My latest realisation will probably be old news to anyone who is involved with social media: It has come to my attention that Twitter is something of an echo chamber. That is to say, I have found that my views about issues pertaining to counselling and psychotherapy have been almost completely affirmed by the therapists I have engaged with on Twitter, and somewhat naively, this has lulled me into the false assumption that most therapists in the UK are in accord, particularly when it comes to the issue of statutory regulation of the profession.
My views on regulation of counselling and psychotherapy in the UK have been touched upon in this blog before. I believe that the current situation does not do enough to protect vulnerable clients, and affords too many freedoms to anyone who fancies calling themselves a psychotherapist. I think there is an assumption of accountability which simply does not exist when a therapist in private practice chooses not to be a member of a professional body. For the dissatisfied or abused client, there is nobody to complain to, and nobody to turn to. To me, this is completely unacceptable, and by allowing the status quo, I feel we as a profession are failing in our collective duty of non-maleficence to clients.
So anyway, back to my naive assumption that most therapists think along these lines. Recently, on a closed internet forum, I have been engaging with therapists who are overwhelmingly against statutory regulation. In fact, I believe I have been the sole voice in favour on some of the forum discussions. So much for pottering around my comfortable corner of the twittersphere!
So why the divide? Why is there seemingly this silent split in the profession? And how do we constructively bring these these sides of the debate together for meaningful dialogue?
I do want to say that I think many of the anti-regulation arguments are actually valid concerns that need to be addressed. How, for example, do we ensure that regulation does not lead to homogenisation of the profession? I think it’s very important that any move towards regulation is respectful of the diversity and evolutionary development of psychotherapeutic practice in this country, and does not seek to standardise or snip at the edges of the relational tapestry.
Recently, several professional bodies have come together to work on a framework of competencies for counselling and psychotherapy. I find this encouraging and concerning in equal measure. On the one hand, it seems like common sense that the public should have clarity about what therapy entails, and crucially (to my mind) what the minimum requirements for qualification are. On the other hand, its development has hardly been inclusive; not all professional bodies have been invited to take part (read here for the NCS’s open letter in response to the framework) and membership consultation has been invisible as far as I am aware. I think, if we want to move towards regulation, we need to think carefully about whom we want to do the regulating, and how we ensure that we properly represent the needs of the practitioners who will be impacted by it, as well as their clients.
I have heard a (kind of) compromise suggested, whereby the titles of counsellor, psychotherapist, psychoanalyst etc, become legally protected titles, and anybody wishing to practice under these titles must join a register, justifying their use of the title and stating which professional body they will maintain membership of, adhering to their chosen body’s ethical framework and being accountable to them in the event of complaints. To me this sounds like a promising compromise, avoiding the need for non-expert interference from state regulators, reducing the risk of homogenisation, and also safeguarding clients. While a lot of work would be necessary to realise such an ambitious project, I think it has mileage, and should not be discounted. It has to be preferable to division and mudslinging, which, sadly, I am beginning to feel exists, in pockets, on both sides of the current debate.
From the perspective of a client, I know how a no-regulation system can disenfranchise and disempower. I say this with caution, as I am aware that my own experiences could be used to attempt to invalidate my perspective. I would argue that there is no objective voice in this debate because everybody with investment in the regulatory process brings their own perspectives. So I will say this. My first therapist claimed to be a member of the BACP; this was a lie. Several unethical actions later, I would have liked to have had the opportunity to make a complaint. Of course, this was not possible; there was nobody to complain to. If this individual chooses to practice again, they are free to do so. I have found this set of circumstances extremely difficult to accept, and I sought further therapy, in part to come to terms with this injustice.
I have heard it argued that there are such a small number of these types of cases (I’m not sure how we would know) that mitigating this risk is not worth the risk to the wider profession. I feel that, if there is an identified risk to clients that we can mitigate, then we need to mitigate that risk. If any clients at all face this avoidable situation, we are failing them.
I am still confident that we can find some common ground. That we can work together to achieve something positive. I don’t want a split in the profession, and I don’t think anybody really wants a split in the profession. It will take hard work and respectful dialogue from all sides, but I see no reason why we can’t develop a way forward which both protects clients, and protects psychotherapy, in all of its diverse and creative forms.