Sarah: Thank you Martina for agreeing to do this interview for Inside Out at such a busytime of the year. You are stepping down as Chair at the next AGM and perhaps this is a good time to reflect on how the last two years have been for you.
Martina: Yes it is a good time and it has flown by so fast. Sometimes you need to slow down and reflect on the many things that have happened.
Sarah: What would be the key issues?
Martina: I would say that training matters have dominated the Agenda since ICP announced in April that from January 2008 all training courses in psychotherapy are required to adopt the standards as set out by the Training Accreditation Committee (TAC) of the EAP. It has been a time of much debate with ICP facilitating much of the dialogue. IAHIP also facilitated a very successful Training Discussion Day in September which was well attended by our traditional training organisations. Three key issues were raised. The first was the question of psychosocial placements, the second was equivalence, as in acquired previous learning for those entering training, and the third, which is of key concern, is the requirement for Training Institutes to take responsibility for trainees up until time of accreditation. This raises many questions which need looking at and a follow up day was held to carry on with this process.
Sarah: ‘Who is responsible for the graduate?’ I suppose is something that’s always been a bit of a limbo place. Is that the space we are talking about?
Martina: Yes, that’s the space. Essentially we are talking about the post-practicum period where presently the pre-accredited member who has graduated from a training course completes 400 hours under supervision before applying for accreditation. The TAC requirement at present is that the Training Institutes take responsibility for this clinical practice part of training and must sign off on it. Even if this practice is not directly organised by the Institute it remains under its responsibility.
Sarah: Do you think things will become more complex and bureaucratic?
Martina: The first decision is how to manage this responsibility piece. During the Discussion Day it was suggested that training courses would need to extend duration of training programmes. Also difficulties within the university systems were highlighted. Some good ideas were put forward as to how a partnership arrangement between IAHIP and the Training Institutes might be worked out but the details of this need to be worked out. That would be part of the task of the working group going forward.
Sarah: And the Training Institutes are being co-operative?
Martina: Yes, they have been very cooperative and very positive. A request has been put forward that IAHIP might continue as the accrediting body for the section, and this needs to be discussed at European level. IAHIP is such a sophisticated and developed professional body that it may be possible for Europe to allow us to work with our traditional style of accreditation.
Sarah: With regard to placements – my sense is that there are not enough appropriate placements at the moment to accommodate all the trainees.
Martina: This is certainly a problem and has grown as an issue for trainers and trainees. This is part and parcel of psychotherapy becoming a discipline in its own right and there is a growing demand for programmes and qualifications in this area. Will some programmes be academic in content, and others offer a more integrative approach to training? I attended a recent conference run by HETAC (Higher Education and Training Awards Council) which validates training programmes in the national context and it was interesting to hear that in many ways the language of HETAC reflects much of what is good in our ‘grand parenting’ tradition. Terms such as acquired previous learning, APL, and work based learning, WBL, and life long learning, LLL were part of the vocabulary.
Sarah: Would this approach then dovetail into the humanistic and integrative model?
Martina: Yes, the philosophy of HETAC appears akin to our traditional system of accreditation. A question which this ‘stepped learning’ process raises for our present ‘four year system of training’ under Bye-Law 6 , and also under EAP/ECP, is how can we accommodate a progression from one stage of learning to another? Then there is the question of transferability of students should they wish to change from one training college to another, and at what stage do we decide the learner has reached the point of being eligible for Accreditation?
Sarah: In other words they are looking at post-grad as essential?
Martina: I think that many of the Training Institutes are interested in the HETAC route, Honours Degree, or Higher Diplomas at Level 8, Post-Graduate Diploma and Masters at Level 9. We have invited ICP to engage with HETAC at national level and to examine how the dovetailing of the EAP/TAC standards and those of HETAC might be merged in relation to the professional award for psychotherapy.
Sarah: It seems what is emerging is an academic training on the one hand and applied psychotherapy on the other. The placements would apply for those who wish to go on to practice psychotherapy.
Martina: Not necessarily so. Already some colleges and universities are successfully integrating the professional training and the more academic requirements into their trainings.
Sarah: Do the professional bodies in conjunction with training programmes have a role to play in controlling intake numbers and ensuring a sufficient supply of placements are provided?
Martina: The placement issue is a cause for concern to most Training Institutes, and to the professional bodies. IAHIP currently requires 600 hours as a minimum for Accreditation. This is much longer than for some of the other modalities. The Family Therapists have gone down the route of incorporating the experiential and academic training into the HETAC framework, but then they have a smaller number of training providers and as such the placement issue would be different from our situation.
Sarah: It sounds like Family Therapy is setting a good example by keeping it small and managing to do it effectively.
Martina: Yes, but are we heading into territory then where programmes are part of a university system and do people have a right to engage in this type of education? Maybe the answer is that some programmes cater for academic study only and that the practice part is undertaken only by those who wish to become professional psychotherapists. So for the trainee who wishes to practice as a psychotherapist we need to retain a strong experiential element within the training.
Sarah: There is a fear amongst some IAHIP members that a degree requirement might weed out a lot of potentially good psychotherapists who may not hold a degree so how do we hold on to the equivalence piece?
Martina: It was really very heartening to hear on the Training Discussion Day that many of our very experienced trainers were very keen to hold onto the equivalence. One particular university has to have a certain percentage of entrants coming in from the equivalence route rather than through degree. Most trainers will have experience of trainees who come through equivalence route and have proved to be very fine psychotherapists by the end of training. So I think there is a strong consensus around valuing the equivalence route.
Sarah: Another issue causing rumblings is CPD (Continuing Professional Development) – what are your thoughts on that?
Martina: Many of our members are already engaging in CPD, through personal therapy, supervision, teaching, and training. In the Governing Body discussions around CPD and also within the Re-Accreditation Committee we looked at suggestions which helped to broaden the guidelines and that we feel might facilitate people meeting CPD with ease. So the rumblings may be unnecessary as already people are fulfilling most of the requirements.
Sarah: Some recently accredited members feel they have a hard enough time just making a living without having to do extra work and established members feel their CPD is acquired through their work and that attending workshops just to make up hours to get re-accredited feels disingenuous.
Martina: Most professions see it as necessary to have core ongoing professional development. It is necessary for accountability and maintenance of standards and it is a feature of the professionalisation of the association.
Sarah: Is it politically correct to be seen to be doing something?
Martina: In the lead up to statutory regulation it will become mandatory to have CPD and therefore it is wise to be prepared. It is necessary to establish a framework and monitoring system within the re-accreditation process.
Sarah: Do we really want to be part of the HSE in its present state? How is statutory regulation progressing?
Martina: I believe that access to psychotherapy at primary care level is a human right. The access to mental health services is one of inequality with the marginalised population having to wait for long periods to access services. Those of us working in private practice are familiar with the client who is referred by their G.P. who can only continue for a short period in therapy as it is too costly. The issue of psychotherapy at primary care level was raised at our last AGM by Ed Boyne and again at a workshop during the ICP conference. At our Governing Body meeting on 29th June we discussed the issue and following this meeting I, as Chair, consulted with ICP representatives to raise this agenda as a matter of some urgency with ICP. Following this on 5th July, a letter was forwarded by ICP Chair, Brian Sweeney, to Martin Rogan, HSE National Care Group Manager for Mental Health advocating the case for psychotherapy services at primary care level and requesting a meeting to progress mutual dialogue. IAHIP Governing Body is fully in support of any campaign on strategy that ICP undertake in relation to this matter.
Sarah: I notice that you are now acting as an IAHIP representative on ICP.
Martina: One of the issues that I faced as coming in as Chair was an unresolved legacy of a felt need for more communication with ICP, so over the last two years we have worked extremely hard to communicate effectively with ICP and to have that communication heard and reciprocal dialogue. I do feel things have changed and perhaps part of the legacy of these two years might be that communication is now at a much more open level. The Governing Body considered it useful to have a member of the Board, or one of the Officers of the Association as one of the representatives so that direct and on-going communication with ICP can be maintained.
Sarah: So it doesn’t sound like you will be retiring in March. It would seem that you have an important role to play in the future.
Martina: When I committed to the Chair it was for two years and the job has become an increasingly busy part of my week. The commitment to ICP as a representative will end with my term as Chair and any further decision relating to continuing in that role will be up to the new Governing Body.
Sarah: Have you enjoyed your two years?
Martina: I have enjoyed it, I have been very challenged by it, at times daunted by it. It has been very rewarding working with the Governing Body members and committees. I feel rewarded by the improved communication and dialogue with ICP and their acknowledgement of IAHIP as the largest section within ICP, where I feel our wishes and concerns are being heard and addressed. The job of Chair is very demanding in the sense that the organisation has grown so much in recent years and new issues and concerns are constantly arising. Recently the Governing Body proposed a Strategy Day to explore how the organisation goes forward. The short term of two years as Chair means that sometimes things are only coming to fruition when the Chair is stepping down and an incentive is needed to encourage length of service. Such fine people represent IAHIP on the Governing Body and at committee level but they just cannot take the required time out of their lives to offer the continuity that we perceive is now required.
Sarah: Have there been any frustrations or disappointments?
Martina: Since Bye Law 6 has been passed three training programmes have been ratified under the training recognition process. It would make the work of accreditation much easier and bring clarity to the process when further trainings declare that they are beginning the recognition process. Part of the frustration for the organisation has been managing the expectations of trainees who have graduated from training programmes outside of the recognition procedure.
Sarah: What might be the priorities for the incoming Chairperson?
Martina: I feel some of the priorities might be to negotiate on the matter as to whether the time of graduation/accreditation should be a simultaneous event as dictated by Europe or whether we can hold these two separate events with IAHIP working as the Accrediting Body. Another important agenda would be to get the CPD process formally up and running. I would like to see primary care isues kept in the foreground. This might include some form of alliance with the Irish College of General Practitioners. I would advocate continuing support for ICP in the process of working toward statutory registration for psychotherapy.
Sarah: Do you have an overall vision for IAHIP?
Martina: I would like to see IAHIP maintain its independence as a professional association following statutory registration. Perhaps it would be nice to have a more interactive dialogue between the modalities. At the European conferences I was struck by how easily attendees and participants dialogued and how they spoke of working across the modalities. They spoke freely of working with individual clients, working with couples, families, using integrative models and drawing from various psychotherapy traditions. I would like to see us engage more with the other modalities even in terms of training and CPD and be less isolationist in our approach. Holding on to our ethos as a ‘Humanistic and Integrative Association’ is important but does not preclude us from more engagement with other sections.
Sarah: How do you feel about moving on?
Martina: Some part of me is counting the days but another part of me will be sad to leave. It has been a very rewarding time and a privilege to have been trusted to undertake the task of Chair. As I said to a good friend and member when taking up the position – I am not an innovator but perhaps can be a caretaker – I hope that I have undertaken my caretakership with some success.
Sarah: Thank you very much Martina for sharing your thoughts and it has been a pleasure talking with you. With your excellent grasp of the bigger picture you seem to have been much more than just a caretaker for IAHIP. I’d like to wish you the best for the future.