Protected Titles or Protected Functions? How best to regulate psychotherapy?

I’ve been mulling over some of the counter-arguments to bringing in regulation for counselling and psychotherapy. One of the main objections is that if “counsellor” and “psychotherapist” were made protected titles, practitioners who didn’t want to be regulated would simply switch to other job titles. “Life coach”, “Jungian analyst”, “humanistic therapist” and so on.

The survey I recently did suggests that protecting those titles would have at least some impact. People looking for therapy to help with a mental health problem are more likely to look for a counsellor or psychotherapist than a life coach. So somebody switching their job title could expect to lose business by doing so. That said, on its own this doesn’t seem particularly foolproof as a measure to squeeze out the cowboys.

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Pathological Demand Avoidance: does it exist, and if so what is it?

In recent years in the UK there’s been an increasing amount of talk about something called pathological demand avoidance, or PDA. It’s described as a subtype of autism that children (and some adults) are increasingly being diagnosed with. The National Autistic Society has been promoting acceptance of it, there’s a PDA Society, training courses and parent support groups are being set up. Paediatric and CAMHS services are seeing increasing numbers of referrals requesting assessment for PDA.

This is perhaps surprising because (and you wouldn’t know this from scanning the NAS or PDA Society websites) it’s not a recognised condition. Neither the DSM-5 nor the ICD-10 (the two main classification systems for mental disorder) have anything to say about pathological demand avoidance. The NICE guidelines (which set out best practice for UK clinicians) don’t mention PDA in their guidelines for diagnosing autism either for children or adults. It’s virtually unkown outside the UK (and a few parts of Scandinavia and Australia), and the research evidence base for it is wafer-thin.

So, I decided to look into PDA. What is it, does it really exist, and if it does exist, is it really a form of autism?

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Would regulating counselling and psychotherapy make a difference?

I’ve argued on this blog in favour of making counsellors and psychotherapists protected titles in the same way as nurses, social workers, occupational therapists etc. A previous survey suggested that at least one in four counsellors or psychotherapists who were struck off by the BACP or UKCP for misconduct simply carried on practising. And that’s perfectly legal to do, because neither “counsellor” nor “psychotherapist” are protected titles.

In response, some have argued that there’s no point in having protected titles. Suppose you have a practitioner who’s been struck off and doesn’t want to stop practising, or doesn’t want to submit themselves to a statutory regulator, or simply never acquired any qualifications in the first place. If protected titles were brought in, all they would have to do is change their job title. Say, to “humanistic therapist” or “Jungian analyst”. I decided to test this hypothesis.

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Professional Standards Authority issues statement on transgender conversion therapy

Following a recent controversy over conversion therapy and transgender people, I contacted the Professional Standards Authority for comment. Today I received a reply.

Conversion therapy is a controversial form of psychotherapy which aims to turn gay people straight, or in some cases to revert transgender people to their birth gender. Pretty much all the research evidence suggests it’s ineffective and harmful. Most psychotherapy organisations in Britain have condemned conversion therapy for gay people, but have not done so for transgender people.

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BACP Fellow resigns over transgender conversion therapy

In January 2015 a memorandum of understanding was signed by a host of organisations, including the British Association for Counselling and Psychotherapy, the UK Council for Psychotherapy, the Royal College of Psychiatrists and NHS England. The memorandum condemned so-called “conversion therapy” or “reparative therapy”, which aims to turn gay people straight.

I fully agree with the memorandum that such “therapy” is both unethical and harmful. However, it was criticised for not also condemning such tactics when used with transgender people. Just under a year ago the UK Council for Psychotherapy announced it was “developing its position” on transgender people and conversion therapy, but since then nothing has happened. Yesterday Dominic Davies, a fellow of the British Association for Counselling and Psychotherapy, resigned in protest over what he feels is foot-dragging over the issue.

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Struck-off psychotherapist caught impersonating abuse victim

Readers of this blog will be familiar with the story of Ray Holland, the psychotherapist who was struck off by the UK Council for Psychotherapy in 2014 for serious sexual misconduct with a vulnerable client. Since then he has changed his name to Ray Bott-Holland and carried on practising, registering with a string of impressive-sounding but non-accredited bodies. Along the way, he’s occasionally sent me spurious legal threats for having the temerity to put information in the public domain that was already in the public domain to begin with. Continue reading

Professional Standards Authority publishes reasons for recent UKCP suspension

From November 2015 to January 2016, the Professional Standards Authority briefly suspended the UK Council for Psychotherapy from their list of accredited registers. After the UKCP made a number of changes, the suspension was lifted. The PSA have now published their reasons for the suspension. When I commented about it online, various people suggested I was making a fuss about a “storm in a teacup”, and that this was simply a normal part of the reaccreditation process.

From reading the PSA’s review, it becomes clear that this was no storm in a teacup. It involves, among other things, the apparent mishandling of a sexual misconduct case.

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The Strange Family of Derek Gale

[Trigger warnings: abuse, suicide]

A bit of context to the following post. About a year ago I started writing a book on therapy abuse. The project foundered due to, well, my own laziness, quite frankly. However, before procrastination took hold I’d gathered a substantial quantity of research materials about a notorious therapist-turned-cult-leader by the name of Derek Gale. What follows was originally intended to be a chapter in the book. I recently dug it out and finished the chapter, so that an awful tale does not remain untold.

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