Introduction
The recent publication of Richard Mowbray's controversial book The Case against Psychotherapy Registration: A Conservation Issue for the Human Potential Movement (hereafter, CAPR) has already been met with enthusiastic acclaim from within humanistic circles in the field: thus, in an 'Open Letter' to Mowbray, John Rowan writes, 'Congratulations on your new book.... I think it is very thorough and well argued, and should make quite an impression' (Rowan, 1995, p. 43); and Self and Society editor John Button writes that 'Richard Mowbray's important and thought-provoking book should be essential reading for all current and would-be therapy practitioners.... [he] has done psychotherapy an enormous service...' (Button, 1995, pp. 52, 54). Thus far, however, the central arguments in CAPR have received only limited attention within the pages of Counselling (see House, 1996d), yet those arguments are just as relevant to the professionalisation of counselling, with the BAC's impending register of counsellors and the expressed desire of at least some in the field to introduce a legal restriction on the use of the term 'counsellor'.

In this article I will review and comment upon the relevance of Mowbray's CAPR for the broad field of counselling, in the hope that a fertile and enlightening debate can be opened up around these quite crucial questions that profoundly affect all of us, practitioner and client alike. In the space available I have only been able lightly to scratch the surface of the range and depth of the arguments in CAPR, and a full reading of this remarkable and challenging book is necessary to take in the full import of views which are so counter-culturally challenging to established beliefs about accreditation and professionalisation.

I will therefore confine myself to just two of the nostra underpinning the conventional wisdom: namely, (1) the view that stricter controls are necessary to protect the public from incompetent or unscrupulous practitioners; and (2) that it is possible to generate or even guarantee competent practice in this field via training and formal top-down accreditation and registration procedures. I will alas have no space to consider Mowbray's detailed arguments about, inter alia, the defining features of the UKCP, the various harmful side-effects of licensing/registration, the non-demonstrability of the pre-conditions for licensing being present, vested training interests and monopolising tendencies, the rise of 'defensive psychotherapy and counselling', the distinction between psychotherapy and human potential work, and the various viable alternatives to statutory registration. The client-protection and practitioner-competence issues are perhaps the two most powerful reasons cited in support of current professionalising developments; and if it can be shown that the respective rationales underpinning these two positions are based on inadequate and erroneous reasoning, then the whole raison d'etre for professionalisation is at the very least thrown into severe doubt.

Client protection?...
There are as many certified charlatans and exploiters of people as there are uncertified. (Carl Rogers, quoted in Mowbray, 1995, p. 113).

The most commonly held justification for the kinds of professionalising developments seen in the field in recent years is that of client protection from harmful counsellor practitioners - aided and abetted, of course, by a litany of sensational (but usually grossly ill-informed) media horror stories about the harmful effects of counselling and psychotherapy. According to Mowbray (p. 100), 'Safeguarding the public from harm is the key argument upon which any claim for the legitimacy of a licensing system must rest'. Because this argument is so central to the case for licensing and registration, then if it can be shown that the client protection argument has at best flimsy evidential underpinnings and is driven more by practitioner anxiety than it is by any coherently argued case for intervention, then immediately the case for professionalisation threatens to evaporate before our eyes.

So what does Mowbray have to say about client protection? Even if we assume for a moment that protection is necessary (an assumption which will be refuted below), to what extent do current and mooted professionalised structures in practice provide any reliable guarantee of client protection - or to what extent could any conceivable licensing system ever furnish such guarantees of protection? On these questions Mowbray is unambiguous: 'Studies of disciplinary enforcement in professions in the USA have revealed that disciplinary action is extremely ineffective as a means of protecting the public' (p. 81, his emphasis). Furthermore, it has recently been shown that the General Medical Council is reluctant to take effective disciplinary action against malpractice, and 'once established, professions are unlikely to take steps to actively expose [malpractice] in their midst.... [There is a] poor track record of systems based on professional codes of ethics and conduct and self-disciplinary action as a means of protecting the public' (pp. 83-4).

Yet those favouring the public-protection licensing rationale can always argue that their system of protection will be more effective than those of the other professions, and of course it is impossible to disprove such a claim - even though the record of the other professions hardly inspires much hope in this regard. Certainly, arguments such as that of Stacey (1994) suggest that, notwithstanding the various public protestations to the contrary, professionalisation is far more likely to be driven by the self-interest of the nascent 'professionals' themselves than it is by any high-principled and authentic concern for the affected clientele - no matter how convincing the moral tone of the accompanying professionalising rhetoric might suggest. (I am not arguing here that a motivation from practitioner self-protection or self-interest is necessarily wrong - simply that if this is the real rationale for current developments, then at least we should be honest about it.)

An added difficulty is that it is in fact far harder to prove malpractice in this field than it is in virtually any other profession. Thus, Mowbray quotes Trebilcock and Shaul (p. 148) who argue that 'if ignorance about what is a good or bad outcome, or what is good or bad procedure, is... pervasive..., then... no settled bench mark can be identified upon which to base any regulatory strategy directed to promoting service quality' (my emphasis). Similarly, Mowbray also quotes Danial Hogan, who writes that 'the lack of consensus as to what causes danger and how to measure it should prevent the enactment of laws restricting a person's right to practice... factors quite apart from the practitioner... may account for a large share of the harm that occurs in therapy' (p. 108).

Yet another compelling argument against the alleged protective function of licensing-oriented professionalisation is that, quoting Hogan again, 'a similar array of horror stories could easily be assembled about highly credentialed psychiatrists and psychologists, all of them licensed' (p. 105, my emphasis) (cf. the Carl Rogers epigraph at the start of this section); and 'practitioner--client sex occurs in professions that are already licensed and have specific sanctions against it... there is no clear evidence to show that its incidence differs between licensed and unlicensed settings' (p. 112, his emphasis; cf. Gonsiorek, 1995). Indeed, it may well be harder to challenge the abuses of those practitioners with licensed status in the community (p. 113). In sum, then, for Mowbray, 'If protection of the public from harm has not been a proven consequence of [licensing] systems in general, there is little prospect that such a system would protect the public in a field as indefinite as this one' (p. 114).

The foregoing discussion has assumed, of course, that it is true that damage to clients resulting from bad practice occurs to an extent that necessitates remedial protective legislation in the field. Yet such an assumption is itself not only open to very severe doubt and lacking in substantive empirical evidence, but in addition, the very act of practitioners taking such an assumptive belief into their client work will likely have the self-fulfilling effect of making damage more likely by effectively infantilising clients - in that the assumption is made that clients are not able to look after themselves, and therefore require some kind of external guarantee of safety and protection. In other words, and to put it crudely, if practitioners treat clients like children, they're actually far more likely to behave in a responsibility-eschewing, child-like manner. (And of course, the tacit and surreptitious encouragement of client infantilisation is in the pecuniary self-interest of 'professional' practitioners, who derive a direct financial benefit from their clients becoming more dependent on them, and thereby experiencing a need for more therapeutic help than would otherwise have been the case.).

Mowbray points out how members of the professions typically act as agents for their clients, 'carrying out for them tasks that they would not [otherwise] have the knowledge base to perform' (p.12); in other words, the professions have a vested financial interest in the incapacity of their clientele to carry out the tasks for which they approach the professions for help. Yet if counselling and psychotherapy are about anything, they are surely concerned with self-empowerment.... so that equating the practice of psychotherapy and counselling with the 'professional' ethos of client dependency on 'expert' guidance and its hand-maiden, client ignorance, is not only singularly inappropriate, but actually totally antithetical to the very raison d'etre of what counselling and therapy are really about.

In similar vein here is Ivan Illich commenting on what he calls 'the disabling profession' of medicine: 'in medicine, ever more "ills" became "illnesses" to be treated by doctors and people lost their will and ability to cope with indisposition, or even with discomfort' (Illich, 1977: 23, my emphasis); 'The professionals appropriate the special knowledge to define public issues in terms of problems. The acceptance of this claim legitimizes the docile recognition of imputed lacks on the part of the layman' (27, my emphasis); 'Beyond a certain level, medicine engenders helplessness and disease' (28, my emphasis); and 'People become prisoners to... sick-making medicine because beyond a certain threshold of intensity dependence on a bill of... professional goods destroys human potential' (31). Those who would professionalise our field along the lines that are currently planned would do well to contemplate Illich's cautionary and sobering strictures on the disabling nature of the professionalising mentality.

In contradistinction to what are in effect the infantilising assumptions of didactic licensing and registration, Mowbray argues that, 'given access to appropriate information..., clients are the best judges of who are competent practitioners for them, and on the basis of their personal responses to practitioners... rather than on the basis of the misleading criteria such as those that UKCP promotes' (p. 124, his emphasis). And a bit later, 'supporting the potential client's existing autonomy... is more appropriate than enhancing the official status of the practitioner with the accompanying assumption that competence has been assured' (p. 131; cf. Mowbray, 1996). Thus, 'the accreditation route fostered by UKCP promotes the myth that the public can be protected from the difficulties of choice in this area... [which] actually increases the potential risk of harm to the public' (p. 129, his emphasis). By encouraging clients to defer to the authority of an external licensing body in choosing a practitioner, this actually 'fosters dependency and a letting down of appropriate self-protection guards' (p. 130). In sum, then, 'official recognition based on unconfirmed criteria begets vulnerability' (p. 131, his emphasis), rather than reducing the risk to the client, as the conventional wisdom would have us believe.

All in all, then, for Mowbray, 'the evidence available does not appear to indicate that psychotherapy and personal growth work pose a particularly significant threat of harm to the public' (p. 106); and the onus is therefore on those who would statutorily license our field to demonstrate why such steps are necessary, rather than upon those who see no need for such changes to show why it is not necessary or appropriate. For Mowbray, no such case is demonstrable, either in principle or evidentially.


A guarantee of competence?...
Sadly, the correlation between training and effectiveness as a therapist is low. (Mark Aveline, quoted in Mowbray, 1995, p. 132).

A very good therapist does not get that way primarily by taking more courses or studying at a particular institution. It is not easy to measure how they get that way or who has 'it'. This is a socially and philosophically deep issue....
(Robert M. Young, 1993, p. 84)

psychotherapy transpires in the realm of meaning.... in contrast to facts, meanings cannot be confirmed or disconfirmed by the objective criteria of the scientific method. (Jerome D. Frank, 1989, p. 144)


Readers involved in the field will no doubt be aware of the dramatic changes that have been occurring apace in counselling training in recent years, with lengthening courses, ever more stringent course requirements, increasing academic content and associated moves towards the post-graduatisation of the field, and so on. For Mowbray, 'There is little if any evidence that possession of academic qualifications by psychotherapists relates to basic competence or protects the public in any way' (p. 116, his emphasis); 'The personal qualities that are prerequisites of competence in this sort of activity cannot be "trained in"' (p. 118); and 'factors which UKCP is promoting... will not produce more competent practitioners' (p. 124). A survey of the available evidence indicates that 'the effectiveness of psychotherapy does not appear to depend upon any of the following: (1) The practitioner holding academic qualifications. (2) The length of training of the practitioner. (3) The school to which the therapist belongs. (4) The practitioner having had a training analysis' (p. 122). It is often remarked in sporting circles that the likes of Bjorn Borg and Vivian Richards would never have reached the pinnacles of their respective sports had they been exposed to the training techniques and principles of the prevailing conventional wisdom; and Mowbray is getting at a similar point when he asks rhetorically 'Do good mothers mother on the basis of a "developed body of mothering theory"?' (p. 140).

On this view, then, it is quite simply an illusion (and a very expensive one for trainees and a very lucrative one for trainers!) that extensive training can in any sense create or guarantee competent therapeutic practitioners. Rather, and quoting Guy Gladsone, 'becoming a therapist is a personally transmitted craft for which no amount of academic course work can substitute' (p. 135); and (Mowbray) 'The apprenticeship model..., which involves working alongside a more experienced "craftsperson"..., is in many ways more appropriate... then training programmes modelled after traditional professional disciplines' (ibid.).

It would no doubt be going too far to argue that good counsellors are born rather than made - or as Freddie Truman once famously said about the art of fast bowling in cricket, 'You can't put in what God left out!'. For such a view would make a nonsense of the need for or value of training, and would contradict our taken-for-granted belief that it is through learning, growth and personal integration that we can become more fully human and whole as persons. And yet perhaps there is more than a grain of truth in the view that intrinsic nature does play a very important part in the capacity to do the work of counselling and psychotherapy. And to the extent that it does, then approaches to competency which make a fetish of training, skills, technique, theory and doing-orientation in general will be misrepresenting the art (a term I choose advisedly) of what good and effective counselling is really about.

There is also a wider philosophical question here (cf. the Bob Young epigraph at the start of this section) regarding what, precisely, is the role of training in the development of practitioner competence. The conventional wisdom seems to contain the implicit and unarticulated assumption that there is a simple and direct causal relationship between training and competence, with training being a process that makes a person into a competent practitioner, and which they would not have been had they not trained - i.e. that it is the training qua training that is the crucial variable. Yet such a view is naively positivistic and is squarely trapped within what is increasingly being seen to be a grossly inadequate framework for understanding reality, from the level of sub-atomic physics to the level of human consciousness and astro-physics. Thus, as Jill Hall has recently written, 'the time has come to go beyond causal thinking.... If material existence is far too intricate and subtle a phenomenon to be understood through a cause/effect mode of thought, then surely we must let go the attempt to approach the human psyche from such a standpoint. When we come to try to understand the psyche causal thinking is not only inadequate but is even positively dangerous' (1993, pp. 2, 7).

In the specific case of the training--competence nexus, for example, it makes at least as much sense to reverse the taken-for-granted direction of causality, such that the crucial variable is that people are in the position within themselves to be able to choose to embark upon training, and that this is the crucial variable in competence, rather than the mechanistic view that it is training per se that somehow transforms non-counsellors into competent practitioners.

And as soon as we begin to take this kind of argument on board and problematise taken-for-granted assumptions of the causal efficacy of training, then it comes as no surprise whatsoever to find that, as Roberta Russell concludes in her exhaustive review of the outcome literature, 'A professional training does not appear to increase the effectiveness of the therapist; [and] therapists who have undergone traditional training are no more effective than those who have not' (1981, p. 7) (cf. the Mark Aveline epigraph, above). Many other commentators have challenged the conventional wisdom that training necessarily leads to practitioner competence. Here is Jeffrey Masson in characteristically robust form: 'If it is really the case [that clients benefit as much from non-professional as from experienced professional help], why then bother to have elaborate, expensive, and pretentious training institutes at all?' (1990, p. 227; see for example Strupp and Hadley, 1979). Masson goes on to quote Hans Strupp, who wrote in 1973, 'I have become increasingly skeptical that psychotherapy has anything "special" to offer, in the sense that its techniques exceed or transcend the gains that may accrue to a patient... from a highly constructive human relationship' (ibid.).

If we accept the commonly heard view that the burgeoning demand for counselling and psychotherapy services has temporally, and by no means coincidentally, coincided with a wider cultural decline in the extended family and the influence of organised religion, together with a more pervasive cultural decline in the quality of human relationships more generally, then why on earth should we accept the view that elaborate and expensive training be required in order to discharge a societal function that has previously been effected through the quite natural medium of real-world human relationships? I am reminded here of the great Georg Goddeck, physician-psychoanalyst-healer who lived at the time of, and had a significant influence upon, Freud (House 1996a). In describing Groddeck's remarkable work with his patients, Morris Robb wrote half a century ago that 'it is impossible to schematise such a [healing] process, and to talk of training anyone else to achieve its results is absurd, yet some approximation to a character of this sort is the only basis on which psycho-therapeutic power can be built' (Groddeck 1951, p. 15, my emphasis).

As soon as we begin to question taken-for-granted assumptions about causality within the training--competency nexus, it then becomes quite natural to move away from the counsellor-centred and infantilising belief that successful therapeutic outcome is largely a function of counsellor competency, and towards the alternative, client-centred view that what matters more in terms of therapeutic efficacy is the way in which clients 'use' whatever help is available to them to effect their own healing (whether through Groddeck's 'old wive's poltice', shamanic ritual, the church confessional, placebo medication... or the most sophisticated of counselling or psychotherapeuic interventions). (I return to the change process at length, below.) On this view, not only does the erstwhile rather puzzling and counter-intuitive finding that all therapeutic modalities yield very similar success rates (Smith et al., 1980; Andrews and Harvey, 1981) make complete sense, but more crucially for current purposes, the very basis for the view that the training of practitioners is the key factor in successful outcome is decisively undermined. It might well be, for example, that it is not the absolute level of the counsellor's personal development and technical expertise that is crucial in the healing process, but rather, the extent to which a given practitioner is congruent within him- or herself at whatever level of development and competence s/he has reached; or perhaps the extent to which s/he is aware of and able fully to own her or his limitations (these two factors are, of course, not unrelated). Such a view is entirely consistent with Russell's finding, based on a thorough literature review, that 'Paraprofessionals consistently achieve outcome [sic] equal to or better than professional outcomes' (1981, p. 7; see Strupp and Hadley, 1979).

A cautionary note from psychoanalytic theory is relevant at this point: for in his brilliant 1985 paper, Howard Stein implies that what a client might subjectively experience as a true healing might not in reality be so, but might be a so-called 'transference cure' - or a kind of magical flight into a health that is not founded upon authentic personality change and is unlikely to sustain. Thus, for Stein, the client's receipt of a 'magic bullet' engages with the client's 'earliest mental world where gesture commands the world that is its extension. In this world there are only deeds, not people.... the healer... helps the patient to become healed or reconciled to life's irreversibility and loss's irrevocability by first declining to comply with the patient's request for magic' (1985, p. 189). I do not have the space here to respond to this psychoanalytically driven scepticism about so-called superficial kinds of healing and cure; but suffice to say that it touches upon the fundamental philosophical conflict that exists between a client-centred and a theory-oriented, therapist-centred conception of what change actually consists in.

Of course, counsellors and therapists with extensive training will very likely experience themselves as better practitioners as a direct result of their training; but it by no means necessarily follows logically from this that the outcome from the standpoint of their clients will be more successful than it would otherwise have been: i.e. the practitioner's subjective experience of her or his own competence is logically quite distinct from the question of outcome from the client's point of view. And if it is the case, as Frank (1989b) argues, that the practitioner's sense of competence 'indirectly strengthens the patient's confidence in the therapist as a person who knows what he or she is doing' (p. 109), such a subjectively experienced practitioner competence is by no means the sole preserve of those who have done ex(t)(p)ensive training, or fulfilled stringent accreditation standards. And yet there no doubt exists a strong and understandable urge to 'feel professional' as a way of cementing one's identity within a field which is perhaps intrinsically uncertain, a-rational, and even ultimately mysterious. But when the desire to feel and experience oneself as 'professional' is driven more by practitioner anxiety than it is by genuine, authentic concern for the clientele, then once again the danger is that professionlisation becomes practitioner-centred, rather than being in clients' best interests... not to mention the severe doubt that must exist as to whether such acted-out and un-owned anxiety can serve as a good role model for the clients we work with!

There exist a number of research findings that support the view that client efficacy in the therapeutic change process is relatively far more significant than the infantilising medical-model ontology (Stein, 1982) would have us believe. Thus, for example, research evidence shows conclusively that 'patients' expectations concerning the duration of treatment affect the speed of their response', and 'speed of improvement may often be largely determined by the patient's expectations... as to the duration of treatment' (Frank, 1978, p. 45-6, my emphasis). In addition, there are the so-called 'transference cures', through which 'changes following brief therapeutic contact... in which little seems to have occurred beyond the arousal of the patient's faith in the therapist are sometime deep-seated and persistent' (ibid., p. 46). Further, 'the emotional state of trust and faith in itself can sometimes produce far-reaching and permanent changes in attitude or bodily states..., [such that] the healing force appears to reside in the patient's state of faith or hope and not in its object (ibid., pp. 46, 48, my emphasis; see also Menninger, 1963, Chapter 15). And here is Frank again: 'therapeutic success or failure depends not primarily on therapeutic procedure per se, but on the personal qualities of the patient which determine responsiveness to the healing properties of the therapist's personality' (1989b, p. 106, my emphasis).
More generally, we delude ourselves if we underestimate the degree of sheer ignorance we possess about the nature of the therapeutic experience - Frank again: 'Until more is known about the factors in the patient, therapist, and treatment situation which determine the degree and form of influence exerted by the therapist..., it is impossible adequately to isolate either factors specific to each form of psychotherapy or those involved in all forms of therapy' (1978, pp. 55-6). And as soon as we admit of such ignorance, then the kinds of accreditation and licensing procedures that encourage the illusion of certainty in a field that is intrinsically uncertain and mysterious suddenly appear not only largely irrelevant, but actually misleadingly dangerous.

Of course, the possibility that practitioner training might be to some extent superfluous to competency is likely to be extremely uncomfortable and disquieting news for all those practitioners (which includes myself) who have spent thousands of pounds on training, and for those (which again includes myself) who have spent thousands of pounds on their own personal therapy or 'training analysis'... not to mention appalling news for the 'counselling and psychotherapy training business' (as Mowbray calls it - see Chapter 18). For who, after all, is going to want even to begin to hear and let in the reality that the many thousands of pounds they have spent on training and personal therapy has probably, on the average, made comparatively little difference to the perceived benefits that their clients have derived from working with them?... very few, I would venture! And yet taken together, both the available research evidence and the logical coherence of the argument strongly point in this counter-intuitive direction.

Furthermore, the unproblematised and simplistic belief that training qua training leads to practitioner competency only serves to buttress the unhumanistic ideology underpinning mechanistic perspectives on human experience, and medical-model, 'bits-of-person'-centred ontologies of the person - values which are in my view fundamentally antithetical to the person-centred, humanistic values that underpin counselling at its best.

When we begin to question the taken-for-granted assumptions of scientificity and naive causal efficacy in the therapeutic change process itself, then we have yet further reason to question the very raison d'etre of current professionalising developments. Mowbray puts it thus: 'rather than a simple Newtonian "billiard ball" model of cause and effect which implies that a client is a passive recipient of the "effects" of the psychotherapist, a more appropriate paradigm for looking at psychotherapy is that of "Chaos Theory", in the light of which psychotherapy may be conceptualised as a non-linear system of mutually cueing feedback loops' (pp. 106-7, my emphasis). There are echoes here of the great psychoanalyst-healer Georg Groddeck, who wrote well over half a century ago that 'because we live we are bound to believe that... there are such things as causes and effects..., whereas we really know nothing about the connection between one event and another' (Groddeck, 1951, p. 77).

On this view, then, far from being an objective and true reality-based representation of the world, the scientific mentality or Zeitgeist is surely defensively rooted in an anxiety-driven yet normalised fixation with control, in turn deriving from an unconscious terror of helplessness and powerlessness rooted in species-wide and commonly repressed pre- and post-natal developmental traumata (Wasdell, 1990; Hall, 1993). Here is Marie Maguire: 'Men develop a capacity for mastering the universe and a compulsive preoccupation with what can be predicted, possessed, piled up and counted in order to deny the strength of their early emotional link with the mother' (1995, p. 60): and here is David Wasdell: 'Unresolved trauma laid down at an early stage of human development drives a subsequent cyclic pattern of repetition... The person continues to act in the here and now as if facing the next moment of the there and then.... With the common ground collusively denied, the dynamic process [becomes] socially reifiedinto an unquestionable ideology' (1991, p. 1, my emphasis). I would argue that the ideology of the scientific and technocratic mentality is a prime case of such dysfunctional and pathologically rooted ideologies, and that, to quote Lather (1992, p. 89), 'scientific thought is now an archaic mode of consciousness'.

It is little wonder, then, that at this stage in the evolution of human consciousness, the ego is enormously reluctant even to countenance the view that, to quote Groddeck again, 'everything important happens outside our knowledge and control' (p. 78), and that 'It is absurd to suppose that one can ever understand life' (p. 84; see also Hall, 1993). Yet the professionalising mentality inevitably and unavoidably makes the normally tacit and unarticulated assumptions that, (1) it is possible both in principle and in practice to assess and measure the contribution that the practitioner qua practitioner makes towards the we-ness and the outcome of a therapeutic encounter; and (2) that what is healing or transformative in a counselling relationship has more to do with the causal efficacy of the practitioner than it does with the way in which the client will 'use' (in the Winnicottian sense) the practitioner for her or his own healing or transformation. I believe that in the realms of human relationship and co-created inter-subjective experience (Orbach and Eichenbaum, 1994), both of these assumptions are quite simply false (and even if they weren't false, there is absolutely no way in which this could be demonstrated or proven methodologically). In sum, what I am arguing here (and cognitive-behaviourists aren't going to like this) is that the scientific mentality is singularly inappropriate in the fields of counselling and psychotherapy (cf. House, 1996a, b, c). Here again is Jerome Frank (1989b, p. 144): 'traditional scientific methods are not well suited to investigating the phenomena of psychotherapy, since they deal exclusively with facts, whereas psychotherapy transpires in the realm of meaning'.

The anxiety-driven impulse to measure, assess, control and mechanise a process that is quintessentially human, intersubjective, mysterious and quite possibly in principle beyond the ambit of rationalist scientific understanding is not only inappropriate, but actually violating of the essence of the therapeutic healing process. One of the central problems and harmful effects of didactic registration mindedness (DRM) is that it diverts attention from and distorts what is really healing in therapeutic relationships, and as a result, it will inevitably reduce the efficacy of therapeutic practice to the extent that it encourages practitioners to entertain false beliefs regarding what precisely is healing within a counselling experience.

Thus, a de facto scientific and predominantly rationalist mentality entails an assumptive ideology that will inevitably be severely limiting of, and constraining upon, the therapeutic healing process. Here, for example, is Kiev: 'the scientific ideal [rejects] dogmatism and [upholds] objectivity and intellectual comprehension, which... may not be entirely advantageous for psychotherapy. Such an orientation results in an over-evaluation of the cognitive aspects of psychotherapy...' (1964, p. 462); and Frank: 'the physician must be more than a skilled technician if he is to help many of his patients.... The psychiatrist... must recognize that his treatment methods may rely on an important component of faith.... For [some] patients a priest or sorcerer might well [be] a more suitable therapist than a scientifically trained psychiatrist' ' (1964, pp. ix, xi); and Ackerknecht: 'The therapeutic achievements of the psychogenetic movement do not necessarily depend upon real etiological knowledge of causal treatment' (1959, p. 84); and finally the master-healer Groddeck: 'luckily one does not need to understand [life] in order to be able to live or help others who want to live' (1951, p. 84).

Kiev has written that 'primitive [meaning "non-Western" - RH] therapies are fundamentally magical, that is, nonrational attempts to deal with non-rational forces (1964, p. 10, my emphasis). The central underlying rationale of DRM is that of scientific rationality; yet if the ills of the human condition are intrinsically non- or a-rational, then it follows logically that it is inappropriate to apply scientific mindedness to human experience and processes that are in principle beyond the realms of scientific understanding.

To return to professionalisation: my profound concern is that if the compelling logic of DRM is taken to its logical conclusion by those who would uncritically professionalise our field, then a quite possibly terminal damage may be done to the very essence of what is healing in the therapeutic relationship - an unwitting and unintended consequence perpetrated by those who claim, and no doubt sincerely believe themselves, to be doing quite the opposite. And that would be a truly tragic outcome for all of us, practitioners and clients alike. If it's true that the drive towards professionalisation is much more to do with acted-out, dysfunctional psychodynamics than it is to do with a healthy engagement with the dynamics of power, powerlessness and authority, then we'd better wake up to that reality pretty quickly, before substantial, and even irreversible, damage is done to our field.

Conclusion

Licensing does not protect the public. Licensing does not exclude incompetents. Licensing does not encourage innovation. It stultifies.... (Will Schutz, quoted in Mowbray, 1995, p. 213)
And so to return to my original question: I would answer that not only does there exist a formidable and compelling case against the centralised professionalisation of counselling via statutory registration; but that this is as much a question of politics, vested interests and unconscious organisational dynamics as much as it is one of morality and good counselling practice. As soon as we embrace the argument that counselling is a form of healing via two interpenetrating and co-creating subjectivities rather than a mechanistic, scientific medical-model activity, then immediately there must exist very severe doubts as to whether competence can be measured, practice be successfully monitored and controlled, and capacity to practise be accredited and guaranteed in anything approaching a reliable way - not to mention in a way that honours the foundational humanistic values of our practice rather than betraying them. And if such attempts at monitoring, controlling and didactically accreditating are inappropriately foisted upon the field, then the cost in terms of the quality of the healing care that good counselling practice provides may well be an enormous one.

If we agree with Jill Hall (1993, p. 4) that 'Rational thought is not the most fitting mode with which to know the universe..., and thus not a fitting mode with which to know ourselves', and with Groddeck when he argues that conscious thought is a 'tyranny' (1951, p. 103) leading to a fetishisation of human experience, then it immediately becomes extremely doubtful as to whether the rationality-dominated and control-oriented form taken by programmatic professionalisation can have the remotest relevance to the healing orientation that counselling at its best represents. As long ago as 1990, Brown and Mowbray wrote most poignantly that 'Where there is a genuine need for structures, we should develop structures that foster our values rather than betray them' (quoted in Mowbray, p. 225). On the formidable arguments and compelling evidence provided in CAPR, there must surely be severe doubt as to whether the form and momentum taken by unfolding professionalising developments are in the best interests of either clients or the field as a whole.

For those whose response to these disorienting counter-cultural arguments is to ask what alternatives exist to hierarchical professionalisation, there is a rich and rapidly evolving body of creative ideas and rigorous practices growing up quite spontaneously and organically to fill the sense of heartlessness created by recent trends in the field (see, for example, Mowbray, Chapters 28, Appendix D; Self and Society, January 1996 issue; House and Totton 1997; Postle, 1997), with the Independent Practitioners' Network, founded in 1994, being at the forefront of such developments (Totton, 1995).

Whether or not the current bandwagon possesses a self-serving momentum that is now unstoppable and irreversible remains to be seen; but I passionately believe that if the logic of the process plays itself through fully, then the end-result may well be an impoverished field in which those unquantifiable and ineffable qualities that lead to successful counselling and healing outcomes are systematically frozen out and lost because of an anxiety-driven obsession with standards, control, audit, evaluative research, and the other leitmotivs of the technocratic Zeitgeist (House 1996c). And that would be no little tragedy for all of us.


Coda - the emotionality of professionalisation

The internal dynamics of the professionalisation process (Wasdell, 1992) are extremely revealing of the power issues involved (House, 1995a). Of course, those who are 'in' are likely going to tend towards an exclusivity and an attitude towards therapeutic practice that is infused with the values of hierarchy and superiority; and those who are 'out' are going to complain about injustice and marginalisation from their 'rebel' position. Both 'sides' have their own particular deep personal stakes in the professionalisation process and the form it takes, their respective positions no doubt being underlain and fuelled by deep unconscious influences around power, powerlessness and authority from their respective emotional-developmental histories (House 1995a).

Little or no progress can be made in this highly emotional debate if both sides are intent on arguing from these polarised and often wounded-child emotional positions. Rather, our task should surely be to transcend such an internecine warfare that seems to generate more heat than (en)light(enment), and is not only unproductive but positively harmful to the coherence and credibility of our field. One of the considerable achievements of Richard Mowbray's book is that it succeeds in honouring and doing full justice to the emotionality of the accreditation/registration issue, while at the same time presenting an extremely thorough, sober and meticulously argued thesis that questions at root the very rasion d'etre of professionalisation.

Mowbray's formidable contribution deserves a serious and detailed response from those who would take the professionalisation process to its logical conclusion, and coherent authoritative arguments as to why his profound misgivings are misplaced and wrong-headed. As Mowbray himself writes, 'If legislative restrictions such as those sought by UKCP et al. are to be introduced in Britain, the onus should be upon those who favour this change to prove the necessity and to substantiate their position that the restrictions they seek would be beneficial' (p. 4). One can invoke the philosophical principle of Occam's Razor at this point, one variant of which states that the simplest, least involved solution that 'gets the job done' should always be preferable to more complex and involved alternatives. Mowbray clearly not only subscribes to the view that you shouldn't fix something unless it needs fixing, but that any shortcomings that do exist within our field can easily be met and responded to through existing frameworks and structures (see CAPR, Chapter 28; House and Totton, 1997).

Whether the vested training interests, the self-serving bureaucratic momentum and the practitioner acquiescence and inertia that now subsist in the field will allow such existing solutions and alternatives to be tried is open to severe doubt. But one thing seems clear: if rationality has anything to do with it, then Mowbray's Case presents a formidable, and perhaps an insurmountable, obstacle to anyone with the naivity to believe that the case for professionalisation is self-evident and incontestible. A coherent, sustainable, evidence-based rationale for professionalisation has yet to be articulated by those favouring current developments; and Mowbray's Case has only made their task in this regard even more difficult and problematic than it was pre-Mowbray.

Post-Mowbray, professionalisation in our field will surely never ever be quite the same again.


Note
Richard Mowbray's The Case against Psychotherapy Registration: A Conservation Issue for the Human Potential Movement (Trans Marginal Press, 36 Womersley Road, London N8 9AN, ISBN 0-9524270-0-1, 1995, 320pp) is available from Trans Marginal Press at £12.95 (+ £2 postage and packing in UK).


References

Ackerknecht, E. H. (1959) A Short History of Psychiatry, New York: Hafner
Publ. Co.

Andrews, G. and Harvey, R. (1981) 'Does psychotherapy benefit neurotic
patients?', Archives of General Psychiatry, 38, pp. 1203-8.

Brown, J. and Mowbray, R. (1990) 'Whither the human potential movement?',
Self and Society, 18 (4), pp. 32-5; reprinted as Appendix A in CAPR.

Button, J. (1995) Review of CAPR, Self and Society, 23 (4), pp. 52-4.

Frank, J.D. (1964) 'Foreword', in A. Kiev (ed.) Magic,
Faith, and Healing: Studies in Primitive Psychiatry Today, New York:
Free Press, pp. vii-xiv.

Frank, J. D. (1978) 'The dynamics of the psychotherapy relationship', in
his Psychotherapy and the Human Predicament: A Psychosocial Approach,
New York: Schocken Books, pp. 19-56.

Frank, J. D. (1989a) 'Discussion', in M. Shepherd and N. Sartorius (eds.)
Non-Specific Aspects of Treatment, Toronto: Hans Huber Publishers, pp.
142-6.

Frank, J. D. (1989b) 'Non-specific aspects of treatment: the view of a
psychotherapist', in M. Shepherd and N. Sartorius (eds.) Non-Specific
Aspects of Treatment, Toronto: Hans Huber Publishers, pp. 95-114.

Gonsiorek, J. C. (ed.) (1995) Breach of Trust: Sexual Exploitation by
Health Care Professionals and Clergy, Thousand Oaks, Calif.: Sage.

Groddeck, G. (1951) The World of Man, London: Vision (orig. 1934).

Hall, J. (1993) The Reluctant Adult: A Exploration of Choice, Bridport:
Prism Press.

House, R. (1995a) 'The dynamics of power', Counselling News, 20 (December),
pp. 24-5.

House, R. (1995b) 'Legislating against abuse of clients in therapy: a
cautionary view', Self and Society, 23 (2), pp. 34-9.

House, R. (1996a) 'The genius of Georg Groddeck, precursor of humanistic-
dynamic counselling - an appreciation', forthcoming in Network: The
Scientific and Medical Network Review.

House, R. (1996b) '"Audit-mindedness" in counselling: some underlying
dynamics', forthcoming in British Journal of Guidance and Counselling.

House, R. (1996c) 'The dynamics of professionalisation: a personal view of
counselling research', forthcoming in Counselling.

House, R. (1996d) Review Article: '"If it works don't fix it!" - Mowbray on
didactic professionalisation', Counselling, 7 (2).

House, R. and Totton, N. (eds.) (1997, forthcoming) Implausible
Professions: Arguments for Peer Regulation and Pluralism in Psychotherapy
and Counselling

Illich, I. (1977) 'Disabling professions', in I. Illich and others,
Disabling Professions, London: Marion Boyars, pp. 11-39.

Kiev, A. (1964) 'Implications for the future', in A. Kiev (ed.), Magic,
Faith, and Healing: Studies in Primitive Psychiatry Today, New York:
Free Press, pp. 454-64.

Lather, P. (1992) 'Postmodernism and the human sciences', in S. Kvale
(ed.) Psychology and Postmodernism, London: Sage, pp. 88-109.

Maguire, M. (1995) Men, Women, Passion and Power: Gender Issues in
Psychotherapy, London: Routledge.

Masson, J. (1988) Against Therapy, London: Fontana (1990 edn.).

Menninger, K. (1963) The Vital Balance: The Life Process in Mental Health
and Illness, New York: Viking Press.

Mowbray, R. (1996) 'SAFAA is safer', Self and Society, 23 (6), pp. 16-19.

Orbach, S. and Eichenbaum, L. (1994) 'From objects to subjects', Paper
presented at the Freud Museum Conference on 'Psychoanalysis and
Feminism', London, May.

Postle, D. (1997, forthcoming) 'A self and peer assessment process for
existing practitioners', in House and Totton (eds.).

Rowan, J. (1995) 'An open letter to Richard Mowbray', Self and Society, 23
(4), pp. 43-4.

Russell, R. (1981) Report on Effective Psychotherapy: Legislative
Testimony, New York: R.R. Latin Associates.

Smith, M. L., Glass, G. V. and Miller, T. I. (1980) Benefits of
Psychotherapy, Baltimore: Johns Hopkins University Press.

Stacey, M. (1994) 'Collective therapeutic responsibility: lessons from the
GMC', in S. Budd and U. Sharma (eds.) The Healing Bond: The Patient--
Practitioner Relationship and Therapeutic Responsibility, London:
Routledge, pp. 107-33.

Stein, H. F. (1982) 'Toward a life of dialogue: therapeutic communication
and the meaning of medicine', Continuing Education for the Family
Physician, 16 (4), pp. 29-45.

Stein, H. F. (1985) 'What is therapeutic in clinical relationships?', Family
Medicine, 17 (5), pp. 188-94.

Strupp, H. H. and Hadley, S. W. (1979) 'Specific vs. non-specific factors
in psychotherapy: controlled study of outcome', Archives of General
Psychiatry, 36, pp. 1125-36.

Totton, N. (1995) 'The Independent Therapists' Network', Self and Society,
23 (3), pp. 31-3.

Wasdell, D. (1991) 'The pre- and perinatal ground of capitalism and the
free market economy', London: Unit for Research into Changing
Institutions.

Wasdell, D. (1992) 'In the shadow of accreditation', Self and Society, 20
(1), pp. 3-14.

Young, R. M. (1993) 'The profession of psychotherapy in Britain', Free
Associations: Psychoanalysis, Groups, Politics, Culture, 29, pp. 79-84.