Therapist who sexually abused clients returns to practice

A Jungian psychotherapist who was found to have sexually abused a mentally ill client in his care has put up a new website advertising his services.

Stuart Macfarlane was previously registered with the Guild of Analytical Psychologists, a member organisation of the UK Council for Psychotherapy. In 2012 the Guild of Analytical Psychoanalysts found allegations proved that he had committed serious breaches of boundaries with a vulnerable client. Unsafe Spaces learned that these breaches were of a sexual nature, and the client experienced severe trauma as a result of his behaviour.

The case was controversial, because the Guild of Analytical Psychologists chose not to strike him off, but instead gave him a suspension. However, Macfarlane resigned from the GAP during his suspension period. UKCP member organisations are now no longer allowed to handle complaints in-house, which instead go through the UKCP complaints process.

In 2014 a second ex-client came forward to the Daily Mail, accusing him of abusing her in a very similar way to the first.

Macfarlane has now put up a blog, describing himself as a “seasoned and well-respected therapist with over 30 years of experience”. It also states that he “still resides in London and continues to delve into the world of psychology, helping many people along the way.”

This sort of behaviour is sadly not unusual. Our Unsafe Spaces report found that one in four counsellors or psychotherapists struck off by professional bodies continue to practice. This is legal because neither “counsellor” nor “psychotherapist” are protected titles, and anybody can use these titles.

Unsafe Spaces has also issued guidance on keeping safe from abuse when accessing counselling or psychotherapy. We strongly recommend that clients check their therapist’s registration before beginning therapy.

 

 

Keeping safe from abuse during therapy – Unsafe Spaces publishes free resource

Today we publish our free guide, Keeping Safe During Counselling or Psychotherapy. It highlights some of the warning signs that a therapeutic relationship may be turning abusive. It also gives suggestions on how you can take action if you’ve experienced misconduct or abuse.

The guide is based on some of the misconduct cases that have been highlighted by this website, as well as from consultation and feedback kindly provided by a number of professionals and service users.

The guide is free to download, and comes in two versions – full and easy read. The full version is for people who want a detailed explanation for the thinking behind the advice. The easy read version is for those who just want the main points, given with as little jargon as possible.

Go here to download either version.

Outrage at failure to prosecute sex abuse of mentally ill woman

In 2013 I reported on the case of Geoffrey Pick, a psychotherapist who was found to have committed serious sexual misconduct with a mentally ill client. The allegations were found proven by the Arbours Association of Psychotherapists, a member organisation of the UK Council for Psychotherapy, and he was dismissed from his NHS post. Disgracefully, Arbours gave him a one-year suspension instead of a striking off, and then he was allowed to re-register as a psychotherapist. He subsequently resigned his registration after being contacted by a broadsheet journalist. The UKCP has since changed its rules so that member organisations are no longer allowed to investigate complaints themselves. All complaints now have to go through a centralised Complaints and Conduct Process.

I’ve since been told that a criminal prosecution of Mr Pick has been dropped by the Crown Prosecution Service, for reasons that seem both shocking and farcical.

Book Review: Sex in the Forbidden Zone by Peter Rutter

Having blogged about therapy abuse for several years, I recently made the decision to start work on a book on the topic. For that reason I’ve begun reading through the published literature, which isn’t as large as one might think. I have to thank Amanda Williamson (who has personal experience of therapy abuse) for pointing me in the direction of one of the seminal texts – Sex in the Forbidden Zone: When Men in Power – Therapists, Doctors, Clergy, Teachers and Others – Betray Women’s Trust, by Peter Rutter. As well as this review, you can also read Amanda’s own review here.

Exeter church plays Pontius Pilate over Palace Gate abuse case

In recent months I’ve covered the Palace Gate abuse case, in which the two directors of Palace Gate Counselling Service, Exeter, were struck off by the British Association for Counselling and Psychotherapy. John Clapham was found to have taken sexual advantage of two women during therapy sessions. His co-director Lindsey Talbott then aided him in a lengthy campaign of harassment and defamation against the complainants.

Palace Gate Counselling Service rents its premises in the Palace Gate Centre from South Street Baptist Church. Because counselling has only voluntary self-regulation rather than state regulation, Clapham and Talbott have been able to continue running their firm despite the striking-off order. Which is not to say their business hasn’t been impeded. Outside agencies have stopped referring clients there. Fundraisers have pulled their support. Even so, they’re still there at the Palace Gate Centre.

Which begs the question, why haven’t South Street Baptist Church evicted them from the premises? I now have a statement from the church.

A 6 month suspension for sleeping with a client: Rob Waygood and the UKCP

A few days ago I commented on this recent decision by the UK Council for Psychotherapy to give a Jungian therapist, Rob Waygood, a 6 month suspension rather than a striking-off. Waygood admitted to starting a sexual relationship with a client shortly after the therapy ended. There is no statutory regulator for counselling or psychotherapy, but the UKCP recently became an “accredited voluntary register” with the Professional Standards Authority.

Before exploring this case further, I’m going to put something out there. When I’ve discussed similar cases in the past on this blog, I’ve subsequently wound up getting e-mails from people who know more about those particular cases. I’ve no idea if there’s anyone out there in a similar situation who happens to be reading, but if they are, my e-mail address is thus_spake_z at hushmail dot com.

For my own regulator, the Nursing and Midwifery Council, the indicative sanctions guidance is very clear.

In all cases of serious sexual misconduct, it will be highly likely that the only proportionate sanction will be a striking-off order. If panels decide to impose a sanction other than a striking-off order, then they will need to be particularly careful in explaining clearly and fully the reasons why they made such a determination, so that it can be understood by those who have not heard all of the evidence in the case.

Not only did the UKCP not strike Waygood off, but the original sanction was ridiculously lenient. A warning letter, plus an order to spend two years attending supervision. Such slaps on the wrist used to be absolutely typical of some psychotherapy organisations, particularly those of a psychoanalytic persuasion. There’s numerous past cases where serious boundary breaches were written off as transference gone wrong rather than abuse, and the therapist got sent on his way with nothing worse than a ticking-off.

In this day and age, and particularly now that the UKCP is an assured voluntary register, such token sanctions simply won’t do. The UKCP appealed the decision as unduly lenient, arguing that his behaviour “was fundamentally incompatible with the Registrant remaining on UKCP’s Register.” On appeal the sanction was increased to a 6 month suspension.

Given that the UKCP haven’t struck Waygood off, have they been particularly careful in explaining their reasons for such a determination?

I e-mailed the Professional Standards Authority to ask what they thought of the case. It’s the PSA’s policy not to comment on individual cases, but they did state that, “We expect all AVRs to take sexual misconduct seriously.” They also kindly provided me with a link to the relevant guidance.

I’ve been browsing the PSA’s, Clear sexual boundaries between healthcare professionals and patients: guidance for fitness to practise panels to see how it compares with the UKCP’s decision for Rob Waygood.

The PSA guidance doesn’t state anything along the lines of “for x misconduct, issue y sanction”. However, it does give some suggestions of what might be considered aggravating and mitigating factors.

Some of the aggravating factors they list include:

the vulnerability of the patient. Research shows that abusers often target vulnerable groups of patients, including those seeking help for mental health or emotional problems

The UKCP decision doesn’t give any indication of whether the client had any mental health issues or other vulnerabilities. That said, one could argue that anyone undergoing therapy is in a vulnerable position, particularly in a piece of psychodynamic therapy where you’re opening up your deepest thoughts to a stranger. We do know from the decision that the client suffered harm as a result of the relationship.

whether the healthcare professional took deliberate steps to facilitate abuse, for example scheduling the appointment as the last of the day, working without a chaperone being present, making inappropriate house calls, dissuading the patient from seeking a second opinion

In the Waygood decision, “Visiting the client’s house sometime between 18 and 21 April 2011 and acting in an affectionate manner” certainly reads like an inappropriate house call to me.

whether there was any grooming of the patient, ie did the healthcare professional deliberately cultivate an empathetic relationship with the patient over a period of time?

“Making a number of personal disclosures to the client regarding his sexuality and sexual history”? “Commenting on the client’s femininity during a therapy session”? “Hugging and kissing his client on the hair or neck on either 14 or 28 March 2011”? That sounds suspiciously like grooming.

whether the healthcare professional used confidential information obtained in the course of treatment to their advantage, for example by encouraging the patient to discuss marital problems whilst providing ‘a shoulder to cry on’

Yep. The decision accuses Waygood of, “Using material discussed in therapy to attempt to convince the client to pursue a relationship.”

Waygood was represented at his hearing by a Mr Glyn Oldfield of Brookfields Professional Conduct Services. This is a company that provides what looks to me like Tesco Value representation at misconduct hearings by non-lawyers, presumably for people who can’t afford a lawyer – though they don’t view it that way. They say, “You do not need a lawyer!  Most disciplinary processes are not legalistic and what counts is detailed knowledge of your profession, the relevant procedures and how best to respond, not a general knowledge of the law!” I’d be interested to hear what an actual law firm would say about that – particularly a firm that specialises in representing professionals at fitness-for-practice hearings.

Waygood and Mr Oldfield presented a number of mitigating factors – he made an early admission, and demonstrated some insight into what he had done wrong.

The Panel was satisfied that that the Registrant had made early admissions in respect of these allegations and had not sought to deny the allegations, nor indeed to put the aggrieved party to the task of giving evidence at the earlier hearing, or at the Appeal.

Fair enough, he confessed his wrongdoing, and spared his client the ordeal of having to testify. But this results in something that rings an alarm bell for me.

Both Mr Oldfield and the Registrant submitted that the harm to the complainant had not fallen into the category of serious harm, and further that the complainant had not been present at the previous hearing and both her account and some matters of fact that were in dispute had not been tested (by cross-examination).

Was the complainant asked whether she thought the harm she incurred was serious or not? And besides, where does one draw the line between what is “harm” and what is “serious harm”? And even if she didn’t suffer serious harm, was consideration also given to the potential harm that could have been incurred by Waygood’s behaviour? As the PSA makes clear, the trauma from these kinds of boundary breaches has the potential to be absolutely huge and life-changing.

So, going back to that quote I found in the NMC Indicative Sanctions Guidance,

If panels decide to impose a sanction other than a striking-off order, then they will need to be particularly careful in explaining clearly and fully the reasons why they made such a determination, so that it can be understood by those who have not heard all of the evidence in the case.

Has the UKCP been particularly careful in that regard? As a personal opinion, I’d say not.

How much therapy abuse is out there?

I recently had a question posted in the comments thread to one of my blog posts, by ‘Reading Enquirer’.

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?

This is an important question, and one which raises a further question – how can we know how much abuse by psychotherapists is out there?

Abuse, by its very nature, is something that happens behind closed doors, without records being kept. No practitioner – regulated or unregulated, is likely to be auditing how much people they’ve abused. Not everyone who has been abused reports it. Still less of those who report it have their allegations proven in a fitness-to-practise hearing and/or a court of law.

If we’re talking about unregulated professionals, then that does beg the question of who they can report it to. Historically, even being a member of a professional body has not necessarily been a guarantee that a complaint will be heard properly. Until recently, complaints-handling at the UK Council for Psychotherapy was dominated by “crony-ism and amateurism” (not my words, but the words of the then UKCP chair). To give an idea what this “crony-ism and amateurism” looks like, one can read the decision letter for the UKCP’s application to be accredited by the Professional Standards Authority.

The Panel considered a summary of the main themes identified in the Call for Information, and the UKCP’s response to these submissions. It observed that many were related to UKCP’s previous complaints processes, involving the handling of complaints by itself and its OMs. It was felt that the former complaints system was characterised by lengthy times from initial complaint to completion, poor communication from the UKCP and OMs and a lack of support for complainants. There were suggestions of conflicts of interest and procedural failures that appeared not to consider public protection.

The UKCP has now instituted a series of reforms to address these issues, with the result that they’ve now achieved PSA accreditation, though the PSA is insisting on auditing their complaints-handling after 6 months. To be fair to the UKCP, they’re now publishing a growing number of complaints decisions, which appear to have been handled in a considerably improved way.

But…what psychotherapy has at the moment is only regulation-lite, not full statutory regulation. “Psychotherapist” and “counsellor” are not protected titles and you don’t have to belong to a professional body to call yourself one. Indeed, the UKCP recently struck off a psychotherapist called Julia Eastwood. She’s still advertising herself for coaching and counselling.

And then there’s all those people who use other titles similar to psychotherapists and counsellors. Even if those professions became protected titles, there’d still be all the Jungian analysts, life coaches, shamanic therapists…did I mention Ms Eastwood also advertises herself as a “conscious channel of the Archangel Gabriel”? Good luck finding someone to complain to if your conscious channel engages in misconduct.

Still, even if you can’t find anyone to complain to, you could always sue them, though that can be hugely expensive, and you’ll only get no-win no-fee if you have a strong case. So presumably we could find out how much misconduct is out there by looking at the number of lawsuits?

I spoke to somebody who sued their psychotherapist. According to them, their solicitor knew of about 30 ongoing cases, which sounds like a worryingly high number. However, we don’t get to hear about many of these cases, for the reason that most of them end in a civil settlement. These settlements tend to include a confidentiality clause, effectively stuffing the complainant’s mouth with gold.

If it’s a serious form of abuse, say, if someone was sexually exploited, there’s also the police route. But conviction rates for sexual assault are shockingly low. No guarantee there’ll even be a prosecution, never mind a conviction.

One could simply try to publicise one’s case. But that carries the risk of being clobbered by our notoriously draconian libel laws, which have a well-documented “chilling effect” on free speech in the UK. Even with the recent reforms to defamation law, the risk of being hit by a lawsuit would make a lot of people think twice.

So, to answer Enquiring Reader’s question as to whether there’s evidence that unregulated professionals commit more abuse than regulated ones – the simple answer is we don’t know. The reason for that is that without regulation we can’t know the extent of the problem, because there’s nobody to complain to.

On a more pragmatic level, I think it’s important that people have the confidence that if something goes wrong, they have access to a robust complaints procedure. For that reason, my advice to anyone seeking a therapist is to ensure that they use someone either in a state-regulated profession (e.g. clinical psychologists or arts therapists, which are regulated by the Health and Care Professions Council), or belong to a PSA-accredited body (e.g. the BACP, the UKCP or the National Counselling Society). If they don’t fulfil those basic criteria, don’t use them.

 

BACP closes regulatory loophole

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.

A second therapist commits serious sexual misconduct, is not struck off

Back in April I broke the news of Geoffrey Pick, a psychotherapist registered with the Arbours Association and UK Council for Psychotherapy. After conducting an “inappropriate relationship” with one of his patients, he was suspended for a year instead of struck off. He was then allowed to re-register with the Arbours and UKCP. Only when it came to media attention did he resign his registration. Shockingly, I’ve now discovered that this is not the only case of its kind.

A couple of months ago I was researching this blog post, which I wrote after I’d noticed that a high percentage of psychotherapists facing misconduct hearings seemed to be Jungians (Pick was from a Jungian background). It was pointed out to me that there was a case involving a Jungian that didn’t appear in the UKCP complaints archive. Stuart Macfarlane had been suspended for two years by the Guild of Analytical Psychologists (formerly the Guild for Analytical Psychology and Spirituality). The details of what he did were rather vague.

Stuart MacFarlane has been found to be in breach of the GAP Code of Ethics 2008 (1.7) in
two areas:
1. personal relationships – infringing and violating the trust of a client
2. inadequate standards of practice.

He has also been found to have breached the Code of Ethics 2008 (3.6) concerning
Professional Boundaries:

3.6 psychotherapists shall not take advantage of or exploit the dependent nature of the
therapeutic relationship, current or past, for example with regard to fees, sex or in any
other respect.

These breaches constitute Serious Professional Misconduct under section 7.1(b) of the
Code of Ethics.

I’ve since been able to establish that Mr Macfarlane engaged in serious sexual misconduct with a client. The individual in question is a vulnerable adult with mental health difficulties. As a consequence of his actions, she experienced a deterioration in her mental health. She continues to receive psychiatric support.

To give a comparison of what would usually be the sanction, here’s the indicative sanctions guidance for my own regulator, the Nursing and Midwifery Council.

In all cases of serious sexual misconduct, it will be highly likely that the only proportionate sanction will be a striking-off order. If panels decide to impose a sanction other than a striking-off order, then they will need to be particularly careful in explaining clearly and fully the reasons why they made such a determination, so that it can be understood by those who have not heard all of the evidence in the case.

Macfarlane, however, was not struck off. He received a two-year suspension order. Potentially at the end of this he could be allowed to rejoin the Boy’s Club, sorry, Guild of Analytical Psychologists, and resume practice. Oh, and he was also ordered to write a letter of apology to the client and refund her fees – as though she’s a dissatisfied customer at Sainsbury’s rather than somebody subjected to the worst possible breach of boundaries.

I e-mailed the GAP. They declined to elaborate further on his misconduct besides the information posted online. I asked why he was not struck off and whether he would be allowed to re-register. They replied, “The decision reached was in accordance with the complaints process set out under the G.A.P. Complaints Procedure Code, which emphasises the confidentiality of the proceedings. We are unable to comment on an individual’s possibility of being allowed to re-register until the suspension period has ended, and such matters as compliance with the sanctions have been considered.”

And why is his case not in the UKCP’s online complaints archive? The outcomes listed there are, by and large, far less serious than Macfarlane’s. In case there’s any doubt that Macfarlane was a UKCP therapist, here’s his entry on the register, dated 29th October 2011.

I e-mailed the UKCP to ask why he’s not in the archive, and if he will be allowed to rejoin the UKCP register. I haven’t so far received a reply. [Edited to add: the UKCP have now responded]

I did, however, get a reply from Macfarlane himself.

Thank you for your email, and for giving me the opportunity to answer your questions in advance of your publishing. I have made a mistake and I am doing all I can to make amends, including attending therapy weekly.

I broadly support your goal to improve and standardise regulation across the psychotherapy profession, but as I do not agree with the way you are going about it, I shall not be engaging any further with you about this .

However, I wish you well.

Another therapist who has completely overstepped the mark with his client, resulting in catastrophic consequences to a vulnerable person. And this time next year he could possibly be practising again.

Utterly unbelievable.

Reading a charlatan writing about charlatans

This week I was up at my local university doing a bit of training. While I was browsing the bookshelves, I randomly made an interesting find. What is Psychotherapy? A Personal and Practical Guide by Derek Gale. That name immediately rung a bell. He was struck off by the Health Professions Council and by the UK Council for Psychotherapy for a horrific litany of abuse against his patients. I was curious to see what such a character would say about psychotherapy, so I got the book out on loan.

Gale’s story is a pretty nasty one. He groped his patients, discussed sexual fantasies with them, called one a “stupid cunt”, got them to do unpaid work for him, smoked cannabis in front of them and in some cases went on holiday with them. The list of allegations put before the HPC reads more like the behaviour of a cult leader than a therapist. Tragically one of his victims, Gena Dry, later took her own life. Despite this he had some surprising connections. His in-house book company, Gale Centre Publications, listed Windy Dryden, Professor of Psychotherapeutic Studies at Goldsmiths, among its authors.

His saga was also something of a test case in the regulation of psychotherapy. He was registered as an arts therapist with the Health Professions Council (now the Health and Care Professions Council) and as a psychotherapist with the UKCP. At the time, proposals were underway for psychotherapists to also be state-regulated by the HPC rather than the current system of voluntary self-regulating bodies like the UKCP. Although these proposals were subsequently shelved, it’s worth noting that the UKCP ignored complaints about him for years until the HPC took action.

Ironically, his book actually has a chapter on “Charlatans well intentioned and otherwise”. I browsed to it to see what he had to say.

I do not intend to dwell on the proliferation of cranks and charlatans, some of whom are out to make a quick buck. Fortunately the public do not seem to be as gullible as it is sometimes assumed to be and these people do not stay in business long, unless they have some genuine service to offer…

Wow, that took some gall for him to state.

…I find more seriously worrying the practices of people who have a recognised qualification in one of the caring professions and a job which puts them in a position of trust. These professional qualifications are not a qualification in psychotherapy and a doctor, social worker or educator who claims to practise psychotherapy while remaining blissfully ignorant of what psychotherapy is, trades on the public’s confidence in his profession and is therefore as great a charlatan as the person who holds a bogus diploma.

Though perhaps not as great a charlatan as someone who urges their patients to strip naked during group therapy.

Gale isn’t the person to make this point, but there is a valid point in here about who is or isn’t a psychotherapist. A large number of professionals, myself included, are involved in providing psychological therapies but don’t have a formal qualification in the field. You might hear of a doctor or nurse doing, say, cognitive-behaviour therapy, without being a qualified cognitive therapist. In many cases those involved – again, including me – have to acquire training and supervision on the hoof, as and when we can.

Interestingly enough, there isn’t a fixed definition of who is a psychotherapist. If a psychotherapist wants work from the NHS or social services, they’d need to have some sort of recognised qualification and usually be registered with either British Association for Counselling and Psychotherapy or the UKCP. However, if they’re practising independently they could vary from having completed an arduous post-graduate training to being just some hippy with no qualifications at all.

Then, of course, there’s the thorny question of what’s the difference between a counsellor and a psychotherapist.

Thinking about my own nursing practice, I’m heavily influenced by cognitive-behaviour therapy and family therapy. Interestingly enough, I tend in daily practice to be more willing to saying I’m “doing CBT” than “doing family therapy”. Perhaps due to a perception that CBT is more straightforward and less complex than family therapy – though I’m sure there’s people who’d be more than happy to dispute that.

If a psychotherapist is someone’s registered with the UKCP or BACP, then it’s worth noting that Derek Gale was accused of continuing to practice after being struck off. Though according to his Twitter profile he appears to have now retired to write books and send tweets to Ricky Gervais.

Who is a psychotherapist? Ultimately the only thing I can say for certain is that it isn’t Derek Gale.