A few weeks ago I wrote about a loophole that could enable an unscrupulous psychotherapist to evade a misconduct hearing. Of the various professional bodies, it usually isn’t possible to bring a complaint against a practitioner who has resigned their registration prior to the complaint being made. Admittedly this is true for other professions such as nursing. But there’s a difference in that “nurse” is a protected title and in order to practice you have to be registered with the Nursing and Midwifery Council. Any nurse who resigns in anticipation of a complaint is effectively striking themselves off.
This isn’t true of psychotherapy. “Psychotherapist” and “counsellor” are not protected titles, and although various professional bodies exist (the British Association for Counselling and Psychotherapy, the UK Council for Psychotherapy, the British Psychoanalytic Council etc) there’s no legal obligation to belong to one of them. So, if a counsellor or psychotherapist gets wind that a complaint of misconduct is about to be made, they can just resign from their professional body and carry on practising. No complaint can then be made, therefore there’s no record of any safeguarding concerns that could put vulnerable adults or children at risk.
Just so people know why I mentioned this particular loophole, it’s because the above scenario isn’t a hypothetical one. It’s happened. On more than one occasion by the sound of it.
I previously had an e-mail from the British Association for Counselling and Psychotherapy, which is the UK’s largest psychotherapy body. They said they were “currently engaged in the process of changing this procedure.” It now appears they’ve done exactly that.
The BACP have published the following amendment to their Professional Conduct Procedure.
1. Page 1, paragraph 1.3 ‘Complaints against non-members’ is now replaced with:
1.3 Complaints against non-members / former members
a) The Association cannot deal with complaints against individuals or organisations that were not member/registrants of the Association at the time of the alleged misconduct.
b) The Association can deal with complaints made against a former member/registrant if that former member/registrant was a member at the time to which the complaint relates, subject to the provisions of paragraph 1.5.
c) Members/registrants of the Association referred to herein will be deemed to include former members/registrants.
d) Paragraph 1.3 b) only applies to members/registrants whose membership was current at the time of the adoption of this revised paragraph 1.3 by the Association by resolution of its Board of Governors pursuant to 5.1 of the Standing Orders of the Association on the 20th day of September 2013.n [emphasis added]
That should prevent any unethical practitioners from thinking they can avoid a BACP hearing through a just-in-the-nick-of-time resignation. This is welcome news, and I hope the other professional bodies will follow suit.
There’s been a couple of other developments recently with regard to professional regulation in psychotherapy. Under the previous Labour government there were plans to make counselling and and psychotherapy state-regulated professions under the auspices of the Health Professions Council (now the Health and Care Professions Council) which already regulates clinical psychologists and arts therapists. This was shelved by the Conservative-Lib Dem coalition in favour of regulation-lite or “assured voluntary registration” where the existing professional bodies could apply to be accredited by the Professional Standards Authority. So far only the BACP has achieved this accreditation.
In July Geraint Davies MP tabled an early day motion, calling for the previous plan to be reinstated.
That this House notes that anyone can set themselves up as a counsellor or psychotherapist without training or experience with no recourse for the patient if something goes wrong; further notes that there are more than 50,000 registered counsellors or psychotherapists and an unknown number unregistered; further notes that millions of people, often with mental health problems who are therefore vulnerable and at risk, are being given therapy in an unregulated industry with no uniform code of conduct or ethics; and calls on the Government to regulate counsellors and psychotherapists by bringing them into the jurisdiction of the Health and Care Professions Council.
So far 53 MPs have signed it: mostly Labour, though with a fair sprinkling of MPs from the other parties.
Back when HPC regulation was first mooted, there was a small but very noisy campaign by certain psychotherapists who predicted that the sky would fall in if psychotherapists had to be accountable for their actions in the same way as doctors, nurses, social workers or just about any other profession that routinely works with vulnerable people. I’ve previously (and only semi-jokingly) referred to those campaigners as “the worst bunch of malevolent hippies since the Dharma Initiative in Lost.”
Their argument was essentialy that state regulation would bring in “market values” to psychotherapy. If that argument sounds oxymoronic, then…well, that’s because it is. They used a lot of left-wing language to argue against regulation, but essentially what they were saying was that psychotherapists should be left to regulate themselves, much in the same way financial services and the tabloid media were. And we all know how well that ended.
If you’re wondering about the commitment of these anti-regulation campaigners to protecting the public from abuse, take a look at this beyond-parody article by Denis Postle, reporting on the hearings for Derek Gale, struck off by the HPC as an arts therapist for running a nasty therapy cult.
The imaginal universe of the human condition is ubiquitous. Since the Vedic traditions, Buddha, and Freud, we know we can’t turn it off. It runs. It leaps. We may hide from it but we can’t escape. We resonate with the world, the world reverberates through us. As practitioners we know that grasping the ‘real’ is matter of navigating multiple transferences and embodied foregone conclusions, this article included. The HPC as it seems to me stands in defiance, studied intentional defiance of this. The HPC has spectacles through which it sees only categories. Health. Standards. Competence. Treatment. Note-keeping. Effectiveness. This is a ‘hearing’ and in this room, as we were repeatedly reminded, what matters are ‘particularized facts’.
Also in defiance but of another order, from another paradigm, is Mr Gale, who for almost thirty years has had a private practice of individual psychotherapy and groupwork.
His defiance, as was apparent from the first three days proceedings, has its roots in Humanistic Psychology and the Human Potential movement, personal development traditions that stand outside the HPC’s medicalised models of healthcare.
I guess it was the HPC’s “medicalised models” that decided that Gale was sexually, physically, emotionally and financially abusing his clients. I’d attempt to deconstruct Postle’s article, but at this point we’re not talking about oxymoronic arguments. Just plain moronic.
Postle is a leading figure in the Alliance for Counselling and Psychotherapy, which helped coordinate the anti-regulation campaign. What are they doing now? Among other things, they’re crying foul about another development, in which the BACP has apparently applied for a royal charter. If they’re successful, this could mean that the BACP might bestow such titles as “chartered counsellor” or “chartered psychotherapist”.
The Alliance has written an open letter objecting to this.
We do not believe that BACP’s desire to bestow chartered status on its members will do anything for the field as a whole, nor do we think it in the interests of service users or of the public generally. On the contrary, we consider BACP’s move to be a potentially divisive and retrograde step which could be construed as a predatory attempt to steal a march on other organisations at a time when the government’s new voluntary register system, under the PSA, is just beginning to find its feet.
In due course, we will be writing to the Privy Council, the Department of Health, MPs and Peers, asking them to join with us in resisting this move by BACP. But we feel that the major membership organisations of counselling and psychotherapy should
join with us and we invite you to allow us to mention your names in whatever further communications we send out.
Or, to put it another way….
The BACP are of course entitled to apply for a royal charter. If other bodies feel that’s giving the BACP an unfair competitive advantage, then they could apply for one too, and take their place among such august organisations as Marylebone Cricket Club and the Worshipful Company of Lightmongers. Unless of course, such bodies simply aren’t good enough to meet the criteria for a royal charter.
If the BACP are successful, then that would be very good news for them indeed. It would mean that they’re the only psychotherapy body that could give a practitioner both chartered status and PSA accreditation. In other words they’d be the gold standard that any respectable counsellor or psychotherapist would be expected to be registered with.
These anti-regulation campaigners wanted to be free from the shackles of a single state regulator, so they could be left to set their own standards. Well, they got that. Now, for all their anti-market rhetoric they could well be about to discover exactly what happens in the marketplace when your product is visibly inferior to that of your competitor.
I can’t say I feel sorry for them.
I have just been on the PSA website http://www.professionalstandards.org.uk/voluntary-registers/accredited-registers-directory and can’t find the UKCP on there yet and their website seems to be silent about when they sign up – are they having problems?
Last I heard (which wasn’t that long ago) they were having difficulties because some of the member organisations were dragging their feet about signing up to the Central Complaints Process, and the PSA won’t give accreditation unless the CCP covers 100% of the membership.
Many thanks, I kind thought that they’d be laggard about it
I think you may find this set of feedback from UKCP members illuminating.
Click to access Bulletin%2021%20feedback.pdf
Thanks for this, we were just studying the ethical code in class and this very amendment came up, it seems a vital change.
Brilliant Update – thanks Z. With regard to UKCP – what can I say – what goes around comes around and they got the result that they deserve.
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I am struggling to understand what excites you so much about these matters, Zarathustra. Whatever your view of it, the debate within the psychotherapy community is much more nuanced on all sides than your polemic posting would suggest. The standards of training of the organisations within UKCP is very high and there are lots of excellent practitioners who are very dedicated to their clients’ well-being out there under it’s umbrella. Other stuff is clearly getting sorted out. Your beef with these people sounds a bit too acidic to not be more personal than you are letting on. Do you have some personal beef with them? Why so firmly fixed a viewpoint if you are not personally covered by these bodies, anyway?
I’m more than aware that there are plenty of excellent practitioners within UKCP, and have said so. I’m also aware that some stuff is getting sorted out, and these matters have been the topic of my two most recent blog posts on UKCP.
My beef though, is to do with clients who’ve been horrifically abused by unethical practitioners – usually in the Jungian or humanistic modalities – and been absolutely hung out to dry by the OMs when they tried to complain. I’ve sat opposite these people and seen how traumatised they are. Yes, the CCP is in place now and future complainants should be treated better, but that doesn’t help those who were previously failed.
I should also point out that Geoff Pick, Stuart Macfarlane et al are by no means the only ones of their kind out there. They just happen to be the ones who have come into the public domain. There are others.
I’m not playing games of “to catch a predator” here – simply putting stuff out there that has been swept under the carpet when it should not have been.
No friend of the UKCP would stand by and let its good name be destroyed by rogue elements. The good majority know that while there is just one abusive therapist in their midst, they have a problem.
Exactly. Although I’m a nurse by profession, most of what I do all day comes under the heading of psychological therapies, and I’m completing postgraduate study in systemic/family therapy.
I’m proud to belong to a regulatory body that would nail me to the wall if I behaved in the manner of Pick, Macfarlane etc.
I have no idea what Pick and Macfarlane have or haven’t done so I am not going to comment on them. Clearly, I nor anyone else wants to defend exploitative practice of any kind. I was wondering, though, whether there could be a little more space in your philosophy to consider and explore the issues around what to do about practices which have existential freedom and growth beyond what one might call ‘conventional health’ at their core. It seems to me that these therapies need to be treated with particular care from a regulatory point of view. They, including the Jungian and the Humanistic have something very important and unique to offer which is not easily captured in written protocols. They also present the greatest risk of abuse since they may work more creatively and spontaneously with clients for whom this is appropriate despite staying within more traditional boundaries with others. They are also the groups who seem most concerned about the impact on their work of ‘defensive practice’. It seems wise to listen more to those representing these practitioners and the nuances of their arguments so as to avoid throwing the depth baby out with the potentially dangerous bathwater. I am not saying that everything that they say will be right, only that we might all learn something through dialogue and have nothing to gain from turning a deaf or sarcastically dismissive ear.
The Pick case: https://notsobigsociety.wordpress.com/2013/04/10/therapist-who-sexually-exploited-patient-allowed-to-re-register-with-uk-council-for-psychotherapy/
The Macfarlane case: https://notsobigsociety.wordpress.com/2013/09/26/a-second-therapist-commits-serious-sexual-misconduct-is-not-struck-off/
I’m all for creativity and spontaneity, and within systemic/family therapy (the modality I’m most familiar with) there’s certainly plenty of scope for that. But clear and firm boundaries are also necessary, for reasons that are all too clear from cases like Pick and Macfarlane.
Your examples still don’t provide enough evidence to enable me to feel comfortable commenting on the woes of others, either those of the the accusers or those of the accused, so I won’t. I find ‘trial by web’, particularly ‘professional quasi-justice by web’ to be distasteful on many levels and I know no more about any of this than you have written. However, I don’t see anyone defending abuse. I am certainly not doing so.
But how easily you set aside my suggestion for clearer engagement with those with whom you disagree. There may be “more things in heaven and earth… than are dreamt of in your philosophy”, as a much wiser man than I once wrote.
I don’t generally busy myself with psych politics, but speaking personally, I find the manner in which you addressed those you disagree with in this post to be a trifle discourteous and that’s not something that wins me over to a writer’s perspective, on the whole.
I won’t put the case for dialogue again. We just have to note that you have not, on this occasion, been able to fully acknowledge the experience of some of the other voices in the debate and that we have to slightly devalue your observations accordingly in this unruly marketplace of ideas. That’s not to say you are wrong, just perhaps, a bit limited.
I wish you well.
I’m not engaging in trial by web. Both Mr Pick and Mr Macfarlane had allegations found proven against them in disciplinary hearings at their own UKCP member organisations. In both cases the findings were published online.
However, certain details of what they did were omitted from the public findings. Those details were strongly in the public interest, partly from a safeguarding perspective, and partly because it shows the sanctions against them to be unduly lenient compared to what other regulators would issue.
I think I should also point out that in publishing those details, nobody has denied the content of what I’ve published – not the MOs, not the UKCP, not even Mr Pick or Mr Macfarlane.
You have ignored my point again. Ho hum… I have tired of that game. Let’s play another.
Let me ask you two questions whose answers I do not know and you may. I am genuinely interested. Is there actual evidence that a community of statutorily regulated health professionals commit fewer abuses on average than the unregulated? Does this cure depend only on supposition and faith or is there an actual peer-reviewed evidence base? Is there evidence that statutorily regulated health professionals have greater efficacy in the relief of human suffering than the unregulated?
I can give a fairly long answer to this, but I’m currently on holiday in the north of Iceland. I’ll be back at the weekend and will do a blog post about it on my return.
Some answers to these questions may be on the way, thanks to the Clinic for Boundary Studies for the link:
Why is Observing Reader anonymous?
And why would this be referred to as a game?
As for the 3 questions, if somebody is on the receiving end of abusive therapy, having an appropriate recourse is a darn sight more validating than there being no recourse at all. That alone is a decent argument for statutory accountability.
Oh, and the fact that 80% of the public would like it that way, and that the majority assume they’re protected by some sort of regulation.
I’m for protecting clients.
Zarathustra. I hope you enjoy your break.
Amanda. I choose to be anonymous in all internet debate for personal reasons. I don’t see anything wrong with it. I am not connected with any of the cases discussed here or any of the people discussed here.
The game I referred to was my repeating an observation about dialogue and Z’s repeatedly commenting without addressing it. ‘Game’ in this context was an expression of slight frustration We’ve moved on, now.
Those are, indeed, decent arguments, although it’s fair to say that 80% of the public believe all sorts of strange things. However, I was wondering what the science around the question is, since I don’t actually know.
I am for less abuse and more effective therapy, which may or may not be the same as implementing a particular form of regulation. It seems wise not to assume that the two are the same but to have evidence. Protection has to be demonstrably more than a fig leaf.