Re: SR

September 7, 2008

This is log but well worth the read, thanks Tim.

>

> Dear all,

>

> The following article by Guy Gladstone recently appeared in Ipnosis

psychotherapy journal (June 12th., 2008). Guy is happy to see a wide

dissemination of his article.

>

> Although primarily this article relates to the

psychotherapy/counselling fields, it is entirely pertinent to herbal

medicine. Points 9, 10 and 11 are particularly interesting.

>

> Best regards,

> Tim Lane.

>

> STATE REGULATION: ILLUSORY, UNETHICAL, AND HAZARDOUS -

>

> Eleven good reasons to oppose SR

> Guy Gladstone

>

> Preface

>

> The following arguments are laid out to establish a comprehensive

basis for opposing state regulation of psychotherapy and counselling.

Not all will speak to everyone but it would be strange if at least 8

out of 11 didn't. If you can adduce further 'good reasons' please

publish them and let me know.

>

> SR is currently projected for installation sometime between late

2009 and early 2011. Note SR through the Health Professions Council

is intended to be regulation of function, of practice itself, not

just title ('psychotherapist', 'counsellor'). Already there are

significant currents of both discontent and outright opposition

emerging within the umbrella organisations in tension with the party

line that SR is both good and inevitable. I am monitoring the UKCP.

What is the situation within BACP? It is important to make links with

oppositional trends wherever you find them and to agitate/resist in

whatever forum you have access to, - in print, online or at meetings,

and this can be around the central platform that the status quo is

good enough whereas what will ensue from SR is a disaster for the psy

field. Heads in the sand bystander time is over. There is a window

for derailing the SR project and countering its malignancy NOW. Later

may prove too late.

>

> Acknowledgement: With a different preface most of this text has

already appeared in the Summer 2008 edition of 'Transformations', the

journal of PCSR (Psychotherapists and Counsellors for Social

Responsibility).

>

> Eleven Good Reasons To Oppose SR

>

> 1) Surveillance Privacy Neutrality

>

> SR undermines civil liberties. The subjection of the psy field to

state-managed processes of audit and surveillance jeopardises

practitioner neutrality and erodes the client's psychic space.

Foucault identified how the panopticon effect operates as a

disciplinary instrument because subjects (in this instance therapists

as much as clients) never know when they are objects of its

observatory or not and so eventually internalise the panopticon and

act as if always under observation. Boal's political theatre for

exorcising the cop in the head is becoming especially relevant for

the psy field and provides a praxis for undoing the panopticon.

>

> 2) Diversity or Standardisation

>

> The current diverse, local, voluntary and intuitively responsive

ecology of the psy field is superior to and should be valued above

the proposed compulsive and centralised control of standards

administered by a tickbox bureaucracy. Standardisation will paralyse

creativity in developing new forms of practice and will artificially

and arbitrarily restrict research. has contrasted the

diverse local 'metis' with the standard centralised 'techne' and

chronicled techne's dedication to extinguishing metis.

>

> 3) Medical Model Hegemony

>

> SR can only establish effective hegemony by means of distorting

psychotherapeutic practice/praxis through bundling it all in under

the medical model of mental illness, in the future likely to be

glossed or hybridised with a WellBeing ideology imported from the

corporate world. This violates the public's right to choose and

access practitioners working within other paradigms e.g. personal

development, co-operative enquiry, authentic humanistic psychology

and unrecuperated psychoanalysis.

>

> 4) Output Regulation versus Input Regulation

>

> For training institutes SR is a lifebelt to save them from sinking

in the sea of a deregulated market. Obtaining a monopoly on a

protected title (however the HPC wont guarantee this) is linked to

exaggerating the role of input regulation (control of entry into

practice) at the expense of output regulation which is of much less

economic value to trainings. Prioritising the latter entails the

active fostering of self-regulated integrity at the point of contact

between therapist and client by means of ongoing peer review

(Independent Practitioner Network), supervision, wider debating of

ethics (which will bring the state's behaviour into view) and above

all the education of the public in what to reasonably expect from

therapists beyond the clichÃ©s. This last initiative will often run

contrary to government prescription. It has been mostly dodged by the

umbrella organisations (BPS, BPC, BABCP, UKCP and BACP perhaps less

so) which prefer to focus on cultivating a more prestigious and self-

serving culture of highly academised expertise.

>

> 5) Misallocation of Risk and Redress

>

> There is no evidence that SR as a licensing procedure can achieve

the elimination of risk and pre-emption of abuse that its controls

and ideology suggest it can. A quick look at the HPC's publicly

viewable stocks and gallows listings might be in order.The umbrella

organisations are deeply complicitous with government agendas

of 'being seen to be', as though it is fatal not to dance to a public

relations tune. Overegging 'protection of the public' is linked to

the spread of a professional false self.

>

> The scale of risk is exaggerated (the transposed Shipman effect).

There is insufficient evidence that therapists abuse clients on a

scale that warrants the costs (financial, political, psychological

and cultural) of state intervention in the form of the HPC. The HPC

and Skills for Health are between them fostering a dangerous

conflation of ethics and competencies under the bundleword of

standards.Very very few therapists act unethically, all therapists

have issues of competency at one time or another. However as Carl

pointed out there have always been at least as many licensed

charlatans and exploiters as unlicensed and the licensed ones are

actually more dangerous because of their stronger credentials to be

trusted.

>

> If the position taken so far is too laissez faire the Counselling

Society has suggested there may be a case for creating a fallback

instrument of legal deterrence, that is a new category of criminal

offence which would require criminal standards of proof

termed 'Professional Abuse'; this being applicable only in cases of

financial or sexual abuse or physical assault by a professional

acting in a trust-based caring capacity (this charge could apply to

other professions beyond the psy field). Proposals like this have the

virtue of stealing the HPC's thunder and locating redress in its

proper place with the judiciary instead of the executive and its HPC

courtroom. Short of these extremes an expansion of independent

mediation and resort to existing common law are surely the way

forward for redress.

>

> 6) Core Values Erosion and Toxification

>

> SR with the requirement to be registered directly with the HPC will

subvert the values and varied forms of association that traditionally

have held practitioners collectively in what is a consistently

demanding work space; namely the values of responsibility, ownership,

self-management and mutual care for the quality of colleague's work.

The HPC will pull for STASI-style inducements to shop colleagues with

corresponding reactive collusions to cover genuine mistakes rather

than admit and clear them. Together these components of false

compliance will accelerate a spread of fear, shame, cynicism and

internalised oppression towards toxic levels. The deal on offer is

this: follow NICE guidelines and adhere to NOS stipulations and the

government will protect practitioners from the public and the

litigation industry. Refuse these and regardless of your skill and

experience the HPC will pillory you as a charlatan.

>

> Thus the psy field is to be reconfigured according to the gospel

that the government and the Department of Health knows what is best

for you and your clients. Actually you are damned if you do and

damned if you don't so it makes good sense to reject the whole

caboodle of SR. This deal is the next move in the government strategy

of breaking in to be followed by performance management of the next

sector of the caring professions. After stuffing teachers and then

doctors it will be psychological therapists turn next.

>

> 7) Delivering Government Agendas

> Some sections of the psy field have been seduced by government

interest (IAPT) in what they might contribute and don't appear to be

overly concerned with the nature of the use government finds for

their skills. There are obvious dangers, not least contagious loss of

client trust, in being subpoenaed to serve government purposes.

Opposition to SR supports the maintenance of a necessary distance

from the state, even for those who have always been in NHS employment

as the nature of the social contract is shifting. Compliance with SR

will collapse the space for critiques that put the government's

business in question and this is no doubt intended. The current moves

to block further judicial enquiry into BAE style corruption are the

writing on the wall.

>

> Closer to home for the psy field is the Layard formula. Crudely it

runs so: you are out of work because of your individual pathology

which is costing the state too much in unemployment/ disability

benefit. Ergo CBT therapy prescribed. Structural changes in society?

Global level economic factors? How dare you suggest these are

contributing to social misery with associated anxieties and

depression! It is just conceivable that beyond the PR value of

demonstrating some care rather than boosting the profits for Big

Pharma's recently exposed largely ineffectual drug treatments lies a

further agenda for IAPT to screen off more troublesome social/

economic analysis of links between distress and deprivation.

>

> 8) Corporate Appropriation

> SR will install mechanisms of administration paralleling those in

health and education which will enable and excite corporate designs

upon the field (Virgin Asda and Tesco are already bidding for slices

of the NHS) and a corresponding governmental receptivity to takeover.

Here 'choice' and 'change' will be buzzwords that echo but actually

bear no relation to what therapists might understand from these

terms; instead these will be cheatwords that seem to be offering the

public something while actually functioning as government signposts

for the deregulated corporate drive to incorporate in order to open

up new profit sectors in a service 'industry' (some already speak of

the psy field in these terms).

>

> Paternalistic government increasingly adopts the corporate

promoting their wellbeing. SR is here knotted to appeasement of the

fetish of the free market. A captured or training might itself be a

loss leader but its transferential potentials will not be lost by the

new proprietor who will proceed to sell holidays, mortgages or

supermarket loyalty cards off the back of it. Current networks of

informal gratis and beneficent referral safeguard the public seeking

therapy from such incentivised insults.

>

> 9) Bystander Trance

>

> The message generated by the umbrella organisations that SR is

inevitable constitutes a powerful trance induction towards a kind of

helpless assent to SR that is equivalent to bystanding behaviour.

This mantra of inevitability, frequently repeated by psychotherapists

and counsellors, is pitched to simultaneously play on fear and

relieve guilt and anxiety by legitimising apathy. For practitioners

who purport to be in the business of reducing anxiety and

helplessness such a stance is massively incongruent with their core

assignment.

>

> 10) Exhaustion, Despair and The State as Rescuer

>

> Even with making allowance for the hypocrisy of those who,

notwithstanding the above reasons for refusing SR, still see personal

or institutional advantage in passively acquiescing to it, as

indicated by the affecting of a noncommittal detachment or by

adopting a position of reasonableness, pseudo amnesia or feigned

ignorance as to what is going on, there remains a question about the

root cause of the broader acquiescence, this regulationitus. One must

ask why so many in the psy field seem to have turned their attention

away from these issues, as though exhausted by something. One

hypothesis is that after all the years of infighting between

organisations much of the psy field is in some underacknowledged

despair over its capacity to live and let live, to live with

difference and to tolerate diversity of theory and practice without

trying to steal a march on the other. This political despair may be

the Achilles heel, the reason no organisation can trust the others

not to cut a deal with the state to gain advantage and favours (the

UKCP rationale for maintaining a so-called 'ringside view').

>

> Furthermore this scenario would suggest a corresponding unconscious

fantasy in which the state is configured as the necessary

authoritarian parent who restores order, enforces agreement and

rescues the feuding children from destroying each other. That it wont

and anyway cant actually do this is beside the point. Such

infantilism is actually an appalling indictment of a profession that

makes extensive claims regarding its capacity to help clients yet

cant help itself as a whole field when it comes to ordering internal

and external relations at a political level. That said, currently the

UKCP, faced with the exclusion of at least half its registrants (not

to mention several thousand trainees) from the privilege of entering

the HPC compound, on the grounds that Skills for Health can only

recognise this remainder,- which includes the largest section of the

UKCP (HIPS), as derivative variants of the

psychoanalytic/psychodynamic, the cognitive behavioural and the

family systemic, has a major identity crisis on its hands. In certain

reactionary parts of the psy field this is a very gratifying

scenario, one they have waited years for. It remains to be seen

whether this late in the day order from above that Sections organise

their footsoldiers (sorry registrants) to fire off letters of protest

to their MP a) is sufficiently complied with to produce a significant

volley and whether MPs in turn raise enough questions for the

Department of Health to beat a retreat rather than simply ignore it

on the principle that regulators regulate, they don't negotiate,

especially when policy has already been decided elsewhere.

>

> 11) Conjointly Foreclosed Debate

>

> And so in the light of the above the historical conjoint

foreclosure of proper debate and full discussion of what is at stake

by both the umbrella organisations and the state has to be named.

Since both the state and most of the psy field associations are

dominator organisations, structured hierarchically to promote power

over as opposed to power with, this is hardly surprising. Proper

debate however would be extensive and lateral, decentralised, from

the bottom up, practitioner and yes, client/user group driven, the

discussion itself congruent with the activity it is all about, the

results of this discussion pooled by delegates in the true meaning

i.e. subject to right of recall by their constituencies should they

start to represent other interests. PCSR to its credit is attempting

to launch a discussion that will meet some of these criteria.

> In the last 10 years three full-length books (see references) and

numerous articles have been published that argue the case against

state regulation of psychological therapies. No comparable 'case for'

has ever been articulated and if it has it has yet to be produced for

public scrutiny. Apart from the active rubbishing of

Mowbray's seminal work " The Case Against Psychotherapy Registration "

by an early UKCP Chair and Fellow of The Royal College of

Psychiatrists, Dr Pokorny, who was clearly horrified by the

detailed thoroughly researched deconstruction of the UKCP and SR, the

case against has simply been ignored as if many wished it would just

go away. Which it hasn't and if anything it has become more cogent

than ever with recent developments in the governments agenda.

The 'case for' doesn't appear to have got much further than " state

regulation is a good thing for the protection of the public so repeat

that after me " .

>

> This asymmetrical phenomenon should alert observers from outside

the psy field as well as those within it to the fact that something

has been avoided, debate has been refused because one side cant

actually muster a sustainable argument or cant come clean or some

mixture of the two. Perhaps above all debate is foreclosed because

values are at the heart of the matter and there is resistance to full

spectrum declaration. Instead we get mystification, typified by the

continuing both careless and deliberate muddling of statutory

registration (the project of the fortunately failed 2002 Alderdice

parliamentary bill) with state regulation, a very different beast.

>

> Conclusion

>

> After round about 85 years in Britain of freedom from state

interference it seems the largely bemused or even apathetic psy field

in Britain wont know what it will lose until after it has gone. After

which that freedom will be far harder to restore. The state and its

collaborators from within the psy field lack the wisdom that pertains

to knowing when to leave well alone. Those who confront and refuse SR

can take heart from the fact that the body, the unconscious, the

transpersonal, the awareness of power relations and indeed love and

relationship itself, none of these can be computed in Skills for

Health's sorry calculus. In other words very large parts of the

therapeutic process and its context will necessarily escape the

annexation being attempted by the state and it's collaborators and

this gives grounds for hope but not quietism.

>

> References

>

> Mowbray, . The Case Against Psychotherapy Registration. A

Conservation Issue for the Human Potential Movement. Trans Marginal

Press 1995.

> House, and Totton, Nick. Editors. Implausible Professions.

Arguments for Pluralism and Autonomy in Psychotherapy and

Counselling. PCCS Books 1997.

> Postle, Denis. Regulating the Psychological Therapies. From

Taxonomy to Taxidermy. PCCS Books 2007.

> Foucault, Michel. Discipline and Punish. Translation. Vintage 1977.

> , C. Seeing Like A State: How Certain Schemes to Improve

the Human Condition Have Failed. Yale University Press 1998.

>

September 7, 2008

Sorry, NOS is what?

>Together these components of false compliance will accelerate a spread of fear,

shame, cynicism and internalised oppression towards toxic levels. The deal on

>offer is this: follow NICE guidelines and adhere to NOS stipulations and the

government will protect practitioners from the public and the litigation

industry. >Refuse these and regardless of your skill and experience the HPC will

pillory you as a charlatan.

Cheers

Graham White, B. Sc. (Herb. Med.)

Medical Herbalist

=============================

September 7, 2008

National Occupational Standards, I think.

Guy

>

> Sorry, NOS is what?

>

> >Together these components of false compliance will accelerate a

> spread of fear, shame, cynicism and internalised oppression towards

> toxic levels. The deal on >offer is this: follow NICE guidelines

> and adhere to NOS stipulations and the government will protect

> practitioners from the public and the litigation industry. >Refuse

> these and regardless of your skill and experience the HPC will

> pillory you as a charlatan.

>

> Cheers

>

> Graham White, B. Sc. (Herb. Med.)

> Medical Herbalist

> =============================

>

November 2, 2008

Without wishing to stray into politics, we can see from recent events

that governments can do anything if they so wish. Will the UK government

regulate herbalists unilaterally? We don't know but I guess that there

is a certain apprehension that they might and that drives some of the

process. On the other side, people are worried about what regulation

will mean in terms of our practice. My point about what we are allowed

to do after regulation (if it happens) remains a valid one.

At the moment, herbalists are restricted in their use of certain herbs.

However, medical practitioners can use such herbs (with no training or

knowledge of herbs) due to the practice of off-label prescribing. This

gives medical practitioners the right to use any substance that they

believe may be helpful in treating people. I would not like to see a

scenario where herbalists are still prevented from using certain herbs

or using them in particular ways whilst medical practitioners continue

to have the right to off-label prescribe herbs. What is sauce for the

goose........... However, I know that there are hierarchies at work here

and herbalists are not generally near the top (or acupuncturists or

homoeopaths).

One of my concerns is that in the desire to be regulated, we do not sign

away any rights or privileges that we currently have. In the US in the

latter half of the 19th century, homoeopathy was very strong with high

percentages of medical doctors using it as treatment. In a desire to be

approved and part of the system, colleges then instituted conventional

medical training alongside homoeopathic education. Within a generation,

homoeopathic education and treatment had collapsed. It is only now

recovering some hundred years later.

It is important that we work together whatever our practice or therapy.

I would like to see more cooperation and discussion between

practitioners in order to develop our common interests. This discussion

group is a good example of exchanging ideas between practitioners.

Regards

Gascoigne

November 2, 2008

Hi ,

I share your concerns and one of my concerns if the INCREASING

control this government exerts and the lack of influence the public

has on government policy i.e. it will go ahead and do what it wants -

its actually really concerning what's happening. Maybe we will have a

change of government.

In relation to SR what affect might this have, will the government

regulate? I personally doubt it as it has no reason to (financial or

otherwise) but the pharmaceutical industry has huge power and

influence. Even if regulation does happen I doubt very much it will

be anything like the form presented in the Steering Group and to

believe it will is, I think, naive. I too am concerned that because

of a desire to be regulated restricive measures will be accepted -

and are already being accepted. If SR doesn't happen then control can

be exerted through changing the 1968 Medicines Act by reducing our

access to practice under it or limiting our rights to access all

herbs or treat all conditions for example.

The longer this SR process goes on the more controlling this country

becomes - and it is continually delayed. In 2011 if a trap door is

pulled under herbalists who will listen or have power to influence

the government? And if people are struggling to put food on the table

at the time will they be concerned with the plight of herbalists?

No, I am not scaremongering as has been suggested, I am just saying

be careful and wake up - " Trust in Allah but tie up your camel " and

all that. Not that I do not believe in the power of the people - I do.

Verge

>

> Without wishing to stray into politics, we can see from recent

events

> that governments can do anything if they so wish. Will the UK

government

> regulate herbalists unilaterally? We don't know but I guess that

there

> is a certain apprehension that they might and that drives some of

the

> process. On the other side, people are worried about what

regulation

> will mean in terms of our practice. My point about what we are

allowed

> to do after regulation (if it happens) remains a valid one.

>

> At the moment, herbalists are restricted in their use of certain

herbs.

> However, medical practitioners can use such herbs (with no training

or

> knowledge of herbs) due to the practice of off-label prescribing.

This

> gives medical practitioners the right to use any substance that

they

> believe may be helpful in treating people. I would not like to see

a

> scenario where herbalists are still prevented from using certain

herbs

> or using them in particular ways whilst medical practitioners

continue

> to have the right to off-label prescribe herbs. What is sauce for

the

> goose........... However, I know that there are hierarchies at work

here

> and herbalists are not generally near the top (or acupuncturists or

> homoeopaths).

>

> One of my concerns is that in the desire to be regulated, we do not

sign

> away any rights or privileges that we currently have. In the US in

the

> latter half of the 19th century, homoeopathy was very strong with

high

> percentages of medical doctors using it as treatment. In a desire

to be

> approved and part of the system, colleges then instituted

conventional

> medical training alongside homoeopathic education. Within a

generation,

> homoeopathic education and treatment had collapsed. It is only now

> recovering some hundred years later.

>

> It is important that we work together whatever our practice or

therapy.

> I would like to see more cooperation and discussion between

> practitioners in order to develop our common interests. This

discussion

> group is a good example of exchanging ideas between practitioners.

>

> Regards

>

> Gascoigne

>

November 3, 2008

Dear and everyone

This forum has always allowed for the discussion of politics and rightly so.

Politics as it relates to the practice of herbal medicine.

I think a couple of recent posts have made people think that talking politics is

completely out of order.

What is not acceptable is using the forum to discuss issues or matters that

relate to any specific professional body, no matter which one that is.

It is disrespectful to the members of other professional bodies to have

discussions relating to one body discussed as if those people donâ€™t exist or

have no feelingsâ€“ there is a place for discussing those matters and it is not

on a public forum, public as in non-member specific. I am fairly sure that each

PA has its own membership only forum where internal matters can be discussed if

they wish. If they don't it is none of my business.

It is also disrespectful to the members of the particular body to have matters

that relate to them and their membership discussed in a public forum.

So, can I please ask everyone to show some respect to everyone on the list and

abide by the list terms and conditions?

An enormous amount of work has already been done, cooperatively between PAs,

.

All this information information is available from each PA.

A scope of practice has been written and it is as broad as it could be. It does

not narrow or close off any aspect of the herbal profession. I donâ€™t think

there is one person who has been working on regulatory issues who would accept

anything that curtailed our practice. Everyone working on that is in fact a

herbalist just like everyone else so why on earth would they accept something

that restricted themselves?

Regulation also allows for, and in fact requires the development of the

profession, and actively promotes the profession in the public arena.

The parts of medicines legislation that indicate â€˜herbalistâ€™ but without a

definition of what a herbalist is, cannot be enforced so there is no restriction

on the use of certain herbs. However, if the word â€˜herbalistâ€™ (with all its

variant forms) becomes enshrined in UK law, it will mean that the restriction on

prescribing will apply to anyone who does not meet the definition of the termâ€˜

herbalistâ€™. So doctors would not be able to use them unless they had been

trained to do so.

Perhaps one way to look at the American experience is to consider the huge

responsibility we have in the UK. We have colleagues, some of them on this list,

who practice illegally because they live outside the UK or Ireland. At least we

donâ€™t have to do that here. If we gain legal status here, then herbalists all

over the world will be in a position to say herbal medicine is a legally

recognised profession in the UK and we want that in our country too.

That is not to say I look at the world through rose tinted spectacles or that I

have high, unreachable ideals. I can be as sceptical as anyone. It has to be

regulation that meets the professionâ€™s requirements.

Best wishes

========================================

Message Received: Nov 02 2008, 02:00 PM

To: ukherbal-list

Cc:

Subject: Re: SR