As at the time of SCoPEd 1 a year ago I am confused by the need for SCoPEd (The Scope of Practice and Education for counselling and psychotherapy). Minimum standards are already required to be a member of the BACP Register. If these minimum standards are viewed as not high enough, then it is these standards that should be raised for the whole membership. What is the point of a brand new ‘evidence-based’ framework that is not working for a unified membership but seems to have as its aim to split it into three distinct groups?
There is an assumption that everyone, especially employers, are confused by ‘counselling’ and ‘psychotherapy’ [hereafter ‘therapy’ and ‘therapists’]. That’s not my impression. The awareness of therapy as a route to explore self, others and the world for various reasons and desired outcomes is embedded in our culture perhaps more now than ever before. Most people know what it is or have an idea of what it is or at least seen passable representations of it in films and on television. I am more confused as to what counselling and psychotherapy are, after reading the SCoPEd framework.
The implicit assumption of the SCoPEd project seems to be that if only the NHS/IAPT/NICE understood how well trained we are then there will be a huge expansion of employment opportunities. In my view that does not explain the latter’s enthusiasm to employ their own in house paraprofessionals such as ‘PWPs’ and ‘mental health workers’ who tend to work with exactly the same groups of people counsellors and psychotherapists used to before the IAPT ‘juggernaut’. The higher our training standards the higher a salary we will rightfully demand so, from an economic perspective, it is better to hand the work to workers with less training who will accept lower wages. In this context it is the BACP’s job to challenge the marginalisation of therapists at a political level. Buying into the myth that nobody knows what we do and if only we explain ourselves better than all will be well is a defensive move. The BACP should be proud of their ‘kitemark’ and proudly recommend BACP members as providers of quality therapy (versus faster, cheaper versions of ‘mental health’ interventions) and challenge the NHS’s choice to provide its own qualification and accreditation process in therapy provision.
The hierarchical nature of titles seems to have been fudged by just re-naming three supposedly different types of therapist A, B and C with the intention of re-instating titles at a later date. I think the fuss over supposed differences between counselling and psychotherapy has to go and any differentiations of training and experience can be distinguished by already existing academic standards such as BA, BSc, PGDip, MA and PhD. Or all the different numerical levels. This is a framework that already exists. There can also be post-qualification recognition of specialisms and continuing professional development over a therapist’s career. Since BACP represents both ‘counsellors’ and ‘psychotherapists’ presumably they see the two professions as having enough in common to be able to belong to one body. I am confused by where the BACP stands on this issue now, but in 2009 they did not recognise a difference. If they have changed their mind on that I would suggest changing it back quickly. I would also suggest their role is to value counsellors and psychotherapists equally. I understand some psychotherapists would not go along with this view and would like to be perceived as different and/or better by virtue of being a ‘psychotherapist’ — they still have the UKCP to further their interests.
Part of the underlying structural problem is that the therapy ‘industry’ has over time taken on aspects of a ‘pyramid scheme’ in which the newer entrants are finding it more and more difficult to get returns on their investments and those nearer the top have a tendency to stake out their territory with more stringent demands. I think there is an aspect of this problem in the SCoPEd project. Psychotherapists and psychoanalysts have an interest in ensuring they are seen in a superior light to counsellors and need to stake out and claim their territories.
The main qualitative difference in training (I accept the initial quantitative difference) between counsellors and psychotherapists — as far as I can make out — is that most psychotherapists will do a 30 hour ‘mental health placement’ or failing that ‘familiarisation’ via other means. Having worked in mental health for over 5 years I do not see how this 30 hour placement has gained such perceived kudos. The perception that people with ‘chronic and enduring mental health conditions’ are so challenging — whilst sometimes true — for the most part is an unhelpful view which simultaneously idealises practitioners who work with this group as having special skills whilst denigrating the patients/clients as overwhelmingly difficult. For the most part these clients/patients just need the basics of a respectful relationship. In any case, if it is perceived that practitioners lack something because they have not worked in a mental health placement this is a very easy ‘top up’ that seems, according to SCoPEd, to need about a week in practice plus a bit of reading/writing.
This piece is a reflection of my first thoughts and is purposefully blunt. I might well reconsider some of my views and I welcome being challenged. But in sum, despite the reassurance that the views of some BACP members would be seriously reflected in this second iteration, I cannot help but sense that the whole purpose is to privilege psychotherapists and psychoanalysts over counsellors. I totally accept that as the purpose and remit of the UKCP and BPC. But the BACP, in my view, are meant to represent both counsellors and psychotherapists. This means that they need to stand by the assertion that there are no substantial differences between counselling and psychotherapy. Differentiations between practitioners need to be based on actual qualifications and actual pre- and post-qualification experience rather than titles.