Therapist who sexually abused clients returns to practice

A Jungian psychotherapist who was found to have sexually abused a mentally ill client in his care has put up a new website advertising his services.

Stuart Macfarlane was previously registered with the Guild of Analytical Psychologists, a member organisation of the UK Council for Psychotherapy. In 2012 the Guild of Analytical Psychoanalysts found allegations proved that he had committed serious breaches of boundaries with a vulnerable client. Unsafe Spaces learned that these breaches were of a sexual nature, and the client experienced severe trauma as a result of his behaviour.

The case was controversial, because the Guild of Analytical Psychologists chose not to strike him off, but instead gave him a suspension. However, Macfarlane resigned from the GAP during his suspension period. UKCP member organisations are now no longer allowed to handle complaints in-house, which instead go through the UKCP complaints process.

In 2014 a second ex-client came forward to the Daily Mail, accusing him of abusing her in a very similar way to the first.

Macfarlane has now put up a blog, describing himself as a “seasoned and well-respected therapist with over 30 years of experience”. It also states that he “still resides in London and continues to delve into the world of psychology, helping many people along the way.”

This sort of behaviour is sadly not unusual. Our Unsafe Spaces report found that one in four counsellors or psychotherapists struck off by professional bodies continue to practice. This is legal because neither “counsellor” nor “psychotherapist” are protected titles, and anybody can use these titles.

Unsafe Spaces has also issued guidance on keeping safe from abuse when accessing counselling or psychotherapy. We strongly recommend that clients check their therapist’s registration before beginning therapy.

 

 

Revisiting the Accreditation Confusion

(reblogged from www.amandawilliamsoncounselling.co.uk)
Back in February 2015 I wrote an article entitled “Accredited This, Accredited That” in an attempt to address the confusion in our profession about the use of the word Accreditation to describe counsellors and psychotherapists. We have therapists accredited by the British Association for Counselling & Psychotherapy (BACP), therapists accredited by the National Counselling Society (NCS) involving a quite different set of criteria and we have therapists who are on an Accredited Register who may or may not have accredited status.

In that article I questioned the Professional Standards Authority and they offered the following:

“The Professional Standards Authority is aware of the potential for confusion in the different uses of the word ‘accredited’. We are working closely with the Accredited Registers to prevent this confusion by providing clear information to the public. This will include a guide to different types and levels of qualifications in health and care, which we will publish in the coming months.”

Counsellor and Psychotherapist Accreditation

The British Association for Counselling and Psychotherapy (the BACP, at that time the BAC) introduced the concept of accredited membership back in 1983 and for a number of years it has been used to separate a tier of members who have been through their accreditation application process involving set criteria above and beyond the basic membership. The criteria is currently as follows(1):

To apply for BACP accreditation, you must:

• Be a Registered Member of BACP
• Have successfully completed a BACP-accredited or other appropriate professional training of at least 450 hours
• Have been in practice for at least three years and completed a minimum of 450 supervised practice hours
• Have an ongoing supervision arrangement in place for 1.5 hours per month
• Be covered by professional indemnity insurance

You will need to complete an in-depth application providing evidence of your training, practice and supervision. This includes a reflective practice section, asking you to write about your understanding of what you do, using examples from your practice.

In contrast we have the National Counselling Society (NCS) accredited membership level which requires the following (2):

Accredited Membership is awarded to a member who has successfully completed one of the following:

• A National Counselling Society Accredited Course at Ofqual Regulated Qualifications Framework (RQF) Level 4 or Ofqual RQF/Framework for Higher Education Qualifications(FHEQ) Level 5 or equivalent
• A full qualification in counselling or psychotherapy practice atOfqual RQF Level 4 or Ofqual RQF/FHEQ Level 5 or equivalent which complies with the Society’s currently published standards of training

There is also the facility to apply for membership without these requirements based via a complex committee.

The accredited status of these two professional bodies for counselling and psychotherapy is clearly different. Added to that we have had, since 2012, the existence of the PSA’s Accredited Registers adding a further type of accreditation into the mix.

The confusion has been the source of ongoing confusion within the profession and not just amongst service users. I have participated and observed many online discussion on counselling forums with what sometimes amounts to petty spats and resentment between BACP and NCS members.

I asked Phil Doré , author of the blog Unsafe Spaces what he thinks about this issue:

Looking at all the differences in types of registration and accreditation – I’m a mental health nurse, I have an interest in psychological therapies, I read and write about the different professional bodies – and these differences make my head spin trying to make sense of it. So if it does that to me, what does it do to a lay person? Would a lay person even know that there’s a difference between BACP Registered, or BACP Accredited? Or between BACP Accredited and NCS Accredited? Let alone know what those differences are. Also it’s important to bear in mind that when people are accessing counselling or psychotherapy, they’re often experiencing a mental health condition, often at a period of crisis in their life. It’s simply not a time when they should be expected to parse information that’s as clear as mud to begin with.
This is pretty much how I feel about it too.

The PSA, BACP and NCS’s responses to this issue

I wrote the following to the PSA:

I wrote a blog post in February 2015 where I asked the PSA for their response to the fact that there is a lot of confusion around the word accreditation in the counselling and psychotherapy profession. There is a substantial amount of confusion amongst professionals too would appear from various online discussion groups.

I was told by the PSA back in Feb 2015 that they would be working on clearing up the confusion and I would like to have an update on this as it still an issue. I have been involved in a discussion only today on a counselling practitioner’s forum.

They responded within 5 days:

Thank you for your enquiry regarding usage of the term ‘accreditation’. Since your blog post of February 2015, we have updated one of our Standards, specifically Standard 9e, which states that the organisation must ‘make its education and training standards explicit and easily accessible to the public to enable all those using the register to make informed decisions’. The assessment of this additional Standard started in April 2016 for both new applicants and existing Accredited Registers submitting their annual review of accreditation.

When registers are first accredited, we provide them with a communications toolkit with clear guidance on how to share information on their new accreditation status with the public. In this, we ask that they make it clear that it is they, the organisation, which is accredited and not their individual members (which distinguishes it from the BACP’s system of accreditation, for example).

We are aware that the terms ‘accredited’ and ‘accreditation’ are both widely used in healthcare as well as many other professional and public sectors. We addressed this in our original formal consultation and it was agreed that this was still the best descriptor for the programme.

I then wrote the the BACP and the NCS as follows:

When I applied for BACP Accredited status 2 years ago I was unsure about whether it was worth it with the ARs in place although decided to proceed for the professional development and personal validation that the process entails i.e. the self-reflective essays and defining of my approach. BACP Accreditation has also been nationally recognised as a mark of a particular level of experience (3yrs post qualifying and 450+ hours)

There is much confusion between therapists about the value of BACP Accredited member status. Added to that we have the National Counselling Society’s Accredited member status that, as far as I can, requires significantly less experience and written work to apply for. I have seen numerous arguments on therapist forums where some believe that NCS Accred status is the same thing as BACP Accred status. NCS therapists seem to express concern that BACP therapists think that they are somehow better than NCS therapists if they point out the difference in criteria and BACP therapists are perturbed by the perception that their Accredited status is potentially being devalued in some way by it being stated that they are like for like. I can appreciate both view points.

This is all secondary though to the main issue, whichever emotions are provoked within (and without) the profession, which is that since the creation of the Accredited Registers we now have a confusing situation around the use of the word accredited which as far as I am aware, is not being addressed by the BACP, NCS or PSA.

I wrote to the BACP on 1st June and after some chasing up I received an apology for the delay in replying along with a response on 19th July from Helen Coles, Head of Professional Standards:

We agree that there is confusion as the same or similar titles are used for professional counsellors/psychotherapists in different contexts by different organisations. To some extent such confusion is inevitable given the small number of words to indicate similar professional statuses. `Accreditation’ and `Registration’ are not protected titles. What this means in practice is that any organisation can use them as a descriptor. As well as BACP and NCS there is UKCP’s registered status (as distinct from being on UKCP’s PSA Register) and NCP and BABCP use their own terminologies. Perhaps I should also point out that counselling is not the only industry (accountancy is another) served by a number of professional bodies.

BACP is working more closely with other therapy bodies, including UKCP, which provide fora for addressing such confusions. We also have regular contact with the PSA and were heavily involved in discussions about setting up the Registers. However it is important to recognise that other therapy bodies and the PSA are all independent organisations, making independent choices about the choice of titles to reflect different statuses and in the case of the PSA, using the word ‘accredited’ to describe the Register programme. BACP is always willing to meet other bodies and discuss such issues, while recognising it can influence, but not order.

As BACP it isn’t appropriate for us to comment on the quality (or not) of the schemes of other therapy bodies. The requirements for PSA registers are well publicised, enabling people to make their own judgment on quality. We would never encourage members (accredited or otherwise) to imply that members of some other professional counselling/psychotherapy bodies are of a different standard, but that does not negate our pride in our Accredited Members.

We are proud of the quality of BACP’s Accredited members and the BACP Accreditation scheme. A well-established, longstanding scheme, its quality is recognised by therapists, government, the NHS, employee assistance programmes and a wide range of counselling employers. The requirements of the scheme are well publicised, as is guidance on making applications, allowing all to form their own judgment about its worth. The demand for accreditation by counsellors and psychotherapists is steady. Because of this wide recognition as a quality kitemark we would be reluctant to have no current plans to change the title.

I wrote to the NCS somewhat later on 1st August and received a response from their interim CEO, Jenny Parker on 16th August:

Thank you for your email and apologies for the delay getting back to you. The Society is restructuring our membership grades at the moment, and the standards of registration and accreditation will change in 2017. Accordingly there is little point in our answering your queries until these changes have taken effect.

This is a new and interesting development and I do wonder whether they will be looking to bring their level of accredited status more in line with the requirements of the BACP.
Further opinions

Roslyn Byfield, a BACP Accredited counsellor working in Central London, also has concerns around the use of the word accreditation in the profession:

The BACP Ethical Framework is clear that adherents must not misrepresent themselves or their qualifications – a no-brainer, you could think, as this would constitute dishonesty, the opposite of what counselling and therapy stand for.

But unintentionally or otherwise, this could be happening due to widespread confusion about qualifications terminology. It could be argued that professional and standards bodies have been short-sighted in not anticipating the confusion which could arise between being an accredited member of an organisation and being on an accredited register (but not personally accredited). Since it’s well-known that there is still public confusion as to the roles of and differences between a psychotherapist, psychologist and psychiatrist, it follows that there is potential for more confusion when it comes down to the detail of levels of qualification.

Recent exchanges on counselling forums have shown that some practitioners are suggesting they are ‘accredited’ when, in fact, some are on the BACP register (accredited by the Professional Standards Authority) as a registrant or they are ‘accredited’ by the relatively new body, the National Counselling Society, the requirements of which are not comparable with BACP accreditation. Understandably, those who have gone through the rigours of BACP accreditation do not wish their qualification to be confused with one which is not comparable in terms of work, learning and reflection required. In addition some Senior Accredited BACP practitioners are aggrieved that the register icons, which since March 2016 must be included in practitioners’ websites and literature, do not include one for the senior accredited category (the two are for BACP registered and BACP registered and accredited).

This situation could easily result in some practitioners telling clients and potential employers that they are ‘accredited’, when in fact that is not the BACP accreditation which would be assumed by many.

To make the provisions of the Ethical Framework meaningful, BACP and other relevant organisations including the NCS should take steps to clarify this situation and issue advice to members and the public to prevent such confusion arising. BACP could also produce a third icon, which Senior Accredited practitioners could use in their marketing materials. If this situation continues unaddressed, it risks bringing the Ethical Framework and the profession into disrepute.

And finally, I requested some input from peer Patrick Killeen, a philosopher trained in counselling skills who has contributed to this blog before.

The British Association of Counselling and Psychotherapy (BACP) has a strange quirk in the way it uses the word “accredited” that can be summed up in one sentence. You don’t have to be an “Accredited Member” of the BACP to be an accredited member of the BACP. This anomaly stems from the difference between the standard English meaning of “accredited” and the jargonistic way that word is used within the BACP.

According to Google “accredit” means to “give authority or sanction to (someone or something) when recognized standards have been met”. The BACP have a register of counsellors and psychotherapists which they say is “a public record of therapists who have met our standards for registration” [http://www.bacpregister.org.uk]. So by including someone on their register the BACP are literally accrediting them.

However, they don’t include Registered Membership in their so-call “accreditation” programme, instead they refer only to “Accredited Membership” and “Senior Accredited Membership”. They clarify the situation by saying “BACP accreditation is a quality standard for the mature, experienced practitioner who can demonstrate high standards of competent and ethical practice” (my emphasis) [http://www.bacp.co.uk/accreditation/Individual%20Practitioners]. So “Registered Membership” accredits all counsellors including the newly qualified, while “Accredited Membership” and “Senior Accredited Membership” only accredits experienced counsellors.

This idiosyncratic use of the word “accredit” has become an issue recently because the BACP’s register has itself been accredited by another organisations, the Professional Standards Authority (PSA), and so anyone on the BACP register can now say that they are a member of the BACP’s Accredited Register, even though they may not be an Accredited Member of the BACP. A state of affairs that some might find more than a little confusing (even though the underlying situation is quite straight forward: registered members are accredited by the BACP and the BACP’s register is in turn accredited by the PSA).

The BACP could clear this up by renaming the membership categories to make their use of the word “accredited” more consistent with standard English, for example by renaming “Accredited Member” as “Accredited Experienced Member”; but that would stir up a lot of trouble among their members. For years there has been a strong cultural expectation within the BACP to become an “Accredited Member” as soon as possible after joining. They never had a rule saying you must do so, but by withholding the word “accredited” and the public acknowledgement that goes with it they were able to get a high uptake of their “accreditation” scheme without the messy business of making and enforcing official rules. There’s no way for the BACP to resolve the “accreditation” ambiguity without admitting explicitly that (although it is worth it for its own sake) members don’t, and never did, actually have to become “Accredited Members”.

(1) http://www.bacp.co.uk/accreditation/Individual%20Practitioners/

(2) http://www.nationalcounsellingsociety.org/join/criteria/levels/

Keeping safe from abuse during therapy – Unsafe Spaces publishes free resource

Today we publish our free guide, Keeping Safe During Counselling or Psychotherapy. It highlights some of the warning signs that a therapeutic relationship may be turning abusive. It also gives suggestions on how you can take action if you’ve experienced misconduct or abuse.

The guide is based on some of the misconduct cases that have been highlighted by this website, as well as from consultation and feedback kindly provided by a number of professionals and service users.

The guide is free to download, and comes in two versions – full and easy read. The full version is for people who want a detailed explanation for the thinking behind the advice. The easy read version is for those who just want the main points, given with as little jargon as possible.

Go here to download either version.

Unsafe Spaces report discussed in Parliament

Today the Health Select Committee of the House of Commons met with the Professional Standards Authority to discuss their role in professional regulation. Sarah Wollaston MP and Ben Bradshaw MP both raised the issues described in our Unsafe Spaces report, which describes how one in four counsellors and psychotherapists struck off for misconduct simply carry on practising.

The meeting can be viewed online here. It’s quite a lengthy video, but all the discussion of counselling and psychotherapy is finished by 15:16 (there’s a break in the video due to a vote being called, with the meeting resuming at 15:07:15).

http://videoplayback.parliamentlive.tv/Player/Index/2524278c-8db8-4e7c-bdc9-0aa77e21217e?audioOnly=False&autoStart=False&statsEnabled=False

Something that’s of interest is that the PSA is working on a risk assessment model for which professions should be on a regulator and which should be on accredited registers. This model is described as based on three factors – the risk of the intervention, the context in which it takes place, and the vulnerability of the patient or service user. They would then go back to ministers with a recommendation as to whether or not a profession should be regulated.

Counselling and psychotherapy are mentioned as professions that the government may wish to look at as ones that could move from accredited registration to regulation. They also seem to be suggesting that arts therapists could move the other way, from regulation to accredited registration. The rationale given for this latter move (by Harry Cayton, Chief Executive of the PSA, at 15: 15:39) is that, “I’m only aware of one ever fitness to practise case involving an arts therapist, and that was for theft, or dishonesty rather than competence.” This seems to miss out the incredibly nasty case of Derek Gale, who was struck off by the HPC in 2009 for running a cult disguised as a therapy centre. Admittedly that was some years ago, but even so that leaves me concerned about the idea of arts therapists no longer being regulated.

That said, I’m pleased to hear that regulation of counselling and psychotherapy is not necessarily off the agenda, and I’ll look forward with interest to hearing about the PSA’s proposed risk assessment model.

Unsafe Spaces report highlighted in Therapy Today

Last month we published our report, Unsafe Spaces: Why the lack of regulation in counselling and psychotherapy is endangering vulnerable people. The report is highlighted in this month’s edition of the BACP’s magazine Therapy Today (click here and go to page 5).

As a slight correction to the Therapy Today article, although it correctly states that the report calls for “counsellor” and “psychotherapist” to be made protected titles, we didn’t call for the title “coach” to be protected (though we did recommend consideration be given to protecting other titles, such as “psychoanalyst”).

The Unsafe Spaces report was also previously mentioned in the Mail on Sunday.

Our report found that one in four counsellors or psychotherapists struck off by the BACP or UKCP for misconduct continued to practice after being removed from the register. These included individuals struck off for very serious misconduct, including sexual abuse of clients. We believe this evidence shows the pressing need for regulation of these professions in the UK rather than the voluntary registration systems we have now.

Unsafe Spaces report mentioned in Mail on Sunday article

Last week the report, Unsafe Spaces: Why the lack of regulation in counselling and psychotherapy is endangering vulnerable people was published on this site. Authored by Amanda Williamson and I, the report found that one in four therapists struck off by the BACP or UKCP continue to practice.

Today, the report gets a mention in this Mail on Sunday article about a therapist and spiritual healer who has been accused of psychological manipulation. Check out the blue box at the bottom, which has a few names that will be familiar to people who read this blog. The article also states that Geraint Davies MP is hoping to re-present his previous Private Members Bill on psychotherapy regulation.

New report highlights risk to public from unregulated counsellors and psychotherapists

In recent months I’ve been working with Amanda Williamson on a report, Unsafe Spaces: Why the lack of regulation in counselling and psychotherapy is endangering vulnerable people. The report is available for free download from this website.

The report finds that of those counsellors and psychotherapists who are struck off for misconduct, one in four continues to practice afterwards. These included practitioners struck off for very serious allegations, including serious sexual misconduct. We recommend that “counsellor” and “psychotherapist” become protected titles and are subject to a statutory regulator. We also recommend that psychological therapies for mental disorder should become a protected function of professionals who belong to a statutory regulator. Continue reading