The loopholes that can enable unscrupulous psychotherapists to keep practising.

There’s no doubt that times are changing for psychotherapists in the UK. Although plans to make psychotherapy a state-regulated profession were shelved when the Coalition took over from Labour, the new system of “assured voluntary registration” (AVR) is increasingly gearing up. However, the loopholes in this system are starting to show, and those loopholes could put the public at risk.

A quick primer on AVR. It’s basically a form of regulation-lite where existing professional bodies can apply for accreditation from the Professional Standards Authority (formerly the Council for Healthcare Regulatory Excellence, which oversees the work of regulators like the General Medical Council, Nursing and Midwifery Council etc). The British Association for Counselling and Psychotherapy has already achieved PSA accreditation. The other main professional body, the UK Council for Psychotherapy, is working towards it.

At least one loophole has now emerged. An individual recently tried to make a complaint to the UKCP about her former psychotherapist. The allegations were extremely serious, and have been the subject of litigation. However, she was told by the UKCP that she couldn’t make a complaint against him as he had already resigned from their register.

To be fair to the UKCP, the exact same thing would happen if somebody tried to complain to the Nursing and Midwifery Council against a nurse who had previously resigned. They probably wouldn’t be allowed to resign after a complaint has been made, but if they’ve already left the register then it would be outside the NMC’s jurisdiction and there’s nothing they can do.

But here’s the difference. “Nurse” is a protected title and you have to belong to the NMC register in order to practice as one. Any nurse who resigns their registration is effectively striking themselves off. “Psychotherapist”, however, is not a protected title, and you can belong to any professional body or none. As AVR becomes more established it’s likely that a psychotherapist wouldn’t get work from the NHS, social services, schools, universities or the voluntary sector without belonging to a PSA-accreditated body. However, for any practitioner who’s outside of that, accepting self-referrals from the public, anything goes.

All this comes at a time when psychotherapy services are being decimated in the NHS under the pressure of cuts. Waiting lists of six months or more for talking therapies are commonplace, if they can be accessed at all. They’re frequently on a time limit, such as six sessions, regardless of whether or not six sessions are actually enough. The result is that people who feel they need therapy and can afford to do so are more likely to turn to the private sector to seek out a therapist.

Because AVR isn’t true statutory regulation in the manner of doctors, nurses, social workers etc, a psychotherapist who suspects a complaint may be imminent can just resign from their professional body and carry on practising.

Possibly they might join another professional body. For example, the College of Psychoanalysis UK which isn’t PSA-accredited, though they do have a complaints procedure. You can read it here. Complaints have to be proven to the criminal standard of “beyond reasonable doubt” (the usual standard of proof for such hearings is the civil standard of “on the balance of probabilities”). If that isn’t enough to put people off complaining, then Part 5, Section 1.2.1, informs us that, “the Panel shall have the power in its discretion…to require the Complainant to pay such costs and expenses in the event of the complaint not being upheld.” In other words, prove the complaint beyond reasonable doubt or face a big bill. It’s almost as if they’re trying to put people off from complaining.

Or, of course, a therapist can just not bother to join any organisation, but carry on seeing their existing clients and advertising their services.

All this shows why psychotherapy needs proper statutory regulation rather than the halfway fudge of AVR. In the meantime, my recommendation to anyone seeking a psychotherapist is to check that they remain registered with a PSA-accredited body such as the BACP.

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