IAHIP: Time to Re-Assess.

by Susan Lindsay

The time has come to reassess. Otherwise we could do it unconsciously by shooting ourselves in the foot as may be happening.

Background

There are quite a few ‘founding members’ of IAHIP. We came from different places and gradually discovered each other. My motivation, having attended the U.K. Rugby Conference on psychotherapy on the advice of John Rowan, was to ensure that psychotherapy, Humanistic Psychotherapy and its practitioners would be looked after. Those of us who met over the early years, first informally, then more formally, were concerned that the more orthodox modalities – psychiatry, psychology and social work – would not become the only options available to clients when European registration came into being and, reluctantly, decided an organization was needed. We also wanted to have a say in developing the European profession.

Why do I say, ‘reluctantly’? Because central to the ethos of Humanistic psychology is the right to self-determination. Carl Rogers spoke about Person-Centered education, Fritz Perls about taking full responsibility for self. This meant that at the core of any Humanistic Association that was going to be involved in accreditation there would be two contradictory forces. It may be that now we are established we cannot find our way through these contradictions, or are unable to hold the ambiguities, or that we think that too much has been lost in trying to do so.

The therapeutic and human potential side of these apparently contradictory polarities would say that Humanistic psychotherapy aims to facilitate and encourage people to reach their full potential, stand on their own feet and take responsibility for what they do. This means getting past the need for approval from someone else. It means being able to know yourself, your ability and limitations, and being able to say to the world: this is what I have to offer – take it or leave it. When it comes to accreditation it could be argued that a process involving judgment by others is not compatible with a Humanistic ethos of self-determination.

The opposing polarity takes more account of the context: the society in which we practice. This society looks to criteria that tell them whether or not practitioners are fit to practice before according them the right to do so. Accepting this meant establishing criteria for Humanistic psychotherapists which we would have to stand over which could be seen by others without the same ethos -many of whom would have a vested interest in not accepting them – as acceptable, and by which we would have to judge each other’s performance as adequate, or not. It raised, and still does, the serious danger that the core ethos of Humanistic therapy would be lost in trying to establish itself as a serious modality in the mental health field.

So, part of the way forward was to agree that while practitioners should not be judged as adequate or inadequate, their readiness and ability to practice as psychotherapists would have to be assessed by peers. People might be grand as people but that did not necessarily mean that they were skilled enough, aware enough or clear enough of their personal histories to be given an imprimatur to hold therapeutic space for others.

Grand-parenting

The rest is history. IAHIP was established with grand-parenting criteria. Grand-parenting during those first years, was about ensuring that people who had spent years being trained through attendance at short courses, workshops and undergoing therapy could be assessed against core criteria as having sufficient information, likelihood of ability, and self-awareness to be accredited by the organisation. There wasn’t the opportunity to attend full training courses, as they were not in existence then. The standard set was critical as the credibility of IAHIP as a practitioners’ organisation would stand or fall depending on the standard that was observed and operated. The aim was that Grand-parenting would apply for the first two years after the first criteria were agreed to give people time to apply to IAHIP and have their applications processed. Two years turned out to be insufficient so in, accordance with Humanistic principles, more time was allowed.

Later, the criteria evolved and Grand-parenting seems to have developed along with them. I think it became a transitional vehicle allowing for the move, from where we were to where we are today, to happen fairly. It allowed room for the Accreditation Committee to make exceptions in exceptional circumstances where natural justice required it. So, when we use the term nowadays we need to define what it is being used to describe. We also need to take care that a creative response to allow for justice is not abused and made into a new rule instead just when process is coming to a natural conclusion and it is timely for it to die away from disuse.

Training Standards, ICP and ECP

It is important to remember here that twenty years ago the impetus for IAHIP was to ensure that training graduates, current practitioners of the time, and such graduates of future courses could have a recognised place in the field of psychology. It also meant that the few existing courses would be establishing a context of competent peers by whom such courses could be independently assessed. This has now happened as the IAHIP training standards committee has accredited the first courses. It is a measure of the extent of work and effort of so many people and of how far we as an organisation have come. IAHIP has been at the forefront of the development of the psychotherapy profession in Ireland. It has played a strong part in developing The Irish Council for Psychotherapy and the European Association for Psychotherapy. The systems we have pioneered have become blueprints for other ICP sections to work from. We can be proud of people like Barbara Fitzgerald and Brion Sweeney and others who, became our part of the ICP and gave so much to its development and the development of the European Council. When we wonder where our contribution to ICP went and might occasionally wish for more detailed accounting we know, essentially, that it went to this work.

Identity and Accreditation

Identity is linked to boundaries. Every system or entity has a boundary that defines it. Organizations have membership criteria, explicit or otherwise, which define who they are. Hence our identity as IAHIP depends on the core criteria of ethos and accreditation that define our boundary. Whilst the initial grand-parenting was in place the organisation worked to establish and develop criteria for future psychotherapists who would have the benefit of training courses. As we developed accreditation criteria evolved informed, also, by what was happening in Europe.

If we have failed to establish criteria which can assess Humanistic psychotherapists, if we are unable to hold the ethos of Humanistic Psychology sufficiently in a ‘good enough’ way, if we no longer believe that the price is worth it, then arguably, we should not have an Association. The worst of worlds is one where we simply have an organisation to accredit people with no raison d’etre other than that it serves the interests of existing practitioners and existing and would-be training schools by promising them some dubious accreditation. Dubious, that is, if there is only the illusion of a standard, if there is no genuine commitment to the core elements of Humanistic therapy or if we are unable to hold the criteria. It is dubious if we are lowering standards in order to accommodate vested interests. Perhaps in an economic climate people will feel this could be sufficient. It does not accord with a Humanistic ethos. If we do not hold a clear boundary then we are no longer a set of people with clear characteristics and we lose our identity. Either way, we must either choose to adopt the European criteria or we will not be allowed to be part of the European Council and thus presumably unable to be registered. These are real dangers and always were.

As the European Standards set in place begin to bite further people can no longer avoid the issue and will push boundaries. Obviously particular difficulty in holding the boundary can come when courses find themselves getting caught out because they were not involved in either IACP or the ICP and would like to get their students accredited regardless – this has happened before and will again. Pressure can, also, come from courses which themselves are under pressure from universities. The latter most of all depend on IAHIP to maintain standards that enable them to hold their own ground within the university system, not the easiest place within which to deliver a professional practical course. There are specialist trainings who may be undecided whether to become post training courses, or to offer specialist professional development for either IAHIP members or those from other sectors, or to develop full courses for accreditation. These are clearly not what I am talking about – at least so long as what they are offering is clear in relation to what students may expect in terms of accreditation from IAHP, or not, at the end of such training.

The argument that any training school did not know the criteria that were being put in place over the last twenty years is completely spurious. Any trainers of worth in the field must have attended to the question of accreditation from the outset of establishing their training and have educated themselves as to what was happening in Europe. No one living in this country over the past twenty years can have been unaware that European standards are being set for all aspects of education and training, and the most modest of investigations would have informed them about the European Council for Psychotherapy. Some may assume they will accredit graduates through the IACP and have not kept up with rising standards there and try, by default, to accredit through IAHIP with no interest at all in our ethos or understanding of psychotherapy. This also has happened before.

Humanistic and Integrative practitioners probably would have preferred and certainly have argued the case for not requiring a third level qualification for psychotherapists. This has become untenable in the face of seven-year trainings including degrees in many European states. However it has been possible, as I understand it, to extend the range of degrees that will be acceptable from psychology outwards, to include other basic degrees from the Humanities (Note that here we are talking about future entrants or at least those from when this criteria comes into play.)

Time to re-assess?

Ireland can be proud of itself. We, through IAHIP and the other members of the Irish Council of Psychotherapy have played a full participative part in negotiating the standards set in place. It is entirely disingenuous of anyone in the field to want to argue for re-negotiating them now as we are on the cusp of statutory registration.

Of course we didn’t get all that we wanted. But we did get what was needed to meet the first goal. Some years ago psychiatrists and psychologists argued in Brussels that they should be in charge of the field of registration in the mental health field. They lost their case as the European Council for Psychotherapy and others were ready to lobby also. Those issues are not being discussed here, as that is another article. However it is important to note that without being organised and having clearly observable and acceptable standards, psychotherapy would have been subsumed under the remit of psychologists and psychiatrists. These along with social workers have become known as the ‘core professionals’ in the debate about the place of psychotherapy in the mental health field.

Would we prefer to return to becoming an Association for Humanistic and, maybe Integrative Psychology and forget accreditation? Or might there be those who would like to set up such an organisation alongside what we have? This has been mooted before. Prior to IAHIP there were several attempts at such an organisation. Such an organisation can celebrate and develop Humanistic Psychology and need not bother itself with registration. Maybe we would prefer to be free to practice in a more ideal and ethos friendly way albeit that we would not be allowed to call ourselves psychotherapists once registration happens. Interestingly the Lacanian group of the Psychoanalysts argued for this independence for a long time. There is a lot to be said for it. Our identity would then be about an interest in Humanistic Psychology and less about practice. For example, the Humanistic Psychology Association in the U.K. is separate from the Practitioners Association.

As an organisation we have failed to come up with qualitative criteria that we could embrace as adjunct to the quantitative criteria. This is despite the fact that many had worked hard on what these might be. However we did, I think, indirectly address the matter of qualitative criteria by deciding that a Humanistic ethos must be core, and that other modalities could be integrated with it but could not be core of themselves.

On a European level many of our members have joined the Integrative section, which allows for both members who have one core orientation – such as Humanistic – to be integrated with other approaches or for Integrative modalities that do not hold any particular approach to therapy as central.  It is important to remember that we in IAHIP made the decision to continue to hold Humanistic central. In itself this provides a qualitative criteria. So too does our insistence on people having undertaken their own therapy and having been involved in group process whether or not this includes group psychotherapy per se. These are some safeguards providing that we hold to them.

We are almost there

Is Humanistic therapy dead? Have we sold out on the values of experiential, embodied, here and now, Person-Centered psychotherapy for the sake of expediency? If we have done so, the accreditation we achieve is of tawdry value. If so we should close down, now. If not, or if we are in danger of doing so, then a lot is at stake and we have to decide what we want. Supporting both European standards and a laissez-faire approach to standards is not a meaningful option. Alternatively there must be an option to re-consider our decision to hold Humanistic Psychology as central and to become purely Integrative. But that would need serious debate prior to and during an AGM as it would be a decision to alter our identity and possibly have legal implications.

We actively embraced sitting in the horns of a dilemma when we set up IAHIP. We have had to learn to live with ambiguity, which is a healthy thing to do. We have had to ensure we keep the ethos whilst also surrendering some of it for the sake of being part of the Irish and European wide organisation of psychotherapy. In doing this we have had a strong voice and have been able to influence decisions. But we have not been able to have everything we wanted. That is democracy. If we go, or have gone, too far in one direction or the other that would be a pity. The challenge has been and is to keep what is essential whilst also being willing to surrender that which is required to allow overall standards to be set. This article has been written to remind us of what we are about and what the context for the discussion is.

Conclusion

On the cusp of achieving Irish statutory registration and European registration we can be proud to be fully accredited Humanistic and Integrative Psychotherapists in a European context. It is time to give the questions outlined very serious attention and decide what IAHIP today is about and whether the goal set is one we still want to pursue.

It is always good when there is heated debate at AGMs. I was not present at the last one. It appears to have left members of committees bruised and at least one important motion passed, in relation to accreditation criteria, essentially under Any Other Business without regard for the prevailing criteria. The latter is filibustering to me. That is something I can admire and enjoy as political gamesmanship. However, having made the point, I think the issues need to be re-visited with proper notice to enable ethos, trust and democratic process to prevail.

Humanistic therapists specialize in focusing on process. However, in a professional organization that is also a legal entity it is essential that proper procedures are followed at all times, both in Committees and at AGMs. Proposals must be made and seconded. They must be voted on if they are put forward. Proposals about procedure take precedence as do amended proposals. Proper minutes must be kept and agreed as correct, or altered, at subsequent meetings. We must be clear about proper use of proxy votes and due notice for proposals at AGMs. Only those entitled to can vote and must be able to. We are engaging in what is, ultimately, legal procedure. The structure holds our identity as an organization, much perhaps as relationship holds a therapy. So by minding proper procedure we mind boundaries and we mind the structure put in place to hold ourselves, our relationship to each other, and our relationship to the rest of the society we live in.

Maybe having got to this point, we no longer want it. Personally, I would hate to see us let IAHIP and our association with the ICP and ECP go after all the work and enthusiasm of so many people. Worse than letting it go, however, would be to fudge issues and allow IAHIP become something not worth having.

Susan Lindsay was an instigating member and has held the Chair of both the Accreditation Committee and IAHIP.