Some Ethical Questions – Interview with Malachy Kinnearny

Director of ACCEPT

The issues for me are about internal and external accountability. As a benchmark, I
 am going to use Accountancy. Accountancy is a self-regulated profession, and as we
 have seen recently, they have been held to political, economic and legal account
. With regard to counselling and therapy, we are talking about not only self-regulating
 but also self-appointed bodies, where there is no overseeing individual like an 
Ombudsman. People are paying money, so what is their protection? There is no
 point of recourse except under consumer law. How can a member of the public 
know that the organizations and individuals so set up have credibility? To me this is 
not just about law, it’s the ethics of credibility. If a self-appointing, self-regulating 
body sets itself up with no external individual or organization to monitor what is 
going on, that to me is highly suspect, because it means automatically that there is 
no internal or external accountability. This is what we saw with the Accountants 
when the same individuals were on the Board or auditing the accounts. We have a
 similar situation in therapy.

At a time when there are serious issues like child sexual abuse and divorce coming
 forward, counsellors and therapists have to make their credibility clear, but at the
 moment it is a free-for-all. With the increasing interest and popularity of counselling 
and therapy, there is a need for credibility to be built into the system, in terms or
 training, membership, and the nature of contracts. When therapists and their
 organizations have no real anchors, it can’t be good psychologically. I think it’s akin 
to a person not being well as a therapist trying to counsel someone who is unwell.
 And I’m putting that on an institutional level too – the organizations are not well, they 
are taking in the money, but at some level they are aware that there is no real 
recourse, because they ultimately have no contact with the instruments of 
government. A person going in to buy a television has the same legal rights as a
 person who feels that they may have a nervous breakdown and who comes to a 
therapist or counsellor. But whereas a person can produce a television and say it is
 defective, it is extremely difficult for people to complain about therapists, because
 what is there to present? Where is the evidence?

What I am worried about is that one of the outcomes of this free-for-all situation is
 that there is no real voice for counselling and therapy in Ireland. Where is the voice 
in issues of divorce, abortion, child abuse, sexual abuse? And, dare I say it, if you ask
 the average member of the public, the perceived voice would probably be that of 
somebody, like Anthony Clare, who is medical, psychiatric or academic. I think the
 counselling organizations are unclear about legal issues, and so about all the key 
issues in terms of social legislation, there is no voice. I think there are a lot of
 loopholes and a need for an ombudsperson or an overseeing body, because counselling is far behind Accountancy in terms of its controls. If they do not get
 their act together, they will never achieve credibility at government level. 
Government relies, not on these organizations, but on the Health Boards and on 
voluntary sector bodies like the Samaritans and the Rape Crisis Centres. The
 counselling and therapy organizations must be seen to be effective. At the moment
 they don’t make an impact out there as far as government and the public are
 concerned. I’m going to make an accusation here – I fear that the organizations are 
principally engaged in protecting themselves and maximizing their incomes and not 
addressing the broader social and political issues out there. The question, whether 
it be counsellors or accountants, is what is the prime purpose of the institution? Is 
it to protect the individuals who are going into therapy, or to protect the 
organization and members? It raises this question about the legality of the 
individuals involved and the organizations, such as IACT and PSI. I raise that
 question because it has come to my notice that people can be in the extraordinary 
situation where they pay fees to belong these organizations and are yet not allowed 
to allude to that in any way in their headed notepaper. Now that to me, as an
 ordinary citizen, is wrong and it is against the nature of contracts. We are talking
 about money here. The majority of paying members of these organizations are 
usually associate, not full members, which means any member of the public.

There is also a need for the organizations to be clear about distinctions between 
academic, medical, clinical and community parameters, and to make it clear that a
 person may or may not be a clinical therapist, but can be a counsellor within their 
profession. This was not helped by the IAC setting itself up as the IACT. The PSI are 
validating courses at university departments but they don’t validate the individuals
 who do the courses unless they take membership of PSI. Are they wiping their
 hands, and saying that they have nothing to do with any of these individuals unless
 they choose to join us? What is their internal and external accountability? Ironically 
only the Institute of Guidance Counsellors, whose members are employed as
 teachers and so accountable to the Dept of Education, are accountable internally and 
externally and through an organization, the Institute. It is the only organization 
within this field which has some form of internal/external accountability structure s
and national validation.