Psychopractice Regulation: SCoPEd – Generating Psychotherapathy?

by Denis Postle

Sometimes there are projects that in their obtuseness, their folly, and their slippery language, do harm to the human condition. The Scope of Practice and Education framework (SCoPEd)¹, the creation of three of the dominant UK psychopractioner organisations, is one of them.

SCoPEd shines a bright light on the activities and supposed validity of the British Psychoanalytic Council (BPC), the United Kingdom Council for Psychotherapy (UKCP) and the British Association for Counselling and Psychotherapy (BACP), and claims to have synthesized a catalogue of standards for the practice of counselling, psychotherapy and psychoanalysis. But spotlighting casts a shadow and SCoPEd, with its recent formal adoption, is no exception – it excludes and demeans countless other viable forms of working with the human condition in the UK.

After two books ^2,3 and many articles on therapy regulation ^{4, 5, 6, 7} and 28 years as a continuing participant in the Independent Practitioners Network (IPN) ⁸ – an antidote to earlier attempts to regulate UK psychopractice – and publishing the eipnosis website ⁹, I had given up speaking from the regulationist shadow. Except, if direct government control or legalised titles were to emerge. SCoPEd isn’t that, but it points in that direction.

And this is why SCoPEd is a problem. No, worse than a problem, offensive. Younger practitioners may not be aware that SCoPEd is only the latest in close to a quarter of a century of attempts to professionalize their delivery of working with the human condition in the UK, with the barely hidden aspiration of seeking state endorsement of this status.

It was offensive, two decades ago, to sit opposite Anne Casement, the then chair of the UKCP, in a BBC Radio 4 studio,¹⁰ declaiming that:

“At the moment, we’re a voluntary register but we are now in the process of moving to registration by law, to statutory registration, we’re actually in the process of doing that… We’re seeking to protect the title of ‘psychotherapist’, so after that, once we’ve registered by law, anyone who calls themselves a ‘psychotherapist’ will have us to deal with”. (Casement 1999)

Other senior therapy practitioners claimed that there was a need ‘to rid the psychotherapy garden of its weeds’ ¹¹. At a Parliamentary hearing about Health Professions Council regulation, I heard someone behind me describe non-compliants such as myself as ‘charlatans’.

Numerous authors and activists pursued opposition to the ambitions of professionalized counselling and psychotherapy. ^12,13,14 See also my 2007 book Regulating the Psychological Therapies: From Taxonomy to Taxidermy (mapped, measured, captured and stuffed?)² , the title of which continues to encapsulate 16 years of the antecedents (and likely result) of SCoPEd.

If you are as yet unfamiliar with SCoPEd, three previously warring factions ¹⁵ in the UK psychological demographic – BACP, UKCP, and BCP – got together to enable them to become a closed shop in the provision of psychotherapeutic services in the UK. SCoPEd developed three areas of ‘expertise’ and ‘competence’, to represent the claimed capacities of – respectively – counsellors, psychotherapists and psychoanalysts.

In the latest iteration, the three columns have been neatly scrambled to blur this exclusivity, an arrangement that also softens the ascension of BPC psychoanalysis to the heights of psychopractice insight and expertise, leaving BACP members to occupy the prairies of mere counselling.

So what is wrong, mistaken, or harmful about SCoPEd?

Let’s start with it as a taxonomy – describing and circumscribing instances of life and organising them into hierarchical categories.

The SCoPEd taxonomists looked at the practice of the three distinct, and to some extent, antithetical professional organisations, and came up with a hierarchical array of ‘standards’ and ‘competences’. This does two kinds of harm: it does violence to the need for sufficient varieties of caring response to the miasmic diversity of the human condition; and its exclusivity invalidates the many other ways of working with people, as though Co-counselling, Reiki, Sacral cranial, The Alexander Technique, hypnotherapy, Lacanian analysis, massage, breathwork, birthwork, yoga, meditation, dance therapy, EMDR, animal-assisted therapy, horticultural counselling, aroma therapy, sand tray therapy, mindfulness, acupuncture, reflexology, didn’t exist.

SCoPEd diligently explored the professional walled gardens of BACP, UKCP and BPC, and sought and claim to have discovered a legitimate catalogue of psychopractice ‘standardisation’. Apart from making public and underlining the value of the three psycho-professional institutions, what is this for? Isn’t it primarily trying to make them ‘plug and play’ compatible with the NHS and other institutions that hire psychopractitioners? Not least an increasingly privatized NHS. And let’s not forget the 19+ UK universities and the many higher education institutions that run psychopractice courses; for them and the core group of therapy and counselling trainings, SCoPEd’s standardization of psychopractice is happily resonant with the examination/audit culture that infects too much of education.

In The Administration of Fear ¹⁶ Paul Virilio speaks of his WW2 childhood experience in Nantes of living under German rule. There were three ways of coping with it, he says: Occupation, being compliant, making the best of it; Cooperation, actively supporting the occupation; and Resistance, acting to derail or stop it.

I see the gilded credentials of the 75,000 practitioners that support the SCoPEd enterprise as a form of ‘occupation’ of the UK psychopractice demographic. It demeans and excludes. And there seems little doubt this patronizing of the ‘inferior’ is what is intended. While there has been significant disquiet about the ‘occupation’, there does seem to have been too much ‘making the best of it’ and not enough ‘resistance’.

Is it tolerable that the nuances of love, of flourishing, of rapport and presence seem absent from the standards? Will they also be absent from future generations of work with clients?

Is this too strong? I think not. SCoPEd is coercive and prescriptive, the best that could be distilled from warring tribes, built via conversations that we might suspect were conducted in Russian ‘vranjo’ mode: “We know that SCoPEd is ethically dubious”; “you know that we know”; “we know that you know but we all keep pretending it is OK”. But is it tolerable that the nuances of love, of flourishing, of rapport and presence seem absent from the standards? Will they also be absent from future generations of practitioner work with clients?

Some psychopractice organisations have voiced opposition to SCoPEd ^17,18 but there doesn’t appear to have been a coalition of the excluded. SCoPEd partners commissioned an Impact Assessment, ¹⁹ it acknowledged that there was scepticism of the value of the framework but insufficient to derail adoption by the three principal partners, or to deter the National Counselling Society, Human Givens, and the Association of Christian Counsellors joining it for the ride.

The fundamental flaw of SCoPEd, as a protocol promoting a service industry, is that it does nothing to mitigate or even address, practitioner abuse of clients. It leaves clients as the default quality controller; defective practice is identified when someone complains. It doesn’t include what clients need to feel safe – active practitioner engagement with civic accountability. Do other practitioners who know us well personally, stand by our practice? Would they send us clients? And not least, is there ongoing peer assessment of our ‘presence’ and our reputation, that comes with sustained contact?

Sadly, once qualified, a SCoPEd practitioner can keep up a subscription to their regulation club, occasionally dip into CPD, and discuss clients with a supervisor but otherwise avoid reciprocal exposure of their vulnerability with peers. So far as we avoid sharing with peers where we are in our lives, changes in the quality of our ‘presence’ and ‘rapport’ that would merit support, and perhaps challenge, are likely to remain out of sight. These are qualities that appear to contribute more to beneficial outcomes than MA’s, degrees or diplomas ²⁰. The high price of the ‘qualifications’ that entry to SCoPEd requires may justify a paywall for access to psychopractice but for clients looking for a practitioner who can be trusted with their concerns, or their distress, they can often be an inadequate long-term quality guide to practitioners.

The SCoPEd collection of psychopractitioners are people who we might suppose are aware of the social implications of how power and privilege is distributed, of how it can become fossilized, and who are supposedly sensitive to the infinite varieties of grief, fear and anger we may feel. And while mortgages, as a colleague reminds me, may have a significant influence in these matters, how can they submit to their occupation by the SCoPEd catalogue of ‘standards’?

Beyond its politeness, there is something gross about SCoPEd.

Off the page but successfully expressed in the SCoPEd protocol, is the long-standing determination of psychoanalysis to dominate the psychopractice field; how can this illustration of competencies below not be seen as showing ‘C’ (psychoanalysis) as being on top?

And aren’t dominion and its counterpart, subordination, very common client agendas? So how come the flag of psychoanalytic dominion that SCoPEd waves over the enormous UK psychopractice demographic, is acceptable and even cherished by its exponents? Related to this psychoanalytic dominance, is the extent to which SCoPEd, in its apparent drive to open access for psychopractice to the NHS, mirrors/mimics the pyramidal medical establishment, of which psychiatry, a key product distribution arm of Big Pharma, is the dominant, scandalous ²¹ partner.

Off the page even further, alongside all these reasons for rejecting SCoPEd, there is a perhaps an even more fundamental reason for scepticism. Chasing the wraiths of regulation, and reflection on my own practice, led me to see that, along with other aspects of our threatened civilisation, psychopractice has the form of an extractive industry.²² People meet with psychopractitioners to have their distress or concerns attended to, and across generations of these encounters, from what we have learned with clients, practitioners have extracted a theory and practice base. Clients and trainee practitioners buy this accumulated knowledge and practice as a service but it could and perhaps should be more freely shared. So, in as much as the SCoPEd iteration of this knowledge base becomes a commodity, designed as it appears, for privileged access to the NHS, it may need to be seen as a form of psychotherapathy, potentially delivering an impoverished version of psychopractice.

Taxonomy as a basis for regulation can seem to be a societal disease, the grasping and compressing of the ineffables of desire and anxiety and disappointment into categories and hierarchies. My recent engagement with the climate crisis revealed that there was a hidden dynamic in all this. I had hinted at it a long time ago as ‘glaciation’²² but it merits a bigger role. I came to see that civilizations and their institutions such as psychopractice can be helpfully seen as an accumulation of ‘crystallization’ ²³: feeling and perception crystallize as speech; words crystalize as writing, writing crystalizes as books; risk crystallizes as insurance; client behaviour crystallizes as diagnosis; SCoPEd crystallizes psychopractice as ‘standards’.

Today, with crystallisation proceeding at the speed of light via digitisation, taxonomy may be reaching its ultimate limit, with SCoPEd as an example of its paralysing grasp. At our crisis-ridden time, if we want to sustain a fruitful approach to working with the human condition, might not inventing/building/creating ways of contradicting this crystallization be more relevant than reinforcing it as SCoPEd does?

What would that alternative look like?

A very long way off the page of SCoPEd, is self-directed learning. There used to be a university, East London, that ran self-directed education. I taught there, my son did a very good degree by self-directed learning there; it seemed very successful but it disappeared.

I learned my core psychopractice capacity from the self-directed culture of co-counselling ²⁴, and from cooperative experiential work with John Heron ²⁵ and Anne Dickson ²⁶. Building on 25 years as a film director, I learned to facilitate groups as an apprentice, and with Mary Corr and a dozen others generated thriving ‘cooperative enquiries’ ^27,28. Around 2000 hours of this self-directed learning, plus self and peer assessment, became enough to begin to work as an independent psychopractitioner, and 28 years of participation in IPN has supported decades of my practice and civic accountability.

I would like to be mistaken but my guess is that this route to psychopractice – where personal development and self-direction sometimes mutate into a vocation as a psychopractitioner – is now closed. SCoPEd lays the foundations for a day job.

From a long-term client perspective, SCoPEd is bad news. Take it down.

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Notes/references

1 The Scope of Practice and Education framework (2022) https://www.bacp.co.uk/about-us/advancing-the-profession/scoped/

2 Postle, D. (2007) Regulating the Psychological Therapies – From Taxonomy to Taxidermy, Ross-on Wye: PCCS Books

3 Postle, D. (2012) Therapy Futures: Obstacles and Opportunities (Introducing the PsyCommons), London: Wentworth Learning Resources (available from Lulu.com)4 Postle, D. (2000) Statutory Regulation: Shrink-Wrapping Psychotherapy British Journal of Psychotherapy https://www.academia.edu/26110963/Statutory_Regulation_Shrink_Wrapping_Psychotherapy

5 Postle, D. (1998) The Alchemist’s Nightmare: Gold into Lead – The Annexation of Psychotherapy in the UK International Journal of Psychotherapy 3: 53-83.

6 Postle, D. (1997) How does your garden grow? Counselling News, June: 29-30.

7 Postle, D. (2005) Psychopractice Accountability: A practitioner ‘full-disclosure list’ in Bates, Y. and House, R (eds) Ethically Challenged Professions: Enabling Innovation and Diversity in Psychtherapy and Counselling 172-8, Ross-on-Wye: PCCS Books

8 Independent Practitioners Network, https://ipnetwork.org.uk/

9 Postle, D. (2008) eipnosis: A Journal for the Independent Practitioners Network: Contents http://ipnosis.postle.net/pages/IpnosisContents.htm

10 Casement, A. (1999) Straw poll talkback. BBC Radio 4, 4 September.

11 Postle, D. (1997) How does your garden grow? Counselling News, June: 29-30.

12 Mowbray, R. (1995) The Case Against Psychotherapy Regulation: A Conservation Issue for the Human Potential Movement, London: Transmarginal Press

13 House, R and Totton, N. (eds) (2011) Implausible Professions: Arguments for Pluralism and Autonomy in Psychotherapy and Counselling. 2^nd Edn, Ross-on-Wye: PCCS Books

14 Postle, D. (2021) Calling All (UK) Therapists Video London: WLR

15 The Final HPC Professional Liaison Group Meeting (2011) pp 289-294. In Postle, D. (2012) Therapy Futures: Obstacles and Opportunities (Introducing the PsyCommons), London: Wentworth Learning Resources (available from Lulu.com)

16 Virilio, P. (2012) The Administration of Fear semiotext(e): Cambridge Mass. MIT Press

17 Partners for Counselling and Psychotherapy (2023): response to January 22 iteration of the ScoEd framework https://www.partnersforcounsellingandpsychotherapy.co.uk/pcp-response-to-january-2022-iteration-of-the-scoped-framework/

18 The Person Centred Association (2023) Welcome and ScopEd updates and info-where next? https://www.the-pca.org.uk/blog/welcomeandscoped.html

19 ScopEd Impact Assessment (2022) https://www.bpc.org.uk/download/8155/Final-Report-on-the-Impact-Assessment-of-the-SCoPEd-Framework-December-2022.pdf

20 Wampold, B., E. (2001) The Great Psychotherapy Debate, Ch. 8: 2020, London: Lawrence Erlbaum Associates

21 A judge sentences unqualified psychiatrist Zholia Alemi to 7 years in jail but for 22 years the psychiatrists she worked alongside apparently failed to notice that she was as effective, or ineffective, as they were. https://www.theguardian.com/uk-news/2023/feb/28/judge-jails-fake-nhs-psychiatrist-and-criticises-abject-failure-of-scrutiny

22. Postle D. (2014) The PsyCommons: Professional wisdom and the Abuse of Power p16-17 Asylum Spring

22 Postle, D. (1994) The Glacier Reaches Edge of Town. Self and Society 23(6): 7-11.

23 Postle, D. (2021) The End of Progress Self & Society Vol 49 No1 Spring, Podcast version: https://soundcloud.com/denis-postle/the-end-of-progress

24 Co-counselling International (UK) http://www.co-counselling.org.uk/

25 Heron, J. (1996) Cooperative Inquiry: Research into the Human Condition, London: Sage

26 Dickson, A. (1985) The Mirror Within: A New Look at Sexuality London: Quartet

27Postle, D. The Nuclear State (1982) Video Crucible: Science and Society, ATV https://vimeo.com/576904068

28 Spencer A. Postle, D. (1998) From Survival and Recovery to Flourishing: a residential co-operative inquiry, London:  Counselling News

Person-Centred Therapists Call on SCoPEd Partners to Offer PSA-Backed Membership Home for those Opposed to Framework

Photo by Scott Webb on Pexels.com

A group of prominent practitioners, writers, trainers and academics from the Person-Centred community in the UK, along with two organisations, have published an open letter calling on the SCoPEd organisations to provide a professional home on their PSA-backed registers for members who do not wish to be aligned with SCoPEd’s divisive and hierarchical framework.

Referencing the recent Impact Assessment’s recommendation that an ‘important space remain for those therapists who are unconvinced of SCoPEd’s desirability’, the letter lays out some of the main challenges to SCoPEd and proposes a way forward that would include those who do not see the framework as an accurate or ethical representation of their work as counsellors and psychotherapists. As the letter states,

We are calling on the membership bodies to respect and acknowledge the rights and needs of members who do not wish their practices to be aligned with SCoPEd. We value our membership organisations as diverse collectives of professionals and do not want to be forced out of these organisations in order to retain our integrity…. We ask that each organisation develop within their PSA-approved registers an opt-in membership category that is not aligned with the SCoPEd framework’s columns.

See the full letter below.

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Open Letter to the SCoPEd Membership Bodies from Members of the Person-Centred Therapy Community

April 2023

Context

SCoPEd has been formally adopted by all the professional organisations involved, including the three largest membership bodies in the UK (BACP, UKCP and NCS), and the project now turns to the question of implementation. For those of us in the person-centred approach who have long critiqued both the framework and the organisational processes around it, and have serious ongoing concerns about the potential outcomes (PCG, 2020), this is a disappointing moment. Despite our best efforts, little of any substance has changed in the structure of the framework since the first iteration and all our principal concerns remain:

• The impacts on equality, diversity and inclusion in the counselling and psychotherapy profession of adopting a simplistic hierarchical structure based on initial training – a structure which cements and entrenches existing inequalities in the field.

The inability of the SCoPEd organisations to provide sufficient meaningful data on EDI to the Impact Assessment speaks volumes about how seriously it took these concerns until compelled to address them by the assessment process. The proposed ‘gateways’ between levels are still vague, unspecified and fraught with the same issues of exclusion and elitism, while SCoPEd’s likely impact on the training market will only exacerbate the inaccessibility of the top tier(s) of the framework.

• The poorly evidenced return to differentiating ‘counselling’ and ‘psychotherapy’, with ‘psychotherapy’ positioned as the more competent and skilled activity.

‘Counsellors’ and ‘counselling services’ are often found undertaking some of the most complex work in the field and the BACP itself found no evidence for differentiation as recently as the late 2000s, yet under SCoPEd ‘counselling’ has been demoted to a position of inferior competence.

Within the person-centred approach, counselling and psychotherapy are considered indistinguishable (e.g. Rogers, 1942; Thorne, 1999) but hierarchical differentiation effectively downgrades person-centred therapy, an approach that for historical, political and organisational reasons (Rogers, 2019) rather than issues of competence, depth or evidence-based effectiveness, is mostly practiced in the UK under the title of ‘counselling’.

• Hierarchical differentiation flies in the face of decades of therapy research studies and meta-analyses, which do not find psychoanalytic psychotherapy and psychoanalysis and their attendant training norms – that so dominate the top tier of the SCoPEd framework – to be in any way superior in helping clients or in producing more competent practitioners to person-centred therapy, which finds its differing training culture mapped onto the lower two tiers despite being solidly evidence-based (e.g. Cooper, Watson & Hölldampf, 2010; Elliott et al, 2013; Murphy & Joseph, 2016).

This creates the absurd injustice that under SCoPEd a new graduate of, for example, a psychotherapy programme approved by the British Psychoanalytic Council (BPC) is automatically deemed more competent (dropping straight into the top level ‘C’) than a humanistic ‘counsellor’ who could never have afforded such a course but has accumulated years of experience: working in a range of settings with diverse client groups; supervising and managing other therapists; engaging in varied personal and professional development; teaching on counselling and psychotherapy training courses; undertaking research; contributing to the profession in a variety of other ways; and yet still finds themselves in column ‘A’ or ‘B’.

Such an injustice is not only wrong on principle, but is also confusing, misleading and potentially harmful to clients, who may be persuaded by SCoPEd’s claims of differing ‘competence’ that, in our example above, the newly trained BPC graduate is inherently more safe and effective than the experienced humanistic counsellor. We note here that there is no evidence that graduates of trainings leading directly into column ‘C’ are less likely to harm clients through professional malpractice.

• The notable exclusion of person-centred voices in the important developmental stages of the framework and the dominance of psychoanalytic views, e.g. in the make-up of the Expert Reference Group, even after it was minimally expanded, which have distorted the project’s direction.

Here we contrast the role of the British Psychoanalytic Council, which in SCoPEd has enjoyed a prominence and influence disproportionate to its number of members, with the role of the much larger National Counselling Society, which was initially excluded from the project until a draft framework was already in place.

• The framework’s capitulation to the fading notion that therapy will forever be an extension of medicine and healthcare, with their medicalised systematising of human experience and manualisation of psychological ‘treatment’.

The leading edges of counselling, psychotherapy and psychology are moving away from medicalisation (Johnstone & Boyle, 2018; Sanders & Tolan, 2023), yet SCoPEd takes a step back towards it. As person-centred therapists, we cannot sign up to the framework’s delegitimising of the ‘third force’ in psychology, the humanistic approaches, which have pioneered radically de-medicalised theory and practice since the middle of the twentieth century.

• The single-minded commitment to a methodology derived directly from the manualisation of CBT for the IAPT project (Roth & Pilling, 2008).

In SCoPEd, this methodology relied on a narrow and self-referential range of evidence and ignored all other research into practitioner effectiveness and client outcomes (Murphy, 2019), with the result being that the framework grossly misrepresents the reality of practice on the ground.

• The divisiveness of the project, which has talked a great deal about listening to members’ concerns but at every turn has sought to dispute, rebuff, ignore or, in some cases, silence critique and dissent (e.g. by not publishing members’ letters in organisational journals).

‘Listening exercises’ and ‘consultations’ have not led to any substantive change in the trajectory of the project or the structure of the framework itself and it has since emerged that efforts to question the project, temper its excesses and address its failings by senior figures in BACP, such as the former Deputy Chair who recently resigned over the issue (Golding, 2023), have been blocked.

A Way Forward

For us, these are not the characteristics of a project that embodies the values of counselling and psychotherapy. We believe SCoPEd to be too flawed to impose on the field as a whole. We understand that there are complex issues around training, practice and the future of therapy, but we do not find SCoPEd to be a convincing solution to the challenges we face, or even the right path on the way to a solution.

So we are calling on the membership bodies to respect and acknowledge the rights and needs of members who do not wish their practices to be aligned with SCoPEd. We ask that we are not forced to adopt the framework by being assigned a title and position in the columns against our will.

We value our membership organisations as diverse collectives of professionals and do not want to be forced out of these organisations in order to retain our integrity. While some may choose this path to leave (and there are legitimate forms of professional accountability away from the PSA registers), for many this simply isn’t viable due to the requirements of the job market – therapists need to earn a living and being on a PSA register is increasingly seen as a necessity for employment.

The recent Impact Assessment recommends, ‘[a]n important space can remain for those therapists who are unconvinced of SCoPEd’s desirability if the framework is taken forward.’ (Eastside Primetimers, 2022, p.3). In this spirit of inclusiveness and constructive engagement, we call on the SCoPEd organisations to create a professional home for the substantial number of therapists in their memberships, which the NCS member vote suggests could be as high as 46%, who do not see their work and identities reflected accurately in the framework.

We ask that each organisation develop within their PSA-approved registers an opt-in membership category that is not aligned with the SCoPEd framework’s columns.

We would welcome discussion on the practicalities of such a membership track, how it is defined, the standards of entry, accessibility for new and existing practitioner members and so on. We believe this proposal to be a creative, inclusive and growth-promoting response to an issue that has deeply divided the field, threatens to be intractable, and has already consumed too much time and energy for all those involved, including both the SCoPEd bodies and the many therapists, academics, activists and organisations who have attempted to call the project to account.

Therapy is inherently concerned with internal and external conflicts, as well as issues of power, identity, difference and diversity. Therapeutic work untangles externally imposed singular truths and welcomes multiplicity in thought, feeling and being; respectfully holding the tensions this can create. Whatever our concerns, we understand that the leaders of the SCoPEd project believe in their framework and that a portion of members will be content to be mapped onto its tiered practitioner categories. We call on these organisations to respectfully include those of us who experience the framework very differently, not just with words but in action – valuing our ethical, congruent and engaged participation by welcoming us into new membership categories on the PSA registers that are not mapped onto the SCoPEd framework’s columns and titles.

Signed

The Person-Centred Association (tPCA)

United Kingdom Person-Centred Experiential (UKPCE)

Dr Peter Blundell (letter co-author), BACP Registered Member, NCS Accredited, Senior Lecturer, Liverpool John Moores University

Rhianna Broadway, BACP Registered, Primary Tutor/Lecturer, Dip/MSc Contemporary Person-Centred Psychotherapy & Applications, Metanoia

Dr Rose Cameron, Edinburgh University

Dr Shun Chen, BACP Accredited, School of Education, University of Aberdeen

Sally Chisholm, BACP Registered, Programme Director for Counselling and Psychotherapy, Keele University

Lesley Dougan, BACP Accredited, NCS Senior Accredited, Programme Lead MA in Counselling and Psychotherapy Practice, Liverpool John Moores University

Dr Richard Doyle, BACP Registered, Assistant Professor, School of Education, University of Nottingham

Sam Driscoll, BACP Registered

Dr Irene Dudley-Swarbrick, Senior Lecturer, Edge Hill University

Dr Ivan Ellingham, HCPC & British Psychological Society Chartered Counselling Psychologist

Dr Gergana Ganeva, BACP Registered, HCPC, BAAT, CPsychol, Lecturer in Counselling and Psychotherapy, Edge Hill University

Dr Jeff Harrison, BACP Accredited, Senior Lecturer, Liverpool John Moores University

Sheila Haugh, UKCP Registered, Director of Studies, Dip/MSc Contemporary Person-Centred Psychotherapy and Applications, Metanoia

Jen Holland, BACP Registered, Assistant Professor, School of Education, University of Nottingham

Professor Stephen Joseph, British Psychological Society, School of Education, University of Nottingham

Janet Mowat, BACP Accredited, Practice placement coordinator, University of Aberdeen

Professor David Murphy (letter co-author), School of Education, University of Nottingham, Independent Practitioners Network (IPN)

Amber Parkinson, BACP Registered , Senior Lecturer, Edge Hill University

Dr Urszula Plust, NCS Accredited, School of Education, Human Flourishing Research Centre, University of Nottingham

Dr LJ Potter, NCS, School of Health, Science and Wellbeing, Staffordshire University

Dr Sue Price, NCS Accredited

Dr Gillian Proctor, University of Leeds

Andy Rogers (letter co-author), BACP Registered Member, Alliance for Counselling & Psychotherapy, IPN

Federica Savoré, BACP Registered, MCOSCA, Teaching Assistant, University of Aberdeen

Dr Susan Stephen, COSCA Accredited, Lecturer, University of Strathclyde

Janet Tolan (letter co-author), BACP Fellow, NCS Senior Accredited

Dr Kathleen Vandenberg, BACP Registered, Senior Lecturer, Liverpool John Moores University

Graham Westwell, BACP Registered, Senior Lecturer, Edge Hill University

Paula J Williams MSc, NCS Fellow

References

Cooper, M., Watson, J. C., & Hölldampf, D. (2010). Person-Centered And Experiential Therapies Work: A Review Of The Research On Counseling, Psychotherapy And Related Practices. Ross-on-Wye: PCCS Books.

Eastside Primetimers (2022). Final Report on the Impact Assessment of the SCoPEd Framework. Retrieved 02/03/2023 here: https://www.bacp.co.uk/media/16980/final-report-on-the-impact-assessment-of-the-scoped-framework-december-2022.pdf

Elliott, R., Watson, J., Greenberg, L.S., Timulak, L., & Freire, E. (2013). ‘Research on humanistic-experiential psychotherapies’. In M.J. Lambert (Ed.), Bergin & Garfield‘s Handbook of Psychotherapy and Behavior Change (6th ed.) (pp. 495-538). New York: Wiley.

Golding, M. (2023). Linked In post. Retrieved 02/03/2023 here: BACP Resignation Statement Feb 23

Johnstone, L. & Boyle, M. with Cromby, J., Dillon, J., Harper, D., Kinderman, P., Longden, E., Pilgrim, D. & Read, J. (2018). The Power Threat Meaning Framework: Towards the identification of patterns in emotional distress, unusual experiences and troubled or troubling behaviour, as an alternative to functional psychiatric diagnosis. Leicester: British Psychological Society.

Murphy, D. (2019). The Questionable Evidence Base of SCoPEd. Blog retrieved 02/03/2023 here: https://allianceblogs.wordpress.com/2019/01/31/the-questionable-evidence-base-of-scoped/

Murphy, D., & Joseph, S. (2016). Person-centered therapy: Past, present, and future orientations. In D. J. Cain, K. Keenan, & S. Rubin (Eds.), Humanistic Psychotherapies: Handbook of Research and Practice, Second Edition (pp. 185 – 219). Washington: APA.

PCG (The Person-Centred Group) (2020). ‘SCoPEd: Insufficient and Incongruent – An open letter to BACP’. Retrieved 02/03/2023 here: https://allianceblogs.wordpress.com/2020/10/16/open-letter-person-centred-calls-on-bacp-to-halt-scoped/

Rogers, A. (2019). Maps, Languages & Lost Continents: Person-Centred Therapy And The SCoPEd Project. Blog retrieved 02/03/2023 here: https://allianceblogs.wordpress.com/2019/07/31/maps-person-centred-therapy-scoped/

Rogers, C. (1942). Counseling and Psychotherapy: Newer Concepts in Practice (p. 4). Boston: Houghton Mifflin.

Roth, A. D., & Pilling, S. (2008). Using an evidence based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behavioural and Cognitive Psychotherapy, 36, pp. 129-147.

Sanders, P., & Tolan, J. (eds) (2023). People Not Pathology: Freeing Therapy From The Medical Model. Ross-on-Wye: PCCS Books.

Thorne, B. (1999). ‘Psychotherapy and counselling are indistinguishable’ (pp. 225-232) in Feltham, C. Controversies in Psychotherapy and Counselling. London: Sage.

What’s haunting SCoPEd? asks Andy Rogers

Back in February, in the midst of the third national Covid lockdown in the UK, two colleagues and I attended a Zoom meeting with representatives of the SCoPEd Technical Group. We were invited to the meeting following our coordination of an open letter from members of the person-centred community who were concerned about the direction and potential impact of SCoPEd. The letter – which attracted over 400 signatories, including leading academics and international person-centred organisations – called for a halt to the project to allow a wider and more inclusive dialogue about the future of the field.

A few months later and after much reflection on the meeting, gradually something has come into view. There are ghosts haunting the clean and tidy columns of the SCoPEd framework and its accompanying rationale, ghosts the project sometimes calls on for support but which more often it ignores or exorcises from discussion.

First, though, let’s start with what we can see and hear quite clearly. In a noticeable shift in the narrative, the hierarchy inherent in the framework is no longer flatly denied by the SCoPEd team. It is, they now say, a reality of the training landscape, which the framework merely reflects. While the language about valuing different skillsets remains, the new spin here is that SCoPEd will help reduce the impact of this hierarchy by creating opportunities for movement between the levels via the proposed ‘gateways’, but this seems wilfully naïve about the economic strata the SCoPEd framework is built on and threatens to entrench. Building a wall along an existing socio-economic barrier, then offering tightly managed crossing points, no doubt with extra charges, is hardly a step towards greater social mobility and inclusion. The likelihood is that it further inflates the status, costs and inaccessibility of the higher tiers.

Building a wall along an existing socio-economic barrier, then offering tightly managed crossing points, no doubt with extra charges, is hardly a step towards greater social mobility and inclusion.

This new version of the SCoPEd story has also begun to reference the political history of our professions, something it previously preferred to ignore, and yet we find ourselves in the hands of an unreliable narrator. SCoPEd has long been sold as a tale of overcoming old conflicts between the organisations, with the much trumpeted ‘unprecedented collaboration’. Fair enough, I’m sure it feels really good to finally sit in a room together when before this was impossible. But who exactly found it so difficult and why? Ordinary counsellors and psychotherapists from different organisations have worked side by side for decades, been colleagues and friends. Now, though, ex-Chairs and other senior figures in BACP’s recent history are telling us to grow up and move on from our adolescent ‘growing pains’ (Therapy Today, March 2021, pp.18-23), by which they appear to mean that members should consent to SCoPEd and bury their differences on the nature of the human condition in order to impress the government and NHS. In this infantilising account, supporting SCoPEd is spun as professional ‘maturity’ (p.20). But how can therapists, of all people, equate maturity with the appeasement of power through compliance with a fabricated consensus?

The narrative hook for this developmental mythology, as shared with us in the meeting, is a story about how the field got ‘left behind’ by the IAPT project; a story supported by personal anecdotes suggesting that the reason IAPT started life as a CBT monoculture was because we – counsellors, psychotherapists and psychoanalysts – were too busy squabbling, so the powers-that-be gave the work to compliant CBT therapists and psychology graduates instead. The naughty children missed the school trip, in other words, because we just wouldn’t behave.

IAPT, then, is the first real spectre we encounter, invoked by the project for its power to trouble us as practitioners, to unleash its ghostly cry that we weren’t good enough, that we squandered a golden future of jobs and status in the loving arms of the NHS because we were too caught up in petty sibling rivalries. It is a potent tale and one that is perhaps more persuasive than ever when during a global pandemic the NHS is held in such high esteem. It is also one that speaks to an anxious professional reality of our times, that there’s little if any paid work on the near horizon for many counsellors – a therapy mountain of wasted potential, growing each year as more students qualify.

But this moralising and paternalistic fairytale of counselling and psychotherapy’s exclusion from IAPT, which will, the organisations claim, resolve happily in our post-SCoPEd welcome in the corridors of power – redemption arriving with the commissioner’s chequebook – forgets as much as it remembers. If we listen more closely, the spectre of IAPT tells a quite different story. The IAPT project’s vision was not for a universal therapy service to support the wellbeing of the nation, which we fluffed the chance to join through our own bickering and immaturity. At its outset, IAPT was never going to embrace the rich ecology of counselling and psychotherapy practice – if only we all got along better – because in truth it was created and driven by economists and CBT zealots who were recruited into the New Labour government’s desire to reduce the welfare bill by getting unemployed people back to work, with CBT the new psychological wonder-cure that would treat their medicalised anxiety and depression as quickly and cheaply as possible (Jackson & Rizq, 2019). 

The leadership of the SCoPEd organisations expediently forget this history, perhaps because to remember it is to confront the complex reality of what happens when therapeutic values encounter the culture of contemporary healthcare practice and the political intentions of governments, different worlds the project desperately needs to be in alignment for its rationale to make any coherent sense. The person-centred critique of SCoPEd that informed our open letter is just the most obvious manifestation of the incongruence between these worldviews – not for every practitioner in every modality but for a substantial proportion of therapists for whom a standardised, manualised, instrumental and medicalised approach is at odds with our philosophies, trainings and, crucially, our experiences with and as clients (not to mention the research, which we’ll come on to).

Is this really the lost future we want to regain – absorption into healthcare, burning out in IAPT, cooking the data books to survive (Surviving Work, 2019)? Maturity, we are told, means ignoring such complex questions, swallowing our disagreements, deifying and coveting NHS jobs, agreeing shared standards and falling in behind a bland united front of semi-manualised legitimacy. We must now believe the fairytale because the real story of our professions is too awkward – and we don’t want those skeletons to come out dancing when we’re talking to the Department of Health. 

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One such skeleton is the actual evidence. The SCoPEd project has been keen to portray itself as ‘evidence-based’, but while presumably its ‘map’ of training is genuinely based on the course curricula it analysed, the project’s arrangement of this information into three distinct tiers of practitioner competency – with the clear outcome being that a higher tier therapist is automatically more competent than a lower tier therapist – is an ‘evidence-based’ claim too far.

Where is the evidence that those destined for the highest tier of SCoPEd are safer, more helpful with complex client concerns, or that they create more meaningful therapy relationships?

Where is the evidence that longer and more academic trainings with higher personal therapy requirements and a tendency towards psychoanalytic thinking actually generate more competent practitioners at the point of completion, let alone after a couple of years of practice? When we’re discussing the relative ‘competence’ of differently trained therapists, where is the evidence that those destined for the highest tier of the SCoPEd framework are safer, more helpful with complex client concerns, or that they create more meaningful therapy relationships? If it exists, it has yet to be produced.

What we do know from research is that modality is a poor predictor of outcome, as in the famed ‘Dodo bird verdict’. Despite its training requirements, psychoanalytic psychotherapy has not proven itself to be any more successful than Person-Centred Therapy, which has a different training model but a substantial evidence base (e.g. Cooper, Watson & Hölldampf, 2010; Elliott et al, 2013; Murphy & Joseph, 2016). Research also suggests (Lambert, 1992) that practitioner techniques account for less therapeutic change than either factors outside the therapy or common therapeutic factors, such as the therapy relationship, findings which have contributed to our understanding of the co-created nature of therapy and the role of the actively ‘self-righting’ or ‘self-healing’ client (Bohart & Tallman, 1999). 

Categorising practitioners by training alone, using a reductionist input-output model of education, and strongly implying that their relative placings in these categories meaningfully predicts or correlates with their ability to help clients, rather flies in the face of such findings. But the SCoPEd team deem the relevant outcome literature to be beyond the project’s remit, so just march on regardless, merrily declaring their efforts to be ‘evidence-based’ while ignoring some of the few consistent findings that have emerged from decades of therapy research.

Of course training matters in becoming a therapist, but what about training matters? What do people bring into it and how do they integrate and consolidate all of this experience, both within the formal training period and after qualification? It is faith-based, rather than evidence-based, to argue that a more academic training involving years of five times a week psychoanalysis generates a more competent therapist (more skilled, more likely to help, less likely to harm) than a training with a different set of values and expectations around personal development and how it facilitates growth and therapeutic ability in practitioners. Claims for the higher competence level of therapists with more – but not necessarily better – personal therapy experience might make sense within the culture of psychoanalysis, but to enshrine such modality-specific training norms as ‘evidence-based’ markers of competence among all practitioners is misleading at best.

None of which would matter as much if SCoPEd was only a map of available training curricula, but – despite the protestations of its architects – it manifestly is not just a map of training because it extrapolates the findings of its survey of courses into a hierarchical taxonomy of practitioners. The controversial category titles may have been temporarily removed from the framework’s column headings, but the pecking order is transparently obvious. Under pressure to explain how this categorisation system might work in practice without being detrimental to those placed in the lower tiers, we are supposed to be reassured by the organisations’ suggestion that it will all be sorted out during ‘implementation’.

It has been a key feature of how SCoPEd has been justified that there is a slippery movement between three aspects of the project: the mapping of training; the framework of practitioner categories; and the eventual implementation of that framework. Depending on which challenge the project is trying to refute, these areas gets emphasised or downplayed. When in our meeting we pressed the Technical Group members on aspects of how SCoPEd would affect the field, we heard that implementation was not something they were even working on because it is a matter for those higher up the chain of command. “We’re just the foot soldiers”, it was joked.

When my colleagues proposed an independent impact assessment to look closely at how SCoPEd’s implementation will affect modalities, training, employment, and equality and diversity, we were told that they don’t know yet how the framework will be implemented, so there is no impact to assess (make of that logic what you will). In fact there is already evidence of SCoPEd affecting the training market but even if there weren’t, you’d think the organisations would be interested in understanding how implementation might affect their members in ways they hadn’t anticipated. Surely it is imperative that such a far-reaching project is independently assessed for its unintended negative consequences?

The Technical Group representatives, however, were unwilling to engage with these issues. Perhaps they know that examining them too closely lays bare the project’s flaws, or perhaps it really is above their pay grade. Either way, it looks as if implementation is the poltergeist that threatens to disrupt the contrived order of the competence framework’s neatly arranged columns and rows, so – in our meeting at least – it was banished to other realms: to the top of the organisations’ power structures; to the apparently unknowable future, away from scrutiny.

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What value is there in consultations, ‘listening events’ and the like, if the boundaries of what is amenable to change are drawn so narrowly? As coordinators of the person-centred letter against SCoPEd, we had been invited to discuss our concerns, but my experience of the meeting was that none of our concerns were seriously up for consideration, which rather begs the question, what is admissible? Ironically, we were asked if there are any gaps we could identify, anything the project has missed that they might consider including, but given that the substantive issues raised by our letter were either ignored or flatly refuted, all that leaves us to contribute is some peripheral tinkering along the unstoppable path to a final iteration.

What value is there in consultations, ‘listening events’ and the like, if the boundaries of what is amenable to change are drawn so narrowly? 

In SCoPEd’s haunted house we are only welcome to comment on the soft furnishings. Never mind the location and architecture of the building, its environmental impact, or the phantoms that run its halls, perhaps a colour-coordinated cushion on that sofa would make the place feel more cosy.

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Talking of the unspeakable, what of the SCoPEd team’s eye-rolling dismissal of enquiries about the project’s relationship with statutory regulation? Regulation is something decided by parliament, the organisations plead, so SCoPEd simply puts the profession in a state of readiness if it were to become a possibility in the future. The assumption here is that it would be a good thing not to face the obstacles encountered in the late 2000s, when there was an attempt to regulate the field under the Health Professions Council (now the Health & Care Professions Council).

But these obstacles actually helped save us from being legally defined and controlled by a highly medicalised regulator with a poor understanding of the values, complexities and nuances of therapeutic work. BACP’s ‘nothing to see here’ account also jars with the fact that the Professional Standards Authority (PSA), which accredits the registers of the SCoPEd organisations and sits as an observer in some SCoPEd meetings, has been consulting on a proposal for a system of ‘licensed’ practitioner titles (PSA, 2020). As the PSA documents make clear, such a system would require a profession to have agreed common standards (like SCoPEd) and could potentially give existing register-holders (like BACP) new regulatory powers.

We can never really know the extent to which a desire for regulation fuels the SCoPEd project. As the interests of different individuals and organisations align and feed off each other, the role of the pro-regulation agenda will likely go unacknowledged. Similarly, if we zoom out further, it can be hard to pinpoint the influence of the wider cultural and political milieu that nonetheless envelopes therapy like a spectral fog; but it’s clear that SCoPEd’s reductionist desire for standardisation and manualisation potentially does some of the work for those intent on the ‘uberisation’ of therapy (Cotton, 2019) and the alignment of mental health practice with the dominant economic and ideological narratives of the times. Typically, though, the project has little interest in the shadows of its own motivations and possible impacts, so just bats away such concerns as a distraction from the vital matter of signing off its spreadsheet of competences.

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All of which hangs heavily in the air as 2021 progresses and BACP et al set their sights on adopting the framework in the months ahead. Grow up. Get taken seriously. Get more work. Get SCoPEd done! These are powerful rhetorical devices but even if they appeal to some fraught configuration of our professional selves, deep down we know we are being played. We know what our work is about. We know that SCoPEd is a misrepresentation of what makes therapy such a uniquely valuable experience. Personally, I’m concerned that this knowledge itself is under threat, that we will be so consumed by the anxieties of the times that the comfort of SCoPEd’s concocted certainties will unwittingly help diminish the human heart of counselling and psychotherapy. 

To protect against this happening, we need to keep in mind that there are alternative futures for our field that are much brighter than SCoPEd would have us believe, and they won’t be found in competence frameworks, rigid alignment with healthcare, or carpet-bombing our diverse ecology of therapeutic practice in the pursuit of legitimacy. On the contrary, if these futures are not to be lost completely, we might need to tune into the echoes of the past and re-engage with their as yet unfulfilled potential. 

After all, SCoPEd’s ghosts are nothing to be scared of or ashamed about. There is hope in what they have to say, whispers reminding us that the mundanely oppressive reality we are currently being sold is not the only way forward. So let’s do what we do best and listen. Perhaps then, rather than falling in behind the project’s anxious incongruence and expedient compliance with power, we might begin again to fulfil therapy’s potential as a diverse and creative force for understanding, relationship, compassion, critical thinking, and personal and political growth.

If the ghosts haunting SCoPEd tell us anything, it is simply that we can do better.

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Andy Rogers is a BACP registered counsellor and supervisor. For twenty years he was a counselling service coordinator in further and higher education, and now runs a private practice in Basingstoke. Andy has written about counselling and psychotherapy in books and journals and recently co-authored the fifth edition of First Steps in Counselling: An Introductory Companion (2021, PCCS Books).

References

Bohart, A.C. & Tallman, K. (1999). How clients make therapy work: The process of active self-healing. American Psychological Association.

Cooper, M.; Watson, J.C.; Hölldampf, D (2010)Person-Centered And Experiential Therapies Work: A Review Of The Research On Counseling, Psychotherapy And Related Practices. Ross-on-Wye: PCCS Books.

Cotton, E (2019) Ubertherapy – working in the therapy factory: https://survivingwork.org/wp-content/uploads/2019/07/UberTherapy_Final-Version.pdf

Elliott, R., Watson, J., Greenberg, L.S., Timulak, L. & Freire, E. (2013). ‘Research on humanistic-experiential psychotherapies’. In M.J. Lambert (Ed.), Bergin & Garfield‘sHandbook of Psychotherapy and Behavior Change(6th ed.) (pp. 495-538). New York: Wiley.

Jackson, C. & Rizq, R. (Eds.) (2019) The Industrialisation of Care: counselling, psychotherapy and the impact of IAPT. Monmouth: PCCS Books.

Lambert, M.J. (1992). Psychotherapy outcome research: Implications for integrative and eclectic therapists. In J.C. Norcross & M.R. Goldfried (Eds.). Handbook of psychotherapy integration (1st ed.), pp.94–129. Basic Books. 

Murphy, D. & Joseph, S. (2016) ‘Person-centered therapy: Past, present, and future orientations’. In  D. J. Cain, K. Keenan, & S. Rubin (Eds.), Humanistic Psychotherapies: Handbook of Research and Practice, Second Edition (pp. 185 – 219). Washington: APA.

PSA (2020) ‘Authority consultation on the future shape of the Accredited Registers programme’ https://www.professionalstandards.org.uk/publications/detail/authority-consultation-on-the-future-shape-of-the-accredited-registers-programme

Surviving Work (2019) The IAPT Survey: https://thefutureoftherapy.org/iaptsurvey

Open letter from person-centred community calls on BACP to halt the SCoPEd project

An open letter from hundreds of person-centred practitioners and supporters of the Person-Centred Approach has been published, calling on BACP to halt the controversial SCoPEd project for counselling and psychotherapy and to ‘open a more inclusive dialogue about the future of the field’.

The letter (reproduced in full below and also sent to UKCP, BPC and NCS) is signed by over 400 therapists, academics, educators and trainees, among them BACP Fellows, BACP Accredited and Senior Accredited members , UKCP registered therapists, NCS members and leading person-centred writers from the UK, Europe and the United States. 21 organisations have also signed, including person-centred groups from across Europe.

As the letter spells out, the project and its proposed competency framework is ‘divisive, elitist and exclusionary’ and marginalises Person-Centred Therapy, one of the most widely practised therapeutic approaches among BACP members. As the letter states:

‘SCoPEd distorts our professional landscape into a politically expedient shape at the expense of a whole swathe of practitioners whose work is misunderstood, downgraded and delegitimised.’

Read the letter and full list of signatories below.

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SCoPEd: Insufficient and Incongruent

An open letter to BACP

As Person-Centred therapists and supporters of the Person-Centred Approach, we have become increasingly concerned about the development of the SCoPEd project for counselling and psychotherapy. Person-Centred Therapy (PCT) constitutes one of the most widely practised approaches within BACP and yet SCoPEd has marginalised and excluded Person-Centred therapists almost entirely. After the first consultation, we were assured that PCT – an approach supported by decades of research (e.g. Cooper, Watson & Hölldampf, 2010; Elliott et al, 2013; Murphy & Joseph, 2016) – would be more accurately represented in the second iteration of the proposed framework, but in fact little of any substance has changed and there has been no willingness to fundamentally reassess the project’s approach. We now call on BACP to halt SCoPEd and to open a more inclusive dialogue about the future of our field.

Person-Centred therapists are committed to creating the therapeutic conditions for constructive change and the fulfilment of potential, not only with individual clients and trainees but for the therapy field as a whole. How, then, can we best nurture the diverse ecology of therapeutic practice in the UK? This is an important and complex question that the SCoPEd project fails to answer successfully by attempting to ‘map’ training and practice onto a simplistic ‘competency framework’. For us, this signals a failure of imagination and a lack of creativity, but it also demonstrates a troubling commitment to a predetermined outcome.

Far from creating the conditions for growth, the project has proven to be divisive, elitist and exclusionary, not least by privileging some theories, practices and professional identities over others, while simultaneously turning a blind eye to the complex histories and professional politics that feed its erroneously hierarchical understanding of therapy training and practice. SCoPEd creates a professional self-concept that is incongruent with how many practitioners, trainees and clients actually experience the human relationships at the heart of therapy, irrespective of theoretical orientation.

This is not solely about our own interests as Person-Centred therapists. The marginalisation of the Person-Centred Approach in the SCoPEd project is an exemplary case study in how – whatever its intentions – the proposed framework fails to accurately promote, represent or clarify understanding in the field of counselling and psychotherapy in the UK. Rather than ‘mapping’ the territory, SCoPEd distorts our professional landscape into a politically expedient shape at the expense of a whole swathe of practitioners whose work is misunderstood, downgraded and delegitimised.

From a Person-Centred perspective, we are particularly concerned about the following issues:

1) It is a key Person-Centred value that no one group is better equipped to be a therapist than any other. Counselling and psychotherapy is already a disproportionately white, middle class profession but SCoPEd looks set to further entrench these deep structural inequalities by lending even more status to certain titles and trainings at the expense of others. This will inevitably drive up costs, exacerbate elitism and further exclude from the upper tiers of the framework’s hierarchy those experiencing socio-economic disadvantage, discrimination and oppression.

2) Until very recently, well into the project’s development and in our view far too late, the three SCoPEd membership bodies – BACP, UKCP and a relatively small body dedicated solely to psychoanalytic practice (BPC) – have excluded all other membership organisations, interest groups and stakeholders.

3) The composition of the so-called Expert Reference Group (ERG) is deeply problematic. Originally, the ERG had seven psychoanalytic therapists and no Person-Centred therapists. Then an eighth psychoanalytic therapist was added, together with one identifying as Person-Centred/Pluralistic. The ‘independent’ Chair is drawn from the British Psychoanalytic Council. This is not a grouping that can be expected to understand or faithfully represent the complexities and nuances of the family of Person-Centred and Experiential therapies.

4) SCoPEd uncritically adopts the notion that the best way forward for our field is to develop a ‘competency framework’ using a methodology designed originally to manualise CBT for the IAPT project in the NHS (Roth & Pilling, 2008). The Person-Centred Approach has long critiqued manualisation, which potentially dehumanises the co-created, relational art of therapy and, in this case, risks reducing it to a mechanistic, psychoanalytically-informed healthcare intervention.

5) The Roth & Pilling methodology relies on a narrow and self-referential range of ‘evidence’, which distorts the outcomes of its ‘research’ so that assumptions from psychoanalytic psychotherapy become in the SCoPEd framework ‘evidence-based’ assertions about the relative competency of therapists with different trainings and philosophies (Murphy, 2019).

6) Given the theoretical bias in the ERG’s composition and the values inherent in the project’s chosen methodology, it is no surprise that the competence framework itself almost erases a Person-Centred understanding of therapeutic practice. For example:

I. Despite the temporary and somewhat disingenuous removal of practitioner titles in the second iteration, SCoPEd clearly differentiates ‘counselling’ and ‘psychotherapy’, terms which in the Person-Centred Approach are used interchangeably. Indeed, from Carl Rogers’ earliest writings onwards, differentiation has tended to be viewed critically (Rogers, 1942; Thorne, 1999). Until very recently this was also BACP’s position but the organisation has now performed an astonishing and unevidenced U-turn on the issue.

II. Moreover, the framework portrays ‘psychotherapists’ as being not just different but more competent than ‘counsellors’ across a whole range of practice issues, formalising a divisive hierarchy of practice that devalues post-qualification experience and training. It also grants ownership of the language to those who support this hierarchical differentiation and delegitimises those, such as Person-Centred therapists, for whom these terms have different meanings. Proposing (as yet unspecified) ‘gateways’ between the titles does nothing to level this inequality – if anything it highlights how therapists have been organised into an imposed system of tiered enclosures, through which only those with sufficient resources will be able to move upwards.

III. PCT in the UK is commonly – though by no means exclusively – practised under the title of ‘counsellor’, which the hierarchy effectively downgrades. But the professional and political history of this identity (see Rogers, 2019) has nothing to do with the competence or ability of Person-Centred therapists to co-create and sustain therapeutic relationships at depth (e.g. Mearns & Cooper, 2017).

IV. Throughout the framework, a psychoanalytically-informed, instrumental treatment approach – one at least partly located in the medical model – is positioned as superior to holistic, phenomenological, Humanistic approaches. The highest level (‘psychotherapist’/ column C) competences are skewed towards psychoanalytic theory and practice, most obviously in their references to the ‘unconscious’. The addition of the phrase ‘out of awareness’ and other minor language tweaks do not go anywhere near far enough to redress this inequality.

V. The privileging of psychoanalytic approaches belies the claim that the SCoPEd framework is ‘evidence-based’. There is no clear evidence that psychoanalytic approaches achieve higher levels of competence, greater depth of practice or have better ‘outcomes’ for clients than Person-Centred therapies, which are well researched and strongly evidence-based (e.g. Cooper, Watson & Hölldampf, 2010; Elliott et al, 2013; Murphy & Joseph, 2016).

VI. Using UKCP and BPC-approved course curricula as the primary sources for the ‘psychotherapist’/column C competences devalues the alternative – but nonetheless philosophically coherent – approach found in Person-Centred training, which has different emphases, e.g. the value placed on group work (not just individual therapy) in personal development. There is, after all, no evidence that higher academic levels of study, more personal therapy, attending mental health placements and working from a psychoanalytic theoretical base in training result in more meaningful therapy experiences for clients.

VII. The related notion, visible in the SCoPEd competences, that only practitioners who meet the ‘psychotherapist’/column C criteria are able to undertake the most complex therapeutic work, is contradicted by the fact that many trainee and newly qualified counsellors (from all theoretical approaches) will already be working ethically in placements with issues such as complex trauma. It also ignores the pioneering work of Person-Centred practitioners both in psychiatric settings (e.g. Prouty, 2008; Warner 2014) and in the area of ‘post-traumatic growth’ (Joseph, 2011).

Summary

We cannot support SCoPEd because it imposes an understanding of therapy that we do not share and for which there is a lack of good evidence. The project’s organisational processes and research methodology have created a framework that erroneously equates practitioner competency and therapeutic depth with specific theoretical approaches, training conventions, practitioner titles and organisational memberships/levels – all of which evolved for professional reasons that have little bearing on the richly diverse, lived experience of therapeutic relationships.

In its legitimising of redundant hierarchies, SCoPEd misrepresents the profession of counselling and psychotherapy, fails the Person-Centred Approach, devalues the work of thousands of trained counsellors in the UK and risks further impeding diversity in our field.

We ask BACP to halt the project; to reconnect with its own membership; to consult more widely across the field about the best way forward; to fully embrace diversity of thought and practice; to genuinely prize the work of therapists of all kinds; and to put therapeutic values rather than political expediency back at the heart of its approach.

^References

^{Cooper, M; Watson, JC; Hölldampf, D (2010) Person-Centered And Experiential Therapies Work: A Review Of The Research On Counseling, Psychotherapy And Related Practices. Ross-on-Wye: PCCS Books.}

^{Elliott, R., Watson, J., Greenberg, L.S., Timulak, L., & Freire, E. (2013). ‘Research on humanistic-experiential psychotherapies’. In M.J. Lambert (Ed.), Bergin & Garfield‘s Handbook of Psychotherapy and Behavior Change (6th ed.) (pp. 495-538). New York: Wiley.}

^{Joseph, S (2011) What Doesn’t Kill Us: The new psychology of post-traumatic growth. New York: Basic Books.}

^{Joseph, S (2017) ‘The Problem of Choosing Between Irreconcilable Theoretical Orientations: Comment on Melchert (2016)’ American Psychologist 2017, Vol. 72, No. 4, 397–398.}

^{Mearns, D & Cooper, M (2017) Working at Relational Depth in Counselling and Psychotherapy. 2nd edition. London: Sage.}

^{Murphy, D (2019) ‘The Questionable Evidence Base of SCoPEd’. Blog retrieved 26/09/2020 here: https://allianceblogs.wordpress.com/2019/01/31/the-questionable-evidence-base-of-scoped/}

^{Murphy, D, & Joseph, S (2016) ‘Person-centered therapy: Past, present, and future orientations’. In D. J. Cain, K. Keenan, & S. Rubin (Eds.), Humanistic Psychotherapies: Handbook of Research and Practice, Second Edition (pp. 185 – 219). Washington: APA.}

^{Prouty G (2008) Emerging Developments In Pre-Therapy: A Pre-Therapy Reader. Monmouth: PCCS Books.}

^{Rogers, A (2019) ‘Maps, Languages & Lost Continents: Person-Centred Therapy And The SCoPEd Project’. Blog retrieved 26/09/2020 here: https://allianceblogs.wordpress.com/2019/07/31/maps-person-centred-therapy-scoped/}

^{Rogers, C (1942) Counseling and Psychotherapy: Newer Concepts in Practice (p. 4). Boston: Houghton Mifflin.}

^{Roth, AD & Pilling, S (2008). ‘Using an evidence based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders.’ Behavioural and Cognitive Psychotherapy, 36, pp. 129-147.}

^{Thorne, B (1999) ‘Psychotherapy and counselling are indistinguishable’ (pp. 225-232) in Feltham, C. Controversies in Psychotherapy and Counselling. London: Sage.}

^{Warner, M (2014) ‘Client processes at the difficult edge’. In P Pearce and L Sommerbeck (eds), Person-Centred Practice at the Difficult Edge. Ross-on-Wye: PCCS Books.}

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Organisational signatories

The Person-Centred Association (TPCA)

UK Person-Centred Experiential (UKPCE)

Person-Centred Therapy Scotland (PCT Scotland)

The Association for the Development of the Person-Centered Approach (ADPCA)

European Network for Person-Centred & Experiential Psychotherapy and Counselling (PCE Europe)

Counsellors Together UK (CTUK)

Psychotherapy & Counselling Union (PCU)

Psychotherapists and Counsellors for Social Responsibility (PCSR)

Pink Therapy

Aashna Counselling & Psychotherapy

Free Psychotherapy Network (FPN)

Alliance for Counselling & Psychotherapy

Counselling for Social Change

Kaleidoscope Counselling Scotland

Radical Dialogues

Dutch Association for Person-Centred Experiential Psychotherapy (VPeP)

Flemish Association for Client-Centered & Experiential Psychotherapy and Counseling (VVCEPC)

Panhellenic Association of Person-Centred & Experiential Professionals (PEEPVIP)

Polish Society of Integrative Experiential Psychotherapy (INTRA)

Rogers Centre – Foundation for the Autonomous Person (Hungary)

Romanian Association for Person-Centred Psychotherapy (ARPCP)

Russian Community of the Person-Centred Approach (RCPCA)

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Individual signatories

Ray M. Adomaitis Ph.D; Licensed Psychologist, Washington
Sabine Ahlen MBACP Registered; NCS Accredited
Laura Aitken MBACP (Accred)
Maria Albertson, Founder, Counsellors Together UK (CTUK)
Ashley Allcorn A.M., LSW; B Temaner-Brodley PG Fellow, CCA, Chicago
Lee Allen MBACP Registered
Vicki Allen MBACP Registered
Jacqueline Anderiesz-Tyrrell MBACP (Accred); BA (Hons)
Lisa Andrews A.M., LCSW; B Temaner-Brodley PG Fellow, CCA, Chicago
Dan Angel MBACP Registered; NCS Accredited
Paul Atkinson, Free Psychotherapy Network
Jax Ayling MBACP (Senior Accred)
Richard Bagnall-Oakeley UKCP & BACP Registered
Julia Bailey MBACP (Accred)
Williamina Baillie MBACP Registered
Sarah Baimbridge MBACP (Accred)
Charles Baines MBACP (Accred)
Helene Baker MBACP Registered, NCS (Acc)
David Ballantine MBACP Registered
Sal Bannister MBACP (Accred), NCS (Acc); counsellor/psychotherapist
Keith Barber UKCP Registered
Jennifer Barlow MBACP (Accred)
Eleanor Barnes MBACP (Accred), MCOSCA
Larry Barnett MBACP Registered; BSc (Hons), FdSc
Alison Barr MBACP Registered; Director, The Green Rooms
Diz Barton MBE MBACP (Senior Accred); UKCP Registered
Jay Beichman Ph.D; MBACP (Senior Accred)
Alaina Bercilla CCA Intern, Eastern Michigan University
Paul Berry MBACP Registered
Kris Black MBACP/UKCP Registered, ISN, IAP, LLB (Hons); Founder, Radical Dialogues
Martyn Blair MBACP Registered
Jon Blend UKCP Registered
David Blowers UKCP Registered
Dr Peter Blundell, Senior Lecturer, Liverpool John Moores University
Gloria Boadi MBACP (Accred), NCS Accredited
Arthur Bohart Ph.D; Santa Clara University, California
Mihaela Bonațiu, Chair, ARPCP
Margaret Borszcz MBACP (Accred)
Mae Boyd MBACP (Accred)
Heather Grace Bond Ph.D
Carla Boulton NCS member
Anne-Marie Bradley MBACP (Accred)
Fr. William Bradley, St. Joseph’s Mission, Stafford Springs, CT, USA
Yasmina Bradshaw BACP student member
Ben Brett MBACP Registered, Dip.Couns
Alan Brice MBACP (Senior Accred)
Rita Brophy MBACP Registered; Integrative Counsellor
Helen Brown, student counsellor, University of Warwick
Jane Brown MBACP Registered
Daniel Bruck MBPsS, University Sao Francisco, Brazil
Chris Bulpitt ACC Accredited
Terry Butler MBACP Registered
Beatriz Cadavid MBACP Registered
Sarah Callen DipCo., MSc.; Co-Editor, Person-Centred Quarterly
Rose Cameron MBACP (Senior Accred)
Caroline Capon NCS member
Isabel Carballal CPCAP L4 Therapeutic Counselling Dip
Jenny Carlisle MBACP (Senior Accred)
Lorna Carrick MBACP (Senior Accred); Counselling Programme Director, University of Strathclyde
Ian Carty
Nancy Cerritelli BACP student member
Sally Chisholm, Lecturer, Supervisor & Counsellor, Keele University, Metanoia Institute
Agapitos Chrysochoos, PCA counsellor
Celia Clark NCS Accredited
Dot Clark MBACP Registered
Becki Clitsome, Student Member BACP & NCS
Dilys Codrington NCS Member; Psychotherapeutic Counsellor
Peter Coffey MChem (hons), MRes
Jo Cohen, Assoc. for the Development of the Person-Centered Approach
Susan Coldwell MBACP (Accred)
Sophie Coleman
Paul Colley, therapist & supervisor; conscientious membership body objector since 1994
Kim Cooper MBACP (Accred)
Sandra Cooper MBACP Registered counsellor; BA (Hons)
Dr Elizabeth Cotton, Surviving Work
Tom Cowan, Student Member BACP
Geoff T. Cox MBACP (Accred); MA
Mary Coyne UKCP Registered; person-centred psychotherapist
Andrew Cranham UKCP Registered
Daniela Crasan ARPCP
Stephen Crowther MBACP Registered
Christine Cullen MBACP Registered
Leigh-Anne Cummings-Flint
Alisha Cunningham NCS student member
Maria Mirella D’Ippolito, psychologist & psychotherapist, Rome, Italy
Amy Dann NCS Accredited
Catherine Date MBACP Registered
Jayne D. Davidson MBACP (Accred)
Dominic Davies, CEO Pink Therapy; Fellow of NCS and NCP, former Fellow of BACP
Jennifer Davies MBACP & UKCP Registered
Kim Davies MBACP Registered
Maria Davies MBACP Registered
Rebecca Davies nee Howes MBACP Registered
Samantha Davies NCS Accredited
Ryan Dawes MBACP Registered; Mphil, PGDip
Veronica Day MBACP Registered
Mathias Dekeyser
Glenna Demeter NCS Fellow Accredited member
Trees Depoorter, Chair, VVCEPC
Helen Ditchburn BACP student member
Melody Dixon-Oliver MBACP Registered
Lesley Dougan, Senior Lecturer/MA Course Lead, Liverpool John Moores University
Magda Draskoczy, Person-Centred therapist and trainer, Hungary
Sam Driscoll MBACP Registered
Ashleigh Dunford-Bishop MBACP Registered
Charles Durning MBACP Registered
Rachel Dyer-Williams MBACP Registered
Cheryl Edwards MBACP Regsitered, NCS member
Erin Ekeberg A.M., LSW; B Temaner-Brodley PG Fellow, CCA, Chicago
Roisin Elder MBACP Registered; PGDip
Derryn Ellingham MBACP Registered
Ivan Ellingham Ph.D, CPsychol (Counselling & Clinical Psychology), HCPC
Clayton Elliott MBACP (Accred)
Beth Evans UKCP Registered
Claire Fewster NCS Accredited
Melanie Fieldhouse MBACP Registered; PGDip
Christine J. Finch NCS Accredited
John Fletcher MBACP (Accred), UKCP Registered
Palada Florentina ARPCP
Jane Flotte A.M., LCSW; B Temaner-Brodley PG Fellow, CCA, Chicago
Florenta Foca ARPCP
Leeanne Fowler UKCP Registered; NHS counsellor & university lecturer
Heidi Francis Ad Prof Dip PC, MNCS Accred
Peter Freeman MBACP Registered
Pamela Frith MBACP Registered
Sally-Anne Fuller BACP member
Dr Anna Louise Fry Ph.D, MNCS Accredited
Samantha Fulton MBACP Registered
Stavroulla Gabriel MBACP Registered
Jamie Geary
Sharon Gibbons, formerly MBACP Registered, now NCS
Donna Gibson MBACP Registered
Marc Gibson NCS Accredited
Alexandre F. Gieseke MBACP (CYP); Graduated Basis for Chartered Psychologist – GBC – MBPSs
Lizzie Gilbert MBACP Registered
Nick Glenister MBACP Registered
Trish Golding MBACP (Accred)
Jojo Gosney MBACP (Accred); MA
Natalee Goodman BACP student member
Keith Grayson MBACP Registered
Sue Griffiths MBACP (Accred)
Monica Gundrum, psychotherapist, Belgium
Dr Ellen Gunst Ph.D, psychologist and psychotherapist, Belgium
Rob Hack BACP student member
Jules Haley, Person-Centred counsellor
Sonia Hall MBACP Registered
Deborah Hare NCS Accredited Member
Caroline Harland MBACP Registered
Elizabeth Harris MBACP (Senior Accred)
Richard Harris MBACP Registered
Steven Harris MBACP Registered
Dr Jeff Harrison, Senior Lecturer, Liverpool John Moores University
Mark Harrison NCS member (ex-BACP, departed in response to SCoPEd)
Dr Andrew Hart CPsychol, Associate Fellow of the British Psychological Society (AFBPsS)
Colin Hartland MBACP Registered
Michelle Harwood MBACP Registered
Jan Hawkins MBACP (Senior Accred)
Catherine Hayes MBACP (Senior Accred); Assistant Professor in counselling
Lee Healbury
Sebastian Heid MBACP Registered; trustee, the Person-Centred Association (TPCA)
Paula Hendricks MBACP Registered
Suzy Henry, Chair of the Person-Centred Association (TPCA)
Arne Heylen, Client-Centred therapist, Catholic University Louvain, Belgium
Amanda Hignett BACP student member
Antonia Higgins MBACP Registered
Michelle Higgins MBACP (Accred)
Jo Hilton, Clinical Fellow, University of Edinburgh
Kerrie Hipgrave MBACP Registered
João Hipólito, Professor, Universidade Autónoma de Lisboa, Portugal
Cara Hitchcock MBACP Registered
Brennan Holt MBACP Registered
Jacqueline Homonko MBACP (Accred)
Darren Hopgood MBACP Registered & NCS Accredited
Kirsty Horne NCS member
Sophie Horrox MBACP (Accred)
Angela Hotchkiss, Person-Centred counsellor
Richard House Ph.D, Chartered Psychologist, former Senior Lecturer in counselling & psychotherapy
Bernard Howell MBACP Registered
Lin Hudson MBACP (Accred)
Gillian Hughson NCS member
Kathy Humberstone MBACP (Accred); Senior Lecturer, University of Derby
Lee Humphreys BACP student member
Jane Hupston MBACP Registered & NCS
Fiona Hutchings MBACP (Accred)
Lynne Hutton MBACP Registered
Darren Jackson
Gillian James MBACP Registered
Marie Jefsioutine MBACP Registered
Marlene Jenas MBACP Registered
Julie Jenner UKAHPP, UKCP and EABP registered
Julia Jenkins MBACP Registered
Dr Peter Jewel, Person-Centred counsellor and supervisor
William Johnston MBACP Registered
Shirley Jolley Retired Person-Centred counsellor, TPCA
Ruth Jones MBACP (Accred)
Stephen Joseph Ph.D, Professor of Psychology, Health & Social Care, University of Nottingham
Kay Juviler-Bacon MBACP (Accred)
Ewa Kaczorkiewicz, Psychotherapist & Psychologist, Warsaw, Poland
Edwin Kahn, ADPCA
Ali Keen MBACP Registered
Dawn Keenan, trainee counsellor, Liverpool John Moores University
Susan Kelly MBACP Registered
Emma Keir MBACP (Accred); CMCOSCA
Josephine Kerr MBACP Registered
Howard Kirschenbaum, Professor Emeritus, University of Rochester; biographer of Carl Rogers
Grace Klein, ADPCA
Julia Kohnert MBACP Registered
Lisa Kmita MA; Prog. Leader, University Campus North Lincolnshire
Judy Knight MBACP Registered
Farah Kurdi-Villate CCA Intern, University of Chicago
Nicolas Krivine
Lynne Lacock MBACP Registered; Senior Lecturer
Colin Lago BACP Fellow; M.Ed, D.Litt
Adam Laidler MBACP Registered; psychotherapist
Leonore Langner, Chair, PCE Europe
Janey Lansdell MBACP Registered, NCS member
Emma Largesse MBACP Registered
Richard Lasson, Social Worker, Mental Health Support
Barbara Leach Former MBACP (Senior Accred), now retired
Maggie Leathley MBACP Registered; BSc MA PGDip
Rev Dr Jeff Leonardi, counsellor, supervisor, Honorary Research Fellow
Sonica Li, American Counseling Association (ACA), ADPCA
Germain Lietaer, Emeritus Professor, Catholic University Leuven, Division of Clinical Psychology
Jacqui Light NCS member
Mary Lim MBACP Registered
Francesca Lo Verso MBACP Registered
Georgia Looker, level 4 PCT Counselling student
Corrina Lord MBACP (Accred)
Kate Loughran MBACP Registered
Ruth Lyne MBACP (Accred)
Suzi Mackenzie MBACP (Senior Accred)
Colin Mackillop MBACP Registered
Vickey Maddrell, postgraduate student, LJMU
Angela Madeley NCS member
Lisa Major NCS student member; trainee on MA
Barbara Malinen, psychotherapist, supervisor and trainer
Bogumila Malinowska MBACP (Accred)
Lorna Marchant BACP Fellow
Laurel Marks MBACP Registered counsellor
Vivien Marsh MBACP (Accred)
Mary Martin MBACP Registered
Fiona McAlister MBACP Registered
Ali McBride MBACP (Accred)
Jennifer McCann UKCP Registered psychotherapeutic counsellor
Lorna McCarthy MBACP (Senior Accred)
Karon McCarthy-Sadd
Kate McGarry MBACP Registered; PCT Scotland
Elizabeth H. McGauley Sarfaty M.Ed
Susan McGinnis MBACP Registered
Alan McNeill MBACP (Accred), PGDip Couns; NHS primary care counsellor
William Mendez
Beatrice Miller, Chair, PCSR; Person-Centred Therapist
Tina Miller MA; sociologist, social worker, and family life educator
Katie Miller-Cole MBACP Registered; PCU member
Graeme Mills MBACP (Accred)
Catherine Mitchell MBACP Registered
Joanna Mockfrord, Person-Centred Experiential trainee
Mihaela Momoiu MSc; UKCP Registered psychotherapist
Kathryn A. Moon, Licensed Counselor, Chicago, Illinois, USA
Judy Moore Ph.D, MBACP (Senior Accred); former Director, Centre for Counselling Studies, UEA
Dr Shirley Moore BACP individual member
Hilary Moors MBACP Registered
Trish Morgan BACP student member
Kerry Morris MBACP Registered
Rosswitha Morrison MBACP Registered
Kate Morrissey MBACP Registered
Mike Moss MBACP Registered
Vicky Mould NCS (Prof Accred)
John Moulder A.M., LSW; B Temaner-Brodley PG Fellow, CCA, Chicago
Danusia Mulligan MBACP Registered & NCS Accredited
Alison Munro MBACP Registered
Dr David Murphy, Associate Professor, University of Nottingham
Anne Murphy MBACP (Accred)
Claire Murray MBACP Registered
Travis Musich CCA Intern, Illinois School of Prof. Psychology, National Louis University
J. L. Myatt MSc, MBACP Registered
Lynn Naidoo MBACP Registered
Wendy Neil, Person-Centered Counsellor, MNCS, BA (Hons), MSc, DIC
Anna Nelson-Smith MBACP Registered
Paula Newman MBACP (Senior Accred) counsellor and supervisor
Georgeta Niculescu ARPCP
Sally Nilsson, Human Givens Practitioner
Len Northfield MBACP Registered; MSc, PGDip
Stacy Nye MBACP Registered
Donna O’Connor MBACP Registered; psychotherapeutic counsellor
Charlotte O’Hanlon BACP student member
Jeremy O’Sullivan MBACP (Accred)
Sarah Oak MBACP (Accred); member of MK Rogerian Group
Todd Odell M.A.; Senior Therapist, Chicago Counseling Associates (CCA)
Stephen Ong, Person-Centred therapist
Gemma Owen MBACP Registered
Lynn Palethorpe MBACP Registered
Joana Pancada MBACP Registered; MA
Nicola Parry BACP student member
Ian Parker, in solidarity, President, College of Psychoanalysts – UK
Geraldine Pass MBACP Registered
Saf Patel MBACP Registered
Fiona Paterson MBACP Registered
Lorna Patterson MBACP (Accred)
Rachael Peacock, MUCKP Person-Centred Psychotherapist
Sally Pendreigh MBACP (Senior Accred); Person-Centred counsellor
Natali Petkova MBACP Registered
Sarah Pettifer MBACP Registered; therapist and trainer
Gabriella Philippou, Person-Centred Chamber, Pancyprian Association for Psychotherapists (PAP)
Mary Phoenix MBACP (Accred)
Susan Pildes, Senior Trainer, Chicago Counseling Associates (CCA)
Lisa Pinder MBACP Registered; psychotherapist & counsellor
Caroline Plummer MBACP Registered
Maggie Pollard MBACP (Senior Accred)
Chip Ponsford
Martin Poole, trainee therapist
Denis Postle ARCA, Independent Practitioners Network (IPN)
Kevin Powell MBACP Registered
Karen Prescod MBACP Registered
Sue Price NCS member
Dr Gillian Proctor, Lecturer, University of Leeds, and independent clinical psychologist
Steph Quinn MBACP Registered
Rob Radcliffe MBACP Registered
Heather Rai PG Student, University of Nottingham
Pretish Raja UKCP Registered; co-founder, Aashna Counselling & Psychotherapy
Suzi Rankin
Catarina M. Rato MBACP (Senior Accred)
Lyn Rhodes MBACP (Senior Accred)
Anne Richards MBACP Registered
Antonia Richardson MBACP Registered; MUKCP
Helen Richardson MBACP (Accred)
Kathleen Richardson, diploma student
Ruth Richardson MBACP Registered
Nicola Richter MA; MBACP (Senior Accredited), UKCP Registered, MBPsS, Fellow of HEA
Lindsay Riley MBACP Registered
Alison Rimmell MBACP (Accred)
Cashel Riordan MBACP (Accred)
Anne Robertson MBACP Registered
Cy Rodger MBACP Registered
Andy Rogers MBACP Registered; PGDip; therapist, supervisor & author
Blue Roth LCSW; Staff supervisor & therapist, Chicago Counseling Associates (CCA)
Kaye Rowe MBACP Registered
Andy Rushton UKCP Registered
Peter Ryan MBACP (Accred)
Professor Andrew Samuels, former Chair, UKCP
Pete Sanders, author, retired counsellor, supervisor and trainer
Hamilton Sargent MBACP Registered
Martin Sawers, Humanistic & Integrative Psychotherapist (UKCP), IAPT Counsellor
James Schindler-Ord MBACP Registered; BSc
Jane Schindler-Ord MBACP Registered
Carolyn Schneider A.M., LCPC; Director, Chicago Counseling Associates
Julia Scott MBACP Registered; NCS Accredited
Trodi-Ann Scott BACP student member
Becky Seale MBACP (Senior Accred)
Judith Seddon MBACP (Accred); RGN
Tracy Sedgeworth MBACP Registered
Alberto S. Segrera, Emeritus Professor, Universidad Iberoamericana, Mexico
Daniela Ploesteanu Sfirlea ARPCP
Radha Shah MBACP Registered
Mike Shallcross MBACP Registered
Rosemin Shariff MBACP (Accred)
Sandra Sharman MBACP Registered
Kath Shaw MBACP & UKCP Registered
Hannah Shepherd NCS Accredited
Katie Ship MBACP Registered, FdA
Jessica Shipman, ADPCA
Lynne Short MBACP (Accred), Counsellor/Psychotherapist
Lois Sidney, formerly MBACP Registered
Molnár L. Simon, Rogers Centre – Foundation for the Autonomous Person (Hungary)
Helen Skelton UKCP Registered
Al Skiffington-Smith MSc; UKCP Accredited Psychotherapist
Pete Smallwood MBACP (Accred)
Audrey E. Smith MBACP (Accred) Counsellor/Psychotherapist
Deb Smith MBACP Registered
Elizabeth Smith MBACP (Senior Accred)
Katherine Smith MBACP Registered
Liz Smith MBACP Registered; NCS Accredited
Leona Smith-Kerr MBACP Registered
Wendy Snell MBACP Registered
Sarah Sollis MA
Lisbeth Sommerbeck, Danish psychologist and author
Bill Stanley, Director, Merulae Limited
Amy Star MBACP Registered
Geri Stein MBACP Registered
Susan Stephen MBACP (Accred)
Anna Sternberg MBACP (Accred)
Ian Stockridge MBACP Registered
Duncan Stoddart MBACP (Senior Accred)
Helen Storey UKCP Registered; MSc
Julia Stretton MBACP (Accred)
Kate Stubbings MBACP (Senior Accred)
Joseph Suart, College of Psychoanalysts, Free Psychotherapy Network, PCU
Amanda Sugarman MBACP Registered
Árpi Süle, Editor-in-Chief, Dutch Journal of PCE Psychotherapies of the Netherlands & Belgium
Tim Sumner, student member BACP; Level 4 Counselling Course
Heather Swan MBACP Registered
Julie Taylor
Rachel Teare MBACP (Accred); Counsellor and Psychotherapist
Victoria Telfer-Smith MBACP Registered
Veda Tester MBACP Registered; BSc (hons)
Claire Thomas MBACP (Accred)
Peter Thomas MBACP Registered
Alison Thorne MBACP (Senior Accred)
Gloria Tirelli MBACP Registered
Janet Tolan BACP Fellow; NCS (Senior Accred)
Jo Tomlinson, Lecturer in counselling; MA Comm. Psych.
Siobhan Toner MBACP Registered
Agnes Banatine Toth, Person-Centred counsellor, Hungary
Ian Townshend MA; Retired Senior Lecturer, UCLan
Henri Treece NCS member
Melanie Holland Tucker MBACP Registered
Allan Turner MBACP (Senior Accred)
Bridget Tyson-Carr MBACP Registered
Elizabeth Urie MBACP (Accred)
Debbie Vallance MBACP Registered
Dr Kathleen Vandenberghe, Senior Lecturer, Liverpool John Moores University
Daniel Vanyi, Person-Centred counsellor, Hungary
Christine Vinnicombe MBACP Registered; integrative counsellor
Alan Mark Walker MS, LMFT, Texas
Jenny Watkins UKCP Registered Person-Centred psychotherapist; MSc
Catherine Watson MBACP (Accred)
Natasha Wellfare NCS Accredited
Chris Wels MBACP (Accred); Counsellor and Psychotherapist
Neil Weston MBACP Registered
Graham Westwell MSc; Senior Lecturer, Edge Hill University
Louis White NCS member
Andy Whitehouse, Dip. in Person-Centred Counselling & Psychotherapy
Jacqui Whittingham MBACP Registered
Melanie Whyatt MBACP Registered
Heather Whyte MBACP Registered
Cathrin Wildwood MBACP Registered
Heidi Wilke MBACP Registered
Dr Paul Wilkins Ph.D (Psychotherapy)
Paula J. Williams MSc, Fellow of NCS
Liz Willows MBACP Registered
David Wilson MBACP Registered
Marge Witty Ph.D, Professor Emeritus, Illinois School of Professional Psychology, Argosy Uni, Chicago
Judy Wright MBACP Registered
Julie Wright MBACP Registered
Jin Wu Psy.D; ADPCA; licensed clinical psychologist, Illinois, USA
Rae Yates NCS Accredited
Mei Liou Zarnitsyna, CCA Intern, Loyola University, Chicago
Alicja Zwiercan MA in PCE Counselling & Psychotherapy, University of Nottingham

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Partners for Counselling & Psychotherapy

We’re proud to be a part of a new partnership of groups from across the field of counselling, psychotherapy and psychoanalysis called Partners for Counselling & Psychotherapy.

Check out the video above for more about the work of this new and radical collaboration, which includes the following membership organisations, campaign groups and think tanks:

Surviving Work

A Disorder for Everyone

Free Psychotherapy Network

National Counselling Society (NCS)

Psychotherapy & Counselling Union

Psychotherapists and Counsellors for Social Responsibility

Counsellors Together UK

The Person Centred Association

UK Person-Centred Experiential

The College of Psychoanalysts

 

Maps, Languages & Lost Continents: Person-Centred Therapy and the SCoPEd Project

Andy Rogers takes at look at the telling absence of the Person-Centred Approach in the development of the SCoPEd project.

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There is so much to say about SCoPEd that it can be hard to know where to start. Fortunately, many elements of the project – the motivation, methodology, evidence-base, hierarchical structure, consultation process, conflicts of interest and so on – have been closely examined elsewhere, particularly on blogs and social media. So here I want to home in on a few core issues for person-centred practitioners.

Person-Centred Therapy (PCT) has been a major force in the UK therapy landscape since the 1980s. Leading practitioners were influential in the development of counselling services in education and contributed much to the growth of counselling training and professional organisations. The book Person-Centred Counselling in Action (Mearns & Thorne, 1988) is still a core text on many counselling courses and remains one of the UK’s best-selling counselling titles of all time.

Note that already I am referring to ‘counselling’ rather than ‘psychotherapy’. This is important for the SCoPEd project because its draft ‘competency framework’ explicitly differentiates ‘counsellors’ and ‘psychotherapists’, albeit with a third intermediate category labelled ‘advanced qualified/accredited/psychotherapeutic counsellor’. This differentiation, which the largest professional body involved, the British Association for Counselling & Psychotherapy (BACP), had argued previously there was no evidence for, has come in for much criticism; mostly – but not exclusively – from counsellors whose work has been downgraded, with newly qualified psychotherapists defined in the framework as more competent across a range of practice areas.

Inconvenient histories

Before I get side-tracked into the many overlapping issues here – not least around the organisational politics that feed this project – let’s just step back into the world of the person-centred therapist.

In PCT, there is not, and never has been, any meaningful differentiation between counselling and psychotherapy. A contemporary practitioner might be attuned to how others use these terms in a differentiating way and to the tendency for trainings with these labels to meet the differing requirements for professional organisations that cater mostly for either ‘counsellors’ or ‘psychotherapists’. They might also note wryly the way this division operates in the field of employment, with differences in pay, fees, context, status and so on. As Thorne (1999) writes, we need to ‘face the unpalatable truth that the business ethic is all-pervasive… In such a marketplace it is not politic to affirm that counselling and psychotherapy are indistinguishable’ (pp.229-230). Yet, in terms of the therapy itself, i.e. what happens between practitioner and client, there is no substantive case for differentiation within person-centred working.

In the academic literature, the tendency is to refer simply to ‘Person-Centred Therapy’ or to use the terms ‘counselling’ and ‘psychotherapy’ interchangeably. I was going to reference some texts here to illustrate the point but it makes more sense to throw out a challenge: find me a book or paper that articulates the difference between person-centred counselling and person-centred psychotherapy. If any exist, they will still be contradicted by almost all the other person-centred literature.

Much of the contemporary person-centred attitude to these terms has evolved from the position of the approach’s originator, Carl Rogers, who clearly viewed PCT as a form of psychotherapy (just browse his book titles), yet made no distinction between ‘psychotherapy’ and ‘counselling’. As far back as 1942, Rogers was using the terms interchangeably, writing that, ‘intensive and successful counseling [sic] is indistinguishable from intensive and successful psychotherapy’ (Rogers, 1942, p.4, my emphasis). Poignantly for the current debates, the general use of ‘counselling’ for the work of therapy also has its roots in Rogers’s life and work. As a clinical psychologist with no medical training, he made a tactical switch to ‘counselling’ in the mid-1950s in Chicago, when legally the practice of psychotherapy required medical qualifications.

Whatever the pragmatic motivations at the time, it is important to note that the person-centred approach was already becoming a direct challenge to the hegemony of the medical model (and would continue to be so, with increasing vigour and depth), so the switch also made sense politically and philosophically. Clearly, 1950s Chicago is a world away from the UK in 2019, but it is interesting how relevant this moment remains, how the terms continue to have a political potency: are contested, subject to claims of ownership and find themselves jostled into a status hierarchy that serves the interests of those who already have more power in the field by bolstering their portrayal of superior legitimacy, skill, depth or competence.

And there is another more recent historical nugget to unearth here too, which is that PCT’s association in the UK with ‘counselling’ rather than ‘psychotherapy’ could easily have gone the other way. In the early 1980s, as the United Kingdom Council for Psychotherapy (UKCP) developed in parallel with the BAC (then without the ‘P’ for psychotherapy), the person-centred approach had not yet established national organisational representation. So, as Mearns & Thorne (2000) write, there was,

‘no institutional process by which the approach could be involved with the developing professionalisation of psychotherapy/counselling. The result was that the work of engaging with professional organisations was left very much up to individuals, […] person-centred specialists [who] made the pragmatic choice of investing their time in BAC.’ (p.26)

Importantly, the decision not to go with UKCP was not made because PCT failed to qualify as ‘psychotherapy’. In fact, ‘it was only small matters of difference which inspired this choice’ (ibid.), mainly around personal therapy requirements and the approach’s potential positioning within UKCP’s humanistic section.

This alignment with BAC(P) would inevitably lead to an association with ‘counselling’ rather than with ‘psychotherapy’, so it is intriguing to wonder about how the field would have looked had PCT found its professional home within UKCP instead. Who knows how the approach – and indeed UKCP – would have evolved? But the SCoPEd project washes its hands of these inconvenient histories and their attendant complexity and illuminating angles.

Undoubtedly times have changed but PCT has never reneged on its philosophical, political and practical position in relation to ‘counselling’ and ‘psychotherapy’. As one of its leading thinkers in the UK has argued, the case for differentiation – inseparable as it is from professional politics – demands close scrutiny:

‘there is no essential difference between the activities currently labelled “counselling” and “psychotherapy”… [T]o suggest that there is is the result of any one or a permutation of the following: muddled thinking; a refusal to accept research evidence; a failure to listen to clients’ experiences; a lust for status; needless competitiveness; power mongering; a desire for financial gain; or some other unworthy motive prompted by professional protectionism.’ (Thorne, 1999, p.225)

Maps and missing territories

The fact that one of the most established therapeutic traditions in the UK has a lot to say on these matters – not only differentiation but manualisation and professionalisation generally – has been of such little interest to the SCoPEd project that there was no PCT representation on the teams tasked with developing the framework. Even the humanistic modalities more broadly were grossly underrepresented in the Expert Reference and Technical Groups, which were dominated by psychoanalytic practitioners. Statements from BACP following the outcry amongst members about this blatant bias have made small admissions that they got some of the language wrong and were endeavouring to recruit new people to better balance the team.

But how can this have been so overlooked at the outset? What does it say about a project which wants to ‘map’ the world of counselling and psychotherapy that it would erase a whole continent of thought and practice and then, when the inhabitants are outraged, desperately try to patch things up with reassurances that they are ‘listening’ and want to get it right?

What does it say about a project which wants to ‘map’ the world of counselling and psychotherapy that it would erase a whole continent of thought and practice?

Why has the person-centred approach been ignored in this way? Perhaps part of the answer lies somewhere in the SCoPEd organisations’ uncritical embrace of a ‘competency framework’ methodology derived from UCL’s manualisation of CBT for the IAPT project (IAPT, 2007; Roth & Pilling, 2008). While these frameworks might have some uses, it is difficult to understand the perception of the supremacy of this specific method for resolving difficulties in the field and promoting the profession, unless you actually want to bulldoze nuance and erase complexity in order to ‘clarify’ things. But BACP especially seems heavily invested in this approach, having already used it to create frameworks for a range of practice areas (including, it should be said, an IAPT-compliant, manualised version of PCT). Indeed, the organisation is so attached to the Roth & Pilling methodology that in a statement in Therapy Today, the Chief Professional Standards Officer and Chair of the SCoPEd Technical Group, Fiona Ballantine Dykes, claimed that the alternative to developing the SCoPEd framework is ‘doing nothing’ (Therapy Today, May 2019, p.51).

Given this single-minded, blinkered commitment to the competency framework process, it is hard not to conclude that person-centred perspectives – with their critical takes on both the manualisation of therapy and the associated alignment with healthcare values and medicalisation – are simply too awkward, too inconvenient, too damned political. As if a project like SCoPEd could not be political! As if, in its much-trumpeted spirit of collaboration between competing organisations, it could magically transcend all the history, politics, power struggles and diversity of thought and practice in order to objectively ‘map the competences’ of ‘counsellors’ and ‘psychotherapists’, without in the process distorting the field to shoehorn it into such a simplistic hierarchical structure.

I am not suggesting a deliberate conspiracy here, more that a number of professional interests converge around the adoption of these frameworks, whose politically expedient effect – in the apparent coherence of their efficiently organised categories and columns – is to eliminate awkward truths, not least in the profession’s sales pitch to governments and the NHS.

From this perspective, the SCoPEd project is so full of holes that, in one sense, it is hardly there at all. Part of me wonders whether, for all the fanfare and controversy, it will end up – like so many other documents – parked on our hard-drives or floating in the digital cloud, read more than once by almost no one outside of the organisational players, ignored by most of the public, of little interest to potential clients, perhaps skim-read by other stakeholders in the mental health field and then… what?

Well, it is how these things linger on the edges of awareness that says something about their potential power, about how – once installed – their unspoken values seep almost unnoticed into all sorts of areas of our lives as therapists (practice, training, supervision, organisational procedures, government policy). In person-centred terms, they begin to form a hard-to-grasp but nonetheless influential set of conditions of worth for therapeutic practice, which further externalise our professional loci of evaluation.

This is particularly problematic for PCT because, as I wrote in my own submission to the BACP consultation, the draft SCoPEd framework is alarmingly ignorant of person-centred working. Some of the exclusively ‘psychotherapist’ competences, for example, are almost the bread and butter of person-centred therapeutic relationships, which in the real world are often engaged with under the banner of ‘counselling’. Check out 3.5.c:

Ability to negotiate issues of power and authority experienced in the inner and outer world of the client or patient as part of the therapeutic process.

As I say in my response, for person-centred counsellors this would be a central principle of everything they do. Yet ‘qualified counsellors’ are deemed only to have the:

Ability to recognise and understand issues of power and how these may affect the therapeutic relationship.(3.5)

They are perceptive but passive witnesses to issues of power, which for me edges into an unethical disavowal of both the potential impact of their role and the asymmetry of the therapeutic encounter.

Read on and we find that only trained ‘psychotherapists’ have acquired the:

Ability to evidence reflexivity, self-awareness and the therapeutic use of self to work at depth in the therapeutic relationship and the therapeutic process.(5.1.c)

Which, again, is at the very heart of person-centred working (e.g. Mearns & Cooper, 2017). Yet ‘qualified counsellors’, we are led to believe, have only an:

Ability to demonstrate a commitment to personal development that includes self-awareness in relation to the client or patient to enhance therapeutic practice. (5.1)

Elsewhere, other competences make ‘psychotherapist’ the sole territory of those who lean heavily towards medical or psychoanalytic thinking, e.g. Ability to demonstrate the skills and critical awareness of unconscious process (3.10.b), which further alienates and excludes person-centred therapists.

Language barriers?

In response to the criticism attracted by the draft framework, BACP has suggested it will attempt to iron out some of these issues with language tweaks in future iterations, but such errors are extremely revealing of the way the unique theory and practice of PCT is invisible in the project, subsumed and submerged within generic statements around counselling practice while its more challenging perspectives have been redacted or just ignored into oblivion.

In any case, we should be wary of the reassurances from the SCoPEd teams that they just need to get the language right. For one thing, this smacks of PR rather than full engagement with the critiques (as in the infamous politician’s or corporate CEO’s defence, “I misspoke”). Furthermore, in this focus on language, BACP et al seem (wilfully?) to misunderstand the various challenges and objections, which are not only about words – as if swapping them with others would make it all better – but rather see language as the most obvious manifestation of deeper flaws in the project.

Something else I find troubling here is my own personal experience of having the same conversations with senior individuals at BACP about another competency framework, one drawn up for university and college counselling in 2016, which I had criticised as inappropriately redefining the sector as a branch of manualised healthcare (Rogers, 2019). In a face-to-face meeting and follow-up emails, it was acknowledged that BACP did not ‘get the language right’ and I was offered reassurances that this would be taken on board for future frameworks. Yet here we are again. I have no idea what the people I spoke with took away from our chat but somewhere in the subsequent organisational processes these reassurances evaporated into nothing and PCT once more finds itself ignored and excluded.

The person-centred approach, arguably, is not blameless in all this. Perhaps we have not been great at organising; perhaps we have felt so compelled to make concessions to the dominant narratives in ‘mental health’ and the therapy professions that we have our lost ourselves a little along the way, woozy with disorientation and gripped by a fear of judgement if we defy the trajectory of our own field. Nevertheless, the fact that a voice speaks with less assertiveness amid the noise of our culture’s deepening conversation with psychological distress is no excuse to ignore it, and it is troubling – and disturbingly ironic – when therapy organisations fall into this trap.

Perhaps my own tiny sketch of PCT’s political difficulties does it a disservice too. While I have drifted away from person-centred forums (journals, organisations, conferences etc.) over the years, social media – for all its flaws – has reminded me recently that there is a vibrant community of practitioners out there and PCT still has a unique and vital contribution to make to our field, to ‘mental health’ thinking generally and to our culture more widely. As ever, what the person-centred approach has to say is not always easy listening for those with professionalising aspirations and intentions, but surely it is our job as therapists to hear the things that others cannot bear, to listen to the most difficult truths, to welcome their complex, quietly spoken messages, to meet and fully engage with the challenges they present – why can’t our organisations do the same?

Tipping point

 As I researched the background to PCT’s early alignment with counselling and BACP (as discussed above), I stumbled across another passage in the same book (Mearns & Thorne, 2000) that, although written in my early days as a person-centred therapist twenty years ago, rings as true now as it did then:

‘It would be a tragedy… if person-centred therapists lost heart at this stage when, precisely because of some of the unfortunate moves towards a sterile professionalism… there is a greater thirst than ever among therapists and would-be clients for an engagement with what is truly human’ (p.218).

Whatever happens as SCoPEd ploughs on, we urgently need to find our voices. There are shifts in the mental health sector across disciplines and hierarchies. The medicalisation of distress, the dominance of biomedical psychiatry/pharmacology, the related mechanisation of therapy as another manualised treatment for discrete psychological ‘disorders’ and its subsequent co-option by the State in health and welfare policy are all coming under increasing pressure from a range of critical standpoints.

We may be at a tipping point. The more people experience this rigidly medicalised ideology in practice, the more they become aware of a need for something else and actively begin to seek it out. With IAPT’s legitimacy crumbling (Jackson & Rizq, 2019), the promises of psychopharmacology unfulfilled and psychiatric diagnosis itself falling further into disrepute, it is starting to look as if Person-Centred Therapy was on the right side of history all along.

Our professional organisations might want to listen more closely to what we have to say; not to assist their PR blitz around contentious projects, but to reset the course of the professions in ways that more authentically respect and promote the core values and diverse perspectives found in our field’s rich ecology of practitioners.

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Andy Rogers has been a BACP member and counselling service coordinator in further and higher education for 20 years. He also works in private practice in Basingstoke, Hampshire.

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References

IAPT (2007) The competences required to deliver effective cognitive and behavioural therapy for people with depression and with anxiety disorders. https://www.ucl.ac.uk/drupal/site_pals/sites/pals/files/migrated-files/Backround_CBT_document_-_Clinicians_version.pdf (accessed 05 July 2019).

Jackson, C & Rizq, R (2019) The Industrialisation of Care: Counselling, Psychotherapy and the Impact of IAPT. Monmouth: PCCS Books.

Mearns, D & Cooper, M (2017) Working at Relational Depth in Counselling and Psychotherapy. 2^nd edition. London: Sage.

Mearns, D & Thorne, B (1988/2013) Person-Centred Counselling in Action. London: Sage.

Mearns, D & Thorne, B (2000) Person-Centred Therapy Today. London: Sage.

Rogers, A (2019) ‘Staying Afloat: Hope & Despair in the Age of IAPT’ (pp. 142-155) in Jackson, C & Rizq, R (2019) The Industrialisation of Care: Counselling, Psychotherapy and the Impact of IAPT. Monmouth: PCCS Books.

Rogers, C (1942) Counseling and Psychotherapy: Newer Concepts in Practice. Boston: Houghton Mifflin.

Roth, AD and Pilling, S (2008). ‘Using an evidence based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders.’ Behavioural and Cognitive Psychotherapy, 36, pp. 129-147.

Thorne, B (1999) ‘Psychotherapy and counselling are indistinguishable’ (pp. 225-232) in Feltham, C. (1999) Controversies in Psychotherapy and Counselling. London: Sage.

 

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Joint letter to BACP, UKCP and BPC on the SCoPEd consultation results

In response to the SCoPEd initial consultation results, a joint letter to BACP, UKCP and BPC has been signed by the Alliance for Counselling and Psychotherapy, the National Counselling Society, Psychotherapists and Counsellors for Social Responsibility, the Psychotherapy and Counselling Union and the College of Psychoanalysts.

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Dear Chairs and Chief Executives of BACP, UKCP and BPC,

The Alliance for Counselling and Psychotherapy, the National Counselling Society, Psychotherapists and Counsellors for Social Responsibility, the Psychotherapy and Counselling Union and the College of Psychoanalysts have noted your claims hailing the results of the recent consultation.

We have analysed the available statistics, and, on behalf of our combined memberships of well over 2,000 practitioners, nearly all of whom register with yourselves, respectfully beg to differ.

The results are hardly a ringing endorsement of the SCoPEd project (dramatically so, as far as BACP is concerned).

The return rates are assuredly below acceptable minima for the adoption of such wholesale change in any profession. We calculate that there is an overall return rate of the survey of around 13 per cent (7,087 respondents out of 53,500 members) – or about one in eight.

BACP’s return rate appears to be 13 per cent (5,878 respondents out of 44,000 members. (If the smaller register were used then the return rate will have been higher.)

BPC’s return rate appears to be 15 per cent (230 respondents out of 1,500 members).

And UKCP’s return rate appears to be 12 per cent (979 respondents out of 8,000 members).

Our organisations consider that it would be foolhardy to attempt to make such fundamental changes to the structure of our professions on the basis of the level of response garnered up to now. Don’t forget, it is you yourselves who have asserted that the changes will be fundamental, not only your critics. We will continue proactively to oppose any such developments.

Nor do the more detailed statistics offer you anything like the succour that you have claimed. Drilling down, we find that:

60 per cent of respondents did not believe SCoPEd would improve things for clients.

46 per cent did not believe it would help recruitment.

39 per cent did not believe it would make things clearer for trainees.

46 per cent did not believe it would help professional organisations to promote therapy.

Given that the leaderships of the three organisations so strongly supported the direction of travel of the project, these figures should make for depressing reading for you.

And among BACP members, the positive responses were even lower. Only 36 per cent of BACP respondents to the survey believe SCoPEd will make things easier for clients trying to find the right help (Question 1a). This is just 2,131 members, which is about 5 per cent of BACP’s total membership.

For comparison and to get these returns into some kind of proportion, this is 1,000 less than those, mainly but not all BACP members, who signed the petition to scrap the project.

It also contrasts fairly dramatically with the 57 per cent of BPC and 56 per cent of UKCP respondents who believe the framework would be positive for clients – an intriguing difference that is reflected throughout all the results, as laid out here.

On the question of how useful SCoPEd will be for employers (Q1b), 50 per cent of BACP respondents answered that it will be easier to establish who to employ, whereas 78 per cent of BPC and 71 per cent of UKCP respondents agreed.

On the effect on clarity for students choosing training pathways (Q1c), 57 per cent of BACP respondents were positive, compared with 84 per cent of BPC and 78 per cent of UKCP. Similarly, 50 per cent of BACP members answering the survey believed SCoPEd would make promotion of members’ skills by professional organisations easier (Q1d), whereas 75 per cent (BPC) and 73 per cent (UKCP) felt the same.

What are we to make of this? Is it surprising that organisations representing those identifying more often as ‘psychotherapists’ (and in BPC’s case, exclusively psychoanalytic psychotherapists), rather than ‘counsellors’, would favour a framework that places psychoanalytic psychotherapy at the top of a hierarchy of practice? We also note with as little cynicism as we can manage the close ties these organisations have with training programmes that would profit from such an assertion or reassertion of superiority.

Despite the deeply problematic nature of the consultation methodology, as shown in this article, and the lack of any real endorsement of the project in the results – not to mention the widespread dissatisfaction with the framework (particularly amongst ‘counsellors’ and especially the under-represented person-centred/experiential/existential/humanistic communities), as well as the substantive critiques of the political agendas and claimed ‘evidence base’ of the project – despite all this, BACP, BPC and UKCP assert nonetheless that, ‘we have an early indication that we should progress this work’.

Surely, if anything, a dispassionate viewpoint would be that there is an ‘early indication’ that the entire project is deeply flawed, and is pursuing a path that a substantial portion of the field finds at best misguided, and at worst a complete betrayal of their practices. In what sense, then, can this work be said to be happening ‘alongside our memberships’?

To progress the SCoPEd framework anywhere near ethically, it would mean reappraising every single aspect of it: its motivations and intentions, its assumptions, its methodology, its form, the composition of its ‘expert reference group’, the ‘independent’ chair, the disputed ‘evidence base’, the nature of further consultations, and so on.

Is there any will at all to do this within BACP, BPC and UKCP? The leaderships of your organisations may ‘acknowledge’ the ‘strength of feeling’ in the debates around ScoPEd, but how can they possibly continue with the project in this form, knowing the numerous substantive critiques of the project and its current functioning?

Perhaps the 3,000 consultation comments, as yet not analysed by the ‘independent research company’, hold some of the answers. Is it possible that all of these comments and all other relevant data beyond what you have released thus could be published on one of your websites? We are serious about this and consider it to be normal good practice for a consultation. Not to do so, or to refuse to release the comments, will leave you open to allegations of cooking the books.

In the meantime, the organisations sending this letter would welcome open dialogue, above all in a public format, with BACP, BPC and UKCP about the future of the therapy field.

Collegial greetings from,

The Alliance for Counselling and Psychotherapy

Psychotherapists and Counsellors for Social Responsibility

The Psychotherapy and Counselling Union

The College of Psychoanalysts

The National Counselling Society

 

19 March 2019: post amended to add the National Counselling Society to the letter signatories.

 

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SCoPEd Consultation: Methodologically Challenged

Richard House Ph.D., former Senior Lecturer in Psychotherapy, Counselling and Psychology at the University of Roehampton, subjects the SCoPEd framework consultation exercise to critical analysis.

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Introduction and Context

In this commentary I wish to deconstruct, and subject to critical analysis, the apparent methodology used by the psy sponsor organisations in their recent SCoPEd consultation process. In precipitating a process that could end up having major implications for the practice of many thousands of psy practitioners, organisations surely have a grave responsibility to ensure that, as far as possible, any research that is carried out is methodologically robust, and transparently fair and unbiased. In the case of the SCoPEd consultation, I will show below that this is, alas, very far from being the case – which, in turn, places substantial doubt on the reliability of the initial findings as recently announced.

A Fair Consultation?

The first observation to make about the consultation process is that the most important question of all wasn’t even posed – i.e. “Do you think that it is necessary and appropriate for the psy organisations to develop an explicit written framework for competent practice in the therapy field?”.

Rather, the need for a competency framework is merely asserted and assumed by “organisational fiat”, as a background given; and only then do respondents answer the questions posed, having already tacitly and implicitly agreed to the need for such a framework by the way the consultation has positioned them, and by the very act of them completing the consultation.

It should by no means be tacitly or casually assumed that everyone who completed the consultation necessarily agrees that such a framework is necessary; yet there is no mechanism within the consultation as implemented to discover this vital information. One has to ask whether this was an oversight, or a quite deliberate “positioning” by those conducting the process.

So one has to ask, further, why were members not asked, first and foremost, to give their view on whether a generic framework is necessary and appropriate? Although of course this has to be speculative, it might conceivably be because by doing this, it would then have been far more difficult to position members into accepting the principle of a framework per se without any debate. And as mentioned above, the very “democratic” act of completing the consultation can easily be read as giving tacit legitimacy to that which, at the outset, should have been open to discussion and possible refutation, rather than merely assumed as an uncontested datum.

Thus, a fair and proportionate consultation that was genuinely aiming to find out members’ views – as opposed to one merely seeking rubber-stamping legitimation for a pre-decided view – would have sent all potential respondents both the proposed framework and a document of equal length critiquing the need for a proposed framework. This would then have left members free to make up their own minds, “un-nudged”, with an accompanying, genuinely open-ended set of consultation questions.

As it is, a methodological “coach-and-horses” can be driven through this whole process, as anyone with any expertise in research methodology will know. (I can just imagine what a group of sharp, methodology-savvy Roehampton PsychD research students would have made of this! – and it wouldn’t have been pretty…)

It’s therefore extremely disappointing to this commentator, at least, that this consultation wasn’t far better informed methodologically. Moreover, this in turn is, at the very least, consistent with the suspicions of organisations like the Alliance for Counselling and Psychotherapy that this is yet another choreographed, top-down power move by our field’s psy organisations, still intent on importing the dead hand of state regulation into our work.

An “Independent” Research Company?

We read in the rubric from the organisational sponsors of “[t]he consultation exercise, which was run by an independent research company on behalf of BACP, the British Psychoanalytic Council (BPC) and the UK Council for Psychotherapy (UKCP), … [and that] … More than 3,000 members and stakeholders submitted a comment as part of the consultation process. These are currently being analysed by the independent research company for the key themes, which will be published in the summer.” (my emphasis)

The phrase “was run by” needs to be carefully interrogated and unpacked. It is indeed potentially reassuring to be told that the research company “running” the consultation process was “independent”; but such cosy reassurance is of no substance unless respondents are told in detail what the term “running” actually means in practice. For example, to have any methodological confidence in the consultation’s reported findings, the public needs to know what written remit the “independent research company” was given by the sponsoring organisations prior to the consultation exercise. This is critical, because it needs to be totally transparent to what extent the research company is, indeed, genuinely “independent” – e.g. merely in the sense that they carried out the data-collecting exercise, or in the sense that they themselves decided on the questions to be asked in it, and how those questions were framed.

Moreover, regarding the analysis of the comments received, we also need to know what, if any, guidance was given to the “independent” company by the sponsoring organisations, in terms of how the company analyses and presents the qualitative findings. If this information is not completely transparent, respondents will have no way of knowing whether the presentation of the results is a fair and representative depiction of the actual feedback which respondents gave in their thousands.

The Questions Themselves

Regarding the actual questions posed in the consultation procedure: first, respondents were asked, “Q1a – How will the framework affect clients or patients being able to find the right kind of help to meet their needs?” (my italics).

First, note that the tell-tale word “will” is used here, rather than “would”. If this were a genuinely open-minded consultation that hadn’t already pre-decided the desired outcome, the word “will” would most certainly not have been used in this question. Rather, the hypothetical “would” should and would have been used.

This is by no means a minor, semantics-oriented issue – for the way these questions are worded will have a major impact in creating the background “mood-music” to ease the driving through of any required institutional agenda. Those composing the wording of these survey questions will have been well aware of this (and if the sponsoring organisations weren’t, for any reason, then any reputable “research company” worth its salt certainly would have been).

In my view, and strictly speaking, respondents who were expecting a fair and open consultation which was not already positioning them by the way the questions were posed should have refused to answer this question. A much fairer and objective wording for this question would have been something like the following:

“Q1a – Would a framework like the one suggested have any impact, negative or positive, on clients/patients being able to find the right kind of help to meet their needs; and if so, how?”.

The key point here is that such a question might well have yielded significantly different results from the question that was actually posed (on which, see below).

Indeed, all four consultation questions commit this elementary methodological error in using the weasel word “will”. So, in relation to question 1b, a fair, more objective wording would have been as follows:

“Q1b – Would a framework like the one suggested have any effect, negative or positive, on employers being able to establish which counsellors and psychotherapists to employ in their service; and if so, how?”

And for question 1c:

“Q1c – Would a framework like the one suggested have any effect, negative or positive, on trainees in their understanding of the pathways open to them for core training with adults; and if so, what and how?”

And finally for 1d:

“Q1d – Would a framework like the one suggested have any effect on professional bodies being able to promote the skills and services of their members; and if so, how?”

If the employed research company wished to test the reliability of the first reported consultation results, they could quite easily carry out a much smaller survey of practitioners who did not complete the first survey, using these alternatively worded questions. The results of such a survey would then provide clear evidence on the extent to which the original survey results are reliable and representative, or otherwise. Without doing such a follow-up, the reliability of the original survey results must remain in question.

Finally, regarding the raw presented statistical results, it’s clear that even when we ignore the multiple biasing effects of the way in which the whole consultation process was conducted (referred to in detail above), around 25 per cent of respondents – a considerable minority – were not happy with the proposed framework. If I were one of the psy organisations wishing to see this framework implemented, I certainly wouldn’t be feeling at all triumphant about these initial results.

In Conclusion

I have raised a number of core methodological issues in this commentary, and I ask the sponsoring organisations to reply to the concerns I have raised here in adequate detail.

If there is no full response, the silence will be deafening, and the many thousands of concerned practitioners will no doubt reach their own conclusions.

 

Dr Richard House, C.Psychol., AFBPsS, Cert.Couns.

Former Senior Lecturer in Psychotherapy, Counselling and Psychology, University of Roehampton; former PsychD research supervisor; former counsellor and psychotherapist in General Practice (1990–2007); author of Therapy Beyond Modernity (2003) and co-editor (with Del Loewenthal) of Against and For CBT (2008).

richardahouse@hotmail.com

 

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SCoPEd: Butchering Psychopractice

Denis Postle (ARCA; Independent Practitioners Network) interrogates the power relations of the SCoPEd project.

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SCoPEd seems to be yet another instance of ethical sleep on the part of its authors, BPC, UKCP and BACP, institutions that aspire to the high ground of human sensibility and civic accountability. One of the long-standing deficiencies of the psy trainings that they validate, and thus the crust of institutions that represent them, notably for 1:1 work, is the lack of explicit attention to the ubiquity of power-relations. If this were not so, how else can the current SCoPEd initiative – and its likely tame acceptance by the psy demographic it refers to – be understood?

The shenanigans of UK therapy training schools’ efforts to secure their economic status via state regulation, has a long history. Isn’t SCoPEd, a remarkable pro-active coming together of entities previously laden with toxic animosity, yet another precursor for state regulation? Or as time may tell, a defensive response to whispers from government that it is minded to take the psy world in-house?

Let’s back off from this to a reprise of what, to a long-term watcher of power relations in the psy demographic, appears to be a continuing ethical contradiction. This can be outlined as follows: the overwhelming source of complaints from clients (leaving aside mistakes) is the result of practitioner behaviour that drifts from facilitation to coercion, manipulation, exploitation or bullying, i.e. dominance behaviours. But if we look at the organisations whose work has given us the SCoPEd taxonomy, they are top-down structures in which dominance behaviour has for decades been intrinsic to their ethos and operation.

People who have trained since say, 2010, may not be aware of this but it was blatantly evident in the previous decades in conflicts over market share, modal validity/invalidity, and here it is again in SCoPEd. Yet another definition of what psychopractice is, yet another taxonomy, with no sense – as I pointed out in 2007 – that such taxonomies are forms of violence and lead to taxidermy of the organism they engage with. What were then relatively open, rich multitude of modes of therapeutic relations are now in SCoPEd reduced to three levels of competency, free of any sense of the coercive forcing of the ecologies of psy practice that this entails.

“overwhelmingly likely to distort or corrupt the wildernesses of nuance in client practitioner relations”

As too often with such intentionally seductive interventions by power-brokers, the context is hidden. Why might this be so? What benefits are intended to accrue for clients and practitioners from SCoPEd? The context that is obscured seems potentially to come in two parts: preparations as I have mentioned, to embrace/field state regulation of the psy demographic; and secondly to provide succour for training schools that not only have the UKCP, BPC, BACP etc. on their backs but also the commodification of their courses via universities selling authority/validation/status. Universities that increasingly are being run as businesses, with ‘products’ and ‘services’.

In this relegation of context to invisibility, the SCoPEd initiative is also a notable example of what I have come to understand as a ‘trance-induction’. Trance induction captures attention via cogent images, sounds, phrases and naming which make the background context go missing. Current examples include ‘take back control’, ‘project fear’, ‘Make America Great Again’. Trance inductions are ubiquitous and through their temporary exclusion of the street, the venue, or the rest of the audience, in cinema, theatre, sport and literature, they can be beneficially entrancing. However when ‘trance inductions’ such as SCoPEd become embedded in our psy culture as agents of dominance, or claims of entitlement, they seem overwhelmingly likely to distort or corrupt the wildernesses of nuance in client practitioner relations.

The claim implicit in the SCoPEd initiative is that it is ‘evidence-based’, currently a very potent trance induction that typically excludes the context of how the evidence for their taxonomy was derived, how the choices were made. SCoPEd doesn’t appear to have been generated via research with people, more likely it has emerged from research on people (or even research without people); the point being that the ownership of the research rests with the researchers, which as in SCoPEd, emerges yet again as institutions presenting entrancing power-over assertions of psychopractice entitlement.

That said, the psy ecology has many inter-related strands, embracing cooperation, challenge and support – some form of civic accountability is essential. SCoPEd demonstrates only too clearly that if its layers of competencies are intended to enhance client safety – i.e. freedom from coercion, exploitation and abuse (why else would the initiative be undertaken) – the way they celebrate top-down power relations in both form and intention means they unawarely subscribe to its opposite, an ethos of entitlement, that is likely to result in client harm. This may support the economic dynamics of training institutions and their validity networking, but it is hard to see how it would be other than harmful to clients.

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Against SCoPEd: actions and materials

The consultation for the draft SCoPEd competence framework for counselling and psychotherapy closed on Friday 22 February 2019. If you are concerned about SCoPEd or you just want to understand more about the project, here’s a summary of some of the materials and activities that have emerged in response, which hopefully will help you to join the debate.

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1) Read and comment on the Alliance’s blogs, which have been viewed and shared hundreds of times each:

Joint letter to BACP, UKCP & BPC from the Alliance, PCSR, PCU, the College of Psychoanalysts and the National Counselling Society. 17 Mar 2019.

The SCoPEd Consultation: Methodologically Challenged. Dr Richard House subjects the consultation survey to critical analysis. 12 Mar 2019

SCoPEd: Buthering Psychopractice. Denis Postle interrogates the power relations in the SCoPEd project. 23 Feb 2019.

A damaging business paradigm – latest SCoPEd response by Keith Barber. 20 Feb 2019.

SCoPEd: new consultation responses Arthur Musgrave (BACP Senior Accredited counsellor and supervisor) and Joe Suart (UKCP Registered psychoanalytic psychotherapist) share their SCoPEd consultation responses. 15 Feb 2019.

The Questionable Evidence Base of SCoPEd. David Murphy, Associate Professor at the University of Nottingham, interrogates the claim that the SCoPEd framework is ‘evidence-based’. 31 Jan 2019.

SCoPEd Denial, Distortion & Deception. Andy Rogers – BACP member and counselling service coordinator in further and higher education for two decades – responds to BACP’s consultation survey. 30 Jan 2019.

‘Psychoanalytic Coup’ – Andrew Samuels on the SCoPEd competence framework. 30 Jan 2019.

Regulation, Professionalism & Cultures of Dominance, by Denis Postle. 25 Jan 2018.

2) Read the Alliance’s newsletter, which has been sent to over 500 addresses.

3) Watch the Online Events live webinar event We’ve Been SCoPEd!, featuring David Murphy, Andrew Samuels, & Clare Slaney. This was oversubscribed and can still be seen on Facebook, where it has had almost 5000 views.

4) Follow and join the debate on Twitter with #SCoPEd

5) BACP members might like to sign the petition for BACP to scrap the SCoPEd project. 2500 members have already signed.

6) Read the National Counselling Society’s letter challenging BACP’s apparent u-turn on the counselling/psychotherapy differentiation.

7) Read PCSR’s excellent 10-point statement on SCoPEd.

Last, it is important that as many people as possible fill in the BACP, UKCP and BPC’s consultation survey by end of Friday 22nd February 2019.

The consultation is now closed but if you are a BACP, UKCP or BPC member, please do still contact your organisation to express your views on SCoPEd.

You can see the draft SCoPEd framework here and the equally controversial Methodology document here.

Thank you.

From the Alliance for Counselling & Psychotherapy

Contact info@allianceforcandp.org

 

Blog amended 25/02/2019 following closure of the consultation survey, and will be updated as and when new materials emerge.

 

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