Truth is a pathless Land.... Truth cannot be organised; nor should and organisation be formed to lead or coerce people along any particular path.... A belief is purely an individual matter, and you cannot and must not organise it. If you do, it becomes dead, crystallised; it becomes a creed... to be imposed on others. Jiddu Krishnamurti (Talks, 1929 & 1974)

If the former Chair of the United Kingdom Council for Psychotherapy were to describe a newly published book as 'articulate', 'incisive' and one which will become 'an indispensable element of good training in the field', one might expect it to be predominantly favourable towards the professionalisation of the therapy field. The book in question is Alex Howard's Challenges to Counselling and Psychotherapy, published (as I write) this very week by Macmillan; and the former Chair of the UKCP is Emmy van Deurzen-Smith, who has written the Foreword to the book. Yet far from Alex Howard being approving of current professionalising developments, the very opposite is the case - here are some choice selective quotations from this important book:

'There is no evidence that training, supervision or experience make a
person less likely to abuse a client.... Nor, it seems, do accreditation
and training schemes detect the likelihood of an individual abusing a
client' (p. 22). 'Can essential counsellor virtues be detected, taught
and accredited within selection and training programmes? There is
absolutely no evidence, or reason, to believe that they can. Why, then,
should we regard counselling and therapy as professional activities if
the human qualities they depend upon cannot be reliably delivered by due
professional process?' (p. 23). '...[accreditation]... certainly reveals
a great deal about the understandable search for power, status and a
secure income' (p. 32).... 'Nor... can ordinary human virtues such as
love, warmth, compassion and empathy, be professionally organised....
Let us be wary of any group that accredits itself as being able to
provide love, or a substitute, and which siphons off ordinary humanity
and sells it back for a fee' (p. 159).

From Professionalisation...
Rather than rehearse here the plethora of arguments that have been made against what might be called 'didactic professionalisation', I believe that a formidable case against registration as a general principle (whether statutory or voluntary) can convincingly be made in a few paragraphs. In a recent article in Human Potential (Autumn 1996), Tricia Scott provides the following rationale for registration: 'The important question is how best to organise the profession to ensure that the best job is done in the public interest' (my emphasis), given that 'the people who come to us are vulnerable...'.

However, the public-interest argument in favour of registration simply doesn't stand up to scrutiny. There are two strands to the argument: first, can didactic accreditation and registration procedures be shown to create and guarantee practitioners who are more competent and less likely to harm clients than in a non-registration environment?; and secondly, if such a guarantee of competence can't be demonstrated or sustained, then the only remaining rationale favouring registration is that of weeding out and disqualifying abusive or incompetent practitioners.

On the first point, Alex Howard's comments are very pertinent: 'I have found no relationship between the qualifications of a counsellor and the quality of his or her work', and 'Highly trained counsellors succumb at least as much as less skilled colleagues [to abusing their clients]'. He goes on to cite an unpublished paper presented to the British Psychological Society in 1991 by Carol Sherrard, which reviewed some 41 empirical studies comparing the effectiveness of professional and non-professional workers, only one of which concluded that the professional group was more effective. This somewhat counter-intuitive finding is entirely consistent with that of Roberta Russell, who in her exhaustive review of the literature concluded that 'Paraprofessionals consistently achieve outcomes equal to or better than professional outcomes', and 'therapists who have undergone traditional training are no more effective than those who have not'.

If, then, there is no evidence that registered or accredited practitioners are more effective or less abusive than the unregistered, the only remaining rationale for registration is that in the real world of therapeutic practice, registration and its associated disciplinary regime will be used to bring incompetent or abusive practitioners to heel. Such a justification turns on the following crucial issues: first, in reality, will the mechanisms and procedures set in place actually be used on the ground, and to any significant extent, against abusive or incompetent practitioners?; secondly, assuming for a moment that registration will bring about a real and significant weeding out of abusive practitioners, will any benefits that this brings to the client/public interest in terms of enhanced safety more than outweigh any harmful side-effects that registration brings in its wake?; and thirdly, is registration the only means of achieving enhanced client safety? - for if there exist alternative and equally effective means of enhancing client safety and practitioner accountability, but without the accompanying negative side-effects of didactic registration, then clearly it will make far more sense to go for the former than the latter.

First, to what extent will disciplinary procedures actually be used? According to Daniel Hogan (quoted in Richard Mowbray's Case), 'In the mental health professions [in the USA], data from the field of psychology support the proposition that board discipline is virtually non-existent'. Richard Mowbray himself maintains that 'Given the poor track record of systems based on professional codes of ethics and conduct and self-disciplinary action as a means of protecting the public, what reason do we have to be confident that such a system would be any more effective in producing its purported benefits for the public?'. And finally, the very nature of the therapy field suggests that abused clients will very often feel unable or be unwilling to make official complaints anyway (not least because of the experienced shame involved) - no matter how confident they might be about the outcome. So once again, registration will no doubt be very good at conveying an illusion of effective policing of the field - while abusive and incompetent practitionership continues apace.

Yet even if it could be shown that disciplinary procedures under a licensing system would be effective, a wealth of empirical and logical evidence has been accumulated by a number of sceptical commentators which strongly suggests that the harmful side-effects of registration by far outweigh any conceivable benefits that it would confer upon the field.

Finally, is registration the only way to secure practitioner accountability? One of Daniel Hogan's list of pre-conditions for licensing is that 'simpler and less restrictive methods that would accomplish the same purposes must be unavailable' (for example, existing laws). Richard Mowbray sets out in detail a whole host of existing and comparatively easily implemented procedures which would, at the very least, effect the same purported benefits as licensing, but without the many negative side-effects - including education of the public, the application of existing laws, full disclosure provisions, non-credentialed registration, and self and peer accreditation.

In sum, it seems clear that the case for didactic registration falls at a whole host of hurdles - any one of which would alone be sufficient to conclude that registration is an inappropriate direction for our field to move in.

...via the Statutory/Voluntary Sleight of Hand...
There is also an important question to address regarding the alleged and to date little discussed distinction between statutory and voluntary registration. There has recently been a discernible shift within the humanistic movement towards embracing voluntary registration as a more palatable and apparently more 'humanistic' fall-back position, as the anti-statutory arguments have gained increasing currency in the field. Yet in practice and in the longer term, there may actually be very little effective difference between statutory and voluntary registration. There must be many unregistered practitioners who are increasingly experiencing a fall-off in their practice, as training organisations stipulate that trainees must only work with registered practitioners (I, with many others, could relate some horror stories about this!), as the public services increasingly demand registration or accreditation for all their employees, and as referrers increasingly refer only to registered/accredited workers. What this amounts to, then, is a form of de facto statutory regulation; indeed, the term 'voluntary register' is in fact a logically incoherent notion - for a register surely loses its very raison d'etre if people are allowed not to be on it (whoever heard of a 'voluntary' school register, for example!)...What this amounts to, then, is a 'sleight of hand', such that, (a) 'voluntary registration' sounds far less unhumanistic than statutory registration; (b) approximately the same degree of regulation of the field can be brought about by pursuing the 'voluntary' path as could be effected by statutory regulation; so (c) we'll support 'voluntary' registration, sound much more reasonable and humanistic, and yet still get precisely what we want, i.e. a de facto, effectively statutorily regulated field in all but name - and one which could, of course, be 'topped up' at any time in the future with further restrictive legislation.

It follows from this that the anti-regulation arguments set out above apply with just as much force to the so-called 'voluntary' position as they do to statutory registration.


...towards a Post-Therapy Era
The tide may well be beginning to turn against the professionalising mentality, as a steadily increasing number of practitioners begin to question many of the unsubstantiated assertions of the professionalisers. More generally, surely the very energy of professionalisation (not least its desire to tighten, control and above all somehow guarantee the safety of the therapeutic process) is quite fundamentally dissonant with the energy of personal growth, human potential development and transformation. We would do well to listen closely to that eminently wise sage Krishnamurti, who vehemently criticised all institutions and man's urge to institutionalise - not least because it is unrealistic to expect more institutionalisation and systematisation to lead to healthy change when those very processes invariably aggravate rather than alleviate societal ills.

If we agree with Brian Thorne that counselling and therapy are essentially subversive activities, then as soon as the therapeutic mentality becomes a cultural norm and part of an Establishment orthodoxy, then perhaps that is by definition the time to challenge the very idea of 'therapy' and 'psychopathology', and to transform and transcend what are rapidly becoming ideologies that have outlived their usefulness as ways of comprehending and engaging with the world. Krishnamurti again: 'if one is only concerned with helping the individual to conform to the existing social pattern..., is one not maintaining the very causes that make for frustration, misery and destruction?' Indeed, for Krishnamurti, any kind of 'adjustment therapy' to a psycho-social norm inevitably infringes and prevents true freedom.

Perhaps, then, recently published books like those by Alex Howard, Richard Mowbray, Ian Parker et al. and David Smail (not to mention Jeffrey Masson, of course) are but the harbingers of a new post-therapy era which questions quite fundamentally the individualising, ideological assumptions of the psychotherapeutic mentality. Profound disquiet about the existing paradigm is even beginning to emerge from within psychoanalytic orthodoxy. Here are some recent thoughts of Joyce McDougall:

'The question of a paradigm shift with regard to our metapsychology
merits a full exploration.... there is the ever-present risk that our...
analysands may employ much of their analytic process in an attempt to confirm their analyst's theoretical expectations!.... our standard psychiatric and psychoanalytic classifications... are equally questionable....It would be presumptuous to imagine that it is our theories that bring about psychic change and symptomatic cure!.... Is not our leading perversion... the belief that we hold the key to the truth?'
(her emphasis).

Krishnamurti would agree: 'You will always experience what you believe and nothing else. And this invalidates your experience.... Belief conditions its own supposed proof'.

One thing seems clear: registration or no registration, the human potential movement, in both its humanistic and transpersonal forms, will most surely take a leading role in this r/evolutionary process as the evidence relentlessly accumulates that the old paradigm and its associated Weltanschauung is no longer remotely adequate to meet the urgent needs and challenges of our deeply troubled times.



Further Reading
Alex Howard, Challenges to Counselling and Psychotherapy, Macmillan, Basingstoke, 1996

Joyce McDougall, The Many Faces of Eros: A Psychoanalytic Exploration of
Human Sexuality, Free Association Books, London, 1995

Richard Mowbray, The Case Against Psychotherapy Registration: A Conservation Issue for the Human Potential Movement, Trans Marginal Press, London, 1995

Ian Parker and others, Deconstructing Psychopathology, Sage, London, 1995

Roberta Russell, Report on Effective Psychotherapy: Legislative Testimony, R.R. Latin Associates, New York, 1983 (update, 1993)

David Smail, How to Survive without Psychotherapy, Constable, London, 1996

Indeed, as David Kalisch has recently pointed out to me in a personal communication, even if it could be shown empirically that a system of registration would positively benefit client safety, this would be an argument in favour of a totally inclusive register rather than for the exclusive variety proposed by UKCP and BAC/COSCA. For it hasn't been demonstrated empirically that so-called 'competence' criteria of the kind enthusiastically embraced by the register-builders have any predictive value whatsoever in relation to practitioners' ethical behaviour - which is of course the real issue as far as client safety is concerned. Such an inclusive register would be essentially the same as the system of Non-Credentialed Registration mentioned by Mowbray, and might best operate at local authority level in a manner that's very different from the high-status, high-profile exclusive registers currently being promoted by the training-accrediting lobbies - and which, effective as they are in terms of career-building for those on the registers, have never been shown to be effective in protecting clients from the 'professionals'.