The Department of Health ‘Command Paper’ February 16th 2011, confirms what has previously leaked fairly clearly; the DH is not presently minded to support HPC regulation of counselling and psychotherapy.

A delightful spring present for those of us who have long opposed it. The new situation installs an intrinsically pluralistic framework; if you have, or can build, a voluntary register of practitioners, it may be possible to have the newly refurbished CHRE validate it for you.

The CHRE is re-created as a commercial enterprise, a quality assurance organization. It has been, and continues to Quality Assure the HPC. We might guess that following the outcome of last December’s judicial review proceedings, some questions must have been asked about the CHRE’s quality assurance of the HPC.

The huge march of regulatory question marks that have converged on the DH seems to have the kind of influence on this government that the HPC chose to ignore. (and so much for Marc Seale’s vociferous insistence at one of our meeting, that the HPC was ‘independent of government’). Anne Milton, MP, Earl Howe and Viscount Eccles have been more in touch with the client and practitioners issue than the HPC‘arms length body’.

This derailing of SR is a major success for the SR skeptics not least at eIpnosis (be sure to buy the forthcoming book of how we got here).

Here at eIpnosis, ever willing to look a gift horse in the mouth, we’d argue that caution is in order.

From a practitioner point of view, the government’s decision to drop SR, at least for the moment (see below) relieves the tension of a forced choice between signing up to the HPC and standing aside with a new working title. If CHRE validation is implemented, the present mainstream accrediting bodies get to run things as before, with some enhancements. Will this added-value be consistent across the voluntary registers? No imposed standards of proficiency but a unified ethical commitment? Will there have to be cross modal agreement to this? Once again, pigs might be required to fly.

From a counselling and psychotherapy client point of view the looming promise of the HPC regime fades, or does it?

For a year or more following the Anne Milton, MP convention at Westminster, eIpnosis has been very cognizant of the scale of the pro-SR-HPC lobby and though it seems to have been defeated at the HPC level, this is unlikely to mean that these determined vested interests have gone away.

40% of the BCP work in the NHS
Many/most of the BABCP cbt trained staff work in the IAPT programme
Perhaps a third (tbc) of the UKCP list work in the NHS
Many/most Child psychotherapists and Family and Systemic psychotherapists work in the NHS

In addition all the counselling and psychotherapy trainings will at least hint at offering trainees something acceptable to the NHS.

Now that this constituency has been deprived of an NHS professional identity enhancement – status and privilege has always been at the root of enthusiasm for state regulation, we can assume they will be busy chasing some alternative. What might it be? Will CHRE validation count in a commissioned NHS? How does the HPC recover from its huge loss of face due to being passed over as herder of the psychopractice cats?

Let’s pause for a moment and commune with the HPC, and think of what they could do.

The obvious answer, hinted at several times at the last PLG meeting, is to attempt to continue with some version of the PLG recommendations, based on the standards of proficiency.

With not too much of a tweak, a voluntary HPC regulatory regime could be constructed that all the NHS oriented practitioners could sign up to. Something the HPC could implement much quicker than the CHRE. And it might be very attractive to NHS oriented practitioners who also want or need NHS parity.

Such a choice would answer Professor Fonagy’s worry that psychotherapy would otherwise be destroyed. And also the divide that already exists between psychotherapy and counselling might be consolidated in a potentially benign way. The BACP does seem an overwhelmingly attractive candidate for CHRE validation.

So let’s sit around the HPC regulation table with Marc and Michael and Charlotte. ‘Our huge PLG investment in the command and control of counselling and psychotherapy is about to be toast, what shall we do? What would Professor Fonagy want us do? Ah yes, what about that research into the level of practitioner abuse we commissioned when this difficulty with the DH first came into sight? That could be useful.'

eIpnosis paranoia engine in over-drive...

HPC's response to command 'Enabling Excellence'
Position statement
17 February 2011

…for currently unregulated groups, voluntary registration will in future be the Government's preferred option. However it also says the Government will consider statutory regulation where there is a compelling case on the basis of public safety risk and where assured voluntary registers are not considered sufficient to manage the risk…
(eIpnosis emphasis)

A client correspondent tells eIpnosis that she has discovered the HPC have commissioned research from the Clinic for Boundary Studies (Jonathan Coe) on practitioner abuse and that it will be published ‘in the summer’. If it supports an HPC argument that counselling and psychotherapy pose a significant public safety risk, a recommendation to the government that they should be statutory regulated might be on the cards. Remember such a recommendation has already been studiously put through the HPC mincer by the PLG.

The HPC have the registration funds of around 200 thousand practitioners to play with. They once threatened the psychoanalysts with the argument that they had the bigger advertising budget. They don’t give up.

I want to end by pointing to a distant if uncanny parallel with recent Egyptian history. A revolt by a determined minority toppled an oppressive regime, and a distant superpower knocked heads together to enable actual change. Don't miss the background echo, as in Egypt, the professionalization generals though narked and challenged, are still in charge of the troops.

Of course seeing this as a claim that an eIpnotic psycho-alliance engineered this regulatory about turn is probably an exaggeration, as in Egypt a swing of the pendulum away from HPC authoritarianism has long seemed built into its abuse of power and the collaborative collusion with which it was met. Enantiodromia, Jung called it.

In both cases, how it plays out may yet require a return to the streets.

Enantiodromia: a principle introduced by Carl Jung, that the extreme versions of any force eventually reverses into its opposite.

Marc Seale, HPC CEO
Michael Guthrie, HPC Head of Policy and Standards
Charlotte Unwin, HPC Policy Manager Policy & Standards department

All I have is a voice to undo the folded lie
W.H. Auden
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eIpnosis is edited, maintained and © Denis Postle 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010 , 2011

Psychological therapies, regulation of,

Government reverses policy - from centralised control to pluralism

Health and Social Care Bill January 19, 2011