time and money going to counsellors. Get a hobby, go on holiday, do anything but sit with some self-righeous nosy parker who is charging you cash for you to tell her your secrets. Emo-porn for the counsellor really, and most are half nuts themselves anyway. I have yet to see any real evidence that counselling is any help at all but have seen a lot to show how damaging it is.
But the American fashion for therapy is here - and fits perfectly with our self-obsessed age - so it must be regulated, as all other fields are - counselling is in no way a profession though.
Even taxi drivers and cleaners are regulated, so why not you? Methinks you have a little god complex there, probably with a deeply needy and narcissistic personality disorder...
As for my "deeply needy narcissistic personality disorder" You seem to be talking the same destructive language as the worst kind of counsellor. "Personality disorder" is the worst kind of nonesense as a label. "Person I don't like" would do it better.
You and I are not so far apart as it seemed at first. But I know lots of examples where the counselling has been healing and transformative.
If that had not been the case I would have left it years ago.
I withdrew only when I saw the profession becoming a procrustean bed of regulations crushing the creativity and quality of relationship out of it.
Everyone resents regulations but everyone has to be regulated for reasons of health and safety and security. Bus drivers are, cleaners are, everyone is - so why not counsellors? YOu may not like it but so what? Maybe teachers don't like it either - does that mean teachers, nurses, doctors shouldn;t be regulated?
I think counselling is a waste of time and money and the danger of abuse is massive - the power relationship is very skewed and counsellors are in a hugely powerful position - without responsibility. And power without responsibility is asking for trouble.
Let's face it - counselling is just a business, so counsellors have a vested interest in saying how good counselling is and that everyone should have it. They do it for themselves, not their 'patients' - as is evidenced by your last sentence I feel.
Not an assumption just a guess. Your level of animosity suggests it that is all.
Everyone resents regulations but everyone has to be regulated for reasons of health and safety and security. Bus drivers are, cleaners are, everyone is - so why not counsellors? YOu may not like it but so what? Maybe teachers don't like it either - does that mean teachers, nurses, doctors shouldn;t be regulated?
Health and safety has run of of control. It is one of the most absurd delusions of our tie that life should have risk minimised. A moderate level of stress is good for everyone.
health and safety laws stop people standing on chairs at work now. It is mad.
As for security. The Government continually adds more draconian controls on our freedom by threatening us with attacks by terrorists. Even the retired head of MI5 has complained about it.
I sympathise with you here. I just don't believe the regulation would help the client. It will more likely sanction abuse in the name of health protection.
Let's face it - counselling is just a business, so counsellors have a vested interest in saying how good counselling is and that everyone should have it. They do it for themselves, not their 'patients' - as is evidenced by your last sentence I feel.
For some it may be just a business but for some of us it was a vocation. 100 years ago we would have been priests.
I have run a number of free or low cost counselling services.
Very few people make a good living as counsellors. It costs a great deal to train and many do not get their money back as qualified practitioners.