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

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

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:

• 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:
  

1. Many of the generic standards were not appropriate for the psychotherapy and counselling profession, for example the standard on infection control.
2. 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.
3. 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

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.