Regulation of Psychotherapy in the UK
Unlike medicine, nursing or psychology, psychotherapy and counselling in the UK are professions that are not regulated or licensed by government as they may be in some other countries. A few years ago the UK government declined to assert State control over psychotherapy and counselling in response to a petition signed by individuals who wanted the State to do so. Many professionals in the field vehemently objected to external control of their work.
Private trade organisations have set themselves up as systems of over-sight and management of professionals who choose to become paying members. Membership with them is neither a legal nor professional requirement in the UK, but is purely voluntary. Some fully qualified practitioners take out membership and other fully qualified practitioners choose not to, as is their right to do so. I operate within the code of ethics, goodwill policy and professional boundaries laid out in my agreement, and put both the welfare of my patients and customer service first in my practice, operating in life according to personal responsibility, accountability, autonomy, transparency and fairness. I currently choose not to take out annual membership with any private organisation whilst it remains voluntary. However, if it is important to you that you see a practitioner who is a member of a private trade organisation then please seek help via one of their membership lists, which contain the details of thousands of counsellors and therapists who choose to be affiliated with them.
For and Against
Opinion is divided between those who favour regulation and over-sight of the helping professions by government or private organisations, and those who object to such control and interference. Many believe that centralising power and asserting even more control over individuals under the threat of scrutiny, penalty or loss, is simply allowing citizens to further submit themselves to a ‘Nanny State’ culture of fear and taxation, with citizens already suffering the daily loss of civil liberties and freedoms that countless agencies impose upon us all in return for our paying for the privilege of being dictated to, managed, and sometimes punished by them for non-conformity. Others believe that without over-sight and regulation patients and clients could be easily harmed or exploited by unscrupulous practitioners, the implication being that adult citizens are not competent enough in themselves to recognise and address any problems they encounter. This is one of the main arguments used by advocates of so-called ‘regulation’.
Whilst there are valid points and arguments on both sides, it is also true that unscrupulous practitioners continue to exist in every field whether professions are regulated or not. And I have personally witnessed toxic individuals who are members of regulatory organisations e.g. psychologists, counsellors, doctors etc, manage to remain within the rules and ethical codes prescribed by their institutions, and who still manage to slip through the cracks and loopholes in policy manuals and arbitration panels, whilst being permitted to practice in incompetent or objectionable ways.
Furthermore, I have also seen with my own eyes such individuals escaping penalty from their regulatory bodies even when substantial evidence existed against them. Breaches of the spirit of ethical codes can still be interpreted favourably in terms of the letter of those codes, thus allowing toxic practitioners to evade accountability of such breaches with the aid of bias and favour brought by committees of bureaucrats serving their own interests, and where membership fees fund the entire organisation. A similar situation exists in courts of law around the world, whereby the guilty escape justice every day of the week based on technicalities, clever argument, and the absence of common sense, all the while making fortunes for those who operate within the system.
Misuse of Complaints Procedures
A small minority of highly toxic individuals (patients, members of the public, and even other practitioners) attempt to use the institution’s complaints procedures to indulge their own needs for cruelty and destruction, seeking to ruin the lives and careers of competent, caring and genuine member practitioners who did them no harm whatsoever. Even when offered kindness, fairness, refunds and recompence, such individuals often still desire to act out histrionic or vengeful impulses that defy reason. Complaints to authorities often then become the convenient vehicles by which they are permitted to wreak such vengeance, often in long, drawn-out proceedings spanning months or years, that can be ruinous to health, reputation and livelihood.
Lastly, I have been a patient (during my training years) to therapists who were ‘registered’ with private organisations and those who were not. The most helpful, insightful and ‘human’ therapists I saw either chose not to be members of such institutions, or had the personal integrity to put common sense before institutional policy when required, thus breaking rules that defy and defeat common sense. By contrast, one very abusive, manipulative practitioner I saw very briefly (before I had the good sense not to return) not only trumpeted such membership, or ‘registration’, but also occupied executive and teaching positions in a well-known therapy training centre in London.
Despite the culture of suspicion that has developed around questions of ‘registration’ (a quasi-medical-sounding culture created by those who wear membership as a badge of honour and who may treat detractors with suspicion), there is nothing sinister, shameful or criminal about non-affiliated practice. Membership of a trade organisation guarantees very little in terms of real practitioner competence or real protections for the public, and in my experience there is no relationship between registration and skill or competence, or the absence of skill or competence with non-registration.
Personal Responsibility and Working Philosophy
Having been a member of a regulatory body for many years as a requirement of my employment at the time (employers are often compelled by the demands of insurance companies with a corporate agenda that seeks only to maximise profits), my current position on the question of whether or not to have increasing, automatic over-sight and regulation over individuals and their livelihoods errs more towards the recovery and preservation of individual autonomy. I’m passionately supportive of the individual’s power of self-determination, liberty and responsibility, whilst also building into my professional practice sufficient practical safeguards – fully declared upfront – to preserve and empower patients to protect their own interests as competent adults, session by session, in the form of, for example:
- A full psycho-social and risk assessment of patient needs and history prior to any work
- A Goodwill Refund policy that provides a full refund, no questions asked, to anyone at any stage of the work who is dissatisfied with the support they receive in any psychotherapy session
- Numerous guides and written guidance on how best to use therapeutic support
- A common sense complaints process based on caring, fairness and compassion that allows patients to discuss difficulties for the purposes of modifying approach, clearing up misunderstandings or ending the work amicably
- Continuous review and reflection with my patients during sessions, with regular invitations to patients to monitor whether they are getting what they want from sessions; and encouragement to ask for anything they may feel is missing.
- A detailed Agreement setting out boundaries that are designed to make my practice transparent, secure and safe
- A full disclosure policy regarding who I am as a person, the way I work in sessions and my intervention rationale, and my professional status and qualifications
- A substantial Resources section containing psycho-educational material designed to empower patients to make informed choices about their care, encouraging self-support, understanding and self-reliance, thus discouraging long-term dependence on therapy
- A core therapeutic philosophy that values and develops personal authenticity, autonomy and responsibility, which are philosophically opposed to the authoritarian and paternalistic controls asserted by institutions over the free individual, akin to parent over child
- Continuous personal and professional development as a feature of my vocational interest in developing my skills, knowledge and competence in the service of my patients
Your Freedom to Choose
The world does not lack therapists and it is very likely that you have many dozens, hundreds, if not thousands of them within travelling distance of your location. Once again, if it is important to you that you see a practitioner who is a member of a private trade organisation or if you are in any doubt whatsoever, then please seek help via one of many membership lists. Such lists contain the contact details of counsellors and therapists who choose to be affiliated with private trade organisations and regulatory bodies.