Regulation of Psychotherapy in Ireland


by Ger Murphy


In this article I wish to put the question as to whether
 we, at this stage, need an umbrella body to oversee the
 regulation of psychotherapy in Ireland. If, as I believe, 
the answer is an affirmative one, I wish to pose the
 question as to how we might go about this and what 
may need to happen within the Humanistic and
 Integrative Psychotherapy movement as part of this 
process.

I am prompted to write this article and argue for the beginning of an
 umbrella organisation by a number of events. Firstly, we hear the rush of
 advertising regarding the creation of a free labour market in the European 
community in 1992. This seems to give rise to a mixture of interest, fear, 
and confusion among psychotherapists here. The free Labour Market to be 
created will mean that if you are qualified and registered to practice in one
 country you will have the light to work in any other EC country. Within
 psychotherapy, as no one is currently registered to work in Ireland as a 
psychotherapist, how will this affect us? Those registered in Holland, Italy
 etc. could, in theory, claim the right to work here and under current
 circumstances, no reciprocal right for Irish psychotherapists would exist.

Secondly the rapid growth of psychotherapy here over the past 5-10
 years means that there now exists a sufficiently large pool of practicing 
psychotherapists to begin a worthwhile debate leading eventually to
 regulation. This is especially in order as the client population served by the 
growing profession is now of sufficient size to warrant a system of consumer 
protection, a major responsibility to be undertaken by any regulatory body.

Thirdly my interest in writing this is sparked off by the recent controversy 
arising from the inauguration of a register for psychologists in Ireland, and 
the question it posed for psychotherapy. When this was launched an
 explanatory article appeared in the Irish Times which stated that one of the
 concerns out of which this register was formed was the Psychological
 Society’s concern about “self styled psychotherapists….who may have minimal training. Vulnerable people need to be protected from such 
charlatans…..” While such protection may be necessary, the question is posed 
as to who should undertake such protection. It also highlights the absence of
 a clearly identified professional body for psychotherapy so as to allow the
 distinction between psychology and psychotherapy to be clearly drawn and 
boundaries of professional responsibility clearly marked.

The consideration of these three issues, the growth of the profession and 
the arising need to demark boundaries of the profession both within this
 country and in the context of Europe highlight strongly for me that the time 
is now right to develop an umbrella structure to oversee the growth of
 psychotherapy as a profession in Ireland.

The U.K. Experience

What might this structure look like? In answering this question I wish to 
look initially at the experience in the United Kingdom, from whom many of 
the other professional bodies in Ireland, while in their fledgling days, took 
their model. We at the Creative Counselling Centre have been a member of
 the growing structure in the UK for the past four years, and I believe that 
the model arrived at there has a great deal to offer us in Ireland at this time.

In the UK in 1982, in the aftermath of the Scientologists and concern
 being voiced, a Private Members Bill was proposed in Parliament to regulate
 the practice of psychotherapy. This bill failed to become law probably due to
 the complexity of the questions that it raised regarding the many strands 
emerging in the profession, and the valid belief that Government legislation
 needs to be the end point and not the beginning of such an important
 debate. However, out of this, the profession was asked to “put its house in
 order” and return to government with a coherent structure whereby 
regulation could eventually become a real possibility. Out of this emerged 
the United Kingdom Standing Conference for Psychotherapy (UKSCP). This was inaugurated in 1989 after a long debate and exists as an umbrella
 organisation formed in sections along lines of core philosophical orientation.
 This includes sections under tides of analytical psychotherapy, Behavioural 
Psychotherapy, Family, Marital and Sexual Psychotherapy, Humanistic and
 Integrative Psychotherapy, Hypnotherapy, Psychoanalysis and Analytical 
Psychology. This model is an exciting one in that it is an inclusive model
 which does not favour one core philosophy orientation over another and 
thus fosters unity within the profession. Unity of purpose across the various 
schools of psychotherapy in the pursuit of a shared identity (recognisable to 
the public) encourages dialogue, cross fertilisation of views and a concern for
 the maintenance of the standards of all. This model is in contrast to the 
models currentl y employed in other European countries and in the USA. In 
several countries of Europe, psychotherapy is not seen at all as a profession but as an activity to be undertaken by other professionals, e.g. psychiatrists,
 psychologists, social-workers etc. This is the so-called “core professions”
 model.

In the absence of a definable and integrated psycohotherapy structure,
 other professions with an interest in the field have needed to take
 responsibility for standards etc. However, while these trainings as well as
 others may offer a good grounding from which to move to train as a
 psychotherapist, they are not per se any guarantee of psychotherapeutic
 ability or skillfulness. In contrast in the UK such professions are represented 
at the Standing Conference where they can voice their concerns to the 
profession of psychotherapy, I believe that this model is far preferable to the
 public, in the clarity of professional boundary and role which it offers, and to 
our own profession as it offers a forum to further develop and enrich our 
response to the psychotherapeutic task, which is significantly different from 
that of other professional roles.

To conclude this part of my discussion I hope that I have given adequate 
cause to add fuel to the already growing move towards unifying the
 profession under one inclusive umbrella in Ireland. I believe that this needs
 to happen in the near future having consideration to the natural length that 
this process will take. Further I suggest that we seek guidance and
 encouragement from the Standing Conference in the UK and seriously 
consider the value in emulating the structure which has been created there.

Humanistic and Integrative Psychotherapy


The proposed development outlined above brings into focus the second 
theme to which I wish to address myself. I see the need to begin developing a
 coherent sectional structure under the banner of a Humanistic and
 Integrative Psychotherapy forum. This may also need to happen in other
 sectional groups. I see this as important as it will begin to draw together
 practicing psychotherapists and trainings currently operating here within this
 core philosophical base. I would like to see this forum take on two functions.
 Firstly the creation of a clear identity for this grouping and a set of criteria
 for minimum training requirements. Secondly I see the group as potentially 
developing an accreditation structure for such psychotherapists. This
 distinction is an important one, for while there currently exists a number of 
training courses qualifying graduates in this field there does not exist a
 system of renewable accreditation or licence to practice. At present any
 humanistic and integrative psychotherapist in Ireland seeking accreditation
 needs to apply either to a training body elsewhere, e.g. UK or else to the
 Association of Humanistic Practitioners in England.

How would one belong to such a grouping? A great deal of debate will need to take place on this issue and I will draw out only a few possible 
pointers. Firstly to belong one would need to be a practicing
 psychotherapist, having undergone ones own therapy and having adherence 
to the basic tenets of humanistic psychology, along with an interest in an 
integration of perspectives in ones work. To explore the basic tenets of
 Humanistic Psychology I would refer to Rowan 1987 who points to four
 major threads:

  1. An emphasis on the whole person, in that one recognises that the
 human being exists on at least four levels – body, feelings, intellect and 
spirit, and that in our efforts to respect the emergence of human
 potential we must do justice to all four levels.
  2. A belief that at depth the individual is OK, and that under the
 socially conceived niceness there may exist a pent up destructiveness,
 neither of which colour the intrinsic value of the person. This is at 
variance with some other theories which see the individual as value
 neutral or perhaps destructive.
  3. An emphasis on abundance motivation arising from the need theory
 developed by A. Maslow and others where the individual is not only
 motivated by deficiency but by the need not only to repair damage but 
also to realise innate potential.
  4. An emphasis on change and development seeing the individual as
 being set up on a natural and needful growth path through childhood,
 adolesence and adulthood.

Integrating a Variety of Techniques


The emphasis on an integrative perspective sees that a pragmatic attitude 
towards the tools of therapy is endorsed where a wide variety of techniques 
and strategies are used according to the dictate of client need. For example 
expressive bodywork informed by the work of Reich and Lowen may be 
used, along with a more analytically oriented holding of the client and use of 
the transference, by the same therapist with different clients or at different 
periods of the same therapy. For me this integrationist stance is speaking to 
the attempted integration of approaches within humanistic psychotherapy 
e.g. gestalt, bodywork, transactional analysis etc., but also the valid
 integration of the findings and perspectives of other forms of psychotherapy,
 particularly analytic and systemic ones.

“Integration unlike eclecticism is concerned with the chasm not by denying 
that there exists a distance between the sides but by building bridges that unite
 them”.

WarcheI 1983.

These thoughts as to the ground occupied by a forum for Humanistic and
 Integrative Psychotherapy may contribute to the debate which is now 
necessary to fully develop this forum so that we can take our place in the 
overall umbrella structure in a constructive way. The part that this forum can
 play in the development of an overall umbrella body and in the growth of the
 profession as a whole is an important one in arguing for.

a)    growth perspective to be held firmly alongside a pathology
 perspective

b)    a focus in the body, and feeling expression alongside insight
 development and behaviour change

c)    a focus on the therapist and his/her part in the therapeutic 
relationship as being as important as on the client.

In these and other ways I see this forum as being an important ingredient
 alongside the other major forces in the development of a responsible and 
healthy profession of psychotherapy in Ireland built not on exclusion but on
 the acceptance and honouring of difference which will challenge us all in the
 years ahead to deal with our anxieties and come to a nourishing and vibrant
 co-existence in a united profession.


March 1990.