the psychotherapist

Transcription

the psychotherapist

41614 The Psychotherapist
13/12/07
16:04
Page A
Issue 36
Winter 2007-08
Professor Peter Stratton
Professor David Winter
Some of the members
of the UKCP Research
Committee
Making research useful for
the practicing psychotherapist
the
Dr Tirrill Harris
14/12/07
09:32
Page B
the psychotherapist
Diversity and
Equalities Statement
The United Kingdom Council for Psychotherapy (UKCP) promotes an active engagement
with difference and therefore seeks to provide a framework for the professions of
psychotherapy and psychotherapeutic counselling which allows competing and diverse
ideas and perspectives on what it means to be human to be considered, respected and
valued.
UKCP is committed to addressing issues of prejudice and discrimination in relation to
the mental well being, political belief, gender and gender identity, sexual preference or
orientation, disability, marital or partnership status, race, nationality, ethnic origin, heritage
identity, religious or spiritual identity, age or socio-economic class of individuals and
groups.
UKCP keeps its policies and procedures under review in order to ensure that the
realities of discrimination, exclusion, oppression and alienation that may form part of the
experience of its registrants as well as of their clients are addressed appropriately.
UKCP seeks to ensure that the practice of psychotherapy is utilised in the service of the
celebration of human difference and diversity, and that at no time is psychotherapy used
as a means of coercion or oppression of any group or individual.
Editorial Policy
The Psychotherapist is published for the benefit of UKCP registrants and aims to keep
them informed of developments likely to impact on their practice and provide an
opportunity for registrants to share information and views on professional practice and
topical issues.
The material in The Psychotherapist is only provided for general information purposes and
does not constitute professional advice of any nature.Whilst every effort is made to
ensure the content in The Psychotherapist is accurate and true, on occasion there may be
mistakes and readers are advised not to rely upon its content.
The Editor and UKCP accept no responsibility or liability for any loss which may arise
from reliance on the information contained in The Psychotherapist.
From time to time The Psychotherapist may
publish articles of a controversial nature.The
views expressed are those of the author and
not of The Psychotherapist.
Advertising Policy
Advertisements are the responsibility of the advertiser and do not imply
endorsement by UKCP or the editor of The Psychotherapist.The editor reserves the
right to reject or to cancel advertisements without notice.
Managing Editor: Jude Cohen-Phillips
Guest Editor: Peter Stratton and David Winter
Editorial Board: James Antrican, Jude Cohen-Phillips, Courtenay Young
Published by UK Council for Psychotherapy,
2nd Floor, Edward House, 2 Wakley Street, London EC1V 7LT
Registered Charity No. 1058545
Company No. 3258939 Registered in England
Contents
Page
Making research useful for the
practicing psychotherapist
Editorial
1
A way forward with PRN:The importance
of two-way communication strategies that
link research to practice and vice versa
2
Beyond the “Research-Practice Gap”
3
Right Answers or Wrong Questions?
5
Introducing Relational Research
6
Attachment and Relationship to
Psychotherapeutic Outcome
7
Attributions, Intellectual Disability and
Family Therapy
9
Finding an Identity as a Researching
Psychotherapist
10
Developing practitioner effectiveness
through training
11
Researching process-and-outcome in
psychotherapy
12
What does ‘ending’ mean to a client?
13
PRN in action: Constructing an
outcome measure for therapy with
relational systems.
14
Book review (1) What is
psychotherapeutic research?
15
UCKP News
Chair’s Update
The New Savoy Declaration
UKCP EGM report
Letter from the Vice Chair (Registrants’
Services)
Letter from our foreign correspondent
Committee vacancies
Letter to the Editor (1)
Reply from the UKCP Chair
Standards Board Update
Letter to the Editor (2) Wilhelm Reich
and Gerda Boyesen
Psychotherapy with Children
Committee Report
Planning the future shape of UKCP
New UKCP Psychotherapeutic
Counsellors
New UKCP Psychotherapists
Ethics conference Oct 2007
16
17
18
18
19
19
20
20
21
22
23
24
26
26
28
Registrants’ Contributions
Letter to the Editor (3) Good ethics?
Book review (2) Counselling,
Psychotherapy and the Law
Asylum Seekers Today:
Further Reflections;
30
Diversity and Equalities
A Representative Balance
Events
32
36
Continuing Professional Development
38
28
30
www.ukcp.org.uk
13/12/07
16:04
Page 1
the psychotherapist feature
Editorial: Making research
useful for the practicing
psychotherapist
Guest Editors Peter Stratton and David Winter
This research section of The
Psychotherapist explores various
ways in which research can give
therapists information about the
most effective aspects of their
practice.
We have concentrated on research that
is in a form that practitioners can use to
increase their effectiveness, their value
to their clients and their credibility.
There is an enormous volume of good
research, with much more variety than
implied by the current focus on finding
out whether one therapy is, on average,
better than another.
One could speculate that the
dominance of the outcome question
has been partly responsible for the
resistance of many psychotherapists to
becoming engaged with research.
“every psychotherapist
already has most of the
skills needed”
We hope to demonstrate through this
issue of The Psychotherapist something of
the great variety of ways that therapists
can become involved both as users of
research and as participants.
Research is a challenging but fascinating
pastime and every psychotherapist
already has most of the skills needed to
become an active researcher (Stratton
& Hanks, 2007).
Our outstanding collection of papers
indicates something of the range and
scope of existing research while
demonstrating ways that every
practitioner could become more
involved.
“the research is driven by
the needs of
practitioners”
The UKCP Research Committee has
concluded that Practitioner Research
Networks (PRNs) provide the most
practicable and effective route to
meeting the research needs of
psychotherapy.
They have the advantage of providing a
route into research for practitioners
who are not working in a research
environment, while ensuring that the
form of the research is driven by the
needs of practitioners.
thinking as a psychotherapist, that you
will join us on 2nd February (see the
flyer included in the mailing).
If that is impossible, let us know if you
are interested to join a PRN or,
perhaps, even consider joining the
UKCP Research Committee.
For more details, please contact Alan on
020 7014 9964 or e-mail
[email protected]
References
Stratton, P & Hanks, H. (2007, in press) From
therapeutic skills to research competence:
Making use of common ground. Human
Systems 18.
Thomas, R., Stephenson, S. & Loewenthal, D.
(2007) UKCP Report on Practice-Based
Research Networks. London: UKCP Research
Unit.
Members of the UKCP Research
Committee
Chair Peter Stratton (FCSST)
Sheila Butler (HIP)
Tirril Harris (AP & PP)
Georgia Lepper (AP & PP)
Del Loewenthal (AP & PP)
David Winter (E & CT)
The committee commissioned a review
of PRNs from the UKCP Research
Unit, Roehampton University (Thomas
et al, 2007) and this report is available
from UKCP.
The survey of practitioner research in
this issue starts with an overview of
PRNs as promoted by UKCP’s
Research Committee and ends with a
set of examples of PRNs in action.
Guest Editor: Peter Stratton
The Psychotherapist
We hope you will be encouraged to
place research more centrally in your
Guest Editor: David Winter
1
13/12/07
16:04
Page 2
A way forward with PRN:
The importance of two-way communication
strategies that link research to practice and vice
versa Sheila Butler
There has been considerable
discussion concerning the impact
of evidence-based debate on policy
and practice.
This has included the importance of
developing a different model of research
which is linked to both practice and
development, the need to develop
research capacity amongst all
contributors and beneficiaries of
psychotherapy research, and the
importance of two-way communication
strategies that link research to practice
and vice versa.
Recent years have seen the
development of different debates which
aim to address some of these issues.
In this context the UKCP Research
Committee (RC) sees the importance
for increased collaboration between
researchers and practitioners and
started a process of developing
proposals for new forms of research
programmes that involve practitioners
directly with researchers in
collaborative teams or networks –
Practitioner Research Networks
(PRNs).
“involving practicing
psychotherapists in all
stages of research “
The RC sees PRN as one of the most
effective ways of involving practicing
psychotherapists in all stages of
research.
A successful research workshop was
held in 2006, focussing on practicebased research, and initial proposals for
practitioner involvement have been put
forward.Various of the participants
expressed an interest in joining
practitioner / PRNs.
2
Practitioners engaging with PRN reflect
the diversity and range of psychotherapy
practice within UKCP. Current areas of
interest reflect a wide spectrum of
experience.The RC wishes to give
priority to developing such networks
and to take forward this momentum.
The efforts of the RC at present are
focussed on creating a PRN framework
and putting in place the systems that
UKCP will make available to support
the network and to develop a PRN
strategy.
“The focus is to mobilise
existing knowledge and
co-create new
knowledge”
In a series of workshops, in
collaboration with the PRN participants,
we are exploring ideas for projects and
practical methods for developing
research which informs the practice of
psychotherapy.
The focus is to mobilise existing
knowledge and co-create new
knowledge with a PRN that includes
researchers and practitioners.
In this way we see the collaborative
development and a shared environment
for reflection and inquiry.The early
steps have gathered pace and scale
resulting in a range of initiatives.
At our last PRN event in London we
started to identify the initial ideas and
themes to be developed into research
projects. How can PRNs take the pulse
of practitioner research interests in
order to ensure that psychotherapy
research connects with them?
We started planning the types of
collaborative research projects which
could provide practitioners and
researchers opportunities to explore
and develop a range of initiatives to
expand psychotherapy practice and
knowledge.
We suggested getting started with two
projects; one focussed on the
psychotherapist and the other focussed
on exploring intersubjective moments
in psychotherapy.
One of the initial suggestions is based
on the idea of exploring intersubjective
moments in Psychotherapy using
CORE and the Process of Change
model (using D Stern model and
CORE).
The other focus proposed by one of
the PRN participants is to establish a
PRN project focussed on the
psychotherapist. It might include the
nature of our profession, our
professional identity and the trials and
tribulations of working as a therapist.
“our professional identity
and the trials and
tribulations of working as
a therapist”
This seems a particularly timely focus
given the likelihood of statutory
regulation. It would be good to have a
range of experience and interests.
The network could be supportive for
those already doing research,
informative for those thinking about
doing research, an opportunity to
contribute expertise for those who have
retired from, finished or given up on
their own projects and an opportunity
for those who would like to be involved
in research in a small way but are not in
a position to do research on their own.
www.ukcp.org.uk
13/12/07
16:04
Page 3
The PRN would plan to meet a number
of times a year and between times have
email or message board contact.
It is hoped that the PRN initiative
within UKCP will lead to new
partnership and collaboration
opportunities between practitioners
and researchers, to both strengthen and
add new dimensions to psychotherapy
research and practice.
“to both strengthen and
add new dimensions to
psychotherapy research
and practice”
We are planning to explore and develop
a range of initiatives at local and
international levels developing strategies
for supporting practitioners’ research
and looking at what types of research
potentially provide a widening of our
understanding of psychotherapy.
The programme for 2008 builds on
these initial steps taking the planning,
implementation and the debate forward.
If you would like to get involved in this
new initiative participating in a dynamic
and innovative PRN environment, if you
would like to experience the potential of
PRN in contributing to the development
of psychotherapy research and practice,
please contact Alan McConnon
([email protected]) for
details.
Sheila Butler
UKCP Research Committee
Your contributions are wanted
Would you like to guest edit an issue
of The Psychotherapist? In the new
year, the Editorial Board will be
planning the content for Autumn
2008 onwards. Send in a brief
summary of the subject and articles
you would commission.
Beyond the
“ResearchPractice Gap”
Howard Liddle
My nomination for today’s most
boring topic in all of
psychotherapy concerns the “gap
between research and practice”.
In 1991 I published a paper called
Empirical Values and the Culture of Family
Therapy.This article (Liddle, 1991) railed
against the empirical health (or lack
thereof) of the family therapy field at
that time.Too little relevant research
was happening and too little of it was
being “used” in standard practice.
My intention in that paper was to offer
an intervention – to present an
argument about what was wrong and
how the field could be improved. Over
time I realised that papers like these
cannot change a field, and that what
would inspire the needed changes
(reduction of the research-practice
divide) was a new kind of work.
On the research side this would mean
studies that met the test of relevance
(clinically understandable and feasible
and of course effective models [effective
with the kind of cases that are seen in
regular practice vs. rarefied “research
cases”]).
On the clinical side it would mean a
transformation of clinical settings,
training programmes, and work settings,
including changes in how mental health
and substance abuse care is funded so
that more effective means of treatment
could be introduced.
Or do you want to respond to
something you have seen in this
issue? Or to something else that
affects you as a psychotherapist?
Write to the Editor.
Over the past fifteen or so years
enormous changes have happened in
family therapy research (Liddle, Rowe &
Dakoff, 2007).
Jude Cohen-Phillips:
[email protected]
As part of the evidence-based practice
movement, family therapy research has
been well funded (compared to other
The Psychotherapist
Howard Liddle
therapies such as CBT for instance), and
new programmes of work have
produced clinically significant and
relevant findings for therapists and
policy makers alike.
Using my own specialty of youth
substance misuse and delinquency as
examples, it is clear that these research
areas have exploded in recent times.
New research groups have produced
findings proving family therapy’s power
to engage and retain reluctant
adolescents and parents into treatment.
Moreover, clinical symptoms of drug
abuse and delinquency can be reduced
or eliminated during a three to four
month therapy.
“Clinical symptoms of
drug abuse and
delinquency can be
reduced or eliminated
during a three to four
month therapy”
And beyond symptom elimination,
protective factors can be enhanced
3
13/12/07
16:04
Page 4
and changed – parenting and family
functioning can be improved
dramatically, and areas of functioning
that relate to long term improvement
and the maintenance of change, such
as positive changes in school
functioning and a disaffiliation with
drug using and antisocial peers among
clinically referred teenagers have been
found across research groups, studies
and versions of particular evidencebased family based therapies.
“a disaffiliation with drug
using and antisocial
peers among clinically
referred teenagers have
been found across
research groups”
Training protocols that go along with
this new generation of studies now
allow therapy manuals (how to guides
to practice), used as part of clinical
trials to be available and disseminated
as part of regular clinical practice.
These materials are now evaluated and
used for the guidelines that licensing
and professional groups consider when
they write practice guidelines for
various clinical conditions.
State jurisdictions, national level funders,
and health ministries from national
European governments have all
discovered evidence-based family
therapy.
And now, projects that test these
therapies outside of research settings –
in regular clinical care – are being done
to see if the good results obtained in
research studies can be replicated in non
research environments (Liddle, 2004).
Given these many accomplishments,
the “research-practice gap” has thus
been transformed.This is why it
should be considered, as I said earlier,
a boring or at least anachronistic topic
in contemporary psychotherapy.
At least as far as family therapy is
concerned, there is a large body of
clinically relevant knowledge attesting
to the effectiveness of various family
therapy approaches with a variety of
4
clinical populations. So the issue is no
longer than a gap exists – today the
issue is more complex and
sophisticated than is offered in that
narrow frame.
“studies today address
the conditions under
which therapies can be
transported to nonresearch settings”
The most interesting studies today
address the conditions under which
therapies can be transported to nonresearch settings, the things that have to
be done to change a workforce to be
able to implement therapies that their
graduate school professors were never
trained in, and the broader systems
issues such as how to sustain
innovations in practice, once initial
demonstration projects, for instance,
leave the scene.
“Clinical research has
not solved all of life’s ills.
It never will”
Clinical research has not solved all of
life’s ills. It never will. But if the issue is
whether or not therapy has been
transformed by the changes in and
expansion in clinical research and the
context in which this research is now
evaluated, considered for use, and
actually used, the answer is a
resounding yes – the therapy field is
vastly different than a few years ago.
The nature of these changes, however,
including such things as the mandating of
evidence-based therapies in regular
clinical care, and the implications of
research-based, proven therapies for
clinical training programs remains, among
many other matters, to be worked out.
At the same time, although far from
perfect or trouble free, the clinical
research activity in the field is more
clinically and policy relevant than ever
before (Liddle & Frank, 2006). Researchbased therapies seem here to stay.
Now we need to take the next steps,
and ask questions and engage in
debate appropriate to our field’s
developmental stage.
Howard Liddle
References
Liddle, H. A. (1991). Empirical values and
the culture of family therapy. Journal of
Marital and Family Therapy, 17(4), 327-348.
Liddle, H. A. (2004). Family-based therapies
for adolescent alcohol and drug use:
Research contributions and future
research needs. Addiction, 99(s2), 76-92.
Liddle, H. A., & Frank, A. (2006).The road
ahead: Achievements and challenges for
adolescent substance abuse treatment
research. In H. Liddle & C. Rowe (Eds.),
Treating adolescent substance abuse: State of
the science (pp.473-500). London:
Cambridge University Press.
Liddle, H. A., Rowe, C. L., & Dakof, G. A.
(2007). Empirical and clinical foundations of
family-based interventions for adolescent
substance abuse, pp. 185-196. In E. Gilvarry
& P. McArdle (Eds.), Alcohol, Drugs and
Young People: Clinical Approaches. London,
UK: Mac Keith Press.
Howard Liddle is a Professor in the
Departments of Epidemiology and
Public Health, Counselling Psychology
and Psychology, and Director of the
Center for Treatment Research on
Adolescent Drug Abuse, University of
Miami Miller School of Medicine.
Ethics question for the
next issue of The
Psychotherapist.
“My client is talking about suicide (I am
not certain how serious it is).
“I know that my ethics code instructs
me to report such potential suicide, yet
the client is unwilling for me to speak to
authorities.
“I fear that reporting him without his
consent will sever our therapeutic
relationship and alienate him even
more.
“What shall I do?”
What do you think? How would you
deal with this situation?
Contributions welcome, please send
your view to Jude Cohen-Phillips at
[email protected] by 25th
February 2008
www.ukcp.org.uk
13/12/07
16:05
Page 5
Right Answers or Wrong
Questions? David A. Winter
Introducing the Improving Access
to Psychological Therapies (IAPT)
programme, Patricia Hewitt
proclaimed that:“Successful
psychological therapies ensure that the
right number of people are offered a
choice of the right services at the right
time with the right results.” (p. 2, bold in
original).
This emphasis on rightness is consistent
with the notion that some therapies are
‘right’ in being supported by research
evidence, and thus finding their way into
the treatment guidelines prepared by
the National Institute for Health and
Clinical Excellence (NICE).
As stated in Lord Layard’s Depression
Report,“The demand from each of us
should be quite simple:“Implement the
NICE guidelines””. (Centre for
Economic Performance, 2006, p. 14, bold
in original).
Statements in bold type offering right
approaches and simple messages are
enormously appealing to health service
commissioners confronted with a
choice between over 500 different
psychological therapies.
However, to borrow the rationalist terms
in which these statements are couched,
claims to produce right answers need to
be derived from the right questions
investigated by the right methods.
A question such as “What Works for
Whom?’” (Roth and Fonagy, 2005) may
seem reasonable but “what” is usually
taken to refer to a particular type of
therapy,“works” to refer to
symptomatic improvement, and ”whom”
to refer to psychiatric diagnostic groups.
However, therapist, therapeutic
relationship, and non-specific factors
are generally found to be more
influential ingredients of therapy than
are specific therapeutic techniques
(Wampold, 2001); measures of change
in symptoms should be complemented
by measures of intrapsychic and
The Psychotherapist
interpersonal change if not to bias
research towards symptom-focused
therapies; and clients’ philosophical
assumptions, or ‘personal styles’, may
be more relevant to their therapeutic
preferences and responses than are
nosological categories (Caine,
Wijesinghe, and Winter, 1981).
In regard to research methods, the ‘gold
standard’ of the randomised controlled
trial has come under criticism in terms
of both its external and internal validity
(Westen, Novotny, and ThompsonBrenner, 2004), and it has been privileged
at the expense of research designs that
may be more appropriate for the study
of psychotherapeutic processes.
“it is still advisable for
psychotherapists … to
play the empirical
support game”
In the current climate it is still advisable
for psychotherapists of all theoretical
persuasions to play the empirical support
game. Several have done just that,
producing evidence for the effectiveness
of their therapies (Winter, Metcalfe, and
Grenyer, 2008), although not always
complying with the research criteria (e.g.
studying problem-defined client groups)
that would earn them a place in lists of
empirically supported therapies.
While such studies may still be necessary
to ensure the survival of the therapies
concerned, more productive areas for
future research may be “empirically
validated psychotherapists” (Lambert and
Ogles, 2004) ,“empirically supported
therapy relationships” (Norcross, 2001),
and client personal styles as predictors
of outcome in different therapies.
In addition, the introduction of practicebased evidence approaches promises
greater external validity of research
findings, but such approaches are still
limited if evidence of therapeutic
David Winter
effectiveness is only collected using
standard symptom-oriented measures,
such as CORE, rather than
complementing these with methods
more concerned with changes in
meaning, such as qualitative approaches
or repertory grid technique (Winter,
2003).
David Winter
References
Caine,T.M.,Wijesinghe, O.B.A., and Winter,
D.A. (1981). Personal Styles in Neurosis:
Implications for Small Group Psychotherapy and
Behaviour Therapy. London: Routledge and
Kegan Paul.
Centre for Economic Performance (2006).
The Depression Report:A New Deal for
Depression and Anxiety Disorders. London:
London School of Economics.
Lambert, M.J. and Ogles, B.M. (2004).The
efficacy and effectiveness of psychotherapy,
Bergin and Garfield’s Handbook of
Psychotherapy and Behaviour Change (pp. 139193). Chichester:Wiley.
Norcross, J.D. (2001). Empirically supported
therapy relationships: Summary report of
the Division 29 Task Force. Psychotherapy, 38,
495-497.
Wampold, B.E. (2001). The Great
Psychotherapy Debate: Models, Methods, and
Findings. Mahwah, NJ: Erlbaum.
Westen, D., Novotny, C.M., and ThompsonBrenner, H. (2004).The empirical status of
empirically supported psychotherapies:
assumptions, findings, and reporting in
controlled clinical trials. Psychological Bulletin,
130, 631-663.
Winter, D.A. (2003). Repertory grid
technique as a psychotherapy research
measure. Psychotherapy Research, 13, 25-42.
5
13/12/07
16:05
Page 6
Introducing Relational
Research Del Loewenthal
What is the difference between
relational research and
psychotherapy?
Could psychotherapists and
psychotherapeutic counsellors
contribute to the larger research
community aspects of their experience,
in exploring the use of the relationship
between the researcher and the
researched as a means of research?
To what extent do approaches to
qualitative research (for example,
heuristic, case study, phenomenological,
narrative, grounded theory, discourse
analysis and action research) help
and/or hinder the relational researcher?
For some, the relational is most
apparent in the psychoanalytic traditions
of Freud, Klein and object relations
theories as well as Jung; however, the
increased interest in relational
psychotherapy now also includes a
whole range of humanistic, existential,
integrative and other approaches as can
be seen for example in the European
Journal of Psychotherapy and Counselling
special issue Relational Psychotherapy in
Europe (Hargaden and Schwartz, 2007).
There is indeed a growing interest in
relational therapy (Greenberg and
Mitchell, 1983; Mitchell and Aron, 1999;
Safran and Muran, 2000) and research
on relating in psychotherapy (for
example, Birtchnell, 1999) as well as
research in counselling and
psychotherapy in general (for example,
Loewenthal and Winter, 2006; McLeod,
1994; 2001).
There is also recent interest in the role
of the self in research (Etherington,
2004;Woskett, 1999), as well as an
increasing concern about both the truth
and the values of research (for example
Scheurich, 1997).
The ‘relational’ can be defined as that
which emerges between the researcher
and the researched.As such it can be
6
seen as phenomenological (or postphenomenological).
Moreover, regarding the link between
the relational and phenomenology there
is the argument that the term
‘phenomenological research’ is a
misnomer in that ‘phenomenology’ as
originally intended by the likes of
Husserl (1960) implies research. But it is
precisely arguments such as these that
psychotherapists can also engage in
once they have learnt something of the
current language of research.
Thus, rather than attempting to provide
the type of objective measures of a
relationship as, for example, devised in
relation to attachment theory (see for
example, Fonagy et al., 1991) the
relational research considered here will
always be within a subjective context,
however much we may strive to
minimise personal biases.
An exploration of relational research
for UKCP psychotherapists can thus
be seen to have two main purposes:
firstly, to examine the usefulness of
existing qualitative research methods
and then start to identify new ways of
carrying out research, for example,
through reverie and ethics (see
Loewenthal, 2007).
Whilst one can argue that
psychotherapists, in conducting therapy,
are carrying out an important form of
relational research, it is assumed at least
initially that there is a fundamental
difference in the agenda of a
psychotherapist carrying out therapy
and that it is unhelpful to confuse these
approaches, even though there may be
considerable overlap in know-how.
Should we be trying then to develop a
hermeneutic science of the relational? It
could help UKCP where we seem to
have what C. P. Snow describes as two
cultures: the scientific and the nonscientific, where he argues that there is
a gulf of mutual incomprehension
between scientists and what he terms
the “literary individual”, the traditional
culture.
“If scientists have the
future in their bones, the
traditional culture
responds by wishing the
future did not exist”
He said “If scientists have the future in
their bones, then the traditional culture
responds by wishing the future did not
exist”! Here at the Research Centre for
Therapeutic Education at Roehampton
we are interested in bringing those two
cultures together, but perhaps the real
danger is our place regarding
technological thinking, which may be
gravely endangering both science and
the traditional culture.
There are further important issues such
as intersubjectivity for relational
research raising such questions as to its
ideology. Included is the place of
psychotherapy regarding the
encouragement of tradition and
continuity, rather than rupture and
change, with such questions as:What is
our role individually, and particularly
collectively, in orchestrating meaning?
What other ways of understanding have
been dismantled and destroyed with the
success of late modernism? Has the
political basis of modernism, particularly
with its managerialism, been pushed
aside so that we think of our practice
as apolitical?
Has modernism therefore restructured
knowledge and what effects have our
classification and professionalisation
systems had on meaning? So, where is
research regarding psychotherapy and
the status quo?
www.ukcp.org.uk
13/12/07
16:05
Page 7
There is now the hope, indirectly
supported by governments, that the
teaching of research will strengthen the
talking therapies. Relational research is
caught up in that process, but in doing
so we also have to consider
relationships more broadly, including
where are the critical histories of
psychotherapy, and, most importantly
for us, what place will the relational
researcher take up?
A Description of
an Ongoing
Research Study:
Del Loewenthal
[email protected]
Attachment and Relationship to
Psychotherapeutic Outcome
Jo MacKay
References
Birtchnell, J. (1999) Relating in psychotherapy:
The application of a new theory. Westport:
Praeger
Etherington, K. (2004) Trauma: a
practitioner's guide to counselling. British
Journal of Guidance and Counselling 32 (3)
443-444
Fonagy, P., Steele, M., Steele, H., Moran, G.
and Higgitt,A. (1991).The capacity for
understanding mental states:The reflective
self in parent and child and its significance
for security and attachment. Infant Mental
Health Journal, 12(3), 201-218.
Greenberg, J. and Mitchell, S. (1983). Object
relations in psychoanalytic theory. Cambridge,
MA: Harvard University Press
Hargaden, H. and Schwartz, J. (eds) (2007)
Relational Psychotherapy in Europe.
European Journal of Psychotherapy and
Counselling special edition. 9(1)
Husserl, E. (1960) Cartesian meditations:An
introduction to phenomenology (trans. Cairns,
D.) The Hague: Martinus Nijhoff
Loewenthal, D. and Winter, D. (2006) What is
psychotherapeutic research? London: Karnac
Loewenthal, D. (2007) Case Studies in
Relational Research Basingstoke: Palgrave
Macmillan
McLeod, J. (1994) Doing Counselling Research.
London: Sage
McLeod, J. (2001) Qualitative Research in
Counselling and Psychotherapy. London: Sage
Mitchell, S. and Aron, L. (eds) (1999)
Relational psychoanalysis:The emergence of a
tradition. Hillsdale:Analytic Press
Safran, J. D. and Muran, J. C. (2000)
Negotiating The Therapeutic Alliance:A Relational
Treatment Guide. New York: Guilford
Scheurich, J. (1997). Research Method in the
Postmodern. London: Routledge
Woskett,V. (1999) Therapeutic Use of Self.
London: Routledge
The Psychotherapist
This brief account aims to convey
that research does not have to be
complicated, by setting out simply the
theory behind the project and the way the
study is being conducted. It is intended to
demystify the idea of psychotherapists
getting involved in research.
The importance of attachment
patterns in psychotherapy
Adult attachment style is related to
interpersonal behaviour and is
predictive of ability to function both
within intimate relationships and within
work (Hazan and Shaver, 1990). Secure
attachment style is usually contrasted
with the insecure styles, the latter
differing between dismissive avoidant,
fearful avoidant and preoccupied
enmeshed.
patterns of relating will be
unconscious and as such unavailable
for evaluation.
“Both therapist and
patient bring with them
their past experiences,
either good or bad”
Others will be accessible through the
use of attachment measure
questionnaires. Moreover, individuals’
experience of relatedness within a
therapy session can be explored
through validated questionnaires about
the therapeutic alliance.
Attachment patterns of both client and
therapist will impact on therapy in
terms of psychological problems,
process of psychotherapy and outcome.
It is accepted that there are
connections between insecurity of
attachment, and psychological problems
impacting on help-seeking behaviour, the
ability to use therapy and the ability to
be self-disclosing.
Interaction of therapist and client
attachment pattern
There is research evidence for an
interactional effect between therapist
and patient attachment patterns.Whilst
three studies appear to demonstrate an
interactional effect (Dozier et al 1994;
Rubino et al 2000;Tyrrell et al 1999)
shown by the in-session behaviour of
therapists, Sauer et al (2003) found no
interactional effects.
For the therapist, the ability to function
as a secure base could be potentially
compromised by their own insecurity
of attachment.
Neither the Dozier et al study nor the
Tyrrell et al study involved psychologists
or psychotherapists but case managers
who had not had therapy training.
Both therapist and patient bring with
them their past experiences, either
good or bad, of relating and being
close to another. Some of these
It is possible that mediating factors in
interactional effect might be personal
therapy and/or therapeutic training.
7
13/12/07
16:05
Page 8
“patients with different
attachment patterns
might benefit from
different models of
therapy”
Rubino et al (2000), studied trainee
psychologists and utilised a videovignette format. Personal therapy and
therapeutic training might be mediating
factors.
Attachment Pattern and Outcome
Whilst it might be assumed that more
secure patients will have better
outcomes, most patients are likely to
have insecure patterns of attachment.
There is some evidence (Fonagy et al
1996), that different patterns of
insecurity are associated with varying
outcomes. It is possible that patients
with different attachment patterns
might benefit from different models of
therapy.
Current Study
This study is exploring the interactional
effects of attachment patterns of
therapists and patients on outcome and
questioning whether this is mediated by
the therapeutic alliance.
Therapists whose early history resulted
in insecure attachment patterns may
have earned security through training
and personal therapy but may find they
work more effectively in some
therapeutic models rather than others.
The theory explored can be conveyed
schematically in the diagram below:
Therapist Attachment
Style
Alliance
Patient Attachment
Style
Patient mental
state
Patient mental
state at end
Current Study Procedure
Questionnaire packs are being sent out
to psychologists and psychotherapists
within a NHS Trust and to private
practitioners nationwide.
8
Therapists: Participating therapists are
asked to complete 2 attachment
questionnaires (Experiences in Close
Relationships, Brennan et al, 1998;The
Relationship Questionnaire,
Bartholomew 1990) together with the
CECA-Q - Family Relationships in
Childhood (Bifulco et al, 2005) which is
a measure of childhood adversity.
Participating therapists are asked to
recruit their next 3 patients
commencing therapy.
Patients: need to complete
a) the same attachment measures.
b) at the beginning and end of therapy,
the CORE-OM (an outcome
measure that measures reliable and
clinically significant change).
Therapist and patient complete:
the Agnew Relationship Measure
(Agnew-Davies et al, 1998) at session 5
and at the end of therapy/session 40.
This measures the 5 dimensions of the
therapeutic alliance - bond, partnership,
confidence, openness and client
initiative and will be used to explore the
role of the therapist/patient relationship
in mediating the relationship between
attachment status and outcome.
A quantitative methodology is being
used in which various reliable and wellvalidated self-report instruments
measure the participants’ experiences
of relating and thus determine their
attachment style.
Although quantitative methodologies
can be criticised for their
restrictiveness, there is a case for
exploring attachment relationships in
this way. Whilst not denying the
richness and complexity of human
relationships, it is seen that ways of
being in relationship are repeated over
an individual’s lifetime and can be
captured by self-report measures which
offer a valid and reliable form of
description.
Although some of the rich material
which might have been elicited from
interviewing participants will be
foregone, a quantitative approach
utilising self-report measures will be
more cost-effective, more time-effective
and less intrusive.
References
Agnew-Davies, R., Stiles,W.B., Hardy, G.E.,
Barkham, M., Shapiro, D.A. (1998).Alliance
structure assessed by the Agnew
Relationship Measure (ARM). British Journal
of Clinical Psychology. 31, 155-172.
Bartholomew, K. (1990).Avoidance of
intimacy:An attachment perspective. Journal
of Social and Personal Relationships. 7, 147-178.
Bifulco,A.; Bernazzani, O.; Moran, P. M.;
Jacobs, C. (2005).The childhood experience
of care and abuse questionnaire (CECA.Q):
Validation in a community British Journal of
Clinical Psychology. Volume 44, Number 4,
November 2005, pp. 563-581.
Brennan, K.A., Clark, C.L., Shaver, P.R. (1998).
Self-report measurement of adult
attachment: an integrative overview. In: J.A.
Simpson & W.S. Rholes (Eds.). Attachment
Theory and Close Relationships (pp 46-76).
New York: Guilford Press.
Dozier, M., Cue, K.L., Barnett, L. (1994).
Clinicians as caregivers: role of attachment
organization in treatment. Journal of
Consulting and Clinical Psychology. 62, 793-800.
Fonagy, P. , Leigh,T., Steele, M., Steele, H.,
Kennedy, R., Maltoon, G. et al. (1996).The
relationship of attachment status, psychiatric
classification and response to psychotherapy.
Journal of Consulting and Clinical Psychology. 64,
23-31.
Hazan, C., & Shaver, P.R. (1990). Love and
work:An attachment-theoretical
perspective. Journal of Personality and Social
Psychology. 59, 270-280.
Rubino, G., Barker, C., Roth,T. & Fearon, P.
(2000).Therapist empathy and depth of
interpretation in response to potential
alliance rupture: the role of therapist and
patient attachment style. Psychotherapy
Research. 10(4), 408-420.
Sauer, E. M. , Lopez, F.G. & Gormley, B.
(2003). Respective contributions of therapist
and client attachment orientations to the
development of the early working alliance:A
preliminary growth modeling study,
Psychotherapy Research. 13(3), 371-382.
Tyrrell, C.L. (1999). Effective treatment
relationships for persons with serious
psychiatric disorders: the importance of
attachment states of mind. Journal of
Consulting and Clinical Psychology. 67, 725-733.
Jo MacKay is a Chartered Counselling
Psychologist in Lewisham Psychological
Therapies Service (South London and
Maudsley NHS Trust).
Jo MacKay, BA, MSc
www.ukcp.org.uk
13/12/07
16:05
Page 9
Attributions, Intellectual Disability
and Family Therapy Suzanne Haddad
dominant ‘blame-frame’, often directed
towards the identified patient (frequently
a child) (Stratton, 2003).The findings of
this study did not appear to follow the
clinical impression that families come to
therapy with a tendency to blame the
referred child. However, given the small
sample size, caution must be taken when
interpreting the findings.
Suzanna Haddad
Introduction:
This research study was conducted
within an intellectual disability (ID)
family therapy service. Using the
Leeds Attributional Coding System
(LACS) (Munton et al., 1999), the first
part of the study explored the causal
attributions of families and therapists
attending a first session of family
therapy (FT).
Using semi-structured interview, the
second part of the study explored
therapists’ perspectives on their
consultations with the families, in
particular their perspectives of the
families, their attributional styles and
how this fitted with the findings of the
attributional analysis.
The study was conducted as part of the
Doctorate in Clinical Psychology at
Surrey University in Guildford. Four
families and two therapists were
recruited through an ID FT service.A
mixed method analysis was employed,
firstly the LACS was used to code causal
attributions made during the FT session,
Interpretative Phenomenological Analysis
(IPA) was then used to analyse and
interpret interviews with therapists.
Mothers in this study made most of the
attributional statements, with fathers
making approximately half those of the
mothers. Children made few
attributional statements. Parents within
the study tended to make statements
that exonerated the children.
A point of interest across the study is
that parents presented their children as
agents more often than themselves, but
saw themselves as targets more often
than their children; similar to findings in
Stratton (2003). Both therapists
involved in the study made few
attributional statements and these did
not appear to be either blaming or
exonerating in nature.
The second part of the study explored
the therapists’ perspectives of the
therapeutic process, before the findings
of the LACS were fed back.
Comparisons were drawn between the
LACS analysis and the therapist’s
perspective, together with their thoughts
on the therapeutic utility of the tool.
“There is a paucity of
research exploring
therapists’ perceptions”
The results were presented in the thesis
as case studies.An overall analysis was
also conducted to explore similarities
and differences across the case studies.
There is a paucity of research exploring
therapists’ perceptions of families in FT.
There were a number of emergent
themes that transpired from the IPA
analysis, which supported the LACS
findings.
Discussion and Conclusion:
Attributional research within generic FT
services have shown there to be a
Of interest was the negative language
used to describe mothers in the second
part of the study. In light of feminist
The Psychotherapist
critiques of FT, the researcher is
interested in how these discourses
might reflect a wider tendency by
clinicians to speak negatively of mothers
(Vetere & Dallos, 2003).The use of
diagnostic labels to define children and
their difficulties was an issue highlighted
by therapists (Chavira et al., 2000).
“ways in which to work
with these families
without increasing feelings
of hostility towards their
children”
The LACS proved helpful in both
identifying and validating the therapists’
experiences so that they could think
about ways in which to work with
these families without increasing feelings
of hostility towards their children.The
therapists also identified the utility of
the LACS in allowing them to think
about agency, as they and their team
were not always aware of attributional
statements (Stratton, 2003).
Suzanne Haddad
References:
Chavira,V., Lopez, S.R., Blacher, J. & Shapiro, J.
(2000). Latina mothers’ attributions,
emotions and reactions to the problem
behaviours of their children with
developmental disabilities. Journal of Child
Psychology and Psychiatry, 41, 245-252.
Munton,A. G., Silvester, J., Stratton, P., &
Hanks, H. (1999). Attributions in Action:A
Practical Approach to Coding Qualitative Data.
Wiley: Chichester
Stratton, P. (2003). Causal attributions during
therapy I: Responsibility and blame. Journal of
Family Therapy, 25, 136-160.
Vetere,A. & Dallos, R. (2003). Working
Systemically with Families: Formulation,
Intervention and Evaluation. London: Karnac.
Suzanne Haddad is a Trainee Clinical
Psychologist at Surrey University/Surrey
and Borders Partnership NHS Trust.
[email protected]
9
13/12/07
16:05
Page 10
Finding an Identity as a
Researching Psychotherapist
Joanna North
I think it was vital that I finally accepted
that research in the field of
psychotherapy, in writing about human
experience, is qualitatively different from
any other kind of research.
Psychotherapeutic research might have
been held back by the perception that
case study is one of the only more
obvious forms of methodology (i.e. Freud)
outside of the quantitative methods.
Joanna North
After fifteen years of practice and a
Masters Degree in my subject as a
psychotherapist I felt it was time for
me to find an identity as a
researcher and contributor to the field
of my area of expertise and profession.
What researching practitioners are now
finding is that we can create tailor made
methodologies to fit our subject rather
than trying to fit ourselves into
frameworks that don’t enhance
understanding of the field.And that for
me this is what research is about –
enhancing understanding.
For me the journey was about finding the
right methodology of research.This brief
article describes the process of discovery
to finding my place as a researcher and
practitioner. I hope some of my
experiences might support others who
are extending their professional
development through research.
With illumination of the subject matter as
my goal, I have progressed over the last
year on my Doctorate in Psychotherapy
course from a position of frozen apathy
to research to a position of excitement
and enthusiasm about my doctoral thesis.
The most helpful concept to support my
work was that of praxis or the notion
that practice and theory are inextricably
linked and that observation and attention
to praxis is the crucible for discovery and
development in psychotherapeutic
practice. Praxis has been described as ‘the
legitimacy of knowledge gained through
practice’ (Costley 2000).
“I can create a
methodology that fits my
own unique enquiry into
attachment based
psychotherapy with
children”
“writing about human
experience, is qualitatively
different from any other
kind of research “
Having undertaken a ten month course in
Research Challenges run by Professor
Paul Barber of Middlesex University, I
have found that I can create a
methodology that fits my own unique
enquiry into attachment based
psychotherapy with children who have
disorganised personalities.
To engage with a course that specifically
focussed on research in psychotherapy
was possibly my best move towards
identifying the ideal way to research my
practice.
My defining moment as a researcher was
to read Clarke Moustakas’ small but
significant book on Heuristic Research in
which he describes the process of
enquiry as:
10
‘Emphasis on the investigator’s internal frame
of reference, self searching, intuition and
indwelling lies at the heart of heuristic
inquiry.’, Moustakas 1990)
There are of course a broad range of
qualitative methods to choose from –
heuristics being just one practical tool that
I believe fits the practice of psychotherapy.
It tends to serve the more ‘internal frame
of reference’ that many schools of
psychotherapy are adopting.
Having said this, I would not want to give
the impression of rejecting quantitative or
traditional methods for psychotherapy.We
have a choice about the best tools to fit
the purpose of the research.
“We have a choice about
the best tools to fit the
purpose of the research”
If you wish to read further on becoming a
research practitioner I would recommend
Professor Paul Barber’s book which is
named below.
I wish you well with your enquiry into
your practice.
Joanna North M.A. UKCP registered
psychotherapist.
References
Barber P. (2006) Practitioner Researcher.A Gestalt
Approach to Holistic Enquiry. Middlesex University
Press. North London Business Park, Oakleigh
Road, South London. N11.
Costley C and Portwood D. (2000) Work Based
Learning and University: New Perspective and
Practices. Birmingham SEDA.
Moustakas C. (1990). Heuristic Research. Design,
Methodology and Applications. Sage Publishing. 6
Bonhill Street, London. EC2.
Joanna North is a practicing
psychotherapist and works as an
Independent Expert Witness for the
Family Court. Joanna is completing her
Doctorate in Psychotherapy with the
Metanoia Institute.
[email protected]
www.ukcp.org.uk
13/12/07
16:05
Page 11
Developing practitioner
effectiveness through
training Biljana Van Rijn & Charlotte Sills
Introduction
This research project was an evaluation
of a new approach to clinical training in
Transactional Analysis at Metanoia
Institute, using the methodology of
action research.
The training year was based on the
concept of an ‘internship’ year that
placed trainees’ clinical practice at the
heart of their training as they started to
see clients.
The design aimed to close the gaps
between clinical practice, supervision
and formal training, facilitate translation
of theory into practice and integrate
findings from the ‘common factors’
research into effectiveness of
psychotherapy (Wampold,2001) by
emphasising the focus on therapeutic
relationship.
Training and supervision were linked
and focused on emerging issues in
clinical practice, the development of
students’ capacity for critical reflection
and a research attitude to practice.
“How do I become an
effective practitioner?”
The year taught research skills by
posing a research question “How do I
become an effective practitioner?”,
which students engaged with.
Methodology
The evaluation project was a
naturalistic study which used
quantitative (CORE System) and
qualitative methodologies within the
action research framework (Friedman,
2001) to reflect on the impact of the
year on the participants, and the clinical
practice.This methodology involved
collaboration with all the participants
The Psychotherapist
within the training system - students,
tutors and supervisors.
Outcomes
Quantitative analysis of the clinical data
offers a descriptive comparison
between the internship and two
comparative groups – firstly, other
students at the same stage of training
working within the same placement
(Metanoia’s in-house placement) and
secondly, CORE national benchmarks.
THEORETICAL
TEACHING
Based on Clinical
Practice
PREPARATORY
READING
EXPERIENTIAL
LEARNING
and Development
of Personal
Awareness
APPLICATION
OF LEARNING
Triads,
Supervision
This analysis was particularly relevant, as
the main aim of the programme was to
increase effectiveness of early clinical
practice and students’ ability to establish
and maintain a therapeutic relationship.
The results were striking. Compared to
students at the same stage of training,
internship students used the CORE
System more fully to evaluate their
practice, worked with more distressed
clients for longer and were on the
whole more effective.
In comparison to CORE benchmarks,
their practice was well beyond
expectations and overall in line with the
performance of nationwide, NHS based,
qualified practitioners.
These quantitative outcomes show that
Biljana Van
Rijn
Charlotte
Sills
the training design and emphasis on
evaluation of clinical practice
demonstrably improved effectiveness of
students' clinical practice.
The qualitative analysis was based on
the thematic analysis (Miles and
Huberman, 1994) of transcripts of
research meetings with students and
staff and analysis of students' written
work.This offered insight into the
process by which the training
objectives were achieved, personal
experiences of training and the impact
of research.
Feedback by students consistently
emphasised the link between
theoretical and experiential input, the
application of this learning in practice
sessions and integration of both
through supervision and development
of personal insight.
This presented live application of
cycles of action research within the
programme, which enabled
coordination of training methods,
challenged students into deepening
reflection and evaluation of their
clinical practice and led to the
development of their effectiveness.
The challenge of the year and process
of change it instigated also resulted in
11
13/12/07
16:05
Page 12
high levels of anxiety during the year
and consequently anger. It is interesting,
and worthy of further research, to
wonder whether the experience and
management of strong feelings were a
necessary contributor to successful
practice.
Finally, the resulting training programme
offers a framework for introducing
practice based research and action
research methodology as a training
method and an evaluation tool within
psychotherapy training.
Dr Biljana Van Rijn
[email protected]
Professor Charlotte Sills
[email protected]
References
Friedman,V.J (2001) Action Science: Creating
Communities of Inquiry in Communities of
Practice in A Handbook of Action Research:
Participative Inquiry and Practice Eds. P. Reason
and H. Bradbury. London: Sage
Van Rijn, B. ( 2005) An Enquiry into
Psychotherapy Training. Challenges to developing
a generic foundation year and links to clinical
practice training. D.Psych. Metanoia Institute
and Middlesex University
Miles, M.B. & Huberman,A.M (1994) An
Expanded Sourcebook: Qualitative Data Analysis.
London: Sage
Wampold, B.E (2001) The Great
Psychotherapy Debate NJ: Lawrence Erlbaum
Associates.
Dr Biljana Van Rijn is Clinical Services
Manager and tutor at Metanoia Institute
Professor Charlotte Sills was Head of
Department at Metanoia Institute at the
time of this research and is now a tutor
and supervisor for the courses.
Researching process-andoutcome in psychotherapy:
the challenges and the rewards Georgia Lepper
That psychotherapy works has
been established by decades of
careful outcome research, reviewed
in the work of Bergin & Garfield (1971,
1978,1986,1994 and Lambert, 2004).
The major findings, however, fail to
distinguish large differences between
the modalities, although there are some
indications of specific benefit from
particular interventions.
More recently, the processes and effects
of psychotherapy have started to attract
the attention of researchers. However,
driven by economic considerations,
process research has lagged behind
outcome research, with the result that
while we know that psychotherapy,
overall, is beneficial, and confers
enduring gains in mental health and wellbeing, at the same time we have only
limited understanding of what aspects in
the process contribute to outcomes.
Common factors in the psychotherapy
process have been identified as
important mediators of change: the
‘therapeutic alliance’ recognised across
modalities; therapist factors, (style,
12
warmth, empathy), and client factors
(expectations, willingness to confront
problems) contribute to the processoutcome relationship, in addition to
specific techniques on offer.
The implication of these studies is that
it is in the context of ordinary practice,
in the relationship between real people,
that the therapeutic process unfolds
and has its effects.This finding presents
clinicians with a deep challenge.
On the one hand, it supports the
traditional view that it is in the day to
day engagement with practice that
discoveries are made about how human
beings recover from distress, achieve
insight or mastery, and move to new
ways of living.
On the other hand, it tells us that if we
are to truly understand what factors in
the therapeutic process reliably
contribute to positive change in
everyday practice, and to recognise
those factors which may mitigate against
patient progress, we must open our
practice to closer scrutiny.
Two methods are available to achieve
these aims. First, the technology of
digital recording devices, small and
unobtrusive, and of such high sound
quality that it is possible to track not
only the talk but some of the nonverbal events – breathing, change of
tone, pauses and silences – that tell so
much about what is happening.
Second, there are simple, easy to use
outcome measures that track changes
in patient experience and progress from
session to session (Lambert. 2001).
What kinds of events in a session might
contribute to a marked change, for
better of for worse? Do these changes
relate to events we and our patients
have experienced in the clinical
engagement?
For example, does one kind of
intervention lead to a negative reaction,
followed by a marked improvement,
while another leads to apparent
agreement but no particular shift, and
yet a third leads to progressive
deterioration? What were the qualities
of these interventions? Can we compare
www.ukcp.org.uk
13/12/07
16:05
Page 13
and evaluate these observations with
others’ experience and practice?
I can envision a quite different case
discussion group to those we normally
participate in. In this group, clinicians are
listening to tape recorded events,
discussing the impact of interventions,
following hunches, and critically
evaluating these in the context of their
impact on session evaluations (the
patient’s experience).
Such a case discussion group would be
a practitioner-based research group,
slowly building up a picture of what
actually happens in the clinical process,
and evaluating its impact in terms of
both micro-outcomes (in-session effects
of interventions) and clinical outcomes
(the changes achieved as a result of the
therapy).
Georgia Lepper PhD
[email protected]
References:
Bergin A. & Garfield, S., Eds (1971,1978,1986,
1994) A handbook of psychotherapy and
behaviour change. Editions I – IV. John Wiley
& Sons.
Lambert, M., Ed. (2004) Bergin and Garfield’s
Handbook of Psychotherapy and Behaviour
Change. 5th Edition. John Wily & Sons.
Lambert, M., Hansen, N. & Kingston, M.
(2001). Patient focused research: Using
patient outcome data to enhance treatment
effects. Journal of Consulting and Clinical
Psychology, 69, 147-149
What does ‘ending’
mean to a client? Susan Stuart
As a practicing psychotherapist,
undertaking research (Stuart 2006) was
a creative opportunity to explore a
facet of my practice. It was very
important that the research was more
than a ‘paper exercise’, and would
enable me to become a more effective
therapist.
My question about endings came from
an experience with a client. Contracted
for 20 sessions, after 22 she said she
had to end. Shocked I had forgotten our
agreement, the final session felt abrupt,
but was evidently timely for her.
I was forced to think about my own
‘ending trajectory’ and assumptions
about clients’ understanding.What did
the process and experience of ending
mean to them?
I found there was a dearth of literature
giving the client’s own view, and
undertook a study designed to
challenge my ideas about ending,
increase my clinical and theoretical
understanding, and enhance my work as
a therapist.
“to increase my clinical
and theoretical
understanding”
I was drawn to the heuristic method of
Clark Moustakas (1990), because its
features are analogous with those of
The Psychotherapist
psychotherapy. He suggests that the aim
of research is to explore “the essence
of the person in experience”
(Moustakas 1990 p39) and describes
the heuristic process as an opportunity
to discover meaning while developing a
method for further investigation.
This requires that the researcher has
had direct personal encounter with the
phenomenon being investigated so she
“also experiences growing selfawareness and self-knowledge”
(Moustakas1990 p9), both essential for
a psychotherapist.
What emerged was an exploratory
project which sought the thoughts,
feelings and attitudes of ten clients who
had experienced what they perceived as
a positive ending of personal integrative
psychotherapy. Eight one-hour
interviews were conducted at the
Northern Guild for Psychotherapy, and
two at co-researchers’ homes, at their
request.
All interviews were recorded and notes
taken to document non-verbal
responses. Such interviews are
dependent on the skill of the researcher
to encourage honest and
comprehensive responses, accurate
empathic listening, openness, flexibility
and freedom to respond to what
emerges.
Heurism invites a researcher/ therapist
to be reflexive, to filter a participant’s
Susan Stuart
experiences through her own, and not
superimpose her own experiences onto
theirs (Etherington 2004).All of these
are familiar skills that make the research
process very accessible to
psychotherapists.
The transcripts were written up as
focused depictions of ending, without
interpretation. Co-researchers were
asked to respond to them in terms of
accuracy and impact.All the data
received was explored for statements
relevant to the topic, and grouped into
units of meaning, using a diagram to
visually link those that were
interrelated, as described by Clark
(1988 cited Moustakas 1990 p50).These
units of meaning were then clustered
into themes (Stuart 2006 p 76 & 93).
The findings of the study did not wholly
13
13/12/07
16:05
Page 14
reflect the available literature. Issues
that have preoccupied therapists over
years e.g. semantic discussions about
terminology, or outcomes that are
deemed to be indicators for ending, did
not emerge as important.
The participants all experienced ending
as “one of the most important parts of
the therapy. I will never forget it…”
(Respondent 5 cited Stuart 2006 p97).
It is a significant positive event when it
is timely, thought through in advance,
feelings are acknowledged and
expressed, and both therapist and client
invest energy in creating concrete and
symbolic representations that can be
carried into the future.
“one of the most
important parts of the
therapy”
Many avenues for further enquiry are
suggested by this study e.g. exploring
the views of client/therapist dyads
about their experience of ending;
examining the implications of ending on
different racial, cultural or gender
groups; exploring differences between
endings with adult clients or children,
and any impact on therapists who
manage both.
The heuristic process in which I
engaged remains a live part of my
practice. My enhanced understanding of
ending, through reading and carrying
out research with clients, continues to
enrich my psychotherapeutic,
supervisory and educational work.
Susan Stuart
References
Etherington K. (2004) Heuristic Research as
a Vehicle for Personal and Professional
Development Counselling and Psychotherapy
Research 4(2)48-63
Moustakas C. (1990) Heuristic Research
London, Sage
Stuart S A (2006) The Experience of Ending
Psychotherapy Unpublished MSc Thesis.
Newcastle: Northern Guild for
Psychotherapy
Susan Stuart is a psychotherapist, clinical
supervisor and tutor at the Northern
Guild for Psychotherapy.
[email protected]
14
PRN in action:
Constructing an outcome measure
for therapy with relational systems
Peter Stratton
A group of therapists, with support
from the Association for Family
Therapy but without research
funding, undertook to create an
outcome measure appropriate to
Systemic Family Therapy (SFT).We have
operated a number of projects in the
form of Practitioner Research
Networks (PRNs), some described in
this article.
Because SFT has a conceptualisation of
psychological distress radically different
than that of other psychotherapies, we
felt existing outcome measures fail to
capture therapeutic change achieved by
working with clients’ relationships.
The project was modelled on CORE
outcome measure (Evans et al, 2000),
and because it has similar objectives but
is geared to systemic therapy, became
called the SCORE project.
SFT, like other psychotherapies, has a
recent history of neglecting research
but is moving towards a greater
engagement both in taking value from
research (Stratton, 2007a) and
increasingly with practitioners
undertaking research.
“Does it work” is a legitimate question
for clients, managers and therapists to
ask.We want to give practising
therapists a tool for evaluating their
own work as well as providing a well
constructed outcome measure for use
in research.
In addition we intend the SCORE
project to be informative in detail about
therapeutic change in ways that will
assist research into effective processes
in SFT.The items in the final version of
SCORE can be viewed as an account of
the changes that therapists attempt to
foster in their clients’ relationships.
Clinical applications of SCORE will than
be able to indicate which of the changes
are achieved in which circumstances.
The SCORE PRN
The SCORE team is a group of family
therapists in varied locations and
professions who have come together to
work on developing a self-report
outcome measure.This PRN has held
regular face-to-face meetings to work
on the construction and psychometric
development of the outcome measure.
The core PRN was extended through
email discussion lists and by sending
pilot versions to practitioners who had
worked on outcome measures.
A network of 16 clinics is generating
data for the project.As these clinics are
spread throughout the UK a major
initial part of the work has been in
obtaining national ethical approval via
COREC.
This second phase of the PRN operates
largely through email though getting a
clinic’s contribution started is facilitated
by a preliminary visit to go through
procedures and share learning and
feedback from existing members of the
PRN.
The non-clinical sample
A different network was set up through
the participation of 22 trainees on the
Leeds MSc in SFT. Entry to the training
requires a professional qualification and
work setting, so this is a practitioner
group.
NHS ethical approval was still being
pursued so this group, under
supervision, took on a collaborative
project to pilot the SCORE with a nonclinical sample. Ethical approval came
from the ethical committee of the
University Psychology Department.
Each trainee administered the SCORE
to a minimum of three people with a
brief to achieve as much diversity
(gender, ethnicity, age etc) as possible.
This study found an interesting
www.ukcp.org.uk
13/12/07
16:05
Page 15
dimensional structure to the questions
and a correlation of the total score with
self report of level of family difficulty.
The expert sample
Another PRN involved three qualified
family therapists who each took a
version of SCORE to three highly
experienced therapists, recorded
individual interviews as they worked
through the questions, and each
conducted qualitative analyses of the
sample of nine interviews (Stratton,
McGovern,Wetherell and Farrington,
2006).
Perhaps the most consistent finding was
the enthusiasm of therapists to use the
research measure for creative clinical
purposes.
Overview
Our experience has been that PRNs
can take many different forms.Where
one member of the team has greater
research experience a ‘hub and spokes’
pattern of communication tends to
develop, but much effort is put into
fostering dialogue among the whole
group.
Shared email has been a very effective
vehicle for much of the work. Large
PRNs based on quantitative data are
administratively complex, while the
small PRN conducting qualitative study
created methodological complexity in
co-ordinating the analyses. So far, all the
different formats have been highly
productive.
The core SCORE PRN
The current SCORE team consists of:
Julia Bland (Maudsley Hospital),
Peter Stratton (Leeds University),
Emma Janes (SLAM),
Judith Lask (Institute of Psychiatry),
Grania Clarke (Tavistock Clinic).
Peter Stratton
References
Evans, C; Mellor-Clark, J; Margison, F;
Barkham, M;Audin, K; Connell, J; McGrath, G.
(2000) CORE: Clinical Outcomes and
Routine Evaluation. J. Ment. Health 9:3, 247255.
Stratton, P. (2007b) Formulating research
questions that are relevant to
psychotherapy. Mental Health and Learning
Disabilities Research and Practice,.4, pp 83-97
Stratton, P., McGovern, M.,Wetherell,A. and
The Psychotherapist
Farrington, C. (2006) Family therapy
practitioners researching the reactions of
practitioners to an outcome measure.
Australia and New Zealand Journal of Family
Therapy. 27 pp. 199–207
Peter Stratton is Professor of Family
Therapy at Leeds University and Chair
of the UKCP Research Committee.
[email protected]. Papers on
www.psyc.leeds.ac.uk/staff/p.m.stratton/
Book review: What is
psychotherapeutic
research?
UKCP/Karnac books, 2006
Del Loewenthal and David Winter (eds) ISBN-1 85575-301 4
The importance of this text, compared
to other writings on this topic, is that
here UKCP gives its authority to the
argument that psychotherapists need to
be research minded, drawing on
research to support our practice and
becoming ourselves active researchers.
This is not always an easy argument to
make.The text is peppered with
phrases like ‘randomised controlled
trials’ and ‘dose response curves’.
There is a recognition that such
language may leave therapists with
feelings of “anxiety, confusion and
ambivalence” and many of the authors
carefully question whether the demand
for evidence base practice arises from
the needs of clients/patients or the
demands of the market place within
health care, and whether most research
is dryly academic, destined to be unread
in libraries, or can be practitioner
friendly.
In the end, however, because and not
despite these concerns, a coherent case
is made for research that is scientific,
humane and relevant.
The chapters are committed to helping
develop approaches for “systematically
defining, recording and interpreting
clinical data” (Gumley, p.80) and the
rationale for this is that “even
experienced therapists have a relatively
small pool of experience from which to
draw conclusions” (Aveline, p.4).
The volume is grouped around five
related themes, the first outlining the
details of the research process and the
various methodologies, the second
section builds on this with fuller
discussions of the various
methodologies while part three focuses
on examples of research into the
process of psychotherapy.
Part four explores methods of
evaluating outcomes for patients/clients
and the volume ends by investigating
the therapeutic context as it relates to
the personal preferences of the
therapist.
Most papers are brief, accessible
certainly, but I was often left wanting to
know more about either the
methodology or the research areas.
Longer discussions are provided on the
impact of researching into sensitive and
distressing topics and identifying
cohesion in group therapY.
The last section explores “the therapist
and the therapeutic context”, includes
research into therapists drawn to
behaviourism and those to
psychoanalysis, concluding that between
the two “dialogue (is) extremely
difficult”.
I was left thinking about those
therapists enthusiastic about research
and those who see no place for it in the
work.
No one book will, in itself, resolve the
tensions but the UKCP has provided a
useful service in publishing a text that
offers the possibility of meaningful
dialogue.
Jeremy Weinstein
UKCP registrant
15
13/12/07
16:05
Page 16
the psychotherapist ukcp news
Chair’s Update
form and shape of UKCP. SPAG
demonstrates UKCP’s commitment to
consult before any actions are taken.
Since the AGM there have been a series
of road shows across the country and
others are planned to ensure there is
input from all levels of interest.
James Antrican
We continue to face the
challenges of how UKCP and its
members and registrants retain
core values in a changing world.
Currently we are investing much of our
time, energy and resources in our own
internal world and affairs.Although this
is a necessary process we need
everyone to engage and to be aware
that such processes do have an external
impact, in particular with those who
hold the political power.
Being able to change and challenge our
structures in the face of statutory
regulation and changes that impact our
workplace is a burden and opportunity.
UKCP’s strength and future is derived
from the member organisations (MOs)
and registrants. Our diversity through
the representation of a world of
modalities for true choice is essential.
UKCP has to modernise its structures if
it is to continue to provide a service to
the public.The need to modernise
within UKCP means that there will be
innovation and change.
The advent of statutory regulation will
challenge UKCP in the following areas;
a core ethics
b high achievable standards
c how the psychotherapy profession is
seen in the world
d research
Successive AGMs and EGMs have made
decisions about how UKCP will
operate.The Strategic Planning Advisory
Group (SPAG) has been mandated by
the Board of Trustees to facilitate the
Board’s consideration of the future
16
The British Psychological Society (BPS)
had a Section 60 order served in March
this year and the government hoped to
place the appropriate legislation before
Parliament this autumn.The order has
been revised and the formal
consultation period will now begin in
the next few weeks and will last to
March/April 2008. It is likely that BPS
will come within the remit of HPC in
the autumn of 2008.
There are many within UKCP who are
ambivalent about statutory regulation.
Yet it should be remembered that
UKCP was formed with the idea of
statutory regulation being the final goal.
It is important to try to influence the
Department of Health and subsequently
HPC so that the conditions which will
apply to UKCP registrants and MOs are
favourable.An important aim is to
ensure that HPC recognises the
importance of maintaining and holding
the diversity of the profession of
psychotherapy.
The recent initiative from Improving
Access to Psychological Therapies
(IAPT) with its emphasis on the delivery
of a form of CBT within the NHS has
been perceived as a threat to the wider
profession. IAPT has focussed on CBT
with its application to anxiety and
depression.There are significant
constraints imposed under the recent
initiative with regards to the length and
type of treatment. Initially the driving
force in this initiative is to increase
access but it is also concerned with the
choice of service.
Participation in IAPT and its
contributing groups gives UKCP an
opportunity to secure a position for its
registrants to have the recognition to
be able to work with people at all levels
in the NHS.The current initiative will
not deal with cases of people who have
a complexity of illness and we will
continue to evaluate the impact of IAPT
in community and private practice.
Change in UKCP is ongoing, including a
turnover in both staff and committee
members.
Alex Walker-McClimens, PR and
Development Manager and Angela
Willessey, General Enquiries
Assistant/Receptionist have bothl
moved on to new and exciting
opportunities.We are enormously
grateful for their vital contribution to
UKCP and its activities.
The following have left the Board of
Trustees, but many are still working
with other parts of the organisation.
We have seen the departure of Sally
Openshaw, Chair of the Family, Couple,
Sexual & Systemic Section, Linda
Matthews, Representative of the British
Association for Behavioural and
Cognitive Psychotherapies, Sarah
Collins, Chair of the Psychotherapeutic
Counselling Section, and Irene Tubbs,
Chair of the Cognitive Behavioural
Section.All of these people will be
greatly missed.Their contributions have
been of incredible value to the UKCP.
Linda Freeman and Ian Moore stood
down from acting as Co-Chairs of the
Registration Board in John Monk-Steel’s
absence on health grounds.They have
dealt with the complexities of the
Registration Board and brought
refreshing view points to the discussion
of the business of the Registration
Board.
UKCP’s current engagement in activities
with government, other professional
associations and in relation to internal
change will define what psychotherapy
is in the UK for several decades. It is
our responsibility to make sure that our
voice is clear and strong.
James Antrican
UKCP Chair
www.ukcp.org.uk
13/12/07
16:05
Page 17
30th November 2007
Psychological Therapies in the NHS
was the first national gathering of the
professional bodies, charities and
service providers at the forefront of
making psychological therapies available
to NHS patients.
“This body demands that the NHS
should offer choice of
psychological therapy for all who
need it…”
So the New Savoy Declaration
Conference began on 30th November
and continued through 1st December
2007. UKCP, in supporting this
conference, is a part of the message to
the Government that the NHS should
offer people with mental health
problems a genuine choice of proven
psychological therapies. For the full
New Savoy Declaration and its
signatories please see below.
James Antrican, attending the
conference on behalf of UKCP,
reported that Alison Faulkner, a Mental
Health Service User Consultant and
Researcher told of her experiences in
dealing with seeing and hearing things
that other people didn’t. In a passionate
personal and intimate presentation she
told the conference how she noted
diagnoses and undelivered promises
concluding that:
“The future of our mental health
services, I believe, lies in our capacity to
listen to those of us who have direct
experience of mental health problems.
Psychological therapies have to respond
to people as individuals and that means
offering choices. One size does not fit
all.
“It is not enough to listen to people
individually.We also need to respond to
what people are saying about their
experiences and how to make our
mental health services something to be
proud of. In the same way that Valium
was not the answer to everyone’s ills in
the second half of the 20th century, so
The Psychotherapist
too is CBT unlikely to resolve
everyone’s difficulties in the 21st.
“We need to be more sophisticated
than this and realise that there are
different responses required for
different people and for people with
different types of problems.”
Professor Lord Layard welcomed the
Government’s £170 million investment
in psychological therapies. He told the
conference:
“This is a key moment for improving
access to psychological therapies.The
government has said it will provide the
money, but it is up to all of us to ensure
that it is well spent.We owe this to the
millions of sufferers who have so far
been denied the treatment they are
entitled to.”
The conference saw the publication of
the New Savoy Declaration, a joint
statement of support for comprehensive
provision of psychological therapies on
the NHS.
Full copies of the presentations, subject
to copyright, will be on the UKCP
website.
Depression and anxiety affect millions
of people in the UK, yet few receive the
psychological therapies that could help
us to recover. Many of us with the
courage to seek help have to wait for
many months for treatment or have to
pay for it privately.
The Government has committed itself
to turning this around and to
implementing NICE Guidelines for
depression and anxiety so that all GPs
have timely access to state-of-the-art
evidence-based therapies for their
patients.
We congratulate the Government on
this welcome initiative and call on the
NHS to offer appropriate psychological
therapies free at the point of delivery to
all people who need them, within six
years.We call for people to be given a
choice of appropriate, evidence-based
therapies available close to home when
they need them.And we urge
government to invest in the further
development and evaluation of
psychological therapies to make the UK
a world leader in this field.
We commit to working together to
support the NHS to build up its
psychological therapy provision and to
ensure that the new services are safe,
effective and successful.
Signed:
Malcolm Allen, Chief Executive, British
Psychoanalytic Council,
Madeline Andersen-Warren, Chairperson,
British Association of Dramatherapists,
James Gray Antrican, Chair, United Kingdom
Council for Psychotherapy,
Nicola Barden, Chair, British Association for
Counselling and Psychotherapy,
Jeremy Clarke, Chair, Psychological Therapies
in the NHS,
Prof Chris Evans, President, UK Society for
Psychotherapy Research,
Paul Farmer, Chief Executive, Mind
Angela Greatley, Chief Executive, Sainsbury
Centre for Mental Health,
Barbara Herts, Chief Executive,Young Minds,
Paul Jenkins, Chief Executive, Rethink,
Dr Gillian Leng, Implementation Director,
National Institute for Health and Clinical
Excellence,
Dr. Chris Mace, Chair, Psychotherapy Faculty,
Royal College of Psychiatrists,
Prof Pam Maras, President, British
Psychological Society,
Andrew McCulloch, Chief Executive, Mental
Health Foundation,
Stephen Sandford, Chair,Association of
Professional Music Therapists,
Neil Springham, Chair, British Association of
Art Therapists,
David Veale, President, British Association for
Behavioural and Cognitive Psychotherapies
17
13/12/07
16:05
Page 18
EGM 2007 report
Statutory Regulation
James Antrican’s report to the EGM is
represented elsewhere in this issue (see
Chair’s update).
Organisational change
Successive AGMs and EGMs have made
decisions about how UKCP will operate
as an organisation.The Chair committed
both the Executive Committee and the
Board of Trustees to embrace the
motions which are passed so as carry
out the necessary actions to move
UKCP forward.
Discussion subsequent to James
Antrican’s introduction focused on the
concern that the full range of modalities
should be represented in the interface
with government and other agencies. It
was agreed that the price of regulation
may at times feel too high.The reality is
that statutory regulation will take place
and there is a need for all the
professional bodies in talking therapies
to talk together and to remain united in
their joint discussions with the
government and its agencies.
Discussion and debate
Through the discussion and debate
around the motions brought to the
meeting, the meeting affirmed the
UKCP’s commitment to a central
complaints process by a large majority.
Because Motion 2 was deemed to be
inappropriately worded, this motion
that aimed to affirm the authority of the
Registration Board to decide the best
method of managing the CFAP to meet
its constitutional duties was withdrawn.
Motion 3, which called for a decision on
any motion concerning the ICO's
relationship with UKCP and its member
organisations to be deferred until
members have had the opportunity to
consider the constitutional
arrangements of ICO and the contract
between UKCP and ICO, was carried.
Motions 4 and 5 were withdrawn, and
Motion 6, putting arrangements in place
for the support of UKCP Trustees, was
narrowly approved.
Strategic Planning
Subsequent to the ‘business’ of the
meeting, there was a presentation and
workshop by the Strategic Planning
Advisory Group (SPAG) which aimed to
ascertain views of delegates about the
future (post-statutory regulation)
organisational purpose and shape of
UKCP.
It is clear that opinion at this stage of
the consultation strongly favours
maintaining UKCP as a strong ‘brand’
standing for quality in psychotherapy
training and standards, bringing together
and representing both training and
accrediting organisations and individual
registrants.
The consultation process will be carried
forward via
Chairs’ Day (8th December 2007),
Delegates’ Day (12th January 2008)
Registrants’ Day (3rd February, 2008).
Mary MacCallum Sullivan
UKCP Honorary Secretary
Letter from the Vice Chair,
Registrants’ Services
I hope that you appreciate the changes
you have seen in The Psychotherapist. In
the Spring edition we will be enclosing a
survey, so you can tell us what you
think of the changes and suggest other
articles and items we could include.
We have done some research on
Professional Insurance on your behalf.
Some of this information has been
included in a fact-sheet delivered with
this issue. It is intended to inform you,
not to recommend any particular type
of insurance.This information will also
be added to the website and up-dated
as appropriate.We encourage you to
find the insurance policy that works
best for you - and you may save some
money as well.
18
We are trying to evolve UKCP into
much more of a Registrants’
professional association, with all that
that implies.
We would like to extend the facilities
available to Registrants via other
services, publication possibilities, and so
forth.
We are open and welcome to any
suggestions. Please send them to me.
A UKCP Statement on Torture was
developed recently and published in the
last issue of The Psychotherapist. Maybe
there are similar statements that you
wish to assist in formulating on other
relevant topics. Please let me know and
I will discuss it with the Executive
Committee.
Finally, we are trying to organise a
couple of one-day regional seminars in
2008, on Professional Issues – Best
Practice as a Psychotherapist.
Our first thoughts are of holding these
in Newcastle or Manchester and Bristol
in the summer or autumn.To make this
happen, we need a couple of local
groups to help organise the
programmes and to contribute as
workshop presenters. If you are
interested in helping, more details are
available, again from myself.
Best wishes
Courtenay Young
UKCP Vice Chair,
Registrants’ Services
[email protected]
www.ukcp.org.uk
13/12/07
16:05
Page 19
From our European
correspondent… Why
compensation leaves
you worse off
Psychotherapy is generally
unregulated in Europe – hence the
need for UKCP and so many other selfregulatory national and modality
organisations – and the need for the
European Association of Psychotherapy
(EAP) itself.
State Regulation occurs in 5 European
countries; some, like Austria, take a
liberal view of who can become a
psychotherapist; others, specifically Italy
and Germany, restrict the title of
psychotherapist to suitably qualified
psychologists and doctors.
In those countries, most of us in UKCP
would work illegally if we called
ourselves psychotherapist; we would
have to call ourselves counsellor or
similar.This, however, flies in the face of
EU principles such as free movement of
labour.
As a result, EAP is working hard to
make psychotherapy the first profession
to enact a ‘Common Platform’ – a
device hidden deep within EU legislation
which would allow psychotherapists to
work anywhere within the EU.
To achieve a common platform, the
Membership Committee
The Membership Committee has vacancies
for UKCP Registrants from across all
modality Sections and Institutional Members.
We would love to have some 'new blood'
committee members who are interested in
and have some experience of organisational
standards, ethics and governance issues, as
well as those who may have ideas about what
it should mean to be a member, whether
individual or organisational, of UKCP
The Psychotherapist
profession has to prove first of all that
there is real hardship and discrimination
amongst practitioners.We in the UK
may not experience that greatly – but
what if you are a practitioner working
in Liege? You would not be able to work
or teach over the border in Aachen, a
mere 43 minutes drive away.
Once a need has been established, it is
necessary to establish that there is a
general, basic lower limit of training
requirements across the EU.This would
be difficult except that the profession,
through the EAP, can point to the
European Certificate in Psychotherapy
as a standard agreed by the profession
across Europe.
The next step is to identify a
reasonably restrictive, national law as a
representative standard; the EAP is
working to persuade the EU that the
Austrian law (surprise surprise!) does
that. It will then be possible to
establish a minimum standard of
training, both content and grade.
Having agreed all that, it will be a simple
matter (!) to get the politicians to agree
with the civil servants that a Common
Platform can be established.
If you are interested in joining or would like
further information on our work, contact
Mary MacCallum Sullivan on
[email protected]
Psychotherapeutic
Counselling Section
The Psychotherapeutic Counselling Section
(PCS) is looking for volunteers to sit on its
ethics committee. If you are interested in
joining or would like further information on
the work, involved, contact Pete Lavender
on [email protected]
So where does ‘compensation’ come in?
In my naivety, I assumed at first it would
be money paid to a practitioner
prevented from working in, say,
Germany, nice if you could get paid for
not working! However, compensation
works the other way.A practitioner
from, say, the UK, wishing to work in
Italy, would have to show that their
training meets the ‘common platform’
level. If not, it would be necessary to
top it up (it might be, for example, a
module in psychopathology which is
missing). Having done that, they would
be able to practice in Italy, irrespective
of the local, national law.
This work is one of the core tasks of
EAP over the next couple of years.And
whilst practitioners in the UK may not
be directly affected, the outcome would
be that across Europe, psychotherapy
would be established as a distinct
profession, whose trainees could be
drawn from a wide variety of primary
professions. Much like in the UK….
Adrian M. Rhodes
Vice-Chair (Regulation)
UKCP Representative to the EAP
PCS is also looking for two people to join
its assessment committee.The posts will
include assessing courses for accreditation
by UKCP, so experience in training and
assessment is essential.
Remuneration is offered for carrying out
assessment visits and reporting upon
these. If you are interested in becoming a
PCS assesor or would like further
information, contact Pete Lavender on
[email protected]
19
13/12/07
16:05
Page 20
Letter to the Editor
I was very interested to read the
‘Message from the Chair’ in the Autumn
edition of The Psychotherapist.
The Chair was concerned that ‘we are
not being heard’. I wonder if we have
here a direct example of identification
with the aggressor going on within the
various structures of the UKCP over
this issue of regulation?
The phrase ‘we are not being heard’
also seems to be resonating around the
section to which I belong, but the
deafness is on the part of the UKCP
executive.A telling phrase towards the
end of James Antrican’s letter is this:
“We as an organisation are getting
more involved with our member
organisations and registrants …”.
This phrase “we as an organisation” was
used earlier in the piece, as were other
examples of “we” and “our”.
As a registrant of the UKCP I initially
read this as including me. However, the
realisation that the ‘we’ referred to the
executive as a separate group to the
“member organisations and registrants”
was something that I may not be alone
in finding both significant and disturbing.
Surely we are all part of the
organisation? Without the Member
Organisations and the registrants that
they bring into the UKCP, the UKCP
would not exist.
There are moves to reduce the
democratic base of the UKCP and for
decision-making on crucial issues to be
delegated to the Board of Trustees,
thereby by-passing the scrutiny of
members and the implementation of
such policies being imposed rather than
put in place by a democratic process.
These developments make me deeply
uncomfortable, as does the apparent
wish held by some UKCP members
that those who question these moves
should not voice them.This organisation
belongs to all of us and we should all be
allowed to participate in vital decisionmaking. If some choose not to
participate that is up to them, but to
have the possibility removed and to
start to create a real power base
outside and above the membership is
unacceptable to many of us.
Julia Carne
CFAR
Reply from the UKCP Chair
Dear Julia,
I would like to firstly focus on the part
of your letter that speaks to being
heard.Your first thought, that it includes
all of us, is what was intended and
where we have to be. It is often difficult
to hold the past, present and future in
an environment where we are facing
both internally and externally driven
change agents.
We are making the work we do more
transparent and although there are
sometimes failures, we are committed
to over coming them.
The moves toward making UKCP as an
organisation responsible to registrants
and member organisations in a real way
are taking place.The Strategic Planning
Advisory Group has been, and is, having
20
workshops for every level of the
organisation, the registrants, and
delegates from the member
organisations, to hear what the UKCP
needs to look like as an organisation
going forward.
We are making the opportunity for
more involvement at the General
Meetings for discussion and debate.
Next year there will also be a meeting
for Chairs and Delegates to promote a
common dialogue.
To my knowledge this not only the first,
but most extensive consultation before
a major change in UKCP being
proposed that has been undertaken.
There is a symbiotic relationship
between all levels of participation in
UKCP that must be respected and
valued in meeting the challenges of
statutory regulation and changing
workplace requirements.This is an open
invitation to all to focus and contribute
on how that change needs to take
place.
Please let me know how you think we
are trying to reduce the democratic
base of UKCP. My commitment has
been and is to make UKCP more
responsive.There is more time being
given to getting out to registrants to
speak to the issues, there were 5 ‘road
shows’, there have been two Chairs
days, and other meetings.
Respectfully,
James Antrican
UKCP Chair
www.ukcp.org.uk
13/12/07
16:05
Page 21
Standards Board Update:
Key Developments for
2007-2008 and beyond
Carmen Joanne Ablack, Chair Standards Board
A summary of this report was
presented to UKCP member
organisation delegates at the EGM
of November 2007.
The report relates to current draft
documents and draft update documents
central to the work of the regulatory
boards and committees of UKCP.They
will be developed in consultation with
sections, colleges, member organisations
and registrants of UKCP.
The UKCP Regulatory Framework
The UKCP Regulatory Framework is
currently being redrafted and updated
and will address the following:
• Current requirements and
responsibilities
• Requirements that will transfer to an
external regulatory body
• Framework responsibilities that
would be retained by Quality
Assurance and Control (QAC)
bodies of UKCP, post-statutory
regulation.
The regulatory framework will include a
set of generic core principles and values
for all of UKCP.The document
summarises these at a generic level with
more detailed values being defined at
board, committee, section, college,
institutional member and member
organisation levels.
The principles set out here are the
overarching principles that will
eventually guide the regulatory
framework.The values set out in this
article are not exhaustive or
proscriptive, but are part of the process
to generate dialogue.
The Psychotherapist
It is hoped that discussion of our shared
values as psychotherapeutic practitioners
and professionals working in the field of
psychotherapeutic endeavour can
continue to be an ongoing dialogue in
UKCP that will be enriched by
contributions from UKCP registrants,
member organisations, sections and
colleges and professional staff.
Core Principles and Values of
Psychotherapy
The suggested core principles and values
are expressed below as specifically
relating to adult clients. However, it is
suggested that these possible principles
and values can be read to include all
client groups, trainees, supervisees,
colleagues and allied professionals,
including all staff in MOs and at UKCP
centrally where appropriate.
These would form a further part of the
ongoing dialogue between all of UKCP.
The principles and values could and
should be expanded to suit the remit
and modality, where appropriate, for
each area of work at that level.
For example, there could be specified
further principles and values for the
work of UKCP Ethics Committee or
for any practitioner suitably qualified to
work with children.They also need to
be read with an awareness of the
possible diversity and equality
implications of each principle or value.
There is a recognised overdue need for
diversity and equality considerations
being integrated into any dialogue in
UKCP, at every level.These
considerations should include attention
being paid to the different client groups
with whom we work: children, the
elderly, people with learning disabilities
etc.
Core Principles of Psychotherapy
• Justice
the fair and impartial treatment of all
clients
• Beneficence
a commitment to promoting the
client’s well-being
• Non-maleficence
a commitment to avoiding harm to
the client
• Fidelity
honouring the trust placed in the
therapist
• Autonomy
respect for the client’s right to be
self-governing
• Self-respect
fostering the therapist’s self
knowledge and care for self.
Values of Psychotherapy
• Respect for human rights and dignity
• Ensuring the integrity of therapistclient relationship
• Enhancing the quality of professional
knowledge and its application
• Alleviating personal distress and
suffering
• Fostering a sense of self that is
meaningful to the person(s)
concerned
• Increasing personal effectiveness
• Enhancing the quality of relationships
between people
21
13/12/07
16:05
Page 22
• Appreciating and engaging with the
variety of human experience, culture
and customs.
UKCP Standards of Education and
Training
The intentions with this working
document for all the levels of training
standards and education in the
organisation are:
1. To produce a comprehensive
working document that will allow
every MO and modality – through
section, college or member institute
training standards criteria – to see at
a glance where and how they comply
with the core generic criteria of
UKCP and of any eventual statutory
regulator.
2. To provide an at-a-glance matching of
our Common Values as
psychotherapists and
psychotherapeutic counsellors
against the criteria of education and
training at the MO, modality, UKCP
generic and statutory regulatory
level.
This document will map the core
generic criteria of the UKCP against
those of the HPC (see below). It will
eventually allow every level of
organisation in UKCP to map its
training standards and education criteria
against those of both the internal
(UKCP) and statutory regulators (the
illustration has assumed this to be the
HPC).
Honouring Professional Practice
There are several projects being carried
out collaboratively by the regulatory
officers, boards and committees of
UKCP on behalf of its member
organisations, registrants and in the
interest of the public.The Standards
Board is the place in the UKCP
structure where this collaborative
working is shared, developed and guided
by these boards and committees prior
to:
1. Consultation for input, feedback and
information to one or more of the
following parts of the UKCP:
sections, colleges, member
organisations and registrants;
2. Presentation to the Board of
Trustees for their agreement.
Of key importance to all of the work
outlined above is the emphasis on
inclusion, respect for diversity, attention
to equality considerations and
awareness of the tripartite concepts of
principles, conduct and practice.
Carmen Joanne Ablack
UKCP Member Organisation
Criteria
UKCP
Section/
Psychotherapy College/MO
criteria
Criteria
AP-PP
BCTS
ECS
FCSST
HyPS
HIPS
UKCP Criteria
5.5 (2007 UKCP Training Criteria - draft) a masters level of
competence evidenced by a masters degree or equivalent is
required for entry onto the UKCP Register of Psychotherapists
(See separate document for Psychotherapeutic Counselling)
UKCP Value
Transparency of entry requirements to the UKCP Register
Standard Text
The Council normally expects that the threshold entry routes
to the Register will be the following:
(1.1.2 Masters degree for the arts therapies)
HPC Standard Title
Level of qualification for entry to the Register
Mapping of UKCP Standards of Education and Training criteria (SETS) against the
SETS of the HPC.
22
Letter to
the Editor
Following the discussion of body
psychotherapy in the articles on Reich
in The Psychotherapist,Autumn 2007, may
we add that a seminal force in the
development of body psychotherapy in
the UK and in Europe was Gerda
Boyesen, whose Centre and training
school flourished in Acacia House,
Acton, for over two decades.
The biodynamic training - now
broadened to include a wider range of
inter-personal work - is carried forward
by the London School of Biodynamic
Psychotherapy, of which the
undersigned are the Directors.
Yours etc
Clover Southwell
Dr. Elya Steinberg
Editor’s
Reply
Following the favourable response to
the article on Wilhelm Reich, whenever
possible future editions of The
Psychotherapist will contain a profile of a
prominent psychotherapist, past or
present.
As with Reich, we hope to offer more
than one perspective on those featured
and, where relevant, to see the different
directions in which their work has been
carried forward.
The next issue will look at the work of
Gerda Boyesen, and readers are
welcome to suggest who they think
should be featured in future editions –
and to offer to write contributions
towards these features.
Suggestions of well known and lesser
known figures are both welcomed.
Please send your suggestions or offers
to help to: [email protected].
Jude Cohen-Phillips
Managing Editor
www.ukcp.org.uk
13/12/07
16:05
Page 23
Psychotherapy with Children
Committee (PwCC)
The field of child psychotherapy and
psychotherapeutic counselling with
children is distinctive in being a cross
modality field practising with a
particularly vulnerable client group.
According to a UKCP survey
conducted in 2006, a third of
responding registrants confirmed they
work with children as part of their
clinical practice.This clearly indicates
that there is a need to consolidate the
cross-modality expertise within UKCP.
standards within their own modality.
The Psychotherapy with Children
Committee (PwCC) was set up in early
2002 in response to the need for
professional support for UKCP
members who work with children and
to give child and adolescent
psychotherapy the recognition it
deserves. It would also provide
regulation of psychotherapy with
children and provide a framework for
registration of practitioners in the field.
• Training Standards sub-committee
From the early work of PwCC came
Psychotherapy with Children: Principles,
Aims and Guidelines for Training, which
became known as the “Blue Booklet”. It
provided the first clearly formulated
framework for establishing standards of
good practice in the child
psychotherapy field.
PwCC is a cross-modality committee
and strives to enlist representatives
from all sections of UKCP. Inclusiveness
is of primary importance to the
committee as well as liaison with
potential partners in the field outside
UKCP.
It has been a recent decision of PwCC
not to formulate itself as a Section of
UKCP or to pursue a college structure.
For the present time our intention is to
remain as a Committee but to ensure a
place at the UKCP Board level with
voting powers.This will secure
recognition of the child psychotherapy
field within the cross modality
framework but will give Sections the
power to develop child psychotherapy
The Psychotherapist
The current PwCC structure has
allowed the sub-committees to develop
cross modality documents which will
serve as a framework for Member
Organisations within Sections to
develop trainings in child psychotherapy
and child psychotherapeutic counselling,
should they wish to do so.
Until September PwCC consisted of
two core sub-committees:
• Ethics Committee
Sub-committees report and make
recommendations to the main PwCC
but they are not decision-making
bodies.
The Training Standards sub-committee
of PwCC has been chaired by Angela
Gruber (HIPS). It was formed to hold a
comprehensive overview of all the
strands and elements involved in setting
standards and propose the benchmarks
for detailed accreditation requirements
for child psychotherapists as well as for
psychotherapists who work with
children within the context of another
modality.
The Ethics Committee has been more
of a working party due to the lack of a
chair and has relied on the hard work
and expertise of Stewart McCafferty
(FCSST) and Joady Brennan (EC).
In September this year we decided that
the two committees should merge to
form the Professional Standards subcommittee of PwCC.
To date the following documents have
been developed:
1 Guidelines for Sections for the
Development of Training Standards in
Child Psychotherapy
3 Guidelines for the Supervision of
Child Psychotherapists
4 AP(E)L Procedures
5 Child Psychotherapy Knowledge,
Skills & Competencies Checklist
6 Ethical Principles for Psychotherapy
with Children
7 Ethical Code of Good Practice
All documents incorporate the
previous Psychotherapy with Children
Principles,Aims and Guidelines for
Training and are in line with all the
relevant legislative documents relating
to work with children i.e. Every Child
Matters, Children Act, and Safeguarding
Children.
As the core documents have now been
developed to a ‘good enough’ standard
and fit for purpose, it is time to begin a
new round of consultation and find a
new place within UKCP.The Chair of
PwCC, is meeting with the Executive
and the Chair of UKCP Standards
Board to develop structures to allow
PwCC to develop its voice both within
and without UKCP.
PwCC aim to set gold standard
benchmarks for child psychotherapy
and psychotherapeutic counselling
within UKCP.
We hope to produce a regular column
for The Psychotherapist, to keep you
informed of our work as well as of
matters of interest, and as a forum for
debate and discussion with regard to
child psychotherapy within UKCP.
We welcome feedback and suggestions
from all those interested in our work.
Jennie McNamara
Chair of PwCC
[email protected]
2 Guidelines for Post Qualification
Training Standards for Psychotherapy
with Children
23
13/12/07
16:05
Page 24
Planning the future
shape of UKCP
UKCP has been in a process of forming and reforming
since its beginnings at the Rugby conference in 1993.
We are about to embark on the next phase of that
reformation.We need to respond to pressures to
change from within and without the organisation.
In planning for the next phase of this process the Board of
Trustees held an away day where we celebrated our
achievements to date – still together, still working (maybe still
crazy) after all these years emerged as a theme, as something
that we could and should be proud of.
The vision of the Rugby Conference was an umbrella body
which would speak for the profession – across all modalities.
Organised by training organisations who wanted to distinguish
their graduates as having received a high standard of training,
as adhering to an established code of ethics, as having
colleagues who could vouch for their work, UKCP became a
brand name that registrants wanted and could feel proud of.
This we achieved and now the context is changing again.
There will almost certainly be a statutory requirement to
register in order to work as a Psychotherapist or Counsellor
within the next five years; and the registering body will almost
certainly be the Health Professions Council.
Statutory regulation will mean that individual therapists will
need to register directly with the HPC, it means that training
organisations will need to meet the statutory requirements
and be accredited by the HPC.
Other external changes like the government’s Increasing
Access to Psychological Therapies (IAPT) and the increasing
emphasis of NICE guidelines on health care will also influence
the public’s perception of psychotherapy and counselling and
the detailed form that statutory regulation will take.
These changes will have an impact on what we do and provide
us with an invitation to reassess our purpose.What it is that
we as an organisation want to be and, if we are going to be
relieved of some of the burden of self-regulation, what else
might we do more of or do better?
In July the Board of Trustees established a Strategic Planning
Advisory Group (SPAG) as described in the last issue of The
Psychotherapist, to create a space where creative thinking could
take place.
We have worked with this question within the board and with
delegates at the EGM to try and establish a new vision for
UKCP, to ask people what they really want from the
organisation and – more importantly – what they will
continue to want from the organisation after statutory
regulation.
24
So far we have established that the majority of those
consulted would want UKCP:
to be a professional organisation for both training organisations /
accrediting organisations and individual practitioners, to be a
political lobby for the profession, and to be a focus for research
– most particularly for research which uses methods that are
congruent with our own philosophy about what we do.
If that is to be our function or purpose, what then should be
our shape – i.e. how should our constituent parts work
together? Is our current shape the best for the new purpose?
What are the alternatives and how should we chose between
shapes?
These are the questions that we are asking chairs, delegates
and registrants between now and the AGM in March.
Four shapes are briefly outlined in this article, we are asking
delegates and registrants to propose others and to assist in
the process of evaluating the different shapes.
Shape 1
UKCP
ICO
Institutional
and special
members
Sections
Member
organisations
Practitioners
Practioners are
members of
Member
Organisations
and Registrants
of the UKCP
Description:
The current shape, designed for modality specific registration
standards, is based upon registrants belonging to member
organisations (MOs) which are organised into sections. MOs
control UKCP through UKCP’s general meetings, with power
delegated to trustees to implement the policies determined by
the general meetings.With the exception of the Treasurer, at
present trustees are all MO delegates. Day-to-day
management is delegated to the executive officers who are
elected at general meetings.
While many MOs represent the views of their registrants,
many others have little contact with registrants at all.This
leaves this shape open to criticism as a ‘trade organisation’.
www.ukcp.org.uk
13/12/07
16:05
Page 25
If we consider a post-regulation world where our purpose is
as described above, does this continue to be the best shape?
By making colleges central to the structure we make it difficult
for new colleges to be created.
Gains:
Keeping our existing shape has the advantage of ending the
effort to reorganise.
Shape 3
HPC
Undetermined:
There are many pressures to change.
UKCP
Losses:
Keeping our existing shape misses a perhaps unique
opportunity to adapt in advance of change.
Practitioners’
Chamber
Shape 2
UKCP
Training
Organisations
Description:
This is a ‘bottom up’ shape which would mean enfranchising
the present 6,500 UKCP registrants in some way that does
not disempower the present 80+ member organisations.
Colleges
Practitioners
Member
Organisations and
Practioners are
UKCP members
HPC
Practitioner
Organisations
Training
organisations
College
Chamber
Member Organisation
and Practioners are
College members and
the College is a
member of the UKCP
Description:
This shape offers a streamlined UKCP. Each college would take
over responsibility for most of the functions carried out by
the current UKCP in this ‘middle up’ shape.
This shape is likely to cost more as it would lead to
duplication of the current central functions, such as committee
administration, PR etc.
It would have the advantage of strengthening major modalities
at the cost of weakening the voice of smaller modalities.
There would need to be a generic college to enable smaller
training organisations and practitioners to have a place.
We could create a unified association for a large majority of
the diverse community of psychotherapy. MOs continue their
membership of UKCP.We will therefore be able to retain
much of the knowledge, skills and experience of all the
current MOs, as well as bringing direct involvement of
registrants into the various boards, committees and working
parties, adding to the skills, knowledge and experience base
for all.
With this shape, MOs that are registrant-based could form
nuclei for individual practitioners, enabling colleges to focus on
modality development. It would allow training organisations to
begin to move towards becoming a university of
psychotherapy.
Power and responsibility would be shared between two
chambers: a registrants’ chamber and a colleges’ chamber.
Power and responsibility would rest with the college.
The aim is to draw towards a ‘home or family’ community
that may remain after regulation.
The decision on how to balance power and responsibility
between practitioners and member organisations within the
college could be decided by each college.
All practitioners have an opportunity to influence the centre
through a democratic chamber.
Practitioners would need to become individual members of
the college.
Undetermined:
Balance of power / money between individual practitioners
and MOs within the college.
Role of UKCP would need considerable revision and could be
difficult to sustain.
Losses:
Opportunity for cross-modality debate and cross-fertilisation
reduced.
The Psychotherapist
All practitioners are invited to participate in cross-modality
debate and committee work.
Gains:
Enfranchisement of registrants.
More participation by registrants.
Undetermined:
Balance of power between the two chambers.
Losses:
Member organisations lose some power.
Individual colleges have less power than shape 2.
25
13/12/07
16:05
Page 26
Shape 4
New UKCP Registered
Psychotherapeutic Counsellors
Training
organisations
Chamber
Practitioners
Chamber
Member Organisations
and Practioners are
UKCP members
UKCP
HPC
Join appropriate
group and/or
college
Join relevent
college
Colleges
Work and
interest
groups
Description:
Like shape 3, this shape requires the enfranchisement of registrants.
This is a more ‘bottom up - top down’ shape, enabling practitioners and training
organisations, as stakeholders, to shape the organisation through a UKCP
centre.
This shape allows the evolution of colleges and ‘work and interest groups’
rather than enshrining them within the structure.
This will enable practitioners to have choices as to which groups interest them.
They can belong to more than one, creating a flexible UKCP that can change
organically to respond to changing needs without disadvantaging any minority
groups.
Power and responsibility are shared between member organisations and
individual practitioners and then delegated to the UKCP centre for operational
management and oversight of colleges and ‘work and interest groups’.
The power of colleges and groups can develop organically.
Gains:
Major advantage of shape 4 over shape 3 is its flexibility and adaptability,
allowing groups to evolve and with increased opportunities for cross-modality
work.
Undetermined:
Balance of power between the two chambers, as shape 3.
Losses:
Sections would have less power than now.
Next Steps
Is our current shape the best for the new purpose?
What are the alternatives and how should we chose the most effective of all
the possible shapes?
These are the questions that we are asking chairs, delegates and registrants:
what do you think?
To have your say and contribute to the future shape of UKCP you can e-mail
[email protected] and/or attend registrants day (see back cover for
details)
26
Judy
Diana Joy
Vallie
Joan
Pauline
Annette
Moya
Martha
Lisa Jacqueline
Will
Elizabeth
Patricia
Marian
Caroline
Michael Charles
Vaughan
Lynne
Mary-Kate
Bill
Janet Alexis
Margeret
Rae
Alison
Tony
Stephen
Linda
Clare
Anna Maria
Jennifer
Robert Campbell
Jeanette
Michael
Julia
Diana Elizabeth
Elizabeth Anne
David Menachem
Balroech
Sharon Elizabeth
Jackie
Susan
Paula
Christopher
Ruth
Geraldine
Wendy
Aitkens
Barry
Beagle
Bristow
Brumwell
Budd
Chase
Doniach
Ferguson
Flewett
Garsten
Grouse
Harper
Hine
UKAHPP
WPF
CPC
WPF
UKAHPP
WPF
WPF
WPF
WPF
CPC
UKAHPP
WPF
WPF
NGP
Johnson
Kaye
Kelly
Knightsbridge
Land
Lomax
Michaelis
Miles
Morris
Morris
Newbold
Papamichael
Patelli Zamblera
Perren
Perry
Prever
Proctor
Robinson
Russell
Shelley
WPF
UKAHPP
UKAHPP
WPF
WPF
UKAHPP
WPF
WPF
UKAHPP
WPF
UKAHPP
WPF
WPF
WPF
WPF
UKAHPP
WPF
UKAHPP
WPF
UKAHPP
Soetendorp
Start
Stewart
Wakefield
Wedgewood
Westbrook
Winocour
Wisbey
Wood
WPF
WPF
UKAHPP
WPF
NGP
WPF
WPF
WPF
WPF
New UKCP Registered
Psychotherapists
Tracey Alexander
Jennifer Alison Allan
Philip Ronald Allin
Bernard Alvarez
Catherine Amphlett
Heleni-Georgia Andreadi
Anthony Wee-Kiat Ang
Matthew Ainsley Appleton
Ian James Argent
Sally Ann Ashworth
Kimberly Astrand
Sofie Bager-Charleson
Lorraine Barreau
STTDP
ITA
NGP
NCHP
UPCA
KCC
IGA
KI
ITA
NLPtCA
UPCA
UKAHPP
BABCP
www.ukcp.org.uk
13/12/07
16:05
Page 27
the psychotherapist new ukcp registrants
Edna De Oliveira
Kevin
Wayne
Patricia Anne
Sarah
Daniel Matthew
Elaine Ann
Deike
John
Karen Elizabeth
Fiona Karen
Biggs
Walter Pierre
Joshua Francis
Alexander
Sue
Janis
Charlie Cawthra
Susannah
Hazel Diane
Stephen
Angela
Annalisa
Richard Alexander
Maureen
Miriam
Charlotte
Andrea Maria
Melvin Van
Mark Anthony
Susan
Joan Margaret
Heather Louise
Maura
Jeanne Margaret
Marie Therese
Alexandra Pascale
David John
Eugene Sean
Sumita
Carl John
Jo
Bryan Jeremy
Jan R
Stephen
Catherine Therese
Andrew Barry
Yvonne
Jill
Heather
Kathryn
Chris
Kelly
Gianfranco
Martin William
Della Penelope
Maria
Diana Sylvia
Anouchka
Hilary Beth
Suzanne
Lesley
Diana Marcela
Matthew Karl
The Psychotherapist
Barreto
Barrett
Barron
Barton
Bashford
Beales
Beaumont
Begg
Bennett
Beswick
Biddle
Biggs
Bouman
UKAHPP
UPCA
CAPP
BCPC
FPC
NWIDP
BABCP
PET
UPCA
AFT
NRHP
AFT
BASRT
Bowler
Brady
Briedis
Briggs
Brindle
Broom
Buller
Buxton
Caldon
Casebow
Cavill
Chachamu
Chiu
Chrustawczuk
Claridge
Collinson
Courtney
Crooks
Currey
De Pretis
Defries
Delaney
Dorrington
Dove
Doyle
Dutta
Dutton
Edwards
Emden
Etkin
Ettling
Evans
Farley
Forward
Fowler
French
Gadsby
Garnett
Garrett
Germiniani
Gill
Glazebrook
Gousti
Groom
Grose
Gura
Harper
Haswell
Henao Mendez
Henson
KI
ITA
SEA
ITA
KI
CPC
UPCA
SEA
CCBP
PCP
UPCA
AFT
KCC
KI
SEA
GUILD
RE.V
FPC
UPCA
CCPE
KCC
CFET
IGA
NRHP
GAPS
AFT
BPA
NHPC
CTP
CAPP
AFT
UKAHPP
NGP
CAPP
UKAHPP
CCBP
STTDP
SPTI
UPCA
WPF
NWIDP
CCPE
SPTI
AGIP
CFAR
SEA
NLPtCA
SEA
KCC
SEA
Rosa
Elizabeth Mary
Monica
Karl Andrew
Annie
Amanda Jayne
Donna
Simone Roberta
Louise Elizabeth
Fiona Mary
Jo
Margaret
Jimmy
Janet
Myrom
Roland Satkunan
Barry Charles
Janette
Laura
Maria
Darren
Gaye
Frania
Sue
Raphael
Henrica Lydia Maria
Sarah Ellen Nichol
Caz Alison
Sara Lucy
Claire Mary
Susan
Janet Elsie
Federica
Pauline Ann
Jane
Susan Raine
Susan Julie
Kay
Gerrard Desmond
Lynn
Pat
Ben J.
Lee
Frances
Mairead Mary
Pauline
Anne
Paul Anthony
John
Stella
Caroline Bridget
Christopher Martin
Bernadette
Hester
Geraldine
Hugh James
Stuart
Andrew
Alia Ines
Valerie
Malcolm
Mary Elizabeth
Mikenda Louise
Anna
Hernando
Hill
Hill
Hill
Hockley
Hon
Hope
Howlett
Iannetta
Inglis
Jackson
Jones
Jones
Joosten
Kahaner
Kandiah
Keeble
Kelly
Keyte
King
Langdridge
Langham
Le Guilly
Lieberman
Lopez De Soto
Los
Lowes
Lyall-Ford
MacGregor
Mackinnon
Maddox
Manning
Marino-Francis
Marsden
Massey
Mathews
McCann
McCreadie
McCullagh
McEwan
McGrath
McKie
McOwan
Middleton
Millmore
Mitchell
Moellers
Monaghan
Murphy
Newrith
Nielson
Oakley
O'Brien
O'Connor
O'Meara
Palmer
Paterson
Pearce
Perez-Wehbe
Perry
Peterson
Pipes
Plant
Polya
BABCP
SPTI
UPCA
UPCA
AFT
CTP
BPA
UKAHPP
BABCP
FPC
KCC
BASRT
FIC
SEA
CCBP
AFT
AREBT
IGA
BCPC
ARBS
UPCA
UKAHPP
PET
UKAHPP
CCPE
GAPS
NCHP
CCPE
CCBP
UPCA
NCHP
SPTI
UPCA
NCHP
IGA
FIC
UPCA
IGA
IGA
SPTI
CCBP
UKAHPP
MET
SEA
NHPC
WMIP
UPCA
NCHP
BPA
UPCA
CSP
SITE
KI
IGA
NCHP
AFT
UKAHPP
NLPtCA
AFT
SPTI
UPCA
KI
AFT
AFT
Anita
Veronica Anne
Natasha
Azmin
Carol Anne
Sonia
Joanna Louise
Margaret
Diane
Nicholas David
Bridgeman
Pauline Mary
Dawn Giulietta
Chris
Sandra
Brian Martin
Steve
Linda Mary
Michael Richard
Carole Lesley
Sharon
Renee
Emma Catherine
Victoria
Rebecca Louise
Beverley Marcelle
Sarah Jane
Wendy Susan
Alison Pamela
Sally Ann
Paul Douglas
Margaret Anne
Alex Susan
Kevin
Katharine Mary
Corinne
Lucy
Esther
Christine Eleanor
Robin William
Gemma
Olivia Ruth
Hayley
Jason William
Paul Robert
Diana
Ellen Elizabeth
Katharine
John Leonard
Judith Anne
Miyabi
Barbara
Amanda Jayne
Rose
William
Verina
Jo
Sylvia Mae Valerie
Michael
Tim
Melanie
Maureen
Martina
Penelope
Pow
Read
Redina
Rehemtulla
Richards
Richards
Ringrose
Robertson
Rogan Sofer
NRHP
IGA
CCPE
IATE
PET
GUILD
UPCA
WMIP
IGA
Rose
Ross
Rosser
Rowland
Schmool
Shand
Sharkey
Simpson
Skinner
Smith
Spindler
Stafford
AFT
CTP
CCPE
CSP
CCPE
IGA
FPC
NCHP
SPTI
SPTI
KCC
CAPP
Starck
Stevenson
Stobo
Stringfellow
Sullivan
Sutton
Swain
Swift
Swift
Tagg
Taylor
Taylor
Taylor
Templeton
Tete-Donker
Thirlway
Thorburn
Thorley
Trimbee
Tuffin
Upton
Vallance
Voller
Wade
Wakelin
Waller
Warren
Watanabe
Webb
Weir
Whiteley
Whittaker
Wilde
Williams
Williamson
Wilson
Wood
Wood
Woolf
Wright
Wright
CAPP
BPS
IGA
GPTI
NLPtCA
AFT
GUILD
SEA
WPF
IGA
ScPTI
KI
FPC
CTP
KCC
BCPC
NCHP
SPTI
KCC
AFT
SEA
KI
UKAHPP
ARBS
SPTI
NCHP
GUILD
KCC
PET
IGA
UKAHPP
CCPE
BABCP
AGIP
ScPTI
UKAHPP
WMIP
IPSS
SPTI
WMIP
FPC
27
13/12/07
16:05
Page 28
the psychotherapist registrants’ contributions
Ethics Conference:
6th October 2007
The 2007 UKCP Ethics
Conference
Acting Ethically? A dramatic exploration of
personal and professional dilemmas in
psychotherapy was attended by over 100
UKCP registrants.
Held at Kings College London, it started
with actors reading Compromise, a play
by John Woods, who is himself a UKCP
registrant.
The afternoon featured a wide range of
workshops.
Feedback forms were overwhelmingly
positive, with the majority of complaints
being about the temperature of the
water for tea and the lack of airconditioning.
“The play brought the ethical issues to
life”
“Afternoon session – experiential –
very well facilitated”
“Compromise – thought provoking, and
Peter Jenkins workshop was excellent”
“The workshop on self care”
Many also commented favourably on
the fact the afternoon workshops were
longer than is usual, (two hours) to
allow more in-depth discussion,
although some simultaneously regretted
the fact that they could only attend
one.
Also in the responses to what
participants liked best was:
“The knowledge passed on in the
workshop”
“Excellent choice of workshops”
“Variety of approaches offered in the
pm sessions”
In the practical section, the food was
highly praised, reflecting changes in
Kings College’s catering arrangements.
And, as always at UKCP events,
networking opportunities were also
clearly identified as important.
Planning is already underway on
planning the 2008 Ethics Conference.
Suggestions for subjects and offers of
help will both be welcomed: please send
both via [email protected].
37 of those attending answered the
question in the feedback form What did
you consider the best aspect or session of
today's conference? with positive
comments on the use of the play.
Examples include:
“Use of the play to provoke discussion
and energy in workshops”
“The play was very powerful”
“The play is an excellent way to elicit
complexity in these issues”
“The play; an excellent way of involving
participants experientially in the
issues”
Audience members talk with John Woods, author (seated, left)
Letters to the Editor
Good Ethics?
Reflections after the October
conference: Psychotherapy does
not make for good drama.
Attempts to stage it, whether in films, in
novels or in the theatre tend to fall
28
prey to the author’s understandable
wish to ‘dramatise’ what goes on and
the real work of therapy ends up being
misrepresented, sometimes to a
ridiculous and painful degree.Therapy as
entertainment seems to always end up
in a veritable pile-up of shenanigans.
There was no shortage of shenanigans
in John Wood’s play Compromise which
took up most of the morning sessions
of the recent Ethics Conference and,
unsurprisingly given the play’s
somewhat didactic stress on boundary
violations, much of the discussion was
taken up by the issue of therapists’
transgressions and what might be done
to prevent them.
www.ukcp.org.uk
13/12/07
16:05
Page 29
In consequence ethics was, as so
often, rather narrowly conceived as a
question of conduct proper to our
profession.
There is no doubt that we need to be
very clear about the boundaries which
safeguard our clients and which are a
sine qua non of our work, and breaches
of our ethical codes must be responded
to with determination, fairness and
rigour.
Who would disagree with that? Who
would argue against the prohibition of
sex with clients? What is there to
discuss?
Do breaches of boundaries constitute
ethical questions? If so, I would like to
hear them.
Consider the following idea: If there
were no more breaches of boundaries
(I know, I know, I am dreaming here...)
would the problem of ethics disappear?
What is the ethical basis of our work?
And is this type of clarification not all
the more needed at a time when
psychotherapy is coming under
powerful pressure by ‘third parties’ to
adapt to extraneous demands? At
present, a largely economically driven
socio-political agenda and the ideology
of ‘evidence-based practice’ are leaning
on our profession to reinvent itself as
a form of ‘service provision’ under the
general rubric of ‘healthcare’. Does
this raise an ethical question for
anyone?
What seemed to be missing from the
conference as a whole (unless it took
place in the workshops I did not go to)
was an engagement with precisely the
question of “What kind of ethical
position do we take up when we
engage in therapeutic work?”, or “What
is the ethics of therapy?”
As far as I can see, the therapy situation
gets constituted in its ethical dimension
by the particularity of the therapeutic
relationship: one person’s subjective
suffering leads them to make an appeal
for help to another person who
responds to this appeal within a
professional (that is also economic)
framework, thus indicating that help
might indeed be available.
How this appeal or ‘complaint’ (a rather
The Psychotherapist
quaint term perhaps, but one that might
tell us something important) is heard,
understood, maybe categorised, etc and
ultimately responded to - these issues
are replete with implicit questions
regarding what is normal and what
excessive, what is healthy and what is
problematic, what is destructive and
what is within the normal range.
This kind of ethical position accords
with the classical Greek conception of
ethics as the analysis of the relationship
of thought to action. It is, of course, the
particular contribution of psychoanalysis
to draw our attention to our
unconscious thoughts and wishes and
to trace their effects on our present
lives.
(The wish to splatter the foregoing
paragraph with inverted commas is
almost irresistible, indicating the
strength of my wish to distance myself
from this normative and possibly
prescriptive language.)
Psychoanalytic therapy is the lengthy
process of enquiry in which our
patients can think through the ways in
which they position themselves in
relation to their own desires and
perhaps find new ways of living and
regulating them.
The point is that we are operating
within this force field of value
judgements which carry a heavy moral
load.Who do we take on for therapy
and why? What ‘conditions’ are we
‘treating’? What do we offer in response
to the problems our clients bring to us?
And to what aim?
Try to think of responses to these
questions which do not convey your
values of what is good and healthy! But
what is the status of the values we
bring to our work?
The fact that clients tend to adopt (all
sorts of) values in the process of
therapy is reasonably well documented,
and this transmission of values is very
much a one-way traffic. Do we think
this is a good thing? Do we think this is
problematic? And why?
From a psychoanalytic perspective it is
important that the therapist stays clear
of preconceived ideas, both regarding
what is ‘pathological’ or ‘problematic’
and regarding the outcome that is
sought from therapy.
Rather than orientating the work
towards the achievement of goals which
are set at the beginning (whether by the
client themself or by some kind of
therapeutic or social agenda)
psychoanalysis views both the
‘symptom’ and the wished for end
result as requiring elucidating and
questioning.
In doing so it refuses to accept
preconceived and generalised ideas of
‘good’ and aims instead at a critical
examination of the values dominating
the life of the individual seeking help.
It is perhaps easy to see that this kind
of position puts psychoanalysis into a
necessarily critical (in the sense of
questioning) stance vis-à-vis power:
Who knows what is good? Who is to
say what is healthy or satisfying?
Psychoanalytic ethics suggests these are
good questions to ask (ourselves as
well as our patients!).
Unsurprising that psychoanalytic
therapists in particular tend to feel very
worried at the idea that our profession
should be regulated by the state,
especially that it should be subsumed
under the ‘health care’ rubric.
Not only are we meant to subscribe to
an implicit but nevertheless powerful
notion of ‘health’, but our own
‘professional health’ will come under
state supervision.The Health
Professions Council, who must feel they
know what this means, will arrange for
our ‘pulse’ to be taken at regular
intervals to insure we are all ‘fit to
practise’.
UKCP has displayed a worrying
readiness to accept these ideas and
indeed thought it to be the best
strategy to do this kind of regulatory
work pre-emptively, on behalf of the
government.The ethics of our
profession is in danger of being
forgotten about.
Werner Prall
Editor’s Note: Unfortunately, entirely
due to space constraints and its length,
this letter had to be cut.The uncut
version is on the UKCP website.
29
13/12/07
16:05
Page 30
Book review: Counselling,
Psychotherapy and the
Law Author: Peter Jenkins
Sage Publications Ltd Published 2007 ISBN 978-1-4129-0005-8
hardback and 978-1-4129-0006-5 paperback
Price £60 hardback £19.99 paperback
The second edition of Peter
Jenkins’s book Counselling,
Psychotherapy and the Law brings
up to date his comprehensive
overview of a rapidly evolving field.
The book provides a good resource to
encourage and back up a practitioner’s
own thinking about legal and ethical
issues in psychotherapy.
demonstrates the relevance of such a
book to the development of good
ethical practice and also presents
historical and international information
to enhance our understanding of the
subject. He ends the book with
chapters on the background to the
current debate about statutory
regulation.
It covers a wide range of topics, ranging
from contracts and confidentiality
through to the latest case on the
complex law surrounding data
protection legislation and a client’s
access to records.
This book represents a helpful addition
to practitioners’ bookshelves as a
reference work, but also a beneficial
read to stimulate thoughtful responses
to practice dilemmas. It provides a good
support to both therapeutic and
supervision practices across the
spectrum of experience and theoretical
models.
He considers with welcome clarity
many of the dilemmas arising in real
world of therapeutic practice, including
every day issues such as involvement
with the courts, professional insurance,
the risk of libelling someone, the
defining of what is negligence, and
aspects of working with young people.
His approach to these topics is relevant
to varied settings, and uses a
straightforward style and helpful
summary boxes.
Barry Gower
30
Through months of research, getting in
contact with Medical Justice and Medact
and attending their meetings, I wasn’t
sure if I wanted to really find out about
what truly happens to asylum seekers
behind closed doors, when their only
crime is to have sought asylum.
Knowing that there would be no
turning back, I finally gathered enough
courage and cautiously had a peek
through that door and this is what I
saw.
A couple of loud knocks on the door,
then the door is forced open at five
o’clock in the morning.A child hides in
the corner shaking, the other child
crying loudly, the mother tries to calm
the children but is forced out of their
flat without any questions asked.
“You have no rights, you are an asylum
seeker”, she is told.“If you refuse, I have
to use force”. She is handcuffed and
forced into the car.Your children are
with you, something to be happy about.
Confused children, and a frightened
mother who tries to stay brave for the
children and raise no questions. Hearts
pounding, minds going blank and the
feeling of nausea when the oldest child
asks:“Have I done anything wrong,
mommy?”
There is much to provoke a reflective
and pro-active, rather than merely reactive, response to the world of the law
in relation to therapy and ethics. It
begins with a thoughtful introduction
from James Antrican, Chair of UKCP, in
which he encourages us to engage with
rather than avoid the challenges the
topic gives rise to.
The book reflects the author’s wide
experience of training as well as his
interest in the development of ethical
thinking. In particular, his introductory
chapters explain how legal thinking is
set out in common law, statute and case
decisions together with the interface of
legal issues with important ethical ones
in psychotherapy. In doing so, the author
Since my last article in The
Psychotherapist, and my attempt to
raise awareness of Home Office
policies, I decided to learn more
about what happens when asylum
seekers are detained. To have a clear
understanding of what I disagree with
and what I am campaigning for I had to
face my fear and meet with an exdetainee.
“the oldest child asks:
‘Have I done anything
wrong, mommy?’”
Peter Jenkins
At the detention centre, food is finally
served at 2 pm. Children are hungry
and eat without any questions asked.
They are grateful.There is no washing
liquid for the bottles. Despite being told
that she has no rights as an asylum
seeker, she looks for something to
sterilise the bottle. She finds her tooth
www.ukcp.org.uk
13/12/07
16:05
Page 31
Asylum Seekers Today: Further
Reflections
paste and brushes the bottle with her
tooth brush, and quietly sobs.
Four months later, the children have
stopped asking questions, stopped
eating and stopped smiling. Instead they
have learned that they are being fed
chicken most of the week, that they
need to pray together for their release
every night, and that they should be
grateful for what they get.
Mother sits in the dark and looks at the
palm of her hand. She can barely see
the two white pills that should make
her sleep.As she touches them with her
index finger to make sure that they are
there, she remembers Dr. R’s words:
“You need to come back next month
for us to review your medication.”
Knowing that she will run out soon, she
swallows the pills and says a prayer.
Another sleepless night.
When they receive the letter stating
the date of removal, she shakes, then
vomits and then shakes some more. She
wishes for home, a mother who would
stand in the doorway to make it all
better.
“Harsh words, harsh grips
and harsh attitude”
Arrived at the plane, she is in despair
and cries out loudly, they find this
“uncooperative” and “destructive”.This
is when the pilot refuses to take off as
he feels that the passenger isn’t mentally
fit enough to fly.Verbal racial abuse is
thrown at her. She keeps silent as she
wants to keep her dignity. Harsh words,
harsh grips and harsh attitude. She
understands their anger, she has made
them look like fools, and she has made
them fail.
If they only knew what they were
sending her back to. No need to
explain, they wouldn’t understand
anyway, they don’t care, they are only
The Psychotherapist
doing their job.Who would apply to do
such job? Who would come up with
policies like that?
Back to the detention, live to see
another day and in the meantime
remember to pray and to be grateful.
As for me, through this research, I felt
powerless at times. Doors shut in my
face and phones thrown down on me
for wanting to challenge the system.
The asylum seekers are not receiving
proper information regarding any
changes in Home Office policies.They
rely on gossip and stories of what has
happened to those who have been
detained, released or even deported.
According to the reports from Amnesty
International and the Princess Diana
Trust:“detention centres are not a place
for children”,“children should not be
detained”.
There is a clear lack of emotional and
psychological support for detainees.
According to reports from Medical
Justice, there is a lack of medication and
proper GP attention for detainees.
Serious illnesses that need proper
medication and attention, such as
Malaria and HIV, are not being attended
to.
The officers’ abusive language and
behaviour is humiliating according to
ex-detainees. Inevitably the system will
break them mentally.
“asylum seekers are being
treated like criminals, for
seeking asylum ”
I am embarrassed to be living in a
society where all of this happens behind
closed doors and where it has been fed
to the detainees that they are asylum
seekers and as such they have no rights.
So, therefore, they have no voice: no
one can hear them in there.
I am embarrassed to live in the only
country in EU where they detain
children and hide behind the excuse of
not wanting to separate a mother from
her children.
I am embarrassed to live in a society
where asylum seekers are being treated
like criminals, for seeking asylum.
How sickening to hear that this is how
the Government can deal with the issue
of their asylum seekers today. Is there
no other way? Is there no other option?
Verbally, mentally and physically abusing
asylum seekers is the answer to
decrease the numbers of asylum
seekers? Is this what it has come to?
Shirin Amani Azari
Shirin is a UKCP registered
psychotherapist and BACP
accredited counsellor/
psychotherapist. She worked at the
Refugee Support Centre from May
2000 to April 2005 and since May
2005 has worked at the Refugee
Therapy Centre.
Since September 2006 Shirin has
worked at the Mapesbury Clinic as
a Senior Therapist and, more
recently, as a Group Conductor.
She is also a Clinical Supervisor
and has worked at Dockland’s
Outreach since 2002, and is also in
private practice.
As a result of Shirin bringing her
experiences to their attention
Psychotherapists and Counsellor
for Social Responsibility (PCSR) is
campaigning against these
procedures which are so clearly
disadvantageous to the mental
health of asylum seekers.
Please contact Shirin if you would
like to support this campaign.
[email protected]
31
13/12/07
16:05
Page 32
the psychotherapist diversity and equalities
A Representative Balance
Pamela Gawler-Wright
A Training MO shares its experience
of creating a representatively diverse
membership and explores how an active
Diversity and Equal Opportunities Policy
grows from both conscious and unconscious
dynamics.
As new kids amongst the
neighbourhood of UKCP training
organisations, BeeLeaf Institute of
Contemporary Psychotherapy has had
an interesting and challenging couple of
years. One example of how UKCP
works well is having access to so many
models of good practice and the
generosity of the community to share
literature and developed protocol.
Due to this collective and diverse
wealth, we have been inspired and
empowered as an organisation to
improve several aspects of how we do
what we do in the preparation of
effective and ethical psychotherapy
practitioners.
Also, BeeLeaf members have been told
we have something to offer in this
exchange and, in response to several
requests, here is a taste of our
philosophy and practice that has
resulted in BeeLeaf enjoying a genuine
diversity of trainees, in terms of race,
religion, sexuality, age and physical ability.
I hope, too, that it is safe to be honest
here about areas of diversity and
equalities practice that still raise
challenges for us, and around which we
often witness continued confusion and
dissonance within UKCP.
Despite years of effort and talk, a
UKCP general meeting is peculiar in
our age in that it is still almost
uniformly attended by white, middleclass and middle-aged folk, with the best
representation of diversity being most
visible amongst UKCP staff members.
Whereas some points of process that
are offered here are useful in building a
more representative diversity amongst
UKCP registrants and candidates-intraining, what I will argue first is that,
32
without the accompanying beliefs, values
and internally driven motivation for
such an aim, a diversity and equality
process alone might achieve nothing
more than a PC ritual to assuage liberal
discomfort.
Don’t Tolerate Diversity.
Celebrate It!
Male
Female
Ethnic Minority
Minority Sexuality
(gay, lesbian, bisexual)
Actively Practicing Religion
(Buddhist, Christian, Hindu,
Judaism, Moslim, Sikh)
Physical Disability
42%
58%
29%
15%
22%
3%
To give a little context, this table
presents the representation of some
sub-groups within the trainee
population of BeeLeaf over the last five
years.These figures are from core
training and do not take into account
open seminars and CPD events.
Before going into the content of this
information there are a couple of other
points to consider.
One is, who is obviously missing from
this table?
The other is that we have this
information at all. Not because of some
government directive. Not because of
some burden of required quota. Not
because of an adherence to political
correctness.We keep such records at
BeeLeaf as a celebratory ritual, an
utterance of gratitude for the individuals
who are drawn together to create a
group, a community, a culture.
These records are for us as much a
ledger of gain in our collective wealth as
would be an annual rise in academic
achievement, or a set of accounts
calculating a drop in overheads.
This sentiment spreads its conscious
and unconscious dynamic in our training
rooms.We do not train in a manner to
promote tolerance of diversity.
Tolerance would be a questionable goal,
built on a presupposition of difference
as in some way intolerable without
special developmental activity.
We train in a way that identifies, utilises
and celebrates diversity.The qualities we
wish our practitioners to develop are
not toleration or charity, but respect,
curiosity and delight in another’s
experience and meaning-making,
especially when different to theirs.
Without this diversity our training
would be deeply impoverished.
This was borne out recently when, by
some unusual array, a group of trainees
in one of our Sexuality seminars was
entirely heterosexual, except for one of
the trainers.
Sincere though all members were, the
ensuing dynamic of discussion and
learning was lacking dimensions that the
normal multiple perspective affords.
Having experienced the presence of
diversity and its advantages, it caused us
to wonder how such an absence of
diverse experience could create a
marked paucity in training if all seminars
were with similarly homogenous
groups.
Could much of our syllabus, which
revolves about the core themes of
sameness and difference, belonging and
individuation, even make anything more
than abstract sense if we did not have a
community wealth of diversity?
I am blessed to number amongst my
friends Rev. Patricia Novick, an intimate
of Martin Luther King, who continues
her pledge to her murdered mentor in
her ongoing work across the US,
ranging from programmes in intergenerational storytelling to health
programmes for carers and leaders.
What I observe in her indefatigable
spirit and awe-inspiring executive
www.ukcp.org.uk
13/12/07
16:05
Page 33
intelligence is that Patty, like King,
dreams of and focuses on
connectedness rather than barriers.
That does not mean a denial of barrier
and difference.The line of difference is
recognised and quickly interpreted as a
further frontier for connectedness,
strengthening our ability to embrace
other through enhancing security in our
self-definition.
I can retrospectively see this system of
values-driven beliefs and action as an
unconscious dynamic within BeeLeaf’s
service provision, upon which I believe
our realisation of a truly diverse
membership has been based. Policy and
procedure has followed beliefs and
values, rather than the other way
around. (See references below for some
of Patty’s projects).
Some of Your Members
are Missing!
Writing this article has made me do a
fair bit of head-scratching to delineate
the frontiers that the community that is
UKCP could work on to extend its
diversity of membership.
Progressive Christianity is owning that
biblical injunctions against
homosexuality were in fact late
additions to the scriptures, inserted as
reflections of cultural and historical
obsessions and that the only direct
Levitical edict on the subject was in the
context of ceremonial purity within a
specific religious order.
simply does not affect them. Like the
poem says,“I did not speak out because
I was not a Jew” (Niemoeller M. 1945).
However, achieving a representative
balance in our training rooms and
General Meetings would also be
indicative of raising numbers by a
significant percentage, something which
I understand to interest most MOs. I
hope that I have already made above
some good arguments for other
benefits to the collective in having a
representative balance.
A non-hostile yet observable frontier in
the achievement of this goal is the
perception that diversity issues are just
problems to be solved, satisfactorily
attended to now by legislation and
procedure.As I recently heard a UKCP
Registrant say “People don’t need to go
on about this sort of stuff anymore.
Everyone accepts everyone these days
and we’ve got Equal Ops policies.
There’s no homophobia that I’m aware
of”.
I would love to live in this friend and
colleague’s world. However her logic
would be a bit like me claiming that the
proof that there is no more racism in
Britain is that nobody has ever called
me “Pxxi”. It is not a term likely to be
thrown at us blonds.Yet when I shared
a house with a Pakistani friend, walking
beside her in the street taught me how
she and I lived in different worlds, as for
her a simple trip to the corner shop
had the potential to become another
experience of racial abuse.
Rather than dismissing experiences of
discrimination as neurotic symptoms,
would it not be more accurate to
recognise denial of discrimination as a
coping mechanism for those of us
whose membership of the majority has
shielded us from dealing with a truth
too painful to acknowledge. Procedures
can give us ways of dealing with
discrimination; they do not put an end
to discrimination any more than having
laws puts an end to crime.
During the 2007 AGM’s session on
diversity and equalities, a comment that
came from the floor was “We don’t
pretend to know about what we can’t
know about”, the inference being that,
as members of the white, middleclass,
Judaeo-Christian majority, minority
perspectives eluded them.
This perspective is in itself a culturally
shaped one, an abdication from the
state of human connectedness through
the Western creed of individualism.
While an admirably humble and
listening position is implied in this
statement, if it is not accompanied by
the pursuit of opportunities to further
our knowing through exposure to
diversity, it can become a bastion of
monoculturalism.
Another frontier where we can grow
through our greater understanding and
Do we not, as psychotherapists, need to
take a similarly honest look at the
institutionalised discrimination still
present in the absence of diversity
within UKCP membership? Can we do
this in a way not castigating us for the
present state, but accepting the facts of
it and open to exploring a remedy? Can
we find enthusiasm for this goal and
collectively reach it, rather than cast it
to a few individuals of minority identity
and drown it in apathy?
Consider this.The majority of readers
have not continued this far in this
article.Yes, dear reader, some have failed
to be captured by my scintillating prose
(and what kind of minority are they?!)
and, I would suggest, that some others
have already turned the page because
they have decided that the subject
The Psychotherapist
33
13/12/07
16:05
Page 34
exploration is the prevailing
misconception that Equal Opportunities
somehow equates the lowering or
disparity of standards in our training
and accrediting systems.This
widespread yet understandable
confusion is, I believe, a hang-over from
certain experiments in strategies of
‘positive discrimination’ and their
resultant abuse.
Such a conflict of values has possibly
served to repel interest in maturing our
understanding of diversity and equalities
philosophy as supportive of educational
standards, rather than detrimental to
them. Equal Opportunities is not about
making allowances or special cases.
Robust and consistent policies and their
confident application help to protect
organisations from the abuse that can
issue from the victimhood of a trainee,
as well as generate enlightened
approaches to recognising a diversity of
challenges and diversity of teaching skills
to help diverse people meet the same
goals and standards.
There are other frontiers for
development within the UKCP
community which may currently be
delineated by even more complex
structures of defence.This I believe
could lie in our, at times, religious
adherence to certain modernist
theories of psychotherapy while living in
a post-modern society.
Earlier pioneers of psychotherapy lived
and worked within a Eurocentric
mindset, wherein disability was hidden
and diverse sexuality not spoken of
except as sin or pathology.They also
grew within a time when the pursuit of
reason was to establish universal truth,
a goal necessarily abandoned when we
collide with multi-culturism and a meta
cognition of positivism as one other
culturally-based epistemology amongst
many.
Some of our cherished gems of theory
need to be reappraised as the flawed
diamonds that they are.The ‘modality
wars’, which we can all hope are behind
us, are themselves manifestations of
diversity dynamics.
Below I offer some ideas for an MO’s
possible contribution to promoting a
representative balance within the UKCP
community. Some may be obvious, but
that does not invalidate them.
I am looking forward to the results of
pooling effective diversity and equalities
processes and philosophies, as Shila
Rashid, Chair of UKCP’s Diversity and
Equalities Committee (DEC), has
suggested. So here is a log or two to
add to that fire.
Get Conscious and Keep Records
The veil to comprehension is so much
more easily lifted when the wall of
ignorance has been jumped.You may
have a more diverse membership than
you realised if you start to keep
records.
Some people don’t like to give details
about their race, creed, sexuality or
special needs.That’s fine. Record that
group too.Then consider, who is missing
from your family table? Sometimes just
starting to think this way can generate
ways to attract a greater diversity of
trainees and members.
Get Your Trainers On
What representation of difference is
there amongst your staff? Chances are
that anyone obviously in a minority
group may be more aware of the
dynamics of diversity at work already
and might be consciously or
unconsciously shouldering a degree of
your organisation’s responsibility in
managing this.
Have an inset event with staff, exploring
their good practice in holding the
dynamics of diversity of gender, culture,
age, race, religion and psychotherapeutic
orientation.
The need to manage this and celebrate
its gifts for potential growth can also
sometimes be observed within sections,
often with minority members again
having to take responsibility for naming
these unconscious processes or raising
diversity issues.
Diversity is as much an issue for
members of majority groups as it is for
those whose position makes them
more aware of the dynamics of
exclusion. Repeatedly leaving the
responsibility of this to one group or
individual forces the position of ‘other’
rather than an embrace of diverse
perspectives into the collective
consciousness.
Keep Standards High and
Processes Clear
I have a theory that one cause for eyebrows raising and groans escaping in
UKCP meetings, when diversity and
34
www.ukcp.org.uk
13/12/07
16:06
Page 35
equalities issues are brought up, is
because people may have experiences
of the minority-of-a-minority attempting
to abuse processes to defend
themselves from required development
and rigorous assessment.
Where there are processes there can
be abuse of processes.Training
organisations in particular need to be
clear that diversity and equality good
practice does not advocate making
special allowances or colluding with
poor performance or psychological
immaturity. It is about spotting the gaps
that exclusion has left so the trainee
can take responsibility and embrace
opportunity.
Our responsibility as trainers is to work
to offer a person equal empowerment
to reach equal standards. Equally, we
have a responsibility to all trainees that
standards are not compromised by the
single case where special needs
provision is exploited rather than
responsibly engaged with.
“I Don’t Want to Cause Trouble
But…”
Experiencing bullying and discrimination
is often accompanied by a deal of
shame.Accusing someone of prejudice
is so serious that those experiencing
discrimination can feel that they are in
the wrong if they report an experience
of it.
As well as your required diversity and
equality statement in your trainee
handbook, include some simple steps of
what to do if discrimination is
experienced, either from the
organisation or from an individual.Aim
for mediatory solutions first that enrich
the learning process for everyone and
offer growth to all involved.
Do not fear taking firm action with a
clear perpetrator.The respect and
safety of the whole group are at stake.
Acknowledge Economic Exclusion
The ‘Pink Pound’ phenomenon, the
comparative economic security of male
gay couples making them a target
consumer group, has been widely
publicised. Not so the economic
inequality that is still experienced by
women and most minority groups
(CRE, DRC, EOC 2007).
The Psychotherapist
To make our trainings financially
accessible to a population who truly
represent our society and service users
we need to be skilled and inventive in
designing training through a variety of
media, getting the balance right between
quality and cost-effective distance
learning and the vital but expensive
requirement of sufficient tutor and
group contact learning.We also need to
address the availability of sufficient
quality personal therapy at affordable
cost.
Get Involved in DEC’s Work
Show an interest in DEC’s work and
see how you can both benefit from it
and contribute to it.This is as important
whether your organisation attracts a
diverse population or a more
homogenous one. Contact Shila Rashid,
Chair. [email protected]
Pam Gawler-Wirght
[email protected]
References
Martin Niemoeller, (1945) German Lutheran
Pastor “First they came for the Communists”
For more on Patti Novick’s work, visit
www.Aliveltd.org and www.eriehouse.org
Commission for Racial Equality, Disability
Rights Commission, Equal Opportunities
Commission, now merged into the Equality
and Human Rights Commission.
www.equalityhumanrights.com/articles
Pam Gawler-Wright has been leading
workshops and seminars since 1986
and was Registered by UKCP in 1993.
She is Director of Training for BeeLeaf
Institute of Contemporary
Psychotherapy and her theoretical
mainframes are Ericksonian
Psychotherapy and Systemic NeuroLinguistics.
Pam is an Animal Assisted therapist and
works closely with her colleague, Stella,
who is an extraordinarily talented cat.
Have you a story
to share?
MOs and registrants alike: do you
have specific client group(s) that
you specialise in working with?
Or are you involved in a particular
project that you think is innovative
or unusual?
The Psychotherapist might be able
to publish an article so you can
share ideas, make contacts with
registrants with similar interests
and build on each other’s
experiences. If you are interested,
contact the Managing Editor, Jude
Cohen-Phillips, with a brief
summary of your work.
[email protected]
35
13/12/07
16:06
Page 36
the psychotherapist events
Events
Begins January – London
Diploma Course in Biodynamic
Psychotherapy
London School of Biodynamic
Psychotherapy (Gerda Boyesen Method)
Details from: 020 7263 4290
[email protected]. www.LSBP.org.uk
January to November - London
10 Seminars series for clinicians and
practitioners.
Core concepts & principles of Biodynamic
Body Psychotherapy
London School of Biodynamic
Psychotherapy
[email protected] www.LSBP.org.uk
5th January – London
An exploration of using touch in
psychotherapy with Bernd Eiden.
10am - 5.30pm, Chiron Centre for Body
Psychotherapy, 26 Eaton Rise, London W5
2ER.
Details from: www.chiron.org, 0208 997
5219 or [email protected].
6th January - London
Working with breathing with Jochen Lude.
2ER.
11th/12th January - Luton
Harnessing the Power of the
Relationship: Utilising a Client-Directed,
Outcome-Informed Approach with David
Nylund,Associate Professor, California State
University,The KCC Foundation.
Details from: www.kccfoundation.org, 020
7720 7301 or [email protected]
13th / 14th January
Person Centred Counselling and
Psychotherapy with Irene Fairhurst.
Express Holiday Inn, Hammersmith.
Details from: www.lifetidetraining.co.uk, 020
Addiction in the therapeutic relationship
with Francie van Hout.
2ER. Details from: www.chiron.org, 0208 997
Working with borderline and narcissistic
tendencies with Alun Reynolds.
Chiron Centre for Body Psychotherapy, 26
Eaton Rise, London W5 2ER.
Exploring the mind in the body - Seminar
36
3: Muscle with Roz Carroll.
6.30pm - 9.30pm, Chiron Centre for Body
2ER.
22nd January - Luton
What happens to the future when a
child is parentally bereaved? with Ana
Draper, Systemic Psychotherapist,The KCC
Foundation.
Details from: www.kccfoundation.org, 020
23rd January
Organisational Consultation Forum for
managers, consultants, coaches and other
professionals. 5.30pm. Details from:The
Administrator, !GA, 1 Daleham Gardens,
NW3 5BY 0207431 2693 or
[email protected]
23rd January
How to create enjoyable and extraordinary
supervision:The formula for success. with
Martin Weaver & Sandra Dickson.
Novelist Esther Freud in conversation
with John Tydeman on the themes of the
absent father and coming-of-age explored in
her latest novel, Love Falls.
7.00 - 8.30pm,The Resource Centre, 356
Holloway Road, London, N7 6PA.
Details from:
www.connectingconversations.org
25th/26th January
ACAT Annual Conference and AGM - The
Relational Present: Skills in Dialogue.
Details from: www.acat.me.uk, 0844 800
9496 or email: [email protected].
26th/27th January
Cognitive Behaviour Therapy with Dr.
Christopher Whiteley.
29th January to 18th March - London
Biodynamic Massage Introductory
Course
Eight sessions learning and practicing a
variety of Biodynamic massage techniques
£360.
1st/2nd February
COMPLEXES Do we have them? Or do
they have us? with Lindsey Harris & Fiona
Palmer Barnes. Fri 1st 7.15pm – 9.15 pm Sat
2nd 10am – 1pm The Jungian Seminars,
Quay House, Quay St. (off Castle St.)
Hereford.
Details from: 01432 272 170,
[email protected]
orwww.hereford-monmouth-jungians.org.uk.
2nd February - London
From Research-Based Practice to
Practice-Based Research: a conference for
Mental Health practitioners.
9:30 to 5:30.
Franklin Wilkins Building, Kings College,
London.
3rd February- London
Working with borderline and narcissistic
tendencies with Alun Reynolds.
Chiron Centre for Body Psychotheray, 26
4th to 8th Febuarary - London
Working Successfully with Addictions
Early Bird Discount if booked by 1tth
January.
Book online: www.beeleaf.com
9th February - London
Mindfulness for Therapists AHPP David
Elias will explore the overlap and integration
of mindfulness and psychotherapy, and how
we can cultivate this life enhancing skill.
10am-5pm
Details from: www.ahpp.org or 01508
482724.
9th February- London
Maudsley Psychotherapy Service
conference:Why Do Psychoanalysts Insist
on the Unconscious? The Institute of
Psychiatry, London.
Details from: [email protected] or
0750 607 4438
13th February
Refugee & Asylum Seekers Forum
12.00pm to 4.30pm at the Refugee Council
240-250 Ferndale Road Brixton SW9 8BB
Details from:
[email protected]
15th February – London
4: Fluids with Roz Carroll.
2ER.
16th to 17th February – London
“The diaphragm is the gateway to the
unconscious”
Workshop exploring the emotional
significance of how we are breathing. £150.
23rd February - Herts
Authentic Movement in Relational
Psychotherapy,AHPP Professor Helen
Payne will introduce the world of symbolic
movement as ‘embodied knowing’, enabling
participants to work with body process.
10am-5pm
482724.
23rd February - London
Embodied transference and
countertransference (1) A body/mind
perspective on transference with Michael
Soth.
www.ukcp.org.uk
13/12/07
16:06
Page 37
the psychotherapist events
10am - 5pm, Chiron Centre for Body
2ER.
24th February - London
Embodied transference and
countertransference (2) A body/mind
perspective on ‘habitual
countertransference’ with Michael Soth.
10am - 5pm, Chiron Centre for Body
2ER.
29th February – 1st March
Beyond Belief - Resisting cognitivist
dominance in psychological work –
Conference organized by the Midlands
Psychology Group.
Friday 29th February - Saturday 1st March,
2008 at Midlands Art Centre, Birmingham.
Details from:
www.midpsy.freeuk.com/conference.htm
1st March
Desire and Boundary Violations in
Psychotherapy- PD Conference
Details from: [email protected]
or [email protected]
or 0118 918 0820
1st March - Oxford
Starting in Private Practice,AHPP
Charlotte Barrow will address the various
challenges and options. Of interest to newly
qualified counsellors and psychotherapists in
particular.
10am-5pm
482724.
7th/ 8th/ 9th March – London
Working with illness in counselling and
psychotherapy with Michael Soth.
Fri. 6.30-9.30pm;Weekend 10am - 5pm.
7th (eve) Who lives in the symptom? Who
wants to get rid of it? 8th Bringing holisticrelational understanding to psychosomatic
symptoms 9th:Working with the
transformative potential of the symptom
5219 or [email protected]
8th March - London
Group Process,AHPP John Gloster Smith
will identify key issues and pitfalls of group
facilitation and explore how group process
works on a variety of levels.Anyone working
in, or with, groups will benefit from this indepth workshop.
10am-5pm
482724.
14th March - London
5:The Senses and the Skin with Roz
Carroll.
Psychotherapy. 26 Eaton Rise, London W5
2ER.
14th March
Desire and Boundary Violations in
Psychotherapy - PD Conference.
Details from: [email protected]
or [email protected] tel: 0118
9180820s
14th to 16th March - London
Ethical Practice
Book online at www.beeleaf.com
15th March – London
Wordlessness and meaning: the
beginnings of attachment with Sue Law.
2ER. Details from: www.chiron.org, 0208 997
15th March - London
Family Consultancy Divorce Therapy,
AHPP Juliet Felton will introduce the
emerging role of Family Consultants, who
support clients and lawyers through the new
non-litigation, couple-driven, divorce process.
This will interest therapists who would like
to add another aspect to their work.
10am-5pm
482724.
To all registrants of UKCP’s AP-PP Section
We are aware that our email addresses have not been kept up to date.
If you have not received emails from the CPJA web site concerning research or
workshops, it means that we do not have a current email address for you.
Unique information is sent out through ‘our TextBase’. This requires your
current email address for you to receive it and keep up to date with the many
changes occurring at present, both within and without the Section.
If you are one of the registrants missing out please send a current email
address to me at [email protected].
Ann Bowes
Section Chair of the Research Committee
AP-PP
The Psychotherapist
29th March – Sheffield
Body Awareness,AHPP Tyagi will introduce
a selection of techniques for amplifying our
own body awareness, and be looking at
what happens when there is another body
in the therapy room.
10am-5pm
482724.
5th April - Brighton
Couples,AHPP Glenys Jacques – this
popular workshop explores how couples, in
becoming observers of their mutual dynamic
process, can encounter creative
opportunities for relating.
10am-5pm
482724.
18th April – London
6:The Nervous System with Roz Carroll.
2ER.
19th April
A Cascade Professional Development Day
for Supervisors to explore self-with-other
in the supervisory relationship.
Details from:
www.counsellingsupervisiontraining.co.uk or
ring Jane: 01273 411654
25th April
Novelist and psychoanalyst Gregorio
Kohon in conversation with Leon
Kleimberg and Ignes Sodre
The Institute of Psychoanalysis, 112a
Shirland Road, London,W9 2EQ
Details from:
www.connectingconversations.org
25th/26th April
Terror Within and Without – Attachment
and Disintegration – Clinical Work on the
Edge.
John Bowlby Memorial Conference, ICH
London, organised by CAPP.
Details from: 020 7247 9101 or
www.attachment.org.uk
25th/ 26th/ 27th April - London
Erotic desire in the therapy room – dare
we embody it? Can we afford not to?
with Shoshi Asheri.
Fri. 6.30-9.30pm;Weekend 10am - 5.30pm,
Eaton Rise, London W5 2ER. Details from:
www.chiron.org, 0208 997 5219 or
[email protected].
3rd/4th May - London
Somatic dialogue in the therapeutic
relationship with Tom Warnecke.
2ER.
37
13/12/07
16:06
Page 38
the psychotherapist continuing professional development
38
www.ukcp.org.uk
13/12/07
16:06
Page 39
To advertise in The Psychotherapist, contact [email protected], 020 7014 9966
39
13/12/07
16:06
Page 40
40
www.ukcp.org.uk
13/12/07
16:06
Page 41
To advertise in The Psychotherapist, contact [email protected], 020 7014 9966
41
13/12/07
16:06
Page 42
Future conferences and events
From Research-Based Practice to
Practice-Based Research:
UKCP Research Conference 2008
a conference for Mental Health practitioners
Saturday 2nd February 2008 – 9:30 to 5:30
Franklin Wilkins Building, Kings College, London
Keynote speakers:
Peter Fonagy PhD FBA
Freud Memorial Professor of Psychoanalysis
Director of the Sub-Department of Clinical Health Psychology, UCL
Chief Executive of the Anna Freud Centre.
Robert Elliot PhD
Professor of Counselling, the Counselling Unit,
University of Strathclyde, Glasgow
Details: www.ukcp.org.uk [email protected] 020 7014 9966
Registrant’s Day
Free workshop for registrants to become involved in
shaping the future of UKCP, post-regulation
University of Westminster, Regent Campus
Sunday 3rd February 2008 – 9:30 to 5
Political and Professional Issues in Psychotherapy:
Ways forward into the future
a one-day UKCP conference and workshops
Saturday 15th March 2008 Buxton, Derbyshire – 9:30 to 5:30
(followed by networking opportunities and optional conference dinner)
Despair, resolution, evolution: the emergence of hope
a conference on working with children, young people and families in ways that
instil hope, raise aspirations and develop the potential of those involved
Saturday 17th May 2008 – Newcastle-upon-Tyne
Northern Guild for Psychotherapy (with support from UKCP). Details from:
www.northern-guild.co.uk [email protected] 0191 209 8383
UKCP Supervision Conference 2008
Saturday June 7th 2008 – London

the psychotherapist

Transcription

Similar documents

OKOTOKS • HOLY TRINITY ACADEMY

Now

Alfred Adler`s Individual Psychology

The Medical Channel_Presentation

NSCAP Annual Report 2014_15 - Northern School of Child and

- Attachment and Trauma 2016 Attachment and Trauma

about horses and body psychotherapy

Applying the stages of change