PSYREG
       
   
       
     
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  FEBRUARY 2011

 
  Important News - Government abandons plans for statutory regulation

 
 
 
  The government has now halted the project to regulate the talking therapies via HPC. In its command paper published yesterday ‘Enabling Excellence’, it makes clear that statutory regulation will not apply to any new fields (except herbal medicine, following EU law). The Council for Healthcare Regulatory Excellence will aim to kitemark existing registers, such as UKCP, yet without the direct and intrusive framework of HPC. Practitioners will be able to use the title they choose, and registration with a CHRE-approved list will not be obligatory.  
     
 
This is the result we hoped for in the campaign, and the government seems to have responded to many of our arguments. We are very pleased with this development, and with the dialogue with politicians that has been possible. We should remember that the detail of CHRE kitemarking is not yet known, although preliminary talks with them seem positive. Reading between the lines, the government message seems to be that basically practitioners should sort out their own system, and if this fails, they may consider some form of statutory regulation at some point in the future. So, there is still a lot to be done, but we have achieved a substantial victory.
 
     
  Thanks once again to everyone who has participated in and supported the campaign.  
 
     

 

Dear Colleague,

The Health Professions Council have now published their Draft Standards of Proficiency for Psychotherapy and Counselling. Although they have been working on the proposed regulation of the talking therapies for the last three years, the Standards will surprise many therapists and counsellors. They apply more to medical processes than to therapies, and will be unrecognisable to many practitioners. Indeed, they seem to apply more to a surgical team preparing a patient for an operation than to the open-ended relationship-based work of a talking therapy. The Standards dictate that practitioners should:

- know how to operate equipment and minimise the risk of infection.
- know how to select appropriate hazard control and risk management, reduction or elimination techniques.
- have a knowledge of health, disease, disorder and dysfunction.
- be able to evaluate and implement intervention plans using recognised outcome measures.
- know how to use protective equipment.
- know how to formulate and deliver plans and strategies for meeting health and social care needs.
- understand the principles of quality control and quality assurance and conduct audits correspondingly.
- maintain an effective audit trail, participate in audit procedures and work towards continued improvement.
- be able to formulate specific and appropriate management plans including the setting of timescales. 
- demonstrate a logical and systematic approach to problem solving and be able to initiate problem solving techniques.
- observe and record client's responses.
-be able to demonstrate effective and appropriate skills in communicating information, advice and instruction.
- understand the need to engage service users and carers in planning and evaluating the diagnostics, treatment and interventions to meet their needs and goals.
- understand the importance of maintaining their own health.
- know how to meet the needs of the client.

A detailed critique of the Standards is available below, together with a response to the HPC Professional Liaison Group's Report on the proposed regulation of psychotherapy and counselling. Accepting the HPC Standards threatens the talking therapies with the same fate that has met other professions: practice simply becomes a technique of risk management, with the prime concern less the work undertaken with the client than the avoidance of litigation or complaint. Complaints, indeed, would be much more likely given the definition given by HPC of a 'service user': this no longer simply refers to the client, but to "anyone who is affected by the services of a registrant", including a client's relatives or spouse, thus encouraging third party complaints. 


Therapists, on the HPC model, would be obliged to act in exactly the ways they may be encouraging their clients to escape from: submission to rather than questioning of internalised authority, and a conformity to socially-agreed expectations, rather then the fostering of creativity and uniqueness that therapies have traditionally aimed at. Whereas the system of values that the talking therapies have always offered was freed from the moral judgments of social authorities, it is now made to conform to exactly these moral judgments. It will no longer be psychotherapy as we know it.


All trainings in the field will, according to HPC, be obliged to meet the Standards of Proficiency, and the hearing of complaints and fitness to practice cases will use the Standards as a benchmark. Aside from the obvious problem of medicalising the talking therapies, the therapists of the future, in such a climate, may feel they are perpetually under a judgmental gaze, the private space of the therapy becoming the stage for an internalised judge or examiner. The consequences of this on therapeutic practice cannot be underestimated, and there is an irony here that many traditional descriptions of psychotherapy define it as the effort to find freedom from the internalised observer-judge that may be at the root of the client’s unhappiness. 

While we unreservedly support codes of ethics and practice that ensure the practitioner's accountability, we do not believe that HPC's approach is suited to our field and so urge you to write to both the Department of Health and to your MP explaining what is wrong with the current proposals. If the Government and HPC recognise how many therapists and counsellors will refuse to register with HPC, perhaps they will realise the enormous mistake they are making, and our field may not face such a grim future.

 

Arbours Association

Association for Group and Individual Psychotherapy

Association of Independent Psychotherapists

Centre for Freudian Analysis and Research

The College of Psychoanalysts-UK

The Guild of Psychotherapists

Philadelphia Association

The Site for Contemporary Psychoanalysis


 
       
 
LATEST NEWS
 
 

The judicial review of HPC is now in its first stage. Documents prepared by Dinah Rose QC and John Halford of Bindmans have been sent to the High Court which point to problems with the HPC's actions to date. It had been charged with assessing the regulatory needs of counselling and psychotherapy and whether its own system was capable of accommodating this field, yet proceeded as if this was a foregone conclusion. Despite stating several times unequivocally that it had not made any attempt to study these questions, HPC could then write to the Department of Health in December 2009 claiming that it had in fact done so. Attempts to query this contradiction proved fruitless.

 

The JR papers discuss and document this, as well as other major failures in the process, which indicate that the HPC did not approach its work in a rational or fair way. Alternative models of regulation were not given proper consideration despite being repeatedly brought to HPC's attention. Key questions about the nature of the talking therapies were ignored, and hardly any of the HPC's criteria for regulating professions, such as homogeneity of knowledge base or practice, are applicable to our highly diverse field.

 
 

The first set of documents will now be scrutinised by the courts. The instructing organisations are The Association for Group and Individual Psychotherapy, The Association of Independent Psychotherapists, The Centre for Freudian Analysis and Research, The College of Psychoanalysts-UK, The Guild of Psychotherapists and The Philadelphia Association. Funding of the review has been made possible by contributions from thousands of therapists and members of the public who feel strongly about the issue.

 
 

Significantly, the Department of Health has now said that it will await the outcome of the judicial review before acting on the HPC's recommendations and that it is exploring alternative models of regulation. This is an important decision, as until now the DoH has simply stated that it will regulate the talking therapies via HPC, and the HPC itself has refused to discuss alternative models of regulation. The fact that other models will now be studied is real progress, and we hope that the DoH will work with our organisations and examine the models used in other countries, where regulatory arrangements have been arrived at that are satisfactory to both government and the field itself. 

 
       
 
September 2010
   
 
We’ve just heard from the High Court that there will be an oral hearing on 10 December to examine two questions prior to the Court’s decision on the Judicial Review. Firstly, there is the question of why the Judicial Review was not begun sooner given the last government’s wish that HPC assess the regulatory needs of the therapy field. Secondly, whether the Secretary of State for Health is an interested party or not.

 
 
It is doubtful if there will be any further development in the Judicial Review process until after this hearing so we will keep you informed of its results as soon as possible after 10 December.
 
 
Many thanks for your support.