The sixth in our series of responses to the BACP/BPC/UKCP SCoPEd project, following responses from Andrew Samuels, Andy Rogers, David Murphy, Arthur Musgrave and Joe Suart. Here, Keith Barber (UKCP registered psychotherapist) critiques the consultation process, differentiation, methodology and the framework itself.
The clear implication of the introductory remarks to these questions is that SCoPEd is a ‘done deal’ and will be rolled out regardless of the content of consultation responses. If so, this whole exercise is therefore meaningless PR. It does UKCP no credit, as a professional body, to associate itself with such a flawed process.
The questions and multiple-choice answers are worded in such a way that it is almost necessary to be deliberately perverse if respondents wish to answer in a way that does not support this framework. Again, the consultation process itself is fundamentally flawed.
I do not believe that the outcome of such a flawed process will command respect in the Profession(s) nor the assent of practitioners.
The question of differentiation between Counsellors and Psychotherapists has been a vexed one for many years. In spite of repeated attempts to discern such a differentiation, none has been identified that might command sufficient support among practitioners or the public to be accepted. I can see nothing to suggest this exercise has succeeded where its predecessors have failed.
“the vast majority of therapeutic practice takes place in this overlap, in which counsellors and psychotherapists are equally competent”
Let me be clear: I believe it is possible to differentiate between some activities that are truly counselling and some that are truly psychotherapy. However, my experience shows there is a huge overlap between them – the overlap covers ground far more extensive than the both differentiated areas put together – and the vast majority of therapeutic practice takes place in this overlap, in which counsellors and psychotherapists are equally competent to practice. I am quite certain that a considerable majority of counsellors are either trained in or acquire skills sufficient to practice in the area known as psychotherapy (and those who can’t have the skills to refer as appropriate), while it is nonsensical to suggest that psychotherapists cannot function in the area of counselling. The framework does not, it seems to me, acknowledge the practical implications of this reality.
Any attempt to differentiate the titles will force those seeking our help to choose, right at the start, what kind of work they seek, regardless of their actual need. Given the stigma that still attaches to mental and psychological distress, this is likely to lead to people in need of psychotherapy choosing, rather, to enter counselling. If the (entirely artificial, in most cases) differentiation is in any way enforced, they are unlikely to find the help they seek.
Moreover, most clients bring a huge and complex range of experiences that will require an equally large range of responses from a practitioner. In that case they will find that significant areas they seek to work on are characterised as needing an entirely different kind of help (another practitioner entirely, at additional expense – even assuming the issues around working with two therapeutic practitioners simultaneously can be negotiated). I quite fail to see how this may be considered to help or protect the public and would welcome enlightenment – if such exists!
“cursory inspection of Appendix viii of the Methodology document reveals that the Chair is both a member of the British Psychoanalytic Council and closely associated with Roth & Pilling, therefore hardly independent”
Selection of the Roth & Pilling methodology must be considered controversial, at best, in view if its focus on manualised treatments. It is impossible for an informed member of the Profession(s) to be unaware of the vigorous debates and deep unease at such ‘treatments’; the way research is used to (supposedly) support such ‘treatments’ is likewise strongly contested and there is as yet no sign of consensus in the field. It is claimed that the SCoPEd methodology is evidence-based (another area of continuing controversy), yet it is acknowledged that this has had to be adapted “…due to a paucity of empirical research into differentiated competencies.” In other words, we read that the study was set up with the deliberate intention of establishing differentiated competencies and that the evidence was selected with a view to achieving this result.
Given these manifold defects, I am minded to say that the Framework is not worth the paper it is printed on. It is incomprehensible to me that such a document could be presented for approval with a view to adoption by our profession(s), and incredible that a learned professional body should allow itself to be associated with it.
I learn from a variety of other sources that the composition of the Expert Reference Group is heavily weighted towards psychoanalytic modalities; cursory inspection of Appendix viii of the Methodology document reveals that the Chair is both a member of the British Psychoanalytic Council and closely associated with Roth & Pilling, therefore hardly independent. Again, we see defects that negate the credibility of the Framework.
Given the prevalence of psychoanalytic thinking on the ERG, it is most striking that the Framework does not see fit to prescribe competences for psychoanalysts. I wonder if they are considered, in some way, to be above such reductive and limiting descriptions? But why should that be so? Or is the answer, perhaps, to be found in my previous paragraph?
“hierarchical structures, universal application of economically-driven models of outcome evaluation and a strict regulatory model”
More generally, it seems to me that the endless initiatives to systematise the field with standards identified as ‘competences’ indicates an attempt to fit the therapeutic field into what we may describe as the ‘business’ paradigm. Here I follow Kuhn (1962/1970), who showed that the paradigm we are committed to dictates and limits even the questions we can ask, let alone the ways they can be answered. The business paradigm privileges hierarchical structures, universal application of economically-driven models of outcome evaluation and a strict regulatory model that facilitates command and control of virtually every aspect of a field of work. It may (the jury is still out) provide economic benefits, but there is no evidence whatsoever that it is good for the psychological health fo the human beings that inhabit it.
This would not be so bad if the competency-based approach was effective. But my experience in a previous career is that it is, in general, of little utility but comes at the cost of a huge bureaucratic overhead that quickly damages the organisation’s ability to perform its most basic tasks. Again, the approach of this Framework is unlikely to gain the assent of most practitioners in our field and, given the increasingly-recognised association between psychological distress and (business-inspired) austerity and insecure work, gives every indication of being rather part of the problem than of the solution.
This Framework is not a response to any currently known need. It is misconceived, insufficiently evidenced and reaches an inappropriate predetermined conclusion. It will do nothing to help or protect the public but – like the proposals for statutory regulation in 2009 – will do enormous damage to the work of counsellors and psychotherapists, if it does not entirely destroy therapy as we know it. The SCoPEd process should be terminated and the resources our profession commands be redirected to meeting the needs of people in distress in the UK.
Kuhn, T. S, 1962/1970: The Structure of Scientific Revolutions; University of Chicago Press