A Client First

In both my work as a therapist and in my personal therapy, covid 19 has presented some profound and complex challenges to the therapeutic frame.

As has been widely discussed, moving to work online has had benefits for some, and involved significant difficulties for others, including issues around privacy, grounding, internet access, technology, loss of therapeutic touch and adapting to this very different way of working, and all the while, both therapist and client are managing multiple external disruptions, difficulties and often, grief. It has, and continues to profoundly impact on therapeutic work globally.

I have written many times about the importance of a safe and predictable therapeutic frame, most crucially when working with trauma, but actually this is a fundamental part of what all therapists must offer their clients, and what sets the therapeutic relationship apart from other relationships in our lives.

I am someone for whom the boundaries of time and space have always had particular significance for me in therapy. I have always had therapy at the same time, on the same day, in the same place. This (along with a therapist I can rely on to be fairly predictable in his behaviour and what I can expect from him) has always been a key part of why I have been able to engage so fully with the process of therapy, and why I am able to be so vulnerable in the room. This didn’t happen by magic – it was a matter of my therapist proving himself reliable and trustworthy, again, and again, and again over a number of years.

Covid 19 is disruptive to the therapeutic frame in a number of ways. Decisions about face to face or online working have not been straightforward, and often made at short notice as scientific guidance is updated and tier-changes are announced. The truth is, along with everyone else, it has been difficult for clients and therapists to know what is the right or best thing to do, and making important decisions like these in the context of such a high degree of uncertainty is inevitably unsettling for both therapist and client. Often decisions have necessarily had to be made unilaterally by therapists, creating a potential trigger for rupture in a relationship that has previously been experienced as collaborative by the client. The therapist, while managing their own uncertainty, also must pay careful attention to how power and disempowerment impacts on their therapeutic relationships, whilst also, very likely not feeling particularly powerful themselves.

While unexpected illness and emergency always present a potential for disruption in therapy, the threat of sudden cancelled sessions is greater with covid; one of my concerns for my practice is that if were to be asked to self-isolate due to symptoms, or contact with somebody who has tested positive, I would not be able to see clients for the period I am isolating, because I work online from my office, and do not have a sufficiently private space at home from which to see clients.

Therapists still seeing clients face to face will have had to recontract with their clients around confidentiality in case of needing to disclose the names of those with whom they have been in contact for the track and trace system. Clients will have to agree to this change to the therapeutic contract, yet a change to the contract it is. In my view, every change to the frame is significant and worth paying attention to.

Some therapists have begun offering walk and talk sessions; this seems to have been a helpful addition to therapy for many, and also, it is a significant change to the therapeutic frame. Again, these considerations are so important. What meanings come with that change of space? What influence on the therapeutic process does the absence of the physical boundaries of bricks and mortar have? This might be good, bad, neutral or all three, but one thing is for certain – it has meaning.

I think the biggest uncertainty for me, both as a therapist and as a client comes when I look at the long picture. When will I be welcoming clients back into my room again? What impact might the not-knowing have on them? When will I again sit with my therapist, in the safe little room which had become so familiar to me? For me, in both chairs, the key must necessarily be ongoing discussion about how the client is experiencing the relationship and the changes to the frame of therapy.

The therapeutic frame cannot be underestimated. It is the container which allows the chaos and uncertainty of life to emerge safely in the room. It is the boat which the sailors must have confidence in its integrity before they set sail, or they will be too busy worrying about it sinking to explore new lands.

The uncertainty of covid is not insurmountable, it is not the case that good work can’t happen in its midst, but we mustn’t underestimate it either, nor minimise the experiences of those who are navigating these choppy waters.

What follows is an open letter to the BACP, which I sent today, 23rd September 2020.

  Dear BACP, 

    I am writing to you regarding your resolution and motion process this year. Like many others I am shocked and deeply saddened by the behaviour of governance in not notifying members that their resolutions and motions would not be accepted.

Last year, I was given the opportunity to amend, and although I am certain it would have been argued that my resolution was against the interests of the charity (which I, of course, refute) the resolution was accepted anyway, after due amendments. I am particularly shocked also by the other items you reject, most notably the one regarding voting percentages, after you raised the percentage without consulting members, and the motion regarding advertising harmful adverts, which contravene widely-accepted ethics surrounding working with eating disorders. 

Putting the letter of your rules aside for a moment, I would like to know how you justify from a moral perspective, not notifying proposers prior to the resolution vote opening, so they had an opportunity to resubmit? There seems to be no reason to do this other than to block resolutions you disagree with, which I would like you to try to justify from a moral and ethical standpoint. The ethical principles of integrity, candour and justice, in your ethical framework may help you to consider this question.

If you believe you have no duty to respond to me as I am no longer a member, you might wish to consider that I am a long-term client of a BACP member, dating back to the days when I truly believed BACP to be at the pinnacle of fair and ethical practice. The days when I would recommend that others sought a BACP therapist, and later, when I sought out a BACP accredited course for myself. 

As a client, you are charged with decision-making which impacts on the most vulnerable aspects of my being. Not only mine, but many thousands of other clients too. Crucially, when you act disingenuously, unfairly and, in my view, dishonestly, you can bet this trickles into what happens in therapy rooms around the country. How can it not? You must model the principles you espouse or they have no impact, as we see in national politics today.

So as a client, I am asking you explain to me how not notifying proposers that their resolutions have been cancelled so that they can resubmit is morally justified, and how your decision not to allow these proposers (who are not lawyers, and perhaps need guidance from you to meet criteria) a chance to submit a legitimate resolution/motion, serves me, as a client?

Please note, this is an open letter, and as such I reserve the right to publish any reply or lack thereof.  

I look forward to hearing from you.

Erin Stevens

*UPDATE 25/09/2020

I received a reply from BACP today, which I have responded to. Here is the communication exchanged:

Dear Erin,

Many thanks for your email, and for sharing your concerns with us.

We’ve received similar feedback through our social media channels, and we’ve issued a full statement in response, which you can see here:

https://www.bacp.co.uk/news/news-from-bacp/2020/22-september-update-on-the-motions-and-resolutions-process/

Where our members have submitted motions & resolutions for board consideration as a proposer, I can confirm that we have liaised with them directly.

Where motions and resolutions were not progressed, this has been communicated to the relevant proposer along with a clear rationale for the board’s decision. Whilst many of our members may wish to see this information, it is not appropriate for BACP to share this publicly on behalf of the proposer.

Where the Board collectively felt that submissions could be progressed with very minor amendments, we liaised directly with the proposer and encouraged a resubmission based on our feedback. Unfortunately, the nature of several submissions meant that the changes required would radically alter the nature of the original submission. In these instances, these submissions have been rejected.

With the above in mind, whilst I recognise your frustration with regards to the non-progression of specific motions & resolutions, we are unable to publicly share further details.

I hope that helps. Please don’t hesitate to contact me directly if you’ve any further questions.

Many thanks,

Adam Pollard

Head of Marketing & Engagement

Here is my response:

Dear Adam,    

Your stock response is inadequate for two reasons.  

  First, you point me in the direction of a statement which contains the following lie: “Where this is the case, our decision was communicated to the relevant proposer in advance of the member support process opening along with a clear rationale for our decision.” Having spoken personally with three proposers who each report having not received notice of the rejection of their motions/resolutions until the day of the resolution process opening,  and having seen the documentary evidence myself, it is clear to me that no advance notice was given by BACP for members to resubmit, and any suggestion otherwise is dishonest.

BACP has a duty of candour, and the BACP’s actions, and your repetition of them, are contrary to the terms under which the organisation is accredited with the professional standards authority. This initial statement, and any further repetition of it, provide further evidence of BACP’s failure in their duty of candour, which is a very grave concern. 

It may be that you were not personally aware of your employers’ failure to notify members, in which case, it would be advisable to check the date the letters were sent (as opposed to when they were written) and you will see that they were sent on the day that polling opened.

The second reason your stock answer is inadequate is that it fails to answer my question. I am asking you, in light of the fact that you now know the proposers were not given advance warning and an opportunity to resubmit, how it is justified from a moral and ethical standpoint (I again refer you to the BACP ethical framework) to fail to notify members in advance of the decision, giving them an opportunity to resubmit? You may want to think again about how the process was approached differently last year, with reference to the ethical principle of justice. Again, how do the BACP’s actions serve me, as a client?

I look forward to your considered and personalised response.

Kind regards

 Erin Stevens

SCoPEd 2 has been released. I’ve had a look through and tweeted a few significant points. I won’t have the time to write anything more substantial today, so here I have replicated a few high[low]lights that I have highlighted in tweets:

The first thing I notice is that for ‘column C’ you need 450 client hours during core training. So if your training involved less than 450 client hours, you can never achieve column C.

 

They have removed the titles, but they plan to put them back in (so why remove them, unless it is simply to make it appear more palatable?)

You are still incapable of taking an active role in the profession nationally, and communicating effectively with other professionals in imparting information, advice, instruction and professional opinion, unless you’ve done UKCP/BPC/450 cl hour training, for some reason:

Enshrinement of the medical model persists:

 

Fabulously ironic one here about recognising discriminatory practices and power differentials. Gotta be a proper elite top of the heap psychotherapist for that!

 

Again, the assertion that non-column C therapists can’t work therapeutically with ruptures is frankly insulting:

Remember, fellow non-Column C-ers, you dont have the ability to critically appraise the history of psychological ideas, the cultural context, and relevant social and political theories to inform and evaluate ongoing practice:

Only column C therapists are deemed fit to evidence reflexivity, self-awareness and the therapeutic use of self to work at depth in the therapeutic relationship and the therapeutic process. Yet isn’t that necessary both in training and in the accreditation process?

 

There are plenty more nuggets like this in the framework, and I am yet to take a good look at the methodology paper, so expect to hear more from me in the coming days and weeks.

 

In the meantime, a poem:

 

Counsellors, you’ll never be

A therapist in column C

You’ll never have the skills you see

So just make do with column B

And counsellors in column A

Just reach for B, you’ll be okay

But never C, you hold no sway

So stick with A and B, we say.

 

– Erin Stevens

 

 

 

 

The BACP members’ Facebook group, set up last year, has been the single most revealing environment I have been a part of, when it comes to highlighting systemic harm, privilege and abuse of power in the counselling and psychotherapy profession.

A recent thread on racism was deleted by BACP, apparently after complaints from some BACP members that the post was not relevant to the profession (in spite of the discussion in the thread demonstrating the relevance unequivocally). After several anti-racist members protested (and BACP initially simply directing the original poster to their (inadequate, in my experience) complaints process) they finally apologised for the deletion. Further threads and posts popped up, more comments, microaggressions and, in some cases downright racist comments were made by members on various threads, each challenged by therapists including the OP herself.

One post in particular, which went unchallenged by the BACP for over a week (until I saw and publicly highlighted it), has led me to the inescapable conclusion that BACP is an organisation whose values are no longer compatible with my own. This incident managed to combine the assaultive weaponisation of pathology (which I have highlighted with the org a number of times) and the silencing of a black woman as she spoke about racism. It was truly abhorrent. On a personal level, I am also deeply saddened that the organisation has learned nothing from the damaging experiences I had of being publicly pathologised by therapists, last year.

The offending poster, naming the OP, claimed that she had placed herself in the ‘victim role’ to BACP’s ‘persecutor’ and went on to attempt to silence the discussion about race by claiming it was being “utilised to foster division”.  The original post was long, and went on in this vein. The post received 6 ‘likes’ from other therapists.

The fact that 7 therapist are willing to publicly align themselves to the weaponisation of pathology to attack a black woman talking about race is shocking. The fact that a professional body would do nothing about it for over a week, in spite of having plenty of previous opportunities to learn these kinds of lessons means, in my view, the organisation’s understanding of racism, white supremacy, power, pathology and structural inequality is wholly inadequate, and, given that this is not the first time that these kinds of dynamics have occurred in the forum, not sufficiently open to change.

I stayed with the BACP for this long because I see good in the organisation. I have volunteered with their older people’s expert reference group and met fantastic people, putting clients first, with real, honest passion and integrity. I wanted the systemic problems in the body to change; I wanted to be a part of bringing about change and re-centring social justice and client needs in the largest professional body in the country. I submitted the scrap SCoPEd resolution to open up debate about the kind of future we want for this profession, and to highlight the acts of inequality that exist silently, subtly in the upper echelons of the organisation, but become seismic for clients, trainees and therapists when they are enacted. I wanted to be a part of that change, so that I could continue to support the BACP. But sadly, I have to concede that my values and those of BACP have diverged so far, that at this point,  I no longer feel it is congruent or proper for me to continue to pay a membership fee to the organisation.

I have been a member of NCS for some time, so this decision does not leave me without ethical support or recourse for my clients, but it does leave me with a sense of loss. Both in terms of the cessation of my work with OPERG, which I enjoyed very much, and also the loss of the potential to be a part of bringing about the change I wanted (and still want) to see from BACP. I am not ruling out a return to BACP one day, but this would only be possible if considerable structural change occurs at many levels of the organisation, including the overhaul of their resolution process to make it statistically possible for a member resolution to be heard at AGM. The current system is completely undemocratic, and in my view, shows disdain for member views.

So for me, this is goodbye to BACP. I will continue to be a committed campaigner against SCoPEd, and I have extended an invitation to Fiona Ballantine Dykes to keep open lines of communication, should she wish to do so, however, I cannot tolerate the systemic issues that, in my opinion, the organisation has proliferated by not deleting abusive posts, and instead deleting important anti-racist posts. This feels like the final straw for me, and so I must now, with some regret, vote with my feet.

 

This weekend, for the first time, it has felt okay for me to talk openly about some of my harmful experience of therapy. I tweeted about an incident which took place two years post-termination, in which my former therapist messaged me out of the blue, told me he had split up with his wife and asked whether I wanted to “catch up”. I chose to disclose this incident in particular, I suppose, for two reasons. Firstly, because it is probably the least subtle of his abusive behaviours, and therefore the one I felt was least likely to be excused, or dismissed as not as bad as I think (which is sadly something that victims of abuse do have to consider when deciding whether it is safe to speak out), and secondly because it happened two years after termination, I felt less vulnerable at the time it occurred, so it did not, in itself, have a traumatic impact on me (more validating actually, due to just how illustrative it was of things that had previously occurred, but had been much more difficult to explain to others). I chose this example primarily to keep myself safe.

Most of the therapists responding to my tweet, really wanted to engage with the topic and learn more about how harm occurs. Other people who have been harmed in therapy joined the thread, and it truly feels that a positive conversation has been happening. I had quite a few people tell me I should report my former therapist, some suggesting that I owe it to the profession or to any future clients.  I explained this was not an option for me, and furthermore, I strongly believe that the onus is not on the victims of abuse to protect the public. I may have reported him given the opportunity, however the complaints systems themselves can be harmful and retraumatising, and I do not believe any victim of iatrogenesis should be pressured to do so, or blamed if they don’t.

A small number of comments from therapists were not altogether validating. One suggested that perhaps his emails had been hacked (a response which feels like “maybe you are wrong about it”) and another saying that in not reporting, I am playing a role in enabling him to do it again (feeling like “you are partially to blame for future abuse”). These are very common responses that people who are abused face when disclosing. The illuminating recent #IWasBlamed hashtag shed some light on this phenomenon.

Now, I don’t actually mind that therapists responded this way. In fact, I already know that there is a culture of denial regarding harm in counselling and psychotherapy. It is structural and it comes from the very top. For me, it is to be expected that some of this shadow will seep into online conversations about harm in therapy. In fact, I would venture a guess that far more therapists thought these things than actually said them, when they read the thread. For me, it is only when we hear our thoughts and attitudes out loud that we are most likely to recognise and reflect on them. What I really hope to do in speaking out is to raise these questions now, so that we are thinking about them honestly, because when a client who has been harmed walks into our therapy room, it is far better that we have a greater awareness about our unconscious biases, attitudes, and even our propensity to want to deny. Because if these parts of ourselves emerge for the first time with clients, we have the potential to do further harm.

I ran a workshop last year for therapists as a part of Nick Langley’s residential week, The Comfy Chair, in which therapists had the opportunity to reflect on their attitudes, feelings, bodily sensations when hearing about harm in therapy, and were also invited to put themselves in the position of somebody returning to therapy after a harmful experience, and consider what their particular feelings and needs might be. It was a fantastic exercise, full of rich discussion and learning. We are facing our professional and individual shadows here. We all have the potential to do harm, and the profession demonstrably does do harm, not just to individual clients but systemically too. It takes courage and honesty to face up to our shadow.

Earlier I said there is a culture of the denial of harm in the profession. I just want to touch on that a bit. Counselling and Psychotherapy in the UK is deeply political, and one of the key reasons I oppose political manoeuvres such as SCoPEd, is that the potential for harm to clients, therapists, or the profession, resulting from the project has been completely overlooked. For example, no declaration of conflicts of interests were made in the research, and no assessment was made about how enshrining elitist trainings would impact on diversity and equality in the profession, and the detrimental effect decreasing diversity in the workforce might have on the diverse client population. Especially important considering that clients from marginalised groups report experiencing significantly higher levels of harm in therapy than the general population.

So, I believe SCoPEd is a structural example of the plausible deniability of harm in the upper echelons of counselling and psychotherapy. I also have a more personal one, again, relating to my own experiences:

When I submitted a resolution to scrap SCoPEd, I experienced bullying on the BACP’s own Facebook group, with upwards of 40 therapists piling on to pathologise me for submitting the resolution, claiming that my opposition to SCoPEd was the result of unresolved childhood issues. Nothing was done at the time by BACP when I asked for the thread to be deleted so I submitted an official complaint to them. A key finding of the BACP complaint was that I was not bullied. I contested this point, citing the Government’s own definition of bullying, from their workplace bullying and harassment guidelines: “Bullying and harassment is behaviour that makes someone feel intimidated or offended.”.  BACP’s official response to this (and this is what I recognise as the plausible deniability of harm) was as follows:

“With regards to our definition of bullying, we have already stated that BACP does not have its own definition however we would use the commonly understood meaning of seeking to harm or intimidate others. The government link you sent refers to bullying and harassment in the workplace which differs slightly from the current topic.”

So, as we can see, because the incident took place in the BACP’s forum (which I would argue is an extension of the workplace when we are engaging online in the forum of a professional body) allows the BACP here to deny that the behaviour was bullying, and therefore absolve themselves. The focus on intention rather than impact concerns me from an organisation concerned with counselling.

When a culture of denying harm exists at the very top of a profession, it seems to me that it is likely to filter down into trainings, into supervision and into the attitudes and responses of therapists, at least to some extent (I want to say again that there is also a wonderful amount of reflection in the profession, and some truly fantastic trainings) But this trickle is how the shadow forms. The shadow belongs to the whole profession, and in my opinion, it is up to all of us to examine it together.

I have been reading a book about supervision called “In Love With Supervision” by Robin and Joan Shohet. A section exploring fear in supervision, and the phrase “If anything appears to go wrong, there may be some unacknowledged fear in the system” have led me to reflect on what has happened with SCoPEd in this last year or so.

It is quite straightforward for me to recognise fear in myself, as an individual, around SCoPEd. I am scared that the profession will move further from relational practice, that certain organisations will monopolise, and that this will damage diversity of practice. I am scared that the hierarchical nature of SCoPEd will further the inequalities that are already in evidence in this profession, both on a practical and attitudinal level. More personally, I am scared that I have invested myself into a profession which is not what I thought it was. I am scared that the profession does not mirror the expectations I had from my experiences as a client, and probably most of all, I am scared of a rupture in my relationship with counselling and psychotherapy. I am scared of the pain inherent in that conflict, and I am scared of the loss I already experience, and will continue to experience as the SCoPEd train inevitably trundles along the track which already appears so clear. I am scared for what that means for my identity.

I also recognise that these fears in me mirror other fears in my life, past and present. From loss, grief, and rupture in relationships, to political issues which feel so out of control, such as Brexit, and of course, coronavirus. My vocal opposition to SCoPEd must necessarily be in relationship with my fear.

On a wider level, it seems to me that therapists, systems and organisations also experience fear, on all sides of the SCoPEd debate. It is not for me to speculate on which individuals may be experiencing fear or why, but it seems to me that the creation of SCoPEd in itself may reflect a fearful position (What are we? Will we be recognised? What happens if we become statutorily regulated?), and I feel a sense that some of the interactions I have had with BACP in particular (but also with other supporters of SCoPEd) have been conducted from a mutual place of fear. I have certainly felt very defensive and vulnerable in the face of some really targeted and personal comments and actions. I own the fear that I have felt, and I am also coming to understand fear as systemic, and perhaps on some level we all share in it, I am not sure.

So why am I sharing this? Principally because one thing I have noticed about SCoPEd and the way it has played out, is how easy it is to dehumanise individuals and fail to recognise that we are in relationship with the very human feelings that emerge, both individually and collectively. I think from this place, we will only ever have division. I am not sure if there is a way to resolve these types of systemic dynamics, at least not simply. When money, livelihoods, reputations, and status are thrown in the mix, it is a complex web to untangle indeed. On all sides. I do feel that an important step is to acknowledge it. I invite others to do the same (if you have not already), whatever your opinion of SCoPEd. Do you feel fear in connection with SCoPEd? If so, what sense can you make of it, and how do you think it connects to a sense of collective fear, not just in people with whom you agree, but those with whom you don’t, as well?

I will continue to challenge SCoPEd robustly, because I believe that scrutiny is helping the team developing SCoPEd to reflect on the impact of the project on therapists, clients and counselling, and more needs to be done on that, especially around hierarchy and its impact on equality and diversity in the profession. But I will also do this with a renewed awareness of fear in the system. Mine, others’ and that of the system itself.

Yesterday I posted two Twitter polls. One asked whether therapists would consider more than one supervisory relationship, inviting comments about how they would manage conflicts of advice, modality etc, and the other asked therapists whether they would work with a client who was also seeing another therapist at the same time. The results are in and show that, of the 129 therapists who voted on the supervisee/supervisor poll, 78% would consider seeing more than one supervisor and 22% would not, whereas on the client/therapist poll, of 129 therapists, 36% would see a client who saw another therapist, while 64% would not.

I posted the polls because I am curious about how other therapists work, and how they conceptualise therapeutic relationships they form with clients and supervisors. I strongly believe in the importance of autonomy, both for therapists and clients. This means that I think it is important that therapists develop their own boundaries (within the bounds of ethical practice, of course) and that clients should be free to either accept or reject the terms that the therapist offers. I think this is the value of a diverse profession – some therapists’ ideas around boundaries will be useful for some clients, and others will be useful for others. Autonomy goes both ways.

While therapeutic and supervisory relationships are not the same, I feel that they are comparable in some respects. They both usually offer holding, space for reflection and are characterised by some kind of process (how this is conceptualised and understood will depend on a range of factors). In the thread below my supervision poll, therapists reported that different perspectives from different supervisors were often useful, and that the therapist themselves were able to make sense of differing advice, and integrate their learning into their practice. Some preferred to keep different client groups for different therapists, and some found taking the same client work to different therapists beneficial. There was a real sense of autonomy, self-trust and learning permeating that thread, I felt.

There was less in the way of consensus on my thread asking about clients with more than one therapist. Some said it would depend on circumstances – for example somebody might want to work on a particular issue with a specialist therapist, or try particular interventions such as CBT or EMDR whilst also seeing a more relational therapist alongside, and that this would be okay. Others theorised that clients wishing to see more than one therapist might be playing out relational enactments, possibly even oedipal in nature. Another simply said “unethical”. Others took a different view, considering the balance of client autonomy, and the potential impact on the therapeutic relationship, or the process. Another said that not ‘allowing’ (my word and my inverted commas!) clients to see more than one therapist seemed like “protectionism” on the part of the therapist.

So what are my thoughts about the questions I posed, and how would I have answered the polls? Well, fundamentally, I believe that there is a richness and dynamic quality to multiple relational dyads in the context of counselling and psychotherapy, and I think this can be true both for therapists as supervisees, and for clients.

Anyone who regularly reads my blog will know I am interested in issues of power in the therapeutic relationship. My interest is piqued immediately when I think about the notion of a therapist ‘allowing’ or ‘not allowing’ a client to do something outside of the therapy hour. Of course, clients are free not to work with a therapist with such a rule, but if the desire to consult with a second therapist emerges some way into the relationship, I propose that it might very much feel that they are being prohibited from doing so, by their therapist.

Are there other circumstances when we, as therapists prohibit clients from doing something outside of the therapy room? All that comes to my mind is that therapies with certain foci, such as self-harm or substance abuse may create ‘rules’ around behaviour outside of the room and these examples seem directly related to the issues the client is in therapy to address (I still think debates could be had about power and autonomy, but perhaps that is for another day).

I can’t think of another circumstance where a client would be explicitly told that the therapist will not work with them if they do a particular thing outside of the therapy room, with their own time and money. For this reason, I am very curious about therapists’ stance on the issue, and the reasons that are given for the choices they make. For example, if, as some therapists believe, the desire to see more than one therapist has its basis in relational patterns or attachment, is there value to allowing it to emerge and working with it? If we believe it might damage the relationship or the process, do we know how? Might it enhance the relationship or process? How do we know? How much of our concern about this scenario has its basis in supposition?

Do we carefully examine our potential discomfort about being talked about to another practitioner? What is our fantasy about our relationship with therapists we don’t know? What about the comparisons that a client would inevitably make about the different styles and personalities of their therapists? How do we feel we would ‘measure up’? I say this without any guesses or judgment about the practices or processes of others. I want therapists to feel free to practice in a way that works for them. But I do think it is important that we consider these feelings for ourselves, especially when we are dealing with the precious and delicate balances of power and autonomy in the therapeutic relationship.

I have two experiences of seeing two therapists at once as a client. The first time, was when I consulted with my current therapist whilst still seeing my previous therapist, with whom I experienced multiple relational difficulties. I knew that my first therapist would not ‘allow’ me to see a second therapist, so I did not tell him. And herein lies a significant issue, for me, with prohibiting the client to do something outside of the therapy room – they might just do it anyway, and if their therapist is unlikely to trust their decision, they are unlikely to trust their therapist with the information. For me, “you don’t trust me, so I don’t trust you” would characterise that first relationship very well. Going to see a second therapist helped me to recognise the multiple abuses which were taking place in my first therapeutic relationship, and I subsequently left and stayed with my current therapist. I am grateful to my current therapist for trusting my process when I came to him and told him that I already had a therapist. Without it, I may have had a great deal more difficulty leaving an abusive therapy situation.

My second experience was relatively recent – I wanted to consult with a second therapist about a particular issue. I didn’t ask my therapist if I could, I told him that I am. I know that he trusts me wholeheartedly to make the right choices, or to learn from it when I don’t. That unwavering trust has been the single most valuable and enduring ingredient in the nurturing and growth of my own self-trust. By gifting me self-determinism at a time I felt unable to take it for myself, I had an opportunity to take ownership of it, and now that I do, will readily gift him a place alongside me to explore it: “You trust me, so I trust you”.

I don’t have any answers, or truths, but, in the spirit of sharing ideas and reflecting on our practice, I offer my own experiences, and questions that come up for me when I hear therapists say that they don’t see clients who see another therapist. I hope this blog post opens up this discussion, and I invite therapists, whatever your policies, thoughts or gut responses, to continue conversations about our boundaries, power in the therapeutic relationship, and how we think about our relationships with clients and supervisors.

Here we are on the brink of one of the most extraordinary and important elections for a generation. Our society is almost unrecognisable from that of twenty years ago, as we were approaching the millennium. Technology now connects us inextricably, and I think that this ability to connect with one another has driven great movements, promoting voices and/or influencing positive policy change for historically oppressed groups including LGBTQ+ communities and people of colour. Alongside this has been the undeniable rise of right-wing politics in the mainstream, Trump, Johnson and Farage gaining popularity, and right-wing ideas influencing the direction of this country, from Brexit to the NHS.

The questions that I can see being mooted amongst therapists, both overtly, and more indirectly, are: what role does politics have for therapy and for therapists? Should we, and indeed can we, separate ourselves from the political? What impact does our political activity have on clients?

I see a great deal of discomfort on therapist forums as we broach the political. Are we “sullying” the profession by talking about party politics? Is being vocal about our political allegiances going to be damaging to our clients? Is there an ethical difference, for example, between my saying “I am anti-austerity.” and saying “I am going to vote Labour.”? Is one less ‘professional’ to admit to than the other? Are they both okay? Or should we not be talking about politics at all?

I might as well come right out and say it: my personal opinion is that we cannot separate the political from the professional. It is my view that in counselling and psychotherapy, the political runs to the very heart of what we do.

Austerity impacts on the lives of clients, it impacts on the counselling services on offer, and it impacts on the lives of therapists too.

IAPT is political. We need to talk about the fact that, according to a new survey, 41% of IAPT workers are being asked to manipulate performance data. All of this is inherently political and if we are not talking about it, we are missing an opportunity to challenge harms which are being enacted on clients and on the profession.

The voluntary culture of counselling is political, as is the accreditation of uncapped courses. SCoPEd is extremely political. Ethics, and the therapeutic values we uphold, from autonomy to authenticity to respect are steeped in politics. This profession does not exist in a vacuum, it exists in a deeply political context.

BUT I have experienced significant discomfort about it. And I am not alone. When I trained as a therapist, I probably thought to myself “It is best that my clients never know my political views, and therefore they should not be shared publicly”. And while, of course, a therapy session is not an appropriate place to whip out a party political leaflet, I have a much more nuanced view of how we manage the uncomfortable marriage of therapeutic neutrality (if such a thing exists, or even ought to exist), and our wider political selves.

My clients, past, present or future, could Google me. If they did, they would probably read about my views on SCoPEd. They would probably read that I oppose it on the grounds that it promotes inequality, and further espouses an elitism, which I believe already exists in the profession. They would read that I disagree with the way in which it encourages a system of unpaid labour post-qualification, and they could probably make some pretty accurate assumptions about my political views.

They might also note that I have joined the PCSR steering group, an organisation whose stated aims include challenging racism, sexism, homophobia, classism and all discrimination, as well as “developing ideas about how economic, political, ecological and cultural issues can be integrated into theory and practice”.

These are authentic parts of who I am, and they follow me into the therapy room whether I choose to hide them or not.

So no, I don’t introduce myself to clients by outlining my political opinions, and no, I do not judge clients who express different views to my own. But I acknowledge that we all see political issues in the therapy room every day. From the economic, to the social, to national politics, it appears in the therapeutic relationship and we work with it in our practices whether we name it or not.

Recently, when the Met police were outrageously arresting Extinction Rebellion protestors engaged in peaceful protest, UKCP erroneously released a statement which suggested that members who were arrested for peaceful protest could be bringing the profession into disrepute. This created understandable challenge from members, and the UKCP later said that the statement had been sent out in error. It seems to me that the fact that it was written at all says enough about the attitude to activism by some in the profession, particularly certain professional bodies. Incidentally, BACP were unable to categorically state that arrest for peaceful protest would not bring the profession into disrepute, whereas NCS were immediately forthcoming with a categorical statement that arrest for peaceful protest would not constitute disrepute.

I am concerned about these mixed messages, and lack of clarity, not least because autonomy and authenticity are central values, and ‘professionalism’ in counselling and psychotherapy needs to embody the values we espouse, unequivocally. Professionalism must not become synonymous with compliance. If we were not able to challenge injustice, or question the status quo, our profession would not be able to move forward at all. Indeed, there would have been no Carl Rogers, whose development of person centred therapy challenged psychoanalytic dominance and was borne of a period of political and social change. Carl Rogers described himself as a rebel, and his courage, integrity and tenacity to challenge the status quo is widely celebrated. In my opinion, now is not the time to lose that courage.

I think this is a difficult area for many therapists and what I have seen recently expressed about party politics seems to confirm this (not to mention the response by many to the challenge to the SCoPEd framework). I think we need to own that discomfort, name it and feel it, but we also need to acknowledge the centrality of politics to our profession, how it impacts us at every level. And therapists as a whole need to be talking about it. We don’t have to agree, but we need to be able to discuss. If we ignore politics, it won’t cease to exist, in therapy or in our lives.

So this is an invitation to therapists, and clients, and supervisors, and tutors (and whoever else is uncomfortably straddling political spheres and the world of counselling and psychotherapy) to see, touch, explore and own the huge area on the Venn diagram where these worlds overlap. It’s okay to talk about it, as much or as little as feels comfortable, it’s important to understand it, and in my view, it’s vital we don’t pretend that it doesn’t exist.

It has been an eventful ride since I last updated these pages. I’m sure many readers of my blog will already know that our resolution asking BACP to discontinue its association with SCoPEd achieved an amazing 1780 votes, amounting to 3.5% of the membership. I fully expect (when the BACP finally respond to my request for the historical voting figures) that our resolution will have attracted the highest ever number of votes on a resolution.

An unprecedented membership engagement! Member interest clearly demonstrated. So when do we get to vote on the resolution at AGM? Well, we don’t. Two years ago, a resolution passed which asked the BACP to stop advertising volunteer roles on their platforms, the BACP said they “believed it was not the solution for addressing the wider employment issues.” and were clearly unhappy with its passing. The following year, the bar had been raised from 25 votes (around 0.05%) to reach AGM voting, to 5% of the membership, or roughly 2500 votes. 100x greater than the previous target.

To give an indication of the impossibility of the 5% target. Here are the statistics from the 2017 resolution which appears to have precipitated SCoPEd:

So at this crucial second stage of voting, (having received the 0.05% needed to get to this stage), this resolution passed with approximately 1.89% of membership support. If this is indicative of the levels of general membership engagement, our 3.5% was spectacular, and 5% seems an impossible and prohibitive target. It should be highlighted that the purpose of the first stage is to indicate membership interest in the topic. If members haven’t demonstrated their interest over the last few months, I don’t know what ever will.

In spite of the disappointing result, a great deal of good has come from the campaign. The original implementation date for SCoPEd was expected to be spring 2019, and I believe this period of ongoing consultation, and addition of…erm…one person centred therapist to the psychoanalytic-leaning ERG is, in no small part a result of the organised way we have been able to hold the BACP to account. That is a massive achievement in itself.

I want to talk a little bit about the way in which the SCoPEd discussion has played out on social media. It seems to me, in parallel to national events, the emergence of SCoPEd has exposed deep divides within the profession, and, perhaps surprisingly, those divides have translated to some quite uncomfortable exposure of the professional shadow, in my view.

There has been a lot of ‘othering’ of colleagues online during the discussions around SCoPEd. It seems to me that each side sees the other as outrageous and wrong, when actually, I suspect we all actually want what is best for clients, and need to develop a respectful way to articulate our differences, and listen to others regarding the ways this might be achieved. I have seen glimpses of respectful discussion, for example, in my online conversations with Andrew Reeves, but not nearly enough. I think it is the responsibility of everyone to do better.

I would particularly like to highlight the weaponising of armchair diagnosis to discredit colleagues; having been on the receiving end of this myself, I can tell you it is the most horrendous abuse of power, and has been deeply hurtful to me personally. I have seen speculation about unconscious motivations appear on both sides of the debate. I would like to see something introduced to the BACP ethical framework, similar to the APA’s Goldwater Rule, which specifically addresses public diagnosis and speculation on the psychological processes of others. I think that publicly pathologising to discredit those legitimately seeking to bring an issue to a membership vote is a serious ethical breach, which raises questions about our attitude to pathology and to activism as a profession.

In this, I also note the position of power that the BACP finds itself in when it assumes the responsibility to moderate online debate. It took the BACP days to close the thread on their Facebook group, by which time there had been 109 comments. In my view, this is an enabling position which amounts to complicity in contributing to my personal distress. The Psychotherapy and Counselling Union have expressed concern about the BACP’s handling of this issue on my behalf. The response from the organisation so far has been wholly unsatisfactory in my opinion. I will happily share their response on my blog, once I have pre-warned the BACP of my desire to do so, and offered them the chance to make further comment.

After the resolution results came through, I received an email inviting me to join the SCoPEd team for a meeting, in order to start a dialogue. I have not had positive experiences of one-on-one engagement with the BACP with regards to SCoPEd and the power imbalance I am likely to experience in attending such a meeting by myself is befitting of the power issues inherent in the whole process of SCoPEd. I have not said yes or no to such a meeting yet; I am considering my options, and of course will provide an update on this either here, or on other social media.

I want to give my heartfelt thanks to Tara Shennan, who has also faced a lot of flak in putting this important topic to a members’ vote, as well as the brilliant organisations Counsellors Together UK, Psychotherapy and Counselling Union, Psychotherapists and Counsellors for Social Responsibility and The Alliance for Counselling and Psychotherapy, who have been so generous with their time and support throughout this process.

The road does not end here. The BACP have expressed a desire for a dialogue, and I will do my best to make sure that can happen in a fair and safe way. There is a lot more campaigning to do; I await the second iteration with interest, and there are many of us on hand to ensure it receives the careful analysis and scrutiny it requires.