[Trigger warning: sexual abuse]
A few days ago I broke the news that a psychotherapist, Geoffrey Pick, had been allowed to return to practice after sexually exploiting a patient. His professional organisation, the Arbours Association, had given him a one-year suspension instead of a striking-off. When the suspension ended he was re-registered with both the Arbours Association and the UK Council for Psychotherapy. It was only after being contacted by a journalist that he resigned his registration.
Mr Pick caused enormous harm to the patient involved, who is still in therapy for the trauma. Having posted the news, I’m now going to consider how this could have happened.
I noticed something about the press release the UKCP sent me:
In January 2011 Mr Pick was dismissed by his employer for gross professional misconduct. Following on from this his UKCP organisation, the Arbours Association of Psychotherapists (AAP) considered the matter in relation to his fitness to practise, and found Mr Pick to be in breach of Article 6 of the AAP Code of Practice, and Mr Pick was suspended from the membership of AAP and UKCP for a period of one year from 16 May 2011.
AAP notified us of the decision and this was published on the UKCP website.
At the end of the suspension period AAP confirmed that Mr Pick had complied with the conditions imposed during his suspension and that it was now permissible for Mr Pick to resume membership of AAP and UKCP.
In April 2013 Mr Pick informed us that he was resigning from AAP and UKCP with immediate effect. In compliance with this notification his name was removed from the UKCP Register.
Maybe I’m reading between the lines a little, but there seems to be quite a bit of, “the Arbours Association of Psychotherapists considered the matter…”, “AAP notified us…”, “AAP confirmed that…” Almost as if the UKCP are keen to hand ownership of this almighty screw-up to the Arbours.
The matter of psychotherapy regulation is currently living in interesting times. At present the discipline is mostly self-regulated by its own professional bodies. Under the previous Labour government, there were plans for psychotherapists to be state-regulated by the Health and Care Professions Council. This was shelved when the Coalition took office in favour of “assured voluntary registration”. Self-regulators like the UKCP would be able to apply for official accreditation from the Professional Standards Authority, if they were deemed to be doing a good enough job at maintaining standards and dealing with complaints.
The UKCP have a problem here. Their main rival organisation, the British Association for Counselling and Psychotherapy, has been granted PSA accreditation. Another rival, the British Psychoanalytic Council, hasn’t been accredited yet but is expected to get it in the not-too-distant future. The UKCP, however, haven’t been accredited and probably won’t be for some time. There’s a blunt reasons for this: its complaints procedures simply aren’t up to scratch.
Back when HCPC regulation was being mooted, there were some vociferous opponents who insisted that state regulation would bring free-market values into psychotherapy (they didn’t do a very good job of explaining why, but that was their argument). Those opponents within the UKCP may well get a nasty lesson on what happens in a free market when your product is visibly inferior to the competition.
The UKCP is essentially an umbrella body for 75 smaller “member organisations”. Previously if you wanted to make a complaint against a UKCP therapist you first had to complain to their member organisation, many of which have shockingly bad complaints procedures. If your complaint was rejected you could then appeal to the UKCP.
The UKCP is aware that this “two-tier” complaints system is riddled with “cronyism and amateurism” (not my words, but the words of the UKCP former chair) and is unacceptable to the Professional Standards Authority. In order to get PSA-accredited, they need to bring in a “single-tier” central complaints service. The new system has only been tried once, with a Jungian analyst called John Smalley. It was a shambles from beginning to end. They need it to be more effective and credible in future.
There’s an article about this in the current edition of the UKCP magazine The Psychotherapist, by their new Complaints and Conduct Manager, Sultana Khanum. (Click here and go to pages 28-29) I wish Ms Khanum well in her new role, and don’t doubt her sincerity, but oh Lord has she picked up a poisoned chalice. This is alluded to in the article.
We believe that the system we have developed is robust and meets PSA requirements. However, to secure PSA accreditation, we need maximum sign-up from you…A number of individual and organisational members have signed up to our new scheme and we look forward to working with them. But several of you haven’t.
This problem is also alluded to in the December 2012 UKCP bulletin. According to the chief executive David Pink:
I am disappointed that many of our member organisations seem to be reluctant to engage with the central complaints scheme…By this time next year we need everyone to be signed up to the central complaints or in the process to becoming signed up. By then, other leading reputable therapy organisations (including BPC and BACP) are likely to be fully PSA accredited. Employers, referrers, commissioners and clients will begin to expect practitioners to be on a PSA-accredited register as a minimum requirement. We must not fall behind.
The Arbours Association is one of those organisations that haven’t yet signed up for central complaints. This is entirely speculation on my part, but I’m wondering if that was why the UKCP were so keen to tell me that it was Arbours who handled the complaint, not them.
So, what sort of an organisation is Arbours?
I can’t claim to have an insider perspective on the Arbours Association, but it was founded in the 1970s by Joseph Berke and Morton Schatzman, former colleagues of that old psychiatric rogue and 60s counter-culture icon RD Laing. Berke and Schatzman were both involved in the famous (or infamous depending on your point of view) Kingsley Hall community. This was sort of a cross between a therapeutic community and a hippy commune where psychiatrists and patients shared a roof and an “anything goes” ethos. The Arbours Association still runs therapeutic communities and also trains psychoanalytic psychotherapists.
As so often seems to be the case with these organisations, I couldn’t find details anywhere on their website of how to make a complaint against a therapist. However, if you want an idea of how rigorous their standards are likely to be, some hints can be found in a little-known report.
Back in 2009 the Maresfield Report was published, supposedly a rigorous analysis showing how HCPC regulation would be completely wrong for psychotherapy. The Arbours Association was one of the organisations behind it, along with various psychoanalytic bodies such as the Centre for Freudian Analysis and Research, and other Laingian groups such as the Philadelphia Association. I wouldn’t necessarily recommend you read the whole thing. For one thing, it’s long and quite spectacularly boring and badly-written. It contains all sorts of straw-man arguments, leaps of logic and reductio ad absurdum claims. I’m rather fond of Jo D Baker’s description of the report as, “the most self-incriminatory piece of evidence since the discovery of human remains under Dr Crippen’s basement floor.”
Just to give you a brief flavour of the report, here’s an example from page 49. The report discusses a set of draft standards that the HCPC (then known as the Health Professions Council) had proposed for the regulation of psychotherapists.
Psychotherapists and counsellors are required here to ‘understand their duty of care with regard to the legislation on safeguarding children, young people and vulnerable adults’. There is a question here of differentiating the duty of care of the healthcare professional and the responsibility of a therapist. Many therapists would believe that they certainly have a duty in relation to their clinical work, but this duty must be differentiated from the standard of notion of duty of care, especially when it concerns questions such as confidentiality.
Do I even need to deconstruct this? Within a relatively short paragraph there’s several glaringly obvious statements of concern. For one thing, they seem to have assumed that the legal concept of duty of care only applies to healthcare professionals (it doesn’t). The bit about “with regard to the legislation” seems to have completely slipped by them, apparently blissfully unaware that the law doesn’t end at the consulting-room door. As for the suggestion that confidentiality overrides safeguarding obligations – no, no, no!
In this paragraph alone (never mind the rest of the report) there’s a message that might as well be flashing in great big neon letters about the authors. That message is, “We don’t understand our obligations with regard to safeguarding, and we don’t understand the concept of duty of care either.”
I’d suggest that this is how an organisation can believe that a therapist who sexually exploited his patient doesn’t need to be struck off.