Background to Regulation
The profession of counselling and psychotherapy is not currently regulated in the Republic of Ireland. While counsellors and psychotherapists are subject to legislation similar to other practitioners (including consumer legislation, competition, contract and criminal law) and some are subject to additional statutory restrictions (psychiatrists who practice psychotherapy, for example), the titles of Counsellor and Psychotherapist are not protected.
In recent years, however, moves have been made to change this situation. The Department of Health recently invited submissions in relation to proposed regulation as part of a public consultation process.[i] Regulation under the Health and Social Care Professionals Act 2005 will introduce protected titles to be restricted to practitioners granted registration under the Act; registrants will be required to comply with a code of professional conduct and ethics and will be subject to “fitness to practice” rules similar to those applying to other registered healthcare professionals.
The system of statutory regulation will comprise registration boards for the professions, a committee structure to deal with disciplinary matters, and the Health and Social Care Professionals Council with overall responsibility for the regulatory system. These bodies are collectively known as CORU.[ii]
IACP’s Position on Regulation
The Irish Association for Counselling and Psychotherapy (IACP) was formed in 1981. It is the largest professional body representing counsellors and psychotherapists in Ireland, with nearly 4,000 members from student members to accredited members in practice. At present, IACP accredits counsellors, psychotherapists, and supervisors, and also accredits academic courses at Diploma, Degree and Masters Levels. To become an accredited member of the IACP, an applicant must attain a minimum level of academic qualification and clinical experience (including post-training experience under supervision), as well as completing a formal process of Garda vetting.
We strongly welcome the initiative by government to commence the process of formal recognition and registration of counsellors and psychotherapists – this is a necessary step towards ensuring the safety and protection of the public as well as protecting the interests of our members and enhancing the reputation of the profession. The Act will introduce a statutory basis for mechanisms similar to those already in place within IACP, such as those related to accreditation and discipline.
Regulation will safeguard the public, especially those who are most vulnerable, by enforcing agreed standards of training and competency, as well as introducing a legal framework to ensure visibility and accountability. It will also lead to a better understanding and recognition of counselling/psychotherapy.
Issues Surrounding Regulation
The Minister’s invitation for submissions identified a number of issues to be clarified as the Department prepares to introduce regulation. Some of IACP’s main responses are as follows.
Counselling/Psychotherapy: Comparable Practices
The Department of Health’s invitation for submissions requests clarification regarding the number of professions to be regulated. We submit that it would be appropriate to regulate one profession, that of Counsellor/Psychotherapist. IACP has represented both counsellors and psychotherapists for the past 35 years and, while it acknowledges distinct modalities, it recognises no meaningful distinction between the two for administrative purposes.
We have found a high level of common usage of the terms by a wide variety of practitioners, course providers, agencies and associations throughout the profession, both in Ireland and abroad (IACP’s list of courses demonstrates this fact).[iii] In a recent survey of members in 2015, 70% of members identified themselves as both counsellors and psychotherapists. Based on our overview of the field, we believe that regulating two professions would create a division in the therapeutic field that does not exist in the marketplace; it would also introduce an unnecessary administrative burden into the health system.
IACP considers the core activities and outcomes of both counselling and psychotherapy to be indistinguishable. As Marcella Finnerty has noted, the practices “have much more in common than any serious and demonstrable differences”.[iv] This is borne out by empirical research: M.J. Lambert, for example, finds that there is a “substantial and multidimensional” research base to suggest that “common factors are probably much more powerful than the contribution of specific techniques” in determining treatment outcomes.[v] A survey of the literature on counselling and psychotherapy demonstrates the frequency with which the two activities are discussed in interchangeable terms.[vi]
Many international organisations do not specify a difference: for example, neither the Canadian Counselling and Psychotherapy Association (CCPA), which has approximately 5,300 members,[vii] nor the British Association for Counselling and Psychotherapy (BACP), which has approximately 44,000 members,[viii] differentiate between counselling and psychotherapy. Indeed, a 2006 Report on this issue from the BACP’s Independent Research Committee concluded that “in practice, counselling and psychotherapy are both generic terms, describing generic activities, with a huge overlap between them” and found that
“there is no science or research base to justify differentiation of counselling and psychotherapy and regulation by these titles.”[ix]
IACP has urged the Government to recognise the clear body of research and practical evidence demonstrating that counselling and psychotherapy should be considered as comparable practices.
Appropriate Level of Qualifications for Future Applicants
IACP is recommending that the appropriate level of qualifications for future applicants for registration be set at Level 8 on the National Framework of Qualifications (corresponding to Level 6 on the European Qualifications Framework). The QQI Awards Standards for Counselling and Psychotherapy 2014 show clear differences between levels 7 and 8. Graduates of Level 7 training, for example, can engage only in “supervised clinical practice with volunteers”; this low level of independence contrasts with Level 8 training, which requires graduates to be capable of engaging in “reflective independent practice” and to “exercise the skills required for managing professional practice.”[x]
Setting the minimum level for registration at Level 8 will establish the level of qualifications for counsellors/psychotherapists on a par with other healthcare professions. It will ensure a clearer accreditation process, higher standards of practice, and ultimately, a safer environment for clients. This minimum standard will also provide a clearer platform upon which to enable the pursuit of further professional development.
Regulation will necessitate a framework for enabling “grand-parenting” qualifications for existing practitioners. Given the wide range of training and education for counsellors/psychotherapists in Ireland during previous decades, IACP is proposing that provisions be made for practitioners who have obtained prior training qualifications that do not meet the new academic standards. To this end, we suggest that existing practitioners, providers of existing training programmes, and current students be given every opportunity to meet the required standard. We also advocate the creation of an appeals process, to be adjudicated by CORU on a case-by-case basis, in order to deal with exceptional cases.
In conclusion, IACP welcomes the process of regulation and we hope that it will consolidate and enhance the contribution of counselling/psychotherapy to emotional wellbeing in Ireland.
[iv] Finnerty, Marcella. 2005. “Counselling and Psychotherapy: A Perspective on Past History, Current Trends, and Possible Future Directions.” Éisteach 3.5: 7-11.
[v] Lambert, Michael J. 2005. “The Efficacy and Effectiveness of Psychotherapy.” In Bergin and Garfield’s Handbook of Psychotherapy and Behaviour Change (6th edition), edited by M.J. Lambert.
[vi] For examples, see: McLeod, John. 2013. An Introduction to Research in Counselling and Psychotherapy; Short, Fay and Phil Thomas. 2015. Core Approaches in Counselling and Psychotherapy.