As part of the current opposition in the psy world to the blanket regulation
of the psy professions by the HPC, a process which will eventually subject
the practice of psychoanalysis to standardised norms of supposed good
practice and so herald its demise in everything but name, the College of
Psychoanalysts is organising a one-day conference on June 6 ŒAre you fit to
practise? From Ethical Framework to Model of Good Behaviour¹. In view of the
importance and urgency of the situation, we are taking the liberty of
informing you of this conference through our mailing list.
Registration fees are: £70 (non-members); £60 (members); £30 (trainees).
To Register: please send cheques (payable to ŒThe College of Psychoanalysts
– UK¹) to: The College of Psychoanalysts – UK, BCM Box 2629, London WC1N
3XX.
Véronique Voruz
Chair, London Society of the NLS
The College of Psychoanalysts – UK
CONFERENCE PROGRAMME
Saturday 6th June 2009, 10am – 5pm
Room MAL BO4
Birkbeck, University of London
Malet Street, Bloomsbury, London WC1E 7HX
Are You Fit to Practise?
From Ethical Framework to Model of Good Behaviour
R
A one-day conference
organised in association with the Academy of Psychoanalysis
Registration
£70 (non-members); £60 (members); £30 (trainees)
Please send cheques (payable to ‘The College of Psychoanalysts – UK’) to:
The College of Psychoanalysts – UK, BCM Box 2629, London WC1N 3XX.
Please note:
Lunch and refreshments will be provided only for attendees who register in advance.
The Health Professions Council is moving to regulate the talking therapies in the UK. If this goes ahead, practitioners will be subject to its ‘fitness to practise’ policy and procedures. The HPC explains:
‘Fitness to practise involves more than just competence in a registrant’s chosen profession. When we say that registrants are fit to practise, we also mean that they have the health and character, as well as the necessary skills and knowledge, to do their job safely and effectively. We also mean that we trust our registrants to act legally. Our main responsibility is to protect the public… The type of complaints we can consider are about whether a registrant’s fitness to practise is ‘impaired’ (affected) by: their misconduct; their lack of competence; a conviction or caution for a criminal offence (or a finding of guilt by a court martial); their physical or mental health; and a determination (a decision reached) by another regulator responsible for healthcare. We can also consider allegations about whether an entry to the register has been made fraudulently or incorrectly. There is no time limit on considering complaints.’ (http://www.hpc-uk.org/complaints/making/nothappy/)
This conference provides an opportunity to explore the effects of demands for a shift from an ethical framework for the professions to a functional framework of behaviour regulation. This shift has meant that practitioners should no longer be trained, supported and trusted to work ethically, but must be held to account for a specific promise of ‘good behaviour’, demonstrating their adherence to uncritically defined notions of ‘good character’. Where ethical positions seek to guide them to develop a relationship with their patients/clients appropriate to the specific and individual work undertaken, the new proliferation of codes of conduct assert how they should behave, what they should or should not do in any situation, and even what they should or should not feel.
What may be lost to professions by the equation of ‘ethical practice’ with a prescription for ‘good behaviour’? Can an authentic professional relationship be guaranteed or even encouraged by enforcing adherence to a definition of ‘good character’ or ‘fitness to practise’ that claims to be underpinned by an objective universality? Would subscribing to this model commit professionals to a practise that is fundamentally ill-equipped to respond to the unknown, the contingent and the unpredictable — in other words, to human life itself?
10,00am – 10,30am
Registration (tea/coffee)
MORNING SESSION
Chair: Haya Oakley
10,30am – 10,50am:
Darian Leader
Welcome and Introduction
10,50am – 11,15am
Mary Clark-Glass
Public protection not punishment: the Health Professions Council’s modern approach to Fitness to Practise.
The talk will set out how the HPC disciplinary processes work, and will emphasise why protection of the public, upholding of professional standards and the need to maintain public confidence in the professions regulated by the HPC are the paramount considerations of the panels hearing disciplinary cases.
11,15am – 11,40am
Jacques China
Is psychoanalysis in danger of being judged unfit to be practised?
The professions of psychotherapy and counselling are, in accordance with the wishes of both the government and many practitioners, currently being reviewed for proposed regulation by the Health Professions Council, as a regulatory agency of the state. Many other practitioners, while not opposed to effective regulation, are bitterly opposed to this particular form of regulation. Many psychoanalytic practitioners are rightly concerned about whether it will be possible, any longer, to engage effectively in the psychoanalytic encounter, under the proposed rubric of HPC. There are many aspects of such proposed regulation that might make this difficult, if not impossible, but none more so than the concept of fitness to practise. In pursuit of this principle by HPC, patients will be able and maybe even encouraged to bring almost any form of complaint against the practitioner they are seeing. We will explore the implications of this and consider whether such a worrying possibility will put an end to the therapeutic role of and insight into transference phenomena within psychoanalytic treatment and, as a result, entirely undermine psychoanalysis as the valuable resource and effective form of psychological intervention and means of understanding human experience that it has been until now.
11,40am – 12,05am
Phil Mollon
Fitness to practice what? The destruction of psychotherapy in 21st Century Britain.
The combination, of the profoundly flawed NICE guidelines on psychological therapy and the moves towards state regulation of psychotherapy, creates a powerful and malign oppression of the life of the therapeutic encounter. There are several reasons why psychotherapy is not analogous to a pill or a standardised quasi-medical procedure – although NICE treats it in just this way. State regulation raises the following spectre: attention to the unique qualities and needs of the individual client will be proscribed, whilst what is prescribed is a small number of standardised ‘therapeutic’ protocols. This is to be done in the name of protecting the public!
12,05pm – 12,30pm
Panel Discussion
12, 30pm – 1pm
Question Time
1,00pm – 2,10pm: Lunch
AFTERNOON SESSION
Chair: Sian Ellis
2,15pm – 2,40pm
Kevin Jones
Fit to practice? Teaching art psychotherapy under state regulation.
This paper suggests ways in which future state regulation might affect training in counselling and psychotherapy. It situates ‘fitness to practice’ in relation to the marketization and regulation of higher education and the public sector. It describes how state regulation influences the teaching of theory and practice on the MA Art Psychotherapy at Goldsmiths. The effects of HPC regulation are also influenced by the universities Quality Assurance Agency, the drive towards education geared toward ‘’Skills for Industry’’ and in the NHS, providing training linked to government policy regarding Skills for Health, Increased Access to Psychological Therapies and ‘Evidence Based Practice’. These agendas combine to increase bureaucracy and intensify the micromanagement of a workload focused on regulatory procedures. As this model is internalised by practitioners, students and clients are increasingly related to as consumers of goods and services. For trainings in counselling and psychotherapy, the character ‘fit to practice’ will be a character fit to practice relationships of exchange in the neo-liberal market place.
2,40pm – 3,05pm
Paul Verhaeghe
“Fitness to practice”: if they don’t make you happy, sue them.
The idea of the state regulators to regulate and control psy-practitioners is problematic for at least two reasons. First of all, a psychotherapeutic manualized treatment based on a protocol like approach is doomed to fail. A genuine psychotherapy is to a large extent unpredictable and what is “good” for one client can be very bad for another. This implies that it is impossible to measure the “good behavior” of a practitioner. Secondly, and even more importantly, the failure of such a manualized “good behavior” approach will dovetail with a certain conviction shared by many clients. The contemporary discourse tells people that their problems are caused by things (other people, genes) outside them, meaning that they can’t do anything about it and that a solution has to come from an almighty Other. When they discover a) that the therapist fails in this respect and b) that an organization provides them with the opportunity to put a complaint if the therapist doesn’t make them happy, a number of them will be all too happy to use this outlet. My prediction is that this organization will be submerged by mostly irrelevant complaints and that patients with a genuine complaint will almost never present one.
3,05pm – 3,35pm
Question Time
Chair: Sian Ellis
3,35pm – 3,55pm
Break (tea/coffee)
4,00pm – 4,50pm
Full Panel Discussion (all speakers)
Chair: Darian Leader
4,50pm – 5,00pm
Closing Remarks
Anne Worthington
CONTRIBUTORS
Jacques China (speaker) received his clinical training in psychoanalysis at The Guild of Psychotherapists, London. His background was in academic and research psychology at University College, London. He designed and ran, as course leader, an MA programme in clinical psychoanalysis at the University of Hertfordshire. His clinical work has been both within the National Health Service and in private practice. He has a keen interest in research and the scientific validation of psychoanalysis, particularly in relation to possible links with attachment theory. He has been trained to administer the Adult Attachment Interview (AAI). He was one of the founding members of The College of Psychoanalysts – UK and The Academy of Psychoanalysis (formerly known as The College of Psychoanalysis), and their first President.
Mary Clark-Glass (speaker) was appointed a lay member of the HPC in 2003. She sits on the Finance & Resources Committee, on the Conduct and Competence Committee, and is currently a lay member of the Professional Liaison Group (PLG) for Psychotherapists and Counsellors, having previously chaired the PLG on Standards of Proficiency. She also chairs Fitness to Practice cases for the GMC and GDC, having previously served on the GMC Council from 1999-2003. From 2004-2007 she was a non-executive member of the Royal Belfast Hospitals Trust Board. Her professional life includes having been a lecturer in law in Belfast from 1974 until 1980. In 1975 she was one of the founders of the Women’s Rights Movement in Northern Ireland, and served on the National Consumer Council and the Economic and Social Committee of the EU in the late 70’s and early 80’s. In 1984 she was appointed chair and chief executive of the Equal Opportunities Commission for N. Ireland. In this time, she served as a Human Rights Commissioner in N. Ireland, and for 25 years was closely involved with the charity Victim Support at local and national level. In 1990 she was appointed a CBE for services to equality in N. Ireland. She also served as a member of the N.I. Commission for Racial Equality. Between 1992 and 1997 she was heavily involved in political negotiations with other N.I. political parties and the British and Irish governments, but retired from all political activity after the signing of the Good Friday agreement.
Sian Ellis (session chair) is a psychoanalytic psychotherapist in private practice. She is a member of the Association for Group and Individual Psychotherapy (AGIP) and a registrant of the UKCP. She is also a member of The College of Psychoanalysts-UK, The Academy of Psychoanalysis and their Board of Governors.
Kevin Jones (speaker) – Starving Artist, Street Theatre and Political Activist 1979-86, Dip Art Therapy Goldsmiths 1986-87, Dip Psychoanalytic Psychotherapy and MA Psychotherapy and Social Studies 2001, private psychotherapy practice as member of Institute of Psychotherapy and Social Studies, UKCP Registered, 2000- present. Lecturer Art Psychotherapy Goldsmiths University of London, 2000-present. Interests include art and psychoanalysis in the age of the neo-liberal drive toward death.
Darian Leader (speaker, session chair) is a psychoanalyst practising in London and the current President of both the College of Psychoanalysts–UK and The Academy of Psychoanalysis. He is a member of the Centre for Freudian Analysis and Research. His books include Why do women write more letters than they post?, Freud’s Footnotes, Stealing the Mona Lisa: what art stops us from seeing, Why do people get Ill? (with David Corfield) and The New black: mourning, melancholia and depression.
Phil Mollon (speaker) is a psychotherapist (Tavistock Society), psychoanalyst (British Psychoanalytical Society), and clinical psychologist (British Psychological Society). In addition to his work within the NHS, he has a small private practice. He has authored a number of books on trauma, dissociation, narcissism, shame, EMDR and, most recently, Psychoanalytic Energy Psychotherapy. With Richard Reeves, he is also co-author of the recent publication ‘The State Regulation of Psychotherapy: From Self-regulation to Self-mutilation?’ (Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, Vol .3, Karnac 2009).
Haya Oakley (session chair, conference organiser) has been practising and teaching psychoanalysis in London for over thirty years. She is a member of The College of Psychoanalysts-UK, The Academy of Psychoanalysis, and their Board of Governors. She is also a member of The Guild of Psychotherapists and The Site for Contemporary Psychoanalysis.
Simona Revelli (conference organiser): psychoanalyst in private practice in London. Member of the Site for Contemporary Psychoanalysis, and The College of Psychoanalysts-UK, The Academy of Psychoanalysis and their Board of Governors. Affiliate member of CFAR. Was a UKCP registrant for many years but recently resigned. Over the last eight years also worked as a psychotherapist and consultant psychotherapist in the NHS, but recently resigned as a result of the corrupting effects of Agenda for Change and the Knowledge and Skills Framework on service delivery and clinical practice. Is the translator of a number of Italian psychoanalytic contributions, including the correspondence ‘Psychotherapy and psychoanalysis: forming or conforming?’, available through the website of The College. With Ian Parker, is co-editor of Psychoanalytic Practice and State Regulation (Karnac 2008), which contains the contributions made at the 2006 international conference organised in London by The College of Psychoanalysts-UK.
Joseph Suart (conference organiser) has worked in the mental health field since 1989, initially as a counsellor, and after training with The Guild of Psychotherapists in private practice in Cornwall. He also works with parents in an NHS Child and Family Service (CAMHS). He is a UKCP registrant and a member of The College of Psychoanalysts, the Academy of Psychoanalysis and their Board of Governors. He is keen to ensure that the independence and vitality of psychoanalytic theory and practice is maintained and allowed to flourish.
Paul Verhaeghe (speaker) is senior professor at the University of Ghent (Belgium) and head of the Department for Psychoanalysis and Counseling Psychology. He teaches clinical psychodiagnostics and psychoanalytic psychotherapy, and also works as a psychoanalyst in private practice. He is the author of Does the Woman Exist? (Other Press 1999) and On Being Normal and Other Disorders (Other Press 2004), which won the Goethe Award for Psychoanalytic Scholarship. His latest publication is New Studies of Old Villains (Other Press 2009).
Anne Worthington (speaker, conference organiser) practises as a psychoanalyst in south London and lectures in psychoanalysis at Middlesex University. She is a member of The Guild of Psychotherapists and its Training Committee, and of the Centre for Freudian Analysis and Research. She is also a member of The College of Psychoanalysts-UK and the Academy of Psychoanalysis, for which she acts as Honorary Treasurer.