Full Report from the May 12th 2010 HPC PLG
From Carmen Joanne Ablack, UKCP PLG Representative
Please note that this report contains navigation tools to allow you to move to different headings and attachments as you go.
Full report
Structure and further briefings
I am going to include here a report that summarises the various areas contributions at the meeting covered. I set out also the other considerations that were raised, many were not discussed in any detail at this stage. The main report will split between pre lunch and post lunch work for ease of presentation and reading.
Finally please note the timetables set out in sections 7 and 8 of the Workplan document Click here for Workplan from HPC. Members may wish to be aware of the various points at which UKCP may need to gather feedback. Or invite our members to respond to the consultations from HPC and the DH.
As in the past, feedback from members will be vital to support Andrew, David, Kathi and I in tracking what is needed in the thrust of all UKCP engagements, challenges and influences on the eventual outcome from the HPC work. Namely what goes forward from the PLG to the HPC full Council and what the Council then put to the DH for production of the draft for consultation and then final Section 60 Order.
I have chosen a detailed format for my first report so that members reading this can get a fuller picture of the PLG work and reacquaint themselves with the issues and areas under discussion and challenges facing us in this work.
Subsequent briefings will be in a simpler format reporting on the meeting, particularly as the meetings will be monthly. I hope get to a coherent and reflective briefing up within a week or so of each meeting. Where possible a web-link will be made on the UKCP website to the papers from the actual meetings, so you can choose to read these if you wish.
I encourage every member of UKCP to keep looking at what is set out on our website, in the e-briefings from the Chair and CE and what HPC puts on their website.; so you can remain informed of the work being done. Click here to be taken to the HPC website; click here for link to earlier UKCP HPC consultation papers.
Reflections and areas of work remaining for the PLG
After apologies for absence and corrections to and acceptance of the minutes of the PLG meeting of 26th and 27th May 2009 we moved to matters arising. The meeting felt that the agenda for the day would address such matters and so moved on to the main work of the day. I was formally welcomed as the new representative to the PLG from UKCP. The was attended by a smaller than usual number of members, I imagine this reflects part of the difficulty of sustaining the process over such an extended period of time. This was the first meeting of the PLG since May 2009.
In that time we have had a number of changes internally and externally to our political landscape, and yet once we started speaking at the table it did feel to me that a year had not elapsed, so vivid and large were the issues facing the group.
In the absence of the Chair of the PLG, Professor Waller, due to illness, the group chose to be chaired by the President of the HPC, Dr. Anna van der Gaag. Anna started by inviting members to give their reflections on where they believed we had got to in the process thus far:
Reflections
The first speakers' comments acknowledged the amount and range of activity and interest shown outside of the PLG over the last year, whilst PLG has not been meeting. (Fiona BD)
It was stated that there remained fundamental questions about the nature of the regulator. (Brian M,). How would regulation by HPC be acceptable to the field - ie. the need to command the support of the profession; the need for collective backing. (Jonathan C) The BABCP representative (Linda M) said that some of their members still had concerns and were asking them if HPC was really the best way forward.
Annie Turner, a sitting member of the full council, stated that more work was needed on profession specific standards of proficiency. The work on the generic standards has moved HPC forward in their thinking and understanding of what is needed now, away from past paradigms.
Peter Bell, representing Relate, but also the chair of BASRT (a UKCP organisational member), reminded us that the work had a different look depending on the lens through which it was being viewed, he contrasted the pragmatics of a service delivery organisation against those of an organisation that had members from across the professions and also had members who were trained volunteer practitioners.
I think this was a useful reminder of the range and complexity of the field for the whole group. He also asked what the debates happening outside means for us (the PLG) as a group and how we could also hold the impact of a change of government?
The BACP representative (Sally A) said she thought there had been an unconscious attempt to define the professions and that the focus needs to come back to public protection.
This was followed by some interesting comments as questions from Professor Fonagy:
- (Will there be) an agreement to review the arrangement on the basis of evidence collected?
- What are the criteria, transparent and explicit?
- What would be a deal breaker?
He said that any register must be voluntary and that we need to ask:
- Who are we representing and are we checking back for validity?
He described the role of the PLG as an arbitrator between HPC flexibility and the demands from people behind us (the representatives of the professions). Julian Lousada followed these thoughts with a further question: How the PLG would engage with those opposed to the project; not in a vacuum, and added that the professional organisations have a task to do.
As the final person reflecting from the representatives I thought it important to emphasize that "opposition" over the past twelve months had been coming from many quarters, those opposed to being under a health regulator per se; those opposed to specific aspects of the regulators work; those with anxiety about aspects of the work of the regulator. I saw a need for greater clarity from the PLG and HPC to practitioners.
The importance of partnership between the HPC and the professional organisations, needs to be acknowledged (my addition for this report-if statutory regulaton is going to work effectively).
I raised that the PLG meetings previously had not acknowledged the limitations of the variety of approaches taken to responding to consultations by the professional bodies. UKCP specifically requested that our members respond through the main document UKCP submitted. Other professional bodies had asked their members to respond as individuals. Therefore the population of practitioners responding individually was not reflective enough and the information gathered could not be seen as properly canvassing the views of the wider profession.
I added that it is important that all further consultations had an agreed protocol by the PLG which every professional body and organisation sitting at the table agrees to follow so we are responding from the same base for evidential purposes.
Discussion Arising
This was a wide ranging and at times quite discursive part of the meeting; the following could be read as the group exploring different possibilities and considerations, and people laying down markers for later areas of contention / interest to be settled.
Anna van de Gaag said the external dialogue has to be mapped onto the internal dialogue that the PLG has with the HPC Executive and the HP Council. She stated there was a balance to be achieved and that the strongest weapon is dialogue. The PLG needed to review its progress and contribute to the plan of activities over the coming months. She asked Michael Guthrie to name the process needed for the external dialogue in relation to the workplan of the PLG.
Michael Guthrie said the PLG need to decide: who we invite to the meetings; the format of these meetings and the topics we need covered. This ongoing work was set out on pages 4 and 5 of the workplan (click here for workplan); he asked the PLG what more was needed.
Several speakers stated the need to ensure we speak to a wider range of service users; not just those who have experienced harm, but also those who have experienced good from psychotherapy and counselling. "Building on what works" was one comment; addressing the question what does regulation have to offer and is it anything better that what we currently have; the limitations of anything that seems like blanket assurances was stated.
Peter Fonagy said that psychotherapy and counselling are different in quality to other professions that are regulated by HPC; that the nature of the risks and attention needed regarding the complaints procedures must be present in the work produced by the PLG and the HPC.
Some of us spoke to the concepts of differential impact and risk assessment of regulation on diverse populations and groups needing to be present in the work we do. Julian Lousada summed up the part of the discussion that recognised whilst all professionals regulated by HPC have some form of relationship with their clients or patients it is in psychotherapy and counselling where " the relationship with the person delivering the service is the service".
Many of us around the table emphasized the need for statutory regulation to pay attention to the quality of the relationship as central to the work of the professions. This was seen as vital, not least because the providers of these services need to buy into the regulatory frame that gets produced.
It was raised that how service users are accessing services has been changing face some organisations are seeing people being "sent" by social care bodies etc. to be "fixed". This has an impact on the nature of the risk being dealt with and the nature of the service being provided.
There was some discussion about the need for some kind of mini-study and /or evidencing of the jobs people actually do; as well as discussion about the service users that are contacted.
I thought it important to remind the group that many of the 'service users" were actually clients and patients who had chosen to seek private psychotherapy or counselling and that the PLG needs to find a way to hear from people in this group and not just from those who see practitioners in voluntary and statutory sector organisations and services.
Annie Turner raised some key points at this stage these were along the following lines:
PLG need to look at the public we are aiming to protect;
What do we want to learn from the people we talk to?
How can we make this sufficiently representative?
How can we (PLG) say to service users this is why/ how HPC is an improvement on what we have.
There is a need to involve a range of service users, to look at the questions offered to them and to create an exchange of information.
Brian Magee brought in the need for the PLG to take note of international perspectives; this led to talk of the Bologna Agreement (technical protocol and agreement for universities) and also the national qualifications framework in relation to FEs and HEs.
It was acknowledged that the level of the training is not the same as describing the nature of the training and the SOPs need to pick this up. (CJA note - for example masters level 7 or equivalent for UKCP psychotherapy trainings).
Annie Turner informed the PLG that the HPC Education and Training Committee (E&T) were looking at the usefulness of HPC SET 1 and questioning whether the level of trainings was actually useful for the protection of the public (CJA note- this was not new information and has been part of HPC discussions for some time).
She reiterated that standards of proficiency were not the same as learning outcomes on a course; there may be a need for this distinction to be made more explicit. Gateway entry levels were coming back to the E&T meeting in June. Need to consider what are the issues if that standard is removed; is it a ed herring, what does it mean in terms of what goes into a programme. She later invited us to consider levels of delivery and for whom is level of delivery important.
Mick Cooper introduced the idea that one of the people the PLG might want to hear from at the later meetings was an educational expert who could talk to the group about levels; some thought this a not bad idea, others felt that we already had that kind of expertise at the table and in the professional bodies.
The counselling question was raised as being bigger than just education; that it was not just about the academic, but about the relational of the activity; Peter Bell summarised this as 'qualifications plus...'.
Who to include
The discussion moved onto who needed to be included at the next four meetings - intended to include in each day a gathering of perspectives from stakeholders.
Sally suggested we should look at curricula from courses;
Fiona suggested community counselling training organisations; and added that we may just have to battle out key issues;
Other groups named included those representing children and young people ; employers, and objectors to the regulatory framework;
Fiona suggested that this latter group of people who had problems with the framework (and are not already at the table) should be asked to present their problems and possible solutions.
Peter Fonagy added to his earlier thought of PLG as arbitrator by suggesting the PLG be mediators between the filed and the HPC; that the PLG was a bilingual group between two tribes.
At this point Anna said we needed to come back to the Workplan and practicalities for the next series of meetings. We broke for a 45 minute lunch, where people continued conversations informally;
Post Lunch - Workplan issues and practicalities
Workplan for the PLG
Click here to read the workplan papers from the meeting.
This part of the meeting, saw people popping in with suggestions much more and making one statement points:
We started by looking at page 4 of the Workplan and acknowledging that there was a need to bring in other perspectives to the questions asked there.
- The outstanding questions for the PLG are: differentiation of counselling and psychotherapy and recogniton of practitioners working with children and young people.
- Following on from these are questions of under what titles people are employed and how clients are affected, if at all, by the title(s) used.
- The centrality of the relationship was reiterated by someone and Peter Fonagy suggested that something could go into the preamble that states HPC's recognition of this centrality (for the practitioners on this register). He felt the instruments of statutory regulation must keep this in mind. I added that the centrality of how one handles the relationship is a key part of training courses that people undertake and needs to be in our overall picture.
- Bearing in mind the concept of "feasibility in relation to regulation' was reiterated by Anna.
- The competences needed in addition to (the generic competences) and the specialised competencies will need to be identified/clarified.
- The question of differentiation will need to be addressed and not left to the last meeting, as happened before - Sally, got a lot of agreement from the practitioners around the table to this comment.
- Linda clarified that accreditation by the professional body was separate from accreditation on the training course itself ( CJA note for UKCP accrediting organisational members in particular, this is an important distinction to keep in awareness of PLG and HPC, it paves the way for professional body recognised accreditations to have a place).
- The group agreed that the areas of overlap between counselling and psychotherapy would always be greater than the areas of differentiation;
- Another consideration that we needed to keep to the forfront was risk and protection of the public
- What did you need to know / be able to do when you started? Was a key consideration. Some saw these as the same thing, I said knowing and doing were not the same and both were necessary.
- I went on to say that talking about difference between conselling and psychotherapy was not the same as differentiating between the two, I used the example that how I am different to you is not the same as how I differentiate myself from you - that this distinction has to be captured;
- The question of inclusion and representation needed to be addressed - there is an impact on the populations who come into the profession;
- We need to consider the ways people are exposed to training; the questions of personal therapy/development or not
- Someone suggested we could ask the service users: do you think you get a better service from someone who has personal work than from someone who hasn't ( We had drifted well into the territory of SETs on this one) so it was inevitable that the next comments /questions would be...
- The need for a common statement on relational, something on reflective practice and ...
- Do clients who present for counselling need psychotherapy - there was strong reaction to this and I believe it is a fair reflection to say that most felt it was an unhelpful /impasse direction question; some felt it was not relevant to the PLG work, others thought differently - (my guess is it won't be the last time this is raised)
Stakeholder Meetings
We were then asked to note Appendix 1 Section 4 click here to navigate to this - stakeholder meetings; there will be parallel meetings with stakeholders for the PLG and the HPC will continue to meet both individuals and external bodies.
The work of the PLG is the question of differentiation; the SOPs and the SETs.
Each stakeholder meeting will have the same format, the PLG need to decide how they will participate at these specific meetings;
We ended on the unanswered question of what happens with the views from these meetings?
The meeting came to an end just after 2.00pm
UK Council for Psychotherapy | Registered Charity No. 1058545 | Company No. 3258939 Registered in England
|
