A Professor's Perspective on the process

Thanks to Prof Ian Parker for allowing the publication of this letter to the President of the HPC:

Department of Psychology and Social Change
Manchester Metropolitan University Elizabeth Gaskell Campus
Hathersage Road Manchester M13 OJA UK
Ian Parker BA PhD AFBPsS CPsychol FRSA Professor of Psychology


13 April 2009

OPEN LETTER

Anna van der Gaag
President, Health Professions Council, UK
Park House
184 Kennington Park Road
London, SE11 4BU

Dear Anna van der Gaag,

I attended the HPC stakeholder consultation day in Manchester on 31 March 2009. There were three presentations in the morning. The first was by an art therapist, Diane Waller who I have heard before extolling in similar vein the virtues of the HPC, to the psychoanalytic section of the UKCP last year, a meeting where she reassured therapists that all they need to do is send in their registration payments and ‘nothing will change’ for them. The third presentation was by two speech therapists, and they spent much of their time telling of their delight in being consulted by the government on policy issues, so the message here seemed to be that therapists who are brought into the HPC will be recognised in some way.

The second presentation on that morning was the most disturbing, for three reasons. First, there was the content of Jonathan Coe’s presentation, which did indeed make the point that there is abuse of power in therapy. Some of us have long argued, and we did again make the point in our small groups in the afternoon, that resources should be directed to law centres, for example, to demystify the legal process and make it possible for clients who have been subjected to this kind of treatment to have recourse to the courts. Legal remedies are concerned with each separate infraction of the law and do not, as HPC appears to do, chain one crime to another into a moral system (as is the case, for example, in the hearings that view driving under the influence of alcohol or possession of A class drugs as evidence of bad character).

The Coe presentation was disturbing, second, because the patient whose case was described at the end of his talk was, we were told, present at the meeting. This meant (as Darian Leader from the College of Psychoanalysts – UK pointed out) that key elements of the patient’s relationship with her therapist were replicated as she was spoken about as an object of abuse. It is this aspect of the presentation that, whether or not the patient is enrolled to say that she is happy with this situation, already merits what we were treated to that morning being described as scandalous. Abuse in therapy often occurs precisely because the patient believes that it is for their own good.

There is a third reason the morning as a whole was disturbing, however, which is that the second presentation on ‘ethics’ was sandwiched between the two other presentations that were designed to reassure and flatter us as stakeholders. This is an indictment of the HPC approach to the world of psychotherapy. Perhaps the HPC knows, or perhaps the arguments that many of us have been making to it are simply not noticed, that our problem with the HPC regulation is precisely concerned with ethics. The particular psychoanalytic point that was made about the Coe presentation could be articulated in different ways by psychotherapists working in other orientations. Ethics grounds our work, and it means that for many of us the HPC would at least start to make sense if the whole morning had focussed on this question.

Ethical questions are now bringing therapists together who are shocked by assumptions made about good behaviour, and how it may be enforced, that underpin the work of the HPC. If the HPC cannot understand the difference between their conception of good behaviour and therapeutic practice, then surely the organisation could take a minute to reflect on the fact that there is at least a serious misunderstanding, a gulf between the organisation and those it seeks to regulate. Thousands of psychotherapists and counsellors have signed petitions and attended meetings organised by a myriad of groups that have sprung up against state regulation. The HPC should appreciate that regulation as it is presently conceived is anathema to good ethical therapeutic work, and draw the conclusion that it is time to step back, to abandon this process, and to look to other models (such as an open register of practitioners that has been adopted in other countries following consultation). Failure to acknowledge that problem, that gulf, is also, is it not, scandalous?


Ian Parker