Parents never really understand, do they? They just go about their business. But anything could happen. It’s as if they don’t realize how important they are. And then, later, it’s as if they don’t realize how unimportant they are.
The latest issue of The Psychotherapist, the journal of the UK Council for Psychotherapy (UKCP), is dominated by opinions on what the UKCP’s role should be. Its guest editor (there’s a different guest editor for every issue) is “relational body therapist” Tom Warnecke, and that in itself tells you a lot about the UKCP’s difficulties.
Its primary difficulty is very limited relevance. At its core, UKCP is a federation of training providers, “laundered” as it were through member organizations and concealed behind individual subscriptions. The primary driver for its continued existence is that it helps guarantee revenue for the training industry by insisting on more and more training for professionals who are already over-trained.
And the professionals who pay for all this training also pay for the UKCP. And pay for their member organizations too.
It’s uncomfortable for members to be reminded of this reality, though. So they go to enormous lengths to avoid making eye contact with it.
The result is an obsession with every conceivable side issue, quibble and fantasy. Tom Warnecke’s feature article, Paper — Scissors — Stone, is based on the fantasy that psychotherapy has an underlying set of values that could save the UKCP if only someone could find out what they are.
To his great credit, he does give reality some furtive sideways glances. On the benefits of psychotherapy:
There is no evidence that the three most developed markets for psychotherapy, namely the USA, Brazil and Germany, are functioning any better as a result of their population’s psychotherapy experience than other, less psychotherapy-privileged societies.
And on the culture of the UKCP:
We may also need to live down the image of UKCP as a cabal of trainings driven by vesed self-interest.
The idea that UKCP should somehow embody, articulate and stand up for a set of ideals is a popular one among contributors to the journal. It’s as impractical as it is popular, however, because no one can agree on which ideals they should be.
It’s easy to see how so many UKCP therapists, dominated by variants of psychodynamic theory that encourage emotional dependency, yearn for an all-powerful parental body to validate their professional existence. The work itself is insidiously invalidating. Being validated by completing training doesn’t feel enough. Being validated by membership, and by registration, and by paying the annual subscription, still doesn’t feel enough. There’s always a feeling of something missing.
“Integral-relational body therapist” Carmen Joanne Ablack, in her feature article, yearns for a magical transformation of the many factions in UKCP to make it feel safe for her:
We have a web to build together that can weather the storms and that we can learn to repair as needed.
Family systems therapist Judith Lask, in her detailed and specific feature article, deplores UKCP’s pervasive infighting. She catalogues several of the things that have gone wrong, and that have made her feel UKCP is like “a rather scary family”:
Dissent could often be met by personal attack. This felt like bullying at times and such unpleasantness was left to run, it seemed. It was like a family that did not have an effective parental subsystem.
Other articles continue along similar lines. Someone wants UKCP to acknowledge the harmful effects of market-led economies. Someone wants UKCP to promote more research. “Validate me!” “Validate me!”
Those who run things have settled on five strategic themes to guide UKCP’s development over the next three years. Characteristically, each of the themes carefully evades the difficult issues.
One theme is to establish the core values of psychotherapy:
…a safe place in which personal exploration and reflection can take place, respect for the autonomy and safety of the client/patient, and recognition that the personal qualities of the therapist are as important as any specific technique or method.
The difficult issue of personal qualities, techniques and methods that are inherently unsafe for the client/patient is not mentioned.
Another theme is improving access to psychotherapy, partly by providing low-cost and free psychotherapy. The extent to which this will amount to handing out tasters in order to get people hooked on forms of therapy that will eventually damage them is not mentioned.
Another is engaging members, where none of the problems Judith Lask catalogued are mentioned.
Another is maintaining excellence and professionalism, and the last is recognition of psychotherapy:
The general public is currently, for the most part, denied excellence in favour of a quick fix.
The quick fix being referred to is, of course, CBT. For these two themes measurement of outcomes is the difficult issue. No realistic view of excellence and professionalism can exclude what actually happens to the people subjected to therapy, and the public will increasingly want to understand the outcomes, too.
The NHS piloted comprehensive outcome measurement in its Improving Access to Psychological Therapies (IAPT) programme (though the outcomes have turned out to range from not great to terrible), and it has well-publicized plans to extend outcome measurement to the whole of medical practice. UKCP doesn’t stand a chance in the medical world unless it understands this and gets on board.
The outlook for UKCP is not good. It has been trying hard recently, under the leadership of Jungian psychotherapist Andrew Samuels, but he has announced that he will soon stand down.
Huge issues not only remain unresolved, but remain without any intention to resolve them: UKCP’s position in relation to CBT, its propensity for savage in-fighting, its avoidant reaction to consideration of outcomes, its continued blind allegiance to the training paradigm.
Underlying all these failures of intention is UKCP’s inability to grasp its role as surrogate parent to those therapists who have made a profession of dependency and insecurity.
It looks like the time is almost right for some of the more grown-up organizations to jump ship in the way BABCP did.