Meeting of The College of Psychoanalysts - UK with Health Professions Council
13th October 2008
Present:
Darian Leader and Jacques China, representing The College
Marc Seale (Chief Executive) and Sam Mars (Policy officer) representing HPC
MS welcomed DL and JC and introduced himself and SM.
MS asked what The College is and also for an explanation of what psychoanalysis is: neither MS nor SM knew what psychoanalysis consisted of or how it was different from other therapies. DL explained what The College is, detailing this in terms of our numbers and pluralism. JC explained, in addition, that our members are registered from across the profession of psychoanalysis with UKCP or BPC and that we regard ourselves as a professional body looking after the interests of psychoanalytic practitioners, rather than as a regulator of practitioners, albeit we do have standards of professional conduct that must be adhered to.
MS said he would outline the process now being undertaken by HPC as the proposed regulator but wished to be clear that the process would be open to all interested groups. He went on to refer to the nine regulators of different professionals now in place in the UK. HPC, however, is unique among those regulators in being required to advise the Secretary of State about new professional groups that might be regulated by HPC. The current process arises out of that requirement. Psychologists are the latest professionals to be regulated by HPC and their HPC register is expected to operate with effect from 1st July 2009. There are now between 20 and 30 other groups of professionals who seek regulation by HPC and it is within this context that HPC has now turned its attention to counsellors and psychotherapists. However, if regulation of counsellors and psychotherapists does come about, this is not expected to come into operation before 2011, following the introduction of enabling legislation.
As a result of the process now begun, the objective will be to determine the following:
Thresholds for education.
Standards of proficiency - there can be more than one. The aim of HPC is for around 70% of these to be in common and for around 20% of these to be more specific. It is HPC that has the final say on these issues and not any other body such as SfH.
Protected professional titles. It is not professional function that is protected but only professional titles. However, HPC clearly recognise that it is possible for practitioners to avoid regulation by adopting a professional title that is not registered.
A final package of proposals for submission to government, following proper consultation of the professions concerned. The final proposals might be that the professions concerned should be regulated or that those professions or certain parts of them e.g. psychoanalysis, should not be regulated.
Following the above, the government would reach its own conclusions on those proposals and the Secretary of State would then be obliged to open the government's own separate consultation process, prior to finalisation and introduction of any proposals for regulation.
As an initial stage in the above process, HPC will, within the next two weeks or so, be announcing the names of those representatives of stakeholders who will constitute the Professional Liaison Group. That group will consider the above objectives with a view to advising HPC on how, if at all, regulation might proceed. The deliberations of the group will be held in public and anyone will be free to attend. Minutes of all those deliberations and recommendations will also be published by HPC, as the deliberations proceed. Any group not directly represented on the PLG will be free to submit representations which the PLG will be obliged to consider.
MS then made the following points:
The main concern of HPC will be how many practitioners from the professions concerned are likely, in the end, not to be regulated by them and how many avoid regulation.
Ideally, they would like one standard of education for each profession regulated by them.
The professional title counsellor will not be acceptable without some additional descriptor but psychotherapist would be.
HPC wants as few regulated professional titles as possible.
HPC wants short documents wherever possible e.g. for standards of proficiency. DL questioned why brevity of documents should be an aim in itself. It seemed clear that they wanted a series of equal-sized pamphlets, even if this risked compromising the complexity of a discipline.
CPD is likely to be dealt with very much along the lines of relying on practitioners to use their own discretion to ensure CPD input but regular audits will be carried out by HPC on a spot-check basis.
DL then attempted to inform the representatives of HPC about how their proposals are likely to affect psychoanalysis. For example, does HPC include psychoanalysis within the remit they have given themselves to regulate psychotherapy? The response from MS was vague and clearly they have not yet begun to address this issue. It was very clear that they have little understanding of what psychoanalysis entails. MS did, however, state that, if a suitable case could be made, it would be possible, in theory, for HPC to recommend specifically to government that psychoanalysis should be excluded from any proposals to regulate psychotherapy.
DL then went on the explain how psychoanalysis is considered to differ significantly from many forms of psychotherapy. In particular, he explained the importance of the difference between conscious and unconscious motivation and the significance of transference phenomena in the relationship between analyst and patient and how these might have very serious consequences for issues relating to complaints, under fitness to practise provisions. It became clear that MS and SM had some difficulty in understanding the concept of transference but they were very willing to listen to the points made by DL, particularly in relation to specific examples that he was able to give them, namely libidinal and other issues and their effect on the transference. DL emphasised how analytic work aimed to undermine any ritualisation of the experience, so that the analyst endeavours never to be in the expected place, a fact which runs counter to the standardisation of technique. Analytic work also has no fixed outcome and makes no promises regarding healthcare goals.
DL also emphasised that training does not involve the transmission of knowledge but is, rather, about questioning knowledge and particularly oneself as the analyst. A personal analysis is therefore the principal feature of any training which cannot promise to 'train' anyone, since training in psychoanalysis is retroactive. Furthermore, analysis does not aim primarily at removal of symptoms. Given the importance of transference and the retroactive effect of training, standards of proficiency might be antithetical to the training of psychoanalysts.
DL emphasised that The College is not against regulation but that we question very seriously whether the form of regulation proposed by HPC is suitable for psychoanalysis. DL raised the question of whether some other form of regulation might be feasible.
MS asked whether psychoanalysts were regulated statutorily elsewhere in the world. DL told him briefly of the models in Australia, France and the USA. MS paid due attention to all of this and again stated that a recommendation by HPC that psychoanalysis should not be included in any plans to regulate psychotherapy would be one possibility. It was clear, however, that what he was saying in this regard was entirely hypothetical and constituted no specific proposal or undertaking.
Finally, JC asked MS specifically whether, if a practitioner was registered with HPC as entitled to use, for example, the regulated professional title psychotherapist, they would nevertheless be free to use, in addition, some other non-protected professional title currently in use within the profession, for example Jungian analyst. MS attempted to deflect the question by beginning to outline the powers of HPC to regulate, in addition, specialist professional titles such as this. JC stopped him, saying he was well aware of those provisions but wanted an answer to the specific question: if there is a regulated professional title, say psychotherapist or psychodynamic psychotherapist, would a practitioner registered with HPC as entitled to use such a professional title be at liberty, in addition, to use a specialist non-registered professional title e.g. Jungian analyst. MS responded unequivocally that such a practitioner would be free to use such an additional professional title if it was indeed not a protected professional title.
Darian Leader
Jacques China
13.10.08