Tag Archives: regulation

BACP backtrack on audit consultation

Counsellors and psychotherapists following the controversy around BACP’s audit consultation survey might be aware that the organisation has issued an apology: ‘We are really sorry. We’ve messed up!’ they say. But what precisely are they sorry about?

‘Our intention with the survey is not simply to introduce all or any of the ideas it contains, but rather to gather opinion and inspire debate. We recognise that we haven’t been at all clear on this point and that this has caused some members considerable concern. We’re very sorry that we didn’t make things clear from the outset.’

Let’s break that down a little. The intention of the survey (and its proposals for mystery shoppers, practice inspections and a fundamental shift in the nature of the supervisory relationship) was only ‘to gather opinion and inspire debate’?

If that was the intention, then an email survey to members with a mostly multiple-choice tick-box format and limited space for longer responses seems a less than ideal way to gather opinion. As for inspiring debate, the space for that was limited, not least because hardly anyone seemed able or willing to make a reasoned case for the proposals, not even BACP themselves, who made no meaningful attempt to articulate a substantive argument, beyond the fact that such measures are used by ‘other [non-therapy] professional bodies and regulators’. And let’s not forget that BACP initially responded to those writing to the BACP journal, Therapy Today, to say they would not publish the letters, which would be forwarded instead to the consultation team (a decision they have now reversed). If the intention was to inspire open debate within the organisation, this seems a strange way to go about it.

Now BACP have apologised – but, if we look at the text of the apology, what they are sorry for is a lack of clarity about their intentions: ‘we haven’t been at all clear on this point and… this has caused some members considerable concern.’

In this version of the furore around the consultation, it is as if members’ concerns were generated by a miscommunication about, and misunderstanding of, the purpose of the survey, which BACP says was ‘not simply to introduce all or any of the ideas it contains’. So BACP simply misspoke, as an on-the-ropes politician might put it, and members then misunderstood their benign intentions. They are sorry for upsetting people, in other words, but not for being wrong.

This spin on events demonstrates a convenient misunderstanding of the disquiet the survey created. BACP members who got in touch with the Alliance certainly thought that the survey was an inappropriate tool for the kind of questions being asked, but mostly they were disturbed by the fact – unchanged by the apology – that BACP would seriously consider such measures as appropriate for the therapy field.

The frantic backpedalling, then, distracts from the deeper concerns raised by the survey, which the apology does little – if anything – to address. Why would BACP ask for members’ views on specific changes to the audit process unless they consider those changes, or something like them, to be a) possible or workable, and b) of some potential value? Someone somewhere at BACP must think such methods could be a runner, or why bother asking members about them? And even if these specific proposals get (temporarily?) binned, we are still left with BACP’s apparent desire for more surveillance and control in an effort to pull therapy into line with ‘other professions’, regardless of the gaping absence of evidence that such a move would either enhance therapeutic work or ‘protect the public’.

Whatever is happening at BACP HQ, the executive agenda seems to be drifting further and further from both the realities of actual practice and the values of its members. The feeling in communications we’ve had around this issue is that the survey was something of a last straw for many practitioners; that they have already tolerated much from BACP that is incongruent with therapeutic principles and that this is just a step too far. There are already huge demands placed on practitioners attempting to sustain the unique qualities of the therapeutic space in the face of toxic cultural trends but it becomes intolerable when these efforts are betrayed by their own professional bodies.

Might the PR disaster of the survey nudge BACP’s leaders into supporting its members by articulating what’s different – and therefore so valuable – about therapy, rather than attempting to homogenise, control and rebrand the field?

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Why is BACP stifling discussion and debate?

Recent days have seen something of a furore in response to BACP’s 2017 Audit Consultation, which is being run to a very tight deadline – it closes at 5pm on Monday 30th January. Find the survey here: https://www.surveymonkey.co.uk/r/BACPAudit

We know from anecdotal evidence that BACP members are checking out whether they can join another professional body.  Others have resigned or are threatening to do so. Reactions are fiercer than over proposals for either the regulation of counselling and psychotherapy by the Health Professions Council in 2009/10, or BACP’s review of its Ethical Framework in 2014.

These BACP members clearly appreciate the seriousness of the situation. Yet the deadline for responses is very much shorter than in 2014’s Ethical Framework consultation – in this case, just three weeks. This timescale strongly suggests that BACP are trying to pre-empt proper discussion.

Members are telling us they have written to BACP’s journal, Therapy Today, but have been informed that – instead of publishing the letters – BACP wants all correspondence about the survey to be forwarded to the register department, which is where responses to the consultation are being collated. In any event, due to the publication schedule, no letters on the issue could have been appeared in Therapy Today before the consultation closed – but BACP are still preventing members’ concerns reaching the pages of the next issue.

Why? Is BACP determined to present its own conclusions before wider concerns about context or implications have been properly aired? What’s going on?

The questions in the survey don’t invite comment about these wider implications – the final question is a narrow one that simply asks for suggestions on how ‘the audit process’ could be improved. No space is provided where any questions about the underlying rationale can be put, or where any reservations about the process as a whole can be expressed. It’s as though each and every suggestion is regarded as a potential incremental ‘improvement’ on the status quo. The fact that a major change of direction for BACP is being proposed is not acknowledged. That there is no opportunity to make any observations about this raises the possibility that the organisation is trying to slip major change through without proper input from its membership.

At the very least BACP needs to undertake a thorough analysis that weighs up the potential benefits of any proposed changes and set these against any possible unintended negative consequences. This should be done with transparency and with full membership participation – not after BACP managers have already presented their views and their interpretation of the survey results.

“the impression is that BACP regards its members as inherently untrustworthy”

As the Alliance has pointed out, what BACP is proposing is a regulatory framework based on distrust. During the 2014 review of the Ethical Framework, it was emphasised time and again that clients have to be able to trust BACP registrants. Indeed, BACP placed trustworthiness at the very heart of the new Ethical Framework:

‘Therefore, as members or registrants of BACP, we take being trustworthy as a serious ethical commitment’, it says in the opening pages.

Yet the impression from this consultation survey is that BACP regards its members as inherently untrustworthy, so much so they are badly in need of extra monitoring and surveillance. When the Ethical Framework was first introduced in 2001 as a replacement for the previous Code of Ethics, it was argued that the time had come to treat counsellors and psychotherapists as mature professionals. The impression in 2017 is that BACP members are not grown-ups at all but a bunch of potentially naughty schoolchildren who constantly need someone looking over their shoulder.

It beggars belief that such fundamental change is being presented via what is essentially a tick-box survey with further boxes in which comments can be added but which are hard to revise – both because so little text is visible in the space available and because scanning back to revisit earlier comments is so tedious. It’s as though obstacles have been deliberately placed in the way of anyone wishing to make more than perfunctory observations. We were told this survey ‘should take no longer than 20 to 25 minutes’, but a thoughtful response requires much more time than that.

In short, have we already witnessed a managerial coup at BACP HQ that is eager to suppress proper discussion and debate about these matters?

 

PCSR & Alliance September Conference Announcement

THE  BIG  ISSUE(S) – Addressing the Crisis in Psychotherapy and Counselling


An invitation from Psychotherapists and Counsellors for Social Responsibility and the Alliance for Counselling and Psychotherapy to a day conference at Resource for London, Holloway Road, London N7.

Saturday 26th September 2015 – 10am to 5pm. Donation: £10 in advance, £20 on the door.

This event is intended as an opportunity for practitioners to express their concerns about the current direction of counselling and psychotherapy, and to discuss plans for action. If you care about the future of counselling and psychotherapy, please come!

More details and booking form here

Statement on Regulation

REGULATION OF COUNSELLING AND PSYCHOTHERAPY

STATEMENT FROM THE ALLIANCE FOR COUNSELLING AND PSYCHOTHERAPY, MAY 2014

Some years ago, the Alliance played a prominent role in the campaign against the statutory regulation of counselling and psychotherapy (SR). In reviewing the success of this campaign, it seems clear that it was not due solely to a change of Government in 2010. Petitions signed by several thousand practitioners against the plan to regulate the professions via the Health Professions Council (HPC, now HCPC) were remarkable, given the reticence usually shown by therapists in the political realm. Permission to proceed with a Judicial Review of HPC’s conduct was also highly significant. In general, the Alliance considers that, in the words of a Coalition health minister, ‘[we] won the argument’.

We are aware that SR is once again being discussed in some political and professional circles. We have studied Geraint Davies MP’s early day motion and Patrick Strudwick’s articles, and noted some pressure and mobilisation from the same groups of counsellors and psychotherapists who were previously supportive of SR under the HPC.

To us, it is, at the very least, foolhardy to consider rejecting the current Accredited Voluntary Register (AVR) scheme run by the Professional Standards Authority (PSA) which is not even a year old. AVR is a progressive institutional innovation that addresses the vast majority of the defects that existed with the old, traditional voluntary registers. It should be given the opportunity to prove itself by allowing it to continue for at least five years.

The Alliance continues to welcome this scheme which, on balance, we see as substantially superior to the proposals for SR under the HPC. In our view, the PSA scheme has already improved matters. For example, although the old voluntary registering organisations were already operating under ethical codes that made the offer of reparative therapy a matter of serious professional misconduct, it was the PSA’s committed anti-discriminatory policy that underlay the decision by the Association of Christian Counsellors (ACC) to follow suit. Until their accreditation by PSA required a rethink, this organisation was one of the main sources of providers of reparative therapy.

The PSA also deserves much credit for the United Kingdom for Psychotherapy’s (UKCP) adoption of a mandatory Central Code of Conduct, a long overdue reform.


“It is simply not the case that counsellors and psychotherapists are untrained and unaccountable”


The Alliance would like to see the PSA doing more to promote counselling and psychotherapy, including drawing the attention of the public to the existence of its accredited registers. It is simply not the case that, as some supporters of the early day motion state, counsellors and psychotherapists are untrained and unaccountable. Our understanding is that the PSA promised such a promotion during early discussions with the former voluntary registering bodies, so is therefore now obliged to conduct an appropriate campaign.

We hope that the PSA might now engage more with its accredited bodies with regard to how serious sanctions, such as striking off, can be better and more widely communicated to the public.

The PSA has, so far, remained silent on the matter of SR. We realise that it may be politically difficult for the PSA to speak in defence and justification of its own existence but now seems a good time to start such a process. Many of the proposals to reintroduce the failed project of SR seem strikingly ignorant of the nature and even the fact of the AVR scheme. In the face of this, we would like to see the PSA issue a statement on the progress of the AVR scheme so far.


“a damaging and misleading idealisation of statutory regulation is taking place”


The Alliance believes that a damaging and misleading idealisation of statutory regulation is taking place. Unless there is a change in primary legislation, we will continue to see people struck off by statutory registers rebranding themselves and continuing to practice as before. It is highly misleading to claim that evasion of sanction is only a problem for accredited voluntary regulators as has been claimed.

We are perplexed at the linkage of the quite legitimate concern over reparative therapy with SR. We speculate that those who want to see statutory regulation are using current repulsion at general homophobia to further their own political agenda. In reality, most reparative therapy was and is offered by people with a religious orientation whose practice is not going to be affected by any kind of regulation of counselling and psychotherapy.

The Alliance also believes that, whilst prejudice can never be eliminated entirely, the situation in our professions has changed substantially since one small-scale research project of 2009 discovered the extent of reparative therapy being offered.

A key factor in the successful campaign against SR was the development of a convincing argument that statutory regulation of counselling and psychotherapy as ‘health professions’ was and is inappropriate for this field. The medical model of clear-cut diagnosis and treatment does not apply. In particular, an adversarial and generic system of complaints, founded on tendentious principles, and with no systematic inclusion of alternative dispute resolution (ADR – conciliation and mediation) will never be fit for purpose.

We should not forget that, when the HPC’s process was halted, there was no agreement over such central issues as the difference (or not) between psychotherapy and counselling, or whether (or not) work with children required different trainings.

The Alliance for Counselling and Psychotherapy will, of course, fight against any new plans for statutory regulation. But the previous experience was so divisive that we sincerely hope that those who are looking to reintroduce the project will read this statement, reconsider their position and engage with us and the majority in our field in making the still-evolving AVR system work as effectively as possible – in the interests of clients and patients, the professions, and society as a whole.

The above statement has been sent to a number of key figures in the debate, including politicians, journalists, regulatory bodies and therapy organisations.

Soundings #1

An Odd Couple: Gay Rights and State Regulation

A bill – supported (on Twitter) by the British Psychoanalytic Council – proposing the regulation of counselling and psychotherapy by the Health Professions Council [1] is awaiting its second reading [2] in Parliament on 6 June 2014. However, no sitting is expected, nor is the bill (sponsored by Labour Co-op [3] MP Geraint Davies, Swansea West) expected to become law.

It is, however, expected to become a campaign issue, and indeed, it is already showing signs of gathering support. Those in the psy-therapy field who favour state regulation are hitching their wagons to it, the motor of which, you may be surprised to hear, is gay rights.

The bill proposes that Section 60 of the Health Act 1999 (Regulation of health care and associated professions) be amended to include a paragraph requiring that a code of ethics for registered counsellors, therapists and psychotherapists must include a prohibition on gay-to-straight conversion therapy. You can read the bill here – it is one page long.

Let’s look at some of the threads that hold this ‘object’ in place.

1. Davies claims that 16 per cent of therapists practise gay conversion therapy, and cites Bartlett, Smith & King (2009) [4] to support his claim. The quote from the article actually says: “Although only 55 (4%) of [1,406 surveyed] therapists reported that they would attempt to change a client’s sexual orientation [if asked] … 222 (17%) reported having assisted at least one client/patient to reduce or change his or her homosexual or lesbian feelings.”

The major organisations, including UKCP, have responded to this by banning reparative therapy, and making it “an ethical offence” to offer it “even if asked”. In practice this seems to relate only to work done by the Association of Christian Counsellors (who are not registered under the UKCP), which leaves the wider questions which are raised here apparently undiscussed.

2. The Society of Radiographers recently considered these issues with Davies and have gone on to adopt his ideas as policy. At their Annual Delegates Conference, 7-8 April 2014, they formulated their wish to campaign with the TUC to push for counselling and psychotherapy to be given to the HCPC in order to prevent practitioners from trying to convert gays to straights. Conference notes that gay conversion therapy has recently been evidenced as an active practice within the UK psy-scene, with one in six psychiatrists, therapists and psycho-analysts admitting to having attempted to change at least one patient’s sexuality. This practice has no medical indication and is deeply rooted in the idea that homosexuality is a mental illness.” They go on:

“Psychotherapy in the UK is an unregulated practice, with practitioners free to practise out with professional bodies and their ethical statements.  With the majority of referrals coming from general practitioners, the Government is debating a Bill to regulate psychotherapy under the Health & Care Professions Council (HCPC).  However, Norman Lamb, Minister of State for Care and Support, has said that the Government has no plans to ban conversion therapy and believes that regulation of therapists is not appropriate due to the cost to registrants and taxpayers.” And finally, the Radiographers conclude: “As a regulated profession we call on the UK Council of the Society of Radiographers to: Support the Government Bill and make it clear they believe any health and social care profession should be under statutory regulation. Work with relevant gay charities, such as Stonewall and Gay Men’s Health, to ensure that vulnerable people are protected from this unregulated practice.”

This Motion was supported by the UK Council of Radiographers and passed by Conference earlier this year. In speaking for his motion, Ross McGhee quoted Freud’s letter to an American mother in 1935, which says: “Homosexuality … is nothing to be ashamed of, no vice, no degradation. It cannot be classified as an illness; …. Many highly respectable individuals of ancient and modern times have been homosexuals, several of the greatest men among them (Plato, Michelangelo, Leonardo da Vinci, etc.). It is a great injustice to persecute homosexuality as a crime, and cruelty, too.” [5] McGhee wants to know why such enlightened opinion seems not to be figuring in the current debate.

3. Another supporter of the bill is journalist Patrick Strudwick who came to prominence in February 2010 with his article in The Independent newspaper reporting his undercover assignment to ask a Christian BACP counsellor (subsequently struck off as a result of this article) to help him to “pray away the gay”. On 24 February this year, Strudwick penned another article, this time for the Guardian supporting Davies’ bill, and concluding that: “If the government votes against this bill on Friday [6], as they have suggested they will, they will be failing every Briton – not only the one in four of us who will suffer mental ill health but everyone affected by it. They will leave you, your child, your partner, or anyone reaching out, vulnerable, scared, to quell their distress, at the mercy of the untrained, the unqualified and the unethical. This is not simply a scandal; it is an emergency.” UKCP Chief Executive David Pink wrote to the Guardian, rebutting Strudwick’s article and suggesting that the public were more at risk of harm from such simple assumptions and misleading reporting.

4. Leo Abse, famously flamboyant lawyer and former Labour MP for Pontypool (and then Torfaen) from 1958 until 1987, pioneered a private member’s bill to decriminalise homosexuality. Abse’s bill was eventually passed on 28 July 1967. This important private member’s bill is apparently being prepared for spinning by the Labour Party [7] as one of its great contributions to this country, rather than the result of the personal struggle of one of its backbenchers. You can listen to a BBC interview with Leo Abse, broadcast on 20 December 1966, here.

5. The Law Commission published its report (following the consultation on the regulation of health and social care) on 2 April this year. The 465-page document can be consulted here, and you can find its analysis of issues around ‘voluntary registers’ from paragraph 5.24 on page 60, and its “Recommendation 28: The [existing] regulators’ powers to keep voluntary registers should be removed”. This means that regulators like HCPC could not also hold a voluntary register.

6. The attempt by the then HPC to capture counselling and psychotherapy was squashed by the Judicial Review hearing at the Royal Courts of Justice, 10 December 2010. Dinah Rose QC maintained that the HPC had unlawfully failed to address critical questions about whether counselling and psychotherapy should be regulated by statute, and whether the HPC is the appropriate body to administer such regulation, given the fact that many practitioners explicitly eschew a ‘medical-model’ orientation.

Despite the HPC’s attempt to have the application ‘timed out’, Mr Justice Burton also ruled that the Judicial Review had been brought without delay and was ‘clearly arguable’. Furthermore, he criticised the misleading nature of HPC statements. For example, practitioner groups had been led to believe that the HPC would fulfil its legal responsibility to report to the Department of Health on whether it had the requisite capability to regulate the field. This never happened, and the HPC proceeded as if the requirement to report on the matter did not exist, despite acknowledging it in an early-minuted meeting. Specifically, the judge questioned the HPC’s reassuring communication to the DH in December 2009 that it had completed its exercise and was ready to accommodate the talking therapies. He invited the HPC to “reword or revise” that letter. This never happened, and the HPC’s embarrassment was allowed to fade away when the new government changed the name to HCPC, gave it the social workers to register, and told it to drop its hope of capturing counselling and psychotherapy.

The questions now are whether enlightened opinion is still against state (HCPC) regulation, whether the new voluntary regulatory mechanisms under the Professional Standards Authority (put in place by the major bodies during the last few years – BACP, UCKP etc.) are widely understood and in good use, or whether the turmoil of the 21st century has left practitioners and public without the necessary bearings to think through these difficult issues.

For anyone who would prefer not to be defeated by rhetoric, babble, confusion and the wild commands of the super-ego, please do join the debate.

@Alliance4CP

info@allianceforcandp.org

http://www.allianceforcandp.org/

Soundings, a research report for the contemporary context of psy-praxis, is written by Janet Haney, who would like to thank colleagues for their part in supplying ideas, references, information and edits. All websites were sourced: 9-11 May 2014.

[1] The Bill cites the Health Professions Council, even though this institution has recently been renamed the Health & Care Professions Council in order to take the social workers on to its register.

[2] The ‘second reading’ is the moment for the first proper debate; the ‘first reading’ is a formality to read the title of the proposed bill into the records.

[3] The British Co-operative movement stretches back to 1844 when the Rochdale pioneers invented consumer co-operatives as a response to ‘the invisible hand’ of capitalism which was funnelling profits to a few, and leaving many to struggle.

[4] Bartlett, A., G. Smith & M. King, “The response of mental health professionals to clients seeking help to change or redirect same-sex sexual orientation”, BMC Psychiatry 2009, 9:11 

[5] Freud, Sigmund, “Letter to an American mother”, American Journal of Psychiatry, 107, 1951: p. 787.

[6] In fact this ‘first reading’ in Parliament is a formality to read the title of the Bill into the records.

[7] On-line survey taken by the author this month.