But…
- Darian Leader calls for a waaaahmbulance
- Regulation of Psychotherapy – why it matters
- Regulation of Psychotherapy – Who’s Against it
- Regulation of Psychotherapy – More from its opponents
- Psychotherapy self regulation – a licence to carry on abusing?
- Psychologists join the HPC register
- The sham of self-regulation
- Regulation of Psychotherapy – A Psychotherapist Responds (1)
- Regulation of Psychotherapy – A Psychotherapist Responds (2)
- Regulation of Psychotherapy – Response to Zarathustra
- Regulation of Psychotherapy – Another Arts Therapist struck off
- Regulation of Psychotherapy: The Maresfield Report (1)
- Regulation of Psychotherapy: Maresfield Report (2)
- Regulation of Psychotherapy: Something rotten in the state of Denmark?
- Regulation of Psychotherapy: Something Rotten in the State of Denmark (2)
- Professor Andrew Samuels caught lying about his role in abuse case
- An Open letter to the UKCP
- Regulation of Psychotherapy: UKCP document leaked to Mental Nurse
- Regulation of Psychotherapy: More on the leaked UKCP document
- Regulation of Psychotherapy: More leaks from the UKCP
- Regulation of Psychotherapy: Samuels’ Damascene Conversion
- Regulation of Psychotherapy: Therapist struck off by BACP, remains registered with UKCP
- Regulation of Psychotherapy: HPC calls UKCP critique “gobbledegook”
- Regulation of Psychotherapy: 85% of service users want statutory regulation
- Regulation of Psychotherapy: Acclaimed Journalist Calls for Psychotherapy Regulation
- Regulation of Psychotherapy: Charity Commission urges UKCP to seek legal advice
Meet Andrew Samuels, Jungian psychotherapist and Professor of Analytical Psychology at the University of Essex. He’s a leading spokesperson for the campaign against HPC regulation of psychotherapy. A month ago he was elected chair of the UK Council for Psychotherapy, the main umbrella body for psychotherapy organisations in Britain.
So, how will the UKCP’s new chair engage with the Health Professions Council on the tricky issue of regulating psychotherapy? The answer, it would seem, is by posting ranty, paranoid video messages attacking the chief executive of the HPC.
In the video Samuels accuses the HPC of planning to prosecute him after “psychotherapist” becomes a protected title, though this appears to be on the basis of little more than having received a couple of letters from them asking what job title he intends to use after regulation kicks in. He announces that he will use the term “Jungian analyst” or some similar wording that won’t come under the list of protected titles. Regarding any possibility of prosecution by the HPC, he glowers, “Don’t try it!” Which really begs the schoolyard taunt of, “Or you’ll do what?”
But what does Andrew Samuels think of the Derek Gale case, which I’ve flagged up as an example of why psychotherapy needs to be regulated? (Quick primer: Derek Gale was struck off as an arts therapist by the HPC for running a manipulative, cult-like psychotherapy practice with shedloads of emotional, sexual and financial exploitation. But because “arts therapist” is a protected title and “psychotherapist” is not, he simply retitled himself as a psychotherapist and carried on practicing.)
It turns out that the good professor took a strong interest in Gale’s spot of trouble with the HPC. In fact, as the transcripts of the HPC hearings show, Samuels tried to help Gale out.
The transcript of the relevant hearing, which I’ve put online here, is a review of Gale’s interim suspension order. The panel is trying to decide whether to keep Gale suspended, to lift his suspension, or to allow him to practice under certain conditions. It’s quite a long file, but you can find the relevant section on pages 36 and 37.
In the transcript, Gale’s lawyer is offering conditions that Gale would be prepared to operate under if his suspension order were to be lifted.
The conditions I have in mind are intensive supervision. You will see at page 1 of his bundle a letter from PS, who is a training analyst at the Society of Analytical Psychology, a Professor of Analytical Psychology, University of Essex, and an honorary fellow of the UKCP. He says he is happy to supervise Mr Gale on a weekly basis.
That’s a pretty specific CV, to the extent that it pretty much narrows who they might be talking about to a shortlist of one. The “PS” they’re referring to is “Professor Samuels”.
This is confirmed a couple of paragraphs down, where an apparent typo refers to Professor Samuels by name rather than the initials. It is also revealed that the “intensive supervision” being proposed really ain’t all that intensive.
PS will go through the notes with him, audit his practice in effect. He is willing to be contacted by the Council at any time if the Council wants to check that supervision is taking place and that Professor Samuels has no concerns.
So, this “intensive supervision” would actually be no more than Samuels meeting up with Gale once a week to go through his notes? No actual observing of Gale in practice?
Scrolling to pages 44-46, the HPC’s counsel raises these very concerns, asking why there is not meant to be any direct supervision “given the nature and seriousness of the allegations”.
The hearing then adjourns, after which, on page 47, Gale’s counsel announces that he has spoken to Samuels by telephone.
I was just saying that I have spoke to PS about the possibility of direct supervision. In the therapy world it does not happen. These are not his words but it is what Mr Gale tells me, that clients are not willing to open themselves up with a stranger in the room. What he is proposing is standard in the psychotherapy world as supervision, including of people whose performance is being monitored. That is how it is done.
Doesn’t seem a very safe way to guarantee that Gale isn’t abusing his patients. The panel clearly thought so, because they rejected Samuels’ offer and maintained Gale’s suspension.
Not withstanding the offer of supervision by the registrant and the potential supervisor, by reason of the nature of arts therapy and how treatment takes place, it would be impossible for any supervisor to be present at all times so as to adequately protect the clients of the registrant from areas covered by the allegations. The supervisor would have to rely on the registrant’s own account to his supervisor of his practice which in the panel’s view would be an inadequate way of protecting the public. (page 54)
A quick word on the idea that direct supervision “does not happen” in psychotherapy. The family therapists in my CAMHS clinic make regular use of therapy rooms where a co-therapist sits in an observation gallery, watching proceedings either through a two-way mirror or on CCTV. This is used to provide feedback on the family interactions, or for training and supervision purposes. Direct supervision may not happen in whatever boondocks version of therapy Derek Gale and Andrew Samuels are practicing, but it certainly happens in family therapy.
Howard Martin, the original complainant in the Derek Gale case (and occasional contributor to Mental Nurse) has written an open letter to Andrew Samuels to congratulate him on his appointment as UKCP chair. It can be found on the Rick Ross anti-cult website.
It is widely known that one of your key complaints against the HPC is (to quote your website) “The standards being proposed for the HPC registration are scandalously low. Almost anyone will be able to be registered.” This is a very admirable stance to set very high standards for those who call themselves psychotherapists.” Some would also admire you for your willingness to hypocritically ignore this position when it came to protecting the interests of your friend the discredited psychotherapy cult leader Derek Gale who was struck off by the HPC, UKCP and AHPP in June of this year. In fact your involvement in the Gale case also seems to directly undermine your position that the HPC are ineffective in protecting the public, because despite the best efforts of you and your colleagues that is exactly what they did.
[...]
Is it not fair to say that if you had your way Gale would have easily exploited your public endorsement of his cult like practise to carry on his abusive behaviour under your supervision? Luckily the HPC panel was not made up of your and Gale’s associates and they were sufficiently independent and technically skilled enough to not fall for your solicitations. Gale’s public suspension was upheld until he was finally struck off. From my experience of dealing with the AHPP and UKCP I am pretty confident that if you had made the same submissions to any of the self regulation bodies with a panel made up of your colleagues it is pretty much a forgone conclusion that Gale would have been allowed off of his suspension. This of course raises the question; is your anger at the HPC informed by your experience of having your authority undermined by them in the Gale case? Did the HPC humiliate you in front of your peers?
The rest of Howard Martin’s letter makes for pretty juicy reading, and makes some allegations against Samuels that I won’t comment on here as I’m not personally aware of the evidence for or against them.
Oh, and Professor Samuels was not the only leading figure in the psychotherapy community to leap to Derek Gale’s defence when he was up before the HPC. More will follow on that subject in a couple of days.
Finally, and for a quick laugh, have a look at this exchange of letters between Samuels and David Pink, the chief executive of the UKCP. Samuels’ letters are ranting and paranoid to the point of near-incomprehensibility, but as far as I can gather it seems to be that somebody at the UKCP asked an organisation for a reference without getting Samuels’ permission first. Samuels’ response appears to be to fire off a series of letters from himself and his solicitor making wild allegations of a conspiracy against him. He’s now published those letters on his website.
The guy sounds like he’s got some issues with anger and trust. Maybe he should get some therapy.
Andrew Samuels has been known as a ranter for many years. In the mid-90s I trained in a university dept of psychology in a form of post-Jungian therapy known as Archetypal Psychology, founded by the profoundly anti-cultic James Hillman, the man who tried to clean up the C G Jung Institute but was blocked and finally fired by Jung’s former girlfriends. Our course leader was as inoffensive a person as anybody might hope to meet, who expressed the opinion (in line with Hillman) that AP was a way, not the only one, of informing and understanding what else we were doing and was profoundly at odds with the traditional power relationships of psychotherapy. He said that if in ten years’ time any of us were still practising as therapists he would consider he had failed.
Samuels, already being seen then as the Adrian Mole of the counselling and psychotherapy world, turned up at a meeting addressed by the course leader and delivered himself of an intimidating, ad hominem rant which left the poor guy wishing he’d stayed in bed that day. What Samuels seemed to object to was any perceived attack on his personal power, insofar as it was possible to tell, given the wild and unsubstantiated accusations of this and that ‘ism’. It should be noted that Samuels considers himself to be an expert on Archetypal Psychology, which he scarcely is given his travesty of a chapter on the subject in ‘Jung & the Post-Jungians’. More seriously, as you show in the Samuels-Pink letters, he appears to believe that nobody may speak on any subject on which the grandiose Professor Samuels considers himself to be the leading expert without first seeking his permission. And remember that AS started out not as a psychologist but as an ack-taw who turned to social work for a crust.
On 30 October, 2009, Samuels recorded two videos, technically so poor that they keep stopping to re-buffer but worth persisting with: ‘What’s Gone Wrong and Why I Want to Do Something About It,’ and ‘How to Do Better Than HPC’.
http://www.psychotherapy.org.uk/andrew.html
The first is his pitch to become Chair of the United Kingdom Council for Psychotherapy and the second an attack on the British Association for Counselling & Psychotherapy, and on the British Council for Psychotherapy, for their treachery in coming to terms with the HPC, both without asking his permission. He is seated in his office in shirtsleeves and open-neck shirt attempting to be casual. In the first video he adopts a more-in-sorrow-than-anger tone as he tells us of the power struggles between various factions within the UKCP, which alone would disqualify it as a licensing body, and shamelessly speaks of his expertise in all forms of psychotherapy, even those theoretically incompatible. In the second he starts by telling us how the cameraman was so overcome by what he had to say in the first video that he had to go and sit down, before going off on one of his signature rants.
In the video to which you (so unmercifully to the innocent browser) provide a link, Samuels’ body language is interesting. He has donned jacket and tie and done up his buttons. He is standing square onto and staring into the camera with his shoulders hunched. Somehow, this all seems to lend prominence to his well-’ard shaven head. His ludicrous ‘warning’ to the HPC need not detain us. Whatever he may say it’s clear from his behaviour that he and those who think like him are about naked power. Such people should never be allowed near the vulnerable or the emotionally frail.
Very sorry, I appear to be developing a geriatric tendency to mangle names. Recently I referred to a Tony as ‘Tom’ and somebody called Patricia as ‘Sue’. When I say ‘British Council for Psychotherapy’ I mean British Psychoanalytic Council. BTW anybody who feels the need for counselling or therapy I would advise to contact the British Association for Counselling & Psychotherapy (Google), a highly kosher organisation in my view, and ask for their Directory of Practitioners.
There’s a letter in today’s Times (p43) from Nicola Barden, who chaired BAPC 2005-08, replying to Dr Richard House, who had a letter published on 8 Dec. In his letter, House accused the HPC of “stultifying mechanistic thinking” which left no place in the consulting room to discuss “deep personal concerns”, which he said was inevitably the result of state regulation.
Describing House’s “vision of therapy being separated out from the rest of the world” as “a fiction”, Barden continues, “at the moment professional bodies provide the safeguards of training and ethical standards. These are generally [but not universally we may note, BM] excellent, but entirely voluntary, as membership cannot be enforced. While we can and do debate critically with the HPC over the quality and accuracy of the standards set, it will at least provide a minimum standard and a single route for complaints…I have not heard any clients complaining about this prospect.”
Barden is right, of course. When I saw my GP this morning and she made certain suggestions, these related i) to my needs not hers, and were entirely about ii) life as I live it day by day, not an abstruse idea of Life that exists only in the consulting room. If I believed she was behaving unprofessionally (which I don’t, she’s excellent!), I would have iii) the right to complain to a state regulated body, the General Medical Council. When Ronnie Laing was hauled before the GMC for being drunk in the consulting room, he resigned before he could be struck off because “I don’t need to be on the Register to practise psychotherapy”. This is the crux of the matter, state regulation is necessary, albeit subject to vigorous discourse so as not to to deteriorate into a sterile box-ticking exercise, because self-regulation doesn’t work.
I’ve done it again! BACP, gert Bristle pillock, BACP not BAPC…
The link to Nicola Barden’s letter is here:
http://www.timesonline.co.uk/t.....952042.ece
Also a reply to Barden from Andrew Samuels
http://www.timesonline.co.uk/t.....953728.ece
Samuels is quoting selectively. BACP rejected the original proposals as incoherent but has since entered into negotiations following a clarification by HPC.
Obviously rogues can carry on by using a non-regulated title but under regulation it will be far easier for people to avoid them. If UKCP does eventually join in they will need to do something about the hypnotherapy section of their register, which some have been concerned about for a long time. It’s possible at present for a quack to become a ‘registered psychotherapist’ via the hypnotherapy section after as little as nine months’ part-time training.
Andrew Samuels defended the abusive psychotherapy cult leader Derek Gale during the HPC hearings.
You can read my open letter to Andrew Samuels here:
http://forum.rickross.com/read.php?8,79233
Professor Brian Thorne of University of East Anglia also defended Gale – if anyone knows anything about him why not share it with us.
Cheers
H
I don’t understand why these people are so against regulation. Look, AEROBICS INSTRUCTORS are regulated. They must all have completed an approved exercise to music course and have appropriate insurance. If Cindy teaching the grapevine step doesn’t have a problem with this, why do the therapists?
Well said DeeDee. Fuck knows, I thought psychotherapy was supposed to be about helping people, not about a bunch of over inflated egos battling it out in a surreal competition of Whose Balls Are Biggest. I just want a sodding therapist who isn’t going to touch me up or tear me to pieces.
Lola x
“I thought psychotherapy was supposed to be about helping people, not about a bunch of over inflated egos battling it out in a surreal competition of Whose Balls Are Biggest.”
That there was your mistake Lola.
*Throws in the therapy towel and goes out to buy a cat*
See the other thread – cats make very good therapists.
Have you read the draft consultation document by the HPC and how they envisage psychotherapy under HPC regulation? If my therapy had been HPC regulated i would probably be dead by now…..I would not have had the space to talk about what was needed to be talked about. I dont think people are against regulation per se, but HPC regulation.
Psychotherapy is not a science or a technological endevour, and this is from a professional psychologist-I have studied CBT and the philosophy behind such things and the HPC, IAPT, NICE (for therapy) etc are very much misguided. CBT for example suffers from one the symptoms it purports to cure, (i.e.,biased thinking) and that is not helpful when it is being dished out by under qualified psychology graduates with 5 minutes training. Further, HPC regulation will encourage people to jump through hoops, leading to more thoughtlessness.
Well, yes, I have read the draft competencies, and to be honest I find it hard to see what’s in there that would have killed you.
One thing that strikes me about the draft is that it specifically avoids specifying any particular modalities, and seems designed to allow the therapist to take whatever approach they see fit within a basic framework of standard good practice (i.e. proper record keeping, respecting professional boundaries etc).
Perhaps you could be a little more specific? Which of the draft standards would have caused your death, and how?
More to the point even I am regulated. If I do anything illegal or suspect or contrary to any of the FSA’s (Financial Services Authority) guidelines they can ban me from working in banking for life. Has the FSA ever taken the slightest interest in anything I’m doing or gotten in the way of me doing my job? No. And as long as I continue to do nothing illegal/forbidden/immoral, they won’t. There’s a bit of a paperwork overhead, maybe, but nothing that can’t be sorted with minimal fuss.
Bang on, DeeDee!:) Whether Cindy the aerobics instructor has balls or not I wouldn’t know, it’s so difficult to tell these days. I once knew a Greek cleric who won a karaoke competition incognito in another county. Maybe we should look out for Ranting Andy on the cheap lager’n'Bacardi Breezers circuit.
Samuels is now rewriting history by denying he made representations on behalf of Gale:
http://www.timesonline.co.uk/t.....953728.ece
But since it is clear from the transcript that not only did Samuels make representations he was also available on the phone he really doesn’t have anywhere to go.
I was also at that hearing and there was absolutely no suggestion the Professor Samuels was not supporting Gale and working with him so that he could have his suspension lifted.
I can’t make up my mind whether Samuels is a Sith lord, Darth Vader or merely C-3PO with grandiose delusions.
I felt like responding in a Zen way- if you dont know I cannot tell you- but then that probably would not satisfy you, or a medicalised/scientistic view of mental health.
Suffice to say, when I was suicidal, I did not WANT to be taken as a risk, or dealt with as such as a risk. I wanted to be able to explore my suicide and thoughts about it without any “duty of care” implementations being activated-or else I would have walked. So I had that space. Plus, I did not want to be measured on any measures of progress or ideas of success/failure….I would have felt pressured. I certainly did not want to be given questionniares, or subjected to ideas of best pratice, where would “I” have been if that were the case
My therapist had the courage to let me struggle in un-knowing (for a very long time), and frustration-she did not jump in and try to save me (with psycho-techniques or explanations), she did not tell me how she worked and why this would help me, she did not tell me there was a cure or a time-scale-that took courage. And when i realised there was nor cure, that in itself was a cure.
I belive Lacan was correct when he adovcated the curative nature of frustration….such a way of working would not be advoacted under the auspices of an HPC/evidence based practice psychotherapeutic system.
These are a few thoughts of mine
so in regard to one of your statements” allow the therapist to take whatever approach they see fit within a basic framework of standard good practice”,
the HPC draft framework would not have allowed my therapist to work in the way she did. It was not a medical-orianted therapy i had….it was something quite other…..and a way of working that is far far older than Freud, Beck, lacan, SSRI’s and the rest.
Bt i am not saying you can have therapy the way you want it….as a former patient, or future patient, dont push upon me what kind of therapy I can or cannot gave….that is very dangerous.
Is there any way of editing one’s posts? I have seen some typos so sorry of there is mis-understanding
I meant to say….But i am not saying you cannot have therapy the way you want it…………as a former patient, or future patient, dont push upon me what kind of therapy I can or cannot have….that is very dangerous.
Current score: 0
Lacan also had a lot to say about power. I’m delighted you found a therapist to suit you but within a patient-therapist model there has to be regulation to prevent abuse; others may not be so lucky. Indeed, this whole debate came out of the Gale case where somebody was caught abusing that power. Believe me, I can’t speak for Z but I would be the first to kick up if HPC or any other regulator behaved in the way you suggest. This commentator is no fan of CBT and if that is indeed an HPC weak point it should be addressed.
You say-Believe me, I can’t speak for Z but I would be the first to kick up if HPC or any other regulator behaved in the way you suggest (Do you mean how my therapist was? or how I see the HPC?) Just out of intrest, do you think my therapist would have been able to practice in the way she did under current HPC ideas?
Well this Is how my therapist behaved and it saved my life……would you have denied me this opportunity? Indeed I find it slightly scary that you might judge “my therapy” as being wrong. What i am saying is, is that she would not have been able to practice in the way she did if she ws HPC regulated (under the draft standards). By the way i am not aganist regulation per se, just the way HPC is setting up its stall. And yes I am against abuse of course i am.
You mention power…..Lacan mentioned the slave-master dialect……the HPC is such a dialect. Lord Layard told me on the radio he knows what causes depression and how to cure it….I find this patronising and very dangerous talk for what is obviously non-sense.
IAPT is abusive as poorly trained people people with 5 minutes training and little thought dish out therapy as though they are experts….the HPC saction this.
HPC regulation will not stop the abuse of the Master-slave dialect. It will promote one who is supposed to know and feed ito an egoic-centred, status power seeking homogenous power base where creative and free thinking (contra the state a big brother state watchdog) is banished. It will not stop the abuse-there are many regulated educated fools out there who tick all the boxes and where the consulting room or NHS clinic is no place for them to be….regulation (HPC style) will never stop that.
I don’t want to get into a tit for tat, which I don’t think would be helpful. In general, while I’ve been logged out Z and TheThinMan have made points I agree with.
As regards your specific questions to me:
i)I would be the first to kick up if the HMC behaved in the way you believe it does. At present, I’m waiting to see how the BACP negotiations with the HPC go. At one time, a decade ago, I would have been satisfied with leaving matters in the hands of the UKCP. Unfortunately that organisation has shot itself in the foot, not so much by electing Andrew Samuels to the Chair as by deteriorating into endemic factional conflict which has given a Napoleonic figure the opportunity to take over.
ii) I do believe your therapist would have give been able to work in the way she did for the reasons stated by Z at 5.41.
The question you asked Z and TheThinMan about having had experience of psychoanalytical therapy from the patient perspective. I don’t know about them but I have. There’s no point in getting personal about this. Nobody is attacking you or your therapist.
Professor Andrew Samuels has some very important information that he would like to share with Howard Martin; Howard can contact him at: samua@essex.ac.uk Thanks.
Probably a writ.
As an after thought. I know of an HPC registered psychologist who is so dissalousined as they feel they cannot practice in any way which deviates from the “evidence based practice” model. This person fears that they will be “struck off” if they practice in a freer or more creative way. They get it in the ear about doing the HPC thing at all times….essentially the way one can practice is becoming restricted.
I know of another HPC registered psychologist, with “fairly paltry training and credentials” and only recently qualified, and this person charges a minimum (a minimum!) of 100 quid an hour. And I know this person see’s their job as a way “making lots of cash. This “dubious” power-mongering morality slips by HPC regulation.
@Jan21
the HPC draft framework would not have allowed my therapist to work in the way she did. It was not a medical-orianted therapy i had
But the draft framework does not dictate a “medical-oriented therapy”. The language of the draft keeps referring to “the theoretical approach” or “the theoretical model” without ever stating what that model or approach should be. Far from trying to shoehorn therapy into a medical or a cognitive-behavioural framework, the language of the drafts reads more to me as though it’s bending over backwards to encompass and allow a wide range of modalities.
I’m a nurse, regulated by the NMC, and therefore far closer to the medical model than anything proposed by the HPC for psychotherapists, but the NMC has never tried to prevent me from using psychodynamic or humanistic ideas in my clinical practice. Likewise, the HPC-regulated arts therapists in my CAMHS service all continue to work in a psychodynamic way.
Plus, I did not want to be measured on any measures of progress or ideas of success/failure….I would have felt pressured. I certainly did not want to be given questionniares
But again, the draft doesn’t dictate doing that. In my own clinical practice I don’t rate people as succeeding or failing, and I hardly ever give out questionnaires except for specific diagnostic processes (e.g. ADHD assessments) that a psychotherapist would not be involved in.
Suffice to say, when I was suicidal, I did not WANT to be taken as a risk, or dealt with as such as a risk. I wanted to be able to explore my suicide and thoughts about it without any “duty of care” implementations being activated-or else I would have walked.
On issue of suicide and risk, I think there have to be some sensible compromises. It’s good that your therapist was able to get you to explore those issues, but I also think if she saw someone approaching a crisis and did nothing, and they were then found dead, then she should be expected to answer some questions about her failure to act.
I work regularly with people who have suicidal thoughts. I’m aware that many of them are not at imminent risk to themselves – Nietzsche once said that the thought of suicide got him through many a bad night – and the overwhelming majority of them never see the inside of a psychiatric ward. Personally I feel that the best way to assess and manage suicide risk is to do exactly what your therapist did – by not acting shocked or judging but encouraging them to talk about and explore these thoughts.
Just out of intrest, do you think my therapist would have been able to practice in the way she did under current HPC ideas?
For the reasons I’ve described above….yes, I do.
Z
if you have read the draft standards and what I wrote before, she would not have been able to practice that way
see 1b.3, 2a.2, 2b.1, 2b.2.-2b.4, 2c.1, 3a.1, of the draft standards (appendix 2).
Further, much of these standards infer a “disease” or illness metaphor.
I’m not aware of any HPC regulation that prohibits therapists from guiding clients through suicidal ideation, if such an action is reasonably demonstratable as a means to reduce the actual risk.
“Duty of Care” refers to maintaining the wellbeing of the client, and avoiding risks to that wellbeing through action or inaction.
Jan21′s therapist would be obligated to guide her through her suicidal thoughts if the therapist had reason to believe that not doing so would have increased suicide risk.
In essence, the very thing Jan21 brings up in opposition to HPC regulation, is also the very thing that would have compelled her therapist to act in the same way. Obviously different therapists will percieve risk differently, but this is also true of unregulated therapists.
Without regulation, you have no comeback except that which you can afford in terms of time, effort and money, things few people who need a therapist can actually afford to spare.
I don’t know why Jan21′s registered associate opposes EBP. If she/he doesn’t have the evidence that what they are doing might work – even if the only evidence is client reports or a theoretical model – why are they doing it? Being ‘freer and creative’ sounds all fluffy and nice, but if they can’t justify it, they shouldn’t be doing it. Regulation exists for a reason. Stopping people from doing potentially harmful things just because they ‘feel’ like it is just one of those reasons.
If one thinks IAPT is a farce, how can one oppose regulation? You may oppose where the line on minimum standards are drawn, but to oppose the idea of minimum standards whilst simultaniously decrying someone else for not meeting your own personal idea of minimum standards seems a bit illogical.
I have not once said i am against regulation….just the way the HPC envisage it and how people are currently being affected by it, and how charletans still slip through the net of HPC regulation.
Jan21, it is not other peoples job to make your arguement for you.
You have been asked to identify what standards you think support your assertion, and to justify why you think so.
Please do so. A out of context list does not cut it.
You are being asked these questions precisely because what you ‘wrote before’ does not support your assertion, please do not insult the people of this website with vague insinuations that it is ‘somehow’ ‘obvious’.
Z, You also wrote- On issue of suicide and risk, I think there have to be some sensible compromises. It’s good that your therapist was able to get you to explore those issues, but I also think if she saw someone approaching a crisis and did nothing, and they were then found dead, then she should be expected to answer some questions about her failure to act.
I did not want a compromise and I got it……this may be hard to take, but I did not want her to act, I wanted to be witnessed, heard, and for no action to be taken, I did not want her to DO anything. This may seem like a risk too far for you or for HPC thinking, but such non-acting spared me taking my life. The compromise (of this type you mention) for many, is the death nail in their lives
A paradox yes….but psychotherapy works via paradox sometimes, and this is outwith/beyond/ etc, a psycho-scientific IAPT/NICE/DSM/HPC etc framework
I did not want a compromise and I got it……this may be hard to take, but I did not want her to act, I wanted to be witnessed, heard, and for no action to be taken, I did not want her to DO anything.
To be honest, for some non-specific suicidal ideation with no immediate plan, that’s probably fair enough. You can just explore it and allow somebody to be heard without necessarily doing anything.
But there does have to be a line, and if somebody were to say, for example, “I’ve drawn up a will, stockpiled up on 6 packets of paracetamol and a bottle of vodka and when I get home I’m going to neck the lot”, then I’d say that line has been crossed.
The idea that “if somebody is about to die, then you should do something” is a view that I don’t really feel is confined to a “psycho-scientific IAPT/NICE/DSM/HPC etc framework”. I’d suggest some other people hold that view too.
Please do so. A out of context list does not cut it???!!
Thinman- this list i gave is not out of context. I have read it, have you? If you have read it you will understand what i mean. I have read it. My therapist would have been able to work in this way as I outlined.
Z- you assume you know much about my therapy with this therapist- what if i said I had made plans….which I had, I asked her to listen and not DO anything-I was not going to blame her if it did not work (my therapy) It really is at the end of the day not up to her if it was going to work. If my therapy had not “worked” I would have carried out my plans. But this would not be her fault….why would it have been?
Thinman wrote:
I don’t know why Jan21’s registered associate opposes EBP. If she/he doesn’t have the evidence that what they are doing might work – even if the only evidence is client reports or a theoretical model – why are they doing it? Being ‘freer and creative’ sounds all fluffy and nice, but if they can’t justify it, they shouldn’t be doing it. Regulation exists for a reason. Stopping people from doing potentially harmful things just because they ‘feel’ like it is just one of those reasons (what about doing helpful and nice things-like nothing- that have no evidence base from an EBP perspective????). Do you ever have an intuition-or does one need a guide book to regulate every single move in the therapeutic space. Therapists do things all the time without an evidence base or relation to an outcome- or should this be the case-
This is my story-why is there so much argument against it? People here cannot tell me why/what my therapy should be like and if it was OK or not-you were not there. I have studied the draft and in my opinion (as others agree with me) the standards would have made my experience of therapy a very different one. My experience worked for me. I have only given a snippet of what occurred, but i am pretyy sure the alarms bells would sound from an HPC perspective.
(correction-Thinman- this list i gave is not out of context. I have read it, have you? If you have read it you will understand what i mean. I have read it. My therapist would not have been able to work in this way as I outlined. She was very psychoanalytic-some of her moves have no evidence base and no relation to outcome (re NICE) so what she was doing was unethical? Have Z or Thinman had experience of psychoanalytic therapy from a patient perspective?
Another thought I have is this, the feeling I get from Z and Thinman is that therapists should never dwell in confusion and if they are, should get themselves out of it asap (in the therapeutic context), so save a situation or patient. However, a therapist may be in confusion for many months, for good reason, and for the benefit of the patient.
Z- I never said my therapist encouraged me to talk about my suidal thoughts or plans- That is an assumption you made.
Jan21
I am very pleased that your therapist acted in such a way as to have enabled you to overcome your suicidal thoughts and/or actions. That is a very humanistic place to be from your therapist’s point of view.
It sounds very much to me that your therapist took similar actions and went through similar emotional processes to those that a good priest/ cergyperson of any belief system would also undertake if confronted by a similar situation. In effect it was irrelevent whether they were a “therapist” or not in doing whatever they did. They did what they did in the same way anyone would. I would stand up in any court or in front of any panel and justify my actions if I thought I was doing the right thing to save a life – and I am not a “therapist” or health professional of any type.
I hope you don’t mind me asking but was your therapist in the private sector? Did you in effect pay them to save your life? Because you see which ever way you look at it that simple element in the equation alters the dynamic of the situation. For example if you had stopped paying them would they have told you to go away and die? Believe me I know of at least one therapist who told suicidal self harmers that if they left him (ie stopped paying him) they would end up commiting suicide.
So considering your therapist was acting truly humanisticly in saving your life I do not understand at what point you think the HPC or any other court would question their methods and motives. Who do you envisage would put them up in front of a complaints process – you? Their peers? Or do you think the HPC have some sort of secret police who will be sitting in every therapy room? So let’s say one of their peers heard about their methods and reported them to the HPC with the intention of putting them up for some sort of ethical review – that would make an interesting test case for the HPC – your therapist would quite rightly then be able to present his case, show their methods and thought process, display their notes and interactions with their supervision, experience they had drawn on and explain that their course of action was positive and in effect protected the public – you.
That is the nature of legal frameworks you see. They test themselves at every hearing. Conclusions are drawn and precedents set. Ideas and principals are tested and learned from. Why do so many in the anti HPC cabal see hundreds of years of experince as being anethema to psychotherapy? Or is anethema to their own cosy little club of self interest?
Howard M wrote: I am very pleased that your therapist acted in such a way as to have enabled you to overcome your suicidal thoughts and/or actions. That is a very humanistic place to be from your therapist’s point of view.
What do you mean by this, that it is a very humanistic place to be from my therapist’s point of view? Do you know my therapists point of view? I think she would feel a little alarmed if she knew or thought that you could know it. It is a huge assumption to make.
Howard M wrote: It sounds very much to me that your therapist took similar actions and went through similar emotional processes to those that a good priest/ clergyperson of any belief system would also undertake if confronted by a similar situation. In effect it was irrelevant whether they were a “therapist” or not in doing whatever they did. They did what they did in the same way anyone would. I would stand up in any court or in front of any panel and justify my actions if I thought I was doing the right thing to save a life – and I am not a “therapist” or health professional of any type.
I think you are again a way off the mark. You say what she did was irrelevant whether she was a therapist or not. They did the same that anyone would. Well who is this anyone? I don’t think she could have responded (or not responded as the case perhaps was) if she was not versed in the type of therapy she practiced that would, under an HPC system (as set out in the draft standards of proficiency) not be allowed to continue. I have been around priests/clergy in my life-no it was a different experience-far different. Further, I don’t think she was “trying to save my life”. I think she may have “helped” me take responsibility for myself and my life. The strange thing is I think for her to get up and justify this may prove problematic, as it rests upon grounds of my therapist knowing me better than I know myself. I think I am the best judge as to what saved my life-I am trying to tell people here-but the frightening thing is, my account is being thrown out-what right do people have to tell me what “good therapy for me is”? Out of interest Howard M, what do you think of the idea of an unconscious, transference, and counter-transference?
Howard M you wrote: I hope you don’t mind me asking but was your therapist in the private sector? Did you in effect pay them to save your life? Because you see which ever way you look at it that simple element in the equation alters the dynamic of the situation. For example if you had stopped paying them would they have told you to go away and die? Believe me I know of at least one therapist who told suicidal self harmers that if they left him (i.e. stopped paying him) they would end up committing suicide.
In response to your last sentence above, I know of Doctors who told me that if I took Prozac it would help me-it took me to a motor-way bridge with the intention jumping off it and killing myself-This Doc still practices, they still make the drug and nobody has been taken to account. I was also told that CBT cures negative thinking, making negative cognitions more positive-that also turned out to be false-who do I blame? Yes my therapist was in the private sector. She operated a sliding scale and I paid what I could afford. If I had stopped paying her I would have left therapy, yes. Because I knew I had to pay her. I really don’t know what your point is here, I knew I had to pay-it would be ridiculous for me to think I would have got it for free. If she was not able to give me (or deny me in some sense by not placating my perhaps infantile demands) I would have went elsewhere. But luckily for me she was able to practice the way she did which would not be possible under HPC criteria. Are you against people paying for therapy? I know some HPC registered psychologists who charge huge amounts and spout dubious efficacy claims about their treatment, treatment that is sanctioned by NICE etc, IAPT, and Layard etc. But, I felt paying for my therapy was positive for me and put some self-responsibility back onto me.
As I said, I have had NHS free psychotherapy (CBT) and SSRI therapy in my time (before I started in therapy. The CBT was a waste of time and overly mechanical and the alleged hopeful efficacy (based on evidence based research) of it very dangerously misleading and turned out to be false (for me) and drugs made me even more suicidal. In an HPC psychotherapy world am I to believe in the therapies they sanction? What if they don’t work. Scientists said that SSRI’s were safe….. Also, I know of many ex in-patients from psychiatric wards who were not helped? Should the wards/staff be held to account for every single patient that has been an in-patient and not recovered?
Howard M said: So considering your therapist was acting truly humanisticly in saving your life I do not understand at what point you think the HPC or any other court would question their methods and motives. Who do you envisage would put them up in front of a complaints process – you?
Well as I said before, my therapist did not “save my life”-she helped me save my own life-that’s a big difference. If I did have a reason to complain about a therapist, I suppose I would complain. But I was well aware that I had recourse to the law, and if needed, was able to complain to her governing body when I saw my therapist. Interestingly, I did hate her for a while, and I thought she was a horrible person at times. Should I have complained? She did not placate my hate for her or my negative feelings about her.
At present I am gong over again the draft proficiency standards of the HPC intended for psychotherapy. I will post later on why I feel she would not satisfy these, and thus be ineligible to practice as a psychotherapist under the HPC. Interestingly, I have done a bit of background research on my old therapist and the organisation(s) she is attached to are against HPC regulation. For me, that kind of implies that she she feels that HPC regulation would not let her practice how she wants (or wanted to do with me).
Lastly, if there will be no watchdog re HPC registered therapists, who would enforce the standards? Are you saying that all therapists would have to do under the HPC is keep their methods secret and tell their patients (dubious scientific claims) about their treatment efficacy? If every patient with seriously negative transference issues with their therapist felt that this was grounds for complaint, the HPC courts would indeed be a busy place. Out of interest, what do you think of negative transference?
I do feel on this forum, that many here find it hard to believe that there are patients like myself who have had psychotherapy, that do not want an HPC regulated psychotherapy world. I am not against people wanting the therapy they want, but I don’t want the kind of therapy I want/had to be taken away by scare-mongerering/power hungry/and/or people who want a political monopoly/hold of the psychological therapies. As I said before, if the HPC existed when I wanted therapy, I would not have got the therapy I needed. I believe psychotherapy has to be free from state influence to enable individuals to break free of “illnesses” of state that contribute to illness. I am appalled by the way of the plans for CBT to be introduced into job centers. Unemployed peoples minds are not ill; the banks, economic system, political system etc have contributed greatly, to the economic situation. They are ill- Perhaps they need CBT.
Most of the evidence? for psychoanalytic theory and humanism is based on the experiences of the middle-classes, and, according to therapists, these are the preferred client group because they are able to articulate themselves. And, surprise, surprise, it is this group who can pay privately (no, really, I’m not being cynical)
It seems that practitioners of humanistic psychology and psychotherapy are arguing that evidence-based practice does not relate to their theory because a) it is individualistic and not open to the usual observations of large groups and/or b) the unconcious is hidden, so how can it be observed individually never mind as part of a broad study. But this fudges the isssue of regulation, in fact it has nothing to do with any prescribed regulation:-
I have, in the past and currently, patients/clients/service users, who have quite unique care-plans which are not evidence based in the usual sense, ie subject to long-term group studies, but these care-plans do, observably, work.
I do not envisage that the NMC is going to intervene or that I will be struck-off the register.
Well I am working class and I know of lots of working class people who have had very good experiences of non-HPC psychotherapy (e.g., prisons, therapeutic communities, hostels, etc etc). I also paid low cost when I was unemployed and then a student.
Evidence based practice is dubious for philosophical reasons. I.e., what is the self, what is happiness, what is it to live a human life. These are tricky things and positivistic statistical and empirical methods are frankly in much of the research non-sense. Many math pofs would agree with as as would physicists.
So your care plans are not evidenced based. Well, why do you know they work, by osberving things, what things? Surly thats a value/social judgment. One does not have to observe if they (care-plans) have worked, a better measure would be to ask somebody if some plan of action worked and for some people it will work, and for others no. I have seen care plans not work. If they work and they dont, one is just hoping that they work is one not? If not and intuition is guiding you, are you advocating intuition or common sense. I have nothing against common sense, or uncommon sense.
Are you advocating a non-evidence based way of working? Surly one’s intuition is a form of evidence, but a form of evidence that is not part of NICE guidlines for example. e.g., I let the patient dwell in frustration as I “felt” it to be the thing to do is never advocated-you have to justify why. If they work why? If they dont work why. The care plans dont do things to people, people do things to change their lives-and people have capabilities. Mind maps work and sometime dont work, as does psychotherapy, hospital care, drugs, etc etc
I am sure the NMC would interven if you just did things cos you just thought they worked as you observed them to work, but what exactly do you mean-but quite clearly with care-plans they often do not work.
So I dont really get your point…please clarify so I can answer fully.
“Surly[sic] one’s intuition is a form of evidence …”
Actually no. That would very much be an example of something that is not evidence.
Mr dazed and confused, what is so wrong with intuition as a form of evidence. Please see definitions below. Perhaps you might be talking about about “scientic evidence” like statistics? Well that is fine. But statistics especially in psychology are in my opionion have questionable validity/reliability (at best), and perhaps are nothing more than mere fictions (at worst)
Intuition: Dictionary def
noun 1. direct perception of truth, fact, etc., independent of any reasoning process; immediate apprehension.
2. a fact, truth, etc., perceived in this way.
3. a keen and quick insight.
4. the quality or ability of having such direct perception or quick insight.
5. Philosophy. a. an immediate cognition of an object not inferred or determined by a previous cognition of the same object.
b. any object or truth so discerned.
c. pure, untaught, noninferential knowledge.
From thesaurus
Main Entry: intuition
Part of Speech: noun
Definition: insight
Synonyms: ESP, clairvoyance, discernment, divination, feeling*, foreknowledge, gut reaction, hunch, innate knowledge, inspiration, instinct, intuitiveness, nose*, penetration, perception, perceptivity, premonition, presentiment, second sight, sixth sense
Evidence dictionary
–noun 1. that which tends to prove or disprove something; ground for belief; proof.
2. something that makes plain or clear; an indication or sign: His flushed look was visible evidence of his fever.
3. Law. data presented to a court or jury in proof of the facts in issue and which may include the testimony of witnesses, records, documents, or objects.
–verb (used with object) 4. to make evident or clear; show clearly; manifest: He evidenced his approval by promising his full support.
5. to support by evidence: He evidenced his accusation with incriminating letters.
—Idiom6. in evidence, plainly visible; conspicuous: The first signs of spring are in evidence.
Theasaurus
Main Entry: evidence
Part of Speech: noun
Definition: proof
Synonyms: affirmation, attestation, averment, cincher, clincher, clue, confirmation, corroboration, cue, data, declaration, demonstration, deposition, documentation, dope*, goods*, gospel, grabber, grounds, index, indication, indicia, info, information, manifestation, mark, sign, significant, smoking gun, substantiation, symptom, testament, testimonial, testimony, token, witness
Notes: evidence (from Latin e- ‘out’ + videre ‘to see’) is information that helps form a conclusion; proof is factual information that verifies a conclusion
*ahem*
I think here is where I rest my case. Please do not get me wrong I have nothing against intuition, but it is not evidence. Sorry for being quick so snarky in my previous comment I had a pounding headache and was being snippy with the Internet as a result.
hence the expression lost in therapy
Jan21
You ask how I know that care-plans work – all of our care-plans are devised with our service-users, they are also assessed on a 6 weekly basis, assessment involves a subjective account by the service-user and any observable changes noted by staff ie behavioural changes. If the care-plan does not work it is discontinued.
Whilst the rest of your post is interesting it deviates considerably from the points I made – that care-plans are person-centred, individualistic and quite unique and are not contrary to humanistic principles. As nurses working for a public organization, we are subject to considerable regulation, but despite this, regulation does not create a strait-jacket or constrain us from being individualist and creative. It is a nonsense for therapists to suggest the contrary.
The care plans are created in the first place by people who want to use care plans and think people need them, e.g., supporteing people. people like them make the forms, print them up, get staff to use them and then use them on patients/clients. Organisations basically invent them. Perhaps ask what patients what they want to do. If they want care plans fine, if they dont, dont use them. What behavioural observation measures do you use?
If the care plan does not work (what would this entail? what do you mean by not working?) it is discontinued-(only after six weeks?) and even if it is discontinued later it may be a neccissity for “the something you are trying to succeed in to stay not succeeding in (have you heard of incubation re Jung). What if the client thinks it is working and the staff dont…what happens then?
I have been in the “care-plan” arena-I feel it does put a staright jacket on life. Supporting people for example “demand” progress and staff are demanded to “use” them and show evidence of using them even if the staff thinks care plans dont work/and the clients dont want to use them. As you said, they are not used for their association with evidence based practice, then why use them? HPC for therapy is the same- It would have been bad for my therapy as a patient- but that is my subjective account (is that taken into account?), if as a patient I say HPC therapy does not work for me, where shall I go? What choices do I have?
Ok, I amk not asking you to belive in clairvoyance or ESP, but surly these we use in dealing with people?
feeling, foreknowledge, gut reaction, hunch, innate knowledge, inspiration, instinct, intuitiveness, nose (use my nose), penetration, perception, perceptivity,
i.e, that I feel you are miserable and I see your tears, you tell me and I “feel” intuitively that you are telling the truth
Intuition: Dictionary def
noun 1. direct perception of truth, fact, etc., independent of any reasoning process; immediate apprehension.
2. a fact, truth, etc., perceived in this way.
3. a keen and quick insight.
4. the quality or ability of having such direct perception or quick insight.
5. Philosophy. a. an immediate cognition of an object not inferred or determined by a previous cognition of the same object.
b. any object or truth so discerned.
c. pure, untaught, noninferential knowledge.
I previve your tears and intuit that you are sad and you confirm that this is so (you could be lying,) but I feel it to be genuine.
(Evidence) something that makes plain or clear; an indication or sign; your tears
Thus your misery and sadness become manifest and clear to me, which then become evidence. I could present this evidence to a court of law how I felt about you and record it in my notes (if it was a therapy session-these notes would be used in evididence in an HPC tribuail for example. I would justify that I felt you were sad as you were crying and you confirmed that was on my asking (you may have been crying tears of joy).
But this evidence is not “hard” in that I cannot really measure it like a table top, or height of a person
As I said, maybe you are getting at a “scientific knowledge”, verifiable, reliable, repeatable, etc etc via hard data like scores on a questionnaire, or statistics or something to be measured. That is fine if that is what you mean. You could me a rock that smashed your window while driving your car-the rock woul be evidence of what smashed your window. Or the speed you ran 100 metres-we could time it, and that would be evidence of your speed to do the race.
But this is where meausuremnt in psychology is very dubious-cognitive processes cannot be measured as where are they? Where is happiness? Where is the self? We can make questionniares that people fill in about what they think is the self, but it is not the self?
This one will run and run. I don’t know why. It’s all a bit undergraduate, quite frankly.
I’m done.
Having read quite a lot of the research for evidence based practice in mental health nursing it is stunning how little actual top quality evidence there is.
Am always confused quite Psychotherapists seem to be held in such regard, whenever I hear the term I mentally replace it with ‘Snake Oil Salesman’.
SOS? I hope not! No wonder the Titanic sank.