Introduction

This report examines the proposed regulation of counselling and psychotherapy under the Health Professions Council. In 2007 the Government White Paper on ‘Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century’ gave the HPC the task of assessing the ‘regulatory needs’ of the talking therapies and whether‘its system is capable of accommodating them’. At that time, nearly all the counselling and psychotherapy organisations in the UK had agreed that HPC was not suited to regulate the talking therapies, and a variety of alternative models were discussed.

Since then, the field has been split into two camps: the groups and individuals who have concerns about HPC yet who do not wish to ‘miss the boat’, so accept the principle of HPC regulation, and those who maintain their original objections and continue to articulate critiques of HPC. Many of these organisations and individuals have made it clear that they would not register with HPC as this would involve not only a breach of professional ethics but a radical redefinition of the nature of psychotherapy itself.

This report details the arguments for and against HPC regulation, and sets out the history and context of the debate, with comparisons to the situation in Europe and internationally. It concludes that:

• The HPC has not done what it was required to do, failing to conduct a proper assessment of the regulatory needs of the field and of its capacity to accommodate the talking therapies.
• The consultation process has been narrow and biased.
• The definition of psychotherapy arrived at by HPC is unacceptable to a large part of the field and will not help the public in making informed decisions about psychotherapy. Many forms of therapy do not consider themselves health professions and are based on highly disparate philosophies and approaches.
• Although there have been several projects to ensure that therapists are registered and subject to complaints procedures, Britain is the only European country which has aimed to regulate the actual content of therapy sessions.
• Although its complaints expenditure is the largest part of its budget, with £4.66m spent in 2009, only a tiny percentage of complaints from the public are heard each year. Of these, more than 70% are found to have no case to answer, compared with only 10% deemed to have no case to answer by one of the field’s main regulatory bodies, the UKCP.
• For the past three years, HPC has consistently failed to process more than 30% of complaints received from the public, creating a growing backlog. Complaints take an average of at least one year to be heard, placing undue stress on all parties concerned.
• Where around 60% of complaints from the public are currently resolved by mediation in therapy organisations, HPC provides no mechanisms of mediation or informal process. Hearings take place in public, depriving the complainant of the confidentiality necessary to articulate details of a case.
• The alternative statutory model of Practitioner Full Disclosure (PFD) would better serve the public and the profession. It is less expensive than HPC, gives the public more web-based information about therapists, and is able to process a greater number of complaints.


This report is named after the home that Freud found in this country, when he was invited here in 1938: Maresfield Gardens. Britain’s hospitality was appreciated by the founder of psychoanalysis, and there is a certain irony that today the UK is the only European country where the many and varied practices of psychotherapy inspired by Freud’s work - as well as psychoanalysis itself - are directly threatened by the current proposals for HPC regulation.