The Story So Far
Back in 1990 the European Association for Psychotherapy was set up mainly by Dutch and German psychiatrists. They invited certain individual psychotherapists (again mainly psychiatrists) from other member states to the meeting. Dr. Michael Fitzgerald and later Dorothy Gunne, attended from Ireland.
One of Dr. Fitzgerald’s responses to this initiative was to establish the Irish standing conference for Psychotherapy comprising 5 sections – Psychoanalytic, Systemic, Constructivist, Humanistic & Integrative and Cognitive/Behavioural.
It is not entirely clear but it appears that the EAP was established in order to protect the Dutch and German status quo (i.e., their system of accreditation for psychotherapists, which limits accreditation to psychiatrists and some psychologists). One version of events is that the EAP hoped to protect their interests by putting pressure on at EC Commission level for a Sectoral directive. A Sectoral Directive is Eurospeak for (in this case) legislation, which would regulate the profession of psychotherapy and be binding on each member country.
The sort of legislation or sectoral directive they wanted would have restricted the practice of psychotherapy in each member state to the so called core professions (i.e. psychiatry, psychology and maybe social work). The EC Commission and several MEP’s were lobbied by EAP (Including Ireland’s Mary Banotti). The EC Commission did not agree at the time and basically told the EAP that talk of a Sectoral Directive was premature.
The EAP seems not to have given up however, and while it is not clear what their strategy is, it appears that they are attempting to become more broadly based among member states without in any way diluting their insistence that psycho therapy can only be practiced by the “core professions”.
I mentioned that this is one version of events. It is a story which is taken as fact however by Emmy Van Deurzen Smith of the UK Standing Conference for Psychotherapy, (see Inside Out Summer 1991) and by the management committee of the British Association for Counselling (BAC). Readers will recall that the BAC which is based in Rugby was the organization which set up the Rugby Standing Conference for Psychotherapy (later to change its name to the UK Standing Conference).
It has 8,000 individual members and 500 organizational members. Many of its members also identify as psychotherapists and are by any criteria fully qualified to do so. It’s a long standing, highly respected and very experienced organization.
In a recent BAC policy document (Aug.’92) I found the following: “We believe that the European Association for Psychotherapy will press for regulations placing restrictions on the practice of certain activities specified as psychotherapy. Because of the overlap between counselling and Psychotherapy, the practice of counselling could become regulated by EC regulations drafted by the European Association for Psychotherapy… in other words they seem likely to seek exclusive rights to regulate the whole field for themselves.
So seriously does the BAC take this prospect that the President of BAC, Professor Douglas Hooper (Emeritus Professor at the University of Hull) and his management group have recently sanctioned the expenditure of approximately £20,000 and the hiring of additional full time staff solely for the purpose of establishing an alternative European Association to be called the European Association for Counselling and Psychotherapy (EACP). The fundamental purpose of the EACP will be to cancel out the impact on the EC Commission of the EAP. The EACP will argue that it is representative of the profession throughout Europe and it will strenuously oppose the “core profession” model, which is being proposed be the EAP. The first meeting of the European Association for Counselling and Psychotherapy is scheduled for 5th and 6th December 1992.
Two Dutch members of the steering group of the EAP, Dr. Rien Van Dyk and a Professor Dijhuis came to Dublin on September 4th 1992 and met with the Irish Standing Conference for Psychotherapy. I asked them if the EAP had ever applied for a Sectoral directive or had it any intentions of applying? Dr. Van Dyk gave an emphatic “no” in answer to both questions. Speaking to him later on a one to one basis I asked him why someone like Emmy Van Deurzen Smith should claim that they had made an application for a Sectoral Directive. In response he suggested that she was putting around this rumour because she had not been asked to become a member of the EAP. He could make no comment on why the BAC would be rushing to set up a European Association.
I confess that I find all this very puzzling.
Why Does It Matter?
The Irish Standing Conference for Psychotherapy has been asked to join the EAP. If the BAC and Emmy Van Deurzen Smith (of UKSCP) are on the right track then the EAP stands for a core profession model (i.e. Psychiatrists, psychologists and maybe social workers can only practice psychotherapy) and is prepared to spend large sums of money and a great deal of time and effort to try to persuade the EC Commission to legislate for this model for EC member states.
If the Irish Standing Conference were to join it would further strengthen the EAP’s hand in Europe and would be taken as an Irish statement of support for the core profession model.
We have never had a full and proper debate in this country on the question of who should practice psychotherapy. The question is of the first importance. It is now time to have this debate. Holmes and Lindley (The Values of Psychotherapy, OUP. 1989) set out the various arguments very well.
The core profession model contradicts Freud’s belief in lay analysis and it can be seen as an attempt by vested interests to achieve monopoly.
It can also be argued that many psychiatrists and psychologists, because of their training, probably have more to unlearn when entering the field of psychotherapy than others. While they certainly can have considerable knowledge and experience of mental illness, the intellectual baggage they are forced to take on in order to qualify in their professions is generally contradicted in the theory and practice of most forms of psychotherapy. For example, the logical positivist, biological/organic basis of much of psychiatry is profoundly at odds with some of the basic tenets of psychoanalysis.
Courses leading to degrees in psychology at University level do not include much reference to Freud. The unconscious is not acknowledged, certainly not in psychoanalytic terms. Rogers’ ideas do get a mention but usually in a stilted, academic way rather than in a more alive, experiential mode.
The Way Forward
I believe that the Irish Standing Conference for Psychotherapy should postpone formally joining the EAP indefinitely. Less formal links should be maintained instead. The ISCP should sort out its own criteria to the highest possible professional standards across the different branches of psychotherapy. These standards should be the highest standards, consistent with the history of psychotherapy in Ireland and with Irish Cultural conditions and should at least insist on graduate entry (or equivalent). Graduate equivalent could include – counselling with a number of years experience.
Having achieved this the ISCP should make contact with other National organizations in the 12 member states, with a view to assisting the setting up of a Confederation of European Psychotherapy bodies. The main job of this confederation would be to agree a common denominator among member states of the EC in terms of standards and entry requirements for psychotherapy. This common denominator would eventually be the yardstick to facilitate mobility between the member states.
In the short term I would encourage all psychotherapists opposed in principle to the ”core profession” model to discuss the matter with their colleagues, particularly those in other sections of the ISCP, in the interest of achieving a wider consensus on this issue.
As far as the IAC is concerned, I believe that the time has come for a change of name to “The Irish Association for Counselling and Psychotherapy”. The reasons for this are quite straight forward. The word “counselling” on its own is now almost meaningless. These days there are diet counsellors, financial counsellors and all sorts of others advertizing their services. Adding the word “psychotherapy” to the title would make it clear that we are in the business of psychological counselling and not something else. Merely adding the word “therapy” would not suffice.
In addition, the concept of counselling as a separate profession is unknown in Europe, outside Ireland and the UK. What we call counselling in Ireland is known as psychotherapy in Europe. If we are to be professionally influenced by events in Europe, a change of name would serve to underline that the activity we call counselling, in Ireland translates into psychotherapy in European terms. In this way we would emphasize the seriousness and importance of our work, which might not be appreciated otherwise.
In addition a change of name would be consistent with the IAC’s future membership of the European Association for Counselling and Psychotherapy.
EDWARD BOYNE is a Director of the Creative Counselling Centre, Secretary of the IAC’s Course Recognition Group and a member of the IAHIP (The Irish Association for Humanistic and Integrative Psychotherapy)