Enter Alter Ego

Mental Health Nurse is a blog run by mental health professionals and service users. Its blogger Zarathustra has been running a fascinating series on the regulation of psychotherapists. The last government introduced proposals for psychotherapists to be regulated by the Health Professions Council – just as doctors are regulated by the GMC and nurses by the NMC. Currently the HPC regulates occupational therapists, physios, paramedics, and the like.

Last year it struck off an arts therapist named Derek Gale. This is why:

During that period you inappropriately treated patient B in that: you inappropriately touched her by pinching her breast; you entertained patients at your home when illegal drugs mainly cannabis, were available… you referred to C as a ‘cunt’ on several occasions in one to one and group sessions… you placed patient D under undue pressure in that you informed the group that unless her demeanour changed, the group would devote the whole of the next session to a discussion of D’s negative characteristics… between 1999 and 2004, you gave C a number of greeting cards in which you signed off as ‘Daddy’… at the opening of the Gale Centre, and on a number of other occasions between 2001 and 2004, you referred to yourself as ‘the father’ and to YY as ‘the mother’.

Even a cursory reading of the charge sheet should tell you that Derek Gale is an abusive, cultish maniac who should under no circumstances be left alone with vulnerable people. From the Panel’s conclusion:

The Panel has already stated that it finds Mr Gale’s attitude to be cavalier, and this is so not only in relation to his clients, but also in relation to the justifications for his practice and in his ambiguous relationship with the truth… Mr Gale’s casual neglect of the HPC’s standards does not inspire confidence in the Panel that he would in the future comply with them either in spirit or in principle… Striking-off is also a necessary and proportionate response to the allegations because of the need to protect particularly vulnerable clients who might consult Mr Gale, and in order to ensure that the public can maintain the level of confidence it is entitled to hold in both the registered profession and the HPC’s regulatory process.

After the ruling, Gale simply carried on advertising his services, except that he now called himself a psychotherapist – which anyone can. You don’t need any clinical training or qualifications to set up as a therapist and no body monitors psychotherapists apart from a couple of self-regulatory organisations called the UKCP (UK Council for Psychotherapy) and UKAHPP (UK Association of Humanistic Psychology Practitioners).

Howard Martin, the original complainant in the Gale case, explains that: ‘These fine and dandy sounding associations and councils actually have no legal status above that of a local golf club.’ As Zarathustra says, a doctor struck off by the GMC will go to jail if he continues to call himself a doctor. A psychotherapist struck off by the UKCP can go on practicing.

They are also very obstructive and evasive to outsiders. Martin (who was never treated by Gale) is pretty much at the end of his tether:

At the hands of these people and their caring sharing ‘humanistic’ complaints process I have encountered more disingenuous, vindictive and outright nasty behaviour than I have ever encountered in my 30 years in the back stabbing, bitch slapping, exploiting media circus that is TV production… Take one step back and forget that it’s me in this process and imagine for one moment you are a vulnerable client who has been abused and is standing alone trying to make a complaint against your abuser.

Government proposals to regulate the laissez-faire carnival of psychotherapy have met with strong objections. The Coalition Against Over-Regulation of Psychotherapy has many name writers and intellectuals on its list of signatories – Alain de Botton, John Gray, Andrew O’Hagan. Of psychiatrists, psychologists and other mental health professionals, not so many.

Zarathustra takes apart their arguments, which are a ludicrous combination of anti-capitalist and consumer-is-king rhetoric. The unwritten assumption is that psychotherapy is an art, not a practice, and to regulate psychotherapy would be to break the butterfly upon the wheel.

The thing is, a therapist can make or break the client. A good cognitive behavioural therapist got me back on my feet when I lost it a couple of years ago. She was sympathetic and practical and I still miss her on occasion. When confronted with a dilemma, I ask myself what her advice would be. If I’d been less fortunate in my therapist, I might still be in the attic in Salford, raving to this day.

Zarathustra nails it:

Where I work, in an NHS eating disorders unit, the people attending psychotherapy are not highbrow literati trying to get over a dose of writer’s block. They’re deeply troubled, highly vulnerable people who need help to fight the anorexia that is actively trying to kill them. They are not going through a shopping catalogue of therapies like a basket to be ordered from Harrods. They need careful, expert support to help them develop a sense of control in their lives. Above all, they need to know that the therapist is not going to inflict further trauma upon them through misconduct or abuse. That means regulation.

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