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Jenaway, A., 2009. The Big Debate - Health Professions Council. Reformulation, Winter, p.7.
At the September Supervisors and Trainers event an important issue was raised that could have major implications for many ACAT members. The Health Professions Council, which has been set up to monitor counsellors and psychotherapists working in the NHS, has decided on only two categories: counsellor or psychotherapist. It has set out the differences between these two categories in a draft consultation document entitled “standards of proficiency for psychotherapists and counsellors”. In the current draft, most standards apply to both psychotherapists and counsellors, with the only real difference being that psychotherapists “understand typical presentations of severe mental disorder and understand methods of diagnosis of severe mental disorder appropriate to the theoretical approach and be able to conduct appropriate diagnostic procedures” and also “understand and implement treatment methods to address symptoms and causes of severe mental disorder”. The implication seems to be that psychotherapists are able to diagnose and treat severe mental disorder while counsellors should work with those with mild and moderate disorders.
The Big Question for ACAT
At the moment ACAT reserves the title psychotherapist for those who have completed the advanced training and are able to register with the UKCP. The majority of our members, however, are called practitioners, but probably meet the requirements under HPC to be eligible as psychotherapists. Does this mean that ACAT should rename our practitioners as psychotherapists and create another, more senior, category for those who have completed the advanced training? The terms “Fellow of ACAT” or “senior psychotherapist” have been suggested. We are not even sure if this will be possible given the timescale for registering with the HPC. It may be that only those already registered with the UKCP will be automatically included.
The Pros and Cons
At the meeting in London there was a lively debate and I have attempted to summarise the points made. However, we were very conscious that this is an issue which will affect almost all of our members and so we needed to widen the debate to include you all.
Pros
If we feel that our practitioners meet the criteria for the category of psychotherapist, then it is vital that we do not downgrade their qualification (and thus our practitioner training) when other trainings (which may be less rigorous than ours) will register their members as psychotherapists.
But those who have put in the huge extra time and effort to complete the advanced training will be “down graded” as there will no longer be any clear distinction between the practitioners and the psychotherapists.
If CAT has a place in the NHS it is with more complex patients such as those with eating disorders and borderline personality disorder. If most CAT therapists are seen as unqualified to work with more severe patients then we will be shooting ourselves in the foot.
But the NHS and the public should be able to tell a more advanced CAT therapist from one with only basic training – otherwise what is the point of the more advanced training? More importantly, how will the client know what they will be getting?
We could create a new category of advanced therapists to distinguish the two, such as Fellow of ACAT.
Will the advanced course survive if there is no longer the requirement to do it in order to fulfil UKCP entry? Many of the trainees are doing it for partly that reason, although they also get a lot more out of it. We don’t want to lose it.
Maybe the advanced course will need to change in some way as the regulatory bodies change and the needs of members change. Could it be more geared to advanced training for consultancy work?
Future Plans
A small working group is being set up to look at this issue, how it affects ACAT and its members, and what the possible options are at this stage, but do take the opportunity to make your opinions known by contacting us.
Do catch up with the latest news about the HPC at www.hpc-uk.org