Statutory Regulation and the Future of Professional Practice in Psychotherapy & Counselling: Evidence from the Field

This report is based on a research project funded by the GMC/ESRC Public Services Programme entitled „The Visible and Invisible Performance Effects of Transparency in Professional regulation‟. The research compared the effects of regulation for doctors with developing regulation for psychotherapists and counsellors (as outlined in the 2007 White Paper „Trust, Assurance and Safety: The regulation of health professionals‟). We summarise here some of the key findings in our study focusing on issues that are relevant to the HPC consultation on the regulation of counsellors and psychotherapists. We conducted 50 formal interviews and 22 informal scoping interviews with regulators and other officials, representatives of professional bodies, patient representatives, doctors (GPs and psychiatrists), psychotherapists and counsellors. In addition we observed Health Professionals Council (HPC) Professional Liaison Group (PLG) Meetings for Psychotherapists and Counsellors, as well as for Psychologists. We also observed four professional conferences on the regulation of counselling and psychotherapy. Finally we conducted a stakeholder workshop where we presented our provisional findings to a group including those involved in regulating psychotherapy and counselling at the national level and practising psychotherapists and counsellors, to validate our results. We present our findings as follows. First we examine the way that doctors (GPs and psychiatrists) said that current forms of regulation affected their practice. Although their practice and context differ from those of psychotherapists and counsellors, their experience highlights a number of issues and questions about professional regulation, which we believe should be considered in the future regulation of psychotherapists and counsellors. Second, we examine the experiences of psychotherapists and counsellors working in the NHS, voluntary and independent sectors. In particular, we focus on a large, integrated NHS mental health service, whose work is influenced by the local development of an Improving Access to Psychological Therapies (IAPT) service. Again, although these experiences do not reflect the wider contexts of psychotherapists and counsellors per se, they do shed light on the effects of a more regulated mental health context. Third, we briefly highlight what we regard to be an emerging assemblage of regulatory processes in the field of psychotherapy and counselling. Whilst the question of regulation is ostensibly restricted to the present focus of the HPC PLG, we draw attention to what we believe are important wider forces shaping this process. Finally, we draw conclusions and make some recommendations designed to inform the development of future regulation. Our research is a relatively small scoping study based upon a limited number of interviews and observation. We do not claim that the findings outlined in this report are representative of the whole field of psychotherapy and counselling. However our research does reflect how regulation is perceived in different contexts, it may indicate how future regulation would be interpreted and implemented in practice, and suggest some of its potential visible and invisible effects.