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• I read with interest Nicola Barden’s valedictory article ‘Thinking ahead’ (Therapy Today, December 2008). I was taken with her pronouncement that ‘BACP’s position is to support the principle of public protection and therefore of statutory regulation.’ Whilst I do not think that the primary issue here is necessarily a regulatory one, this did at least get me thinking about what we as a profession might do if we were really serious about protecting the public.
  
  As most people are probably already aware, there are two main regulatory mechanisms: titular regulation, which protects the practitioner’s title (which is what we’re presently heading for under the auspices of the HPC) and functional regulation, whereby no unregistered practitioner is allowed legally to perform the function that is being regulated, such as in the case of surgery. If we were truly committed to affording the public the highest level of protection available, once we have secured the protection of our titles, should we not proceed to consider pressing for full functional regulation; on the basis that, if the public really are at risk from incompetent or unethical practitioners, then surely no non-registered practitioner should be allowed to practise the functions of the psychological therapies, irrespective of whether or not they are laying claim to one of our hallowed titles? If we are satisfied to curtail our regulatory mission once we have secured titular regulation, we would risk our true motives being perceived as principally self-interested – first and foremost in protecting our professional status and the incomes thereby afforded us.
  
  One of the difficulties in configuring some form of functional regulation of the psychological therapies lies in uniquely defining those functions that therapists actually perform with their clients: in the main, they sit around listening to and talking with them. But just as this admittedly rather rough and ready description of therapy would not fit every psychotherapeutic endeavour, nor too are these difficulties insurmountable. With sufficient political will, I have no doubt whatsoever that this is manageable.
  
  But I suggested above that I did not consider regulation to be the fundamental issue at stake here. To my way of thinking, Nicola hinted at a more significant issue when she remarked that ‘we seem to be trying to engage in a paradigm that doesn’t fit.’
  
  She had been writing about the principle of evidencebased practice that underpins the guidelines recommended by NICE. Surely the paradigmatic difference to which Nicola rightly alludes is illustrated by the divergence between the physical and the material on the one hand, and the psychological and the spiritual on the other.
  
  Although it is pleasing to read of those ways in which we are already embarked on a mission to convince society that our emotional and spiritual wellbeing is just as significant as our physical and material wellbeing, we clearly have some way to go with respect to this endeavour.
  
  Over the years I have done a great deal of work for managed care companies with clients who have come to me for treatment for psychological trauma, especially following road traffic accidents (RTAs) and such like. In this line of work, it is not unusual to have clients referred for such treatment between two and three years following the RTA that has been presumed to have initiated their trauma.
  
  Sad to relate, most of them will tell of how they have received no form of psychological treatment in those intervening years. Of course, had they sustained physical trauma as a result of such an RTA, then they would have been taken straight to Accident and Emergency, probably in an ambulance. Why do you think that there is such a striking difference with respect to the urgency with which these two forms of injury are treated? Clearly, working towards the elimination of this disparity must constitute an integral element of realising BACP’s tag line of working ‘towards an emotionally healthy society’. It is, however, a matter for further debate as to whether doing so through a regulatory approach that is similar to that adopted for medicine would best serve this goal of eliminating the evident disparity in the way in which the two professions are regarded, or whether an attempt to eradicate this disparity by using the medical model of functional regulation would constitute an attempt ‘to engage in a paradigm that doesn’t fit’, as Nicola puts it.

• DCouns, MBACP (Snr Accred), FBACP, UKRCP Registered Independent Practitioner