Issue 61 â€˘ Autumn 2015
Psychotherapy training Discussions on some contemporary issues
The maga zine of the UK Council for Psychother apy
Follow us @UKCP_Updates
contents Feature articles Some contemporary issues in psychotherapy training Let’s change training standards How gender and sexually diverse-friendly is your training? Updating psychotherapy training: equality and diversity Breaking free from the shadow(s) An ethical endeavour ‘Still evolving …’ Reflections on teaching relational psychotherapy Humanising psychotherapy research and training in research book review Cradling the Chrysalis The role of UKCP in education and training standards Developing doctoral-level training Rising to the challenge of developing the profession Discussion Being the self I truly am UKCP news Welcome Professional Conduct Committee: an update Working collaboratively We’re going digital… How do we know we make a difference? The first Children’s Faculty forum UKCP members Policy round-up The Psyche in the Modern World: Psychotherapy and Society Obituary of Dr Kenneth Evans 1947-2015 book review Telling Time: A Novel book review The Sower and the Seed Welcome to our new UKCP members Diversity and equalities statement The UK 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 wellbeing, political belief, gender and gender identity, sexual preference or
4 6 8 11 13 15 18 21 24 25 28 30
GSD issues in training 8
33 3 35 36 38 40 41 43 44 45 46 46 48
orientation, disability, marital or partnership status, race, nationality, ethnic origin, heritage identity, religious or spiritual identity, age or socioeconomic 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 members 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.
Experience of being the Other 13
Teaching relational psychotherapy 18
Editorial policy The Psychotherapist is published for UKCP members, to keep them informed of developments likely to impact on their practice and to provide an opportunity to share information and views on professional practice and topical issues. The contents of The Psychotherapist are provided for general information purposes and do not constitute professional advice of any nature. While 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 on its content. The Editor and UKCP accept no responsibility or liability for any loss which may arise from
Welcome I have been a charity sector Chief Executive for eight years, during which time I have enjoyed leading POhWER, an advocacy services provider, and the Mental Health Helplines Partnership (now the Helplines Partnership). Both of these are membership organisations with high profiles in the mental health sector and are very well networked. These roles have enabled me to develop a well-informed understanding of mental health, including the importance of psychotherapy and access to services for people seeking therapy and counselling. I am drawing on this recent experience as I learn about UKCP, our thousands of members, and what the current and future priorities are for the organisation and sector. The staff team and I have clear priorities determined by our members. With the Board, we will be introducing the changes resulting from the Shape Review consultation, which featured in the last issue of The Psychotherapist. We will be launching the next stage of system development required for us to improve our processes and services to members. These developments will also underpin improvements that we will be making to the website, which will be of great benefit to members, potential members and people seeking psychotherapy services. We will also be actively raising UKCP’s and the sector’s profile through working with members to enhance activity, networking and partnerships that will increase awareness of our members’ professional excellence and
improve recognition of the role and value of psychotherapy. This issue is about psychotherapy training, and here at UKCP another priority is to continually develop our staff team and the opportunities available to them. We know that bringing more focus to this priority will lead to improved performance that will contribute greatly, along with new systems, to UKCP developing member services and increasing satisfaction. We look forward to members benefiting from UKCP’s investment in these activities during 2016. I would welcome opportunities to meet more members. So, if you have upcoming events where I could join you, please let me know. I will be delighted to hear from you.
Fiona Kerr is currently the Interim Chief Executive of UKCP. She is Director of Head for Success and specialises in providing management consultancy services and undertaking interim management roles in the charity and social enterprise sectors. Fiona has had a varied career that commenced in the commercial sector and then moved on to the charity, public and social enterprise sectors. Fiona was a carers support worker and job coach before gaining an MBA. She then moved into senior management as a project manager in the public sector and to charity sector chief executive roles.
reliance on the information contained in The Psychotherapist.
Managing editor: Sandra Scott
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 Editor or of UKCP.
Consulting Editors: Mary MacCallum Sullivan, Rachel Pollard, Karen Demsey
Advertising policy Advertisements are the responsibility of the advertiser and do not constitute UKCP’s endorsement of the advertiser, its products or services. The Editor reserves the right to reject or cancel advertisements without notice. Display ads: For a current advertising pack and rate card, please contact UKCP on 020 7014 9490 or email email@example.com
Editorial board: Sandra Scott, Janet Weisz, Mary MacCallum Sullivan, Richard Casebow, Rachel Pollard, Karen Demsey
Could you help shape The Psychotherapist? We’re looking members to join our Editorial Board. As a part of the editorial board, you will: • Agree a rolling programme of themes for future issues. • Consider proposals from prospective guest editors and, where necessary, invite individuals to serve as guest editors to cover particular themes. • Develop proposals for future developments in terms of themes, content, presentation and promotion of the magazine. If you would like to get involved and have experience of working or volunteering in a similar role, we’d love to hear from you. Get in touch with us at firstname.lastname@example.org
Published by UK Council for Psychotherapy, 2nd Floor, Edward House, 2 Wakley Street, ondon EC1V 7LT Registered Charity No. 1058545 Company No. 3258939 Registered in England
Advertising enquiries: 020 7014 9490 email@example.com Layout: julianhowell.co.uk Printers: Newnorth Print Ltd, Bedford
Some contemporary issues in psychotherapy training This special issue of The Psychotherapist on psychotherapy training is guest edited by Val Thomas
s a counselling and psychotherapy educator who has worked for over 13 years in a range of training contexts, I am very pleased to have the opportunity to edit this issue on psychotherapy training, a subject which in my view has not been debated enough.
Changes and challenges Until recently, the UK psychotherapy field has been embroiled in a highly political debate concerning the regulation of talking therapies. Now that this issue has been resolved, at least for the time being, it clears a space for other important discussions to take place regarding how psychotherapy as a discipline and profession can meet the demands of a rapidly changing world. In recent years, we have faced many changes and challenges, including the evidencebased agenda, the standardisation of HE
Dr Val Thomas BA (Hons), PGCE, PG Dip Counselling, MA (Counselling and Psychotherapy), DPsych, MBACP (Sen Acc) is a practising counsellor, psychotherapist and supervisor. She is a highly experienced trainer and was, until recently, course leader for professional counselling training at Anglia Ruskin University. Prior to that she was lead tutor for the Diploma in Integrative Counselling at Inter-Psyche, West Kent Social Care NHS Trust Centre for Counselling and Psychotherapy Training. She is a Fellow of the Higher Education Academy. Val is currently working at The Minster Centre as course developer and member of the Research Training team.
courses, reduction in some traditional work opportunities, the privileging of short-term interventions over longer-term therapy, and cuts in public sector spending. It is also important to recognise that therapists need to meet the requirements of a more mobile and diverse population facing new challenges in employment, housing and family life. It is imperative that psychotherapy continues to conduct a serious review of its nature and practices, and this includes the important matter of how we attend to the training of psychotherapists.
Emerging themes Looking at the literature on psychotherapy training, both theory and practice, since the millennium, it is possible to identify some emerging themes. Two common trends familiar to trainers would be the increasing emphasis on practitioners being research-informed and a more cautious approach to the delivery of experiential training components due to its perceived vulnerability to complaint, and even litigation. However, despite these commonalities, there is a wide range of perspectives on how to take psychotherapy training forward. These views include moves towards developing more sophisticated training responses to the relational turn, where psychotherapy training is seen as an embodied intersubjective practice mirroring the original parental and more latterly the therapeutic dyad (Macaskie et al, 2012). Alternatively, there are attempts to develop new approaches such as Boswell and Castonguay’s (2007) proposal for more comprehensive integrative training programmes centred around common principles of change.
Fresh thinking The aim of this special issue of The Psychotherapist is to stimulate debate and some fresh thinking on psychotherapy
training by asking academics and trainers to step outside their particular schools and approaches and consider the bigger picture. Can we revisit some common concerns in training and develop new approaches and strategies? Admittedly, the field of psychotherapy is very wide and we can only hope to touch on some of the contemporary issues in psychotherapy training here. However, it is hoped that the papers presented will challenge us all to engage with the training field with renewed passion. It is important that we attend to this; the future of the profession rests on the quality of its training.
Overlapping themes The ten papers deal with different aspects of psychotherapy training and the trainee’s experience and are loosely organised around the following three themes (although there are many overlapping aspects): how psychotherapy training positions the other; how training reflects developments in wider theory and practice; and the wider context of developing postqualification training programmes.
A provocative note The issue begins with the first theme and starts on a provocative note with Andrew Samuels’ (page 6) political perspective on training: is the quest for higher academic standards a reactive political move that undermines the inclusiveness of the profession? He goes on to propose that the field needs a radical revisioning of psychotherapy education, one that places the experience of marginalised groups and practices at the centre of the training programme. This theme is developed further in the reflections of Dominic Davies and Meg John Barker (page 8) on current inadequacies in delivering gender and sexual diversity (GSD) training. They make a compelling case that the field needs to move on from viewing GSD as
just a component of syllabus, and instead, owing to its fundamental and universal importance, GSD should inform all aspects of training, both content and delivery. In a similar vein (page 11), Eugene Ellis provides some illuminating insights into the experiences of BME psychotherapy trainees, revealing the extent to which issues of race and culture have been minimised in the training context (an issue that is the focus of research carried out by Isha McKenzie-Mavinga). He goes on to make helpful recommendations on how training organisations can create the safety required for ongoing conversations about race and culture. Dwight Turner elaborates further on this theme in his reflective personal account of the experience as a black transpersonal psychotherapist on a PhD programme (page 13). In his article, he considers the different views on Otherness and argues that the political perspective is sometimes unable to recognise the full complexity of the personal experience of being marginalised. (The value of personal experience in research is further explored in Angela Cotter’s article on page 21.)
Relationality In the second theme, the section broadens out to consider other issues, beginning with Harriett Goldenberg and Mary Sullivan’s thought-provoking examination of the challenge of developing ethical practitioners (page 15). They make a case for the fundamental importance of an ethics of relationality that is forged out of the trainee’s engagement with the training and which then goes on to provide a framework and discipline for professional practice. The theme of relationality is continued in Roz Carroll et al’s article (page 18), where they consider the implications of the relational turn for psychotherapy training. In a wide-ranging and stimulating discussion, they consider some cuttingedge theoretical developments from within the relational school and reflect on their experience of applying these to the delivery of training. This is followed by Angela Cotter’s authoritative overview of how research in health and social care is going through a process of humanisation (page 21). She considers the implications for psychotherapy research and provides some reflections on how relationality, reflexivity and creativity can be further integrated into teaching research to students.
Pragmatic applications Finally, the issue considers some particular pragmatic applications related to the theme of psychotherapy training. It begins by looking at how, in lieu of statutory regulation, UKCP is carrying out its role of regulating training standards. In an informative article, Fiona Biddle (Chair of the Education, Training and Practice Committee) gives a concise overview of UKCP’s regulatory policies and procedures designed to ensure that all UKCP-accredited psychotherapists are trained to recognisable standards (page 25). It then goes on to consider the increasingly important question of how to develop post-qualification pathways that support an established and maturing profession. It begins with Simon du Plock et al’s presentation of how an enterprising collaboration between Middlesex University’s Work-based Institute and Metanoia Institute resulted in doctorallevel training tailored to meet the specific needs of therapists. The two examples given of recent doctoral projects provide unequivocal evidence for the pragmatic utility and relevance of this work-based approach to psychotherapy. (A different but equally valid approach is discussed in the article by Angela Cotter.) The section ends with Lissie Wright’s highly reflective piece
in which she raises the contentious (and rarely discussed) issue of ‘the psychotherapy career’ (page 30). She considers the challenges facing the independent sector as it works in collaboration with HE to create validated trainings. This is illustrated through her account of developing an innovative master’s programme at The Minster Centre designed to support the emergence of post-qualification specialisms in psychotherapy.
Stimulating debate It is hoped that this wide range of articles contributes to stimulating a much-needed debate on the future of psychotherapy training. In the opening interview, Andrew Samuels calls for a ‘radical revisioning of psychotherapy training’. The Psychotherapist welcomes responses to this and other challenges presented here. We look forward to a re-engagement in the field with new thinking in psychotherapy training.
References Boswell JF and Castonguay LG (2007). ‘Psychotherapy training: suggestions for core ingredients and future research’. Psychotherapy: Theory, Research, Practice, Training, 44(4): 378–383 Macaskie JF, Meekums BVF and Nolan G (2012). ‘Transformational education for psychotherapy and counselling: a relational dynamic approach’. British Journal of Guidance and Counselling, 41(4): 351–362.
Let’s change training standards, says Professor Andrew Samuels, former UKCP Chair Val Thomas interviews Andrew Samuels on his political perspective on training Val: The importance you place on viewing psychotherapy through a political lens is very well known in the field. I’d like to start by asking you what you believe the main issues of political concern are in the training field. Andrew: I see the whole question of access to psychotherapy and counselling training as a political question. It requires political will to sort out a problem that has arisen, which is that entry to our trainings is for the elite and the elect. There is a serious money and class problem around who can access training. And many trainings are still somewhat off-putting to members of ethnic and sexual minorities. If there were a political will to address this, we would have to go in for some kind of affirmative action or positive discrimination. This is a more viable course of action in the therapy field than anywhere else. While in law or medicine, for example, assessment really has to be by means of technical knowledge, technical knowledge is not the only important thing in therapy. In the therapy field, assessment is also by means of evaluating someone’s capacity to be a therapist. So, making training accessible for the kinds of people who don’t train these
Andrew Samuels is a psychotherapist (Jungian analyst), professor, writer and activist. He was Chair of UKCP from 2009 to 2012 and one of the two founders of Psychotherapists and Counsellors for Social Responsibility. Andrew’s ‘rants’ (spontaneous talks straight to camera) may be heard at www.andrewsamuels.com
I want to speak in favour of ‘low standards’ because our high standards are a bit bogus days is quite possible – if there is political will to change the standards required for acceptance onto trainings.
you can become a trainer, and then you can take money off people the way money has been taken off you!’ And I’m not joking.
Val: Do you have any thoughts about how this political will can be engaged?
Val: I know you’re not. Although I can’t imagine that these public comments are received well by the training institutions.
Andrew: Well, everyone says they want the problems with training to be addressed. I see the function of UKCP, the umbrella organisation, to open up discussion of this and to address the financial implications. You see, UKCP has resources that organisational members (OMs) don’t have. It could, for example, start some kind of loan fund with the considerable cash reserves it has at present. However, there is also a huge role for OMs in judiciously, constructively and wisely changing entry standards. I want to speak in favour of ‘low’ standards because those ‘high’ standards we have are a bit bogus. They involve pulling up the ladder once you have attained the safety of the upper floor, as the floodwaters rise and rise. Trainings get longer, more elaborate, more expensive. And even though we sometimes replace compulsion with a set of ‘expectations’, we all know that if you don’t do what is expected or advised, you lower your chances of coming smoothly through the training. I don’t understand why psychotherapists, who are so interpretive of all phenomena, can’t see that what they’re doing is preserving their own safety and feathering their own nests. And can I say, in this context, we really should admit that the whole training industry is a pyramid selling scheme? When I give graduation addresses I often say, ‘Look, hang on in the field so
Andrew: There needs to be a discussion in the field about this money issue. We still don’t talk enough about why people become clients but we pay even less attention to why people become therapists. Is it money driven? And if it isn’t, what are the psychological factors that drive people to becoming therapists? Has the socioeconomic status of the therapist received adequate discussion? Who do we aspire to be like in terms of rewards? Primary school teachers? University lecturers? Accountants? Bankers? There needs to be a discussion about this. I do think that money is where it’s at and, in this context, I want to say that I am old fashioned. I cannot understand how a serious professional field can permit the existence of privately owned training institutes. Training institutes should be charitable organisations, not-for-profit associations. I know that the founding generation, especially in the humanistic and integrative field, just had to own their own institutes, but I think those days are gone and we really need to look at the whole ownership question. Val: You’ve talked about the structural issues. Can we turn now to your thoughts on what the trainings should be delivering? Andrew: Well, I’ve been an out pluralist since 1987 and I wrote a whole book on pluralism, which was published in 1989 (The Plural Psyche: Personality, Morality and the
feature article Father). A pluralistic approach to training celebrates the contradictions and rivalry between different traditions and modalities. It doesn’t ignore them. Far from that, it places them centre stage. So, for example, a good pluralistic training would teach around the differences between humanistic and psychoanalytic approaches to therapy work, or the differences between working with transference/countertransference and working with authentic relationship and the core conditions at depth. That’s what should be taught: the tensions between these, looking at the pros and cons of both approaches. That would be a pluralistic training. It celebrates competition and rivalry between things. And the roots for this are in philosophy and, above all, in political theory, where pluralism is precisely about competing sectional interests within a state. I’ve applied this political theory to the therapy field. Val: I think that most integrative trainings would argue that they consider the differences between the schools. What distinguishes your pluralistic approach? Andrew: The emphasis is placed on the differences. It is the understanding that these positions arose in relation to one another. Why was humanistic psychology and the human potential called the ‘Third Force’? Precisely because it was positioning itself against behavioural approaches on the one hand and psychoanalytic approaches on the other. Pluralism is different from both integration and eclecticism. Val: How do you envisage a good training based on this pluralistic approach? Andrew: It is such a divisive and divided field, but that’s the nature of the beast. Let’s enjoy it. Heraclitus said that Polemos (hence polemic) was the father of everything. Let’s stop teaching the history of the splits as some regrettable by-product of the personalities of the great founders. Rather, let’s teach the splits as worthy of attention. That means you have to go back before psychoanalysis and forward beyond psychoanalysis. You have to look at European psychology and psychotherapy and see how, for example, Freud relates to that, see how Jung relates to Freud, see how Ferenczi relates to Freud, and track it through historically to today’s plethora of traditions. The training should choose somebody or a few people who have a good grasp of the history of the whole field
We need to make central what is known by the practitioners and theorists of therapies that have been located on the margins and not just the modality in question, and turn the students over to this person for quite a long time because it’s the history of the field as a whole that, I think, provides the essential bedrock for a good enough training. Secondly, don’t fall for one liners about the crucial and central role played by the therapy relationship or the therapeutic alliance. There’s an equal need to look at the often very different roads travelled by therapist and client. If I were devising a training, I would spend a long time on why the student chose to become a therapist. But I would also spend a long time on deeply understanding and studying the research on the client’s role in the production or creation of a reasonably effective psychotherapy because that is where the cutting edge is right now. And this is quite humbling, you know. We ought to realise that we don’t know much about the central role the client plays in therapy. Maybe this is because we’ve submerged it into the liberal ideogram of the therapy relationship. Val: So, to summarise what you are saying, there are three aspects to a good training: history, motivation to train and the client’s role. Andrew: Yes – and you can teach all of those three things from multiple points of view. The last thing to add, of course, is cultural sensitivity, and that means paying attention to the variables of training such as class, ethnicity, sexuality, spirituality and physical health. These things are better organisers of the training than developmental stages like infancy, childhood, adolescence, adulthood, old age. That developmental stuff needs to be studied, but it shouldn’t be the organiser. In other words, don’t train people on a developmental template; train people on a sociocultural template so that those variables I mentioned – class, sexuality and so on, all the things that constitute the diversity agenda – become the central organising threads of the training, not relegated to term two of year four. Val: As an add-on.
Andrew: Where they tend to be an addon, as you quite rightly say. Organise the training around it. (Perhaps some places do already but I am not sure.) The diversity and equalities agenda is not marginal. It’s secretly central to what we do and who we are. So let’s own it and train on that basis. And that’s also very interesting from an historical point of view because if you take something like ethnicity you can look at the history of psychotherapy in relation to ethnicity and someone could teach that, and that would be very interesting. Val: This is interesting, isn’t it, because your training approach is informed by postmodernism. It seems to me that, in general, psychotherapy training has only changed superficially. It is attached to an old-fashioned modernistic agenda. Andrew: That is a deep point you have made. Training is modernistic when it gets caught up with ideas of progress and of starting at the beginning. I once wrote, back in 1980, that ‘starting at the beginning is no guarantee of comprehension’. Once you start to look at how the margins drive the centre and that there is no set of core/ foundational ideas then I suppose you are in postmodern territory. Val: And this is more than a purely theoretical perspective because you appear to be applying it to all aspects of the training. Andrew: Yes. That is my main point. Once you understand that the margins are more important than the centre, then the way trainings are structured needs to be radically revised. To give you an example, the experience of a transsexual is more important in terms of organising a psychotherapy training than the experience of a married heterosexual person. Val: This seems to be a fundamentally important point. Andrew: To extend the idea of how the margins drive everything, the types of therapy that are sometimes perceived as marginal are, in fact, central. First, there are the creative arts therapies. Nobody should do a psychotherapy training
feature article without learning something about the creative arts approaches. Second, the body psychotherapies. And third, transpersonal psychotherapy. Those three approaches are secretly driving the field right now. Can I explain to you? Val: Please, go ahead. Andrew: Words have their limits, and the whole point about creative arts therapies is that they’re much less dependent on words. Body psychotherapies actually indicate a capacity to work with the whole person, including their physical and embodied aspects. And finally, transpersonal psychotherapy, for me anyway, is about the more than personal, which goes in two directions. One, obviously, is the spiritual direction. The other is the political direction because, hey, don’t forget, politics is a transpersonal or more-than-personal activity. Val: And when you bring all these marginal therapies to the centre along with the sociocultural dimension, you are including the full spectrum of premodern healing practices, modern psychotherapies and postmodern perspectives. Andrew: You’ve extended my point in your question. The thing is, what looked marginal need to be brought to the centre. The problem is not that trainings don’t cover things – they cover everything I’ve mentioned – but they cover it in order of priority and a hierarchy of importance, which needs to be flipped round. It isn’t that people don’t talk about trans in trainings. They do, but they don’t do it in a way that, I think, makes the best use of all the history and all the tensions in the field. Val: You are calling for radical changes in the way that psychotherapists are trained? Andrew: Yes, I am. As I said at the beginning of this interview, we have to find a way to make our trainings more accessible and stop this relentless drive towards higher and higher standards. We need to reorganise the trainings around the experience of minorities in society because this tells us more than organising around the experience of the majority. And we need to make central what is known by the practitioners and theorists of therapies that have been located on the margins – art, body, transpersonal. Yes, we need a radical revisioning of psychotherapy training.
How gender and sexually diverse-friendly is your therapy training? Dominic Davies and Meg John Barker argue that GSD issues need to be integrated throughout therapy training and have a practical rather than theoretical focus
e were delighted to see all the major psychological and therapeutic bodies signing the Memorandum of Understanding on Conversion Therapy, launched at the Department of Health earlier this year (UKCP, 2015). This littleread document makes it an ethical obligation for therapists to be adequately trained to work with requests for changes to clients’ sexuality (we hope to see gender added to this soon). To meet that obligation, training organisations will need to develop a curriculum that embeds gender and sexual diversity issues throughout the syllabus, as well as ensuring separate specialist and specific material.
Unfortunately this still is very far from the current situation. When we were asked to write this article, we asked colleagues on our Pink Therapy Facebook group about their experiences of training. We found the situation had not changed since Davies explored it in a paper in 2007. At best, GSD training is a brief workshop delivered by an LGBT student, rather than a tutor, because they are ‘the only queer in the classroom’. Such tokenism means that many aspects and identities are excluded. This is unprofessional and inadequate. On some courses, students are encouraged to vote for a one-off additional afternoon’s training on a topic of their choice. In such situations GSD has to compete with other vital topics such as race and ethnicity, class and disability.
Dominic Davies is founder and CEO of Pink Therapy, the UK’s leading independent therapy organisation working with gender and sexual diversities (GSD). He was co-editor (with Charles Neal) of the first British therapy texts on working with LGBT people. Awarded a fellowship by BACP for his ‘outstanding contribution to the field’, Dominic has been delivering innovative training in GSD for over 30 years. Meg John Barker and colleagues provide GSD training for general counselling and psychotherapy courses and organisations. Information at: www.londonsexrelationshiptherapy.com/training
feature article Why include gender and sexual diversity (GSD) 1 training? LGBT people are at higher risk of mental health problems than the general population (Davies and Barker, 2015; King et al, 2008), and the evidence suggests that many of them have poor – and even pathologising – experiences when they do approach therapists and other mental health professionals (King et al, 2007). It is therefore clear that counsellors and therapists are not currently sufficiently trained in this area. This is dangerous, as therapists who have not had the opportunity to question their assumptions often give GSD clients messages that they are less normal, or more pathological, than other clients (Moon, 2008). There is further evidence that trans and bisexual people have the highest levels of distress, and the worst treatment at the hands of therapists, of all those under the LGBT umbrella (Moon, 2009); these are the GSD identities which are often the least visible on training courses and elsewhere (Baker et al, 2012). Another important reason for including GSD training is that, currently, LGBT people who embark on psychotherapy or counselling training themselves often have a poor experience. They are frequently extremely isolated and constantly have to decide whether to confront prejudice from their peers – and even staff – or whether to stay quiet about it. The decision is often between allowing poor training to continue (and pass the course) and being the one who constantly has to be labelled ‘difficult’. This is one of the reasons why Pink Therapy recently set up a mentoring scheme for GSD trainees, so they can get support from people who have been through this. People who are marginalised on a societal level should not have to be further marginalised on training courses, or feel unsafe, but sadly this is a story that we hear again and again. Even those whose experience is more positive feel they have to constantly point out when case material assumes heterosexuality, for example, or when theories being covered are explicitly heteronormative or homophobic, biphobic 1 GSD is our preferred abbreviation. It goes beyond the exclusivity and restrictions of LGBT (lesbian, gay, bisexual, transsexual) to include everyone on the gender spectrum and diverse sexualities and practices, including BDSM/kink, asexualities, consensual non-monogamies, etc.
At best, GSD training is a brief workshop delivered by an LGBT student because they are ‘the only queer in the classroom’ or transphobic. It is deplorable that those convening and presenting the courses have not considered the diversity of living in modern Britain. The financial burden of therapy training and the normative nature of many courses clearly put off people from all kinds of marginalised groups, and exacerbate this ‘lone voice’ phenomenon. For that reason, training courses could usefully consider offering bursaries, particularly to members of such groups. Of course, part of the problem here is that the counselling training world is dominated by middle-class, white, cisgender (people who remain in the gender they were assigned at birth), heterosexual women! Also, many of the theories we draw on developed in another time when there was not the understanding of GSD we have today, and LGBT identities and practices were explicitly pathologised and even criminalised. However, most staff do not have the knowledge and understanding
– from their own lives or through training – to offer something different, resulting in a stagnation which perpetuates itself.
What should be included in GSD training? GSD is a lot wider than simply having a couple of sessions talking about lesbian and gay experiences. In addition to the issues with bi and trans mentioned before, sexualities and genders that do not fall into the LGBT category are very rarely covered in training: for example, kink or BDSM practices (Strick, 2015), and openly non-monogamous forms of relationships (Barker, 2015). Beyond this, we need to challenge the common assumption that gender and sexuality issues are only relevant for minority or marginalised groups. In truth, they affect cisgender and heterosexual people at least as much as LGBT people. This is the reason why Richards and Barker, in their two recent books on GSD (2013, 2015), included chapters on cisgender,
feature article The problem is that the counselling training world is dominated by middle-class, white, cisgender, heterosexual women! heterosexuality and monogamy. They make the point that endeavouring to adhere to rigid scripts – of sexual behaviour or gender norms, say – is a major aspect of many mental health problems which is often overlooked. Including all sexualities, genders and relationship forms in training would be an excellent way of ensuring awareness of this, and including everybody. Finally, Butler et al (2009) make the point that therapists and counsellors are notoriously poor at talking about sex in therapy unless specifically trained as psychosexual therapists. Given what a major dimension of human experience this is, it is important that therapy courses include training on how to discuss sex and sexuality with clients (the process), as well as specific information about gender and sexuality (the content). In summary, at the end of their training, students should be able to: • Speak explicitly about sex • Understand the full range of experiences under GSD, including various sexualities, genders, sexual practices and relationship forms • Appreciate the role of heteronormativity, shame and the internalised oppression of marginalised people • Recognise how other identities and practices intersect with gender and sexuality in ways that are vital for people’s experience and mental health (das Nair and Butler, 2012) • Know the evidence base for requests for ‘treatment’ for sexuality and gender ‘cure’.
Who should provide the training? We need to leave behind the current tokenism of students providing training on GSD based on their own personal experiences. We are left with two possibilities: courses can ensure that they have faculty with expertise in this area or they can bring in outside specialists to cover these topics.
However, neither of these is happening on many of the courses that we are aware of. For this reason, Pink Therapy (in addition to its extensive CPD programme) now runs two specialist diplomas, one on GSD issues generally (two years online) and another on GSD relationship therapy (offline) to prepare therapists for the range of issues facing a modern therapist. Also, groups like London Sex and Relationship Therapy have developed a number of plug-in training days on specific GSD topics, which they offer to training courses.
Add-on versus integrated training We are arguing that GSD issues need to be both integrated throughout training and covered in a specific module or set of sessions. This training should be practical rather than theoretical in emphasis – imparting knowledge, information and skills. There is a long history of therapy which neglects people’s social context in its focus on individual experience and the universality of human experience (Barker, 2010). Instead of adding it on in the form of specific sessions, it would be better if courses were mindful of the social element of human experience throughout. This could be done, for example, by ensuring a diverse range of case material, all of which lends itself to discussions of gender, sexuality, race, class, etc (das Nair and Butler, 2012).
Summary It’s a major task to prepare therapists to work with gender and sexual diversity, and therapists need to be prepared to augment their initial training with further specialist training if they want to work at a deeper level with GSD populations. Some courses probably feel overwhelmed; others may have little commitment or motivation to change the status quo. We need to work towards a place where GSD and intersections are woven throughout. There should be a minimum of six days’ additional training to fulfil the requirements made by the Memorandum of Understanding signed up to by our professional bodies.
References Barker M (2010). ‘Sociocultural issues’. In M Barker, A Vossler and D Langdridge (eds) Understanding counselling and psychotherapy. London: Sage: 211-233. Barker MJ (2015). Non-monogamies. Available at: www.youtube.com/ watch?v=nI7wYMBhdZg. Barker M, Richards C, Jones R, Bowes-Catton H and Plowman T (2012). The bisexuality report: bisexual inclusion in LGBT equality and diversity. Milton Keynes: The Open University, Centre for Citizenship, Identity and Governance. Butler C, O’Donovan A and Shaw E (eds) (2009). Sex, sexuality and therapeutic practice: a manual for therapists and trainers. London: Routledge. das Nair R and Butler C (2012). Intersectionality, sexuality and psychological therapies: working with lesbian, gay and bisexual diversity. Oxford: Wiley-Blackwell. Davies D (2007). ‘Not in front of the students’. Therapy Today, February. Davies D and Barker, MJ (2015). ‘Gender and sexuality diversity (GSD): respecting difference’. The Psychotherapist, June. King M, Semlyen J, Tai, SS, Killaspy, H, Osborn D, Popelyuk D and Nazareth I (2008). ‘A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people’. BMC Psychiatry, 8(1): 70. King M, Semylen J, Killaspy H, Nazareth I and Osborn D (2007). A systematic review of the research on counselling and psychotherapy for lesbian, gay, bisexual & transgender people. Leicester: BACP. Moon L (ed) (2008). Feeling queer or queer feelings. London: Routledge. Moon L (2009). A psychosocial approach to counselling bisexual clients. Swindon: ESRC. Richards C and Barker M (2013). Sexuality and gender for mental health professionals: a practical guide. London: Sage. Richards C and Barker MJ (eds) (2015). Handbook of the psychology of sexuality and gender. Basingstoke: Palgrave Macmillan. Strick van Linschoten H (2015). The place of kink in psychotherapy and counselling training. Available at: www.youtube.com/ watch?v=Lp79e6bH59I. UKCP (2015). Memorandum of Understanding on Conversion Therapy. Available at: www. psychotherapy.org.uk/UKCP_Documents/ policy/MoU-conversiontherapy.pdf
Further resources You can find out more about training and CPD on GSD issues on the Pink Therapy website: www.pinktherapy.com/en-gb/ training.aspx
Updating psychotherapy training: equality and diversity issues in psychotherapy training The profession must be much more sensitive to those from ethnic minorities who commit to psychotherapy training, says Eugene Ellis. Our business is the human condition. We have the tools.
sychotherapy is rooted in an ethos and devotion to the common good. It asks us to examine the processes of self-deception that perpetuate individual unhappiness and social structures that are inequitable and oppressive. Yet psychotherapy has for the most part been a white, privileged profession, hence training and treatment has focused on this population.
Inequality and insensitivity The most obvious area where this dilemma is seen is in relation to race and ethnicity. Inequality of access for black and minority ethnic (BME) communities is a wellrecognised reality for many psychological therapy services (Edridge, 20041). The insensitivity of UK mental health services to ethnic diversity is also an enduring problem (Bowl, 20072). There is little research with regard to the BME training experience but, anecdotally, BME students are more likely to drop out of courses, change their training provider more often and take longer to qualify as psychotherapists. It is my belief that psychotherapy and psychotherapy training institutions have the potential and capacity to bring to fruition the good intentions that underlie
the common good ethos inherent in psychotherapy theory and ideals. There is uncertainty about how the profession can bring this about, but it must start with the initial training of therapists and the networks that support continued professional development. At the heart of these issues is the question of whether or not there needs to be conversation about race in training. It is often imagined that there is no need. We take our avoidance of the conversation as a measure of our progress and enlightenment, which is telling in itself. It does nothing however to increase sensitivity to ethnic diversity.
Self-exposure and selfexamination Training in the psychotherapy and counselling profession requires selfexposure and self-examination in order to establish an inner robustness and confidence to hold similar processes in our clients. In a training environment, a BME person’s reflection on the impact that racial bias has on their inner lives and how this has organised their identity can lead to others on the training confronting these issues for the first time. This can result in silence owing to uncomfortable
Eugene Ellis is an integrative arts psychotherapist and founder of the Black and Asian Therapist Network (BAATN), the UK’s largest independent organisation to specialise in working with black and Asian clients. BAATN actively supports new BME therapists into the profession and develops partnerships with institutions and individuals who want to develop their skills with this client group in therapy, supervision and training. Email firstname.lastname@example.org or visit www.baatn.org.uk or @baatnman The Psychotherapist
feelings and/or a lack of confidence in facilitating a continuing conversation. It’s like a huge hole has opened up in the floor and somehow it becomes the BME student’s fault. They can then choose either to say nothing more because it’s too painful, and focus on just getting their qualification, or to insist their voice is heard, get labelled as the troublemaker, and risk not making it to the end of the course because they are worn out by the fighting. I responded to the needs of these students by offering student support groups,3 which have been running in north London since 2009. Their aim is to support students in navigating their course as a black or Asian person without feeling that there is no place for their particular inner turmoil in the field of psychotherapy and counselling. The group connects students with the parts of the psychotherapy and counselling profession that can, and do, respond to their and their clients’ issues of internal distress. Some of the students who attended have given their narratives on video.4 Here are some excerpts: Jitesh: “There were some frustrations on the course and I needed to take it somewhere else. The questions had always been there. You go there with a lot of hope that perhaps this place will be different but there is the realisation that it reflects all the other institutions and that was a disappointment.” Nicole: “The college felt like a microcosm of what was going on in the outside world. You have hope, but your issue of race and culture is sidelined.” Rena:”I have always found it difficult to find my voice and I was finding it increasingly
feature article difficult on the course. I thought that going somewhere outside the institution might help, particularly as my own internal racism was contributing to that.” Melanie: “We were fortunate in that there were a lot of BME students [on my course] and the tutors had the foundation, so we did cover quite a bit. A lot of my stuff is around race … We are trained to see white clients. I’ve had one black client and most of my clients are middle-class white people. My training is suited to them … [referring to the support groups] There is often a lot of emotion in the room and a lot of hurt. Some students have had very negative experiences, which I’m not sure I would have stuck out. For me, the groups calmed me down. The group for some students allowed the pain to come through, where they cannot express that on their course. I felt very fortunate not to have had the experiences that some students had.” Patsy [referring to the support groups]: “The space was constructive for me in terms of learning, in terms of experience and in terms of having a voice. There were lots of things packed into one day on my course and things would pass me by … Most of my supervisors were white and they have a different perspective. Not that their view was not valid. I just really wanted to know what someone like me might think about the same situation. The group was always useful to my self-development.” Overall, the themes that emerged from the student support groups were around: • The student’s disappointment in the world of psychotherapy, which they imagined would be different from other institutions • The possibility for their hurt to be attended to in a psychotherapy and counselling framework • Experiencing being heard as a transformative experience in itself • Raised awareness of how impactful race is for BME people • The group being a place to develop their voice around their own experience and the experiences of others like them • The knowledge that there is theory that speaks to their experience in a powerful way and the safety that comes from this. Nikki Cooper,5 a white tutor and programme leader for professional qualifications,
Psychotherapy has for the most part been a white, privileged profession, hence training and treatment has focused on this population offered this powerful self-reflection in a recent journal article: “My position with regards to students from other races and cultures used to be: ‘Well, I’m absolutely committed to your entitlement to everything that I’m entitled to. We are all absolutely equal.’ I have always believed that, so it was very puzzling for me to have to take on board the idea that not everybody felt that sense of entitlement … And if they’d experienced any racist events in their life then yes, that was terrible and it shouldn’t happen, but it was nothing to do with me. To me, there wasn’t anything to talk about. At the same time, when faced with any person of colour who was naming the difference between us, I would be overcome with anxiety about saying the wrong thing, about upsetting them or exposing my ignorance. Maybe that explains some of the silence. It’s easier to stay quiet than face the embarrassment of messing up. “I think the step that I needed to take was to realise that I was part of the problem as well as the solution. Not that it was my fault, not that I was entirely to blame for all the ills and evils of racism in the world, but that my lack of understanding about my own culture meant that I was also maintaining a problem. I’m not saying we have to go into a silent, guilty, selfflagellating shameful place – although that was a necessary phase for me as well – what Isha McKenzie-Mavinga6 calls ‘recognition trauma’. I’m talking about the process of getting to the other side of that and accepting that we are not all lovely people and there is a conversation to be had.” As a profession, I believe that we have a unique role to play in contributing to the alleviation of suffering that is inherent in the experience of being a minority within society. There are many psychotherapy organisations that share this vision and want to be more effective in this area but then get stuck there.
Trainers forums To move forward with this belief, I decided to create a space called a trainers forum7 for black and white trainers of all backgrounds, with the aim of making therapy training more accessible and more able to meet the therapeutic needs of students from BME
backgrounds. It was evident by the number of people who attend these forums that there were others who also wanted to make progress on this. At a recent forum, the group was given the task of trying to distil the process of change and development in this area for training organisations and translate that into a guide. There was a lot of consensus in the room about what this document might contain. The central issue was how you talk about race without people feeling they are intrinsically bad or overly deskilled. How can organisations create the safety to allow free conversation to happen? The group focused on the process of the individual facilitator’s and trainer’s development, as well as the process of change relating to the wider organisation.
Confidence and comfort With regard to the process around individuals, it was felt there was a need to anticipate that when there are conversations around race there will be an atmosphere, there will be discomfort, and people won’t necessarily feel at ease. Discomfort is not the aim, but at the point where there is that tension, the possibility exists for something new or for some discovery to be made. The facilitator needs to have visited this area before in reasonable depth to feel confident in enabling the process to unfold, minimise the activation of individual defences and for learning to take place. A guide for organisations would point out the inevitable dynamics that happen within the race conversation and provide practice examples that have been found to be helpful to facilitate the process. For instance, the uncomfortable sense of unease that comes with the race conversation can be named and explained as ‘recognition trauma’ and that this is a normal part of the process of sensitisation to issues of ethnic diversity. Another practice example might be naming the tendency in all of us to see ourselves either as good or bad, racist or not racist, and how this view stops the conversation. Although it was acknowledged that the readers would be
feature article searching for guidance on what to do, the group wanted to emphasise the importance of attitude and perspective. It’s about a way of being that will allow an unfolding rather than a closing. The journey of moving through a process and making a paradigm shift would need to be emphasised rather than what to say or not to say.
Organisational change With regard to the process of change that relates to the organisation, the group thought that staffing, recruitment, course content and delivery, support for students and staff, supervision and personal/professional development would need to be addressed systematically. It was also seen as important that organisations involve all the organisational staff in the process rather than leave it to be managed by a few individuals. There is a lot that could be said about the political landscape around these issues and that perhaps change needs to come about through more stringent training standards. However, since our profession specialises in working with the human condition, it would seem to me that we already possess the tools for change. The question we really need to face is: are we willing to go through the painful but ultimately rewarding process towards ethnic sensitivity for ethnic minorities who take on the endeavour of psychotherapy?
References 1 Edridge R (2004). ‘Review of reverence: renewing a forgotten virtue by P Woodruff’. Ethics, 114(2): 385-388. 2 Bowl R (2007). ‘Responding to ethnic diversity: black service users’ views of mental health services in the UK’. Diversity in Health and Social Care 2007, 4(3): 201-210. 3 Student Support Groups: www.baatn.org. uk/students.html 4 Student Support Group video: www. baatn.org.uk/member-videos 5 Niki Cooper is programme leader for professional qualifications and tutor at Place2Be, a charity providing school-based emotional and mental health support services. email@example.com or visit www.place2be.org.uks 6 McKenzie-Mavinga I (2009). Black issues in the therapeutic process. Basingstoke: Palgrave Macmillan. 7 Trainers forums: www.baatn.org.uk/ Trainer-and-Therapist-Forums
Breaking free from the shadow(s) Dwight Turner’s PhD thesis is a creative exploration of the conscious and unconscious experience of being the Other.
am a black, male, transpersonal psychotherapist. I am currently a PhD student; formerly I was a serviceman. It is these types of characteristics that supposedly make me different, with these differences marking me as ‘separate’ and Other on a daily basis.
In the Global North philosophers have often either seen the Other as a hindrance or a burden on resources, whether they are from a different culture, gender or religion. Yet, from within psychotherapy itself, von Franz (1980), amongst many, recognised that the Other was often prone to holding the unwanted projections placed upon it by the majority, while from the African philosophy of Ubuntu, Desmond Tutu’s assertion that ‘my humanity is caught up, is inextricably bound up, in what is yours’ (Hailey, 2008: 2) speaks of the delicate interpersonal connection between subject and Other. Yet, for the Other, what is it like to live as the shadow for the majority? And how does one emerge from the isolation of being the Other, particularly as a PhD student? It was these types of questions, as part of my wider PhD study on what it was to be the Other, which led to my using my own experience as Other in a heuristic exploration of the subject. An exploration designed to understand not just the conscious experience, but also the unconscious experience of being the Other.
Black dogs and cockroaches I decided to study my own experience as Other using creative means, echoing Kalff (1991), who saw creativity as a route towards symbolically uniting our external and internal experiences of being Other. Alongside sand play work, visualisations, diary entries, drawings and working with dreams were all employed over six months to ascertain my unconscious experience of being the Other, my design following Lacan’s (2003) idea that there is a conscious and unconscious relationship between signifier and signified, while also highlighting the experience of my PhD self as the signified. As a student, some of my early diary entries spoke of feeling like the outsider at a meeting of fellow PhD students at the university. Although interested in the topics being presented, feelings of inadequacy prevented me from speaking up, reminding me of how it can sometimes be as the Other; that the Other, be it based on a projection or a reality, feels it is denied its own voice. At the same point, shadow dreams assailed me like the simple example below where: I’m in a room on my own and I’m being attacked by a pack of black dogs who tear the skin off my back as I try to fend them off. I woke up feeling quite low and depressed. The scene reminded me of Churchill’s ‘Black Dog’ depression.
Dwight Turner is a transpersonal psychotherapist in private practice. A lecturer, supervisor and facilitator at the Centre for Counselling and Psychotherapy Education (CCPE) in London, Dwight is currently exploring our experience as the Other for his PhD at the University of Northampton. firstname.lastname@example.org
feature article The political, in its attempt to understand the Other, often struggles to recognise the complex or combined nature of Otherness
Dreams like this or where I was being chased by my own internal Other became a regular occurrence, my unconscious Other presenting itself as anything from cockroaches, which would leap at me, to threatening or aggressive male others. Through my sitting with my own conscious experience of otherness, my unconscious Other had begun to shout of the violent interplay between the intrapsychic and the interpersonal that I now believe sits central to our culture’s reluctance to truly engage with the Other. These difficulties were highlighted personally though, through my conscious egoic mind needing to wake me at the worst points of any dreams, rescuing itself from any unconscious challenge to its authority inherent in acknowledging my own otherness. Eventually, I became able to hold the tension of the opposites in order to see the unconscious split within myself, a split driven by the need to fit in with the majority so as not to be the Other.
Reintegration The recognition of the splits within me then led to an opportunity for change. As a student, in this case, the change involved allowing myself to just be myself, to accept that I was not an outsider, just a doctoral student accessing the unconscious qualities inherent in taking on a new identity, one that would also involve the reintegration of aspects of my unconscious self previously
suppressed in order to fit in with the cultural majority. This was an important lesson, which then allowed me to see beyond my own projections, and take what was offered from those who understood what I was attempting to achieve. This lesson, among many others, led to a series of reintegration dreams, where the aspect of myself that was previously hidden was welcomed home, like the one presented below. I’m in the middle of the M1, and I’m watching as a group of people and cars come past me in celebration. I’m with several friends, including one guy who is cross-dressing, and my brother is to my right. We all wave and cheer the procession onwards as the traffic jam heads north out of the city. The guy in the sky blue dress behind me asks if he can give me a kiss. I say yes, but with no tongue (dryly), so he kisses me excitedly, smudging his lipstick on me. My brother sighs dryly next to me so we all just continue to watch the procession. The celebratory tone of the dream here speaks of the culmination of one process of reintegration among many, with its embracing of my trans Other in a sky blue dress, and the presence of all black men in the car. I am also heading into the centre of London, while that which has been recovered is emerging outwards, beyond the self, and out to be witnessed by the
wider world. So, while there are hints of more reintegration needed (in this case through my reaction to the request for a kiss), there was a growing authenticity in the dreams at this point, different from those in the early stages of my heuristic process. An authenticity that began to translate itself outwards in my presenting papers alongside those same colleagues who years before I felt in deficit to, and indeed in the publication of this very paper in The Psychotherapist. These are the grounded lessons learnt by sitting with my own experience of being the Other.
‘Doing a PhD won’t make you a better psychotherapist, you know!’ Although my own experience as Other has led me to recognise and see my own inauthenticity, and to own aspects of myself that I had suppressed in order to fit in with the supposed majority, this is not to say that this process has been easy. In his work on alchemy, Jung (1974) rightly speaks of the intense pain associated with acknowledging and working through these types of psychic splits. Yet also, as I endeavour to complete my PhD, the aggression of comments like the title of this section from fellow psychotherapists are an irregular reminder of what I am risking by stepping out of the shadows and taking my place amongst the dozens, nay thousands, of majority-culture
feature article psychotherapists who have trodden this doctoral path before me. Interpersonally, these are a reminder that some will not like that the Other, their Other, has become more than just a Lacanian mirror for their narcissistic fantasies. While on an intrapersonal level, this is a reminder that to risk authenticity is to risk being seen, to risk stepping into my authority as a doctor of psychotherapy, an identity where speaking up is inherent, involves having a voice and using it to say something challenging about the nature of psychotherapy from my own unique perspective, something that might actually be heard. As a final point, the political sphere suggests that there are only a few groups who are Other, groups that rightly deserve equality and our respect. Yet I will argue here that the political, in its attempt to understand the Other, often struggles to recognise the complex or combined nature of otherness, for example where there are layers of difference within a particular group. My own research has taught me that experiences of being the Other range from anything from childhood bullying and separation from peers to the elderly being partitioned off in care homes away from their families and communities, with conscious and unconscious interactions between the signifier and signified meaning that at varying times throughout all our lives we will all experience being the Other. It is therefore essential for psychotherapists and trainers to recognise that in order to understand the Other we meet on our trainings or in our practices we have to continue learning from our own often very difficult experience as Other.
References Von Franz M-L (1980). Projection and recollection in Jungian psychology. UK: Open Court Publications.
An ethical endeavour In this article, Mary MacCallum Sullivan and Harriett Goldenberg describe and conceptualise the teaching of psychotherapy as an ethical endeavour. This ethical framework, they assert, can contribute to a wider social discourse about human relations.
he fundamental ethical elements of psychotherapy training and practice are responsibility, dialogue and collaboration. There is also an intricate three-way relationship between power, justice and love, which underpin our human relations, inside and outside the consulting room and the classroom.
The curative impact of therapeutic work Psychotherapy is a new ‘technology’, a methodology which has begun to change the way that human subjectivity and intersubjectivity are understood, to change our understanding of what is required to live ‘a good life’, to make successful relationships. The recent ‘turn to relationality’ in psychotherapy, across modalities, acknowledges the intricate interweaving of my influence on the Other with whom I engage – and his on me – in this kind of conversation. The developing body of practice-based
evidence demonstrates that, whatever theoretical orientation we espouse, it is the person of the therapist, her/his qualities and attitudes, and, we would argue, the ethical framework for the therapeutic relationship itself that constitute the curative impact of therapeutic work. The practice of psychotherapy is a living craft, a set of relational skills, a process which only comes to life when utilised in a carefully managed conversation with an Other – person, couple, family or group. The limited aim in this work is to manage to ‘bewith’ the Other, to be consistently available and attuned to the Other with whom I am engaged, to recognise myself as a part of an open, complex, self-organising, adaptive system. A radical openness and attunement to others (which nonetheless is securely grounded in a strong sense of oneself) is required to facilitate a shared experience in which the listening and creating of internal space for the Other, within the self, is the instrument and the journey.
Mary MacCallum Sullivan, BEd(Hons), MA(Psych&Couns), PMCosca, is a psychotherapy educator and practitioner working with a wide range of clients. She consults for a range of individuals in relation to organisational dynamics in the field of the talking therapies.
Hailey J (2008). Ubuntu: a literature review: a paper prepared for the Tutu Foundation. Jung CG (1974). Mysterium coniuntionis (2nd edn). USA: Princeton University Press. Kalff DM (1991). ‘Introduction to sandplay therapy’. Journal of Sandplay Therapy, 1(1). Lacan J (2003). The Cambridge companion to Lacan (edited J-M Rabate). Cambridge: Cambridge University Press. Available at: http://universitypublishingonline.org/ref/id/ companions/CBO9780511998720.
Harriett Goldenberg, BA, MA, MSc, CPsychol, AdDipEx, MBACP, HCPC, has over 25 years’ clinical experience working with individuals and couples as an existential-phenomenological psychotherapist, in private practice and in the NHS. Canadian and Jewish by birth, Harriett has a professional interest in the experience of marginality in all its guises. Collaboration is a hallmark of Harriett’s work, whether with a client in the consulting room, a colleague in the training process or a fellow author.
feature article Implicit in the remit of gaining greater selfawareness is the suggestion that, to a greater or less extent, I am a stranger to myself. The process of coming to know myself better, more fully, is fraught with possibilities of feeling estranged from myself. The familiar becomes unfamiliar and the unfamiliar becomes known. (Goldenberg, 1997: 13)
A radical openness and attunement to others facilitates a shared experience in which the listening and creating of internal space for the Other, within the self, is the instrument and the journey Ethics – the value base that informs all one’s actions in the world, how we act in relation to our environment and to its creatures, animal and human – is at the heart of psychotherapy… (MacCallum Sullivan and Goldenberg, 2015a: 25) This ‘therapeutic attitude’, however, often conflicts with our deep-seated, adaptive tendencies towards self-preservation and self-defence; it is, to a degree, an ‘unnatural’ stance. A key learning outcome for psychotherapy training should be the formulation of a personal practice-based ethics of relationality which elucidates the basic contract between learner and teacher, as between client and practitioner, that will create a ‘safe space’ in which the learning and the practice can occur.
The training encounter Training in itself is a collaborative enterprise, offering a myriad opportunities for real meeting; it is a milieu for grappling with the very personally demanding struggle to be in relationship – to engage with, to take the time to really hear and to respond to each other. The training encounter is a lived experience; courage is required to expose oneself to the possibility of considerable, if often subtle, change that simply cannot be predicted or predetermined. Becoming a skilled therapist involves the ‘un-learning’ of many taken-for-granted assumptions about oneself. It involves voluntarily embarking on a process of ‘un-knowing’, of daring to unravel and examine the ‘me’ that I think I know. For each student:
Participation in therapy training is learning through practice of a kind of ethical personal discipline rather than, or as well as, a set of illuminating ideas or learned professional techniques. The necessary self-disclosure of one’s own frailties as a human and shortcomings as a learner, a fledgling practitioner, in collaboration with both peers and tutors, carries the risk of moments and situations in which trainees will feel shamed and rejected through tutor and peer criticism and feedback. This often painful but also transformational experience can be seen as ethically analogous to the self-disclosure required of clients in therapy. For each practitioner, an ethics of relationality is forged out of their own engagement with the totality of this learning process, which will provide a framework and a discipline for their professional and clinical work, across all modalities.
Education as conversation For Freire (1972), education is a form of conversation – a collaborative dialogue where learning emerges from ‘between’, where differences, commonalities, new ideas are discovered in dialogue. The experience of one participant is joined with the experience of another, that of the teacher with the learner, and new meaning is generated. In teaching psychotherapy, we attempt to share our own learning about what has been useful to us, rather than impose a set of theoretical propositions as a theoretical orthodoxy to be followed. Levinas articulated a post-Shoah ethics that enjoined upon each of us a ‘radical passivity’ (Hofmeyr, 2009), an absolute requirement to wait upon the Other, a primary motive to respond to ‘the face’, the call of the Other. By finding a way to recognise the irreconcilable singularity and alterity of every Other and yet stand for and remain myself, I recognise the Other as always ‘the Other’, rather than some kind of reflection of myself. Levinas
feature article argued thus that ethics is responsibility for the Other, that this responsibility precedes knowledge and, moreover, has nothing whatsoever to do with reciprocity: that is, I do not do something in order to get something in return. Furthermore, it is this ethical responsibility that constitutes me as a subject: it is the meaning of my subjectivity. Paul Tillich, too, defines ethics as the science of man’s mortal existence, the roots of the moral imperative, the criterion by which the validity of existence is evaluated. ’There is no answer in ethics without an explicit or implicit assertion about the nature of being’ (Tillich, 1960: 72).
Opening out ‘Training to become a psychotherapist or counsellor takes the form of a direct, existential, challenge to the individual to come out of the crowd and take upon herself the burden and the responsibility of being – for this Other’ (MacCallum Sullivan and Goldenberg, 2015a: 86). The learner is called upon to open myself out to the ‘knowing’ Other and to a group of Others who may, or may not, know or understand more than I, and who may be feared as having power over me. The aim of the opening out of myself is to allow, first, a clearing away of obstacles, of secrets, of lies, a revealing of whatever my truth might be in any particular context, because for each of us, the dis-covery of truth enables and makes good. Relational truthfulness, as the connecting force that activates and binds the trinity of love, power and justice, contributes to the restorative and transformational function of the therapeutic relationship. For Tillich, ‘love is … the moving power of life’ (1960: 25). For Fromm, love is an art to be practised, with discipline, concentration, patience and ‘supreme concern’ for its mastery; love and labour are inseparable, love being willing to ‘labour’ for something in the service of its growth, in the project of overcoming human separation and alienation (Fromm, 1975: 90,91). Love drives us from estrangement and loneliness towards connectedness, from chaos to order; love is the interrelational force of gravity; love is the ‘and’ of ‘I and Thou’. Love is a foundational component of a ‘being-forothers’, and therefore is the basic driver of the therapeutic attitude.
The sharing of interpersonal truths Awareness of the nature and use of power is a vital element in an ethical framework for training. Tillich understands the will to power as ‘the dynamic self-affirmation of life’ (1960: 36), while justice has a uniting function between persons: ‘if justice is the form in which the power of being actualises itself, justice must be adequate to the dynamics of power’ (Tillich, 1960: 55,56). It is impossible to say how the power relation in any interaction will be; any and all acts of interpersonal justice depend on my willingness to ‘check my privilege’, to acknowledge my power over the Other, and to take responsibility for action aimed at giving away my advantage in order to affirm our being-with. Thus, in the context of a training group, the sharing of interpersonal truths facilitates a kind of justice to emerge in the clearing of all of us others, being-together. By this justice we mean a form of making good, allowing moments of ‘right relationship’. The most meaningful moments in groups are generated as the outcome of truthtelling and witness, and of recognition, where the plurality of group members is honoured even as the common experience of participation is shared.
An ethical challenge
imperceptibly, a revolution in our understanding of human inter/subjectivity: not only do we more fully comprehend how fundamental human relation is for our most basic survival, but we begin to realise that human relation best supports human creativity and wellbeing when it is ethical. From this particular field and others, there is developing awareness of open, complex, self-organising, adaptive systems across the whole of the natural world, including that of human social organisation. The days of the currently dominant quasi-market model of social relations may be numbered in favour of an understanding of human societies as ‘not mere aggregates of selfish and competing individuals but living totalities in which the life of the whole exceeds the sum of the parts; individuals are phenomenologically embodied and embedded in culture and nature which must be seen as inextricably intertwined and co-dependent and co-evolving’ (Wheeler, 2006: 41). The human being is more a ‘thing of shreds and patches’, a multi-selved being, embodied in animal flesh, embedded in a network of continually changing relationships of different kinds, and moving and being moved in a series of responsive relationships. An ethics of love, power and justice based on my responsibility for the Other offers a framework for understanding relationship as an ethical endeavour.
The role of the tutor in this is to facilitate, point the way, constitute the ‘holding environment’, embody the steadfast, abstinent love that drives the whole undertaking. Yet the emotional impact of therapy training, like therapy itself, is impossible to prepare for, and this creates a gulf between the ‘knowing’ of the trainer and the ‘unknowing’ of the prospective trainee that fosters the inequality of power. An ethical challenge faces me as a teacher in moments where I may struggle to articulate the cause of failure in such a way as to facilitate the vital learning proposed. Clarity and transparency of criteria for the evaluation of the qualities, skills and attitudes demanded of a competent therapist must somehow be communicated and worked through in an interpersonal dialogue that succeeds in opening a door of perception, rather than emphasising a traumatic sense of failure.
An ethics of relationality, that we have described as forged out of psychotherapy training and practice, offers a template for ethical living that may contribute to a wider social discourse about how to be human.
More than a century of phenomenology, psychoanalysis, psychotherapy and counselling has initiated, almost
Wheeler W (2006). The whole creature: complexity, biosemiotics and the evolution of culture. London: Lawrence and Wishart. `
References Freire P (1972). Pedagogy of the oppressed. London: Penguin. Fromm E (1975). The art of loving. London: Penguin Goldenberg H (1997). ‘Stranger in a strange land’ [unpublished paper]. Advanced Diploma in Existential Psychotherapy, SPC. London: Regents College. Hofmeyr B (ed) (2009). Radical passivity: rethinking ethical agency in Levinas. Heidelberg: Springer. MacCallum Sullivan M and Goldenberg H (2015a). Cradling the chrysalis: teaching and learning psychotherapy. London: Karnac Books. MacCallum Sullivan M and Goldenberg H (2015b). ‘Psychotherapy, relationality and the long revolution’. In T Warnecke (ed) The psyche in the modern world. London: Karnac Books. Tillich P (1952). The courage to be. London: Collins. Tillich P (1960). Love, power and justice. Oxford: Oxford University Press.
‘Still evolving …’ Reflections on teaching relational psychotherapy An edited summary of a conversation between Shoshi Asheri, Roz Carroll, Ian Morrow and Judy Yellin
he authors explain the development of the two modules for The Minster Centre MA Integrative Training in Psychotherapy. The majority of students enter the MA programme after completing a Foundation in Counselling followed by two years of the Counselling Diploma at The Minster Centre. These modules are therefore considered third-year modules. Shoshi and Ian teach on the Clinical and Personal Integration module, while Roz and Judy teach Contemporary Theories of Psychotherapy. These modules are intended to work together organically to facilitate each individual student’s integration of their learning in the theoretical seminar with their personal and clinical learning process. Roz: ‘Relationality’ is a buzzword at the moment, but it is one of those terms that, in practice, means different things to different people. So, we start with the definition of key elements of relationality articulated
Shoshi Asheri is a psychotherapist, clinical supervisor and trainer. She teaches at The Minster Centre and is a founding member of the Relational School UK.
Ian Morrow works in private practice in west London and runs training in embodiment for therapists. www.ianmorrow.info
by Helena Hargaden and Joseph Schwartz in their editorial for the special edition of the European Journal of Psychotherapy and Counselling on relational psychotherapy (March 2007, 9(1): 3–5). They name the guiding principles as: • T he centrality of relationship • Therapy as a two-way street involving a bi-directional process • Both the vulnerability of therapist and client are involved • Countertransference is used, not merely as information but in thoughtful disclosure and collaborative dialogue • The co-construction and multiplicity of meaning. Ian and Roz: In our teaching, we draw on thinking from trauma work, the radical beginnings of humanistic psychotherapy, body psychotherapy, relational psychoanalysis, attachment theory, and existential philosophy and psychotherapy. Ian: One of the fundamental aspects of the relational, for me, is making the internal
Roz Carroll is a relational body psychotherapist, supervisor and trainer with an interest in interdisciplinary dialogue. She teaches at The Minster Centre. www.thinkbody.co.uk
Judy Yellin is an attachmentbased relational psychotherapist in private practice. She is Secretary of the Relational School UK and teaches on the relational third-year module at The Minster Centre.
process explicit, and the ‘figuring out aloud’ in the process of negotiating contact. This includes negotiation of the frame itself: how therapist and client are in a shared space together, acknowledging the therapist as a full participant, open to change and influence as much as the client … and willing to be changed. Negotiating how we occupy space with each other becomes a vehicle for the negotiation of deeper contact: form and function, content and process are not separate. This goes much farther than any idea of authenticity as it is traditionally understood. Shoshi: From this perspective, authenticity is not straightforward but built on the shifting sands of multiple self states in flux. There is reciprocal influence between client and therapist, hence the reality of the inevitability of the therapist’s subjectivity participating in the encounter has to be taken into account. These ideas are reflected closely in the way we shape the training. The content and the process become inseparable. We attempt to bring the theory that we are teaching to a lived experience, and the lived experience to theory. This is another aspect of teaching relationality: the medium of the teaching reflects the message. Judy: I think students often come to psychotherapy trainings afraid to use their own subjectivity as a tool of clinical process. They have often absorbed preconceived notions of ‘neutrality’, ‘blank screen’, a taboo on disclosures by the therapist, and so on, as axioms of psychotherapeutic practice, without necessarily knowing where and how they originated in the literature, and they can understandably feel inhibited and anxious about making fuller use of themselves in sessions with their clients. They assume they have to work out for themselves privately how much it is permissible to do so, and the paradigm shift for them is a movement towards mutual or
intersubjective exploration, and accepting that the therapeutic relationship is cocreated and, more specifically, that there may be aspects of their own process that they need to share with clients if they are going to be clinically effective. Shoshi: As soon as we introduce the notion of the ‘relational turn’ and differentiate a ‘one-person psychology’ (an expert and a patient) from a ‘two-person psychology’ (two wounded people), the students realise that their own subjectivity … Judy: ... is on the line. Shoshi: Yes. It’s on the line and, very importantly, it is highly relevant to understanding the relational dynamic. There is no escape from their contribution to the relational matrix, and then they discover that their conscious attempts at relating do not live outside their unconscious participation. Ian: This is the move away from any idea of therapist ‘neutrality’ and it can be very difficult for trainees to let go of that notion – that it is possible to be somehow ‘hygienic’. Shoshi: Yes. We attempt to unfold and legitimise the wounds and trauma that brought the trainees to choose psychotherapy as a profession in the first place. We invite them to recognise these wounds as highly relevant to the therapeutic position they are going to develop. Ian: We are supporting a movement away from saying ‘who am I as a therapist?’ towards ‘who am I in this moment with this person?’ And that’s where the concept
The training requires a very intense personal exploration – an archaeology of relational patterns and habitual internal positions of multiplicity of self-states comes in. The training requires a very intense personal exploration – an archaeology of relational patterns and habitual internal positions. Judy: Hence, in the first term of the theoretical seminar, the students do a brief version of the Adult Attachment Interview (AAI) (Hesse, 2008), interviewing each other in pairs. Each student tapes their own interview, which they can then keep for reflection and reference later on. Mary Main’s comment about the interview is that it is designed to ‘surprise the unconscious’. But students sometimes come to the AAI experience sceptical that they will learn anything new about their own histories as a result. They may not think that their ‘unconscious’ is going to be ‘surprised’, but they often discover new perspectives on narratives they thought they knew very well. There are subjective shifts that open them up to a much deeper understanding. Those understandings then have a space to come to life in a more visceral way in the Clinical and Personal Integration module. Shoshi: In the Clinical and Personal Integration module, they have an opportunity to experience the way in which their attachment style and habitual relational patterns inform and shape their therapeutic position. For example, therapist and client work in the middle in a fishbowl. It is a real live session using the students’
own material: it is not role play. The group functions as a resonating chamber for the implicit – they are learning to track the ebb and flow of the affect. They become attuned to the non-verbal communication, including the coming in and out of contact and the signs of dissociation – the client’s and/ or the therapist’s. Hence they experience the link between their attachment style, their habitual relational pattern, and their therapeutic stance in the moment. The therapist or the tutor can stop at any point to consult with the group, and the relational dilemmas the therapist is facing are discussed, with an emphasis on understanding the co-creation of the relational matrix. In other words, the clinical concepts they learn in the theory module come to life and are explored in their application theoretically, clinically and personally. It is possible to describe what we are attempting to teach as the discipline of ‘felt participation’ and moment-to-moment ‘embodied reflexivity’. Ian: Yes, I agree. I tend to work less with the goldfish bowl in my group but the emphasis is precisely on developing this moment-to-moment tracking of embodied connection and disconnection. The group becomes a constellation of the self-states of the individual and dyad, just as the therapist becomes constellated in the world of the client, and vice versa. Working with the idea
feature article It is a challenge to create a learning environment that addresses but is not overwhelmed by the demands of the culture it sits in of a multiplicity of self-states also invites a wider systems view … thinking about the therapeutic dyad as a crowd as much as a pair! This takes us further than a two-person psychology and addresses the cultural paradigm we work in, bringing history, deep democracy and radical inclusion into view. Shoshi: What I find fascinating about teaching ‘embodied relationality’ as a lived experience is that very soon it becomes evident that psychotherapeutic work can’t be separated from social/political work, and that through open engagement with our differences and our struggle to connect, the mystery of our human interconnectedness reveals itself. Roz: In the second term, in the Contemporary Theories module, we focus on intersubjectivity theory and relational psychoanalysis. Through reading and discussing articles and case material, we get to grips with concepts like enactment and its inevitability, self and mutual regulation, mutual recognition, therapeutic impasse, rupture and repair, and the ‘Third’. Paradoxical tensions are intrinsic to relational work, and to grasp this requires the capacity to manage the complexity of possibilities (of meaning, of position, of development). These are well articulated in writers such as Benjamin, Mitchell, Bromberg and Buber. The exploration and engagement in the theory module gives theoretical ground and support for the experiential work. Judy: By the end of the year, the students get an integrated and clinically useful understanding of how insecurity of attachment, especially disorganised attachment, and relational trauma are related, and the sorts of early life experiences that are likely to be involved. We teach with an emphasis on grasping the effects of splitting and dissociation as a response to human contact that is traumatising, and how they occur in the absence of a containing caregiver, family group, society and culture. The beauty of the theory is how clearly it illuminates the way in which the dissociation and
fragmentation of the self that result from adverse early attachment experiences produce the various manifestations of psychological suffering that we see in the consulting room. In fact, once the students begin to grasp this, it starts to become possible for them to see the dissociative basis for most psychological distress. The theory just makes a lot of sense, and things start to fall into place. Roz: The students come already having a basic understanding of humanistic and psychoanalytic thinking and have taken an experiential module on The Body and Psychotherapy in the second year at The Minster Centre. In the third year they have the opportunity to have a lived experience of the theory and an integration of the learning from previous years, as well as a questioning and re-examining of what they have learned so far. Some qualified and practising counsellors or therapists come to the MA through approved prior learning (APL) entry, and bring valuable differences, clinical experience and alternative perspectives. Through the rigorousness of self-inquiry and wide reading, we encourage the students to take ownership of their own thinking. One manifestation of this is in the extended clinical essay students write in the third year. There is a lot to digest from the teaching and practice as they attempt to develop their theoretical and clinical thinking and link it to their subjectivity. Another fundamental theme is that all theories, models and practices are political. We believe it is important for the psychotherapist to know something about the history of ideas and where, and from whom, they have come: to know their roots and the values associated with the relational paradigm. Ian: It is a challenge to create a learning environment that addresses but is not overwhelmed by the demands of the culture it sits in – in this case an
academic and professional context which may prize certain ways of thinking and acting over others. This way of training is set against a cultural context where short-term, protocolised, ‘measurable’ outcomes and products are often valued above human contact. We try to keep the humanity of an authentic response at the heart of the process. Relationship is at a premium these days, as is space to experiment and play. Winnicott’s 50-year-old statement still speaks truth to me – that ‘psychotherapy is done in the overlap of two play areas’. This is counter to the computerised voices and scripted responses we customarily meet in our day-to-day. Roz: And we try to honour this in the students’ development. Our focus is on trying to hold the fine balance between meeting academic requirements and acknowledging the importance of the experiential work. We want to provide the soil for setting seeds for each student to keep on developing and not burn out with the challenges of practice. We believe that working from an embodied subjectivity combined with rigorous reflexivity will support sustainable development and help maintain a broader context for the future.
References Benjamin J (1999). ‘Recognition and destruction: an outline of intersubjectivity’. In S Mitchell and L Aron (eds). Relational psychoanalysis: the emergence of a tradition. Hillsdale, NJ: Analytic Press. [Original work published 1990.] Bromberg PM (2011). The shadow of the tsunami and the growth of the relational mind. Oxon: Routledge. Buber M (1958). I and thou. (trans RG Smith). New York: Charles Scribner’s Sons. [Original work published 1937.] Hesse E (2008). ‘The adult attachment interview: protocol, method of analysis and empirical studies’. In J Cassidy and PR Shaver (eds) Handbook of attachment: theory, research, and clinical applications (2nd edn). The Guilford Press. Hargaden H and Schwartz J (2007). Editorial, European Journal of Psychotherapy and Counselling, March, 9(1): 3–5. Mitchell SL (2004). Relationality: from attachment to intersubjectivity. Analytic Press Hilsdale. Winnicott DW (1971). Playing and reality. Tavistock. A video of a 75-minute conversation between Roz and Shoshi on ‘Humanising the therapeutic relationship: the transformative power and risk of ’Felt Participation’ is available at www.confer.uk.com/modulerelational.html
Humanising psychotherapy research and training in research: intersubjectivity and beyond Psychotherapy research has the potential to be much more creative and relevant, explains Angela Cotter. Including methods that shed light on the process and speak to both hemispheres of the brain, The Minster Centre sees research as an agent of change not only a measurer of it.
he acute ward buzzed but the movement was beyond us. Jack sat in the high-backed chair by the bed. I perched on the bed itself beside another researcher. He was likely to talk in metaphor like so many people with advanced dementia. I wanted to hear about his experience of being in hospital but he turned the tables: ‘Don’t hesitate, nothing you say to me goes anywhere. Only unless you want to apply for a membership or something like this, but you want the outline, how we work it?’ Over and over I return to this quote in many contexts. In psychotherapy, I have found that the way to bring meaning to the encounter, to ensure our words go somewhere with clients, often means explicitly joining them in the common mystery and vulnerability of being human. In that place of membership, Jung’s view that therapy is mutually transformative for therapist and client becomes a reality (Jung, 1954). But this is old news in psychotherapy itself. And the good news is that research is catching up.
I have often found that the way to bring meaning to an encounter with a client means explicitly joining them in the common mystery and vulnerability of being human The heart of the research process Recent years have seen a change in psychotherapy research from an initial position where arguably the research culture adopted the thinking of the academic lifeworld rather than that of practice. It was ironic that ‘the profession concerned with personal transformation and growth was fostering a research community that was more concerned with the aims of conventional academic research, such as replication and generalisation, than with transformation’ (Lees, 2008: 5). Lees documents the resultant impact on research training whereby students focused on a research question rather than their experience, suppressed their emotions rather than focused on them, removed themselves from the research process
Dr Angela Cotter PhD, Dip Health Ed, BSc (Soc Sci), Dip Anal Psych (GAP, IAAP and UKCP) is a Jungian analyst, Head of Research at The Minster Centre, and a Visiting Lecturer at Regent’s University. For 25 years she worked in the NHS in clinical nursing, education, management and research, including on Department of Health/NHS-funded action research multi-agency projects involving older service users, carers and staff in improving acute and community services. She also has experience of involvement in policymaking at Department of Health level both as a researcher and a psychotherapist. She was awarded a certificate from UKCP (2009) for her outstanding contribution to UKCP and services to psychotherapy. She is on the UKCP Research Faculty Committee, and is or has been an OM delegate to both HIPC and CPJA. The Psychotherapist
rather than putting themselves at the heart of it, and distanced themselves from their experience rather than examined it, all quite in contrast to their clinical training. This may have been due to policy drivers like the emphasis by National Institute for Health and Care Excellence (NICE) on evidence-based care and initiatives such as Skills for Health deriving evidence-based competencies for psychotherapy and counselling. However, the then dominant argument that quantitative research, translated into standard setting, is the gold standard for excellence in care ignores the fact that there is many a slip twixt cup and lip, as is seen below.
Approaches to research In 1981, Reason and Rowan pleaded presciently for a move towards qualitative research away from quantitative research, stating that the latter produced results that were ‘statistically significant but humanly insignificant’ (Reason and Rowan, 1981: xv). The key word here is ‘humanly’. The experience of the Liverpool Care Pathway (LCP), a guideline on end-of-life care, is instructive. The independent review of the LCP (2013), called More care, less pathway and set up because of widespread concern, noted that, in the wrong hands, this quality standard on best care could be used to justify the worst, including withholding nutrition and hydration from the dying
Stories, not outcome measures, change attitudes, and research is about searching for truths and finding meaning patient. A conflict between humanity and bureaucracy, if you will, has been noted in healthcare research for many years (eg Cotter et al, 1998). Indeed, the research movement towards humanising healthcare (Galvin and Todres, 2012; Todres et al, 2009) is an attempt to bring ‘care’ back into ‘pathway’. We need outline and membership, guidelines and care, technique and relationship. But how do we humanise research? Understanding this means looking more widely at what has been happening in qualitative research in human and social sciences since the late 20th century. This in part parallels the movement from the early days of psychoanalysis to current models of relational psychotherapy. At the risk of over-simplifying, I group together several different research approaches to present a skimming overview of a wideranging and interwoven spectrum. The range of qualitative research now contains, at one end, positivist-informed research, which retains the belief in objectivity, claims authoritative knowledge and researcher neutrality. Findings are stable, apparently existing independently of social context, culture, researcher activity and interpretation. Midway along the spectrum is qualitative research, which recognises that, if objective truth exists, it is very difficult to get at; researcher interpretation
is a key, endemic and important factor in data analysis; and knowledge claims are less fixed. The research process is thus in part intersubjective. At the other pole is research that takes an explicitly committed perspective towards transformation of researcher, participants, and those who later read about the research, with an acceptance of pluralism and diversity. This includes, for example, participative forms of action research which emphasise research done with and for people rather than ‘on’ them (Reason and Bradbury, 2006) and subjective approaches including autoethnography (Short et al, 2013) that attempt to offset dominant societal grand narratives with pluralistic local ones synthesising autobiography and cultural critique. These approaches are committed, engaged and explicitly situated within the cultural, social and political context. As McLeod (2015) says about auto-ethnography and other personal experience research, doing it is a good way to learn about the limitations of interview-based qualitative research or the use of measures, because ‘it becomes pretty obvious, quite quickly, that there exist levels of awareness and knowing that are not tapped by standard approaches’ (p209).
Presentness fills time and space The limitations of standard approaches were evident to me early on as a cooperative action researcher on a project
using creative approaches to enhance communication between people with dementia and staff who work with them (Cotter et al, 2001). It was very hard to capture what happened in the room when people with advanced dementia and staff worked together on a collage about the seaside or made puppets together and put on an improvised performance. The focus on the arts activity facilitated a new way of seeing each other, as staff became aware that their clients often had skills surpassing theirs. Stern describes this in the therapeutic context: ‘as soon as a now moment arrives, all else is dropped and each partner stands with both feet in the present. Presentness fills the time and space. There is only now’ (Stern, 2004: 167). Co-researchers described this experience as ‘magic’ and mysterious: it was the coming into being of a transpersonal energetic field, experienced as transformative. The challenge was to find ways of conveying the experience evocatively, calling into being that sense of being there, so that others had the opportunity to develop an empathic understanding. This challenge has led to the use of creative and performative approaches, for example, using photographs and other visual research methods (Stanczak, 2007) and ethnographic performance (Ackroyd,
feature article 2010). Auto-ethnography, born out of the narrative turn in social and human science (Chamberlayne et al, 2000), utilises the conventions of literary writing in its search for an evocative, embodied, feelingoriented and culturally engaged form of expression (Short et al, 2013). An example is the special issue on poetic inquiry in the open access journal Creative Approaches to Research in 2012 (Galvin and Pendergast, 2012). In counselling and psychotherapy, Etherington’s work (2004) presents creative approaches as part of reflexive narratives of students’ research journeys at master’s and doctoral level. The poet May Sarton (1978: 197) speaks of the haunted spirit being charmed back to its own realm by true mysteries in the action of therapy. Romanyshyn (2007) calls back into being the soul of method through the use of an imaginal archetypal approach to research in psychotherapy. This and other creative approaches can indeed be seen as ways of bringing soul back into the picture. Following this path demands the kind of relational and reflexive approach that is part of the fabric of psychotherapeutic clinical work. In particular, Finlay and Evans (2009) explore how research can mirror and parallel the therapeutic experience, while acknowledging the differences, in their search for an embodied, co-created way. This is a humanising process.
The wounded healer It is also a path of vulnerability, since putting oneself under the microscope too is not an easy task. An example concerns an action research group with older people where I, as primary action researcher, found myself declaring that I had been a child in hospital before Bowlby and the Robertsons. One participant said so had she but she had never talked about it before. Then another said the same. I also had never talked about it publicly before. I realised then that without my self-disclosure a whole tranche of experience would have been excluded from our discussion of the wounded healer. It is these hidden narratives that the most qualitative of qualitative research seeks to uncover. And moving into that hitherto private story world is often facilitated by another sharing their experience. So how does this apply to psychotherapy research training? This has the potential to be a much more creative and relevant
process than is sometimes thought, precisely because creative methodological links can be made with clinical practice. At The Minster Centre, we use imagery to shed light on the students’ research process (Thomas, 2013). We talk about research methods that speak to both hemispheres of the brain (McGilchrist, 2010), and put creative ways of doing research on the map of possibility. There is still the tension of meeting the demands of the academy but the role of subjective methods in exploring difference and hidden perspectives is emerging. Reflexivity is an essential part of research and of clinical work. The link makes research more accessible and interesting for students. This article has taken a meandering route to its conclusion, a layered rather than linear narrative. The key point is that we need to see research as an agent of change not only a measurer of it. This year’s UKCP research conference brought together outcome, process and wellbeing in psychotherapy. The striking aspect was that elements of the above discussion were very present. Rolf Sundet spoke about outcome measures as conversational tools – how practitioner researchers integrate the use of an outcome measure into the therapeutic process. Markus Bidell, the Regent’s University Fulbright scholar, integrated his own experience of growing up gay in the USA in his keynote about turning personal experience into professional outcomes in LGBT psychotherapy. We heard during the day that stories, not outcome measures, change attitudes, and that research is about searching for truths and finding meaning. An illustrative poem I wrote at the Inaugural British Auto-ethnography Conference (2014), after an auto-ethnographic performance by two researchers, perhaps captures something of the potential of the emergent approaches to psychotherapy research and training: Presentation sensing vulnerability Moving to see how they stand so Clear frailty yet strong Not performance as I know it from the Globe Of polished actors and well-delivered phrases But moving through stillness And plain speaking Reaching through waves Of tender energy And moments of meeting.
References Ackroyd J and O’Toole J (2010). Performing research: tensions, triumphs and trade-offs of ethnodrama. Chamberlayne P, Bornat J and Wengraf T (eds) (2000). The turn towards biographical methods in social science: comparative issues and examples. London: Routledge. Cotter A, Fraser F, Langford S, Rose L and Ruddock V (2001). Getting everybody included. London: Magic Me. Cotter A, Meyer J and Roberts S (1998). ‘Humanity or bureaucracy? The transition from hospital to long-term continuing institutional care’. Nursing Times Research, July, 3(4): 247-256. Department of Health (2013). More care, less pathway: a review of the Liverpool Care Pathway. Independent review of the Liverpool Care Pathway. London: Department of Health. Etherington K (2004). Becoming a reflexive researcher: using our selves in research. London: Jessica Kingsley. Finlay L and Evans K (2009). Relational centred research for psychotherapists: exploring meanings and experience. Chichester: Wiley Blackwell. Galvin K and Prendergast M (eds) (2012). Poetic Inquiry: Special Issue. Creative Approaches to Research, November, 5(2). Galvin KT and Todres L (2012). Caring and wellbeing: a lifeworld approach. London: Routledge. Jung CG (1954). ‘The practice of psychotherapy: essays on the psychology of the transference and other subjects’. Collected works vol 16. London: Routledge & Kegan Paul. Lees J (2008). ‘A practitioner-researcher’s view of academic life, emancipation and transformation’. In J Lees and D Freshwater (eds) (2008) Practitioner-based research: power, discourse and transformation. London: Karnac, 1-17. McGilchrist I (2009). The master and his emissary: the divided brain and the making of the western world. New Haven: Yale University Press. Reason P and Rowan J (1981). Human inquiry. Chichester: Wiley. Reason P and Bradbury H (eds) (2006). Handbook of action research. London: Sage Publications. Romanyshyn RD (2007). The wounded researcher: research with soul in mind. New Orleans: Spring Journal Inc. Sarton M (1978). Selected poems of May Sarton. New York: Norton. Short NP, Turner L and Grant A (eds) (2013). Contemporary British autoethnography. Rotterdam: Sense Publishers. Stanczak GC (ed) (2007). Visual research methods: image, society and representation. London: Sage Publications. Thomas V (2014). ‘Drawing on creative reflective practices in counselling research: an example of using mental imagery to enhance researcher reflexivity’. British Journal of Counselling and Guidance, 42(1): 68-77. Todres L, Galvin K and Holloway I (2009). ‘The humanisation of healthcare: a value framework for qualitative research’. International Journal of Qualitative Studies on Health and Well-being, 4(2): 68-77.
feature article Book review Leon Redler
Cradling the Chrysalis: Teaching and Learning Psychotherapy by Mary MacCallum Sullivan and Harriett Goldenberg £17.94; ISBN-13: 978-1-78220-149-6 Published by UKCP, Karnac series (first edition published in 2003 by Continuum)
his revised edition of Cradling the Chrysalis includes an introductory authorial note. In the 12 years since the first edition, the authors say, ‘we have developed a stronger sense that psychotherapy is as an analogy for the practice of living, an ethical endeavour’ (xviii). This sets a down-toearth and ethical tone for this seriously good and very accessible book. It is ‘not a ‘how to’ manual: “We seek to honour the uncertainty, complexity, and the sheer un-knowing of an open process’ (xviii). The teaching and learning of the practice of psychotherapy is approached with refreshing openness regarding the vulnerabilities and responsibilities of all concerned in the recommended (and modelled by the authors) dialogic colearning/teaching of this craft. Their respect for students and the learning process is palpable and vital. The profound responsibility in teaching/learning is, first and foremost, that of the designated teacher, an open-hearted responsibility to ‘let learn’ and grow implicit in the title, Cradling the Chrysalis, but also the wisdom,
Leon Redler is a Psychodynamic, Existential, Ethical-Deconstructive Psychotherapist; member of UKCP via The Philadelphia Association.
kindness and courage to assess and relate to those judged unable to effect the necessary transformation, having already passed the selection process for training. The challenges of the training group situation, where students are asked to reveal themselves, their vulnerabilities and mistakes, while being judged and assessed by tutors as well as fellow students, is carefully considered. How the necessary trust for that endeavour might have its best chance of flourishing is an implicit question. The ‘contradictions and dilemmas of training institutions’ are discussed as part of the frame of teaching/learning. The ‘motivations, intentions, and indeed the emotional and behavioural patterns of those who are members of the institution’ (79) are key to the environment shaping learning. The quality and effectiveness of teaching/learning could, I think, often benefit from greater openness regarding these matters ‘Ultimately the project has been as excellent an adventure as is teaching, as is each meeting in the consulting room’ (xiv). The authority and pleasure of Cradling the Chrysalis is enhanced by the liveliness, integrity and passion of the collaborators. I have a few critical comments relating to the authors’ references to the writing of Emmanuel Levinas. Given the importance to the authors of Levinasian ‘responsibility
for the Other’, a discussion of its profound meaning as ‘responsibility for the Other, even for the Other’s responsibility’, would have been valuable, especially as so evidently related to their profoundly ethical approach to teaching/learning and to their concern for all those the student will come to be responsible for. A discussion of Levinasian subjectivity*1 would also have been helpful and served to raise a question about the concept of ‘autonomy’, which the authors, like most of us, may use too uncritically. But, then again, such discussions may have disrupted the flowing, dialogic, down-to-earth and accessible qualities of a book I heartily recommend to all concerned! See also L Redler (2000). ‘Open, Empty and Other’. Contemporary Buddhism, 1(1). London. Cradling the Chrysalis is also available on the UKCP Karnac book series at http://bit.ly/1KPqHwi
1 ‘For Levinas, my very subjectivity is a function of my being subjected to the obligation to respond to face of the Other, respond with something like a ‘Here I am, here for you’. ‘I’ am she or he who responds to the Other’s calling me and calling on me. I am who I am in being responsible for the Other. In this matter, as Levinas derives ethics as first philosophy, I am irreplaceable. Nobody else can relieve me of my responsibility’ (L Redler. ‘We all go astray, 2nd movement’. Radical Psychology, 7(2) [online].
The role of UKCP in setting and maintaining education and training standards Fiona Biddle and Sarah Collings explain the role of UKCP’s Education, Training and Practice Committee in setting standards for psychotherapy education and training
hen UKCP was founded, after the UK Standing Conference for Psychotherapy had served its purpose, it had the lofty idea of making psychotherapy a statutorily regulated profession. I say lofty as UKCP, for the first time in the annals of psychotherapy, represented some 70 different organisations from many different modalities. In order to speak with one voice about professional standards, the first most important task was for UKCP to get to grips with the myriad training requirements and standards operating at that time. I have spoken to those who remember those early years, and they are almost unanimous in their admiration for UKCP and its people, who managed to develop a set of universally accepted standards for the field when many thought it was a fool’s errand. Things have changed, and so have our objectives when it comes to statutory
Fiona Biddle is a UKCPaccredited psychotherapist from the College of HypnoPsychotherapists. She holds a master’s degree in existential psychotherapy and is a qualified educator. Fiona is Chair of the UKCP Education, Training and Practice Committee and has previously been a college chair (hence a member of the Professional Regulatory Committee of Colleges and Faculties) and a trustee.
UKCP is and must remain the guarantor of good professional practice in psychotherapy, with protection of the public at the forefront of all we do regulation in some respects. One thing has not changed however: UKCP is and must remain the guarantor of good professional practice in psychotherapy, with protection of the public at the forefront of all we do. A key part of ensuring this is to make sure that all UKCP-accredited psychotherapists are trained to the very highest standards set out in our standards of education and training (SETs). In this article, I will set out what these standards entail and offer some reflections on the complexities that are inevitably part of the process.
The regulatory framework In 2011, the coalition government pulled the plug on statutory regulation for psychotherapy and instead set up a system
Sarah Collings MA, MPhil is a COSRTaccredited psychosexual psychotherapist and a member of the Executive Committee of CSRP which she represents on ETPC. She is also an accredited psychotherapist with UKAHPP (UKCP reg) and Chair of the Membership and Accreditation Committee. Sarah works in private practice as a therapist and supervisor, and supervises couple counsellors and psychosexual therapists at the West London Centre for Counselling.
for voluntary self-regulation. The body that took this on was called the Council for Healthcare Regulatory Excellence. CHRE changed its name to the Professional Standards Authority (PSA), which set up an accredited register (AR) for occupations not regulated by government statute. PSA is dedicated to what it terms ‘right-touch regulation’ in its mission to protect the public (patients and service users) from risk by ensuring that health and care practitioners are competent and safe. It is not involved in standards of training per se, but delivery of these must match the ethical standards required by the complaints process of any of the organisations on the AR. The National Counselling Society and BACP were the first talking therapy organisations to be accredited by PSA. Both had the advantage of being a single unit with a single code of ethics and complaints procedure. UKCP had the unenviable task of implementing a Central Complaints Process for members of all its 11 colleges and creating systems for all organisational members (OMs), some not exclusively comprising UKCP registered members. However, our Board of Trustees decided to apply for accreditation to give credibility to members. The process was extremely rigorous and meant that we not only needed to make some changes to our regulatory framework but also ensure a clear differential between how standards were set and how they were maintained. While the Ethics Committee sets our ethical
feature article code, the Education, Training and Practice Committee (ETPC) sets our standards and the Professional Regulatory Committee of Colleges and Faculties has responsibility for maintenance, including the quinquennial review (QR) of all OMs. QR is the process whereby it is ensured that OMs meet their obligations, including implementing changes to UKCP governance and maintaining their own standards of Ethics and Practice. ETPC has an appointed chair and two representatives from each college, one usually the chair of the college’s training standards committee. We have two representatives from each faculty, two from the Diversity, Equalities and Social Responsibility Committee, and the UKCP registrar is also a member of the committee. All policies and procedures are subject to full consultation and are ultimately the
responsibility of the Board of Trustees. Training organisations commit to meeting the standards set by the ETPC and their college-specific standards.
Standards of education and training ETPC creates the generic SETs to which all training organisations must adhere. These are rigorous but allow flexibility for modalities and for each training organisation to fulfil them in their own way. There are SETs for adult work and child work, for both psychotherapy and psychotherapeutic counselling, and for supervision trainings. The current adult psychotherapy SETs, adopted in 2012, have recently been reviewed and are out for consultation. The child psychotherapy and supervision SETs are due for review next year. SETs for the child marker – those working with children or adolescents but
not to child psychotherapist level – are in the process of being implemented. When a policy or procedure is reviewed, the committee discusses each element in turn, making amendments, adding new ideas and clarifying anything that has proved to be unclear. It then creates an updated draft, which is sent out for consultation to all stakeholders. Feedback is collated and considered and the committee then produces a new version of the document. As an example of how the committee works, let’s look at an issue that arose when the College for Sexual and Relationship Psychotherapy (CSRP) was formed in 2013. This set a challenge for ETPC around how CSRP would meet UKCP psychotherapy SETs. Psychosexual therapy is a specialism, with many psychosexual therapists coming from a background in medicine, nursing or
Generic SETs are rigorous but allow flexibility for modalities and for each training organisation to fulfil them in their own way
Generic standards The elements covered by the generic adult psychotherapy SETs are: • General: areas such as level of training (postgraduate/master’s level) and length (normally not less than four years), and requirements for a code of ethics, etc • Entry requirements • Diversity and equality: how training organisations need to address these issues in terms of their recruitment of, and relationship with, their students, trainees and staff • Minimum curriculum • Theory and practice • Research • Diversity and equality in training: ensuring students and trainees understand these issues for their work as psychotherapists • Safeguarding in training: ensuring students and trainees understand safeguarding requirements in practice • Mental health familiarisation • Ethics • Human development and sexuality • Social science • Self-reflective process: see below for college differences • Security and confidentiality: a new element added owing to complexities associated with technology • Supervised practice • Safeguarding • Trainee handbook • Staffing and resources • Assessment • Qualification and registration • Continued professional development (CPD) • Specific training: requirements of specific SETs where applicable; ensuring training organisations are clear about what their training qualifies their students to do.
College differences The elements covered by the collegespecific SETs are: • Additional entry requirements: for example, CPJA requires a year of psychotherapy before starting training • Structure of training: for example, hours per year • Nature of the self-reflective process: one of the main areas of difference between colleges; all require a process but the ‘how’ varies • APL/APEL requirements • Client contact hours required • Supervision requirements: ratio, for example • Nature of research training • Nature of external assessment • How the mental health familiarisation component is to be completed.
social work. CSRP prefers students to have completed a piece of research using case study methodology. If this is not done in training, a 10,000 to 12,000-word dissertation has to be written, which may be a piece of original research, a case study with literature search and research element, or a dissertation on a relevant topic. CSRP currently has only one OM, the confusingly named College of Sexual and Relationship Therapy (COSRT), so the process of setting standards involved a three-way dialogue between CSRP, COSRT and ETPC over a period of 12 or so months. The need to be open to change and dialogue is a constant in ETPC, where willingness to listen remains a priority among people from some very contrasting modalities. Of course, there are occasions where there are differences of opinion, but the ethos of UKCP being open to differences in approach usually makes these fairly easy to resolve to the satisfaction of all. An example of ETPCâ€™s work can be seen in how we are addressing the research element of training. We are currently debating whether assessment must include a significant research-based or a researchinformed project. Different modalities have
UKCP is unusual in that we regard the different views in our profession as being a positive different opinions. All agree that we need to develop a strong understanding of research but are not united on how this should be demonstrated. The consultation process will add to the debate and we will then decide which way to go.
Importance of collaborative procedures to ensure high standards UKCP is a democratic membership organisation where the views of all are considered equal. We are, however, unusual in that we regard the different views in our profession as being a positive. One important objective in our articles of association is â€˜to encourage the exchange and understanding of the different theories and practices within psychotherapyâ€™. It is therefore particularly important to encourage everyone to speak up and be heard. We have a wide range of expertise within our membership, not just in relation to psychotherapy, and we do best when we are open to this.
In conclusion, if psychotherapy and indeed UKCP are to mature into a respected profession in which the public and other professions can have confidence, we need to continue to advance the cause of good education and training. We owe this to our clients, and to the students who place their trust in training with a UKCP-accredited organisational member.
If these issues interest you, please look out for consultations and take part. Each college has two representatives on ETPC, so talk to your college training standards chair to see whether there is a vacancy. We are interested in views from all. Whether you are a trainer, trainee, experienced or brand new, from whichever modality, all views are just as important, so please share them!
Developing doctoral-level training that responds to the unique requirements of therapy professionals The Metanoia DPsych is a unique doctoral-level programme run by Metanoia Institute in collaboration with Middlesex University. Professor Simon du Plock, Dr Sofie Bager-Charleson, Dr Ruth Caleb, Dr Stephen Goss and Dr Isha McKenzieMavinga illustrate its value in advancing the field of psychotherapy
owards the end of the 1990s it became clear that there was a significant gap in the training field, i.e. conventional PhDs were not best suited to psychotherapists, who wanted to harness the extensive skills they had developed through their years of practice in order to make distinctive contributions to the world of therapy. This prompted a collaboration between Professor Derek Portwood from the WorkBased Training Unit at Middlesex University and the Metanoia Institute that resulted in a unique doctoral programme bridging the gap between research and practice. In this article, we describe the ethos and structure of the DPsych and present two examples of the research produced by candidates. Both examples have been chosen to illustrate the pragmatic utility of the type of research fostered by the DPsych programme.
Ethos and structure of the programme Candidates begin their doctoral journey on the DPsych by undertaking a detailed, carefully facilitated reflexive examination of
their existing knowledge and skills before moving on to explore the appropriateness of different forms of qualitative and quantitative practice-based research. They then each create a proposal for their individual research and development project, which, once approved, they pursue with in-depth support from programme tutors and appropriately qualified ‘experts’ in their chosen field. Each candidate identifies and refines their own focus – and the products they will develop – for themselves. Mid-career and senior professionals often have highly tuned skills developed in, and thus directly applicable to, their workplace. Such insights, combined with high levels of personal commitment to their work typical of our profession, often make them well suited to this way of setting about the task of advancing their specific field. Our ethos combines a commitment to maximising the opportunities afforded by work-based ‘insider’ research (Barber, 2006; Costley, Elliott and Gibbs, 2010) and a spirit of social and professional entrepreneurialism (du Plock and Barber, 2008; Goss and du Plock, 2015). This is distinct from, say, business or financially oriented
Professor Simon du Plock is Faculty Head, Faculty of Applied Research and Clinical Practice, and Programme Leader of the Metanoia Institute DPsych Programme.
Dr Sofie BagerCharleson is a module leader and academic adviser on the Metanoia Institute DPsych Programme.
entrepreneurialism, referring to the process of adding value to one’s profession, society and career rather than simply to one’s bank balance (Bourdieu and Wacquant, 1992). Among counselling and psychotherapy practitioners, this often means the things that are valued by a given clientele, or emotional and social wellbeing, or political, social or professional impact on a wider scale, as can be seen in the examples that follow.
Situated research Many of our well-established candidates will have already completed research at Master’s level, others have set up agencies or training courses, and many have published in their fields. This often entails a (not yet formally recognised) research attitude, which the DPsych programme values. Significant for work-based research is, as Costley et al (2010) put it, the importance of ‘making explicit knowledge that is often taken for granted or tacit’ (p160). Work-based research is characterised by its ‘situatedness’, which requires attention to the ‘interplay between the researcher as a person, the particular set of circumstances which the researcher is positioned in and the overall context’ (Costley, 2010: 1).
Dr Ruth Caleb is Head of Counselling at Brunel University, London and an academic adviser on the Metanoia Institute DPsych Programme.
feature article Dialogues and collaboration The programme is designed to encourage collaboration. The research relationship is typically one ‘between equals’ (Robson, 2002: 11), and negotiation and a genuine exchange of ideas are an important part of the process. Focus groups, cooperative enquiry as well as collegial groups complement introspection as a means of reflexivity (Finlay et al, 2003; Bager-Charleson, 2014). Rupert King, a current candidate, illustrates the value of feedback and support of others on the programme: The discussions with colleagues accelerated and clarified my ideas more effectively than time spent in solitary introspection, which for me can easily turn into rumination ... I found talking in the group helped reconcile ... creativity and analytical thinking. It was a space for acceptance, enthusiasm and encouragement. Yet at the same time the dialogue tested the robustness of my thinking and brought the necessary academic discipline and rigour to my project.
Completed research The following examples give some idea of the diversity and direct applicability to practice that our programme offers. Dr Ruth Caleb: An inquiry into the role of the university counselling service – towards a collaborative model of institutional support Ruth’s doctoral journey (Caleb, in press) took her from leaving higher education to those who had been told from the start that they were right for it to a point where her work actually challenged the ivory tower of academic research itself. Her starting point was even partially anti-research, having assumed that the abstruse and theoretical would inevitably have to take precedence over the practical and useful – which, on this programme at least, was quite the opposite of the case. She also challenged the image of the isolated doctoral student working under the direction of aloof senior academicians
along narrowly defined lines and worked in close, creative collaboration with a joint doctoral candidate. Her departure for the ‘new world of practitioner-research’ (Caleb, in press) necessitated a broad methodological approach, entirely congruent with the pluralism of counselling and psychotherapy as a field (Goss and Mearns, 1997) and the diverse experiences of students in higher education who were her focus. Her work led to the development not of a dry thesis to sit dustily, if magnificently, on the shelves of a university library but to a final project that included a film of mental health issues experienced by university students and a series of filmed case studies for staff training, in addition to the kinds of publications more traditionally assumed to be the mechanisms for advancing the profession. Along the way, Ruth and her colleague also developed a new model to increase emotional intelligence in universities and so foster prevention and mental wellbeing training module for staff, as well as support for mental health problems among students. In so doing, they discovered a creativity – which they referred to as ‘the third eye’, evolving into originality and inspiration – that made it possible to escape the prison walls of routine, traditional academia. Dr Isha McKenzie-Mavinga: Understanding black issues in the therapeutic process Isha investigated the experience of black and Asian counselling trainees (McKenzieMavinga, in press). Her heuristic approach (Moustakas, 1990) allowed her to incorporate her own experience and use the privileged insight of an ‘insider-researcher’ (Brannick and Coghlan, 2007; Humphrey, 2013) to strong advantage. She created a deliberately inclusive approach that could cross cultural barriers and step beyond the eurocentric
perspective that permeated both her own context and her topic of study. Her investigations corroborated the view that black experience was a largely silenced (McKenzie-Mavinga, 2009) missing element in counselling training, even though everyone involved expressed a desire for that to change. Subtle biases that were powerful, and occasionally institutionalised, operated to stifle discussion of the experience of race, despite the best intentions of trainers. Isha explored this experience among her peers and directly with trainees, and poignantly highlights the isolating effects for many black counsellors, especially in the early stages of their careers. This was compounded by the sense of white trainees (and trainers) that they were unqualified to raise the matter themselves, leaving a role of ‘black expert’ to be filled by black trainees themselves, even though they were, by definition, supposed to be the recipients of training not its providers. Isha’s research led to workshops and training materials as well as a book and a whole series of other publications. Importantly, by engaging in the very act of increasing discussion of the subject, she was able to create new opportunities to break the harmful and universally unwanted cycle. Isha describes the process of the research as having similarities with the phases of a therapeutic relationship, being similarly reparative, involving deliberately created environments where a feeling of personal emotional safety and free expression could flourish, even when some participants might feel that the most important things they could say might not reflect well on themselves, and in which everyone’s unique experience could be valued and actively nurtured. Her work was far removed from the kinds of research that treat people as objects to be measured and shows the very human connections and vulnerabilities that advancing the profession sensitively can both require and thrive on.
Dr Stephen Goss is Principal Lecturer in Psychotherapy on the Metanoia Institute DPsych Programme and Co-Editor (Counselling) of the British Journal of Guidance and Counselling.
Dr Isha McKenzieMavinga is an alumni of the DPsych programme and is a psychotherapist specialising in transcultural counseling.
We hope that these examples, though very brief, show how a creative collaboration between HE and the independent sector has resulted in a unique and valuable contribution to the psychotherapy training field. The Metanoia DPsych programme demonstrates that it is possible to advance the field of psychotherapy without compromising its values.
feature article Acknowledgement Parts of this paper originally appeared in a poster presentation given at the BACP Research Conference in 2015: Goss SP (2015). ‘Making research matter for mid-career practitioners’. BACP Research Conference. 15 May. Nottingham, UK.
References Bager-Charleson S (2014). Doing practice-based research in therapy – a reflexive approach. London: Sage. Barber B (2006). Becoming a practitioner researcher: a gestalt approach to holistic inquiry. London: Middlesex University Press. Bourdieu P and Wacquant LJD (1992). An introduction to reflexive sociology. Cambridge: Polity Press. Brannick T and Coghlan D (2007). ‘In defence of being “native”: the case for insider academic research’. Organizational Research Methods, 10(1): 59-74. Caleb R (in press). ‘Challenging the ivory tower’. In SP Goss and C Stevens (eds) Making research matter. London: Routledge. Costley C, Elliott G and Gibbs P (2010). Doing work-based research: approaches to enquiry for insider-researchers. London: Sage. Doncaster K (2000). ‘Recognising and accrediting learning and the development of reflective thinking’. In D Portwood and C Costley (eds) Work-based learning and the university: new perspectives and practices. Seda Paper 109. London: Middlesex University Press, 51-59. du Plock S and Barber P (2008). ‘Facilitating highachievers to tell their stories of professional entrepreneurialism: lessons from the doctorate in psychotherapy by public works’. In D Young and J Garnett (eds) Work-based learning futures. Bolton: University Vocational Awards Council. du Plock S and Barber P (in press). Facilitating high-achievers to tell their stories of professional entrepreneurialism. In SP Goss and C Stevens (eds) Making research matter. London: Routledge. Goss SP and du Plock S (2015). Capitalising on practitioner social-entrepreneurialism in developing the profession. Workshop at the British Association for Counselling and Psychotherapy Practitioner Conference. Leeds. 24 April 2015. Goss SP and Mearns D (1997). A call for a pluralist epistemological understanding in the assessment and evaluation of counseling. British Journal of Guidance & Counselling, 25(2): 189-198. Finlay L and Gough B (2003). Reflexivity: a practical guide for researchers in health and social sciences. Oxford: Blackwell Humphrey C (2013). ‘Dilemmas in doing insider research in professional education’. Qualitative Social Work, 12(5): 572-586. Mckenzie-Mavinga I (2009). Black issues in the therapeutic process. Basingstoke: Palgrave Macmillan. Mckenzie-Mavinga I (in press). ‘Black issues in the therapeutic process’. In SP Goss and C Stevens (eds) Making research matter. London: Routledge. Moustakas C (1990). Heuristic research. London: Sage.
Rising to the challenge of developing the profession Using her experience of developing an MA for qualified practitioners at The Minster Centre, Lissie Wright discusses the potential for the independent sector to take a more active role in advancing the profession of psychotherapy
want to start this discussion on a provocative note by considering the concept of ‘career’ – not a word often heard in psychotherapeutic circles. I have chosen it, deliberately, as a way of challenging our thinking about training, particularly post-qualification training, in our profession. Why does this term seem to sit uncomfortably alongside ‘psychotherapist’ and ‘counsellor’? For me, I think about being a psychotherapist rather than it being something I do, or my job. Is the concept of career or career development one we even recognise, let alone pay attention to in terms of training, or do we prefer to stay with ideas of seniority and experience, or professional wisdom? Is our collective resistance to these concepts – ones that are accepted as fundamental in other allied professions – holding us back?
An underdeveloped field I have always been discomforted by a tendency amongst psychotherapists to want to define levels of expertise in terms of how long someone has practised. I do understand that depth of understanding
and advanced skill comes with experience but time served is no guarantee of capability. There are competencies and skills we can learn and assess in other ways, as we do in our initial training. In the field we do, of course, support continuing professional development (CPD) but in some ways postqualification training seems to me to be an underdeveloped field. While not wanting to dismiss the concepts of experience and wisdom or to abandon an open and flexible approach to CPD, could it be that we do a disservice to our profession by not investing more in the idea of career development and progression or, more specifically, in the training that would support it? As a profession, how do we support therapists wanting to develop their psychotherapy careers through taking on supervisory, training, management or leadership roles or undertaking a deep and extensive review of their therapeutic practice? The idea of developing some rigorous post-qualification training courses crystallised for me when, some time ago, I heard a colleague at a conference say she had recently been asked to run a counselling service and, although she was confident about the clinical aspects
Lissie Wright is a Director at The Minster Centre, one of the longest established integrative psychotherapy and counselling training organisations in the UK. She has taught at the Centre for most of the past ten years and is also a practising psychotherapist. She previously worked in a series of management and research roles in the pubic sector.
feature article of this role, she felt underprepared for the management requirements and was having difficulty finding training or support which addressed the mix of skills she felt she needed to develop. This resonated with my experience of ongoing discussions at The Minster Centre, and elsewhere, about the very particular challenges managing psychotherapy and counselling services can throw up. Senior staff in these roles are likely to be juggling a combination of responsibilities, including providing a good and clinically safe service to clients, responsibilities to staff working with difficult emotional material that can include trauma and abuse, and responsibilities for practical organisational issues such as premises, finances, fundraising, health and safety. Clinical services, particularly those dealing with trauma and abuse, can also be vulnerable to powerful parallel processes. Many of the same things could be said for psychotherapy and counselling training and membership organisations. At the top of these organisations there is a requirement for a skilled blend of clinical, supervisory and management knowledge, understanding and competencies. Staff holding these roles need to be robust, confident and know how to access information and professional support for themselves and their organisations.
Enhancing skills outside the therapy room Drawing on these observations, and engaging in discussions about the employability of our graduates with university colleagues and past, current and prospective students led me to reflect on the career paths open to therapists post-qualification, and particularly the options available to qualified and practising therapists to undertake formal training to enhance the range of skills they offer outside the therapy room. I began to wonder what we were doing as a profession to support colleagues to develop the particular mixture of skills and knowledge needed to lead and develop the profession in future. There is, of course, a requirement for ongoing CPD and many short and longer courses are available which help therapists extend or deepen their therapeutic work. However, in the main, there are few standards laid out for these courses and it is hard for people to compare courses and levels of qualification, or for courses
Why does the term ‘career’ seem to sit uncomfortably alongside ‘psychotherapist’ and ‘counsellor’? to assess their own standards. In recent years work has begun to set out standards for supervision training and this has led to more and more comprehensive, supervision courses being developed. Professional doctorates are a relatively recent development in the field and offer the possibility of studying at the highest academic level and undertaking significant research. It is also possible, of course, to undertake separate professional training directly in areas such as management, finance or teaching.
University validation I began to wonder if there was a place for more applied qualifications at master’s or postgraduate diploma level that would support the development and career progression of psychotherapists and counsellors from all modalities. And with this thought, a seed was planted that, after a complex and challenging process, has grown into a new suite of MA courses validated by Middlesex University, with whom we have a longstanding partnership. These new courses, which come under the title MA Professional Practice, have
been specifically designed for qualified and practising therapists (both counsellors and psychotherapists). The intention is to provide a range of subject options that will support established practitioners in acquiring the specialist knowledge and developing the advanced skills needed to develop their careers and perform confidently in complex clinical, supervisory and management roles. Initially, we have validated courses in supervision, advanced clinical practice and managing clinical services. If these are successful, we hope to extend the options. We wanted the training we offered to push forward the development of the profession by offering, as in other professions, post-qualification training that advances practitioners’ competencies in key fields against high standards that can be articulated, externally evaluated and maintained. We also wanted to support the development of research skills and interests in these aspects of our profession. One of the most challenging aspects of this project arose out of our decision to seek some form of external validation or
feature article accreditation as a way of supporting the standard of the training. In this case, we decided to seek validation with our partners at Middlesex University who already validate our psychotherapy qualification training as an MA. External validation is not a simple undertaking and it involves various potential compromises or adaptations that are not necessarily beneficial.
A careful balancing act Validation or accreditation, by definition, requires a training institution to subject itself to external scrutiny and to demonstrate that it meets externally agreed criteria that students can see. The Minster Centre has run courses accredited or validated by UKCP, BACP and Middlesex University for many years and has benefited from the input of these bodies. Nevertheless, this has come with its difficulties and requires a careful balancing act. At best, external accreditation and validation can bring high standards and evaluation: opportunities to learn from best practice and collaborate with talented colleagues from different fields; a rigorous, outside perspective that has the potential to challenge settled assumptions, preventing cosy, self-congratulatory or even damaging cultures that can develop within a psychotherapeutic training institution just as easily as they can in any other institution. At worst, they can bring a defensive, riskaverse approach to training, their own unchallenged assumptions and cultures that may be at odds with the philosophy of some aspects of psychotherapeutic training, and a mass of paperwork that can divert energy away from the training of outstanding practitioners. The downsides can reflect a wider trend in society to move towards tick-box processes in which subtleties and relationship can be lost and innovation stifled. At worst, these difficulties can lead to a danger of splitting, where all the irritations of the validation process and the problems inherent in managing the complexities of assessment and communication can be projected out onto the external body, resulting in a view summarised by ‘why is [accrediting body] making us do this? They are rigid, they don’t understand, etc, etc’. When this happens, the commonalities can get lost. We can fail to see, for instance, that universities are striving, just like therapy trainings, to find ways to balance fairness and rigour with capturing the subtleties
of assessing creativity, clinical skills and human qualities like compassion – whether in midwifery or art. There is scope to learn from the work of other disciplines and, perhaps, opportunities for psychotherapists and counsellors to share their insights and practices to influence the field. At a recent staff conference at Middlesex University, I was interested to learn that one finding from a recent report on assessment feedback (Price et al, 2015) was that some students were seeking more ‘relational’ feedback, forming part of an ongoing conversation with them as individuals. This finding runs counter to many of the technical initiatives, such as anonymised marking, in the HE sector to make assessment and feedback objective. The same report also speaks about recognising and developing students’ resilience and capacity for self-evaluation. In this context I found myself able to discuss with university colleagues how we talk directly to our students about their emotional reactions to learning and assessment.
Integration of learning One particular area of difficulty can arise with the modular structure used in HE. Modules have the advantage of breaking down a course into identifiable sections, each with their own learning outcomes and assessment tasks. They can however be at odds with a training that, in its later stages, is seeking to develop integration across the learning on a course. We have found ourselves wanting to assess across modules – a desire which is at odds with the concept of a module as a self-contained element. This is an area we continue to struggle with. We also need to reflect on whether, by seeking university validation or the requirement to meet certain standards, we are in danger of increasing the barriers to training in terms of cost and entry requirements. If these courses are off-putting to those without traditional academic backgrounds then we are in danger of perpetuating the lack of diversity in the profession. We need to consider how we address this issue. In my view, while supporting identifiable standards and external scrutiny, we also need to pay attention to ensuring and supporting a diversity of courses (at different levels) and a diversity of providers, and to taking specific initiatives such as bursary schemes to tackle barriers to entry head on. The Minster Centre has just launched a bursary
scheme to support applications to our foundation and professional qualifying courses from students who could not otherwise afford training. Furthermore, in pursuing excellence, we need to pay attention to staying close to the core skills and values that underpin our work rather than becoming caught up in intellectual assumptions and academic expectations to the detriment of qualities such as compassion and empathy.
An artificial separation This last point leads me to mention the wider cultural issues that surround education and social status. I believe as a society we tend to artificially separate different aspects of learning. We privilege intellectual thinking over the acquisition and practice of skills, analysis (breaking down) over synthesis (combination or integration), and objectivity over relationship. These cultural norms can be reflected in our own assumptions, so that we too begin to act in training as if we value theory, critique and academic convention more than creativity, humanity, selfawareness and interpersonal skills. When we apply these assumptions and values to professions such as psychotherapy, and to medicine and nursing, which require skills and capacities across a wide range of knowledge-based, self-awareness and interpersonal skills, we can overemphasise the intellectual to the detriment of the profession, its practitioners and their clients or patients. Despite the tensions and challenges discussed here, the independent sector has a great deal to offer that could contribute to moving our profession forward. It has the capacity to hold onto the core values of psychotherapy and, at the same time, work in partnership with academic institutions that provide qualification frameworks. This partnership, if managed effectively and creatively, has the potential to support routes to career progression and professional specialisation and, in a small way, even influence thinking in higher education.
References Price M, O’Donovan B and Lloyd A (2015). Domains influencing student perceptions of feedback. Final report of the ‘What makes good feedback good?’ HEA TDG collaborative project. Available at: www. brookes.ac.uk/aske/documents/Domains%20 Influencing%20Student%20Perceptions%20 of%20Feedback.pdf
Being the self I truly am: congruence and the era of manualised therapies While acknowledging the need for a strong evidence base, Deborah Short considers the survival of counselling’s artistry, spirituality and non-manualisable dimensions essential Perhaps psychotherapists have been asked to tackle an impossible task: the care of the soul or psyche without reference to the spiritual aspects of being. (Lannert, 1991)
n an era when working in the NHS involves having increasingly to justify my existence using language and concepts that have little to do with who I actually am or what I actually do as a counsellor, I felt drawn to write something on congruence. I don’t see a useful distinction between the terms counselling, therapy and psychotherapy, so I use the terms interchangeably in this writing.
Innate human capacities I have worked in the NHS for around 16 years now and have seen many changes to the way that counselling and other psychological therapies are structured and managed. During this time, I have endeavoured to protect my humanistic position of trusting to the innate, ennobling human capacities for growth, creative adjustment and enlightened free will. The stance of deep commitment to these values can sometimes feel like occupying the uncomfortable position within the
The emergent culture tends to grossly over-simplify human distress, reducing this complexity to something that can be cured by a course of treatment in a neat and orderly way organisation of something akin to defector. This arises from the very real tension that exists between the intimacy of the therapy relationship and the aspects of NHS life that are laden with officialdom, cold empiricism and political ideology. However, thanks to good supervision, invaluable years of personal therapy, some fine colleagues, the strength of my own convictions and the clients who continue to inspire me deeply, I feel I have managed to do this sufficiently.
IAPT and CBT The latest change for many of us has been the Improving Access to Psychological Therapies (IAPT) programme. IAPT is the first ever provision of talking therapies, mainly CBT, on a mass scale to be provided by a government for the treatment of anxiety and depression (Evans, 2013). The IAPT concept is said to have grown out of a chance conversation that took place in 2003 between Labour economist Professor
Lord Richard Layard and Oxford Professor of Psychology David Clark. Layard has worked for many years on ‘happiness economics’, which underpins his argument that economic security is more likely to be achieved through the government caring for the happiness and mental health of the population. Clark’s background has involved developing evidence-based cognitive treatments and research on ways of making these more readily available to greater numbers of people experiencing anxiety-related problems. Clark and Layard went on to construct an extremely influential economic argument for the British government to significantly increase its investment in evidence-based, NICErecommended talking therapies, that is to say, CBT. In 2005 their recommendations were accepted by the Labour government and were rolled out under David Clark’s direction.
The statutory world
Deborah Short is a UKCP-registered psychotherapist and supervisor who enjoys working in private practice, employee assistance and an IAPT service. Deborah lives and works in Derbyshire. Contact her at email@example.com or through www.deborahshortquesttherapies.co.uk
This initiative had the potential to be devastating for counsellors of a non-CBT orientation in the UK, particularly those of us working within the NHS. However, thanks to the foresight of key members of the academic counselling community and growing awareness among practitioners of the need to provide an evidence base, IAPT became a golden opportunity for
discussion counselling in the statutory world. The IAPT‘compliant’ CfD (Counselling for Depression) approach very cleverly put counselling and humanistic therapy on the NHS map at a time when the threat of becoming entirely marginalised was very real. CfD is a manualised form of psychotherapy based on an integration of person-centred and emotion-focused models. The ‘treatment’ is recommended by NICE for mild to moderate depression.
to have colleagues who, like me, grew up professionally in times when it was easier to see our work as a vocation, an art and as a whole approach to life. It is contact with these colleagues that supports me to maintain my core philosophy of counselling as a living thing: an evolving, changing expression of my values, learning and lived experience. This enables me to be congruent in my practice and, for me, is the foundation of ethical and effective practice.
The self one truly is
Despite being appreciative of having gained a validated position, many of us might still feel marginalised given the growing proliferation of non-counselling/ non-humanistic approaches and the resulting division that exists within IAPT services. The schism seems to be based around the emergent culture that tends to grossly over-simplify human distress, reducing this complexity to something that can be cured by a course of treatment in a neat and orderly way (Lewis, 2012). One disappointing consequence is what Donald Robinson describes as the ‘industrialisation of psychotherapy’, where the work of psychotherapist is reduced to a ‘job,’ rather than a vocation that involves the whole self of the therapist (2010). It is worth mentioning that Donald Robinson is a cognitive behavioural therapist, as this suggests that division within IAPT services is not actually about modality per se, but more to do with whether or not any modality is informed by a solid underlying philosophy.
This brings me back to the theme of this piece – congruence. When he spoke about congruence, Rogers borrowed Kierkegaard’s term, ‘to be the self that one truly is’. For me, congruence is the most important of Rogers’ ideas. I think it probably contains the other core conditions within it but that’s a topic for another time. To embrace congruence is to approach our work with an attitude of equality and transparency that engenders an atmosphere of unconditional respect for personhood, regardless of the confusions, distortions and difficulties a person may be experiencing. The extraordinary environment, ie relationship created through this practice, is in itself already a powerful therapy. In this way we can see congruence as both a means to and an end to therapy (Neville, 2013). Where the therapy relationship is itself the means of growth, there is a very subtle but profound process at work. Carl Rogers wrote about this in his later work (1980), as did Martin Buber in his I-Thou or Dialogic approach to therapy. I believe both were talking about the same process. This for me opens into a deeper reality, which is best described as the spiritual dimension of counselling.
Another criticism of the tendency in the IAPT model to over-simplify mental distress is made by Rosemary Risq (2012). From the psychoanalytic tradition, this author discusses the distortion of care in IAPT services that she sees taking place through ‘the turning aside from the realities suffering, dependence and vulnerability and from the complexities of managing these’.
Equalising and humanising Needless to say, regardless of which modality they come from, such perspectives do not sit comfortably within the pseudomedical culture of IAPT that reduces human distress to something that can be empirically measured, treated and cured. Nor does an approach that values equalising and humanising sit comfortably with the culture of the expert (non-patient) therapist who is there to correct distorted thinking. Thankfully though, I am very fortunate
I require a You to become I. (Buber, translated by Kaufmann, 1970)
The journey towards congruence Putting the spiritual aspects of our experience into words is fraught with difficulty, either because words never do justice to the experience or because anything to do with the word ‘spiritual’ can have many negative and unhelpful connotations. However, for me, the spiritual dimension of counselling comes down to an endeavour to be congruent in relation to the person who is my client and that I do this in the spirit of equality, in service of their growth. This sounds simple, and in a sense it is, but it definitely is not easy. Providing this relationship challenges me in the deepest
ways at times, and I believe I would not have the necessary resilience, wisdom and range of other personal resources without an ongoing commitment to my own personal/ spiritual growth, including times of having my own therapy. In other words, I must be on a journey towards congruence myself if I am to be helpful to others on their journeys. Nevertheless, I welcome the work that this requires of me because it is an opportunity for me to grow too. This whole process is an ethical and spiritual stance that reflects my highest values and aspirations about what it means to be a person.
Limits to our world So, I embrace the need to have a strong evidence base and I understand that requires me to do my best to translate some of the intangibilities and apparent simplicities that are at the heart of my work as a therapist into concrete and measurable terms. I am grateful that we now have a manual that describes the process of humanistic therapy in concrete and measurable terms, and especially grateful that it does this in terms that I find humanising and not pathologising. I also think it is most important that the artistry, spirituality and non-manualisable dimensions that counselling has at its heart continue to have a voice. Otherwise, these limits to our language are in danger of becoming limits to our world, and we might forget about some of the richness and incredible depths that are possible in our work and in our own journeys. When I am at my best, as group facilitator or therapist, I discover another characteristic. I find that when I am closer to my inner, intuitive self, when I am somehow in touch with the unknown in me, when perhaps I am in a slightly altered state of consciousness, then whatever I do seems to be full of healing … it seems that my inner spirit has reached out and touched the inner spirit of the other. Our relationship transcends itself and becomes part of something larger … Profound growth and healing and energy are present. (Rogers 1980)
Professional Conduct Committee: an update Brian Linfield MBE, Chair UKCP PCC
s I move into my third year as the Chair of your Professional Conduct Committee (PCC), I welcome this opportunity to update you all on our work. To start, I would like to flag up a date for your diaries. PCC, in conjunction with the Complaints and Conduct team, are to hold a free event, Sharing Learning from Complaints, on 6 February 2016 in London. The intention is for us to share with you how UKCP’s complaint handling has changed over the past two years, our root cause analysis of complaints, identified trigger points for complaints, and to provide case studies that we hope will give you insight into our work. We will also highlight changes to the Complaints and Conduct Process (CCP) and will launch our second report on complaint handling. If you would like to attend or for more information visit www.ukcp.org.uk/events
Committee composition PCC currently comprises myself as Chair; three UKCP members: Ruth Yudkin, Jane Hetherington and Margaret Headland; two lay members: Carmel Bandford and Clemens-Emanuel Gutwenger; and a representative from the UKCP Ethics Committee, Niki Reeves. The committee is currently supported by case managers Samantha Lind and Sunita Thakore. Our
Brian Linfield MBE is a civil servant who has worked in complaint handling, analysis and resolution in the public, private and voluntary sectors. He sits as a Disability Qualified Panel Member in the Social Entitlement Chamber of the Appeals Service. He is a Family Court Magistrate and Deputy Chairman of the Lancashire Family Panel.
best wishes to Sunita as she goes off on maternity leave.
Speedier process To be the subject of a complaint can be very distressing, as can the ordeal of being a complainant. One of the major successes of the PCC over the past two years has been the dramatic reduction in the time taken from a complaint being received to, if required, a panel hearing. No complaint is currently taking longer than six months to resolve. Compare this to several years previously. Our thanks to Samantha and Sunita for all their hard work in this area.
Effective consultation It has been a very busy year, not only dealing with our usual complaint work but also with major policy issues related to the revision of CCP. UKCP is, in my opinion, to be commended on the fully inclusive way it carried out the consultation process and even more on the way it included, in a truly impartial manner, all feedback into a response paper for the working party set up to revise the CCP to consider. I was fortunate enough to be asked to sit on that CCP working party and to be able to debate with your professional colleagues ways to improve CCP. The discussions were robust at times but I always felt that we were all striving for the same outcome: a complaints and conduct process that was fair to all UKCP members and at the same time gave the public confidence that if things went wrong robust systems were in place to protect them.
Agreed recommendations The recommendations the working party made to the UKCP Board were unanimous bar one and fully accepted. The only issue we could not agree on, with me as the minority voice, was the issue of open versus closed hearings. I was for open hearings, the professionals for closed. I ask myself was I the minority because I was the only truly independent member of the public on
the committee? The UKCP Board eventually decided to leave hearings open but I’m sure that is an area we will return to in the future. At the time of writing this article, it is hoped to launch CCP 15 on 31 October 2015.
Training for panel members With that launch comes training for panel members. I hope to meet all current professional panel members and the lay chairs during that training. It is important that the pool of panel members is fully representative of all our modalities and I hope that any members out there who would like to be considered will contact the Complaints and Conduct Manager, Sultana Khanum, for more information.
Failure to meet standards As I have previously written, the vast majority of our members operate their practices very professionally. However, as in any organisation, there are those whose behaviour falls far short of the standards required. A lot of my and the complaint team’s time is taken up with these few members using any legal argument they can to attempt to circumvent UKCP investigating the allegations. Let’s be realistic here. If, for example, you enter into a sexual relationship with a client/patient, you have crossed a boundary of unethical behaviour. Also be assured, the moment that relationship fails, the other party will contact UKCP with a complaint. (I have yet to see a complaint come in while the relationship is current.) If that behaviour is proved and the complaint is upheld you can have no objection to having your UKCP registration terminated. Can you? For more information about the Complaints and Conduct Process, please email firstname.lastname@example.org A Sharing Learning from Complaints workshop will be held on 6 February 2016 in London. For more information or to register your interest, please visit ukcp.org.uk/events
Working collaboratively This month sees the launch of an official collaboration between UKCP, BPC and BACP. Sarah Browne interviewed the chairs of each organisation on why this has come about and what they hope the benefits will be Sarah Browne: Andrew, could you explain what it is you are announcing today? Andrew Reeves: We are announcing a collaboration between our three organisations. For many years, we’ve worked together informally in different areas and we are moving to a point where we need to formalise that a little bit – keeping our distinct identities, but identifying the common themes that we really do need to address. It feels like a very exciting step forward for a profession that is just starting to gain maturity. Julian Lousada: I think what links our three organisations is the question of how you help a profession emerge and how it plays its part in the provision of services to the mentally distressed. One of the things we are all very aware of is how important it is to have a range of responses to that distress. So we will be looking for ways that we can enter the contemporary discourse around mental health. SB: How will the organisations collaborate and how will they remain distinct? JL: This is a profession where there are all these modalities but we share a discipline. We are all concerned with the quality of what our members deliver. Even though we might do the work slightly differently, we must convince the public and people who make policy that we are credible, disciplined, and that we deliver a service that is essential. Mental health policy, let alone practice, is highly contested. Our collective voice is likely to be more powerful than our individual one. Janet Weisz: Our organisations do have distinct identities. They have evolved differently, and therefore the identity of each organisation will remain and I think needs to be nurtured. The robustness of
the three organisations and their diversity will be beneficial to the public and to the delivery of services. AR: There is something very important in the distinctiveness of the organisations; there isn’t a one size fits all. People are individuals with their individual distress and their individual experience. We all have an important contribution to make and what we can do is contribute to a culture whereby clients and patients have choice about what it is they access and how they access it. For me that is crucially important. SB: Andrew, how do you think the organisations working together will help potential clients? AR: In a whole range of ways, whether it’s around professional standards, accountability, ethics, conduct. What we will do is further the work we’ve done individually to create a robust profession that clients and key stakeholders, such as the NHS or third sector, can trust in. Fundamentally, for our clients or patients, it’s about being able to access a therapist absolutely trusting what they do and why they do it. JW: I agree that clients will benefit by knowing that they will be able to access a therapist from a group of organisations where there is robustness from the training they have gone through and in their ongoing professional development. That will be very important for the clients to know. SB: Can we talk about where you all think the profession will be in ten years’ time? Perhaps I can start with you Julian? JL: Well that’s a very difficult question. I suppose ‘where’ might mean where the
profession is located – is it in the private or the public sector? I think all of us would argue that it needs to be in both, but it’s increasingly being pushed into the private sector. There are problems with that in terms of access for a whole range of clients. So, if you ask where we will be in the future, my view is that together we can press home that debate and really influence policy, which frankly we’ve not done very well in my judgment. It’s not that we‘ve had no successes, but we need to be more robust in being clear about what sorts of policies we think are appropriate and where we can contribute. JW: I would like mental health to have absolute parity with physical health. I had a personal example recently where I was unwell and ended up in casualty. Every part of my body was checked, except for my mind. How did the doctors know that this wasn’t something psychological rather than physical? So that’s a small example of where I’d like the profession to be in five years, not ten years, and I think the collaboration between our three organisations will give us a much stronger voice to go out there and say that mental health is as important as physical health. AR: You can reverse the question and say where might we be in ten years’ time if we aren’t collaborating. I think at best we would be in disarray and at worst that we might be pushed more and more into the margins. Picking up on the parity of esteem that Janet raised, it is absolutely fundamental that we all recognise that our emotional wellbeing is as crucial as our physical wellbeing. I find that when I ask clients how they take care of their emotional health, they look at me blankly, but if I ask about their physical health they’ll reel off a host of things that they
ukcp news ‘The collaboration between our three organisations will give us a much stronger voice to go out there and say that mental health is as important as physical health’ (Janet Weisz) either do or don’t do. And that’s a cultural shift that needs to change. Counselling and psychotherapy have an enormous contribution to make, which, at the moment, I don’t think we do to best effect. JL: I think Janet puts her finger on a strong argument, which is about the health economy. If you think about the price to the NHS of medically unexplained symptoms, it is enormous and everybody knows that these patients are presenting to A&E or to hospitals with very serious symptoms that have no physical explanation. There’s clearly a substantial psychological dimension. We know in terms of the number of people presenting at GP surgeries, the cost is enormous. If psychologically minded people could actually work with these patients, all sorts of benefits would accrue. SB: So, if there was one major change that could come from this collaboration, what would that be? JW: For me it’s got to be about improving access to and choice of therapy in primary care. I also think that we should be educating people about their emotional health and surely that should be in schools. JL: One of the things that I hope will happen is that people trust the integrity of our endeavour. I would hope that all our members have a look and say gosh, here’s an organisation with various parts that we would want to get more active in. AR: For me it would be about how treatment guidelines are developed and how evidence is used. I would like to see us develop even more sophistication about evidence, what that evidence means, how it is conceptualised and its relationship to the development of treatment guidelines. We need to be seen to be professionals who are developing practice-based evidence and evidencebased practice informed by the client voice and client experience.
SB: In a way it’s a moral choice, isn’t it, to collaborate and to do the best that you can for the public and for people suffering from mental health problems? AR: It’s a moral and ethical imperative, actually. We can talk about whether we should or shouldn’t, or whether we have a choice to collaborate. For me there is no choice here. This is what we have to do, not for our own gain; this is about promoting and supporting something that actually saves people’s lives. JL: We all keep saying we agree and we do. But I do think we are swimming against the tide. People talk very easily about a relational world, and that’s what we all stand for, but actually what makes somebody feel better about themselves is the quality of their relationships. We live in a world which is increasingly fragmented, where the glue of family and social life is much less gluey than it was. SB: So, what are some of the specific challenges that the profession is facing at the moment? Janet? JW: I think some of the challenges are around the reduction in services both in primary and secondary care. Alongside that, with an increase in awareness of mental health and ill health, to have a reduction in services creates a deep imbalance. We know that people struggle and suffer with mental health issues and I think that there is a long way to go in improving access, waiting times, the choice of therapies and delivery to the different client groups. JL: I think one of the big challenges is that we have a reputation for being dominated by middle-class issues and we haven’t done enough to change this. We haven’t done enough to show that we understand that there is a mental health consequence to different types of lived experience. So
we have a lot of work to do to demonstrate that we are relevant to people from all walks of life with all sorts of issues. AR: The reduction of mental health services in the statutory sector, in the health service, puts greater pressure on the voluntary sector. Organisations delivering really highquality services, but with even less funding, are being squeezed and closed down. If I want therapy, I might not choose to do that through my GP or through a health service. I might want to do that through an organisation that is much more embedded in my community and understands me as an individual. I think this contributes to a culture where our mental health or our emotional health is kind of dispensable, so that’s a really challenge and a real problem that we have to grapple with. JL: Can I just emphasise that point. We live in a moment where there is a sort of rhetoric about wellbeing and mindfulness and happiness and so on, but at precisely the time when all the services that Andrew has just been describing are losing their funding. Now that is a real problem and it’s the sort of problem that breeds cynicism, which further undermines people’s confidence that politicians mean it when they say they are going to invest in parity of esteem when it’s manifestly clear they are not doing so. JW: And at a slight tangent to that, but not dissimilar, is that there may be people who will choose to access psychotherapy or counselling in the private sector. But if they’re being offered antidepressants as the ‘treatment of choice’, they may take those instead of thinking about whether some form of counselling or therapy would benefit them, as much, maybe more so. So I think it’s the medicalisation and the antidepressant culture that has grown. SB: Thank you all and I’m sure these debates will carry on.
If you would like to find out more about our collaborative project please visit www.ukcp.org.uk/news/announcing-collaboration. You can also visit www.bacp.co.uk and www.bpc.org.uk
We’re going digital… As a UKCP member, we want you to feel the benefits of being part of UKCP. Part of that is improving the way we support you and how you interact with us. To do this, we recognise we need a new website to deliver more member benefits, promote psychotherapy effectively and improve communications within the organisation. We will need your help in drilling down to some of the detail of what’s needed
e are currently working on a project to totally redevelop our website following feedback from lots of you about what you’d like from it. Alongside this, we are introducing a new Customer Relationship Management System (CRM – database to you and me) that will enable us to offer you more membership benefits and allow you more control of your membership administration. Don’t worry, you will still be able to ring and talk to a real human being if you prefer! To help make this project a success, we have set up a group to oversee the whole project comprising both staff and therapists (rather grandly called the Digital Delivery Project Board), but we will need your help in drilling down to some of the detail of what’s needed.
Members survey key findings Respondents
Use of our website
Number of members who responded to the survey
Our members don’t use our website: 46% of respondents said they have used the website only once or twice in the last 6 months
When they do, they find it hard to find the information they are looking for: 63% respondents said they have looked for content on the UKCP website but were unable to find it
of members have never recommended OUR website to colleagues, students or therapy clients
have recommended OTHER websites about talking therapies to these groups
Top 10 target audiences
Respondents felt the website should serve: UKCP individual members 95% The public 69% Service users & clients 61% UKCP organisational members 54% Trainees & students 43% UKCP Colleges, faculties & committees 27% The media 20% Health Service Commissioners & Employee Assistance Providers 21% 9 Potential members / students / trainees 17% 10 Politicians & policy makers 13.3% 1 2 3 4 5 6 7 8
ukcp news This is a huge opportunity to change the way we do things for the better and we want to make sure we get it right, so we will be asking you to help us to really understand what you need. We don’t need to begin completely from scratch. We have started by looking at all the feedback received from members, both about the website and about the way processes such as membership renewal work. We’ve also gathered feedback from the organisation through surveys earlier this year and ran in-depth workshops to get an idea of what you’d like to see. As we move forwards, there will be further opportunities to give us your feedback. Not surprisingly, you identified the Find a Therapist tool as one of the absolutely critical things to get right. You want to see searchability improved and have made
some helpful suggestions around this: you want it to be far more visible on the website, and to see it appear far higher in the Google rankings. We totally agree these are essential improvements if the tool is to help you attract more clients and help potential clients find the right therapist for them.
Teresa Keohane is the Digital Delivery Project Manager leading the implementation of the new UKCP website and database (CRM). She has an extensive background in programme and project management, with over 15 years’ experience leading and implementing large business change programmes in the commercial and social enterprise sectors.
What’s next? The next step will be to complete the supplier selection process, and then to start developing and testing a new website and database. As we do this, we want to get your views and feedback to ensure that, as far as possible, it meets your needs. Our aim is to launch the new website in the spring of 2016 (once we are happy the database and Find a Therapist do their job properly). But to get there we’ve got a lot to do, so please bear with us as we focus
on getting this right. We’ll be sending out regular updates as the project progresses. If you would like to get involved with the project or have any questions, please contact Teresa at email@example.com
Most useful sections of the website 1 2 3 4 5
Find a Therapist
Standards, Policy & Guidance Documents
Events Register Supervision Directory Members Area
However of respondents said that Find a Therapist was not easy to use
The Members Area is key but it
does not support our members effectively Members would most like to be able to: 1 Renew my membership of UKCP
2 Download or print a receipt for my membership fee 3 Create a new password if I've forgotten my old one
4 Access articles, papers and video interviews
5 Download a copy of my membership certificate
of respondents used the Members Area yet there were numerous problems using it such as not being able to change profile information, member profile information not displaying correctly and links within the members area not working correctly
How do we know we make a difference? Outcome, process and wellbeing in psychotherapy UKCP’s Research Faculty Committee report on the research conference at Regent’s University London on 18 July 2015
ver 80 delegates attended on a sunny day, but it was worth it. The fourth UKCP research conference proved to be exciting and challenging. Surprised?
There is increasing interest in developing the ways to discover how therapy works and demonstrate what works best for whom
Central thematic thread One theme permeated many presentations: that outcome measures are not just tools to measure therapeutic efficacy but also conversational tools for facilitating significant and important dialogues between therapist and client. As key speakers Rolf Sundet, Markus Bidell, John Mellor-Clark, Judith Lask and Peter Stratton delivered their presentations, this central thread emerged, challenging the idea that outcome measures are sterile trappings hindering therapeutic process. Outcome measures open the door to conversations, questions, comments and stories; they can inform narratives about change, empowering clients, adding to the therapeutic process. They can assist collaboration and shared understanding, and explorations of change and difference. We left recognising that therapists need not be slaves to outcome measures and can do more with them than comply with institutional policies. Outcome measures are here to stay, and while they may be imperfect, they can have clear benefits. Is it not time to make them work for us as we and our clients create our own therapeutic dialogues?
Practice and provision The presentations and workshops provided opportunities for therapists, academics and researchers to discuss the practice and provision of psychological therapies in the NHS and other settings, and the impact of psychological therapies on individuals and society. While some
focused on the research–practice interface, others explored the identification and measurement of key therapeutic factors and ways of using clinical practice as evidence. Some presentations considered how clinician and service user perspectives can be developed as research evidence. Charlotte Copeland, Biljana van Rijn, Annie Nehmad, Terence Nice and Steve Butler described evaluations of psychological provision to clients, as individuals, in groups, and in various service settings. Some speakers were concerned with using measures and with methods, including John Mellor-Clarke’s review of the value of CORE in its varied forms and Tania Thorn who focused on SCORE. There were also presentations using innovative ways of assessing client change, with Mark Widdowson using Robert Elliott’s work to inform his own strategies.
Therapeutic concerns Presentations also covered research on therapeutic issues, such as blind spots and a refusal to know (Anca Carrington), the experience of clients and therapists when therapy does not result in positive change (Kay Radcliffe, Ciara Masterson, Sophie Hopper and Carol Martin), and the effect of supervision on outcomes (Maria Luca and Desa Markovic, Els van Ooijen, Salma Siddique). Jane Woodend’s work on clients’ and therapists’ retrospective accounts of their real feelings about each other raised the challenging issue of how these perspectives might differ in relation to the therapeutic frame and the impact of therapist feelings. Some research is ongoing. Elena Arora is using grounded theory methodology to capture intersubjective experiences of joy and laughter, exploring how such moments relate to the therapeutic process, while Sheila Butler and Laura Jacobs discussed plans for research into the mutual effects of therapist and client on each other.
ukcp news Outcome measures are not just tools to measure therapeutic efficacy but also conversational tools for facilitating dialogue between therapist and client In contrast, there were presentations prioritising alternatives to conventional research, calling on historical (Heward Wilkinson), material (Matthew Bates, Richard Kettley, Rachel Lucas and Martha Glazzard) and philosophical (Tom Tomaszewski) paradigms.
A moving and inspiring day at the first Children’s Faculty forum Shaun Goodwin, Vice Chair of UKCP’s Faculty for the Psychological Health of Children, sets out the vision behind a new series of forums for those working with children and young people and celebrates the success of the first event
What works best The discussions in and between sessions reinforced our sense that there is increasing interest in developing the ways in which we can discover how therapy works and demonstrate to ourselves, our clients and in the services where we work what works best for whom. The Research Faculty Committee is interested in supporting and developing practice research networks (PRNs). We are currently developing new research projects, and discussing practical methods for gathering relevant clinical data. The most recent of these is concerned with the use of outcome measures to measure change and to provide clinically significant information. Please contact Sheila Butler (firstname.lastname@example.org) if you are interested in finding out more about how to get involved. Thanks are due to the conference organisers, Terence Nice, Helen Barnes, Katrin Maier and Elizabeth Stormfield, and to those individuals who took on additional roles on the day and in the background. Thanks go also to John Nuttall and Regent’s University London, as host, and to Balens, supporters of the conference. We are already planning the next research conference, hopefully for 2016. Watch this space!
Many children and young people have little space to share and reflect on their experience
t is a part of our faculty’s vision to be outward looking – to reach out to all those who are professionally concerned with the emotional and psychological wellbeing of children and young people. This is where the concept of our regional forums began and we are now settling into a format that is appreciated and popular. By providing a more informal, discursive space than a conference, we are able to broaden our understanding of the diverse and complex emotional and psychological needs of children and young people, and to uphold their right of access to appropriate and effective approaches and services.
Space to share and reflect The theme for our forums is ‘listen to my story’, which will be explored in a series of events around the country. The theme is inspired by our recognition that many children and young people have little space to share and reflect on their experience, yet personal narrative is profoundly significant in shaping our understanding and expectations about the world that we live in. We all tell and retell our stories and often a response from another person can help us view the experience from a different perspective. The first forum, held at the University of St John in York on 4 July 2015, brought together people working in a number of projects in the field of emotional health and wellbeing for young people. Cath Heinemeyer is a storyteller. She described
Shaun Goodwin, Vice Chair of UKCP’s Faculty for the Psychological Health of Children, is an integrative child and adult psychotherapist. Shaun particularly enjoys working creatively with older children and adolescents, his passion being art and sandplay. Information at www.transpersonal-healing.com
ukcp news how she has been using the medium of story with young people in mental health settings and schools to create dialogue. She described how rigid narratives can be untangled in the ‘safe space’ of metaphor. However, Cath wanted to emphasise, in a thread that was to permeate the whole forum, that she did not approach the work as a therapist but rather as an artist. She made the case for open-ended, playful and artistic experimentation.
Creativity and art An added dimension to the day was that two of our contributors were young people who had overcome painful adversity in childhood to create their own businesses that run projects to help others. Like Cath, they would not claim to be therapists but creative and artistic facilitators. Natasha Benjamin has created Free Your Mind, in which she uses her personal experience of domestic violence, mental illness and recovery to help others. Her infectious passion for healing, along with her story of resilience and defiance, left everyone in the forum inspired and moved. After realising how healing it was for her to share her story through her blog, Natasha conceived the idea to encourage others to share their experience and voice and benefit in the same way. She has publicised an anthology of their work, with the aim of encouraging, educating and empowering, and the response has been extraordinary. Like Natasha, Kev Curran has overcome the odds of his harrowing childhood to become an award-winning film director. His own experience has inspired him to dedicate his work to making a difference, using storytelling as a way to engage with struggling children and to help charities and third sector organisations campaign and raise their profile. Through his business, Inspired Youth, Kev has been particularly keen to draw on people’s reallife experiences through collaboration with the people closest to an issue to create profound and moving stories.
Feeling they matter Just by being involved in Natasha and Kev’s work, young people can begin to feel that they matter and are capable of achieving something, particularly as they see how their story can move or inspire others. What made the experience so real for everyone at the forum was not just the work of the projects presented but also
From left to right: Kev Curran, Michèle Bartlett, Luke Rodgers and Natasha Benjamin
the fact that the people presenting were living examples of how refusing to be the victim of their story and becoming the hero instead changed their lives. Indeed, the forum was a part of this ongoing process, as Kev so eloquently describes: When I was first invited to speak at this event I really was excited about the subject matter, Listen to my Story, because it really encapsulates my work. I have done previous presentations about my work but never really about me – my story, and how I came to be the founder of a NFP social enterprise that just happens to tell the stories of people affected by a range of social issues. I was really anxious. My slot was fast approaching and my heart seemed to be gaining beats per second. I know my story, but how will people receive it, how will I feel telling it, what if something goes wrong? I have learned to visualise the things I do before I do them to get a sense of how I would like it to go. Just as I was begging to win the battle to defeat the anxiety, Natasha Benjamin spoke and I suddenly felt absorbed in her presentation, mentally emotionally, humanly. The founder of Free Your Mind spoke openly and honestly about her experiences and it really moved me to the point of tears. I’ve never started a presentation feeling so full of emotion but I think it made it the realest presentation I have ever delivered. I brought the driven passion about my work together with the raw and uncompromising truth of my childhood and the loss of a brother to suicide. I didn’t want it to upset
people – inevitably it did – but hopefully people were also inspired. In some ways it was liberating for me, like I was living out my full potential through this opportunity. I was so overwhelmed by the feedback. It can feel raw at the time but I truly believe it can invigorate the minds and hearts of everyone, remembering why they set out to do the work they do and make the most impact as possible. I feel privileged to have been given the opportunity. It has inspired me to pursue more of these opportunities and grown my confidence immensely. I’m even thinking about doing a TedX in the future. I hope my story inspired others as much as I was inspired by being involved. The comments in the Q&A were overwhelming and I appreciated every word!
An impactful day All the therapists and professionals at the forum commented on the value of the day and the impact it had had on them. It gave birth to much discussion about the value of moving away from a specifically therapeutic model to a more creative, collaborative and authentic place. One attendee fed back: ‘I’m very humbled by the speakers’ willingness to share their stories. It just shows how, paradoxically, allowing oneself to be vulnerable is also a great strength.’ We look forward to seeing you at the upcoming ‘listen to my story’ forum in London on 5 March 2016. For more information, please email email@example.com
Policy round-up In his role as Registrar, Alan McConnon gives a brief update on work on UKCP policies. He would like to thank all the volunteers, lay and professional for their valuable contribution CPD policy
Child proficiency marker
We have recently revised our continuing professional development (CPD) policy. In line with maintaining best practice, UKCP requires CPD of all its registrants. We haven’t changed our requirements, but we have aimed to make the policy clearer so individual and organisational members know our CPD expectations. We also want to convey to members that UKCP’s ethos promotes a reflective/reflexive and responsible approach to training, practice and ongoing professional development.
Standards of education and training to underpin our child proficiency marker have been developed. The marker will be used by registrants working with children and young people but not as child psychotherapists/ psychotherapeutic counsellors. Its key aim is to provide reassurance to the public and employers. We ran a consultation on this which ended in 2013. The policy has now been approved and the next step will be to decide how we will implement this marker.
UKCP has begun work on how to imbed safeguarding in its work and provide guidance to members relating to the safeguarding of children and adults. As part of this, we are planning a day workshop on 7 November 2015 for members. For more information or to register for the workshop, please visit ukcp.org.uk/events
To view our CPD policy, please visit ukcp.org.uk/CPD-policy
Re-accreditation of individual members UKCP’s position on re-accreditation is that all clinical members must be able to provide documentation, as set out by their college or organisational member, which demonstrates and supports the way they are practising as a psychotherapist or psychotherapeutic counsellor. This process must be undertaken once every five years as a minimum. Those due for re-accreditation will be contacted by their organisational member or college. To view the re-accreditation policy, please visit www.ukcp.org.uk/resources-andpublications/policies-folder/
Alan McConnon is responsible for working with the relevant UKCP committees in maintaining the integrity of the UKCP registers, ensuring that processes and procedures are in place to obtain the information relevant to supporting an individual’s application to UKCP and overseeing the annual random audit of individual members.
The Psyche in the Modern World: Psychotherapy and Society Published by UKCP, Karnac series
Tracy Jarvis interviews Tom Warnecke about his new UKCP book
Tracy: What motivated you to create this book? Tom: As a profession, we have an issue with psychotherapy being cast as a wallflower in society and many colleagues keep – quite rightly – asking ‘Why aren’t we more out there? Why aren’t we in the press? Why aren’t we being asked for input by policymakers, etc?’ So, first of all, there are some dichotomies we need to recognise. In his foreword for this book, Andrew Samuels wrote: ‘[T]he world didn’t show up for its first session.’ It’s a good line but I’m not sure I fully agree with it. Psychotherapy has had a profound influence and revolutionised western understanding of mental life and human functioning in the twentieth century. But while everybody seems to accept the idea of the ‘unconscious’ today, this has not made psychotherapy more visible in the public space. Other fields – medicine for example or even psychiatry – have more presence in social and political arenas or in public debate. So the motivation and the starting point for the book was the idea to engage the wider world and other disciplines with current thinking about psychotherapy and open up our internal discourse to nonpsychotherapists. Tracy: And what are the main themes that you have running through the book? There are quite a few contributors I notice. Tom: The book is conceived as an anthology of stand-alone chapters on quite a broad range of themes. What unites all the
chapters is that each has socio-political and cultural as well as clinical and theoretical contexts. And a good part of the book looks at client groups that are not served well currently. Camilla Batmanghelidjh, for example, makes her case that the present therapeutic model cannot meet the challenges of working with children with complex needs and presents her paradigm for an alternative framework. Alan Corbett’s chapter takes us into the world of intellectual disability psychotherapy to explore the complexities of consent and intelligence. And Theodor Itten reviews alternative perspectives on schizophrenia that could help facilitate recovery. Tracy: You highlighted dichotomies at the start. What would you say are the three main dichotomies for you? Tom: First, as I said earlier, that psychotherapy is a bit of a wallflower in society in spite of its tremendous influence – always present but not very visible. Second, there is the dichotomy of access: we seem to exclude people, including those who would hugely benefit from psychotherapy services, because they don’t fit very well into our established clinical frameworks. And third, the dichotomies of stigma – how society relates to the deeply personal realm of the psyche. Personal struggle is a very popular theme for the media, for the arts and the entertainment industry, but when it comes to our individual personal problems, we should keep them to ourselves and hide them. Another aspect of this dichotomy is picked up in Claire Entwistle’s chapter
when she looks at motivations to become a therapist: listening and meaningful conversation might be more scarce than we would assume. But I should add a fourth, which is the subject of Peter Stratton’s chapter: the dichotomies that impact therapists’ relationship with psychotherapy research. Tracy: What do you think psychotherapists could be doing more of to bridge these gaps between the public and therapy within society? What can therapists do to put psychotherapy on the map? Tom: Well, I think we need to get out of our ivory tower. If we can find ways to address and lower the stigma, to improve access; if we, as a profession, can open our consulting room doors to the world and adapt what we do to meet the needs of different demographic groups in society – that would be a big step forward. But also we need to speak up and put psychotherapy forward in constructive ways. Michael Musalek’s chapter is a good example. He makes a profound case for medicine to move from an evidence-based paradigm towards what he calls a ‘human-based paradigm’, which could make medicine more effective. Not surprisingly, this human-based paradigm draws on and incorporates what we have learned in a century of psychotherapy about the importance of subjectivity, connections and meaning. Tracy: What else could be done? Tom: Well, the question ‘why aren’t we more out there’ is inevitably complex.
ukcp members Two chapters of the book explore these dynamics, Alison Bryan from psychoanalytic perspectives and Mary MacCallum Sullivan and Harriett Goldenberg using humanistic and relational frameworks. But while we consider the why and how, this shouldn’t stop us from experimenting with anything that takes therapy out into the public domain and makes us more accessible and approachable. The brilliant ‘Black man on the couch’ concept is a great example: it moved therapy into the theatre and right in front of an audience that has issues with accessing therapy. There have also been ideas to organise a psychotherapy festival in a public space, somewhere on the Southbank for instance. Tracy: On the Southbank? That would be fantastic! Tom: Yes, it would. Something like a rolling programme, where people passing by could stop and engage, with public discussions, perhaps featuring public figures happy to talk about therapy in front of a camera, and so on.
Tracy: What about the rivalries between modalities and the current dichotomy around evidence-based psychotherapy and non-evidence-based psychotherapy, for example CBT being the preferred therapy of choice basically for everything in the NHS? Tom: I think this presents a huge distraction from the real issue: how can we improve psychotherapy services? CBT consists of many common interventions that are not unique to CBT, which in any case relies on the same common factors that seem to make all therapies work. We also know that all psychotherapies work equally well overall, and that certain modalities suit the particular personalities of clients/patients and therapists. Tracy: You can treat a certain amount of the population and they will get better on some therapies. But you cannot put all people into one single box? Tom: Yes, indeed. But these divisions are at least in part of our own making. As a
discipline, we have consistently failed to the present psychotherapy as a single field to the world, a single field that includes a vibrant plurality of modalities within its fold. The public quite understandably perceives us as a divided profession and I would expect that this affects the influence we wield. There have been moments: for example a UKCP general meeting voted in 2009 to put the single title ‘psychotherapist’ forward for the expected statutory psychotherapy register. This was a historic moment of unity that unfortunately got lost amongst the heated debate for and against statutory regulation. If we had the political will, I believe it would be very achievable to value and appreciate modalities and at the same time present psychotherapy as single discipline. Tracy: Thank you and everyone who contributed to this book very much. I believe this is raising some important questions and will get people thinking.
Obituary of Dr Kenneth Evans 1947-2015 Dr Ken Evans, who played a major role in the development of Humanistic and Integrative Psychotherapy in Europe over twenty-five years, died suddenly on 15 July 2015 at his home in Normandy, France, at the age of 68.
orn in Tredegar, Wales, into a mining family, Ken Evans took a degree in Economics at Portsmouth, where he met his first wife of thirty years, Mairi (d. 1999), with whom he had two children, Ruth and David. He was successively probation officer, Church of England minister, trained in Gestalt Therapy and Integrative Psychotherapy and he founded Sherwood Psychotherapy Training Institute in the mid-eighties. Later director of Scarborough Counselling and Psychotherapy Training Institute, he put down new roots and developed his passion for sheep farming in Normandy, developing a close association with the European Centre
for Psychotherapeutic Studies. His work here led him to develop, and deepen, the ecological dimension of his sense of spirit. During this period, Ken married Joanna Hewitt Evans. Ken was Training Standards Officer of UKCP in 2000, President of the European Association for Psychotherapy (EAP), the European Association for Integrative Psychotherapy (EAIP), and the European Association for Gestalt Therapy, Senior Editor of the European Journal for Qualitative Research in Psychotherapy, a psychotherapist trainer and supervisor with different training institutes and university validated psychotherapy programmes
across Europe. With Joanna, he was also involved in the development of a Europeanwide association to enable fitting approaches to therapeutic work with children: the European Interdisciplinary Association for Therapy with Children and Young People. Ken had summed up his sense of human existence thus: Live life fully Love generously And Become all that you can be This is his epitaph.
Heward Wilkinson 45
ukcp members Book review
Telling Time: A Novel By Marie Adams Published by UKCP, Karnac series Marie Adams has created an unusual hybrid: as an exciting piece of detective fiction, Telling Time has you reaching hungrily for the next page; as an eloquent, moving and at times unsettling description of a therapist at work, Adams has you wanting to slow down and digest the rich seams of conversation that her therapist-protagonist conducts with herself. This unusual blend of genres works well because the story is written so well, and the overall result is a compellingly good read on every level. Lisa Harden is a successful therapist. As well as running a full practice, she writes a column, publishes books, delivers papers and all in all has a body of confidence attached to her name. Her work is all about insight, self-reflection; challenging patterns of secrecy, fear, avoidance. Early on in the book Lisa Harden takes on a new patient and this world of hers is turned upside down. Lisa, we discover, has her own secret, one she has been running from all her adult life. She has hidden this secret from her therapist, her husband, and even attempted to hide it from herself. As the pages gallop forwards we go on a journey with Lisa that takes us back in time. So used to excavating pain in the lives of others, Lisa is forced to acknowledge how cowardly she has been, sheltering behind her patients, expecting them to have the courage she lacks in herself. A word of reassurance to would-be-readers who are therapists: don’t avoid this book because you fear it will be a busman’s holiday. This terrific and unputdownable detective story may just leave you wondering in a slightly disquieting way whether you, like Lisa, ever use the therapist’s chair to remain safely hidden from yourself. Telling Time is available on the UKCP Karnac book series at http://bit.ly/1KPqHwi
The Sower and the Seed: reflections on the development of consciousness By Alan Mulhern, Illustrator: Lindsey C Harris Published by Karnac Books The Sower and the Seed is a text that ambitiously attempts an interpretation of the origins, development and current dilemmas of human consciousness. It is a remarkable book, drawing a clear narrative from the origins of consciousness to our current struggles with the power offered through the technological and material revolutions of the Enlightenment and industrial revolution. It covers difficult ground easily and is a must-read for those who wish to orient themselves to our current life from a mytho-psychological perspective. It will be of great interest to psychotherapists who wish to examine and explore the metapsychology of their practice from this viewpoint. The book is written in a didactic form, which some may find irritating but I found helpful to react to and question my thinking. This also makes the book briefer and a starting point, rather than something that exhaustively covers complex and contentious ground. It brings together a great deal of thinking and directs that to bear on the economic and material traps we have found for ourselves, having followed the path we have. Each chapter is supported by original illustrations and poems, which amplify and make accessible their meaning. For me, this book asks the big questions we face as we try to take responsibility for the power we have discovered or given ourselves and, to some extent, provides a practical frame for working with them. This is offered within the context of its own thinking rather than deferring to other authors and schools of opinion. It is a great and, more importantly, practical book. The systemic analysis of capitalism and its impact on consciousness, its creative and destructive nature and the lurching to trauma is a masterpiece in the making. I hope this theme will be developed in further publications. The Sower and the Seed is available in all good book stores. Jason Wright is a psychotherapist and Director of Number 42 psychotherapy and wellbeing practice, London SE1 1XW.
Don’t miss out If you are not a member of UKCP and would like to receive a regular copy of The Psychotherapist, send this completed form, along with your payment to: Subscriptions, UKCP, 2nd Floor Edward House, 2 Wakley Street, London EC1V 7LT.
Have you renewed your membership? 2015/2016 UKCP membership is now due Renew by Direct Debit and receive a £10 discount off your membership fees If you would like to setup a Direct Debit, or if you require further information regarding your renewal, please phone, visit our website or email the membership team. T: 020 7014 9955 option 1 E: firstname.lastname@example.org
I would like to subscribe to The Psychotherapist for 12 months New Renewal (three issues). Subscription type: Subscription amount: £50 £25 (Students, educational establishments or libraries) If you are claiming the student discount, please give details of the educational institution, and the name and dates of your course:
Please send my copy to: Name Address Postcode Email I enclose a cheque for £ payable to ‘UKCP’ I would like to pay £ by
Security code (last three digits on signature strip)
Issue no (Maestro only)
Cardholder’s signature Please invoice:
UKCP Adjudication Panel decision Removed from the UKCP register: Charles Davison, Norfolk, 27 May 2015 Charles Davison was a UKCP registered psychotherapist. The Adjudication Panel determined that Mr Davison’s fitness to practise is impaired by reason of serious misconduct and that UKCP remove his name from the UKCP register. The Adjudication Panel’s determination can be found at www.psychotherapy.org.uk/ complaints-decisions
The Psychotherapist is available online You can now read a digital version of The Psychotherapist online. This issue that you are holding in your hands, plus many other back issues, can be viewed at http://issuu.com/ukcp-publications. Please take a look and tell us what you think. Do you find it easy and useful to read the magazine in this online format on your computer, smartphone or tablet? Also, let us know if you would prefer to stop getting your printed copies of the magazine entirely, and move over to only reading the online version from now on. Let us know your thoughts – email email@example.com
Welcome to our new UKCP members Psychotherapists
Nancy Sabbir Sophie Philip Miranda Titilola Melissa Deborah Georgina David Paul Ruth Linsey René Nicole Paula Michael Hilda Ian Claudia Janet Nick Fliss Catriona Samantha Judith Alessandra Sally Anthony Ching Ling Leah Christos Rebecca Harriet Sean Andrew Mairead Lynsey Dena Bridget
Carol Josephine Davies UPCA Victoria Sue Davis GP Adu UPCA Andrew Pedro Diaz GCL Ahmed CF Sarah Suzanne Dinsdale CCPE Amoni MC Sue Kathleen Josephine Fernanda Discepolo Ahmadi ACAT Anthony UKATA Corinne Chris Doris KI Atherton SPTI Mary Amelia Tania Druce IATE Barbour AA Penny Madalina Corina Edwards BPA Baxter AFT Oksana Andrew Elmore AFT Berger RV Jan Roderick Evan MET Berrow MET Pinar Mair Felix SCPTI Billington CCPE Heather Tarisha Finnegan-Clarke KI Birch NLPtCA Evelyn Fiona Firman UKATA Birkebaek UKATA Helen James Fisher MET Blair COSRT Sarah Meghan Fulton KI Bosman NLPtCA John Kimberly Fung AFT Bradley SPTI Emily Lisa Gardner MET Breen CCPE Sam Betsy Garrett RSPP Briggs AFT David Janine Gayler IATE Burke CCPE Carol David Glenister AFT Burton CCPE Janine Jared Green CCPE Businaro PET Laura Giles Greenslade KI Butterworth BC Neil Jayne Gregory CCPE Buxton KI Rachel Rona Gundry KI Cadbury PA Richard Eamon Hannaway KI Cahill RV Stacey Ovidiu-Adrian Harasemiuc UKATA Carbon MET Aisling Claire Hawcock BCPC Carson UKATA Sara Alana Rachel Jane Haydon KI Casini KI Randolph Skomer Marie Hazell KI Chance AFT Kirsty Liza Heatley UKATA Charles IFT Nicky Edward Heeley-Randerson COSRT Chiang FPC Anna Emily Hodgson KI Christodoulou MC Sofi Argyro Ioannou UPCA Christophy UPCA Serena Irene Jardine KI Clarke AFT Lynda Victoria Mario Jerome RV Cookson IATE Ben Marianne Jospe FPC Cox CCPE Gerlandina Frances Judge KI Dale MET James Ian Kennedy BC Daly TER Patricia Jouko Koecher UPCA Daniels CF Kathryn Stefanie Langenhoven CCPE Darling UKATA Mary Joanna Lawrence-Mills KI Davey KI
Sophie Standaert MET Levine RSPP Mona Stylianou CCPE Limb NGPC Maktuno Suit CCOPPP Lockhart CCPE Eileen Sullivan MET Logue RV Nadine Sylvester IATE Loraine AFT Zoe Townsend MET Lowry MET Jon Treanor CCPE Lyons GASW Ruth Tudor BCPC Maddrell KI Edward Tuffnell KI Matto SPTI Moray Twaddle NGPC May AGIP Sarah Tyerman IGA McGivern KI Andreas Vassiliou UPCA Mills UPCA Sarah Walker CCPE Mills IGA Deborah Warman-Freed MC Mott IFT Rachel Watson NGPC Nelson RSPP Louis Weinstock CCPE Nicholls SCPTI Zoe Weston IATE Ollman-Hirt MET Jane Willis AFT Ollman-Hirt AFT Jonathan C Winternheimer AFT Osborn RSPP Leslie Worrall MET Owens UKATA Jinmi Yang RSPP Paisley CCPE Payne CCPE Psychotherapeutic Counsellors Percival UKATA Nicola Allibone IATE Podger CCPE Anita Brown CPPC Potts CCPE Sophia Friedrich NGPC Price IATE Anne Graham SCPTI Price IATE David Graham NGPC Pritchard RSPP Jane Elizabeth Harris UPCA Quinault RSPP Jennifer Kennerley NGPC Rankine KI Francesca Kerr TACT Rawlence RSPP Thomas Marron NGPC Robinson RSPP Harriet Anne Peters UPCA Robinson AFT Jane Rosoman CPPC Roche KI Stephen Simms CPPC Roe SCPTI Caroline Sutcliffe CPPC Roux RSPP Nicholas Thomson CPPC Russo IGA Carolyn Varney CPPC Sedgwick BI Giulia Wilkins SCPTI Sisk Taormina MET Sloane BPA Smeeth AFT
UKCP is delighted to introduce our three most recent organisational members Childhood First offers UKCPaccredited training through its Advanced Diploma in Integrated Systemic Therapy (IST), which is rooted in psychoanalytic and systemic theory. IST has been developed over 40 years in group-based and one-to-one practice in residential therapeutic communities of various sizes, with families and the professional networks surrounding traumatised children, in psychodynamic group relations work at organisational level. childhoodfirst.org.uk
Therapy And Counselling Teesside is a high-quality provider of child counselling training in the north-east of England. Based in in Cleveland, TACT’s Diploma in Psychotherapeutic Counselling with Children is UKCP accredited, and offers affordable entry for all applicants. TACT also offers a wide range of mental health services, such as psychotherapy and counselling for families, children and adolescents, adults and couples. www.tact-ltd.co.uk
The Welsh Psychotherapy Partnership provides highquality psychotherapy delivered by therapists who are in training leading to UKCP registration. Trainees are undertaking advanced diplomas in integrative or gestalt psychotherapy and are in clinical supervision. WPP offers creative, quality psychotherapy and counselling services to the population of Wales, particularly those whose needs are not currently addressed by statutory and existing voluntary service provision. www.welshpsychotherapy.org.uk
ACOMP Accrediting Organisation for Medical Psychotherapy · ARBS Arbours Association · ACAT Association for Cognitive Analytic Therapy · AFT Association for Family Therapy and Systemic Practice · AWAKEN Awaken School of Outcome Oriented Psychotherapies · BCPC Bath Centre for Psychotherapy and Counselling · BPA British Psychodrama Association · CFET Caspari Foundation · CCOPPP Canterbury Consortium of Psychoanalytic and Psychodynamic Psychotherapists · CCPE Centre for Counselling and Psychotherapy Education · CAP Confederation for Analytical Psychology · CPJAC Council for Psychoanalysis and Jungian Analysis College · CPPC Counsellors and Psychotherapists in Primary Care · FIP Forum for Independent Psychotherapists · FPC Foundation for Psychotherapy and Counselling · GUILD Guild of Psychotherapists · HIP Hallam Institute of Psychotherapy · IATE Institute for Arts in Therapy and Education · IFT Institute of Family Therapy · IGA Institute of Group Analysis · IPS Institute of Psychosynthesis · IPSS Institute of Psychotherapy and Social Studies · KI Karuna Institute · MCCP Matrix College of Counselling and Psychotherapy · MET Metanoia Institute · MC Minster Centre · NCHP National College of Hypnosis and Psychotherapy · NGP Northern Guild for Psychotherapy and Counselling · NRHP National Register of Hypnotherapists and Psychotherapists · PCP PCP Education and Training · PA Philadelphia Association · SCPTI Scarborough Counselling and Psychotherapy Training Institute · SPTI Sherwood Psychotherapy Training Institute · SITE Site for Contemporary Psychoanalysis · SEA Society for Existential Analysis · TACT Therapy And Counselling Teesside · TER Terapia · BC The Bowlby Centre · GAPS The Guild of Analytical Psychologists · SPCRC The Regent’s School of Psychotherapy and Psychology · UKAHPP UK Association of Humanistic Psychology Practitioners · ITA United Kingdom Association for Transactional Analysis · UPCA Universities Psychotherapy and Counselling Association · WMIP West Midlands Institute of Psychotherapy
continuing professional development
Your advert here The Psychotherapist, UKCP’s flagship publication, is sent to over 8,000 psychotherapists and psychotherapeutic counsellors and to more than 70 organisations, placing it at the heart of the psychotherapy profession and making it a great place to advertise training, events and other services for the psychotherapy community.
To find out more, email firstname.lastname@example.org Psychoanalytic Practice and Film
10 mon s m n s f om Nov mb 2015 o Augus 2016, S u s 10.30 m-1.30pm, F : £550. CPD c tiﬁc of tt n nc v b . P s con c b g @btin n .com o v s .ps c o p ms o .co.uk
NORTHERN GUILD Newcastle & Teesside
Post Qualifying Diploma in CHILD / ADOLESCENT Psychotherapy or Counselling (Conversion Course)
ACCREDITED DIPLOMA & MSc COURSES Child or Adult route Delivering professional training for over 30 years www.northernguild.org email@example.com 0191 209 8383
continuing professional development
continuing professional development
The Minster Centre Pioneers of integrative training since 1978
Organisational Member of BACP and UKCP, Collaborative Partner of Middlesex University. Part-time professional training, provided in Queens Park, London. www.minstercentre.org.uk
Our new Postgraduate Diploma / MA in Professional Practice, Counselling & Psychotherapy offers a unique opportunity for professional counsellors to attain a higher level qualification in either supervision or advanced clinical practice. You are invited to attend th
our open evenings on 27 October for the advanced rd
clinical practice option and on 3 November for the supervision option. Please contact Gabor at firstname.lastname@example.org to book a place or contact Course Developer Dr Val Thomas to discuss your options at email@example.com. The Minster Centre, 20 Lonsdale Road, Queens Park, London NW6 6RD. Registered charity no 1042052. Company registered in England and Wales number 2966937
THE WINNICOTT TRUST
British Psychoanalytical Society, British Psychoanalytic Association [an association of the British Psychotherapy Foundation] and Association of Independent Psychoanalysts
DONALD WINNICOTT AND THE HISTORY OF THE PRESENT A CELEBRATION OF THE COLLECTED WORKS OF D.W. WINNICOTT An International Conference including: STEFANO BOLOGNINI, VINCENZO BONAMINIO, ANGELA JOYCE, LYNNE MURRAY, KENNETH ROBINSON, RENÉ ROUSSILLON, KENNETH WRIGHT FRIDAY 20TH (EVENING) | SATURDAY 21ST | SUNDAY 22ND (1:30)
DONALD WINNICOTT AND THE HISTORY OF THE PRESENT
INSTITUTE OF PSYCHOANALYSIS AND THE BRUNEI GALLERY LONDON FOR FURTHER INFORMATION PLEASE CONTACT
Photograph of D.W. Winnicott – Courtesy of the D.W. Winnicott Archive Wellcome Library London
continuing professional development The Psychotherapist Ad. 2015_The Psychotherapist Guild Ad 15/8/13 25/08/2015 09:49 Page 1
A New Therapy for Politics? Professor Andrew Samuels The Guild of Psychotherapists Annual Lecture will be held on Saturday, 7 November 2015, 10:00 – 12:30 at The Guild of Psychotherapists, 47 Nelson Square, London SE1 0QA. It will be followed by a light lunch.
Professional Training in Psychoanalytic Psychotherapy
The Guild of Psychotherapists has over 40 years’ experience delivering a highly professional training in psychoanalytic psychotherapy.
Open Day Saturday, 30 January 2016 The Guild of Psychotherapists has over 40 years’ experience delivering a highly professional training in psychoanalytic psychotherapy. We accept trainees from diverse backgrounds, valuing life experience as well as academic qualifications. The first year of the training in psychoanalytic pluralism can also be a standalone one-year course. Applicants applying for the four-year training are required to have been in twice-weekly psychotherapy for one year prior to beginning the training. The training is comprised of a four-year clinical and academic programme that leads to UKCP registration. The closing date to apply for this course is 23 May 2016.
For further information, application forms for all courses, and booking form for the annual lecture please contact:
Introduction to Psychoanalytic Concepts
The Guild of Psychotherapists,
The Guild also offers an Introduction to Psychoanalytic Concepts, a ten-week course
47 Nelson Square, London SE1 0QA
on Wednesday evenings, beginning on 27 April 2016. This course will be of interest
t: 020 7401 3260
to health professionals and anyone interested in psychoanalytic ideas, as well as
those considering future psychoanalytic training.
The closing date to apply for this course is 4 April 2016.
Train with the IGA ABERDEEN • BRIGHTON • EDINBURGH • LONDON • MANCHESTER MIDLANDS • NORTH EAST • OXFORD • TURVEY (BEDS) • YORK Providing training for over 1100 individuals every year throughout the UK, the Institute of Group Analysis is the premier provider of group analytic and group work training in the UK.
The IGA provides:
Relevant to anyone with an interest in the dynamic relationship between the individual and the group, the IGA Foundation Course in Group Analysis introduces students to an exploration of our essentially social nature and the wide range of applications of group analytic theory.
Foundation Courses Introductory Week-ends Professional Training (UKCP Accredited) Short Courses Personal Development and CPD Workshops Bespoke Training and Consultancy Group and Individual Therapy Referrals Supervisor and TGA Referrals
Group analytic training will equip students to understand and to participate more fully in a range of group settings including: work, family, social, learning and therapeutic. Graduates of the IGA Qualifying Course in Group Analysis are eligible to become full members of the IGA and to gain professional registration with the UKCP. Suitably qualified and experienced therapists (including from non-group trainings) can continue their learning and development with an IGA Qualifying Training in Group Supervision or our new Qualifying Training in Reflective Practice in Organisations which lead to IGA associate membership (subject to terms and conditions). If you would like to know more about group analysis and group therapy, or how to continue your learning journey, join one of our free events or courses. Book online at www.groupanalysis.org or ring the National Office on 020 7431 2693.
INSTITUTE OF GROUP ANALYSIS
1 DALEHAM GARDENS • LONDON NW3 5BY • TEL: 020 7431 2693 • WWW.GROUPANALYSIS.ORG
Book online: www.groupanalysis.org
THE IGA IS A CHARITY REGISTERED IN ENGLAND AND WALES (280942), AND IN SCOTLAND (SC040468); AND IS A COMPANY REGISTERED IN ENGLAND AND WALES 01499655
Enquires: 020 7431 2693
continuing professional development Enlightening, practical and inspiring: Gestalt courses, from September onwards at our new Camden premises. Groupwork courses with Michael Ellis A rolling programme of workshops including: Developing Effective Group Facilitation: 1 day next held on 22 January 2016 Conflict, Challenge and Confrontation in Groups: 2 days next held on 25 & 26 February 2016 Understanding Group Dynamics: 2 days next held on 19 & 20 May 2016 Group Facilitation Intensive: 9 days in 2 or 3 day blocks starting 14 April 2016
Organisational Development with Tony Fraser Gestalt in OD In Practice: 6 days, 10-12 December 2015 and 21-23 January 2016 Gestalt in OD Masterclass: 10 days spread over the year
Practitioner CPD Courses including: The Drama of Being an Adolescent with Violet Oaklander Foundation Tutor, Jon Blend. 4-7 November 2015 Free Fall Writing as Creative Therapy with Angelika Wienrich. 21 & 22 May 2016
Learn more. Call 020 7383 5610 or visit www.gestaltcentre.org.uk
continuing professional development
continuing professional development Therapy room to let in prestigious chiropractic and complementary health clinic in Clerkenwell.
Positioned within ten minutes walk of Barbican, Old Street and Angel tube stations we also offer highly trained and friendly reception facilities. For further information visit our website clerkenwellbeing.co.uk or call our practice manager Alistair on 020 7490 4042
The Home of Existential Therapy
Apply now for our MA or MSc programmes MA in Existential Coaching* â€˘ Learn to use existential and phenomenological insights into human predicaments in executive and life coaching. â€˘ Study in 5-day intensive modules over 2-4 years. â€˘ 360+ hours of coach specific training towards your professional accreditation.
The Chiron Association for Body Psychotherapists offers a new
Body psychotherapy is at the forefront of integrating the main contemporary psychotherapeutic modalities and teaches the most versatile and most state-of-the-art approaches to truly integrated work. The main sub-modalities of body psychotherapy (Biodynamic psychotherapy, Biosynthesis, Bioenergetics, and BodynamicÂŽ psychotherapy) and some body-based trauma therapy methods, as well as relational psychoanalysis, attachment theory and Gestalt therapy will be included in our cutting-edge body psychotherapy training. The course is over 2 to 3 years and intended to be completed by therapists who have an ongoing therapeutic practice. It is oriented towards UKCP accreditation as a Body and Integrative Psychotherapist. It is most suitable for those who want to become more rounded, work at a deeper level, and be more clinically effective.
MSc in Typical and Atypical Development through the Life Span* â€˘ Achieve a theoretical understanding of practical skills in helping, children, adolescents and adults with autism spectrum disorders, attention deficit hyperactivity disorder, associated speech language disorders and related neurodevelopmental conditions. â€˘ Study entirely online, from anywhere in the world. * Validated by Middlesex University
Apply immediately to start January 2016 In partnership with
/'+'+%4'))'+'1'))5 #$,/1&,0#4&,/#.2)'6#" -05!&,1&#/-'010#%'01#/#",/#.2'3)#+1 '/011/'+'+%'+1(#'+#-1#* #/ 01#/50!1, #/ -/') 2+#
, ,,(%,1, ,"5-05!&,1&#/-5,/%2( ,+1!11&/'+12$$#/ (1&/'+012$$#/!,2(
FOR FURTHER INFORMATION Existential Academy 61â€“ 63 Fortune Green Road London NW6 1DR
T 0845 557 7752
0207 435 8067 E firstname.lastname@example.org www.nspc.org.uk
UKCP & IGA joint conference Reflecting the diversity of group work in the UK
L RT O F SI
A two-day conference exploring the place of Silence in Psychotherapy, Society and our World 16th/17th April 2016 Regent’s University, London SPEAKE RS
Friday – Saturday, 5–6 February 2016 London (venue TBC) Group work can foster a sense of belonging and developed social and communication skills that can improve social relationships outside the group. Lord Alderdice will be opening the conference on the evening of 5 February with a drinks reception. • Mix with leaders in the field and peers • Share ideas and experiences with group workers from across the country • Certificate of attendance can be used towards your CPD (where appropriate) Call for workshops: We invite you to propose a workshop for this event based on the above theme. The workshops should be designed for 20–25 delegates. The deadline for submissions is 1 November 2015. Please contact Sophia Dick email@example.com To register your interest or for further information please email firstname.lastname@example.org or telephone 020 7014 9966
Brian Keenan – Writer and Poet Maura Sills – Founder, Karuna Institute Rebecca Crane PhD – Director, Centre for Mindfulness Research and Practice, Bangor University Matthew Adams PhD and David Harley – Lecturers, University of Brighton Catherine McGee – International Meditation Teacher and Advisor to One Earth Sangha Mac Macartney – Public Speaker, Author and Embercombe Founder
For all further information visit the conference website: www.theheartofsilence.co.uk
The Association of Core Process Psychotherapists
ACPP is the membership organisation for practitioners of Core Process Psychotherapy. THIS CONFERENCE COUNTS FOR 14 HOURS CPD
Sharing learning from complaints: a complaints case study workshop Saturday 6 February 2016, London (venue TBC) The focus will be on collaboration and information sharing between members, the UKCP complaints team and the Professional Conduct Committee, in the hope that everyone can come away from the day feeling more informed about UKCP’s Complaints and Conduct Process (CCP) and more positive about how to deal with situations that relate to complaints. The workshop will include: • A summary of findings from complaints we have received/handled over the past two years (since CCP came into place) • Common themes and any lessons we have learned from cases that may help members when dealing with similar situations. This workshop is an opportunity for members to discuss these learning opportunities and any possible trigger points to look out for. We aim to encourage a healthy and creative conversation between members and staff to share personal knowledge and experience of best practice. This is a free event. To register your interest, please email email@example.com or telephone: 020 7014 9966