Full speech: The new Care Professions Council shows the way to return to reality

Just imagine ... The new Care Professions Council, a return to trust and reality.

Taken from the new website, the section reproduced below refers directly to the possible prospects for counselling and psychotherapy:

2. CPC and the psychological therapies - a new ethos: connection, relationship and authenticity.

The task of persuading the public that the HPC offers effective protection from trained registered practitioners whom they might suppose could be trusted remains incomplete. Finding ways to reassure potential registrants of the benefits of state regulation of the psychological therapies, and to move forward with current regulatory intentions, has been difficult.

There has been steady support for the HPC's efforts from the business interests in the field; however responses to its Call for Ideas and last year’s Consultation included sustained opposition. The new CPC ethos outlined here is an acknowledgment of the validity of some of this opposition.

In its relations with the psychological therapies the CPC recognises that:

• While it is confident that the HPC has been a reasonable organisation to relate to, it accepts that its approach to the subtleties and sophistication of the psychological therapies has been alienated and technocratic;
  
  
• This alienating approach, and its basis in regulatory duress that the HPC has hitherto deployed, repeats many of the difficulties that clients bring to therapy and will be eliminated from the processes of the new CPC;
  
  
• It is intolerable that at present abusive practice is primarily detected and confronted by clients, leading to subsequent investigation and sanctions. The CPC will work strenuously, beginning with the psychological therapies community itself, to move to a pro-active practitioner accountability culture in which, through improved education and training, and peer scrutiny, abuse of clients approaches zero;
  
  
• Clients expect to be able to trust their practitioners. The CPC appreciates that many psychological practitioners do not have a level of trust in its processes that matches the trust they are expected to deliver for clients. Redressing this deficit is an urgent CPC priority.
  
  
• We now concede that ‘regulation’ as it has been proposed, or even ‘self-regulation’, is fundamentally mistaken. The CPC appreciates that previously claimed 'client protection' is undeliverable for psychological therapy clients. Gradated forms of ‘accountability’ that reflect domains of practice, practice populations, full- or part-time employment and levels of practitioner capability are more appropriate and realisable;
  
  
• The existing stringent, externally generated HPC regulatory framework, based on a ‘skills’ or ‘standards’ perspective, promotes false compliance in practitioners who disagree with them, or who find them problematic;
  
  
• Legally binding commitment to such externally generated practitioner protocols that are subject to legalistic fitness to practise protocols invites litigation and defensive practice and this will be ended; they will be replaced via ongoing experiential research that will identify qualities that are more relevant to clients, such as ‘practitioner presence’ and ‘practitioner capability’;
  
  
• Through existing processes of accreditation, supervision and re-accreditation, almost all psychological therapy practitioners are embedded in forms of accountability;
  
  
• Since a considerable proportion of psychological therapy practitioners have been long-term clients, they are highly aware and respectful of how clients experience practitioners;
  
  
• For at least a ‘good enough’ client experience, practitioners need to be embedded in local cultures of accountability that provide proactive, values-congruent scrutiny of practitioner capability and its potential deficits, and that are able to reflect the diversity of the psy field.
  
  
• With appropriate support, an educated person can be enabled to self-assess the quality and extent of their own and their colleagues’ capabilities and presence, and how this plays out in their work with clients. Trainings that do not support an ability to deliver this capability will be deprecated.

Now that's more like it. How might we bring this about?

Sponsored Run - raising funds for the Judicial Review of HPC

I haven't run for nearly thirty years, but this review of HPC procedures is important. It has become overwhelmingly obvious that the only way to get the HPC to listen, and more important, to hear, is to get beyond the administrators and the council of professionals and engage the people who really hold the power - the lawyers. Expensive, 0f course. Hence the need to raise funds, hence I've decided to learn to run.

The PsyReg page gives the background. The latest news is that the Judge in charge has called a meeting (December 10) to put questions to HPC and to those who have raised the Review.

It's important to support the process. I've been getting up early and padding around the backstreets where I live to get in shape. The sponsored run is 5km from Waterlow Park (near Highgate Cemetery) through Hampstead Heath and ends at the Freud Museum (London) on 16th October. I started my regime a few weeks ago by walking for 70 paces, then running 30, and so on, gradually increasing the pace. Some days are better than others. Recently I dug out my faux-fur designer dalmation doggy spot dress that I made for a laugh 20 years ago, and thought I might trot as the HPC Watchdog - the dalmation dog Perdita from 101 dalmations! As the time draws nearer, however, I must admit that I'm probably not going to be able to run the whole thing, but will have to alternate running and walking. And the dress will almost certainly still not fit me on the day. BUT I'm going to give it my best, and last week I went out and bought a new pair of trainers...

If you have found these pages valuable, please click through to the My Charity page and sponsor me, or go to my profile page in the side bar and email me for more details.

Thank you very much.

Janet

Ethical dilemma?

This month's BACP magazine Therapy Today includes the regular feature 'ethical dilemma' which puts a topical question in practical terms and invites practitioners to think about it. Andy Rogers, a Person Centred counsellor working in Further/Higher Education has submitted this thoughtful and poignant response:

This month’s TT dilemma: "Suzanne has worked in a primary care counselling agency for four years and has become good friends with a colleague there, Michelle. Michelle is a highly respected and well-liked member of the team. Suzanne discovered recently that Michelle has been drinking heavily, and for some time. While she appears to be sober at work, Suzanne is fearful for Michelle’s clients and her capacity to work professionally. Michelle became distressed when asked about this and begged Suzanne not to say anything to her manager – she would ‘lose [her] job and become unemployable’. Suzanne feels torn between trying to support her friend to turn things around personally, and the wellbeing of her clients, which increasingly seems to be compromised."

"Andy Rogers, counsellor in HE/FE replies: "
Many potential assumptions are piled on top of each other in this scenario and we should scrutinise them. What constitutes ‘drinking heavily’ and how has this been ‘discovered’? Is Suzanne also ‘highly respected and liked’, or not? What light or shade does this cast on her account? In what sense might the ‘wellbeing’ of Michelle’s clients be ‘compromised’? If Michelle appears sober at work, why is Suzanne fearful? What are Suzanne’s attitudes to alcohol and – more broadly – what values does she hold about how therapists should conduct themselves in their personal lives? At the crux of this dilemma is the question of what it means to ‘work professionally’ and whether our behaviour outside work can compromise our role as practitioners, even if there is no evidence of it being detrimental to our clients. What conduct, then, is unacceptable, and why? What values lie behind these judgments? Must counsellors and psychotherapists behave ‘better’? Better than whom? Must our personal lives be healthy? What does ‘health’ mean here and is it being conflated with goodness, morality and virtue? Is that desirable? Does Michelle really need to ‘turn things around personally’? Are counsellors not fallible human beings, too? Might not such imperfection be an acknowledgement of our shared existential reality and an aid to ordinary empathic engagement? 

Perhaps, when asked about her drinking, Michelle’s distress and concerns about future employment are not hints that her clients could be at risk – as Suzanne appears to take them – but rather expressions of a thoroughly realistic appraisal of the operation of power and interest in both this encounter and its organisational, professional and cultural contexts. Perhaps Michelle knows that complaints in professional organisations and in our wannabe regulator – whose aims doubtless already mould our professional discourse – are brought more often by colleagues and employers than by service users, and that many motivations will be submerged beneath the claim of ‘client protection’. Maybe she is acutely aware that the culture of her profession is becoming dominated by tendencies towards risk aversion and blame, and that fear and careerism drive these more than client interests. Perhaps she read recently of the psychologist hauled before a Health Professions Council (HPC) Fitness to Practise hearing for being drunk at a social occasion with colleagues. He was cleared of misconduct but only after the charges against him were publicised on HPC’s website and in the national media. Perhaps Michelle realises too, in the very moment Suzanne confronts her, that events are already spiralling out of her control; that sometimes organisations move against individuals, and that while her colleagues will follow procedure with (we hope) good intentions, the system nonetheless has a powerful current of its own – the energy of unacknowledged self-interest – which completes the circuit of professionalised mistrust we increasingly find buzzing around the intimate conversations of therapy. Before Suzanne does anything further, she might want to reflect in depth upon such questions. Her friend’s dilemma, after all, is as potent as her own."