Monday 5 December 2016

Concern over 'extremely dangerous' untrained therapists putting vulnerable clients at risk

Meadhbh McGrath

Published 22/04/2016 | 22:45

Patient during psychoanalysis session
Patient during psychoanalysis session

Counsellors have expressed “huge concern” that untrained therapists are breaking professional boundaries, putting vulnerable clients at risk and could even induce a nervous breakdown.

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Shane Kelly, professional services manager with the Irish Association of Counsellors and Psychotherapists (IACP), warned that people with little training beyond a six-week online course purchased through deal sites like Groupon are advertising themselves as qualified therapists.

“It’s usually a six-week online course in child psychology or eating disorders or something like that. What’s worrying for us is that people think they are now competent and qualified to act as a counsellor and to deal with clients,” he told Independent.ie.

Although such ‘counsellors’ may be working in good faith, Mr Kelly said they could do more harm than good for their clients.

“If a therapist is not qualified and you’re becoming suicidal, for example, they may not spot the signs that they need to address that immediately.

“A client who is slipping into a deep depression or suicidal thoughts may go unsupported.”

He mentioned people suffering with eating disorders as particularly at risk clients, as counselling courses purporting to tackle eating disorders are one of the more popular ones offered online.

“It’s extremely dangerous if you’re not getting the right help. If you’ve got somebody who doesn’t understand how complex it is and doesn’t put in the correct supports you need, that can spiral downwards very quickly. The dangers of these things going wrong are very real.”

In theory, anybody could call themselves a counsellor or psychotherapist without any proper training, qualifications, experience or membership of a professional body, according to Jean Manahan, CEO of the Irish Council for Psychotherapy (ICP).

“The problem is that literally anyone can do a few weekend courses, put a plaque up and set up (as a therapist). It really is most unsatisfactory,” she told Independent.ie.

“It would be surprising as well as highly unethical, not to mention dangerous, if untrained individuals could call themselves GPs, for example. The same applies to the practice of psychotherapy.”

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Trained counsellors and psychotherapists have been advocating for statutory regulation from the Department of Health for many years, worried that vulnerable people may be exposed to unethical and insufficiently trained therapists.

"We have a huge concern. If you are near a breakdown, you need to be contained and supported. If the therapist is not trying to do that, it can become abusive,” said Jose Castilho, psychotherapist and chair of the ICP.

“If you are going to see someone who doesn’t have the skills, it could induce some sort of breakdown and make things worse.”

He added that one of the most frequent problems he hears from clients relates to the breaking of professional boundaries.

“This is the biggest complaint we get, that someone who calls themselves a psychotherapist or a counsellor is saying inappropriate things and breaking those boundaries.

“It’s a very invasive experience for the patient, and it can be re-traumatising, forcing them to relive that pattern of abuse,” he added.

He referred to situations where therapists invited clients to meet outside the consulting room in an “informal, social set-up”, and imposed their own personal views.

“There have been situations of the counsellor or psychotherapist giving their own moral view and making judgements about the person’s life. It’s so out of our scope of practice, it’s almost like taking the role of a priest.”

Mr Kelly explained that a fully trained therapist will have successfully completed an accredited college course, and then carried out 450 hours of supervised client work, before making an application for accreditation by the IACP.

The IACP reviews their members every year, meaning all of their counsellors and psychotherapists must be re-accredited every 12 months.

However, if an applicant is not accepted, or has their accreditation withdrawn, Mr Kelly said there is “absolutely nothing” stopping them from carrying on their work.

All members of professional accrediting bodies such as the IACP or the Irish Association of Humanistic and Integrative Psychotherapists (IAHIP) must sign a code of ethics and practices.

If a therapist violates that code, they can be held to account by the professional body, while unregulated therapists may freely abuse their position and face no consequences whatsoever.

“I’ve had phone calls from people saying they had been to a therapist who did something extremely terrible, but if they’re not a member of the IACP I can do nothing for them,” said Mr Kelly.

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He outlined a number of complaints about unaccredited therapists exploiting their clients by persuading them to give extra money, or to pay up front for a series of sessions they may not need.

“That should never happen. I’ve heard crazy stories where therapists have told their clients they should do their gardens for them as therapy and had them cleaning.

“There's a power dynamic there. People may put trust in a counsellor because they want relief from whatever they’re suffering from, and I’ve heard stories from people who were looking after the therapist’s house while they were on holiday.”

The Irish Council for Psychotherapy and the IACP both advise people looking to speak to a counsellor to ask them about their counselling qualifications or for evidence of their accreditation.

“If someone tells you they are accredited with a professional organisation, ring that organisation and check it. We have seen instances where people said they were involved with our own organisation and they were not,” said Mr Kelly.

In 2005, the Department of Health helped to set up Coru, an organisation dedicated to regulating health and social care professionals.

Although dieticians, dispensing opticians and social workers have been regulated since the organisation was set up, counsellors and psychotherapists have not been included on the list.

A spokesperson for the Department of Health said that a consultation process on the possibility of regulating counsellors and psychotherapists is “now underway”.

The first phase of the process involved commissioning a detailed a report from the Health and Social Care Professionals Council.

The second phase will likely involve broader consultations with various professional bodies and other interested parties before a final decision is reached.

Mr Kelly said the IACP are hopeful that the sector will soon be regulated by the government, and that counselling and psychotherapy will become protected titles.

“When that’s in place, that will put the protection of the public front and centre.”

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