As a senior accredited member of the British Association for Counselling and Psychotherapy (BACP) and a registered member of the United Kingdom Council for Psychotherapy (UKCP), I believe our profession is behind the curve (All psychotherapists in England must be regulated, experts say, after abuse claims rise, 19 October).
The truth is that I could have set up in practice without going through the rigorous processes that these two organisations require of me. The fact that I chose to be held accountable to two separate bodies is because I know that what psychotherapists and counsellors do is deeply important.
Our regulatory bodies require us to undertake ongoing training and have regular supervision with an experienced practitioner who should support and challenge us, and also require that we too undertake our own therapy so that we pay attention to our own wounds and legacies in order to minimise these becoming entangled with our clients.
In addition, both these bodies have complaints procedures, of which I have direct experience early in my career. There was no legal requirement for me to do this, but I learned from the process.
I believe we need a new regulatory body, separate and distinct from the membership organisations we already have, to hold us to the highest standards and protect people from rogue practitioners. We need an organisation whose sole job is to set, monitor and enforce standards. This will give our profession greater standing and the public greater protection and confidence in us. So, let us have statutory regulation and let us not be afraid to have it.
Philippa Smethurst
Duns Tew, Oxfordshire
• It is relatively straightforward to regulate the practice of psychotherapy. Virtually all designated psychotherapy training courses last from four to seven years and follow similar requirements. Most of those who complete this demanding course of study will be accredited as a psychotherapy practitioner and be able to register with the UKCP or an equivalent body, so there is a well-established professional pathway.
If the title of psychotherapist were properly protected, members of the public seeking psychotherapy (as distinct from counselling) would be far less vulnerable to abuse or poor standards of care from ill-trained – or even untrained – people claiming to work as psychotherapists.
The issue is more complex with counselling. Counselling practice spreads over a wide range of organisations and specialisms, and training correspondingly varies in type and intensity. Anyone can currently go on any kind of course in some version of “counselling” and call themselves a counsellor on the back of that. Even good counselling training courses do not necessarily insist on the degree of personal therapy needed for more reliably safe practice, and getting sound regulation in such a wide field is challenging.
In addition, the distinction between counselling and psychotherapy has been muddied in recent years by courses – including good ones offered by reputable academic institutions – in “counselling and psychotherapy”, which effectively provide training in counselling with the implication that this entitles practitioners also to describe themselves as psychotherapists.
Regulation of counselling is more challenging than with psychotherapy and needs to be done, but psychotherapy can be tackled more quickly with immediate corresponding benefits to a vulnerable public.
Sue Lieberman
Retired UKCP psychotherapist, Edinburgh
• Your article highlights the potential for the abuse of power that may take place during counselling sessions, given the private nature of the work and the client’s vulnerability. But the root cause of this isn’t the lack of regulation of the individual therapists, it is the lightweight training process and the ease of access to psychotherapy courses.
I trained as a psychotherapist with a well-known London college and at the end of the three-year degree I knew every theory under the sun, but had been taught nothing about the effects of talking therapy on brain function, nervous system function, or the potentially harmful physiological effects of rekindling traumatic experiences.
At the end of the training I did practice for a short time before fully understanding the inadequacies of the training and the profession. The scope for causing more harm than good became apparent. None of my fellow students really knew what they were doing, and I genuinely fear for their clients.
It is not the regulation of the practitioners that needs attending to, it is about the regulation of course providers, ensuring that what they are providing is adequately researched and proven to be effective.
The only barrier to entry for many courses is money, not qualifications or emotional and intellectual intelligence. If you can afford to do the training, the course provider will find a way to accept you. The course providers and institutions need scrutinising and the entry standards raised.
Allison Alexander
Brighton
• A robust system of regulating therapists has been in place since 2012. It is the Accredited Registers programme run by the Professional Standards Authority (PSA). Therapy organisations can apply to have their own registers accredited by the PSA, which involves meeting and maintaining rigorous governance standards in which public protection is prioritised.
Any therapist on such a register has been properly trained, is subject to professional and ethical codes of practice and a robust complaints procedure is available to their clients. Registrants of a PSA-accredited register will display the PSA logo in their publicity.
As this is voluntary regulation, it does not prevent anyone calling themselves a psychotherapist or counsellor. Only statutory regulation would protect the title. Many counsellors and psychotherapists would like to have their title protected, but not if it means the rich variety of therapeutic approaches, many of which are non-medical and not available from the NHS, get excluded in pursuit of the standardisation and manualisation that makes statutory regulation easier to implement.
The last Labour government in 2010 attempted to impose such a prescriptive statutory regulation of counselling and psychotherapy under the then Health Professions Council. It did not survive the first legal challenge brought by members of the profession. The current government should learn from this.
Any future statutory regulation needs to embrace and protect the diversity of therapeutic approaches, especially those outside the medical paradigm, that psychotherapy offers while ensuring optimum public protection. This will only be achieved through a constructive collaboration between government and the psychotherapeutic professions.
John Fletcher
London
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