Regulation – How is the public to be protected?
The Society has rejected the Department of Health’s proposals for statutory regulation via the Health Professions Council (see President’s column, p.394). We are still receiving your views on how best to regulate the profession, and we will continue to publish them here. As it is a fast-moving area, you may also like to contribute to the discussion at our forum via www.thepsychologist.org.uk.
FIND it uplifting indeed that in recent editions of The Psychologist an
increasing number of brave voices have sought to question the wisdom of
statutory regulation in the form that is currently being proposed.
(Well done! Messrs Osman, Barker, St. Ather and Ward).
I praise The Psychologist for highlighting such an important debate, and with the BPS developing such an excellent website surely it would be simplicity itself to arrange for members to log in and vote, in a simple democratic forum, on matters of such crucial importance?
From talking to my local plumber, electrician and others, I gather that the mantra of ‘regulation’ is indeed political flavour of the month, constituting as it does a form of political control which will soon be affecting just about everyone who works in any trade, profession or form of public service. But is this such a good thing that it is to be attained at any cost? Should not psychologists, above all, be defining their own destiny, defending the very special status that their profession has, preserving a locus of control within their own ranks, demonstrating the individuality of their professional identity and not succumbing to an over-alignment with other professions?
It is indeed a noble aim of regulation that it should seek to protect the public,
but it is far from clear how the proposed regulatory measures are going to achieve this. As expounded, I fear the concept of continuing professional development might draw too exclusively on an academic model – that of attending courses, carrying out study and research – and not sufficiently on a clinical model – incorporating feedback from clients, identifiable change and self-report, which is surely the ‘acid test’ of
our work. True professional development, especially if it purports to protect the public, requires both elements, yet the present model for continuing professional development appears to exclude these more clinical measures and risks becoming little more than a superficial paper exercise.
To ensure the development of best professional practice surely there needs to be an attempt to appraise the actual impact that a psychologist has, both on his clients and on his peer group, but where is this in the present debate on regulation?
No doubt Dr Shipman attended many professional courses during his working life, read widely, and involved himself in many reputable in-service events, yet these were of no help whatsoever in judging the actual quality of his work, nor the impact that he had on clients, nor the manner in which he may have been appraised by his peer group. A system of outcome measures, careful feedback from clients, and some method of peer-group appraisal, just might have rung the alarm bells sooner and helped to protect the public. Surely, we should learn from this awful example what might constitute best professional development for ourselves, and therefore what might comprise worthwhile regulation.
I am fundamentally unsure, as others must be, of the extent of the threat posed
to our profession by bad practice. Can the Society’s Professional Conduct Board perhaps tell us what are the actual statistics of rogue psychology that have necessitated regulation? In any case, one hopes that important before/after measures of malpractice are currently being taken so that regulation itself can be evaluated to see whether it proves effective in reducing such occurrences.
7 Fons George Road
ON reading the proposals for protected titles under the part of the register to be called ‘Applied Psychologists’, it would appear that certain members of the Society have failed to apply any psychology whatsoever to the implications. To protect only the titles ‘clinical psychologist’, ‘sport and exercise psychologist’, ‘counselling psychologist’, ‘health psychologist’, ‘educational psychologist’, ‘forensic psychologist’ and ‘occupational psychologist’ does more harm than good. Does the Society seriously expect the public to commit these titles to long-term memory? On hearing of statutory regulation, the public will naturally assume that the word ‘psychologist’ is protected. Thinking only about my own area, the next stage of thought is that a ‘work psychologist’, ‘organisational psychologist’, ‘engineering psychologist’, ‘business psychologist’ (or even ‘applied psychologist’!), etc., is a legitimate title subject to statutory regulation.
In sum, these proposals give all and sundry creative leeway to think up their own ‘psychologist’ title with impunity and appear to the public to be regulated. In the UK, people can (and do) work under the job title of ‘psychologist’ without the fuss of requiring a degree in psychology! In future their credibility will seemingly be rubber-stamped.
If the Society wishes to statutorily regulate psychology, it should investigate the Australian model as a matter of urgency. Here, the title ‘psychologist’ is protected by law, no matter how one dresses it up. Applied psychologists and academic psychologists all register; there is no distinction. If the current UK proposals become law, please do not expect the public to receive any protection.
University of New South Wales
JOHN Raven (Letters, June 2005) is correct to highlight a central empirical question about statutory regulation – can it really protect the public? To date, the evidence has been weak; with lots of counter evidence that registers can be about self-protection, self-advancement and public mystification (Allsop & Saks, 2002). Other policy mechanisms, which might be more robust and are not mutually exclusive, include the use of criminal law when a client is assaulted, the use of employment law to remove abusive or incompetent practitioners, and the use of competency frameworks and protocols rather than ‘guild credentialism’ (Hayes, 1998), which is the blanket registration of people with acquired qualifications favoured by the BPS. There is no single and comprehensive technical fix to guarantee public protection, when discrepancies of power and knowledge inherently exist in the professional–client relationship, especially when so many practitioners operate privately (in both senses of the word). Moreover, if a single solution were theoretically possible, it certainly would not reside in statutory registration.
Blackburn with Darwen PCT
Allsop, J. & Saks, M. (Eds.) (2002). Regulating the health professions. London: Sage.
Hayes, S.C. (1998). Scientific practice guidelines in a political, economic and professional context. In K.S. Dobson & K.D. Craig (Eds.) Empirically supported therapies: Best practice in professional psychology. London: Sage.
A decidedly better approach?
AS moral, political or legal issues the BPS cannot have a view on
the rightness of the Iraq war. But the BPS can have a view on the
positive or negative outcomes of human behaviour of which the war in
Iraq is just one example. Other sciences are also able to make
predictions in their own fields.
Decision making, like any behaviour, has emotional consequences that are predictable. Why else would we assert we know something about ‘emotional intelligence’? Decision making without awareness almost inevitably leads to negative emotions. That is why there is so much resentment, criticism, lack of trust, and endless argument. In any situation of conflicting emotions there is always a ‘Law of the Situation’ which, if followed, can resolve conflict and establish positive outcome. I know of no better model for the practical application of this ‘law’ than that that of Will Schutz, whose model can establish a unity of decision making in any organisation. I would suggest that the BPS take the view of Will Schutz whose ‘technology for human affairs’ would lessen the likelihood of future catastrophic decisions.
Our knowledge of psychology could inform government, as well as any other body, that effective decision making depends in the first instance upon awareness of what is going on in the situation. Awareness means bringing out into the open all those things that people may be reluctant to disclose, but which are usually the most important matters. Where there is lack of awareness’ it follows that there will be lack of control, leading inevitably unintended consequences.
The state of psychological health of any individual, any group or society can be assessed in Schutz’s terms of self-regard, self-respect and self-acceptance. Manifestly, in relation to the decision on Iraq, our society feels none of these emotions, but is instead angry, justificatory or denying. All defences. All sure signs of poor psychological adjustment. All three of Schutz’s principles were violated. Firstly:
‘If people who are affected by the decision think they have been excluded they will disown it.’ Secondly: ‘If people think they have been manipulated they will resist.’ Thirdly: ‘If people think they have been deceived they will withdraw trust.’
A decision that is made without the approval of all those parties affected by it has the consequence of being renounced or challenged by those ignored, disempowered or deceived.
Anybody who would like to receive short excerpts of some applications of Schutz’s theory, please e-mail me at [email protected]
37 Dorset Road
IT would seem my ‘Careering ahead’ article (Students page, March
2005) has sparked some debate regarding academic concepts of applied
psychology (David Duncan’s letter, May 2005). I think it is a little
unfair though, to berate Darren van Laar for certain words when I was
responsible for writing the article, and it was clearly not a direct
Firstly, I must apologise to Darren for attributing the words ‘non-psychology careers’ to his talk. However I stick to my wording as I believe the issue is crucial to understanding how best to support psychology undergraduates. I think many of the students I spoke to on that day would agree with me that careers in management, health and retail could not be classed as applied psychology, even if the graduates were to use their psychological skills. We may apply psychology to those careers, but a psychology degree is not a prerequisite to gaining those jobs, and I am not convinced that concepts from psychology are regularly used in these areas. Indeed one of the points we were trying to make during the careers day, by holding sessions on ‘non-chartership’ careers, was how useful psychology can be to a wide variety of jobs. I gave the talk on marketing, management and consultancy, and many students there were pleasantly surprised to hear the many ways psychology can inform such work. These included mature students already working in such fields.
Whilst I fully agree with Duncan that academic psychologists could benefit greatly from joining the BPS, I do not agree with his criticisms of ‘archaic academics’ – I work in both areas (academic and applied) and so do many of my colleagues, we all encourage students to join the BPS, and I think it is unfair to make such criticisms. It would be interesting to see the figures for academic membership to assess the extent of the problem, but I think more importantly, we must do more to encourage psychology students to become, and remain, members of the Society. We can only do that if we can clearly demonstrate the benefits of membership and I do not think that creating (in my opinion false) dichotomies between academics and practitioners will help.
Stephanie J. Morgan
Birkbeck College and Crosslight Management Ltd
Educational psychology training confusion
FOLLOWING recent letters to The Psychologist about the ‘waste of
time’ that working as a psychologist assistant in the NHS (for those
wishing to undertake courses in clinical psychology) may be, I would
like to point out what seems to be a far bigger waste of time.
Those of us, like me, who are hoping to undertake masters’ courses in educational psychology were recently shocked to see an update on the BPS website, telling us that we would no longer be able to do this, and that we would have to undertake a three-year course instead. What then for those, who have ‘wasted’ time applying for PGCE courses, doing PGCE courses, and teaching for two years?
To make the situation more stressful, when I rang different organisations to seek clarification of the situation, the picture became more foggy. The Association of Educational Psychologists said that this information was incorrect; the Clearing House for Educational Psychology told me the situation was as yet undecided; and universities all told me different things – many universities said they were only running the one-year course (and will only be doing so for the foreseeable future, but that the BPS was not accrediting this course). Why oh why, is the BPS insistent on not accrediting a course when there is, as yet, no other appropriate course for those who wish to go into this profession to pursue? Why does the BPS insist it knows more than the Association of Educational Psychologists, which is calling for the retention of the requirement for educational psychologists to have been teachers? Does the BPS realise the mess it is making of people’s careers due to its behaviour? Add to this, the fact that those who are about to do PGCE courses (or who are in their first or second year teaching) would now have to do a three-year course as well. Does it seem fair that people who have done a PGCE and two years of teaching now have to do a three-year course as well? It may well be the case that people would have chosen a different career path if they had been advised of the full circumstances when they chose their profession.
I am now left wondering if I should do the PGCE course I have been accepted on, or will this be a waste of time? Unfortunately, no one is willing to advise me. Does the Society not worry that there will be an increased shortage in educational psychologists due to this (in my opinion irresponsible) behaviour? It seems to me that the BPS and the Association of Educational Psychologists (who want to keep teaching as a requirement) have gotten so bogged down in their own argument that they have forgotten to consider the future of this profession.
6 Millers Close
Student participation in experiments
AS a second-year psychology student, I am dismayed to find myself in
a situation whereby I am having to consider alternative methodologies
for my final-year project due to the low numbers of participants
willing to take part in experiments. Wouldn’t it be sensible to
consider the American system of participation in experiments, for
course credit, as an essential requirement for BPS accredited
As far as I can ascertain, the problem lies in the timing of experiments, during March/April, which conflicts with students’ coursework submissions and revision commitments. Therefore, availability and willingness to participate is limited. If there was an incentive, or course requirement, this problem could be alleviated. Psychology relies on the continued use of experimental methods and it seems to be a ludicrous situation that final-year students are eliminating this option purely on the basis of inability to guarantee student participation.
The implementation of ‘course credit for experiment participation’ would appear to be a relatively simple solution. Is the BPS aware of the situation students are facing, and does it intend to take any action?
5 Free School Lane
Richard Latto, Chair of the Psychology Education Board, replies: You make
a very good point, and your predicament is one that all researchers relying on access to human participants find themselves in from time to time. Many UK universities and colleges do already operate a scheme of the kind you suggest. This both helps staff and students with their research and introduces first-year students to the kinds of research they will be doing themselves in due course. However, it would not be possible for the Society to make this a requirement for accrediting degrees. We define a set of learning outcomes that departments have to achieve for their students, but exactly how they do this is up to each department. We would see an experiment participation scheme as a valuable tool, but could not make it compulsory. Why not suggest again that your department introduces one? Everyone benefits, and there are plenty of good models around that avoid the kinds of problems you raise.
[See also Hugh Foot and Alison Sanford’s article ‘The use and abuse of student participants’, The Psychologist, May 2004, or from tinyurl.com/aswhy]
Follies of professional privilege
THE current preoccupation with professional matters has caused me
a severe bout of ‘reminiscencitis’.
There was a time when psychologists had sufficient savvy and candour to challenge the Establishment by stepping outside the systems in which they worked and joining other social scientists in exposing the contradictions and follies therein. It seems that times have changed.
I once worked professionally with a patient, ‘Danny’, in a secure unit. For much of Danny’s adult life he had experienced loneliness, deprivation and regular periods of homelessness.
Eventually Danny progressed to another unit and I came to see how he was settling in. As I was leaving he asked me when I would be coming again.
Danny was without friends; he had never known his natural family and had little contact with his former foster family. Accordingly, as nobody else appeared able or willing, in my own time I visited Danny at intervals during his year at the unit.
I would bring him some small treats, we would have a chat, and I came to know him better.
During this time, the staff made every effort to stop Danny having these visits and eventually prohibited them. After a month, Danny’s RMO lifted the prohibition and apologised for the upset caused. He admitted that the ban had no legality, that Danny found the visits helpful, and that they caused no harm.
At the same time, someone else at the unit informed me that he had written to the BPS about what I was doing (though not naming me). It was clear that the BPS disapproved of the visits. Apparently I was at risk of allegations of professional misconduct and it was in the best interests of Danny and me that we never saw each other again.
This kind of scandalising of innocent behaviour has a long history. In a not-too-distant age the very same reprimand would have been issued to those in the privileged classes who were caught hobnobbing with people below stairs. This was not done simply out of snobbery but out of duty: the social order had to be preserved. This obligation had priority over common values and ideals such as equality, humility and respect for all.
At Danny’s insistence I resumed visiting him, only to find that the unit was discharging him as ‘untreatable’. I never heard from him again. The following year he was found dead in his flat and may have been so for some time.
We blow our professional trumpets and drown out uncomfortable truths. We are part of the social order. We are the privileged ones. And for this, in large measure, we are indebted to the misfortunes of the underprivileged, not least among them Danny.
10 Woodholm Road
Rosten Chorn 1954-2005
ROSTEN Chorn, Head of Psychology for Learning Disabilities in the
North-East London Mental Health Trust, was a South African clinical
psychologist who came to the UK in 1996. Like a number of his
compatriots and psychologists from other countries he was committed to
the NHS and brought his own individuality and compassion to his work,
helping to invigorate and strengthen the profession.
Rosten arrived from South Africa having qualified as a clinical psychologist in 1993. He came to the field in his thirties after working as a professional potter for a number of years. He started life in the NHS as a basic grade and within a few years he was appointed to the role of head of service, which he carried out with vigour and imagination. He was a great champion of the individual patient, while recognising the pain of families with disabled children and the particular social problems about the learning disabled finding a sense of identity and self-worth in an often hostile world. He loved his patients and they seemed to know that.
Those of us who knew Rosten as a colleague and friend were aware of the warmth and playfulness behind the serious exterior. We knew the fighter in him and we also knew the dreamer. When he died tragically within a few months of turning 50, he seemed in many ways still a young man, on the brink of discovery.
He enjoyed a strong and loving relationship with his wife Nadine, and we extend our deep sympathies to her and both their families.
Redbridge Psychological Service
Where are the primary sources?
or emotional differences between children raised in different-sex versus same-sex households’.
Despite the prominence thus given to this aspect of the article, the relevant passages in the text of the article which refer to children’s perspectives have been extracted from policy statements, not directly from research studies. These passages mention findings of ‘the scientific literature’ and ‘psychological research’, but without telling the reader anything at all about the research itself. As psychologists with pretensions to collecting data that is relevant and analysing it accurately, we should surely be concerned to appraise any relevant research rather than taking it on trust and hurrying on to cheer for social justice.
A further but unrelated point occurred to me while I was reading the article. Clearly, some same-sex couples are very anxious to formalise their relationship through a socially recognised marriage, and yet marriage itself is on the decline and many couples opt to live together and raise their children together without feeling the need for any formal marriage tie. Do any of your readers have any theories as to why marriage might be so prized by a group to whom it is denied, at the very time when many of those to whom it is available seem to have turned their backs on it?
GrandparentingJOHN Welch states that Chartered Clinical and Chartered Educational Psychologists who undertake the formal training in clinical neuro-psychology (and those accepted as Practitioner Full Members of the DoN via ‘grandparenting’) are qualified to describe themselves to the public as clinical neuropsychologists. The grandparenting route is no longer an option, and therefore presumably the DoN now considers that two years supervised post-qualification work within a clinical neuropsychology service is not sufficient to qualify one as a clinical neuropsychologist. The precise reasons for this complete change have never been made clear, but it will surely result in a shortage of ‘adequately qualified’ neuro-psychologists?
31 Alpha Terrace
- WE have three spare WISC-IIIs, a British Ability Scales and a
WPSSI. If anyone knows, or has contact details for, psychologists in
other countries who could benefit from them, please get in touch with
Derbyshire Children’s Hospital
Derby DE22 3NE
Tel: 01332 785542; e-mail: [email protected]
- I AM a first-year at Durham University studying psychology with philosophy, and am interested in advertising and consumer psychology. I don’t know much about this subject, and it seems to be really new, but I have a real fascination with this area. I’m interested in a career involving either helping companies to design and use psychology in their adverts or in helping companies understand their consumers better, but I have no idea how to go about this. Does anyone know of anywhere that does a course in this, or a related area, or how I could get into this kind of career?
Tel: 07751 244 750; e-mail: [email protected]
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