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Regulation FAQ Updated May 2010 - updated text is in blue
By Dr Chris Forester
Co-Principal
HYPNOTHERAPY
Will hypnotherapy be regulated by the Government?
No. Hypnotherapy has been identified by the Government as suitable for "Voluntary Self-Regulation" (VSR) along with a number of other complementary therapies. Life Coaching, NLP etc will also not be regulated.
What are the implications of hypnotherapy VSR for me as a Chrysalis student or graduate?
VSR means that the hypnotherapy profession is actively working towards developing common standards and codes of ethics. The largest grouping of hypnotherapy organisations achieving this is called the Working Group for Hypnotherapy Regulation. A "Working Group" is an organisation consisting of professional bodies like the Hypnotherapy Society and training organisations such as Chrysalis.
The Working Group maintains the National Regulatory Register for Hypnotherapy, which is a list of all UK hypnotherapists who the Group believes meets its standards. The Hypnotherapy Society is a member of the Working Group.
Chrysalis students are required to join the Hypnotherapy Society on completion of their year 1 studies. Hypnotherapy Society members are automatically entered on to the National Regulatory Register and remain on it while they maintain their membership with the HS.
There are 2 ideas for the VSR of hypnotherapy and the profession is split.
1.) HYPNOTHERAPY IS A PSYCHOLOGICAL PRACTICE LIKE COUNSELLING AND PSYCHOTHERAPY and so requires special consideration and understanding. Both the HS and Chrysalis support this view.
2.) HYPNOTHERAPY IS A COMPLEMENTARY THERAPY like Reiki or reflexology and so can be regulated alongside these other therapies via the Complementary and Natural Healthcare Council (CNHC) a voluntary registration organisation.
In 2009, the Working Group agreed to cooperate with another hypnotherapy body, UKCHO, to unite hypnotherapy and move forwards by meeting at the Prince's Foundation for Integrated Health to develop common voluntary standards.
This lead to the establishment of the Joint National Regulatory Forum. It has received Department of Health funding and I am one of its 4 committee members, as well having chaired its training and education sub-committee.
In 2010, the Forum agreed to limit its scope of enterprise to option (2) above (i.e. seeing hypnotherapy as a complementary therapy.) This leaves hypnotherapists who see themselves as psychological practitioners to consider other forms of VSR.
Is it a legal requirement for me to be on any Register?
No. VSR is *voluntary.* However, the public will increasingly look for evidence that hypnotherapists are maintaining good standards. It is in your own best interests to maintain your HS membership to facilitate this.
Will this effect my current Chrysalis hypnotherapy training?
No.
What does Chrysalis think of the idea of hypnotherapy VSR?
We feel essentially that voluntary self-regulation is a waste of time. As it's voluntary, it offers no public protection because you can just volunteer not to do it. We also have concerns about hypnotherapy going down the "complementary therapy" route as well because we feel this risks enshrining inadequate training standards which do not understand that hypnotherapy is a psychological practice. We feel hypnotherapy should be seen as a form of psychotherapy and regulated accordingly.
Will counselling by regulated by the Government?
The previous Government wished to regulate counselling and has chosen the Health Professions Council (HPC) to accomplish this. The new coalition government has yet to make its position entirely clear. The HPC regulates a number of health professions (e.g. chiropodists.) In addition, Skills for Health is developing standards for various types of counselling & psychotherapy (e.g. psychodynamic psychotherapy.) However, in March 2010 the Department of Health confirmed that it is still open to considering other appropriate models of regulation and that it has suspended the progress on HPC regulation pending a Judicial Review (see below.)
Was there a consultation?
Yes the deadline to respond was 16th October 2009 and Chrysalis has responded.
The URL for download is:
http://www.hpc-org/aboutus/consultations/index.asp?id=93
When could this happen?
MAY 2010 UPDATE
At present the HPC is putting on a series of meetings to report back to its Council in May 2011. It is unclear at this point what will happen until the results of that May 2011 meeting.
There has been unprecedented objection to the plans to regulate via the HPC, including a statement from BACP that the plans are "not fit for purpose." A number of organisations have now launched a Judicial Review in the High Court. This sets out in detail the many criticisms of HPC regulation. The Department of Health has confirmed that the process cannot go forwards until the outcome of the Judicial Review and that other models of regulation are possible.
There has been, in the HPC's own words, and "unprecedented" response to the consultation above. Most of the feedback was criticial of many of the proposals put forwards With a new Government, although things are at present unclear, the Conservatives are unlikely to allow statutory regulation to proceed without major changes and further debate, and the Lib Dems, while in favour in principle of regulation, also voiced many serious concerns about HPC regulation. In any case drafting of legislation has been postponed, a Judicial Review launched by objecting organisations is pending, and the HPC is conducting meetings which won't finish until May 2011.
Whereas therefore the earliest regulation point could have been 2011-12, this timetable is now obviously unobtainable and the process looks like taking considerably longer, if, indeed, it does continue. Some estimates now put the earliest possible date at 2017 if indeed anything now does happen.
How does Politics affect all this?
The Conservatives may not wish to proceed with the current plans. Tim Loughton MP, former Shadow Mental Health Minister, has stated a preference for a different model of regulation. I have personally met with him and he has tabled Parliamentary Questions about regulation which I have provided him. In addition I have spoken with the former shadow minister, Anne Milton MP, I have privately met with Lord Howe, Conservative health spokesperson in the Lords to talk about this issue and he is not convinced that regulation will protect the public.
An overall feeling from the Conservatives is that the current HPC regulation plans may very well not be actioned and indeed the project may be re-thought or abandoned. In any case the timetable has been extended significantly.
The Liberal Democrats are concerned about the HPC plans. They state:
Our position on the issue you raised is that we do support the introduction of statutory regulation, but that we understand that concerns expressed by a number of worried professionals in this field. I believe that my Norman's colleague Lord Alderdice has proposed the setting up of a specialist organisation to regulate this area given the concerns about the prescriptive nature of what seems to be being proposed by the HPC.
Our basic position is that we believe that there is a need for statutory regulation of any person who is acting as a health professional, but that the need for regulation should not be used as an excuse to exclude practitioners people from practicing legally if there is no evidence that their methods are harmful.
UKIP opposes the plans:
"16.1 UKIP is opposed to the Government's intention to regulate counselling and
psychotherapy through the Health Professions Council as their proposals are unnecessary,
costly and impossible to enforce properly. Consequently UKIP will examine alternative
regulation proposals such as the Practitioner Full Disclosure (PFD) which has been
pioneered successfully in Canada and Australia. This is a simple scheme in which
practitioners register their qualifications centrally and which provides for an efficient
complaints and mediation procedure."
In view of the current political and economic climate quick progression of these issues is unlikely at this point.
Is it popular?
No. The BACP in 2007 stated that 100,000 practitioners were against HPC regulation of counselling (while in favour of regulation in principle). Furthermore, 2 groups with petitions of several thousand practitioners have sprung up in opposition: the Alliance for Counselling & Psychotherapy, and the Coalition Against Over Regulation. Many practitioners are intending not to comply with regulation,e.g. by changing title.
WHY is it unpopular?
There are many reasons given. HPC is not the right regulator; there is no need for regulation; the harm outweighs the benefits; protecting titles doesn't work; HPC uses a healthcare model; there has been no proper assessment of what regulation will work; other countries use much better models; involving the state in psychotherapy will cause harm to clients; HPC complaints procedures are too judicial and adversarial, expensive, and too often used by colleagues rather than by clients.
What is the difference between the HPC role and that of Skills for Health?
The HPC is the regulator; Skills for Health is developing sets of standards which can be used to inform the regulator to develop the regulatory standards.
How is Chrysalis involved?
Chrysalis has been approached by Skills for Health to "field test" some of the standards. We have agreed to do this. We have actively participated in previous consultation excercises. I have provided briefing papers for the Conservatives at their request to better inform the political agenda.
How is Chrysalis assisting Skills for Health?
Chrysalis has examined the standards for psychodynamic counselling and has mapped them against our current course. We may develop additional materials or change existing course materials and test how the new materials work in the classroom. We are taking forward testing in other modalities.
How will regulation happen?
If the HPC eventually goes ahead, it will set up a register of counsellors and will then gain legal protection for certain *titles.* It's possible that the title "counsellor" and/or "psychotherapist" will then only be used by someone on the register.
HOWEVER, the HPC states it will "wish to consider whether it is possible to protect the title "counsellor" or whether this title is so widely used in therapeutic settings that it could only be protected as part of an adjectival title."
Currently, the recommendation to the HPC from its Professional Liaison Group (a group of professionals and lay people) is to protect the titles "counsellor" and "psychotherapist" and to differentiate between them essentially making psychotherapist a more senior title.
However, this is highly unpopular and the Counselling Society and BACP have lodged strong objections to separating the titles. Chrysalis wishes to see the title "healthcare counsellor" protected (to safeguard counselling in the mental health sector), not the title counsellor. We believe that it will be unnecessarily intrusive on the volunteer sector and private practice and will encourage professionals to use other titles.
What is an "adjectival title"?
An example might be "psychodynamic psychotherapist" or "mental health counsellor" rather than just "counsellor."
Why might the HPC not regulate the title "counsellor"?
Because it is too widely used to be able to regulate properly, e.g. debt counsellor, stress management counsellor, relationship counsellor, health counsellor etc. However, the current recommendations from the PLG are to regulate the title counsellor. Also because in regulating psychologists it did not protect the title "psychologist", only adjectival titles. However the PLG recommends it does regulate the title. This issue is quite stuck at the moment.
The HPC did not regulate the title "psychologist" when it regulated psychological therapies instead it regulated only adjectival titles.
Won't I just be able to practice my counselling under a different title?
Yes this is the flaw in protecting titles. You could describe yourself using any word that isn't specifically protected and continue as normal, provided that you made sure that you weren't misrepresenting yourself as an HPC counsellor. In practice this would mean differentiating yourself in your advertising and using a waiver. You would have to be explicit that you were not an HPC counsellor. A leaflet is available from the Alliance for Counselling & Psychotherapy entitled "Alternative Practitioner Accountability (APA)". Many practitioners will choose to do this in the future.
Where does regulation leave me as a Chrysalis student?
If HPC regulation goes ahead, The HPC will "grandparent" existing counsellors and those on courses onto the state register. You will be able to apply to join the state register once we know the details and we will offer advice and support in making the transition. Chrysalis will be applying for HPC recognition as soon as this is available, which will enable you in completing some of our courses to gain entry to the HPC register.
Will I need a degree?
Not to be a counsellor, no. Current recommendations are that counselling training should be Level 5 on the National Qualifications Framework. The Chrysalis Diploma in Counselling is level 5 on the framework and our Advanced Diploma is Level 6.
Is the HPC trying to make standards "tougher"?
The HPC is there to regulate *minimum standards* - not maximum standards. "We want to make sure that any proposals are inclusive so that as many practitioners as possible can be regulated and it is important that the level we set is not aspirational in nature." (HPC). The HPC knows that counsellors could simply change title and so rather than letting this happen, are keen to ensure that everyone can get on the register who is safe to do so.
Will I need to be accredited by this or that body to be state registered?
No counselling regulation will be independent of any accreditation scheme of any professional body. You will only need, eventually, to be registered with the HPC. This said, professional bodies will still accredit training (often to higher standards than the minimum standards required by the HPC) and will have a host of benefits to joining, e.g. advertising your services and having someone to support you in a complaints process. Professional bodies may also have an initial role in providing their registers of members to the HPC.
It will be vital in the next few years to maintain professional body membership to ensure transfer to the state register and to protect you from complaints to the HPC (your professional body will be your support system.)
What will happen to Chrysalis training?
Chrysalis will be applying to become a UK Approved Course by the Health Professions Council. It is possible that we may have to adapt some of our courses or modify materials but as yet no criteria have been decided. Once we gain this status all our future graduates will be entitled to state registration. Those graduates and students who do not wish to be registered can still belong to the Counselling Society and can practice Alternative Practitioner Accountablility (APA) by using different titles
What is Chrysalis doing to prepare for regulation?
Chrysalis is constantly ensuring its standards are consistently high and is involved in an on-going programme of course development, validation and accreditation. In 2007, we gained Royal College of Nursing Accreditation. In 2009, we gained Open University recognition. In 2010 we were recognised by the Ministry of Defence and have a number of other confidential applications for accreditation in process.
On September 1st 2008 we were delighted to announce that Jenny Mcclymont, MA, has been hired full time by Chrysalis to oversee all our future development, regulation and validation needs.
Jenny is an immensely experienced counsellor and trainer and has run a successful counselling training department in London at which she oversaw the gaining of foundation degree status for her course. She will ensure that all our courses meet future requirements as well as actively pursuing further recognition, validation and accreditation routes both with professional bodies and with suitable Higher Education departments.
In the future, if necessary, we will hire additional staff to assist students making the transition to a regulated profession.
What does Chrysalis think of regulation?
Do we really trust the State to understand our vocation as counsellors?
Protecting titles is notoriously inefficient at doing this because practitioners who don't want to be regulated change their job descriptions. For example, in the US many counsellors became "life coaches."
Luckily, if indeed the HPC route is a sensible and professional organisation and they acknowledge that regulation must be inclusive and about minimum standards, not unachievable and unreasonable accreditation criteria. The HPC is keen to see public protection but also keen to see that professionals can continue to offer their services to clients with minimum disruption. It knows that to exclude people will simply see them change their job descriptions.
One view we hold is that counsellors working in mental health settings could be regulated more stringently than those seeing "the worried well." There is, of course, a difference between counselling a seriously ill client in a mental health setting and seeing someone who self-refers to your clinic to talk about their relationship difficulties. This said, the fact that the HPC is wondering whether it can regulate the title "counsellor" at all may indicate just this: that specialist roles working within mental health are regulated but private practice is not.
Put another way, most counselling is not actually a "health profession" it is a relationship between two people.
We don't agree with differentiating psychotherapist and counsellor (neither does the CS or BACP) and we don't agree with seeing counselling as a healthcare profession (although sometimes, it is.)
We view Practitioner Full Disclosure (PFD) as practised in Canada and Australia as the most appropriate model for the regulation of hypnotherapists, counsellors and psychotherapists. Although there are many versions of this, essentially it becomes a legal requirement to register and to fully disclose your training and qualifications, but complaints are handled in a more mediated fashion and the sanctity and integrity of the way you practice are preserved.
In conclusion, Chrysalis will do everything to ensure that our students and graduates make a successful transition should regulation occur. Our graduates will have a number of options available and we will ensure that they can gain the best possible use from their qualifications.
I will update this FAQ as things develop further.
Dr Chris Forester
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