Many people find it helpful to talk to a psychotherapist. However, NHS provision of talking therapies can be patchy, and has been hit by the cuts. For that reason some people have found themselves paying out of their own pocket to see a therapist. But how do you know that you’ll find a good one? A bad, or worse abusive therapist can destroy peoples’ lives. How can people make a safe choice?
Quick pop quiz for you all. What is the minimum qualification required to call yourself a psychotherapist?
a) a doctorate
b) a master’s degree
c) a bachelor’s degree
d) a diploma/certificate
Did you get it right? The answer is e. There is no minimum legal standard to call yourself a psychotherapist or a counsellor.
It’s also not a protected title. My job title is nurse therapist. People often seem impressed by the fact that I’m called a “therapist”. In fact, the part of my title for which I’ve really had to strive and be registered for is “nurse”. Claim to be a nurse when you’re not registered with the Nursing and Midwifery Council and you can go to prison.
The word “therapist” is vague, and can mean a whole range of things. Psychodynamic therapist. Family therapist. Beauty therapist. Dolphin therapist – no, I didn’t make that last one up.
There’s a few exceptions to this. Arts therapists, including drama and music therapists, have to register with the Health and Care Professions Council. So too do what’s referred to as practitioner psychologists, which covers such titles as clinical psychologists, educational psychologists and counselling psychologists. However, simply calling yourself “psychologist” is not a protected title, and again, anyone can call themselves one. That’s something to bear in mind when noticing that Oliver James is simply called a psychologist rather than clinical psychologist when he regularly appears in the media. That possibly explains why he oftenspeaks utter rubbish.
It’s not entirely a free-for-all. While there’s no legal obligation to belong to a professional body, such bodies do exist. A counsellor or psychotherapist who’s been hired by the NHS, social services or education services wouldn’t get a contract without belonging to one. The two main bodies in the UK are the British Association for Counselling and Psychotherapy (BACP) and the UK Council for Psychotherapy (UKCP). For psychodynamic therapy, there’s also the British Psychoanalytic Council (BPC). Do they all do an equally good job of protecting the public from rogue therapists? No, they don’t, and you need to be aware of that when checking which body your psychotherapist is registered with.
First, a bit of backstory. Under the previous Labour government, there were plans to make counsellors and psychotherapists protected titles, who would then be registered by the HCPC alongside arts therapists and clinical psychologists. When the Coalition came to power, this plan was shelved in favour of what’s essentially an enhanced form of self-regulation. The Council for Healthcare Regulatory Excellence (the “regulator of regulators” that oversees bodies like the General Medical Council, the Nursing and Midwifery Council and the Health and Care Professions Council) was renamed the Professional Standards Authority (PSA). If organisations like the BACP, UKCP and BPC were deemed to be doing a good enough job of handling complaints and maintaining professional standards, they could apply for acceditation by the PSA. Effectively, they would get an official rubberstamp from the government.
The BACP have already received accreditation from the PSA, marking them as trustworthy. Word on the grapevine is that the BPC are well on their way to achieving this too. The UKCP? That’s a different story. They’re not PSA-accredited and may not be for some time, if at all.
In order to see why, take a look at the hearings page for the BACP. As you can see, they regularly sanction counsellors and psychotherapists who have committed misconduct. Now take a look at the equivalent page for the UKCP. There’s only two names on it!
The first name is Derek Gale. He was a notorious abuser who physically, emotionally, sexually and financially abused his patients. The UKCP struck him off in July 2009, but only after the HCPC first struck him off as an arts therapist.
The second name is John Smalley, a Jungian analyst. Now this is where things truly start to get boggling.
seven allegations of breach of the Independent Group of Analytical Psychologists (IGAP) Code of Ethics found proved.
The Panel concluded there was a finding of serious misconduct but no sanction was enforced.
Seven allegations proven….finding of serious misconduct….and no sanction?
It gets worse. When the findings were originally published online, it was originally worded as this:
six allegations of breach of the Independent Group of Analytical Psychologists (IGAP) Code of Ethics found proved. No finding of any misconduct and therefore no sanction.
Not only did they seem to think that a therapist could make multiple breaches of their Code of Ethics and not commit misconduct, but they didn’t even get the number of proven allegations right. Cue some angry e-mails, and they had to change it to admit that he did commit misconduct. It’s just that they chose not to do anything about it.
The UKCP acts as an umbrella body for a number of smaller psychotherapy organisations. John Smalley’s was the Independent Group of Analytical Psychologists, though in the last couple of weeks his name seems to have disappeared from their online register. Historically, complaints have been handled by those organisations. If the complaint is rejected, then the complainant can appeal to the UKCP.
As part of its efforts to achieve PSA accreditation the UKCP is attempting to replace this “two-tier” complaints system with a streamlined “central complaints service” that will handle all complaints from the word go. The Smalley case was something of a hybrid of old and new, in that a complaint was rejected as “no case to answer” by the IGAP, and when the complainant appealed it was put through the new central complaints service.
The outcome of their shiny new complaints service speaks for itself. It doesn’t even bother to sanction serious misconduct. Not only that, it took a whopping three years to reach this deeply unimpressive conclusion. Even worse, Smalley freely admitted during the hearings that he’d destroyed his notes – something that would be considered serious misconduct if a doctor or nurse did it, and would very likely be assumed to mean that person was hiding something. They didn’t even treat it as a fitness-to-practice issue.
As dire as the UKCP’s central complaints service appears to be, they may not even be able to fully achieve this. In the UKCP bulletin, their chief executive David Pink issues a stark warning.
I am disappointed that many of our member organisations seem to be reluctant to engage with the central complaints scheme…By this time next year we need everyone to be signed up to the central complaints or in the process to becoming signed up. By then, other leading reputable therapy organisations (including BPC and BACP) are likely to be fully PSA accredited. Employers, referrers, commissioners and clients will begin to expect practitioners to be on a PSA-accredited register as a minimum requirement. We must not fall behind.
It’s not hard to read between the lines here. A lot of the UKCP’s member organisations simply aren’t playing ball with the new complaints system. Given the atrocious way some of these organisations have handled complaints in the past, one might surmise that they simply aren’t interested in being accountable for their actions. This puts whatever chance the UKCP has left of achieving PSA acceditation in jeopardy.
It’s not that there aren’t good, reputable psychotherapists in the UKCP. There are many. If I was one of those, I’d be feeling rather nervous about being registered with an organisation that’s likely to wind up officially second-rate. If the UKCP can’t get their act together and develop a robust complaints system – and they may well not be able to do so – then the results are likely to be utterly predictable. All the reputable therapists will sign up with the BACP or BPC. Meanwhile the UKCP will be left with the quacks, cultists and charlatans of the therapy world.
So, if you’re looking for a therapist the take-home message is this. The British Association for Counselling and Psychotherapy has been officially designated as an effective regulator. The British Psychoanalytic Council hasn’t yet but is likely to do so. The UK Council for Psychotherapy hasn’t and probably won’t be for some time, if ever. I suggest you take this into account when hiring a psychotherapist.
Courtesy of Zarathustra via The World of Mentalists