In recent months I’ve covered the way in which complaints are dealt with (or not!) against psychotherapists, with the result that misconduct or even abuse can continue unrestrained. In particular I’ve looked at the John Smalley case, in which the UK Council for Psychotherapy, after three years of delay, found seven allegations proven against a Jungian analyst, but failed to issue any sanction.
Complaints handling at the UKCP has for years been dominated by “crony-ism and amateurism” – not my words, but those of the former UKCP chair Andrew Samuels. But I’ve just noticed some interesting developments that may well send the UKCP sleepwalking into a crisis. It could even threaten the existence of the organisation itself.
Psychotherapists, unlike doctors, nurses, social workers or teachers, have no statutory regulator. “Psychotherapist” is not a protected title and anyone can call themselves one. However, in practice most are registered with self-regulating bodies like the UK Council for Psychotherapy, the British Association for Counselling and Psychotherapy, or the British Psychoanalytic Council.
The UKCP is an umbrella body for 75 separate member organisations. Until recently, if you wanted to make a complaint against a UKCP-registered therapist, you first had to complain to their member organisation, and could then appeal to the UKCP if your complaint was rejected.
These 75 organisations have a wide variety of complaints processes. Some of them are absolutely shocking. The way to make a complaint can be very opaque. You may find that complaints panels have no lay members, so that the case is being heard only by the therapist’s colleagues. In some cases complaints have to be proven to the criminal standard of “beyond reasonable doubt” (the usual standard of proof is the civil one of “on the balance of probabilities”). For some organisations, if your complaint is rejected, you can be expected to pay legal costs!
To give an example, when I looked into the Smalley case, I contacted his UKCP member organisation, the Independent Group of Analytical Psychologists. Their website contains no information about how to make a complaint. Their Code of Ethics isn’t published on the site – I asked for a copy months ago and still haven’t got it. Oh, and if you’re wondering why they don’t publish an online list of fitness-to-practise outcomes on the site (in the way that bodies like the General Medical Council or Nursing and Midwifery Council do) it’s because they freely admitted that they haven’t sanctioned a member for years. I can’t imagine why not.
The UKCP is currently moving towards a new Central Complaints Process (CCP) that will handle all complaints instead of the member organisations. After the IGAP found “no case to answer” in the complaint against Mr Smalley, the complainant appealled to the UKCP, who found that the IGAP’s decision had been “perverse and incorrect”. They then ordered a new hearing under the CCP.
The new CCP turned out to be a shambles from beginning to end. It took three years of delays to reach a conclusion. At the end of it, the panel found that Mr Smalley had smoked in therapy sessions, he had made derogatory remarks about one client to another, and he had breached professional boundaries by inappropriately setting up two clients in a business relationship with each other. Along the way, he freely admitted that he had destroyed his notes – an act that would be considered serious misconduct if a doctor or nurse did it.
The UKCP’s sanction? Nothing. Not even a caution. Although he resigned from the UKCP during the proceedings, he’s still registered to this day on the IGAP website.
The introduction of the UKCP’s Central Complaints Process comes in the wake of plans to properly regulate the psychotherapy profession. Under the previous Labour government, proposals were made for plans to register counsellors and psychotherapists with the Health Professionals Council (now the Health and Care Professions Council) which currently regulates occupational therapists, arts therapists, clinical psychologists and social workers. Although many psychotherapists welcomed this, a noisy campaign was launched, claiming that the sky would fall in if psychotherapists had to be accountable for their actions in the same way as just about every other helping profession.
After Labour gave way to the Coalition, plans for state-regulation were shelved, and the anti-regulation campaigners cheered a victory. However, the Coalition then proposed a new systems of “assured voluntary registration”. The Council for Healthcare Regulatory Excellence (the uber-regulator that oversees bodies like the GMC, NMC, HCPC etc) was renamed the Professional Standards Authority and given the power to issue an official rubberstamp to self-regulating bodies like the UKCP…..if they were deemed to be doing a good enough job.
Key to getting this rubberstamp from the Professional Standards Authority is the UKCP’s new Central Complaints Process, even though it failed abysmally in the Smalley case. However, the most recent UKCP bulletin suggests their strategy may be running into trouble.
The UKCP chief executive, David Pink, issues a stark warning.
I can understand that organisational members might be nervous about handing over their complaints work to a team in the UKCP office, but it is vital that we take this decisive step. However diligently and carefully a member organisation handles complaints, they can never been seen to have sufficient independence to be free from accusations of bias…I am disappointed that many of our member organisations seem to be reluctant to engage with the central complaints scheme.
I’m really not surprised that there’s a lack of engagement from member organisations. Last May I e-mailed the Independent Group of Analytical Psychologists to ask them if they would be signing up to the CCP. I got this reply.
Since the UKCP Central Complaints Process is not yet finalised, it is too early to say if IGAP will sign up to it or not, but is likely to do so if it is felt to match our professional standards and has nothing that contradicts our existing Code of Ethics.
Hardly a ringing endorsement. And given the gasps of horror from some member organisations at the possibility of state regulation, it wouldn’t be surprising if some of them started dragging their heels over signing up to the CCP.
Pink gives a stark warning of what this might mean.
By this time next year we need everyone to be signed up to the central complaints or in the process to becoming signed up. By then, other leading reputable therapy organisations (including BPC and BACP) are likely to be fully PSA accredited. Employers, referrers, commissioners and clients will begin to expect practitioners to be on a PSA-accredited register as a minimum requirement. We must not fall behind.
And indeed they may well fall behind. To give an idea of how the UKCP compares to its rival organisations, here’s the hearings page for the British Association of Counselling and Psychotherapy. It gives detailed accounts of hearing outcomes and sanctions against therapists who’ve committed misconduct.
Now have a look at the equivalent page for the UKCP. There’s only one entry on it! It’s for Derek Gale, a notorious abuser who was registered with the UKCP as a psychotherapist and with the Health Professions Council as an arts therapist. The UKCP stuck him off in 2009, but only after the HPC struck him off first.
Until recently there were two entries – the other being for Geoffrey Pick, suspended from the register in 2011 for an unspecified breach of boundaries. He’s now back on the UKCP register and his entry in the complaints archive removed. As for John Smalley, the UKCP don’t intend to publish the hearing outcome until Spring 2013, a year after the final ruling.
The UKCP have been failing for years to protect the public from rogue therapists. It now looks like they’re having trouble getting their member organisations to sign up to their new complaint system, which is a shambles anyway. No wonder they’re getting worried that rival bodies like the BACP will get the PSA accreditation and they won’t.
If that does happen, the results will be utterly predictable. All the reputable psychotherapists will promptly sign up with the BACP, leaving the UKCP to shrivel into a rump organisation housing the quacks, hucksters and chancers of the therapy world. I can’t say I feel the least bit sorry for them.