Apparently the Barefoot Doctor is in a bit of a pickle at the moment. Mr Barefoot is a self-styled guru who dispenses advice on health and well-being, via his website, various self-help books, newspaper columns (formerly for the Observer), TV appearances and his touring circus (sorry, that should read public appearances.) As far as I can ascertain he is a yoga-teacher with an incredible knack for making money (which, as any yoga-teacher will tell you, is actually quite a remarkable achievement.) I used to enjoy Mr Barefoot’s column in the Observer. His advice is sound and his Taoist approach to life is one that I mostly admire. The Observer reported on Sunday that the patient group Witness have received complaints against him for ‘making sexual overtures to patients in treatment.’ Mr Barefoot denies the claim, but admits to ‘sexual tensions’ with ex-patients and others whom he implies are ‘Barefoot groupies’ (my words, not yours, don’t sue.) He has made a statement on his website, disputing the claims but apologising for ‘salacious emails’. I can’t check it out because he has a ‘membership fee’ to enter the site which I am loathed to pay: I refer you back to his incredible knack for making money.
The Observer article went on to talk about the importance of regulation for ‘alternative therapies’, including counselling and psychotherapy. I have to say I am quite uncomfortable with psychotherapy being lumped in with crystal healing, meridian-tapping and aura-reading, and I think they should be treated as quite separate entities. I can see no great benefit to hippy-dippy therapies being more formally regulated: if people want to spend their hard-earned cash on the left-field end of alternative therapies, that is undoubtedly their right, and I don’t think these therapies create a patient-therapist relationship that requires sanctifying. But I do happen to think that the counselling and psychotherapy world requires government regulation, and that this should happen sooner rather than later. This is a matter very close to my heart, and one on which I have a selection of opinions, so I turned eagerly to page 24 for the Focus special: sex and betrayal in the consulting room.
The Focus special turned out to be a focus on medics, in particular gynaecologists and GPs who, let’s face it, have unparalleled opportunities to abuse their patients. Given that all of the professionals cited belong to an already well-regulated profession, the argument that we need urgent regulation to prevent psychotherapists from molesting their clients seemed to have lost its internal cohesion. So, in a spirit of public service I will give you the information that the Observer should have published, outlining why regulation for psychotherapists and counsellors is a Very Good Thing Indeed.
It is something of a misconception that the therapy industry is entirely unregulated. There are 2 main governing bodies, UKCP and BACP, both of which have stringent accreditation criteria. UKCP requires:
- Minimum 900 hours of advanced training/supervision over a period of not less than 4 years
- An appropriate psychiatric placement
- Minimum 450 hours supervised clinical practice
- Supervision at a ratio of 1 hour per 6 hours of client contact on no fewer than 450 client contact hours
- A minimum of 40 hours of personal therapy for 4 years
And to maintain registration:
- Evidence of Continuous Professional Development
- Continued client contact (eg, if a therapist takes a year out of practice there are steps s/he must take to re-register before permitted to practice again)
- A minimum of 8 supervision contacts a year
Both governing bodies have their own ethical codes that registered practitioners must abide by, and pay particular attention to the nature of the therapist/client relationship. Needless to say, sex is a no-no. In addition to this, most practising therapists/counsellors will also be members of their own modality’s professional body, which will have its own code of ethics and professional requirements. Technically, I can be taken to two different ethics boards for the same transgression.
So far, so tough. Except that registration with a governing body is optional, and indeed membership of your own professional body remains optional. Which means any Tom, Dick or Harriet can put a brass plaque on their door saying ‘Tea and Sympathy’ and they are good to go. It is currently incumbent upon the client to check out the practitioner’s professional credentials. And this is the really shocking part: in 10 years of practice I have been asked four times for my qualifications and registration details. Just four times: less than 1% of clients seen (and two of those were practising therapists who knew what they were asking for.)
I have no doubt that the government will make it a legal requirement for psychotherapists and counsellors to be a member of a regulatory body before they can practice, with exemptions for trainee therapists practising under supervision. And homeopathy, acupuncture, osteopathy, hypnotherapy and other ‘respectable’ complementary therapies are going the same way. I don’t imagine this will stop some therapists having sexual relationships with their clients. Sexual predators will do it regardless of the rules – look at the medical profession – and there will always be some who ‘fall in love’ and don’t feel able to hold the boundary. But registration will certainly sift out most of those who are incompetent, poorly trained or just well-meaning individuals who once did a ‘skills to counselling’ course at their local tech.
Until then it is the client’s responsibility, unfortunately, to check out the practitioner. Suggestions:
- Ask for their qualifications, but don’t be put off if they say ‘trainee therapist under supervision’ – they have to be deemed competent to practice by their trainer and supervisor, but they are obliged to inform any clients so be suspicious if they haven’t volunteered that information right at the beginning.
- Ask whether they are a member of UKCP or BACP. If not, why not?
- Ask about their supervision arrangements and their commitment to their own Continuous Professional Development.
And if they refuse to answer any of the above, then go somewhere else.
Here endeth the lesson.