23 January 2010, Conway Hall, London
This conference provided an opportunity for members of the counselling and psychotherapy professions to ‘clarify the facts about statutory regulation, explore concerns and to put questions to a panel’. It was well organised and well attended by some 250 delegates from a wide range of modalities and backgrounds. The panel consisted of Lynn Gabriel, Chair BACP, Andrew Samuels, Chair UKCP, Marc, Seale, Chief Executive, HPC, Julian Lusada, Chair BCP, Darian Leader, Alliance for Counselling and Psychotherapy Against State Regulation, Michael Fischer, psychotherapist and researcher from Kings College and Di Waller, HPC Council Member and Chair of the HPC PLG.
During the morning the panel offered their views on some pre-set questions followed by a general question and answer session, and in the afternoon participants took part on café style conversations followed by feedback.
Michael Fischer described his observations of a small sample of doctors and their fear of the growing ‘blame culture’ in society. Julian Lusada spoke about the need for regulatory processes which were ‘sensitive and thoughtful’, but offered protection to both patients and therapists. Lynn Gabriel reiterated the need for counsellors and psychotherapists to be of equal value in whatever system emerged, and the need to address the mis-perceptions which existed about the HPC. Andrew Samuels proposed that there would be ‘independent statutory regulation’ in some form in the future.
My observation was that there was more agreement than disagreement on the need for some form of regulation beyond the status quo. Various options were presented and discussed – HPC regulation, regulation by a new independent regulator, ‘alternative professional accountability’ as well as reference to profession led forms of regulation elsewhere in the world. There was also agreement than whatever form regulation in the future might take, it must, in the words of Darian Leader, ‘respect the diversity which exists within the field’.
It came as no surprise that the panel expressed very different views on almost all topics. However, I was struck by the amount of misunderstanding there was amongst some members of the panel on, for example, the continuing misperception of the universal use of the medical model by HPC regulated professionals, the suggested lack of a contribution from the counselling and psychotherapy professions to the drafting of the current version of the Standards of Proficiency, the mistaken assertion that ‘user groups’ were denied access to the PLG, and the somewhat confused and therefore confusing discussions about the application of the criteria used by the HPC for assessing readiness or otherwise of a profession for regulation.
Despite this, several clear and constructive themes emerged from the panel and from the delegates. First, there was a call for more dialogue, more discussion between the HPC and members of the profession in order to achieve a regulatory process that was ‘fit for purpose’. Second, there was a call for re-assurance that HPC were listening and would address ongoing concerns from the professions. During the feedback sessions in the afternoon, the word ‘trust’ recurred more often than any other. Trust was acknowledged as fundamental to progress. Third, there were calls for the professional bodies to work together and agree more on a way forward.
I found the café conversations particularly helpful. There were discussions about the impact of statutory regulation on the ‘relational space’ in therapy, and the importance of preserving its unique contribution to society. There were also concerns about clients who might have become obsessed with litigation during or before therapy, others who might use litigation as a means to play out other more unconscious and unresolved conflict in their lives. Regulation needed to address these complex areas. On the other side there was acknowledgement that the professions had not to date made much progress themselves with regulation and that perhaps an independent body might actually provide the impetus for positive change. Overwhelmingly however I felt the discussions highlighted to me the mis-understanding and lack of accurate information about HPC regulation and the desire for further discussion and dissemination of facts. If we are to achieve this, we must pursue the facts and work harder to build trust on all sides.
I would like to thank the organisers of the conference for offering this opportunity for dialogue and debate. We look forward to continuing the dialogue at other meetings in the future.
Anna van der Gaag
Chair HPC
26 January 2010
11 December 2009
Conclusions on the proposed statutory regulation of psychotherapists and counsellors
As followers will be aware the HPC Council met on 10 December 2009 to review the responses to the consultation on the recommendations of the Psychotherapists and Counsellors Professional Liaison Group. The Council concluded that there are no specific issues that would prevent psychotherapists and counsellors from coming into the system of independent statutory regulation operated by the HPC. The Council is confident that it can accommodate the regulatory needs of these practitioners.
Having reviewed the responses to the consultation, the HPC has concluded that if the decision is taken to proceed with statutory regulation of psychotherapists and counsellors, then:
• one additional Part of the Register should be established for “Psychotherapists and Counsellors” and these titles should be protected;
• modalities should not be reflected in the structure of the Register;
• the HPC should adopt the approach to dual registration;
• the inclusion of names in the HPC register from other eligible registers should be performed by means of a three-stage process; and
• the ‘grandparenting’ period for those professions should be three years.
In addition, the HPC has concluded that any further consideration of draft standards of proficiency for psychotherapists and counsellors should be deferred until the Council has concluded the current review of its existing generic standards.
Government stated in the 2007 White Paper ‘Trust Assurance and Safety – The Regulation of Health Professionals in the 21st Century’ that it intends to introduce statutory regulation for psychotherapists and counsellors. Hence the HPC was not asked by Government to look at whether the profession should be statutorily regulated, but instead at how they should be regulated.
The HPC set up a working group of stakeholders, known as a Professional Liaison Group or ‘PLG’ to consider and make recommendations to the Council about how psychotherapists and counsellors might be regulated, in light of the conclusions made in the White Paper. The HPC held a public consultation on the PLG recommendations which ran for three months in 2009 and as previously mentioned the consultation received more than 1,000 responses.
The Council approached the task by considering four regulatory ‘building blocks’ and looked at: how the Register could be structured; which professional titles should be protected; what standards of proficiency (SOPs) would be appropriate; and what standards of education and training (SETs) would be appropriate.
This work was intended to be a feasibility study rather than to produce final drafts of either SOPs or SETs. Further work and consultation on those standards will need to be conducted after government has finalised any regulatory proposals in the form of a Section 60 Order.
I do believe the purpose of statutory regulation is to protect the public. Statutory regulation will protect members of the public by setting standards, protecting commonly recognised professional titles and providing a way in which complaints can be dealt with fairly and appropriately.
At the moment, a psychotherapist or counsellor who is removed from the membership of their professional body for any reason can simply continue in practice without there being any legal means for preventing potential harm to members of the public. The protection of titles mean that someone who is ‘struck off’ the Register is unable to continue using the title related to their profession and could be prosecuted if they do so.
Safeguarding professional titles is an important way in which statutory regulation protects members of the public, improving upon a voluntary system in which such titles can continue to be used without any means of redress.
The HPC remains confident that, as a multi-professional regulator and given its experience and approach to regulation, it is well placed to regulate psychotherapists and counsellors should it be instructed to do so. The HPC has a strong track record in bringing new professions into regulation and currently regulates arts therapists, including arts psychotherapists. It also recently took on practitioner psychologists and has successfully integrated them onto the Register.
The HPC agrees with Government that the regulation of psychotherapists and counsellors is important for the protection of the public. However, the final decision about the statutory regulation is one for Government.
Anna van der Gaag
Chair of HPC Council
Having reviewed the responses to the consultation, the HPC has concluded that if the decision is taken to proceed with statutory regulation of psychotherapists and counsellors, then:
• one additional Part of the Register should be established for “Psychotherapists and Counsellors” and these titles should be protected;
• modalities should not be reflected in the structure of the Register;
• the HPC should adopt the approach to dual registration;
• the inclusion of names in the HPC register from other eligible registers should be performed by means of a three-stage process; and
• the ‘grandparenting’ period for those professions should be three years.
In addition, the HPC has concluded that any further consideration of draft standards of proficiency for psychotherapists and counsellors should be deferred until the Council has concluded the current review of its existing generic standards.
Government stated in the 2007 White Paper ‘Trust Assurance and Safety – The Regulation of Health Professionals in the 21st Century’ that it intends to introduce statutory regulation for psychotherapists and counsellors. Hence the HPC was not asked by Government to look at whether the profession should be statutorily regulated, but instead at how they should be regulated.
The HPC set up a working group of stakeholders, known as a Professional Liaison Group or ‘PLG’ to consider and make recommendations to the Council about how psychotherapists and counsellors might be regulated, in light of the conclusions made in the White Paper. The HPC held a public consultation on the PLG recommendations which ran for three months in 2009 and as previously mentioned the consultation received more than 1,000 responses.
The Council approached the task by considering four regulatory ‘building blocks’ and looked at: how the Register could be structured; which professional titles should be protected; what standards of proficiency (SOPs) would be appropriate; and what standards of education and training (SETs) would be appropriate.
This work was intended to be a feasibility study rather than to produce final drafts of either SOPs or SETs. Further work and consultation on those standards will need to be conducted after government has finalised any regulatory proposals in the form of a Section 60 Order.
I do believe the purpose of statutory regulation is to protect the public. Statutory regulation will protect members of the public by setting standards, protecting commonly recognised professional titles and providing a way in which complaints can be dealt with fairly and appropriately.
At the moment, a psychotherapist or counsellor who is removed from the membership of their professional body for any reason can simply continue in practice without there being any legal means for preventing potential harm to members of the public. The protection of titles mean that someone who is ‘struck off’ the Register is unable to continue using the title related to their profession and could be prosecuted if they do so.
Safeguarding professional titles is an important way in which statutory regulation protects members of the public, improving upon a voluntary system in which such titles can continue to be used without any means of redress.
The HPC remains confident that, as a multi-professional regulator and given its experience and approach to regulation, it is well placed to regulate psychotherapists and counsellors should it be instructed to do so. The HPC has a strong track record in bringing new professions into regulation and currently regulates arts therapists, including arts psychotherapists. It also recently took on practitioner psychologists and has successfully integrated them onto the Register.
The HPC agrees with Government that the regulation of psychotherapists and counsellors is important for the protection of the public. However, the final decision about the statutory regulation is one for Government.
Anna van der Gaag
Chair of HPC Council
18 November 2009
Update on the potential regulation of psychotherapists and counsellors
The consultation on the recommendations of the Professional Liaison Group (PLG) has now closed. We received more than 1,000 responses to the consultation, the majority from individual practitioners in the field as well as from service users, charities and professional bodies.
Our analysis of the responses we received is ongoing, but it is clear that a variety of different views have been put forward which we need to properly take into account in determining the most appropriate way forward. In particular, the area of potential differentiation between psychotherapists and counsellors has drawn significant interest and debate.
The Council will meet on 10 December 2009 to consider the analysis from the consultation. It is likely that the Council will also ask the PLG to undertake further work.
Subject to a decision from government to proceed with statutory regulation, we would consult again, following the publication of a Section 60 Order under the Health Act 1999, on the proposed standards of proficiency and educational thresholds. The Department of Health itself would also consult on the draft Section 60 Order.
The purpose of statutory regulation is to protect the public. Statutory regulation will protect members of the public by setting standards, protecting commonly recognised professional titles and providing a way in which complaints can be dealt with fairly and appropriately. The HPC agrees with government that the regulation of psychotherapists and counsellors is necessary for the protection of the public. The final decision about whether regulation goes forward is one for government.
Michael Guthrie
Director of Policy and Standards
Our analysis of the responses we received is ongoing, but it is clear that a variety of different views have been put forward which we need to properly take into account in determining the most appropriate way forward. In particular, the area of potential differentiation between psychotherapists and counsellors has drawn significant interest and debate.
The Council will meet on 10 December 2009 to consider the analysis from the consultation. It is likely that the Council will also ask the PLG to undertake further work.
Subject to a decision from government to proceed with statutory regulation, we would consult again, following the publication of a Section 60 Order under the Health Act 1999, on the proposed standards of proficiency and educational thresholds. The Department of Health itself would also consult on the draft Section 60 Order.
The purpose of statutory regulation is to protect the public. Statutory regulation will protect members of the public by setting standards, protecting commonly recognised professional titles and providing a way in which complaints can be dealt with fairly and appropriately. The HPC agrees with government that the regulation of psychotherapists and counsellors is necessary for the protection of the public. The final decision about whether regulation goes forward is one for government.
Michael Guthrie
Director of Policy and Standards
09 November 2009
Summary points of the event on the statutory regulation of psychotherapists and counsellors by the HPC, hosted by Anne Milton MP
Health Professions Council (HPC), quote:
“The HPC saw the meeting as a helpful opportunity to review the progress made in introducing the statutory regulation of psychotherapists and counsellors. Anne Milton MP, Shadow Health Minister concluded the meeting by stating that ‘we are 80% there’ and ‘that there was clear support for independent statutory regulation from the majority of those present at the meeting’. This is an indication of the progress that has been made towards achieving better levels of public protection than exist under the current system."
The meeting was attended by a wide range of psychotherapy and counselling professionals, service users, professional body representatives and representatives from Mind. The participants numbered over 50 individuals. The Chair and Chief Executive of HPC also attended the meeting, at the request of Anne Milton MP.
Brief presentations were made by Marc Seale, Chief Executive of the HPC, Lynn Gabriel, Chair of BACP, Colin Walker of Mind and Darian Leader of the College of Psychoanalysts.
The key messages from the audience were as follows:
One further point was made:
There should be separate standards for counsellors working with young people and child and adult psychotherapists.
Anne Milton MP emphasised that the amount of correspondence and lobbying that she had received on the issue of the regulation of psychotherapists and counsellors was different from any previous subject she had dealt with as an MP, both in terms of strength and quantity, and that the HPC needed to take note of this. However, she conceded that, despite the volume of correspondence she had received, there was a significant degree of consensus around the need for statutory regulation, both within the professions and particularly amongst service users.
Anna van der Gaag
Chair, HPC
“The HPC saw the meeting as a helpful opportunity to review the progress made in introducing the statutory regulation of psychotherapists and counsellors. Anne Milton MP, Shadow Health Minister concluded the meeting by stating that ‘we are 80% there’ and ‘that there was clear support for independent statutory regulation from the majority of those present at the meeting’. This is an indication of the progress that has been made towards achieving better levels of public protection than exist under the current system."
The meeting was attended by a wide range of psychotherapy and counselling professionals, service users, professional body representatives and representatives from Mind. The participants numbered over 50 individuals. The Chair and Chief Executive of HPC also attended the meeting, at the request of Anne Milton MP.
Brief presentations were made by Marc Seale, Chief Executive of the HPC, Lynn Gabriel, Chair of BACP, Colin Walker of Mind and Darian Leader of the College of Psychoanalysts.
The key messages from the audience were as follows:
- There was a strong consensus that statutory regulation by an independent body was the way forward for psychotherapists and counsellors. Self-regulation was not viewed as a viable option.
- There was considerable criticism and concern expressed by both Mind and by members of the profession that the current system of voluntary self-regulation through the professional associations was failing to protect the public.
- There were varying views on the most appropriate mechanism for achieving independent statutory regulation.
- There was concern expressed that there would be any doubt whatsoever as to whether abuse existed in the UK. A service user who attended with representatives from Mind, herself a victim of abuse, gave a short account of her experience of the current self-regulatory system, highlighting the difficulties that she faced. Her account was reinforced by several professionals who confirmed similar experiences of inadequate handling of complaints by professional associations. A chief executive of one of the professional associations said that member organisations were not in a position to fund fitness to practice processes, despite the disagreement with the Government’s proposals. Several members of the profession said that they welcomed HPC’s work and did not see the HPC standards as ‘stifling’. Another said he welcomed the introduction of independent regulation and expressed frustration at the length of time the process had taken.
- A minority appealed for further exploration of regulation by the profession itself through other means, such as a ‘voluntary internet based Disclosure system’, asserting that the HPC proposal ‘privileges politics over the best interests of patients’, but with little explanation over the basis for this assertion. One individual also expressed concern that statutory regulation was disproportionate to the size of the problem. Several individuals proposed that there was no evidence from the UK that psychotherapists were abusing their clients. They called for a halt to the current proposals and a ‘convention’ to discuss the future regulation of the profession. There was also a proposal for further research to establish whether or not abuse was occurring in the UK.
- There were three substantive concerns about the current proposals that the HPC was consulting on. They were as follows:
- Many of the generic standards were not appropriate for the psychotherapy and counselling profession, for example the standard on infection control.
- The proposed differentiation between psychotherapists and counsellors in the structure of the Register was not supported by the majority of practitioners and it was perceived as potentially divisive and hierarchical. The titles ‘counsellor’ and ‘psychotherapist’ were used interchangeably in practice, to a large extent.
- Some of the professions wanted more involvement in the continuing development of the standards.
One further point was made:
There should be separate standards for counsellors working with young people and child and adult psychotherapists.
Anne Milton MP emphasised that the amount of correspondence and lobbying that she had received on the issue of the regulation of psychotherapists and counsellors was different from any previous subject she had dealt with as an MP, both in terms of strength and quantity, and that the HPC needed to take note of this. However, she conceded that, despite the volume of correspondence she had received, there was a significant degree of consensus around the need for statutory regulation, both within the professions and particularly amongst service users.
Anna van der Gaag
Chair, HPC
11 September 2009
The regulation of Psychotherapists and Counsellors
In February 2007, the White Paper, ‘Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century’ stated psychotherapists and counsellors were a priority for future regulation. The government White Paper also said that these professions should be regulated by the Health Professions Council (HPC).
In preparation, in autumn 2008, The HPC established a working group, known as a ‘Professional Liaison Group’ or ‘PLG’ to discuss and make recommendations to the Secretary of State and Ministers in the devolved administrations about the regulation of these groups. This working group is made up of registrant and lay members of the HPC Council, as well as representatives from professional bodies representing psychotherapists and counsellors, education providers and service users.
To date, the group has made good progress in discussing and making decisions about the structure of the Register, protected titles, voluntary registers, the grandparenting process, standards of education and training and standards of proficiency. It is planned that the group will report to the HPC Council in July 2009.
Recommendations will then be subject to a further public consultation before proposals are finalised in December 2009. Once the HPC makes final recommendations, the final decision about the regulation of these groups will rest with government.
In preparation, in autumn 2008, The HPC established a working group, known as a ‘Professional Liaison Group’ or ‘PLG’ to discuss and make recommendations to the Secretary of State and Ministers in the devolved administrations about the regulation of these groups. This working group is made up of registrant and lay members of the HPC Council, as well as representatives from professional bodies representing psychotherapists and counsellors, education providers and service users.
To date, the group has made good progress in discussing and making decisions about the structure of the Register, protected titles, voluntary registers, the grandparenting process, standards of education and training and standards of proficiency. It is planned that the group will report to the HPC Council in July 2009.
Recommendations will then be subject to a further public consultation before proposals are finalised in December 2009. Once the HPC makes final recommendations, the final decision about the regulation of these groups will rest with government.
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