My memory of learning mathematics as a schoolboy is that Venn diagrams were in some way very important. Now it seems that what I thought were Venn diagrams are really Euler diagrams. Oh well, such is memory…or perhaps, such is school. Anyway, I thought I’d use a Venn Euler diagram to illustrate how accreditation of CBT therapists works in the UK.
An Euler diagram
The diagram starts with a universal set. In this case it’s the set of all therapists in the UK. The universal set is represented by the diagram’s outer rectangle:
Some of those therapists are members of the BABCP, which is “The leading organisation for CBT in the UK”.
Note that the size of the circle has no significance. I made it big to make my diagram look nice. (If I made its area represent the proportion of therapists who are BABCP members, it would be a very very small circle.) The only significance is that some therapists are inside the circle and some are outside it:
Within the BABCP, some members are accredited. This is an indication that they are competent to practice (even though the BABCP does not directly assess competence). Anyway, without going into the details, here’s the circle that represents accredited members.
Again the relative areas have no significance. (When I last looked, the proportion of BABCP members who were accredited was just over a sixth.) The only way you can get to be accredited is by being a member first, so the new circle is completely inside the previous one:
There is also a United Kingdom Council for Psychotherapy (UKCP). but it does not have membership as such. Therapists are either registered with it or not. Being registered is an indication that a therapist is competent to practice (even though the UKCP does not directly assess competence, and indeed it does not directly assess anything at all). Anyway, without going into the details, here’s the circle that represents registered therapists.
This circle overlaps the previous two, because the UKCP is a separate organization that does not necessarily take account of the BABCP in deciding who to register. I’ll explain this further after I’ve added the last circle.
Finally here’s the really interesting circle, the one that represents therapists who practice CBT. It overlaps all the others:
Just two organizations in the UK have managed to create twelve subsets or categories of therapist. Some of the categories are easy to explain, and others not so easy.
There are six categories of CBT therapist, which I have marked A, B, C, D, E, F:
|A||These CBT therapists are accredited and registered. That’s easy to understand, isn’t it? Unfortunately there are very few like this.|
|B||These CBT therapists are accredited but not registered. They could be registered if they simply paid the fees, but they see no reason to pay the fees. Patients or employers who search for them in the UKCP database will not find them there, possibly getting the impression that these therapists are not competent to practice.|
||These CBT therapists are registered but not accredited. Some of them could easily become accredited if they wanted to, but for some it would not be so easy. Even though they work within the BABCP’s guidelines for good practice, patients and employers cannot verify this by searching the BABCP’s public database.|
|D||These CBT therapists are neither accredited nor registered. Some of them might be in training. Like category C, they work within the BABCP’s guidelines for good practice, but patients and employers cannot verify this by searching the BABCP’s public database.|
|E||These CBT therapists are registered, but they have nothing to do with the BABCP. Some of them are registered as CBT therapists. Some of them are registered as other kinds of therapist, even though they practice CBT.|
|F||These CBT therapists are not accredited or registered. Some of them are accredited by other organizations, and some are not accredited by anyone.|
It’s almost impossible for the public or anyone else to make sense of this, and I have not even drawn all the circles on my diagram. What’s more, I have not yet seen any proposals to address the problem. There are certainly proposals that will cause much fuss over little real change, but no one wants to go to the heart of the matter and fix the fundamentals.