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Letter from Tim Brown
The Government proposes to impose state regulation of psychological therapies through the Health Professions Council (HPC).
The proposal would grant a closed shop to some of the existing accrediting organisations, and encourage a medical model of psychotherapy.
Practitioners who choose to work with alternative models of therapeutic encounter are likely to find themselves excluded, or required to demonstrate 'skills' which are irrelevant to their daily practise. Thousands of psychotherapists working successfully in these fields would be barred from using their habitual and long-earned titles.
The Government says its wishes to "…avoid an increase in different types, or modalities, of psychotherapy….Our view of a comprehensive mental health programme is that it should provide three main modalities. These are psychoanalytical or psychodynamic, cognitive behavioural therapy, and family or systemic psychotherapy. Most other modalities are variant of these." 1
It is not clear why the Government wishes to avoid a wider choice of therapies. Many therapeutic approaches fall outside the scope of the three 'main modalities'. For instance, body-centred, client-centred, humanistic and integrative psychotherapists rely on a model which emphasises self-actualisation and the relational nature of human development and experience. These are not 'variants' of the Department of Health preferred modalities, and in many ways offer a more fundamental alternative to the quick-fix of CBT and related outcome-focussed therapies, whose long-term effectiveness remains unproven.
No evidence exists to suggest that state regulation would in any way improve professional competence and enhance public protection. Research2 suggests that registration fails to do either, and will do more harm than good.
The HPC says: "The only justification for statutory regulating Counsellors and Psychotherapists is that public protection will be enhanced. The benefits of statutory regulation will have to outweigh any potential down sides of statutory regulation and in particular the cost of regulation, which will have to be born by those regulated. As many practitioners work outside the NHS, the cost of regulation will have to be paid for by the patients" 3
The professional psychotherapy bodies tend to support regulation, because they have a vested interest in creating a closed shop for their members and trainees. For this reason many therapists choose not to be members of (for example) UKCP, BACP etc, but make their own supervision and professional development arrangements.
In the absence of clear evidence that clients are being abused, or that current voluntary peer and professional structures are failing to deal with any malpractice, it is unclear why exactly the state feels it should intervene. The current system is self-evidently 'not broke'.
1 Letter from DoH Minister Ben Bradshaw to Celia Barlow MP, 13.3.08
2 Eg: The Case Against Psychotherapy Registration , Mowbray 1995; Regulating the Psychological Therapies, Postle, 2007
3 Counsellors and Psychotherapists - road map to their statutory regulation; HPC Council paper 13 December 2007
2. Tim Bown's current state regulation petition provoked elements of the UKCP to circulate their membership with a round robin advising against signing up to it. Happily, as might be expected, this intervention seems to have been counter-productive, or was it perhaps, Machiavellian whisper, intentional!