Psychotherapists and councellors probably should be registered to practice

Ian Parker wrote an article for on how psychotherapists and councellors should refuse registration. I’m neither a psychotherapist nor a councellor, but I for what it’s worth I disagree with what he says.

I fail to see why it is a bad idea to control who is permitted to engage in psychotherapy.  Of course the registration of psychiatrists has not guaranteed no abuse.  And not all registered GPs are fit to treat patients.  But importantly there are—and should be—mechanisms in place to ensure that clinicians practice in the way they ought to practice.  It’s possible to complain about inept GPs.  There are surely bad ways of deciding what drugs to prescribe, and bad ways of delivering therapy.  It is the reduction of bad practice, not over-control of demonstrably good practice that should be encouraged by the state.

Those who are not registered could of course continue to see patients. To continue the parallel with GPs, I am delighted that random people are unable to prescribe drugs.  This does not mean that those without a training in medicine cannot help people who are ill.  Caring for the ill requires more than medical treatment.  Helping those with mental health problems requires a rich network of support and need not be reduced to counselling or therapy.

I fail to see how state regulation would harm radical approaches in psychotherapy.  What it would do is require that there is evidence to support such approaches.  This, I accept, is non-trivial, and we need to move away from tick-box questionnaires trying to assign a number to each person summarising how distressed they are.  But evidence is a good thing when dealing with therapeutic approaches.  There are other aspects of a person’s needs which do not require this approach: friendship, for instance.  One doesn’t need to be a therapist to be a friend.

Why is psychoanalysis necessarily outside the state?  Why is it not possible to be a regulated psychotherapist and still supportive of the user movement?  I’d suggest that if one really wants to remain unregulated, then it’s necessary to remove the status label of “psychoanalysist” or “psychotherapist”.  Maybe then it is really possible to align oneself with “users” (or is a better term, “people”?).

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