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Newcastle is a lovely city. The people are friendly, the bars interesting, the restaurants a-plenty, the Metro a breeze, and the accent really quite fantastic; even when being shouted by a group of 15 young, drunken men running up an escalator the wrong way. How do I know this?
Therapist column - About cats and dogs
Newcastle is a lovely city. The people are friendly, the bars interesting, the restaurants a-plenty, the Metro a breeze, and the accent really quite fantastic; even when being shouted by a group of 15 young, drunken men running up an escalator the wrong way. How do I know this? Well, I’ve just returned from the BACP conference there, and when I wasn’t sitting attentively listening to some pretty amazing presenters, I allowed myself to leave the hotel, even if only briefly (of course).
The conference had some great presentations, and one of the best keynote speakers I have come across. Scott Miller entertained us for an hour and a half on such things as standard deviations, research, evidence-based practice (or practice-based evidence, as he would prefer) and outcome data. You really wouldn’t imagine that this sort of thing could be funny... at all, ever. All I can say is that if you get the chance to hear him, take it.
At one point he used a particularly funny analogy about cats and dogs. Physicians are like dogs, ie a pack animal that do their ‘business’ in public, and stick together. Whereas counsellors and psychotherapists are like cats, any ‘business’ done is private (and therefore can remain hidden), and we’re not so hot at working together. He then went on to do an impression of a cat, which I really can’t do justice to here.
But for me, the analogy had some sort of truth, having overheard several discussions about the relative merits of different modalities. Is person-centred better at this, whereas psychodynamic is better at that? Solution-focused really has the edge over Gestalt, and CBT is, well, what can I say, simply better at everything... apparently.
This theme was revisited by several people throughout the conference, who raised concerns about the fact that after many years of trying, we still seem to be fighting over the same arguments. We seem to be such a modality orientated group, more concerned with how we do something, as opposed to what we do, and why. Several called it ‘tribalism’, and noted the power it has to separate rather than bring together. It seems such a potentially dangerous dynamic when we are at a point where division seems to be the order of the day.
I’m not sure when or how it started. Training is so strongly organised around modality or orientation that the culture of difference is embedded right at the beginning of becoming a therapist. Research so often focuses on whether approach A works better with problem B than approach C might. What comes first: does our structure of training enshrine into us a model loyalty, which is then replicated in the research we undertake? Or alternatively, does the emergence of such research inevitably lead to us needing to take a position? That said, I think it would be really interesting to know how many qualified therapists, five or 10 years post qualification, still work to their purist model from training.
What Scott Miller asserted, as has been supported by other research, is that the model is less important to the outcome than the ability of the therapist to meet with a client and establish a safe, respectful relationship in which issues can be explored. Interestingly, when he said this it was not greeted with gasps of shock, nor was there a cacophony of disapproving tuts. Instead, the collected throng nodded knowingly, comfortable with a familiar truth.
So here we have an interesting paradox: we know that the model is less important than the quality of the relationship, and yet if there are divisions between us, they usually emerge around what model we align ourselves to; a bit like West Side Story, but with feeling. This feels particularly precarious at the moment when statutory regulation and numerous treatment guidelines threaten to define what we do and how we do it – to separate us even further. There is a danger of us being hoisted by our own petard I fear.
However, I would not advocate a homogenous group in which we lose our identity; some sort of gloopy saccharin mess that always looks and tastes the same. That would be an unbearable future and a terrible blow to client choice and autonomy. But I came away from Newcastle thinking that an immediate challenge for us is to think more about our commonality and the ties that bind, rather than focusing on division and difference and allegiances to separate groups.Andrew Reeves is a counsellor at the University of Liverpool Counselling Service and editor of Counselling and Psychotherapy Research (CPR).







