Category Archives: Arthur Musgrave

SCoPEd: new consultation responses

Two therapists – one a BACP Senior Accredited counsellor and supervisor, the other a UKCP Registered psychoanalytic psychotherapist – share their SCoPEd consultation responses with the Alliance.

 

Arthur Musgrave, BACP Senior Accredited Counsellor and Supervisor.


The consultation questions

This consultation exercise seeks answers to four questions –

  1. How will the framework affect clients or patients in being able finding the right kind of help to meet their needs?
  2. How will the framework affect employers in being able to establish which counsellors or psychotherapists to employ in their service?
  3. How will the framework affect trainees in their understanding of the pathways open to them for core training with adults? (sic)
  4. How will the framework affect professional bodies being able to promote the skills and services of their members?

Summary

This draft framework promises to provide clarity but fails to deliver. Take, for example, the employment of counsellors and psychotherapists – there is already a well-established and much more satisfactory way of establishing whom to employ and that is through the use of a well thought out person specification and a good selection process. It is hard to see that whatever is finally ratified will add much to this.

Nor does the draft framework offer clarity to other stakeholders who would much prefer that other, more fundamental issues were resolved The key components of training and practice that lead to a good outcome remain as obscure as ever. To what extent, for instance, is there any correlation with the length of training a counsellor or psychotherapist has undergone? Or with hours of personal therapy? Or with hours of supervised practice? Do trainee psychotherapists in practice receive more supervision than trainee counsellors? And, if they do, does that mean their clients/patients are necessarily more satisfied?

Without satisfactory answers to questions of this nature campaigns promoting the skills and services of counsellors and psychotherapists will have limited value. And neither potential clients/patients nor anyone wanting to decide what qualification to pursue will be much the wiser.

“further layers of complexity and obfuscation”

But a document of this kind does more than fail to provide clarity – it actually adds further layers of complexity and obfuscation. The answer to each of the consultation questions must therefore be that the draft framework will make clarity harder to achieve.

Much is being claimed for this exercise, but at root it is an attempt at tidying up discrepancies in documentation held by each of the three sponsoring bodies in order for these bodies to agree between themselves what they regard as the distinguishing characteristics of a ‘qualified counsellor’, an ‘advanced qualified counsellor’ and a ‘psychotherapist’.

Stripped bare of any significant benefit for others, what becomes starkly apparent is that the three sponsoring bodies are set up to be the main beneficiaries. As a result of reaching a shared consensus about common standards for practice and education, they will be better placed to press for control over the entire field of counselling and psychotherapy.

There a serious danger here that once competencies are laid down in this fashion, a common curriculum will be prescribed and good practice will then be judged primarily in terms of adherence to what is taught on training courses. This would undoubtedly have a devastatingly inhibiting effect on creativity and the development of good practice.

Specific concerns: (1) Language

The language is opaque. The competency statements are peppered with words such as ‘suitable’, ‘appropriate’ and ‘relevant’. This language requires a further gloss from those within the profession and defeats the stated purpose of offering clarity to outsiders such as members of the public and potential trainees.

Even when qualifiers of this kind aren’t used the competency statements necessarily lack precision so that, for instance, it is unclear to what extent practitioners of all kinds have “the ability to reflect on their own cultural background and history and have the capacity to work in an authentically non discriminatory manner” (Theme 4.8). It is equally unclear what constitutes sufficient “knowledge and ability” to be able to work within professional and ethical frameworks (Theme 1.1).Two decades and more ago I was involved in helping to draft standards for National Vocational Qualifications and, time and again, found that the language in competency statements was imprecise. At each iteration of the drafting process we were reassured that this would not be a problem since the assessor would be selected by the candidate and would be someone from within the field. In the case of the SCoPEd Framework such an interpreter will clearly not always be to hand.

At other places in the draft framework rather nebulous concepts are deployed in order to distinguish the work of an ‘advanced counsellor’ from that of a ‘psychotherapist’ – for example a ‘psychotherapist’ is able to “negotiate issues of power” whereas an ‘advanced counsellor’ is only able to “address issues of power”. What is the distinction here – that psychotherapists are expected to be in dialogue whereas advanced counsellors are limited to making a speech?

There is great scope for misunderstanding when imprecise language is deployed and this can have serious consequences. In following a case before a Health and Care Professions Council disciplinary panel I had the experience of seeing how problematic matters can become when definitions established in one context are interpreted by others whose professional expertise lies elsewhere. In the case in point a narrow definition of confidentiality based on the notion of consent for medical treatment was utilised to rule that conventional understandings about confidentiality in a group supervision setting were unethical as, somewhat inevitably, personal information about group members was disclosed to other trainees in the group.

Specific concerns: (2) Skills must be tested in context

A serious and even more fundamental problem lies in the fact that skills cannot be adequately tested in isolation from one another as they are in the draft framework. Let me give an example as to why not. I was once approached for help by a student on a counselling diploma course counsellor who had failed her viva apparently because she hadn’t demonstrated basic counselling skills. She brought a tape with them of the session she’d presented at the viva.

When I listened to it in was clear that, at one point when she said something like, “So what you’re saying is A and B”, the client replied, “No I’m not! What I’m saying X and Y!!!”Although the student got things very ‘wrong’ her client was able, as a result and for the first time, to state his viewpoint forcefully and congruently. The trainee then gave her whole attention not to the ‘mistake’ but to what her client had to say. This exchange proved to be the turning point in their work together – which, of course, was why the student had selected it for the viva.

Overtly, then, there was direct evidence of this trainee’s inability to meet Theme 3.8 (i.e. the examiners had detected a failure to sustain the therapeutic relationship) to the point where the existing relationship had been disrupted. However there was other, more subtle evidence, that the student had been able to deal with this rupture in a wholly positive fashion, thereby not simply responding successfully to a difficulty in the relationship (Theme 3.10) but also demonstrating both an ability to work therapeutically with ruptures and difficulties (Theme 3.10 b) and an ability to work proactively to minimise further damage.

Paradoxically, then, this trainee counsellor, in failing her viva, demonstrated that she was able to do something over and above what this draft framework claims only a trained and qualified psychotherapist is capable of doing.

Specific concerns: (3) A flawed threefold separation of roles

The distinction in the draft framework between ‘qualified counsellor’ and ‘advanced qualified counsellor’ doesn’t really work. It is better understood if it is viewed not as a difference in training but as a difference in experience, e.g. in the use of supervision (Themes 1.6 and 1.6a); team working (Themes 1.10, 1.10a and 1.10b); working online (Themes 2.10 and 2.10a); critical reflection on the client/patient’s process within the therapeutic relationship (Themes 3.8 and 3.8a); ability to find ways of making progress in the face of difficulties (Themes 3.12 and 3.12a); and so on.

The ‘advanced qualified counsellor’ reads more as someone who has assimilated what they gained from their training in the light of some years of practice. The threefold division between ‘qualified counsellor’, ‘advanced qualified counsellor’ and ‘psychotherapist’ is therefore fundamentally flawed as like is not being compared with like.

“There is a fundamental problem that training and experience cannot easily be separated when talking about competence”

There is a further fundamental problem in that training and experience cannot easily be separated when talking about competence. Someone whose initial training was as a counsellor can, for instance, obtain further training and experience that gives them the ability to “understand medical diagnosis of mental disorders and the impact of psychotropic medication during assessment and throughout therapy” (Theme 2.4b). Previous attempts to define competency have sometimes floundered on an artificial attempt to determine that labels are acquired only at the point of qualification, a view that can be hard for commissioners of services, employers and members of the public to appreciate when what they are primarily concerned with is practical applications, not demarcation disputes.

Even more problematic is the point that what distinguishes ‘psychotherapist’ from others is largely to do with matters that aren’t essential to what therapy is and that are perhaps better viewed as distinct areas of expertise.

A surprising number of extraneous activities are captured within the rather eccentric definition of psychotherapy used in this framework including being able “to take an active role within the professional community locally and nationally” (Theme 1.10c); being able to “resolve contradictions between ethical requirements and work requirements” (Theme 1.6b) as if psychotherapists are automatically capable of resolving these matters whereas others are necessarily either incapable of dealing with issues of role clarity or only manage to navigate their way pragmatically through intractable situations and irreconcilable expectations; being able “to assess and formulate when working with chronic and enduring mental health conditions”(Theme 2.1b); being able to being able “to critically appraise the history of psychological ideas”(Theme 4.2b) as opposed to simply being able “to critically appraise a range of theories underpinning the practice of counselling and psychotherapy” (Theme 4.2a); being able to utilise audit and evaluation tools/methodologies “to contribute to improving the process and outcomes of therapy” (Theme 4.9b) as opposed merely monitoring and maintaining standards within practice settings (Theme 4.9a); and being able to undertake substantial research projects (Theme 4.10).

A number of somewhat grandiose claims are made for both ‘advanced counsellors’ and ‘psychotherapists’. Apparently they are able to critically challenge their own values and beliefs, whereas mere qualified counsellors aren’t able to do this (Theme 5.3a). They are also able it seems, and again in contradistinction to qualified counsellors, to critically appraise published research on counselling and psychotherapy and integrate relevant research findings into practice (Theme 4.10a).

But to what extent do ‘advanced counsellors’ and ‘psychotherapists’ do either of these in practice? And to what extent do they differ in these respects from qualified counsellors? It is often forgotten that access to published research is limited for those in private practice who do not hold an academic post.

Some of these grandiose capabilities are in the purlieu of psychotherapists alone. They can apparently even “resolve contradictions between different codes of practice and conduct” (Theme 1.6b). They apparently also have a unique ability “to integrate relevant theory and research in the areas of diversity and equality into clinical practice” (Theme 4.8c).

Finally, over and above this substantial list of supposed distinguishing characteristics, one of the most immediately striking aspects of the draft framework is how many gaps it contains. In only a third of the listed competency themes has the draft framework so far been able to distinguish a ‘psychotherapist’ from a ‘qualified counsellor’.

*

 

Joe Suart, UKCP registered psychoanalytic psychotherapist, working and living in Cornwall.


There is a problem with the Roth/Pilling methodology [used to draft the SCoPEd framework], as pointed out in 2008 when Skills for Health were trying to develop National Occupational Standards for the profession. These problems have not been addressed and so have not gone away. The Council for Psychoanalysis and Jungian Ananlysis (CPJA) sent to Skills for Health its response in April 2009, in which it stated:

“Following continuous discussion and debate throughout this process, within the CPJA and with our colleagues in other professional organisations representing psychoanalytic and psychodynamic psychotherapy in the UK, the CPJA has concluded that it cannot support either the process or the outcomes of the Skills for Health consultation. The CPJA will be recommending to the UKCP as a whole that it withdraw its participation and support from the project in favour of its own more appropriately-derived statements of occupational standards for psychoanalytic/psychodynamic and other modalities of psychotherapy”

While the current attempt to standardise Professional/National Occupation Standards is not the same process, its reliance on the Roth/Pilling methodology (which was produced initially specifically for Cognitive Behavioural Therapy practice and then applied to other modalities) repeats the problem that was endemic to the previous attempt.

The SCoPEd Consultation claims to be evidence based, and yet there is no evidence that it’s methodological basis of matching perceived competencies of the therapist to improved life experience of the patient actually works. The collection of descriptions of activities of the therapist, presented under the term competencies are themselves not based in evidence gathering but in the opinion of practitioners and trainers concerning what it is they think should be the case.

The model of gathering empirical data is not well suited to the confidential conversation of two people in camera. At best it can only be done by reportage, usually only done by the therapist. This is an argument that is well known and leads to a well-worn criticism of the process of the ‘talking cure’, however the attempt to get round this problem by defining competencies in the manner done fails. Rather, in attempting to do so, it presents an image of a reality that has been distorted by the wishes and intentions of the presenters. As workers in the field of Freud’s legacy, this is not something that should be ignored or brushed over.

“there are many different and conflicting psychotherapeutic views, some of which would support the competencies and their implications, and some of which would be vehemently opposed to them”

Even within the framework itself, in its own terms, there are problems. The use of the three terms, ‘Counsellor’ ‘Advanced Counsellor’ and ‘Psychotherapist’ is confusing at the outset. It would have been better to use non-specific terms to denote different levels of sophistication and complexity, such as level 1, level 2, level 3. For the use of these terms that imply a reflection on current qualifications and associated capacities appears to mirror and reinforce a hierarchy of professional status that many would say is already in place.

There is then the additional problem that this implied hierarchy of professional status and capacity is one that is intended to become enshrined in nationally recognised standards which training bodies will be obliged to adhere to, and which, when the next attempt to statutorily regulate the profession occurs, will become enshrined in law. When that happens it will become an offence to practice unless you fit yourself into these frameworks.

The success of this attempt to standardise the activities and responsibilities of counsellors/psychotherapists whilst being carried out in the noble desire to protect patients, will have the effect of both reducing patient care and therapists’ ability to respond to the specific and individual needs of the patient. Many of the competencies as set out in the document are written as if they are neutral and non-controversial in their import. This is not the case as there are many different and conflicting psychotherapeutic views, some of which would support the competencies and their implications, and some of which would be vehemently opposed to them.

For example, there are assumptions which would be vigorously challenged when the competencies use terms like ‘conscious’ and ‘unconscious’, ‘inner world’ and ‘outer world’, ‘transference’ and ‘countertransference’. The nature of the complexities and even existence of some of these apparently neutral terms, let alone how the mechanisms, phenomena and experiences that these terms are meant to refer to have been the subject of debate and even controversy for decades. The validity of this history of debate and disagreement is given no recognition by the consultation.

The consequence of this standardisation attempt being successful will be to reduce the options of talking therapy work available to the public, and risk making it an offence for them to be provided with options that are not in agreement with it. This point has been made with full description and elaboration in the Maresfield Report.

*


 

 

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BACP’s Ethical Framework Revisions – The Emergence of State-Endorsed Therapy?

I want to talk about what is happening within the British Association for Counselling and Psychotherapy (BACP). I want to put it to you that what is going on there represents a shift towards “state endorsed therapy”.

I use the phrase “state endorsed” to draw attention to the fact that these proposals are designed not by government, or by one of its arm’s length agencies, but by one of our own professional associations. I want to make a separation between this and “state approved therapy”, a term that has been applied to the delivery of therapy under the banner of IAPT (Improving Access to Psychological Therapies). There the format and structure are, to all intents and purposes, laid down by the state itself.

BACP is in transition. In February 2013 its register of counsellors and psychotherapists was endorsed by the Professional Standards Authority for Health and Social Care. In December 2013 the BACP Board of Governors decided to align its membership structure to the BACP Register. By April 2016 all members will either be registered or en route to becoming so. In April 2014 BACP began a consultation with its members on professional ethics. This consultation closed on 28th November and its revised Ethical Framework will come into force in January 2016.

Until this summer BACP had not undertaken a thorough review of its ethics since the late 1990s. In April, May and July this year it ran three 2½ hour webinar seminars on Saturday mornings.

To give you an idea of what this involved, on each of these Saturday mornings there were two half hour presentations by Professor Tim Bond, Emeritus Professor of Professional Ethics (University of Bristol). There were questions from the live audience and there were panel discussions before and after each presentation. The presentations themselves were accompanied by a split screen PowerPoint display so you could read as well as listen to what was going on.

The impetus for changing the Ethical Framework comes from a variety of sources. There have been those developments in theory, in research and in the law that one might expect – and there has also been a quantum leap in computerisation. The most important changes though are connected to the abuse of trust. There have been a whole string of celebrities who have been exposed – Jimmy Savile, Rolf Harris and the rest; there’s been the Winterbourne View care home scandal where residents were physically abused by staff; and there’s the Mid Staffordshire hospitals scandal where perhaps 300 or more people died unnecessarily.

Most importantly there have been the two Francis Reports. One published in 2010 was some 2,000 pages long and dealt with what went wrong in Mid Staffordshire. The other, published in 2013, is half that length and is about how to prevent it happening again.

Robert Francis QC wanted a change of culture in the NHS, but his proposals have been taken up not just by Government but by local authorities, trades unions and professional associations. His reports are changing the whole landscape of health and social care.

In brief Francis is demanding that, when things go wrong, managers must be much more active in setting about remedying matters. They can no longer receive a complaint, set up an enquiry and then sit back and wait for it to report. The impact of the Francis Reports was most apparent in the second of these webinar seminars which proposed major changes to line management and supervision – and these changes need to be understood in the context of two notions which had been previously floated in the webinar presentations: (a) that therapy can be conceptualised as a product, and (b) that supervision can be thought of as part of a quality assurance system.

Not surprisingly, I was more than a little taken aback when I heard these comments.

To the specific proposals and their implications –

  • All clients to be informed by their therapist of the name of their supervisor.
  • The jobs of both therapist and supervisor to be defined as operating in the “best interests” of the client.
  • Supervisors to be required to keep records to show that they have acted in this way.
  • These records to demonstrate that each client of each of supervisee has been spoken about at each supervision session and that the supervisor has, in each case, acted in the client’s best interests.

The focus in this webinar seminar was squarely on the position of those in employment in the health and social care sector. The argument was that, as austerity bites and managers, like everyone else, are expected to do more with less and to new “post-Francis” standards, the position of employed supervisors will be in danger of being marginalised unless supervision can be demonstrated to have a direct impact on client outcomes.

But for me, as a self-employed supervisor working from home, the nightmare scenario was that, if my name is given to all my supervisees’ clients, because of the ease with which contact details can be identified via the internet, I will have to be prepared for the possibility of dissatisfied “customers” contacting me at any time of the day or night demanding that I intervene on their behalf to remedy whatever they happen to be concerned about. The pressure to “do something” will be inescapable and I am almost certainly going to get caught up in enacting something that properly belongs within the therapy itself.

But the situation is worse than this. If BACP is to lay down that there is to be a this direct link between supervision and client outcome and I’m required to keep records on all the supervision I do, I need to be mindful that anything I write may be trawled over by a lawyer in order to detect whether a case can be made Musgraveout that, at some point, I have failed to act in the “best interests” of his or her client.

What’s the likely outcome? Three things, I think –

In the first place there’s the danger of supervisors slipping into defensive practice. Secondly, the knock on consequence is that a surface level understanding of reflective practice will be further entrenched – instead of a reflective attitude lying at the heart of good supervision it becomes a kind of “add on”. Another way of putting this is to say that something will be taken away from the quality of attention I believe a supervisor needs to cultivate, who then acts a role model for each supervisee. Let me give some examples. For Freud the ideal state of mind for a therapist is one in which attention is “evenly hovering” or “evenly suspended”. Drawing on a very different body of theory, Carl Rogers identified six necessary and sufficient conditions for therapeutic change. In both cases there’s a focus that requires full attention – and, if this focus is absent or diluted, something is lost in the quality and depth of the work.


under the rubric of revising its ethics, BACP is apparently willing to accommodate its definition of good practice in counselling and psychotherapy to a shift in government policy


Taken altogether, then, what we have here is an impoverishment of supervision and therefore a constraint on supervisees’ learning about good practice. This is bound to lead, I would argue, to a narrower understanding of what in depth therapy is.

Moreover, in these webinar seminars BACP drew explicitly on an understanding of therapy that highlights its role in the alleviation of distress without any acknowledgement that any such understanding needs to be embedded within a contextual understanding concerned with meaning‑making. This is contrary to the research evidence, as Bruce Wampold showed in the meta-analysis he undertook for his book ‘The Great Psychotherapy Debate’, where he carefully examines the results of thousands of outcome studies.

What puzzled me deeply about these proposals for change is that they appeared to run counter to BACP’s traditional stance, which is to position itself as a broad church and so maximise its chances of dominating the field. So, I suppose, it’s not surprising that, when BACP circulated a revised draft early last month it had made changes.

The emphasis on supervisors keeping records of each supervision session was limited to a general obligation to keep records appropriate to the service being provided. And the duty to tell each client the name of your supervisor has been dropped completely.

But what, you may say, are we to make of all this? Should we be pleased that BACP is responsive to feedback? Or should we be alarmed at the extent to which, under the rubric of revising its ethics, BACP is apparently willing to accommodate its definition of good practice in counselling and psychotherapy to a shift in government policy?

At a BACP meeting I attended in September it was claimed that the original proposals were simply possibilities that were being floated rather than serious options. Shades here of Nigel Farage’s recent backtracking from a firm commitment to privatise the NHS (“We never really meant it anyway”, “It was just an idea we were floating”). But I think what we can say is that, in the course of these webinar seminars, we got some insight into what BACP would be willing to countenance.

So what is there in the latest draft of BACP’s Ethical Framework that still gives rise to concern? And to what extent is it still legitimate to be worried about a movement towards “state endorsed therapy”?

I think there is a good deal to be concerned about, but first we need to look more closely at the wider context and the kind of organisation that BACP is in the process of becoming. BACP’s mission includes wanting to be the leading body for counselling and psychotherapy in the UK. BACP was originally founded in 1977 as an educational charity open to anyone with an interest in counselling. Charitable status confers a patina of respectability and, under English law, all BACP’s activities must be charitable and wholly in the public interest so that any personal benefit accruing to members has to be “incidental”.

Yet at the same time BACP operates a trade association – in other words, it is a group, one of whose primary purposes is to attempt to influence public policy in a direction favourable to its members.

BACP’s membership has expanded rapidly in recent years. When I joined in 1992 it had 6,000 odd members. It now claims it has over 41,000. I think it’s pretty self-evident that people join BACP because they think it is an important step in advancing their careers. Is that, then, an “incidental” benefit? So how can BACP continue to be a charity? I have to hold my hands up here and admit I am completely bemused by what looks to me, a mere cottage industrialist, to be a mismatch between the theory and practice of how charity law works. But what do I know? Eton school, after all, remains a charity.

BACP’s Register is endorsed by the Professional Standards Authority for Health and Social Care. By endorsing Registers such as BACP’s the PSA has said it hopes to establish a gold standard for voluntary regulation in the area of health and social care – and thus obviate the need for statutory regulation. BACP has decided to align its membership structure to the BACP Register. By April 2016 its membership will consist of registered therapists or those on their way to becoming so.

This series of steps links membership of BACP back to the state and, I suggest, leaves individual BACP members more anxious than ever that they will need to comply with any requirements laid down by the organisation if their careers are to thrive.

One thing I think we can say is that, whereas in the past statements about ethics issued by BACP could be viewed as the distillation of a consensus about good practice that was derived from the field, matters are now more complex. In the October 2014 draft of its Ethical Framework, BACP is in some respects more prescriptive. Sometimes the requirement is straightforwardly normative – for instance, formally reviewing knowledge and skills in supervision – but elsewhere standardisation is embedded in the very fabric of the document. The argument seems to be that introducing standardised practices is a good thing because it makes matters more explicit and a greater degree of explicitness is the route to establishing greater trust between therapist and client. This is evident in the overarching structure of the commitment to clients, which frames everything that follows –

  • We recognise that our clients must be able to trust their practitioners with their well-being and sensitive personal information. Therefore we have agreed…that we will…

The detail then follows – for instance in paragraph 26 in the section on ‘Good Practice’ there are the new requirements about written contracts between therapist and client. In this way the building of trust is reduced to a standardised procedure.

The relationship between line managers and clinical supervisors is also specified in terms of procedures that have to be adhered to and reviews that have to be undertaken at least once a year in particular ways – again a standardised procedure. Here are some examples:

  • Where supervision is taking place alongside line management we will consider how responsibility for the different supervision tasks is distributed and will review how the allocation of these tasks is allocated at least once annually.
  • We will review the application of this Ethical Framework to the services being provided at least once annually.
  • We will clarify who holds specific responsibilities to our clients between the practitioner, supervisor and any line managers and review how well these responsibilities are working in practice. This review will take place in supervision as required and at least once annually.

Members are even required to be activists outside the therapy room:

  • We recommend supervision to anyone providing therapeutically‑based services, regularly giving or receiving emotionally challenging communications or engaging in relationally complex or challenging roles.
  • We will challenge colleagues or others involved in delivering related services whose views appear to be discriminatory

In other words – it’s not all bad!


BACP is abdicating its responsibility to assert what it believes is distinct about good practice in counselling and psychotherapy


Elsewhere in this document BACP is deliberately using vaguer language. Some of this is both badly phrased and, I want to say, provocative – for example, “we have agreed…that we will demonstrate accountability and candour by being accountable to you for the …effectiveness of services provided”

What on earth does this mean? Statements of this kind could prove a hostage to fortune, for instance when working with people who adopt a wholly passive attitude to therapy and expect their therapist to fix their problems for them without ever themselves really engaging in the therapeutic endeavour. I don’t think it would be hard for such an individual to use this paragraph in order to make a complaint.

BACP has been here before. In the mid 1990s the BBC’s Watchdog programme took what was then just the BAC (the British Association for Counselling) to task for not taking effective action against the comedian Bernard Manning who had joined BAC and then fixed a brass plaque to his wall announcing that he was a counsellor. BAC claimed this attack was unfair as they had no power to stop him and make him take it down – all they could do was expel him from membership. After that BAC redoubled its effort to gain statutory powers.

In offering to be accountable in this way is BACP setting things up for another media furore that will allow them to press Government for more powers? I wonder.

But there’s another even more significant matter, which is that BACP has deliberately put at the core of the 2014 Ethical Framework the notion that therapists will work in clients’ “best interests”.

Who defines “best interests” and from whose point of view? This is a notoriously slippery concept in law and here, I would argue, BACP is quite deliberately leaving it to the courts to decide what good practice is, I would say in line with what good practice is in the health and social care sector – as opposed to asserting what is special and different about therapy.

A statement asserting what is different about the professions of counselling and psychotherapy is something the courts could have reference to if they needed to consider whether therapists, and especially those in private practice, have different obligations in law from those in the state sector – they certainly do under the Children Act and for good reasons.

Here BACP is emphasising the similarity between therapy and health and social care rather than highlighting the difference –

  • Commitment  We recognise that our clients must be able to trust their practitioner with their well-being and sensitive information. Therefore, we have agreed as members or registrants of BACP that we will…. Put our clients first by making you our first and most important concern during our work together
  • Putting clients first  4. We will make each client’s well-being and best interests our priority whilst working together.
  • Working to professional standards  12. We will collaborate with colleagues to serve the best interests of clients.

In short, is BACP in this draft of its Ethical Framework, abdicating its responsibility to assert what it believes is distinct about good practice in counselling and psychotherapy in favour of inviting the courts to determine how counselling and psychotherapy sit within the overall thrust of state health and social care policy?

Looking into what’s going on in this kind of detail reveals the underlying thrust of the present revision of BACP’s Ethical Framework. If you want further evidence, look no further than the new title – ‘BACP Ethical Framework for the Counselling Professions’.

So there we have it – an organisation, whose mission includes being the lead body for counselling and psychotherapy, is subsuming both coaching and psychotherapy under such a heading – and is thereby marginalising both psychotherapy and in depth counselling whilst, at the same time, privileging a narrow definition of counselling that is actively not supported by the research evidence. Not only that, BACP is preparing to redefine coaching, psychotherapy and counselling as subsets of health and social care. And, whilst claiming that this is a review of ethics, BACP is overtly (as was quite clear in the webinar seminars) redrafting those ethics in order to seek to protect members’ jobs – and, I would argue, promote itself and curry favour with Government.


By Arthur Musgrave. This blog was originally a conference presentation for the Universities Psychotherapy & Counselling Association (UPCA), November 2014. For Arthur’s detailed account of the BACP consultation process, see: https://arthurmusgrave.wordpress.com/2014/11/12/the-british-association-for-counsellings-2014-consultation-on-ethics/