Last month we published our report, Unsafe Spaces: Why the lack of regulation in counselling and psychotherapy is endangering vulnerable people. The report is highlighted in this month’s edition of the BACP’s magazine Therapy Today (click here and go to page 5).
As a slight correction to the Therapy Today article, although it correctly states that the report calls for “counsellor” and “psychotherapist” to be made protected titles, we didn’t call for the title “coach” to be protected (though we did recommend consideration be given to protecting other titles, such as “psychoanalyst”).
The Unsafe Spaces report was also previously mentioned in the Mail on Sunday.
Our report found that one in four counsellors or psychotherapists struck off by the BACP or UKCP for misconduct continued to practice after being removed from the register. These included individuals struck off for very serious misconduct, including sexual abuse of clients. We believe this evidence shows the pressing need for regulation of these professions in the UK rather than the voluntary registration systems we have now.
Last week the report, Unsafe Spaces: Why the lack of regulation in counselling and psychotherapy is endangering vulnerable people was published on this site. Authored by Amanda Williamson and I, the report found that one in four therapists struck off by the BACP or UKCP continue to practice.
Today, the report gets a mention in this Mail on Sunday article about a therapist and spiritual healer who has been accused of psychological manipulation. Check out the blue box at the bottom, which has a few names that will be familiar to people who read this blog. The article also states that Geraint Davies MP is hoping to re-present his previous Private Members Bill on psychotherapy regulation.
In recent months I’ve been working with Amanda Williamson on a report, Unsafe Spaces: Why the lack of regulation in counselling and psychotherapy is endangering vulnerable people. The report is available for free download from this website.
Protected Titles or Protected Functions? How best to regulate psychotherapy?
I’ve been mulling over some of the counter-arguments to bringing in regulation for counselling and psychotherapy. One of the main objections is that if “counsellor” and “psychotherapist” were made protected titles, practitioners who didn’t want to be regulated would simply switch to other job titles. “Life coach”, “Jungian analyst”, “humanistic therapist” and so on.
The survey I recently did suggests that protecting those titles would have at least some impact. People looking for therapy to help with a mental health problem are more likely to look for a counsellor or psychotherapist than a life coach. So somebody switching their job title could expect to lose business by doing so. That said, on its own this doesn’t seem particularly foolproof as a measure to squeeze out the cowboys.
Pathological Demand Avoidance: does it exist, and if so what is it?
In recent years in the UK there’s been an increasing amount of talk about something called pathological demand avoidance, or PDA. It’s described as a subtype of autism that children (and some adults) are increasingly being diagnosed with. The National Autistic Society has been promoting acceptance of it, there’s a PDA Society, training courses and parent support groups are being set up. Paediatric and CAMHS services are seeing increasing numbers of referrals requesting assessment for PDA.
This is perhaps surprising because (and you wouldn’t know this from scanning the NAS or PDA Society websites) it’s not a recognised condition. Neither the DSM-5 nor the ICD-10 (the two main classification systems for mental disorder) have anything to say about pathological demand avoidance. The NICE guidelines (which set out best practice for UK clinicians) don’t mention PDA in their guidelines for diagnosing autism either for children or adults. It’s virtually unkown outside the UK (and a few parts of Scandinavia and Australia), and the research evidence base for it is wafer-thin.
So, I decided to look into PDA. What is it, does it really exist, and if it does exist, is it really a form of autism?
Would regulating counselling and psychotherapy make a difference?
I’ve argued on this blog in favour of making counsellors and psychotherapists protected titles in the same way as nurses, social workers, occupational therapists etc. A previous survey suggested that at least one in four counsellors or psychotherapists who were struck off by the BACP or UKCP for misconduct simply carried on practising. And that’s perfectly legal to do, because neither “counsellor” nor “psychotherapist” are protected titles.
In response, some have argued that there’s no point in having protected titles. Suppose you have a practitioner who’s been struck off and doesn’t want to stop practising, or doesn’t want to submit themselves to a statutory regulator, or simply never acquired any qualifications in the first place. If protected titles were brought in, all they would have to do is change their job title. Say, to “humanistic therapist” or “Jungian analyst”. I decided to test this hypothesis.
Following a recent controversy over conversion therapy and transgender people, I contacted the Professional Standards Authority for comment. Today I received a reply.
Conversion therapy is a controversial form of psychotherapy which aims to turn gay people straight, or in some cases to revert transgender people to their birth gender. Pretty much all the research evidence suggests it’s ineffective and harmful. Most psychotherapy organisations in Britain have condemned conversion therapy for gay people, but have not done so for transgender people.