|CORRESPONDENCE & RESPONSES
REGULATION OF PSYCHOTHERAPISTS AND COUNSELLORS
8th January 2010
On 10 December 2009 the HPC met to review the responses to the consultation on the recommendations of the Psychotherapists and Counsellors Professional Liaison Group. The following document highlights its conclusions.
HPC document ‘Conclusions on the Proposed Statutory Regulation of Psychotherapists and Counsellors’ - To read the document click here (link now dead)
Response of The College to the HPC document 'Conclusions on the Proposed Statutory Regulation of Psychotherapists and Counsellors’ To read the document click here
STATE REGULATION OF PSYCHOTHERAPY
28th September 2009
The Health Professions Council (HPC), charged by Dept. of Health to investigate the regulatory needs of Psychotherapy and Counselling and then to see whether the HPC could accommodate those needs, has produced its final consultation documents. These set out how it proposes to redefine the profession in order for the HPC to regulate it.
The College of Psychoanalysts-UK has considered these proposals in detail and considers that the definition of psychotherapy set out by them present a serious threat to the work that our members do. Much of the detail of the proposed Standards of Proficiency are directly in opposition to the way our members work. Much of what is contained in the proposals have no relevance to psychotherapy as our members understand it and yet our members will be required by law to abide by them.
Below is a detailed critique of the HPC proposals, which we, in concert with 7 other Psychoanalytic organisations, have signed and submitted to the HPC.
Co-signed response to HPC-PLG click here
Co-signed response to HPC standards of proficiency click here
A SIGNIFICANT MEETING BETWEEN THE COLLEGE AND HPC
2nd March 2009
On 27th February, Darian Leader, President of The College and Andrew Hodgkiss, who is both a psychiatrist and a psychoanalyst, met with Marc Seale, Chief Executive of the Health Professions Council (HPC), Michael Guthrie, head of Policy and Standards at HPC, and Diane Waller, chair of the HPC Professional Liaison Group (PLG) to discuss the contents of the recent letter from The College to the PLG already published in the February item of Latest News.
To access the LETTER OF THE COLLEGE TO THE PLG, please click here.
To access the NOTES OF HPC/COLLEGE MEETING, please click here.
PROPOSALS BY HPC FOR REGULATION OF PSYCHOTHERAPISTS AND COUNSELLORS
A Professional Liaison Group ("PLG") has now been set up by the Health Professions Council to make recommendations for the proposed regulation by that body of the disciplines of psychotherapy and counselling. A list of those appointed by HPC to the PLG can be accessed from this link to the HPC website.
It will be observed from the above list of participants that, so far as psychoanalysis is concerned, the PLG is heavily weighted in favour of representatives associated with the British Psychoanalytic Council (BPC) and that there is nobody from either The College or the Psychoanalytic Consortium.
All deliberations of the PLG are held in public. However, the number of spaces in the "public gallery" is very limited. Decisions of the PLG are minuted and copies of those minutes, once approved, are published on the HPC website. HPC claims that any interested person or body is free to make submissions and comments arising out of the deliberations of PLG. All of these details, including the dates of all coming meetings of PLG and their agendas, are published by HPC on their website and may be accessed from this link. (link now dead)
The same details of previous meeting of PLG are also published by HPC on their website and may be accessed from this link. (link now dead)
Notes taken by a member of The College who attended the initial meeting of PLG are more interesting than the official HPC mintes of that meeting for what they reveal about the level of opposition to regulation by HPC felt by many members of the profession. This was impartially reported on by the UKCP representative who was present then. The notes taken by the member of The College are available by clicking on this link.
The College has since then made formal representations to PLG setting out its reasons for opposing regulation of the profession in the manner proposed by HPC.
To access the LETTER SENT BY THE COLLEGE TO THE PLG in this regard, please click here.
At the last meeting of the PLG, it was decided that there should be one Part of the Register for Psychotherapists and Counsellors with only one separate registered professional title for each of these i.e. psychotherapist and counsellor. However, in the absence of separate qualifications for each, practitioners will be registered as entitled to use only the professional title that is appropriate to their qualification(s) and the two professional titles will not be interchangeable.
HPC has announced that it is to hold a much more inclusive meeting than the PLG which will be open to all interested stakeholders and, in particular, to those who are not represented on the PLG. The College intends to send a representative to this meeting.
THE HEALTH PROFESSIONS COUNCIL GETS UNDERWAY
The Health Professions Council has now begun the task of exploring proposals for the regulation of counsellors and psychotherapists. They recently sent to stakeholders within the professions concerned, including The College, a Call for Ideas document to help them in their endeavour by answering ten specific questions. The College has now responded to that Call for Ideas. The document in question may be accessed by clicking on this link.
In addition, representatives of The College have now met with Marc Seale, the Chief Executive of HPC and Sam Mars, Policy Officer. To access the notes of meeting, please click here.
HPC is also expected to announce very soon the composition of the Professional Liaison Group that will be advising them on any proposals to regulate counsellors and psychotherapists. The PLG is referred to in the above meeting.
To access a LETTER FROM THE COLLEGE TO SKILLS FOR HEALTH, please click here.
COUNSELLORS AND PSYCHOTHERAPISTS - ROAD MAP TO THEIR STATUTORY REGULATION
To access the comments by The College of Psychoanalysts on the above document published by the Health Professions Council in December 2007, please click here.
SOME RECENT DEVELOPMENTS IN RELATION TO REGULATION BY THE STATE
In May 2008 it was made clear that the Government intended to proceed apace with the regulation of the psychotherapies, including psychoanalysis. The regulator would be the Health Professions Council, despite the almost unanimous agreement among professional groups that HPC was not suited to regulate psychotherapy. A great deal of correspondence was sent which set out reasons for the unsuitability of HPC, yet this was not responded to in any substantial way. Before regulation can occur, a number of steps have to be worked through.
Firstly, the definition of what psychotherapy/psychoanalysis is.
In order to establish this, Skills for Health, a Public Authority, on the instructions of the Department of Health, was given the project of consultation. They were supposedly going to set up working groups with representation from various modalities which would arrive at generally acceptable National Occupational Standards for the psychodynamic psychotherapies and psychoanalysis. The College of Psychoanalysts and the Psychoanalytic Consortium both tried to be part of this process. The Consortium was not given the courtesy of a reply; the process simply began without them. The College was promised two places but was subsequently excluded without any explanation. Thus, those who were from the outset voicing their discontent with the nature of the process were excluded from contributing anything to that process, including being able to explain to those participating in it in good faith, that it was from the outset a biased process. It was clear at this point that careful vetting of the political stance of members was more important than a fair distribution of places.
Secondly, the production of National Occupational Standards.
The working group for psychodynamic psychotherapies and psychoanalysis has now met a couple of times and produced a set of National Occupational Standards, drafted first of all by two academics who are known for their work which adopts methodology similar to that used in an attempt to validate CBT. Despite the clear antithesis between the psychoanalytic and the cognitive approach, the acknowledged framework for the production of the analytic standards is that of CBT. If these are accepted, they will probably become part of a manual to which we may all be expected to adhere, despite being excluded from the process. The NOS produced are based upon a very particular view of what constitutes psychodynamic work and psychoanalysis. This is a view that many feel does not bear more than a passing resemblance to the way they have been trained and experienced in working. Thus, at a stroke, different orientations, the training analysis, current trainings, are at risk of being turned into something outside the remit of what will be defined by this brutal process.
Thirdly, wider consultation within the psychotherapy/psychoanalysis organisations for comments on the NOS.
This is the stage at which we now find ourselves. There seems to be a choice of approach: comply with the demand of the organisation which has up to now refused to allow us to participate, and produce the usual rational and well-thought-out arguments as to why this should not be imposed on those segments of the profession who do not recognise their ethics or way of working in this NOS document; or, refuse at this point to participate as we have been offered no part in producing the NOS and will therefore be unlikely to be listened to at this point.
It seems clear that the objectives of this political process were set at the beginning of the project - of course, this is how political process usually works - and clearer still that objections will not be listened to.
So, what can we do if we don't recognise our practice in the NOS as being circulated currently for comment?
- Argue the points in detail and keep trying to assert some influence on the process;
- Make further representations to Skills for Health;
- Form horizontal alliances with other practitioner groups who find the likely outcome of the NOS and Skills for Health process unacceptable (it was said early on that there had to be agreement to regulation by a substantial proportion of psychotherapists);
- Make public statements highlighting the abuse of power apparent in this biased process carried out by a Public Authority.
These questions are currently the subject of debate and a range of documents are being drafted. We are also encouraging anyone concerned about the undemocratic and biased way that this process is unfolding to write to their MP.
If you want to find out who your local MP is then you can go to http://www.writetothem.com and type in your postcode. You can then write to your MP c/o the House of Commons.
STATE-REGULATION: THE FOG BEGINS TO CLEAR
The government has now published its White Paper Trust, Assurance and Safety -The Regulation of Health Professionals in the 21st Century clarifying and setting out its proposals for state-regulation of a number of professions, including psychotherapists, counsellors and applied psychologists. For those with Acrobat Reader, the White Paper may be accessed from the Department of Health website.
The White Paper follows two earlier reports for consultation, published by the Department of Health: The Donaldson Report, Good doctors, safer patients (outlining proposals for the regulation of medical practitioners) and the Foster Review, The regulation of the non-medical healthcare professions (outlining proposals for the regulation of, inter alios, psychotherapists and counsellors).
An outline of the results of the two consultation documents, as well as the circumstances surrounding publication of the White Paper, may be found on the Department of Health website.
Most of the White Paper is concerned with the government proposals for the regulation of medical practitioners, which it is not proposed to refer to here. Specific proposals concerning the future regulation of psychotherapists, counsellors, applied psychologists and others are interwoven with the proposals for medical practitioners at various points in the White Paper. The three professions referred to will be dealt with in the same way, though not at the same time - applied psychologists will be regulated before psychotherapists and counsellors. The main provisions affecting those professions may be summarised as follows:
1. Except for the pharmaceutical profession, there will be no new regulators
2. Psychotherapists, counsellors and applied psychologists will be regulated by The Health Professions Council ("HPC")
3. The council of HPC, along with all other regulators, will be subject to the following changes:
a) it will have fewer members
b) there will be at least parity of professional/lay composition, subject to future review
c) members will be independently appointed by Appointments Commission
d) there will be a duty to deal with the interests of all stakeholders
e) it will be accountable to Parliament
f) meetings will be open to the public
g) it will function more like an executive board and deal only with strategic matters, rather than with operational matters
4. HPC will draw members for its disciplinary tribunals from a central list of those persons who have been vetted and approved to sit on such tribunals
5. Disciplinary procedures will be subject to the concept of fitness to practise
6. The standard of proof in disciplinary proceedings will be that applicable in civil rather than criminal proceedings but on a sliding scale, so that, in the most serious cases (e.g. risk of loss of livelihood) the standard of proof will be virtually identical to the higher standard of proof in criminal proceedings
7. Revalidation of all practitioners at regular intervals by HPC
8. HPC will be responsible for educational standards
9. HPC must make proposals by Jan 2008 concerning the regulation of those in training
10. The government will seek, where possible, to promote common standards across all the professions in question, such as standards of professional conduct and of professional practice relating to areas of practice that require greater harmonisation. While recognising that there needs to be appropriate flexibility to reflect relevant differences between professions, the government believes that all professionals undertaking the same activity should be subject to the same standards of training and practice, so that those who use their services can be assured that there is no difference in quality.
A notable absence in the White Paper, compared with the Foster Review, is any proposal to delegate to existing voluntary regulatory or professional bodies any aspect of regulatory function on behalf of the regulator, save in special circumstances relating only to the NHS. It seems highly unlikely, in such circumstances, that there will ever be any scope for the continued operation, following the introduction of regulation by HPC, of the Independent Complaints Organisation currently being set up by UKCP.
Another consequence of the White Paper is that proposals formerly put forward for the talking therapies, along with applied psychology, to be regulated by a new and separate regulator, such as the proposed Psychological Professions Council, are most unlikely ever to come to fruition.
The government White Paper, while not casting in stone the proposed legislation that must be introduced, in order to effect these changes, makes it much less likely that future developments in this area will differ significantly from what is now proposed in the White Paper.
In the meantime, The Sector Skills Council for Health has launched its consultation of all interested parties, in order to develop an initial competence framework to identify the scope of practice involved in the area of psychotherapy and counselling. The College was invited to contribute its views in that consultation process, which has now closed.
To access THE COLLEGE SUBMISSION TO SKILLS FOR HEATH, please click here.