I’ve had mental health issues since childhood and recognise that the relationship you form with a therapist is never straightforward. There needs to be mutual respect, which can be difficult to achieve in an institutional setting. Above all, the relationship should be one of trust. Trust that confidences are kept and that intimate and personal revelations will be treated appropriately. It is reasonable to expect that the person with whom you are sharing your experiences and thoughts is properly trained, accredited and registered as a professional practitioner.
Yet in the UK no comprehensive system exists for professional accreditation of psychotherapists. Certainly organisations such as the UK Council of Psychotherapy and the British Association for Counselling and Psychotherapy claim to provide accreditation and professional endorsement. They invite people satisfying their criteria to join as members but they do not provide anything more than a kitemark for their members. The process of membership application and response is not comparable with other areas which have statutory professional regulation. As for practising as a therapist, anyone can do it. You can just put up a card advertising your services in a medical centre or health food shop, describing yourself as a therapist, and wait for the unsuspecting clients to call. There is no regulation and no legal means to prevent any abuse of patients’ trust.
Standards vary widely between NHS practitioners and those operating in the private sector. Although therapists working in the NHS will usually have suitable qualifications from recognised establishments, many working in private practice, usually as self-employed practitioners, often do not. Private therapists’ standards are likely to be far less rigorous than those in the NHS whose accountability is primarily to the patient, not to the institution. They will not be monitored and asked to provide progress reports. So, as happened to me, they are free to suggest that more therapy is required, ensuring their fees are enlarged.
I believe this is widely abused. I feel I was encouraged to become dependent on a therapist who tried to persuade me to increase my contact time. When I declined, taking up an offer of NHS-funded therapy instead, I was dropped like a stone. No one in need of mental health services should be abandoned when their requirements change or when they develop enough independence to question or challenge the recommendations being made.
Anna C Young is a disability activist