The Medicalisation of Therapy – What can we infer from the language of SCoPEd?

The recent conferences and events highlighting the impact of IAPT, and discussions around the medicalisation and industrialisation of therapy on social media, have left me wishing to directly address the significance of the medicalised language of SCoPEd.

The psychoanalytic skew of SCoPEd’s expert reference group has been well documented, and this apparent bias is reflected in the tone and language of the framework itself. Strikingly, the language appears to become increasingly medicalised the further up the competency continuum you go, suggesting that an approach to therapy which aligns itself with a medical model is associated with higher levels of competency.

Some key examples can be found in section 2: Assessment (see below)

scoped assessment

The reality is that many non-‘advanced’ and ‘advanced’ counsellors are working at column C on this, and many other therapists, from all columns, reject diagnostic models altogether. The debates around pathologising distress are well-known, and the SCoPEd group seem to have completely disregarded how limiting, exclusive and irrelevant this framework is to large sections of the profession, and clients too.

Of course, the SCoPEd framework is an outrageous misrepresentation of counselling and psychotherapy theory and practice. So what have the BACP said they will do about this, in response to an unprecedented tidal wave of criticism? Well, technical group chair Fiona Ballantine Dykes has stated that they plan to recruit new members to the ERG to help with the language.

There are some pretty significant problems with this plan. Firstly, the research has been done. Presumably the findings are based on the research, ergo the language is a reflection of what they have found in the research. So how can they change the language without changing the research?

Secondly, this is about more than language. This isn’t just a few misplaced words. The entire thrust of the research is about differentiating counselling from psychotherapy, and enshrining diagnostic-leaning trainings in the process. Take a look at the placement requirements for the top tier:

scoped placement

We are talking about a requirement for psychiatric placement experience, and at the very least, mental health familiarisation, even for the middle tier (as an entry point). So therapists, including many of a person-centred orientation, who reject the concept of therapy as a branch of mental healthcare, will never achieve the top tier. As a reminder, these titles are not owned by anyone; what right do these organisations have to define what we do?

I am deeply concerned that the same three organisations behind SCoPEd are instrumental in the development of the new All-Party Parliamentary Group. When a group with such rigid and inaccurate ideas about therapy, who have continued to steamroller a project without member-support, get their foot in the door of parliament, I think serious questions need to be raised about what they are doing, and why.

Important: Tara Shennan and I have submitted a BACP AGM resolution for the discontinuation of BACP’s association with the SCoPEd project. If you are a member of the BACP please vote for the resolution when the voting opens on 19th August, and again at the second stage in October. BACP resolutions are really difficult to get passed, and we need a lot of support now and going forward. Follow me @aclientfirst Counsellors Together UK @UK_Counsellors and the Alliance for Counselling and Psychotherapy @Alliance4CP to keep up-to-date with the campaign.

8 thoughts on “The Medicalisation of Therapy – What can we infer from the language of SCoPEd?”

  1. I am in complete agreement with this analysis and the conclusions made. The NHS approach to mental health care is a failed model, operated without acceptance of the views of patients, or even of the need in the community for services. A complete redesign is necessary.
    I wil add that I am also concerned at the extremely loose approach of the BACP (and others) to clinical supervision standards. There is no mention of this in SCoPEd yet it is one of the foundation stones of good practice and CPD.

    Liked by 1 person

  2. As a Canadian who happened to watch a documentary on the massacre at Tienanmen Square last night, this level of dictatorship should be heeded as a warning of the push back pharma et al are willing to exert over what ideas professionals are allowed to sell.

    It should also stand as a wake up call to the public about the increasingly real danger to them and their children of attending upon anyone willing to pathologize their experiences and feelings into ‘diseases” to perpetuate what we already know and can prove is junk science.

    We are witnessing the same political control and social silencing here with University professors having their tenure threatened if they dare to speak outside party lines, and in the legal profession as lawyers are being required to sign an agreement to a set of ideologies that they may in fact, not agree with.

    This force and coercion is being argued against as an attack on freedom of speech and thought. But far more insidious than that, it is a threat to choice, a slippery slide into a one thought world where anyone who does not agree, can and will be punished and silenced. Its a do as we say, or no job for you proposition. This is a dictatorship.

    The failure to have litigate the junk science supporting the DSM into a court of law where it needs to be exposed and argued has allowed state controlled medical tyranny to spread into every facet of our existence. Time to start calling the public interest, constitutional and human rights lawyers. Speak now or forever enjoy the new political regime you really live under, and its not remotely a democracy.


  3. Thank you for this insightful explanation as so far for me it’s been as clear as mud, I feel the Board at the BACP have been deliberately vague, in an attempt to get this Scoped through in a stealth like fashion.
    I was completely perplexed when the naming and shaming of therapist was introduced and now I’m just lost for words because of the insulting nature of this set of ideas to so many of us.

    Liked by 1 person

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