Given the growing numbers of BACP members who do not support state regulation of counselling and psychotherapy through the Health Professions Council (HPC), as evidenced by letters and articles in Therapy Today, attendance and dialogue at the recent London conference ‘Against Regulation: The Next Steps’ and the many BACP members and accredited practitioners who have signed the online petition against current regulatory proposals, we write to ask how BACP will be supporting those of us considering a position of principled non-compliance with HPC?

To clarify, we are not against regulation per se but are opposed to the model imposed by the Government, as were all the major therapy organisations when HPC was first announced as the chosen regulatory body. At the time, BACP was concerned enough to propose with others a short-lived alternative, the Psychological Professions Council, which it claimed in a 2006 submission to the Department of Health, ‘would better deliver public protection and safety’.¹ As we all know, this proposal was rejected by the Government, so BACP now publicly supports HPC as the regulator of our profession.

We, however, have not changed our minds about the inappropriateness of HPC and maintain two principal objections: first, most therapists do not work in the medical sector; counselling and psychotherapy are not health professions, nor are they ancillary to medicine and healthcare. As such, the practices and values of the HPC regulatory structure are entirely incongruent with the values of most therapeutic work.

Second, there is no evidence and no substantive case that the model proposed will enhance public protection. On the contrary, there is evidence and substantive argument that it will do more harm than good, both in the matter of public protection and to the field generally. A number of full-length books^{2, 3, 4, 5, 6, 7} have undermined the ‘common sense’ public protection assumption and challenged every other aspect of the pro-regulation case; no such extensive, thoroughly researched and cogently argued literature exists to support the decision to regulate through HPC. For these reasons and more, a portion of the BACP membership is left in something of a dilemma, which we outline below.

We do not believe HPC regulation will add anything of significant value to the work of therapists nor to the experience of clients, certainly nothing sufficient to outweigh the damage it is likely to inflict, damage already being done in three closely related government initiatives in the psy-domain: NICE guidelines, the IAPT scheme and Skills for Health’s ‘competences in development’ for the psychological therapies. We are not, therefore, represented by the BACP executive’s public line on this issue, which has been decided upon without a poll of the membership. The regional consultations cited by Sally Aldridge (Letters, Therapy Today, February 2009) to suggest that the majority of members support HPC regulation have been reported by some attendees as being less consultations – with members’ views sought and recorded – than top-down exercises in information-giving, reassurance and persuasion. By any standards, these events were not a sound method of gauging the membership’s views on such a critical issue.

However, we are fee-paying BACP members and would like to remain so. We support public protection through self-regulatory accountability systems – such as BACP’s Ethical Framework – and we value being part of a large community of practitioners. We believe BACP could be influential in developing improved accountability structures and alternative regulatory models to HPC, including enhanced public education, and might lead the way in pressing for changes to existing laws to confront the worst exceptional cases of malpractice. It might also progress professional conduct procedures towards conciliation, mediation and negotiation, which, in contrast to the deeply inappropriate adversarial model employed in HPC Fitness to Practise hearings,8 would honour the complexities of therapeutic relationships and the overlapping and sometimes contradictory subjective realities that constitute the work.

In essence, the dilemma we face is simply that on the matter of HPC regulation the agenda of the BACP executive is entirely at odds with our own experience and philosophy as practitioners. While the executive members are committed to working with the Government to see that HPC regulation occupies the field, we are considering a position of principled non-compliance, should regulation occur, with accredited practitioners potentially requesting not to be transferred automatically onto the HPC register. To be clear, some of us are considering refusing to register with HPC – a conscientious objection of sorts – supported in our stance by principle, evidence and reasoned argument.

Potentially, the dilemma described can be held – by us, the executive and the membership as a whole – in the same way that BACP professes to hold and support diversity in other areas of its work. But only if we can gain some clarity on how the organisation will respond to such intentions as principled non-compliance. Will BACP continue to accept our individual memberships or will we need to go elsewhere for the professional ethics and accountability systems that as responsible practitioners we believe essential? Will principled non-compliance with HPC become a contravention of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy? Does BACP intend to ask each accredited member for their consent to being transferred onto the HPC register?

We hope BACP will respond to our convictions and questions in a similar spirit to that hinted at by UKCP, who presently remain committed to participating in regulation but nonetheless informed members in their April Newsletter (p5) that: ‘Refusing to participate as a statement is a choice each individual needs to make, and dissent and debate are both healthy and to be welcomed… Some will decide that the Health Professions Council (HPC) codes of practice are not compatible with their values and decide not to register… This may be an ethically sound choice and UKCP will support individuals who make it.’

Can we expect an equivalent or indeed greater degree of public acknowledgement and support for the growing number of BACP counsellors and psychotherapists – employed, voluntary and in private practice – who make the ethically sound choice to oppose HPC regulation because they see it is deeply flawed, potentially damaging, lacking in supporting evidence and incompatible with their values as practitioners, persons and citizens?

Pamela Austin, Charles Becker, Kris Black, Steve Burchell, Beverley Costa, Julia Driscoll, Noreen Emmans, Chris Evans, Cathy Ford, Irene Galant, Penny Georgiou, Judi Hattaway, Robert Henn, Sarah Hinds, Suzanne Keys, Sala Lawrence, Katrina Likhtman, Janet Low, Jennifer Maidman, Candida Maltby, Paul McGahey, Arthur Musgrave, Jenny Nicholson, Justine O’Brien, Manuela Piott, Andy Rogers, Barbara Shannon, Zoe Shobbrook, Anita Spark, Helen Storey, Martin P Tootall, Leo Turner, Els van Ooijen, Katrina Voysey

1. BACP’s formal response (10/11/2006) to the Department of Health’s ‘public consultation on proposals for change’ in Healthcare Professional Regulation. Retrieved on 23/04/09 at: www.bacp.co.uk/notice_board/responses/DoH_HPR_nov06.doc
2 Postle D. Regulating the psychological therapies: from taxonomy to taxidermy. Ross-on-Wye: PCCS Books; 2007.
3. Hogan DB. The regulation of psychotherapists. Ballinger; 1979.
4. Mowbray M. The case against psychotherapy registration. London: Trans Marginal Press; 1995.
5. House R, Totton N (eds). Implausible professions: arguments for pluralism and autonomy in psychotherapy and counselling. Ross-on-Wye: PCCS Books; 1997.
6. Bates Y, House R (eds). Ethically challenged professions. Ross-on-Wye: PCCS Books; 2004.
7. Parker I, Revelli S (eds). Psychoanalytic practice and state regulation. London: Karnac; 2008.
8. HPC hearings described and analysed here: http://hpcwatchdog.blogspot.com/ and in Postle D. War of the worlds: the state vs. Mr Gale – the first three days. Retrieved on 24/04/09 at:
http://ipnosis.postle.net/pages/GaleHearingWarWorlds.htm