20 April 2015

If I had the power to regulate counselling…?




A couple of weeks ago I was asked a question by a peer which he posed as follows:

I’d like to ask you about what you see as the best way to regulate counselling, there’s two reasons for this question.  The first is that your experience as both a complainant and a practising counsellor gives you a valuable first-hand view of the issues and I’d like to find out more about what you’ve learnt from that.

The second reason for starting this conversation like this is that I’d like to see what happens if I apply the style of open questioning and reflecting that I’ve learnt in my counselling training to a conceptual rather than emotion issue (in this case exploring the concepts around regulation of counselling).  Debates in academic philosophy tend to be adversarial in nature, which works well is all the parties concerned are adept philosophers but it ends up excluding everyone else.  I’m curious to see what academic philosophy could learn from counselling practice.

The question is: if you had the power to pass a law to regulate counselling and psychotherapy what would it say?


I was very pleased to have this opportunity to reflect upon where I was in terms of my thoughts on regulation and decided to throw together a compilation of my thoughts as they stand right now (for now….the thinking ever evolves…). These were by and large as follows:

Thank you for your message and for giving me the opportunity to consolidate my thoughts on regulation.

This is such a complex issue for me and I would like to share some of that complexity. My thoughts in answering your questions are:

Emotions

First of all, this is an emotional issue for me, since being a complainant was an emotional ordeal. It affected my career, my family life and relationships. I lost the respect of peers at Palace Gate who decided to believe the opposition's narrative (I believe because it was easier for them to believe that, as they had dependency on Palace Gate for income, prestige, familiarity aka "easy life" etc etc). However, it is the emotional impact on me that has driven me to explore the possibilities of regulation and really get stuck into the debate.

I do not believe that it is ever possible to remove emotions from arguments. I am very interested in the research into the purpose of emotions by Antonio Damasio, particularly the role of emotions in decision making. 

My "natural" response

This is how I refer to my thoughts pre-Palace Gate. It seemed very obvious that there is a need for regulation because there are baddies out there. Abuse and exploitation exists and I believe that this profession is no exception. In fact. I think that all caring professions attract members of the Karpman Drama Triangle; Rescuers. Rescuers can also be Persecutors and Victims. None of these are helpful to clients and keep them stuck in their unhelpful dynamics, or worse. It just seemed a no-brainer that there should be a level of protection. Drama Triangle types have no business in therapy. This is part of the shadow. This lack of self-awareness coupled with the imbalance of power can be highly damaging. People can pay hundreds of pounds plus to feel worse. I wish we could measure ego fragility as part of the fitness to practice.

Being aware of my own agenda - looking at what the public want

As part of the continual scrutiny of my motives in how I behave/what I believe in I asked the public about their opinion of regulation in the profession. I was genuinely open to people not giving a monkeys or being opposed to it. Maybe it was the way I posed the question but there was an overwhelming agreement that regulation should be in place. Moreover, most people thought that we were already regulated and many expressed shock that we aren't. This was very helpful to me and gave me extra impetus. These are the service users and their needs and opinions are incredibly important to me. More so, in fact, than self-serving professionals who clearly do have an agenda (myself included).

The opposition

I know the arguments against regulation. Quite frankly I think that some of those arguments are silly. I struggle with Brian Thorne's and Andrew Samuels' stances. Thorne says that regulation would be like getting a Sergeant Major to choreograph a ballet. I find that argument silly. The sort of gubbins that politicians come out with. I haven't heard any real reasons why we shouldn't proceed with some kind of regulation. I hear name calling. People calling the BACP "empire builders". Judgmental, assumptive terms (not that I am immune from throwing some out myself, clearly). That we would have to practice under a code of fear. I believe that fear is behind the opposition to regulation. Which leads me onto…

"Freedom is what you do with what's been done to you"

Boundaries are freeing. We can work creatively within a code of ethics. I find this empowering. I like to know where the edge of the cliff is lest I fall off it. I want to see the view but if the knowledge and thought of somebody before me has led to there being a clear path that I can safely follow then I can skip along that path instead of fearfully crawling along. Also, I'm less likely to recklessly run around with gay abandon, so I'm probably not going to slip off the cliff and break my neck. Now, if people want to take that risk then fine, but it is not on to tell somebody you'll lead them safely past the cliff edge, then decide to take them cartwheeling past, and to do so with no safety mechanisms in place. It's other people's lives we are dealing with.

I'm not even sure how useful that analogy is. I will ponder on it further. I suppose that one could argue that an individual may be okay with being dragged to the cliff edge by a therapist. I would argue the next point though. 

Therapists as gurus, miracle workers and high-priests/esses 

I have had a number of clients tell me that I have saved their life."You have made me a new person". "Without you I'd be dead". Strong words indeed and such a privilege to hear. But I feel a certain level of discomfort around that and I do reiterate to my clients that they do the work, I simply facilitate and provide a safe, professional, boundaried environment. I do believe that these clients could have had the same result with other therapists although am aware that the chemistry between therapist and client is an important factor (and largely outside of my control!). My point is that I think that the "power" we provide is actually quite simple. "Good enough" therapy can be life changing. I'd like to think that my intelligent insights and references to different theories and research findings in neuroscience are life changing too ;-) but really, at the bottom of it all, I think that the real power is in being boundaried, consistent, self-aware and acting with true beneficence.

Regulation - no perfect solution

So we boil down to the question; what would I do if I had the power to regulate? The short answer is, I'm not 100% sure. I have a few questionmarks around the PSA and I struggle with the fact that the NCS has a register with the conflict of interest in having their Chair as the person who founded Chrysalis, who set up the NCS to oversee them. I am rankled that there are therapists who have done a course with no supervised placements who can call themselves "accredited therapists" (via the NCS system) versus the training I had which according to the AR's puts me in exactly the same category as people with a lot less experience. I have anecdotally noticed a sense of entitlement with a few Chrysalis students from comments online, possibly contributed to by the aggressive marketing (eg stating that the diploma qualification leads to earning at least £45 an hour; a claim which formed the basis of an upheld complaint with the ASA). The origins of the NCS being set up by the management of Chrysalis to regulate their own training and students is something I have heard others struggle with too. I think they'd do well to sever the connections and this will be in the interest of their members. I also feel bad for students of Chrysalis who thought that they could become BACP members once qualified but apparently the BACP rules changed part way through the training for some (I don't know this for a fact). I guess this leads to the "Empire Building" accusations but I totally get why the BACP insist that supervised placements are an integral part of  training. 

I get frustrated by the somewhat infantile name calling against the BACP by therapists who have chosen not to be members of the BACP and those perhaps whose credentials don't match up to the BACP requirements so are unable to join the BACP Accredited Register. I see discussions on LinkedIn between professionals colluding with each other, very much in child ego state with deeply unconstructive criticism; very childish, unfounded rants about the BACP. I'm sure the BACP are not for everyone and, like us all, have their flaws but can't we be reasonable? What are we, as professionals, modelling? 

I am ranting, and unashamedly so and hopefully with reason and consideration to facts. I am also aware that I absolutely have my own agenda in this and actually, in the scheme of things, it's quite petty. Given that the opposition to the HCPC route was so vehement, the best way forward is probably via the PSA AR's. And although I struggle with the fact that the NCS can be on par with BACP and UKCP when I believe I see a clear difference (riddled with my own agenda), the point is that they do have a complaints procedure and they are accountable to the PSA. Given that the Chair of the PSA told me he was on good terms with the PSA CEO Harry Cayton I do have some skepticism, but I consider it a healthy dose. The CEO of the NCS I found to be very professional and I really enjoyed the conversation I had with her last year. I was told that their code of conduct was co-written with the director of the Clinic for Boundaries Studies and I really respect that. 

Idealism vs realism

I flit between the two. I am Myers-Briggs INFJ type. Integrity, authenticity and by default self-awareness are concepts I strive to prioritise in all my decision making. In an ideal world we wouldn't need regulation. But we do. Realistically, the PSA ARs are the best way forward, in my opinion, based upon what I understand presently.

In Summary

This is work in progress. As I learn more I will adapt. I have taken a back seat on the campaign for regulation of late but intend to pick it up again post election. I have a lot of work ahead of me. As far as I know, everybody else in these shoes has given up. That might happen to me but it hasn't happened yet. If regulation came into force and I ended up losing my work because I am not deemed fit to practice then I would retrain. If I was found to be incompetent as a practitioner then I would change jobs. Regulation trumps my career. So I have no fear.

So I'm being honest and throwing it out there. There are lots of conversations being had in the therapy world between professionals about regulation and this is just one of them. What I would like to add is that through being public with my own experience I have become increasingly aware of extreme abuses of power in therapy, as I have been approached by a number of victims. These stories are often not heard by the people commenting on regulation. In fact, due to the hurdles intrinsic in the complaints processes, the industry's collusion with abuse (by failing to truly acknowledge the existence of it) and the fact that the nature of abuse usually invokes deepest shame in the victim, these people's stories will never see the light of day.

More posts on regulation:


Guest Blogger Patrick Killeen - Accredited Registers vs Protected Titles (July 2015)

Regulation - a client and therapist friendly way forward? (November 2014)


The problems with a voluntary regulatory scheme (Sept 2014)


Spreading the word on AVRs - the Professional Standards Authority responds (Sept 2014)

The Regulation of Counselling and Psychotherapy - What the Public Want (June 2013)

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