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As readers of my recent book, will appreciate, I feel that most of what I have to say about the state regulation of psychopractice in the UK has been said. However the process of assimilation continues.
Where are we now?
Shorthand: the astonishing project of the mainstream accrediting bodies in seeking state control of counselling and psychotherapy, seeking to give away counselling and psychotherapy to the state, has stalled. Blinded by the false, un-researched notion of ‘client protection’, (the WMD of professionalisation), their belief that regulation was a safe harbour has led the regulationist fleet to become beached on the Department of Health sandbanks.
And ‘beached’ was the overall feeling I had of the Reference Group meeting March 30, 2007. There was a tangible feeling of sadness and regret, as among business partners facing the reality that their enterprise had failed to prosper. However this perspective is perhaps conditioned by our circumstances, I imagine training schools needing to attract trainees might see the Health Professions Council Regulator as a blessing, - clearly defined standards - a one-size-fits-all - easy to relate to (and sell) structure of registration. But who will want to pay the serious money that current academicised trainings demand to get on that register when, following a cheapo course you will be able to get direct access to the HPC registration for much less commitment, or even as part of existing job/role expansion, i.e. nursing, social work, free?
What else did this Reference Group meeting tell us? Reading between the lines of what was being said; it is hard to avoid the following picture. The DoH, tasked with following economically driven government wishes for the expansion of psychosocial services, Layard etc, (see the prime ministerial petition response) and having seen the professionalized factional realities expressed through the mainstream trade associations, trades unions and accrediting bodies, has decided that putting all the State Regulation traffic through them was not feasible. Instead they have chosen to build a bypass around the congested, titles-riven municipalities of BPS, BACP, BCP and UKCP. And barring some major upheaval in parliamentary politics, contracts have been let (Skills for Health, ENTO, HPC) for a Section 60 order to build this road that will take psychology, counselling and psychotherapy directly into state custody. Leaving the present accrediting bodies to become marginalized ‘dormitory towns’?
The DoH vision of the psychopractice landscape does appear to seek a hugely expanded provision of psychosocial services, including, as a couple of people at the Reference Group mentioned, the continuing mutation of ‘mental health care’ into ‘social care’. For some people, the possibility of such a hugely expanded, economy-grade, stepped, self-help-focused, CBT-based, entry-level ‘counsellorapy’, as outlined by David Richards, Professor of Mental Health at the University of York, in this Independent on Sunday article is anathema. But from an Ipnosis perspective and perhaps that of the DoH, its promise of a way to expand the range of help available and extend psychopractice provision out from the south east rich-belt into the national psyche matters a lot. I am strongly reminded of broadcasting history; until the beginnings of ITV, especially Granada, in the late 50s and early 60s, when the hegemony began to be broken, the south east almost exclusively voiced the nation back to itself.
As I touch on in Regulating the Psychological Professions, for all their value (Ipnosis had 5 years postgraduate study) overly righteous clinging to long, academicized, intensive trainings in psychopractice tends to miss the extent to which people’s human condition needs are very disparate, and uneven in intensity, and that in meeting them entry levels need to match this in range and user-friendly-ness. For instance I have long thought that many of the people doing low key counselling trainings were people who couldn’t handle the loss of face that signing up as clients would entail. Similarly the people who live near where I live who seek ‘soul contract readings’ or ‘flotation therapy’ might not (for the moment) see any need for a deeper or more prolonged confrontation with the politics, spirituality or psychology of their experience.
It is not to the credit of the mainstream accrediting bodies that they still find the energy to compete over title taxonomies and churn internally but, trapped perhaps by their constitutions, have failed dismally in areas where out of the box thinking on behalf of democratizing the client experience would be appropriate. Where through investment in education, embracing user groups and promoting such self-help options as cocounselling, a very powerful personal development process that I have taught to dozens of people, they could have been more active in creating inexpensive entry-level client experiences, rather than building ever higher their professionalisation walled gardens of expertise.
But let’s return to the big picture. Early on in the Reference Group meeting, Ipnosis suggested that there was a need to shift the strategic approach to state regulation from Yes, But’ to a ‘No, Unless’. A gentle Scottish voice later asked for this be modified to ‘If, Then’. Fair enough, and this strategic shift did seem to appeal to a few people present. However understandably there seemed a deeply embedded, if suppressed, discomfort at the prospect of actually saying to the government ‘No, we won’t do it’. Voices argued for continuing to play/engage, that it was not (yet) time to call a halt to the game and take the ball away. A psychoanalytic voice countered this, accurately Ipnosis felt (see below) by pointing out that, through the Skills for Health Competencies enterprise, the government had moved the pitch.
Expanding on the ‘No, Unless’ proposals for a shift of strategy’, Richard House of IPN suggested that the notion of PNC, Principled Non-Cooperation be considered and perhaps adopted but again to no avail, HMS Regulation did indeed seem to be stuck on the sandbank. What to do? Wait for a high tide of a conservative government to lift the vessel? Calls to the harbour-master, the HPC, were ruled to be now a waste of time. Regulators don’t negotiate, They Regulate. Some proposals for lobbying ministers, Lord Hunt, Andy Burnham and Patricia Hewitt, felt to Ipnosis like raising sails and blowing into them to induce movement. The only proposal for partners in resistance that felt like it might lighten the ship was for an active engagement with service user groups. One participant mentioned that after the meeting they were headed for a coalition of hundred such groups. But isn’t this a decade late? The time for such window-dressing is surely past.
Ipnosis was left again with the feeling that the mainstream accrediting psychopractice bodies are in denial of the damage to the client experience that their lobbying for state regulation entails, and will not say no to it and move into PNC, principled non-compliance/non-cooperation.
They will more than likely find a form of spin through which to sell the HPC to their members as the ‘least worst’, outcome, ‘something we will have to learn to live with’, or as a leading figure at the Reference Group suggested, ‘to see it as an opportunity’, and as I have already heard from a horse’s mouth (prolific metaphoric production today!) prepare for dissolution as effective professionalisation bodies. If you are a registrant of one of the mainstream accrediting bodies pulling a handy line in work due to it, keep in mind you created this situation. You sleep-walked into a dysfunctional institutional world lately delineated in wonderful detail by Adam Curtis in his excellent BBC2 TV series The Trap: What Happened to our Dreams of Freedom? Watch episode one, episode two, episode three.
For Ipnosis, supported by the vantage point on accountability that IPN provides, the mainstream accrediting bodies still don’t ‘get it’. The DoH is, as all governments will do, invoking a taxonomy process to make visible (and available for control) what has been discovered to be ‘wild’ in the national ecology of service provision. Taxonomy means mapping, measuring, capturing and bringing into the DoH ‘zoo’, these hitherto ‘invisible’-to-government items of our life-work. The mapping phase, courtesy of UKCP/BACP, is complete; the measuring phase Skills for Health and ENTO, QAA et al, after a brief delay, is expected to be complete by the end of the year; and the capture phase, entry into the HPC cage in the DoH zoo, is being readied.
Such a taxonomy process may be being driven by good intentions on all sides but it doesn’t actually need to engage with the domains being mapped and measured, it is a positivist, alienated, ‘power over’, research ‘on people’ not ‘with people’, approach. This is why consultations mean ‘listen but ignore’, they are facing in an altogether different direction than we practitioners. Actively seeking to invoke such a process, to bring it on ourselves has been, and continues to be, an act of high folly. A ‘Huge Mistake’ as my colleague Richard House described it to a barrage of hostility at a previous Reference Group meeting.
What can we do? There seem to be three tasks:
One: presciently contained in the sub-title of Richard Mowbray’s book, The Case Against Psychotherapy Registration, is a conservation issue – figure out how to keep alive a rich variety of means of providing deep, open-ended human condition work.
Two: Thoroughly explore and develop Principled Non-Cooperation/Non-Compliance.
Three: be more active in extending the availability of psychopractice perhaps through a revival/expansion of cocounselling, or adopting the ‘stepped’ entry-level approach to psychopractice provision that David Richards, Professor of Mental Health at the University of York, advocates. (An example is my 1200 screen CDROM personal and professional development compendium, Letting the Heart Sing - The Mind Gymnasium)
Happy Easter
*present were CEOs/delegates/participants from BPS, UKCP, BACP, IPN, CFAR, College of Psychoanalysis and others
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