Status, Ethics, Consent

 The abuse of politically vulnerable groups by mental health professionals has a long and shameful history. Whether it’s single mothers being subjected to electro convulsive therapy, ‘protest psychosis’, the incarceration of political dissenters or the Martha Mitchell Effect, each individual professional involved in this scapegoating is ultimately paid by and works for the government of their time. The BACP professes to be concerned with an ethical approach to practice but that doesn’t seem hold true when ‘opportunities for counsellors’ are at stake.

In April 2015 442 counsellors, psychotherapists and academics put their names to a letter published in the Guardian calling for our professional organisations to act against the ‘Fit to Work’ programme which linked receipt of benefit to ‘state therapy’: 

“Get to work therapy’ is manifestly not therapy at all. With the ominous news that Maximus (the US company replacing Atos to do work capability assessments) will also be managing the new national Fit for Work programme, it is time for the field’s key professional organisations to wake up to these malign developments, and unequivocally denounce such so-called ‘therapy’ as damaging and professionally unethical.” https://www.theguardian.com/society/2015/apr/17/austerity-and-a-malign-benefits-regime-are-profoundly-damaging-mental-health 

Some of the signatories, like Susie Orbach, were household names. Some, like Andrew Samuels and Ian Parker were presidents of high-status professional bodies. Some were professors based at the Tavistock and red brick universities, others were very well known and respected professors within our professions, some were admired academic authors. Perhaps it was this status-led criticism rather than years of objections from ordinary therapists that finally got through to BACP and UKCP.  Within three months BACP had curbed its enthusiasm about the ‘huge opportunities’ for counsellors to work with the DWP. 

To return to the subject of consent, 

Therapy Today published a piece wondering if it was ethical for counsellors and psychotherapy to participate in Workfare:

“In their 2015 election manifesto the Conservative Party said that claimants who ‘refuse a recommended treatment’ may risk having their benefits reduced. The pre-election budget allocated funds to place IAPT therapists in 350 Jobcentres throughout England; the possibility that claimants may be required to attend a course of CBT treatment to improve their ‘employability’ or risk losing benefits has become very real.” https://www.bacp.co.uk/bacp-journals/therapy-today/2015/july-2015/should-counsellors-work-with-workfare/ 

BACP, BPS and UKCP offered ethical guidance:

 “Individual psychologists will have to make their own decisions about working in this way, bearing in mind that so many professional bodies, including the BPS, have made it clear that it is ethical to offer people therapy only in the context of a free and informed choice.”

 “The principle of autonomy opposes the manipulation of clients against their will, even for beneficial social ends,” and BACP members should “seek freely given and adequately informed consent” from clients.

“Therapists involved in such work may wish to bear the ethical dimensions in mind.”

It's worth noticing that 'even for beneficial social ends' in this context can only be assumed to mean that employment is a beneficial social end, even after many centuries of evidence of many kinds of employment having very dubious social ends. 

As long as counsellors and psychotherapists might wish to bear some ethical dimensions in mind they had the blessing of their professional membership bodies to work with people who had been given the choice to meet a therapist or be sanctioned and become destitute - not poor, destitute. 

That this was not blindingly obvious to BACP and UKCP 'experts' in ethics is yet more depressing testament to the bias, lack of experience and naivety that are the foundations, the bricks and mortar of our professions.