It often comes as a surprise to many people, but in theory anybody can put a brass plaque on their door, an advertisement in the paper, and declare that they are a psychotherapist. The profession is entirely unregulated by the state.
In practice of course things are not quite that cut and dried. In order to get any work via the NHS and many other agencies a psychotherapist must be a member of one of the “approved” professional associations like the BACP (British Association for Counselling and Psychotherapy) or the UKCP (United Kingdom Council for Psychotherapy). These have their own stringent membership criteria and ethics committees to deal with any complaints. In addition personal liability insurance (of increasing importance in our litigious society) is more than usually tied to membership of an approved organisation.
However until recently this situation looked like it was going to change. Circumstance had been pushing the psychotherapy profession towards statutory regulation in the form of the Health Professions Council (HPC), a quango that already regulated, among others, Art therapists, Chiropodists, Dietitians, Paramedics, and Speech and language therapists.
This move caused a major split within the 50,000 strong UK psychotherapist profession, with some welcoming the additional “respectability” statutory regulation would bring, with others railing against what they saw as the bureaucratic restriction of their practice brought about by the practitioners’ code of the HPC.
Specifically the latter proponents pointed to the lack of consensual support for the HPC among therapy practitioners and that previous attempts to force HPC-type regulation on the field has been damaging to the profession. In addition the HPC relied upon a “medical-model” (diagnose-plan-treat-research) orientation which underpinned its standards of practice. Almost all psychotherapy practitioners eschew this model of working with patients as too restrictive and undermining the uniqueness and individuality of patients.
Also the anti-regulation campaigners pointed out that the HPC complaints process was adversarial and could not feasibly accommodate any attempt at discussion let alone reconciliation. Mediation is only available after a misconduct hearing is concluded, by which time the practitioner and the patient may never want to speak to each other again.
This all came to a head in a hearing at the Royal Courts of Justice in December 2010 which upheld the right to proceed with a Judicial Review of the HPC and psychotherapy registration. Mr Justice Burton criticized the misleading nature of HPC statements to both Government and stakeholders. However everything was once again put on hold when the coalition announced that they would not be further expanding the remit of the HPC as part of their cost saving measures.
For an illuminating and eminently readable take on this I would recommend Regulation in Action: The Health Professions Council Fitness to Practise Hearing of Dr Malcolm Cross – Analysis, History, and Comment by Janet Haney. Drawing on actual transcripts and her eye-witness accounts she relates a Kafka-esque tale of all that is wrong in the relationship between the state and civil society.