IS THERAPY HARMFUL?
"THERAPY HURTS" CONFERENCE 30.10.99
Professor Petruska Clarkson
- There is substantial evidence of various kinds that psychotherapy seems to help many people.
- Researchers have found that theoretical approach is irrelevant to the successful outcome of Eurocentric psychotherapies no matter how measured.
- There is substantial evidence that it is in fact the therapeutic relationship rather than diagnosis or technique or "approach" which creates the beneficial effects of psychotherapy.
- Healing of emotional or mental distress is not unique to the last hundred years in the industrialised West. Investigators have found healing practices dating back for thousands of years and in all lands of the world. Research into the most effective ingredient of all such ancient or indigenous healingpractices also find that it is the therapeutic relationship that brings about change. (Two other factors are a culturally congruent narrative or explanation and some prescription for action).
- In addition to the multitude of studies which have testified to the overriding importance of the therapeutic relationship, it has been found that there are different kinds of relationship required for different kinds of patients at different times. This has been found to be more important than diagnosis in predicting effectiveness of psychotherapy.
- Five kinds of therapeutic relationship have been found to be potentially present in all approaches to therapy. These the modalities of relationship are: the Working Alliance, Transference/counter transference (or unfinished relationship) Developmentally Needed or Reparative relationship, the Person-to-Person and the Transpersonal relationship such as in Jungian analysis.
- Evidence exists that there are experiences of psychotherapy by which people feel harmed. One of the most salient facts here is that the harmfulness seems to have to do with the extent to which a psychotherapist entrenches into a theoretical position when challenged or questioned by their client.
- The other major source of harmfulness in psychotherapy is unethical practice such as sexual abuse of clients. POPAN figures show that psychotherapists rank only after doctors as the major perpetrators of abuse.
- Research into the ethical dilemmas of UKCP psychotherapists showed that confidentiality is the most frequently experienced ethical dilemma, followed by serious concerns about unethical practice of colleagues.
- POPAN has found that the experience of clients trying to use complaints procedures is appalling, It is also comparatively rare are likely to continue to be comparatively rare. Research shows that unless their colleagues confront and/or report them, abused by psychotherapists and fobbed off or traumatised by the experience of attempting to use complaints processes - against the well-funded legal and financial resources of large professional organisations.
- There is substantial evidence of organisational collusion with psychotherapist abuse.
- There is also substantial evidence that actions are taken against professionals who attempt to rectify such matters with their own organisations.
- In one case several Governing Board officers of the UKCP have faced contempt of court charges - one for attempting intimidate a complainant who sought to have evidence properly and fairly heard that some UKCP organisations have not followed or abused their ethics and complaints processes.
- The UKCP Ethics Committee is now recommending that UKCP organisations adopt a new complaints procedure at the January' 2000 AGM which would effectively make a complaint against a colleague a "grievance". This motion has been made despite knowledge of the evidence which shows (a) that "the duty to inform" is a foundational ethic principle of all other profession (eg. doctors, psychologists and counsellors) and (b) the fact that collegial misconduct is the second most serious cause of ethical concern for UKCP psychotherapists.
- The UKCP is organised into sections comprising "approaches" despite the evidence that such orientations are not particularly relevant. This exacerbates competition between "schools" rather than focusing on developing and improving psychotherapy practice and ethics across the board.
- Other professions are not organised by professionals' lifelong allegiance to the bodies where they did their original training. This ongoing investment in individual training schools makes the UKCP current organisation more analogous to a trade association. It also raises further serious questions about the ethical foundations of psychotherapy in Britain..
PSYCHOTHERAPY HURTS MORE AND MORE OFTEN WHEN PROFESSIONAL ORGANISATIONS DO NOT TAKE RESEARCH EVIDENCE AND ETHICS AND COMPLAINTS SERIOUSLY
Professor Petruska Clarkson, M.A., D. Litt. et. Phil., FBAC. FBPS, is a consultant philosopher, chartered clinical, counselling and research psychologist. individual and group psychotherapist, supervisor, and business psychologist with almost 30 years' intemational experience, who has more than 150 publications (21 languages) in these fields. These include the books The Therapeutic Relationship. Change in Organisations, the Bystander and the forthcoming Ethics.' Working with Ethical and Moral Dilemmas in Psychotherapy. She is Honorary Professor at the Roehampton Institute of Surrey University and Visiting professor at several other Universities in the UK and abroad and associated with the LSE Complexity in learning Organisations Project. She based the Centre for Qualititive Research in Psychotherapy Training and Supervision at PHYSIS, London where she runs training programmes for psychologists, psychotherapists and consultants. and supervises PhD researchers. Further Information, including research summaries current work and references, contact Petruska at PHYSIS, 12 North Common Road, London W52QB. Te11Fax: 0181-567-0388.