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Introduction to Counselling
and Psychotherapy: From
Theory to Practice
1.1 INTRODUCTION
CHAPTER OVERVIEW Counselling and psychotherapy, following their initial emergence, have moved from the periphery into the mainstream. This chapter considers key definitions of counselling and psychotherapy and outlines the debate on the relationship (in terms of differences and similarities) between the two. In addition, the position of counselling and psychotherapy within wider helping professional roles is explored. The chapter also offers an outline of the overall structure of the book.
So much change in so little time
It is difficult to imagine when thinking of counselling and psychotherapy in today’s context that, not too long ago, it was quite different. The proliferation of therapy across a range of settings and the subsequent embedding of therapy as viable choices for proportions of the population would be almost unheard of just a few decades ago. Indeed, I recall clearly in the mid- to late 1980s when I began my training that finding placements proved to be a significant challenge. Not, as is
2 An Introduction to Counselling and Psychotherapy the case today, because of the number of people chasing the same opportunities, but rather because it was difficult to find counselling and psychotherapy in many settings at all outside of independent practice or specialist environments. Therapy in primary and secondary care was very limited, with opportunities existing mostly in the third sector. A number of factors have led to change in the intervening years. They include: work by a number of professional bodies to communicate the benefits of coun- selling and psychotherapy; increasing acknowledgement of the importance of mental health and the link between mental and physical wellbeing; a slow move away from a medication culture, with a population more willing perhaps to question the treatment they receive; an increasing evidence base demonstrating the efficacy of the psychological therapies across a range of difficulties; a challenge (led by mental health charities) to the stigma of mental health distress and the promotion of help-seeking; a higher profile of counselling and psychotherapy in the media; and a change in policy, particularly around mental health, towards a greater involvement of service users and the increasing potency of the client/ patient voice. When I qualified as a social worker and began working in adult mental health secondary care settings, psychiatry was still a very dominant force: the psychiatrist was rarely questioned and intervention for people experiencing acute and chronic mental health distress typically consisted of medication or in- and out-patient care. Over the intervening years the dominance of psychiatry has waned: the psychia- trist remains an important figure, but one who is now part of a mental health team. Nursing, social work, advocacy and psychology have become more prominent and hospital admission is seen very much as a last alternative. Advances in medication have given medical personnel greater treatment options and people experiencing dif- ficulties have demanded alternatives to medication and hospitalisation. Counselling and psychotherapy have increasingly come to be seen as a viable and beneficial alter- native or addition to other forms of support. Therapy has moved from the periphery into the mainstream. In the process, it has further embedded itself into mainstream culture, such as in films, music, literature, art and television and, in doing so, has entered the public consciousness. This change has brought challenges. Counsellors and psychotherapists need to be equipped by their training to work in a wider variety of contexts and to acquire skills and knowledge to meet a wide range of presenting issues. Each working context demands its own level of competence, with therapists trained on generic courses needing to undertake further training to equip them for their role. With this proliferation too comes the need to ensure that practice remains ethically and legally pertinent, offering high levels of care and integrity to those accessing help. With a greater demand for innovative and effective treatments comes a necessity to demonstrate efficacy in the face of falling budgets and closing services. Counsellors and psychotherapists need to develop competency as researcher-practitioners, or at
4 An Introduction to Counselling and Psychotherapy
The book as a whole: what’s in store
Here I want to offer a pen picture of each chapter so you can quickly see how the book is structured, ‘signposting’ you to sections most relevant for your stage on the journey into practice. The book is structured over three parts: Setting the Context (in which we will look at training, theories, settings, law and ethics); The Therapeu- tic Relationship (in which we will consider the types of problems we may work with in sessions with clients and the management of the therapeutic relationship); and The Professional Self (in which we will consider key aspects of, and beyond, contact with clients that help determine accountable and professional practice). Chapter 1: Introduction to Counselling and Psychotherapy Well, you’re here already! This first chapter outlines definitions of counselling and psychotherapy and how they are different and similar (and, trust me, that is no easy task!), before moving on to an overview of their development.The process of tracing this emergence provides a helpful overview in locating today’s practice in a wider historical context. It is important to view the current situation in the context of its history and development – the past so often helps us make sense of the present.
Part One: Setting the Context
Chapter 2: Becoming a Counsellor or Psychotherapist: The Training Journey The next chapter examines all the factors that inform, shape, support and chal- lenge the process of becoming a counsellor or psychotherapist, starting right at the very beginning of training. While it is, without doubt, a fascinating and life- changing process, it can also bring difficult challenges that you need to consider before you begin. Likewise, knowing what sort of training you are looking for, the context you might wish to work in when you qualify, as well as the multitude of practical considerations, all require commensurate thought. Chapter 3: Principal Counselling and Psychotherapy Approaches and Skills Here I provide an overview of the main theories and models that inform contem- porary counselling and psychotherapy. The chapter does not seek to provide an exhaustive list (given the estimated 450 models of therapy available!): instead, it focuses on the key models and provides a checklist for each of the principal ideas and philosophical assumptions. Models include cognitive-behavioural approaches, the psychodynamic approaches, as well as the humanistic models. Additionally, the chapter considers current developments in counselling and psychotherapy thinking, including the emergence of models such as mindfulness-based cognitive-behavioural therapy and working pluralistically.
Chapter 1 From Theory to Practice 5 Chapter 4: Professional Settings and Organisations The sheer scope of working contexts and settings in which counselling and psy- chotherapy are found can be overwhelming. This chapter considers why and how the setting in which counselling and psychotherapy take place is so important in shaping the form and nature of the therapy on offer, as well as how counselling and psychotherapy ‘sit’ within a procedural and political frame and the importance of your having an understanding of the policies that have particular influence on their setting and practice, including independent practice. Chapter 5: Law, Policy, Values and Ethics Counselling and psychotherapy operate within a legal framework and are informed by policy, yet are fundamentally rooted in strong values and ethics. This chapter looks at how law and policy define what we do, but also how our values and ethics as counsellors and psychotherapists shape and structure our thinking and approach to practice. Here we will consider how the soul of the therapeutic relationship is enlivened by our core beliefs.
Part Two: The Therapeutic Relationship
Chapter 6: Clients and Presenting Issues Clients present with a wide range of problems in counselling and psychotherapy, from struggles with worry and wellbeing, through to complex and long-standing mental health problems. Some clients will have a formal diagnosis of mental health distress, while others will not. Before we can critically reflect on diagnostic struc- tures and labels (or reject them) we need to understand how they work so that we can see problems in context. The problems explored in greater detail will include: anxiety and panic attacks; depression; post-traumatic stress; eating disorders; loss and bereavement; suicide and self-harm; sexual problems; psychosis; and personal- ity disorders. Chapter 7: Managing Aspects of the Therapeutic Relationship Counselling and psychotherapy are about beginning, structuring, contracting, maintaining and ending, and managing all aspects in between; the therapeutic pro- cess begins before the client ever enters the room. Here we will outline and explore all these factors so that you can support your learning and offer your clients a safe, respectful and appropriate space for them to explore their difficulties. Chapter 8: Challenges in the Therapeutic Relationship There are a number of important areas integral to the therapeutic process that can also present particular challenges to it, including: transference and countertransference;
Chapter 1 From Theory to Practice 7 critically evaluating research, as well as theories and ideas that might help us take the first steps to becoming researchers. Chapter 13: Endings and the Next Steps Like all journeys, this one has an ending.This chapter will aim to prompt reflection to help you consider the process you have been through and look forward to what may be next. When we finish our training we step out into the world as qualified practitioners and are tasked with making important decisions about our personal and professional future.The journey from placement to practice is the point at which theory becomes alive, specula- tions become reality and the immense satisfaction that can be gained in meeting with another to help them find their way through difficulty and disturbance becomes realised. I hope that you enjoy your journey as much as I am enjoying mine and that you will find this book of benefit to you along the way. On the companion website I have made a short video talking through the structure of the book, which you may want to watch. So, let’s begin ... 1.2 DEFINING COUNSELLING AND PSYCHOTHERAPY SECTION OUTLINE There is much debate over the differences and similarities between ‘counselling’ and ‘psychotherapy’ and this has vexed theorists, academics, practitioners and researchers for some considerable time. This section explores the question of whether counselling and psychotherapy are discrete disciplines or, in contrast, whether the overlap is sufficient to render distinction irrelevant. There are always challenges in trying to define ‘counselling’ and ‘psychotherapy’ as it inevitably and immediately leads into contentious territory about simi- larities and differences. If one writes about ‘counselling’, the risk is that those psychotherapists who see their role as different from counselling will disengage. Likewise, writing about ‘psychotherapy’ runs the risk of leaving a proportion of counsellors out in the cold.To write about ‘counselling and psychotherapy’, how- ever, runs the risk of presuming they are two, distinct activities, while to use ‘psychological therapies’ as a ‘catch-all’ phrase runs the risk of leaving everyone out in the cold. These dilemmas present problems not only for textbook authors: imagine the implications for delivery of services, regulation and accreditation, training and, most importantly, the confusion potential clients might experience when considering
8 An Introduction to Counselling and Psychotherapy what services to access. Should they see a counsellor or a psychotherapist, and (they may ask) what’s the difference between the two anyway? Kanellakis and D’Aubyn (2010) undertook a study of the public’s perception of the titles of counsellor and psychotherapist. Four hundred and fifty members of the UK public were interviewed by researchers and asked their thoughts about the terms ‘counsellor’,‘psychotherapist’ and ‘psychological therapist’: 30% thought the terms ‘counsellor’ and ‘psychotherapist’ were almost identical, while 64% thought them significantly different. Only 24% thought the terms ‘psychotherapist’ and ‘psycho- logical therapist’ were significantly different, while 66% thought them almost identical. In this study the public’s perception was that ‘psychotherapist’ was much closer to ‘psychological therapist’ than to ‘counsellor’. Perhaps there is as much con- fusion in the public perception as there is within the professional field between the different terms.
Definitions
The British Association for Counselling and Psychotherapy (BACP, 2012) defines counselling and psychotherapy as: umbrella terms that cover a range of talking therapies. They are delivered by trained practitioners who work with people over a short or long term to help them bring about effective change or enhance their wellbeing. The American Counseling Association (ACA, 2005, p. 4) says that counselling encourage[s] client growth and development in ways that foster the interest and welfare of clients and promote formation of healthy relationships. Coun- selors actively attempt to understand the diverse cultural backgrounds of the clients they serve. Counselors also explore their own cultural identities and how these affect their values and beliefs about the counseling process. Feltham (2012, p. 3) says of counselling and psychotherapy that they are: mainly, though not exclusively, listening-and-talking based methods of addressing psychological and psychosomatic problems and change, including deep and pro- longed human suffering, situational dilemmas, crises and developmental needs, and aspirations towards the realisation of human potential. In contrast to bio- medical approaches, the psychological therapies operate largely without medica- tion or other physical interventions and may be concerned not only with mental health but with spiritual, philosophical, social and other aspects of living. Profes- sional forms of counselling and psychotherapy are based on formal training which encompasses attention to pertinent theory, clinical and/or micro-skills develop- ment, the personal development/theory of the trainee, and supervised practice.
10 An Introduction to Counselling and Psychotherapy
The nature of the activity: medical or social?
The Oxford English Dictionary (OED, 2012) states that counselling is ‘the provision of professional assistance and guidance in resolving personal or psychological prob- lems’, while psychotherapy is ‘the treatment of mental disorder by psychological rather than medical means’. Even though they are the simplest, perhaps the OED definitions are also the most helpful in beginning to tease out some of the points of differentiation that some claim to exist between counselling and psychotherapy.The emphasis placed on counselling is that of offering assistance and guidance in an attempt to resolve problems. The emphasis in psychotherapy is on the treatment of mental disorder without using medical means. Here we see an implication that counselling assists and guides, while psychotherapy treats. Also, the use of the term ‘medical’ in the psychotherapy definition strikes at the heart of a philosophical dif- ferentiation, according to commentators who claim that psychotherapy is more allied to medicine, while counselling is more allied to a psychosocial model of help. However, the suggestion that psychotherapy is more akin to a medical model, while counselling is more akin to a social model, does not resolve the problem of differentiation. For example, person-centred therapy has been a predominant model of choice for training for several years in the UK. Rejecting a medicalising or pathologising view of the human condition, this approach is based instead on a philosophical standpoint of equality, acceptance, and empathy. In most modalities the therapist does not take the ‘expert’ role and certainly does not explicitly intend to offer a ‘treatment’.Yet it is possible to train either as a person-centred counsellor or a person-centred psychotherapist. Both retain their non-medical position yet use different titles. Some argue this anomaly strengthens the view that there is more commonality than difference between counselling and psychotherapy. Counselling and Psychotherapy in Scotland (COSCA, 2011a), Scotland’s coun- selling and psychotherapy professional body, additionally suggest that differentiation might be found in the traditions of each discipline, with psychotherapy developing with the emergence of psychoanalysis in the 1920s, while counselling developed somewhat later, in the 1950s.
Duration of intervention: short or long term
Another point of differentiation often made is that counselling typically offers shorter-term or brief interventions, while psychotherapy offers longer-term inter- ventions. Psychotherapy has often been linked with longer-term approaches, and while this may be true historically, over recent years, and with funding restrictions hitting therapy services hard, many therapy providers now offer time-limited interventions, delivered by both counsellors and psychotherapists. Likewise, there are agencies who offer longer-term counselling and, in independent practice where practitioners are freely able to determine their own length of contract, open-ended
Chapter 1 From Theory to Practice 11 or longer-term work is offered by both counsellors and psychotherapists. The dis- tinction between the length of contract offered as a means of differentiating between the two titles is less pertinent in today’s financially demanding world.
Depth of intervention
According to McLeod, some have argued that ‘although there is a certain amount of overlap between the theories and methods of counsellors and psychotherapists, and the types of clients they see, there is nevertheless a fundamental difference between the two, with psychotherapy representing a deeper, more fundamental level of work over a longer period, usually with more disturbed clients’ (McLeod, 2009, p. 10). Psychoanalysis is probably the first approach that comes to mind when people think about psychotherapy. The stereotype of a couch, the therapist (very probably with a goatee beard and an Austrian accent) sitting out of sight encouraging free association and interpreting the results represents many people’s image of ‘in-depth’ therapy. Certainly in my own setting new clients often comment on the fact that I don’t have a couch (or an Austrian accent) with a mixture of relief and disappointment. Of course, the premise of this approach is not just a stereotype: psychoanalytic therapy is alive and well – albeit out of the reach of many clients given its long-term nature (typically it lasts many years), frequency (typically several sessions per week) and cost. Beyond psychoanalysis, however, the depth and extent of work offered by psy- chotherapists becomes harder to differentiate from that of counsellors. Again in my own setting (namely, higher education), I work in a team, some members of which are trained as psychotherapists, and others as counsellors. The nature of the work is the same: the complexity of work is not differentiated between the two titles and the extent of work (i.e., the duration and frequency) is identical too. In super- vising across a range of contexts over the years, including primary and secondary care settings, education, third-sector and independent practice, this seems generally true. However, there are settings where the desired qualification is in psycho- therapy rather than counselling. These tend to be specialist settings, such as thera- peutic communities for people with personality disorders, or eating disorders. Interestingly, the commonality between such settings where psychotherapy is preferred is that they are often allied to a medical intervention, such as psychiatry. Related to this, some psychiatrists will undertake additional therapy training and will describe themselves as consultant psychiatrist psychotherapists. I have yet to come across a consultant psychiatrist counsellor (though they may exist).
Training
Perhaps the clearest point of distinction between counsellor and psychotherapist has been the structure of training. Although in the UK therapy training is in a process
Chapter 1 From Theory to Practice 13 the same activity; UKCP see a distinction between them. Spinelli (2006, p. 38) states: ‘Some have suggested that the main distinction between psychotherapy and counselling is that while the former requires clients to recline on a couch, the latter only provides an armchair.’ For each of the points outlined above, there will be several different perspectives.This has implications for clients, who have to make important decisions when seeking help. For my own view, while I acknowledge differences in the structure and provision (and cost) of training, over the 20 years (plus) that I have been practising I have always worked with practitioners who, regardless of their title, have essentially undertaken the same work. I would define myself as a counsellor in virtue of my training, which was a ‘counsellor’ training. The title for me is defined simply by what my certificate says, rather than any substantive difference between what I do and the role of my psychotherapist colleagues. Returning to my earlier authorial dilemma, for the purposes of this text I will use a variety of terms. Essentially I will refer to ‘counsellors and psychotherapists’ and ‘counselling and psychotherapy’ to acknowledge that, regardless of the actuality of the situation, people define themselves using these terms. I will also use terms like ‘therapy’, ‘therapist’ and ‘practitioner’ for example, simply to facilitate the flow of text – there is no other intent behind the use of these terms! DISCUSSION QUESTIONS 1 How would you define counselling? 2 How would you define psychotherapy? 3 What do you consider to be the key similarities and differences between counselling and psychotherapy? 4 In what ways do you feel current debates around counselling and psychotherapy (a) help inform the development of the profession and (b) hinder it? 1.3 THE EMERGENCE OF COUNSELLING AND PSYCHOTHERAPY AS DISCIPLINES SECTION OUTLINE It is best to understand the nature and scope of counselling and psychotherapy as practised today by placing them within the context of their history. The historical development of counselling and psychotherapy has influenced the shape of current theories and ideas, as well as the contexts in which they operate. This section outlines key milestones of that development and provides the historical background required to contextualise counselling and psychotherapy in general and the particular facets of practice considered elsewhere in this book.
14 An Introduction to Counselling and Psychotherapy When we begin therapy with a new client it is important that, at some stage of the therapeutic process, we find out a little bit more about who they are, their context and where they have come from. Some modalities emphasise the impor- tance of this more than others. Some therapists take very specific steps in taking a client history, while others allow the information to emerge during the course of therapy. However, there would be fewer therapists who would maintain that his- tory isn’t important at all. The more we can understand about the background to something, the more we are able to see its current presentation in a more informed context. For the same reason, it would be unhelpful to launch into the other sections of this book without taking a moment to consider how counselling and psycho- therapy came into being. Certainly, in my own work as a therapist I have, over a relatively short period of time (20 years), seen major changes. The proliferation of counselling and psychotherapy as it is practised today is very different to when I first came into the profession.When I speak with colleagues who have been work- ing as therapists for longer than me, they report the same phenomenon. So, while it is perfectly possible to become a counsellor or psychotherapist without any understanding or insight into the history of our profession, it would be a bit like working with a client while having no knowledge or interest in anything about them beyond their immediate presentation; this option, though possible, is limited. Many people assume that Sigmund Freud was the ‘founder’ of modern-day psychotherapy. While certainly his influence has been profound, and many of our current working practices can be traced back to his work, psychotherapy as an activity certainly existed before Freud began writing. It may be impossible to truly locate the origins of talking therapy given that the human propensity to communi- cate and be in relationships goes back many, many centuries.The process of counsel- ling and psychotherapy, albeit not in a form that we might understand today, can be traced back to early religious and community rituals. In many ways we might argue that what we now call counselling and psychotherapy is merely a systematic form and type of communication with a specific purpose. One could, in addition, argue that all that has happened over the past 100 years, coinciding with the emergence and development of professions such as psychiatry and medicine, has been the application of scientific principles to the human art of discourse.
Medicalisation of distress
The way in which distress has been viewed has changed over the centuries. Ancient Greek and Roman perspectives on mental illness generally looked at causation, and cure, as both coming from the gods. During the 5th and 6th centuries BC the link between madness and the gods was challenged, partly informed by the work of Hippocrates. In the 4th century a tentative relationship between madness with
16 An Introduction to Counselling and Psychotherapy during normal waking consciousness. In other words, the notion of the “uncon- scious” mind was part of the apparatus of 19th-century hypnotism.’ Freud, a psychiatrist working in the late 19th and early 20th centuries, began to move away from models of psychiatry and hypnosis predominant at the time and looked to develop a new approach to treatment. By developing psychoanalysis, Freud had a profound influence on the subsequent development of psychother- apy. Early analysis relied on the interpretation of dreams and the use of free association. Freud wrote about his experiences with patients extensively and these works are still read and have influence today (Freud, 2004, 2009, 2010). We should make reference too to some of Freud’s collaborators who worked with him early on, but later split away to further develop their own ideas. Most notable of these were Carl Jung and also Alfred Adler, Sandor Ferenczi and Otto Rank. They con- tinued to develop theories and ideas set within a psychodynamic tradition.
A shift in emphasis: the emergence of the ‘person’
The work of Carl Rogers from the 1940s and 1950s onwards marked a dramatic shift in the progression of the talking therapies. Until this point, psychotherapy had been developed primarily by psychiatrists and psychologists and, while moving in different directions, retained an important ‘nod’ towards medicine. Rogers began developing client-centred therapy, drawing more on the existence and use of human qualities than scientific principles. It was his assertion that, given the right conditions, each individual had the propensity to move towards health.These conditions included acceptance, empathy and warmth. There was a philosophical shift away from con- ceptualising the therapist as expert and towards therapy as a collaborative process between the therapist and client. The early influences on Rogers came from religion, but as he began his training to become a minister he decided instead to study psychology. His interest first centred on work with children and in 1939 he wrote The Clinical Treatment of the Problem Child. Then in 1942 he wrote Counseling and Psychotherapy , where he first proposed the ideas of client-centred therapy. The development of counselling and psychotherapy was not informed only by the work of individuals, but also by the emergence of the institution of therapy. Table 1.1 outlines how the professionalism of counselling and psychotherapy was inextricably linked with the development of therapy institutions, together with other key events. For example, the early 1900s, around the time of Freud’s early influence, saw the establishment of several key psychoanalytic organisations, such as the International Psychoanalytical Association in 1910 and the Institute of Psycho-analysis in 1919. Likewise, the emergence of client-centred therapy and the writing of Rogers in the late 1940s and early 1950s coincided with the development
Chapter 1 From Theory to Practice 17 of counselling organisations drawing on humanistic principles. While the writing of key theorists and practitioners is often associated with the development of coun- selling and psychotherapy, the emergence of the profession is also located in the development of its organisation and institution.
Key historical developments
Table 1.1, extracted from Feltham and Horton’s Handbook of Counselling and Psycho- therapy (2012), outlines the key historical developments in counselling and psycho- therapy from 1900 to the present day. In summary, while early development was dominated by psychodynamic and psychoanalytic therapy, the emergence of humanistic approaches from the 1940s began to dramatically change the nature and shape of counselling and psycho- therapy. Up until 1938, organisations had predominantly centred on psychoa- nalysis. The National Marriage Guidance Council marked the first instance of a non-psychoanalytic therapy organisation and also the development of a relation- ship between counselling and the voluntary sector. If psychotherapy was born out of medicine, counselling was perhaps born out of the voluntary movement and education. From the 1950s, with the establishment of the Samaritans and then later CRUSE, a bereavement charity, humanistic approaches became more prominent and the development of theory and practice grew apace.The British Association for Counselling (now the British Association for Counselling and Psychotherapy – BACP) was established in 1977. It is illustrative of the growth of counselling as a professional activity that BACP is now the second largest counselling organisation in the world, with membership of approximately 40,000.
Contemporary counselling and psychotherapy practice
As we have seen, there has been much debate over the similarities and differences between counselling and psychotherapy. A number of issues have been highlighted and, despite the best efforts of theorists and practitioners, there remains little con- sensus on the matter. Without historical context, it is hard to understand why such debates fuel passion and divergence. However, when viewed through a historical lens this becomes easier to understand: while there have been many commonalities over the years, essentially the disciplines were born from two different traditions. Perhaps the debate has provoked such passion because counselling and psychotherapy ‘speak’ of very different ways of viewing the world and human experience. Indeed, much of the discussion around the difference between counselling and psychotherapy centres on whether human distress is located within a medical frame. Whatever the philosophical
Chapter 1 From Theory to Practice 19 Year Birth/growth of institutions and professional organisations Significant events Appearance of schools (approximate dates) 1959 Cruse Scottish Pastoral Association 1960 First fee-charging counsellor in private practice in UK Death of Melanie Klein 1961 Death of Jung J.D. Frank’s Persuasion and Healing 1962 Cognitive therapy 1965 Halmos’s The Faith of the Counsellors 1966 Counselling training at Universities of Reading and Keele 1969 Westminster Pastoral Foundation Association of Humanistic Psychology (USA 1962, UK 1969) 1970 First Standing Conference for the Advancement of Counselling (annual) Death of Perls and Berne Primal therapy MPA becomes Royal College of Psychiatrists 1971 Foster Report on Scientology 1975 National Association of Young People’s Counselling and Advisory Services (later Youth Access) Neuro-linguistic programming 1977 British Association for Counselling (BAC) 1978 Sieghart Report on statutory regulation of psychotherapists 1980 Association of Humanistic Psychology Practitioners (AHPP) Smith et al. The Benefits of Psychotherapy 1982 Rugby Psychotherapy Conference (set up by BAC) 1983 Society for the Exploration of Psychotherapy Integration (SEPI) First BAC accreditation scheme Solution-focused therapy 1987 Death of Carl Rogers 1989 United Kingdom Standing Conference on Psychotherapy (UKSCP) 1990 Death of Bowlby Cognitive analytic therapy 1991 British Confederation of Psychotherapists 1992 European Association for Counselling BPS Charter of Counselling Psychologists First UK Chair of Counselling (Windy Dryden) 1993 United Kingdom Council for Psychotherapy (UKCP, originally UKSCP): advice, guidance, counselling and psychotherapy lead body 1994 Independent Practitioners’ Network BPS Division of Counselling Psychology UKCP Register of Psychotherapists 1995 BCP Register NHS Psychotherapy Services in England Review (Continued)
20 An Introduction to Counselling and Psychotherapy Year Birth/growth of institutions and professional organisations Significant events Appearance of schools (approximate dates) 1996 United Kingdom Register of Counsellors (UKRC) (individuals) NHS Psychotherapy Services in England, Department of Health (DoH) Strategic Policy Review World Council for Psychotherapy Data Protection Act 1998 Association of Counsellors and Psychotherapists in Primary Care (CPC) CORE introduced UKRC (organizations) 1999 National Institute for Health and Clinical Excellence (NICE) 2000 BAC renamed British Association for Counselling and Psychotherapy (BACP) BACP’s Ethical Framework for Good Practice in Counselling and Psychotherapy Universities Psychotherapy Association (UPA) adds ‘Counselling’ to its title, becoming UPCA 2001 Lord Alderdice’s Psychotherapy Bill Treatment Choice in Psychological Therapies and Counselling: Evidence-Based Clinical Practice Guidelines (DoH) BACP’s Guidelines for Online Counselling and Psychotherapy 2002 Health Professions Council (HPC) is identified as the regulatory body for all health professions, including counselling and psychotherapy (‘talking therapies’) 2003 UKCP establishes its Psychotherapeutic Counselling Section BACP Service Accreditation Scheme Telephone counselling (contractual) is accepted by BACP for accreditation hours 2004 College of Psychoanalysts Graduate mental health workers in primary care British Psychoanalytic Council British Confederation of Psychotherapists (BCP) renamed British Psychoanalytic Council (BPC) 2006 Improving Access to Psychological Therapies 2007 Death of Albert Ellis 2008 BACP represented on HPC’s Professional Liaison Group 2009 HPC Register for Applied Psychologists opened 2011 Statutory regulation plans abandoned Reproduced with permission from C. Feltham and I. Horton (eds) (2012) The SAGE Handbook of Counselling and Psychotherapy , 3rd edition. London: Sage. TABLE 1.1 (Continued)
