Psychotherapists have learned from Chiropractors mistakes

May 5, 2010
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lisabon2 When The GCC refused to reveal to lawyers representing  psychotherapists, why the GCC’s former deputy registrar Greg Price ( Mr Price was administering complaints for the psychotherapist regulator UKCP) had to leave the GCC and whether he was a suitable person to be involved in the administration of complaints, the psychotherapists smelt a rat. According to an Article by Sarah Boseley in the Guardian

 Psychotherapy rebels consider rebranding to avoid state regulation

Profession split over plans for mandatory registration as critics say abuses show self-policing ineffective

Thousands of psychotherapists are considering adopting new job titles to avoid government regulation of their profession, the Guardian has learned.

Some will drop the title of psychotherapist or counsellor and describe themselves instead as "Jungian analyst", "psychoanalyst", "body therapist" or "humanistic therapist" instead.

Some 3,000 psychotherapists have signed a petition objecting to regulation by the government’s Health Professions Council (HPC), which already regulates and disciplines other groups with registered titles, such as psychologists and arts therapists.

The mass defiance has split the profession and deeply troubles some members. It also angers and disturbs those who have suffered abuse at the hands of psychotherapists and their supporters.

Recent cases include that of Derek Gale, a psychotherapist in Essex who also practised as an arts therapist. When complainants had no success with the United Kingdom Council for Psychotherapy, the existing professional self-regulatory body, they were able to go to the HPC because he was also registered as an arts therapist.

In March last year, the HPC struck off Gale following the testimony of four former clients. He was found to have had inappropriate relationships with them, which included telling them his sexual fantasies, smoking cannabis in front of them and suggesting one should take advantage of "unlimited sex".

Ian Griffiths, who chaired the HPC disciplinary panel, said Gale had "a cavalier attitude towards the needs of clients and the requirement to follow clear guidelines … The behaviour that has been found to constitute misconduct is various, wide-ranging and happened over a long period of time. Some of it was of a very serious and fundamental nature."

Following the HPC ruling, the UKCP also struck off Gale, but television producer Howard Martin, who brought the original complaint, was unimpressed. "I was trying to tell them about Gale for three years. The UKCP did nothing," he said.

The UKCP is an umbrella organisation for a multitude of small professional groups. It says that complaints must first be dealt with by these organisations.

Dawn Devereaux is a psychotherapist who now specialises in helping people who have suffered abuse at the hands of other psychotherapists and counsellors. She says it is common: she sees around 15 clients a week. "It is almost all of my practice now," said Devereaux, who has just written a chapter for a book on the issues for the Royal College of Psychiatrists.

"Sexual abuse gets all the publicity and that is quite common – not just actual sexual contact but people being in a very seductive sort of relationship," she said. "Often what happens is that while they are in therapy, clients feel very special and it is like a romantic relationship. All sorts of fantasies arise. Often people are very depressed when they go into therapy and they have a very seductive relationship with the therapist and the problems disappear."

Clients become dependent, fearing the end of the relationship with the therapist, she said.

It happened to Karen Blakey. The psychotherapist she had been seeing started coming to her house in early 2004 and calling and texting her. "I was very poorly at the time," Blakey said. "He gave me hope and made me dependent on him. He then pushed a sexual relationship with me which I didn’t want, but I was so afraid of losing him and my depression coming back.

"It carried on from January to the end of May, when I couldn’t cope with all the emotions any more."

She went to see her GP and broke down. The primary care trust ended its contract with the psychotherapist, but later Blakey found he was practising elsewhere. "He is still working from home. He has got adverts on the internet," she said.

The fight against HPC regulation is being led by a group called the Alliance for Counselling and Psychotherapy Against State Regulation, which was co-founded by the present chair of the UKCP, Andrew Samuels. It launched a petition whose signatories, including Samuels, state that they are "considering a position of principled non-compliance".

This is spelled out in a document on its website. It involves finding a professional title which is not registered with the HPC. Samuels has committed himself to refusing to hand over details from the UKCP register of members who have decided not to comply.

Samuels insists he supports the official UKCP position, advocating a multitrack approach. "A substantial number of our members definitely want to register with the HPC," he said. "We also have a substantial number who definitely don’t.

"Some feel that what the HPC defines as psychotherapy does not fit with what we do, so they will call themselves something else and thereby not have to register."

He says he agrees psychotherapists need regulation, although not what is proposed by the HPC. He has been extremely antagonistic towards the HPC in the past, but said: "I have changed my job [to chair of the UKCP] and I have changed my views. I actually don’t think that blind opposition to HPC is what’s needed. What is needed is for the HPC to listen to the sensible criticisms that are being made."

However, there is a major schism within the UKCP between those who believe outside regulation is necessary and those who think psychotherapists should police their own.

The mental health charity Mind, which has supported people who have been abused in the past,

believes independent statutory regulation of counsellors and psychotherapists is crucial to protect the public.

Paul Farmer, Mind’s chief executive, said: "While most therapists do an excellent job, the people that do have a bad experience have very few options on how to complain and no guarantee that malpractice will ever be held to account. It is clear self-regulation is not working.

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  • Hussein D

    the above perspective form the Psychiatric profession is an interesting one, and somewhat analogous regarding Chiropractic currently…
    i am glad to see Richard not going the route of osteomyology as title..
    it is easy to see why people would, however, not holding onto the tenets of Chiropractic and the title, simply capitulates to the medicalisation/GCC approach, without determining the validity or lack thereof, of the primary Principles of Chiropractic…
    anybody recall how many there are???
    to my knowledge, these are not taught in colleges to the degree they might be..

    the skeptics have a point, insofar as, the Chiropractic profession in the UK has not promoted the efficacy of

    i think it quite preposterous that the BCA fell for the phrase,
    ‘not a jot of evidence’ as a ‘red rag’ and went for it… the public are smarter than either side has given them credit for, and can figure out that phrase is a blanket swipe, by somebody who has clearly not read or explored all the evidence at hand..

    now the BCA in their self righteousness have dug the largest hole in European Chiropractic history, and will likely get frantic and – dig deeper…

    the general membership of BCA et al are decent people trying to do the best for their clients, but each party seems to theink they are perfectly right all the time, hence the legal professions are the only ones who gain, not Singh, not BCA, not GCC, not the average Chiropractor – and certainly not the average Joe or Jane who wants to get the correct care for they or their families…

    as always the patient/public loses most…

    time for the Chiropractor ‘on the ground’ to get to work and steer the leaders of the profession to get the facts out there, stand firm over what they Can do well, and refer out for that which they Cannot do…

    Come on Portsmouth today!!! HD

  • http://spinaljoint.com Richard Lanigan

    I wonder what Cognito (aka Greg Price GCC deputy registrar)is up to these days?

    Hi Barney, that is really interesting, while I have been a sharp critic of the GCC, it has been about questioning people who pretend to have all the answers and will not be held too account. How to regulate chiropractic is a difficult one and unlike Margaret Coats I would never dream of pretending that I had the perfect solution and the best way to do it.

    Personally I believe regulation should be completely independednt of the profession and done by the users, the people who should benefit most from regulation. They would obviously seek advice from the profession but they would ultimately decide the type of service they wanted and chiropractors who did not want to practice under those terms could practice outside the regulatory umbrella giving patients a choice. Do You want a regulated chiropractor or a non regulated.

  • dazed

    lets hope they don’t seek the services of Cognitio!

  • Barney

    The following (edited) comments are from The Times today

    Certainly there needs to be some independent way to address complaints as Colin Walker asserts.

    However, as Darien Leader, writes – and this is a particularly interesting parallel with chiropractic – one size does not fit all and there are concerns about ‘outcome-obsessed risk management.’

    Should psychotherapy be state-regulated?

    Recommend? (1) YES

    Colin Walker

    Policy and campaigns manager, Mind

    Psychological therapies are the cornerstone of mental health treatment and can be crucial for helping people with mental health problems. Psychotherapists can play a vital role in supporting people in some very difficult circumstances and it is this level of need that makes it so important that when it comes to treating patients with respect, dignity and care, therapists can be relied upon to get it right.

    Given the distressing accounts that we have heard from some of the service users that we represent, it is clear that the present system of self-regulation is not working. The solution is simple: a system of regulation that is truly independent of the profession it regulates, that requires professionals to attain set standards of training and makes registration a legal requirement to practise.

    There has been some conflict in the field about who should be the regulator, with anti-regulation groups coming out against the Health Professions Council. This body already regulates art therapists and psychologists, among others. For Mind, it’s not about who regulates but about how it is done — as long as regulation is statutory and independent, then we have no preference who does the job.

    NO

    Professor Darian Leader

    President of the College of Psychoanalysts-UK

    With a new government, the time is right to reconsider Labour’s project of regulating the talking therapies via the HPC. In 2006, the Department of Health commissioned the two main umbrella organisations in the field — The United Kingdom Council for Psychotherapy (UKCP) and the British Association for Counselling and Psychotherapy — to carry out a consultation on key issues.

    The result was unambiguous: the HPC was inappropriate as a regulator, unable to deal with the complexity of the field. It was designed for professions such as radiology and physiotherapy, not the human relationships that therapy explores.

    The HPC’s guidelines state that the professions it regulates must possess homogeneity of theory and practice. Yet the field is radically split. Therapists from different traditions do different things: some aim to remove the patient’s symptoms, some don’t; some aim to access the unconscious, some deny the unconscious exists; some give advice, some maintain silence.

    The HPC’s fitness for practice codes make this freedom impossible and therapists risk being struck off for conduct which no court would consider criminal. A rigid moralism reminiscent of McCarthyism lies at the core of its procedures, as witnessed in the recent “trial” of a psychologist for making sexual jokes at a private dinner.

    All therapists accept the need to practise lawfully and that rare cases of abuse must be dealt with firmly. The HPC’s record is dismal: it dismisses more than 70 per cent of complaints as “no case to answer”, compared with just 10 per cent by organisations such as the UKCP. Likewise, it has no proper mediation procedures, even though most therapy complaints are dealt with successfully in this way.

    Therapists opposed to the HPC are in favour of statutory regulation. They want an independent regulator, just not one which will change the very meaning of the word “psychotherapy”, turning clinical work into an outcome-obsessed risk-management exercise where therapists will no longer dare to challenge their patients.

    MAYBE

    Professor Andrew Samuels

    Chair of the United Kingdom Council for Psychotherapy

    It is hard to believe that regulation by HPC is not yet a done deal. The United Kingdom Council for Psychotherapy and numerous others have backed rigorous, independent statutory regulation for years. Yet the battle rages and the profession is utterly divided.

    Can organisations such as the UKCP ignore the doubts and fears of its members over HPC regulation? These are serious and experienced practitioners who work under ethical codes whereby they can be struck off if it comes to it. At the same time, many of our members warmly welcome HPC regulation.

    We in UKCP have developed what we regard as a sophisticated and responsible way to manage the problem. We continue to negotiate to get the best possible regulatory regime for public, patients and practitioners.

    But our efforts might not succeed in achieving this goal, so we are also calling for the new government immediately to organise a convention to discuss alternative futures for the profession. Because many of our members seem likely to refuse to register with HPC, we are developing an alternative approach to professional regulation. This is a pragmatic and considered response on our part to a situation created by others.

    All parties in the regulation debate should now strive to create a regulatory regime that will benefit the recipients as well as the providers of psychotherapy.

  • http://spinaljoint.com Richard Lanigan

    Yes the GCC rebranded version of chiropractic is a protected title under UK law. However if you are recognised as a chiropractor in any other EU country you can use the title because EU law trumps national law. As I am a member of the Irish Chiropractic Association and practice in Ireland I am also a member of the ECU, which makes me a chiropractor not an osteomyologist

    People can call themselves whatever they like however if it looks like a rose and smells like a rose, calling a rose an osteomyologist will not make it an osteomyologist despite the best efforts of of those who were not clever enough to get into medical school.

    I am sure there are lots of “true” chiropractors on the register who do not want to pay VAT. I resigned from the GCC “because they are not fit for purpose” and lack integrity and I would rather pay VAT and practice under common law than have Margaret Coats or her private investigators tell me how to practice.

    I respect peoples right to make their own decisions however, I hope you respect my right to point out why they are wrong to support the GCC

  • Simon T

    I understand that chiropractor is now a protected title in the UK. Some in the profession appear to have done a rebranding trick to avoid statutory regulation by calling themselves osteomyologists. I just wondered what your thoughts were on this?

    It appears that you think you are a true chiropractor and those that go along with the GCC are not? Is that right?

  • http://spinaljoint.com Richard Lanigan

    Hi Simon,
    Why would I call myself an osteomyologist when I trained as chiropractor at AECC and practice chiropractic? I am not sure I understand your question.

    You see the people doing the “rebranding” of chiropractic are the BCA, McTimoney and the GCC. You presumably have accepted medical doctors and physiotherapists rebranding of chiropractic and pay them £1000 a yearto do this I refused because the GCC is not in line with the internationl consensus of chiropractic.

    I am just a bog standard Irish Chiropractor and would not know what an Osteomyologist was if I met one. Perhaps you could enlighten me.

  • Simon T

    Richard, why do you not call yourself an osteomyologist as so many other rebranded chiros and osteos have done?

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