ON NOVEMBER 2ND 2009 and not for the first time (the Bright Bill, the Alderdice Bill), the politics of counselling and psychotherapy came to Westminster. On this occasion via a convention on regulation called by the shadow health secretary of a conservative party potentially coming into power next year, and where the health brief is held by someone well informed about and openly skeptical of the present plans for regulation.
Politics might be beneficially based on cooperation, it is more commonly about power expressed as coercion, duress and even violence. And this variety of power isn't always synonymous with either compassion or competence, as the policeman on the entry point into the Houses of Parliament reminded us. He was very jovial. As we waited in line outside the security suite he told us that there were armed police in there but that they were terrible shots, and this was why people like him were issued with bullet proof vests. If I had been able to take to heart what he said about latent enmity and the need for body armour, perhaps I would have been less shaken by the meeting that followed.
This 'convention' of counselling and psychotherapy stakeholders was chaired by the shadow minister for health, Anne Milton MP, and she expertly teased out many of the contradictions and thinly disguised conflicts that showed up.
And how few people did show up, for a room with a capacity of around sixty, I counted only 35 people present. All the usual suspects. BACP, BPC, UKCP et al. Five early birds, the Alliance and IPN, formed a mostly silent front row on one side of the semi-circle of tables. Darian Leader was one of the platform of six, which also included Marc Seale, CEO of the HPC, Anne Milton MP, Lynne Gabriel, Chair of the BACP, Colin Walker of Mind, and Earl Howe, a voice in the Lords on matters of mental health.
And 'mental health' was the barely challenged frame of most of the meeting. MIND argued that mental health users wanted regulation because the existing complaints process was so bad. And they had an exhibit to prove it. In a repeat of a Jonathan Coe exploit at the Manchester HPC stakeholders meeting, a psychotherapy client they had brought to the meeting named and shamed the Guild of Psychotherapists for, as it seemed, an unholy complaints mess. However, as it also seemed from this, a tragic story blatantly used as a weapon, and in a later conversation, the MIND duo present seemed at least as capable of running a culture of dominance as did the majority of the accrediting bodies present.
In what seemed an irony-free meeting, willing submission to the HPC regime of truth co-existed with the barely hidden subtext of a validity contest for dominance between counselling and psychotherapy. Lynne Gabriel denied the differentiation between psychotherapy and counselling, pointing to 3 and 5 items of difference in the HPC proficiency catechism of counselling and psychotherapy 'musts' and 49 shared items. Opposing this, psychotherapy interests insisted on the retention of their high ground of elevated standards.
Marc Seale spoke of 'putting in place the building blocks of regulation' and of the difficulty of the range of practitioners 'from PhD to level 4' that he had to contend with. As though this labeling in itself didn't give practitioners something to think about. BPC CEO Malcom Allen spoke warmly of the Forster Review of a year or two back and its urging that we adopt 'modern regulatory practice'. He evidently hadn't heard, or chose to ignore, that the Forster report was seen in the DoH as so inadequate as to be deeply embarrassing.
The public protection mantra was repeatedly invoked but this was not a setting for the deconstruction of such magical invocations. In the face of perhaps the first public opposition to the HPC's regime of regulatory truth and in the absence of the anticipatory obedience that characterized the Professional Liaison Group, Marc Seale struggled to sustain his organization's regulatory prominence. It was a time for defensive spin. Marc claimed that 'the HPC was not running a medical model', and that they 'already regulated 210,00 people in 14 professions and so there was no reason to suppose they would not be OK for counselling and psychotherapy'. We'll see how well the recent PLG/standards consultation supports this contention when the distillations of it are published. They will apparently be accompanied by consumer research by MORI commissioned by the HPC. (Might the HPC be feeling they are on shakey ground - and using registrant's money to pay for market research?
I had the sense that Marc Seale didn't have a good meeting. He is probably not used to such an unorchestrated setting for his tasks and Anne Milton seemed intent on exposing him to abrasion; she told him the HPC needed to 'stop irritating people' and that 'they hadn't succeeded in bringing everyone on board', she also let it be known that there was something about HPC Chair Anna Van De Gaag's style that she was less than enthusiastic about. Perhaps she was referring to her talent for reassurance. Much of what Anna van der Gaag said was in a mode familiar to attendees at the Professional Liaison Group meetings, 'reassurance' that it would be OK 'not to worry' standards and proficiencies would be adjusted or worked with. This seemed a big surprise to some people in the meeting.
If the HPC's regulatory train was, as Darian leader put it, leaving the station, in this meeting it clattered along with bits of credibility falling off on the track.
This may so far seem an unduly jaundiced account of a remarkable meeting, remarkable not least for the only lightly hidden skepticism about the regulatory situation from the chair. I could imagine that Anne Milton might privately have told Marc Seale it was time to get his act together. After a while, a sense that the HPC was not up to the task it had been given and/or the approach it was taking to it, seemed palpable in the room. Seizing the moment, Andrew Samuels made a proposal for a convention to look afresh at what form of regulation would be acceptable. This was received by some present with gasps of exasperation. 'We've had our chance'... 'the psychologists broke ranks'...
Was there another breaking of ranks here? How come the UKCP were not part of the panel? There were other omissions too, Remembering how I'd been smeared in the Observer earlier in the year I had no appetite for being a civic accountability snowball in a regulationist firestorm and didn't feel able to unilaterally voice my opposition to the meeting's otherwise overwhelming acceptance of statutory regulation. No one, including myself, thought to ask Marc Seale how many of the eligible psychologists had completed an HPC signup by the close of the deadline at the end of October. And the Alliance Six didn't raise, perhaps wisely, the likelihood of widespread principled non- compliance with HPC regulation.
The meeting was also remarkable for having been triggered by the scale of the objections to HPC regulation that Anne Milton had received, a post bag bigger than any before in the whole of her previous parliamentary career. However, while this cracking of the mould by Anne Milton was very welcome and may lead to moderation of the HPC's lunacies, this was a meeting that was overwhelmingly in favour of statutory regulation of counselling and psychotherapy. And I came away in little doubt that subject to cosmetic adjustments to the proficiencies, and a deal between BACP and the UKCP, the HPC will prevail.
Was this why, 24 hours later I still felt so shocked, even traumatized by the meeting? Had I reached overload? Or even burnout? Or was it because for the first time the whole cast of the psychological therapies regulation tragedy that I have been researching and writing about for almost twenty years had all been present in one place? Regulator, government-to-be, and the usual regulation enthusiasts. Something certainly got to me.
'Client protection' is the cover story of these enthusiasts for state intervention. At several points in the meeting the accrediting bodies who are so eager to be regulated echoed the HPC article of faith of 'client protection' ie protection from 'unqualified' 'rogue' practitioners. I wonder why I hadn't previously seen that the HPC regulatory regime is being imposed on them so as to protect the public from the practitioners they qualify and their complaint processes
. I.e. that HPC regulation confers 'rogue' status on the field's accrediting bodies and their membership.
What seemed more present in the Grand Committee Room in Westminster Hall than any authentic concern for the quality of the client experience was a sluggish incoming tide of status-seeking, power, and career enhancement, coupled to the economic dynamo of the cascades of training, trainee and supervision interests. (I make no apology for the stream of mixed metaphors, certain kinds of truth can only live as images). Through the avid pursuit of professionalization, academicization and marketisation, the mainstream accrediting bodies have morphed into 'rogue' practitioners and 'rogue' organizations, from which, as MIND correctly requests, the state is now determined to protect the public. Here they were seeking a mix of protection for themselves and preferment at court, to be docked in one of the safe harbours of the Privy Council, uncaring that the likely effect of embracing state coercion and duress would be the freeze-drying for a generation of counselling and psychotherapy as ways of working with the human condition.
I wasn't the only person at the Anne Milton meeting who had a non-professionalized practitioner experience of knowing that there is a world of valid human condition work outside of counselling and psychotherapy. And when a person behind me, a 'cognitive analytic' voice I believe, rolled out the charlatan's charter of 'rogue practitioners', 'rogue organizations', and 'anybody can set up as a therapist', I looked across at these 'rogue' accrediting bodies for counselling and psychotherapy and found myself wishing for the most draconian regulatory regime imaginable to be imposed on them; a regulatory regime ruthlessly imposed and enforced; that features weekly fitness to practise trials of errant practitioners; coupled with the further academicization of trainings and their gradual absorption into HPC accredited university/higher education, the better to create, as Lynne Gabriel pointed out, a wholly new profession.
A curse I suppose. But isn't this what is already on the way?
In the evening following the meeting and next morning, a song that I associate very strongly with grief kept surfacing and eventually my distress evaporated. By Charles Trenet, it begins...
...Goodbye… no use leading with our chins, this is where our story ends…
...my breaking heart and I agree that you and I could never be…
...I wish you bluebirds in the spring to give your heart a song to sing…
...but more than this… I wish you love…
Play track of I Wish You Love