There is a long and intricate dance between the forces of standardisation and dissent and this dance is, I believe, central to the manner in which psychotherapy perceives itself and is perceived; its role in the voluntary, private and public sectors; the manners in which it offers itself to vulnerable people; and the manners in which vulnerable people are used to fulfil the training and accreditation needs of psychotherapists; the targets of the Health Service, the Department of Work and Pensions and central government; and the relationships between government and psychotherapy. It would appear that counselling is uncertain about its own societal status and purpose.. . . the highly peculiar nature of the therapeutic project, whose very essence is typically that of self-interrogation and awareness – but which typically and uncritically takes the pursuit of that very process itself as an unproblematic given . . . therapy can be routinely and intrinsically abusive to the extent that it self-fulfillingly constructs a framework – professionalized therapeutic discourse and practice – which serves to guarantee the legitimacy of their own existence within a discursive regime of truth, and outside the confines of which it can become very difficult for clients and therapists even to think.
In a profession which holds relationship, empathy and positive regard dear discussion around the casual exclusion of people on a low income from being able to enter the profession, and the use of people on low income to facilitate the training and accreditation needs of counsellors is deafening in its silence. This is simply – as always in issues of discrimination – a consequence of the uses and abuses of power. It covers every aspect of the counselling relationship and is not limited to people on low incomes.
The counsellor just couldn’t understand what I’d been through. I spent 6 of the eight sessions just explaining what the religion was about and the way it worked.Underhill 2008
I was given 6 sessions but I only went to two. She couldn’t offer me a time when I could go.Personal conversation
One of the BACP Ethical Framework ‘Values of Counselling and Psychotherapy’ is
I couldn’t go, they didn’t have any childcare.Personal conversation
The ethics and practicalities of ‘fair and adequate provision’ is very patchily covered in the Framework and then only in terms of statutory provision and does not include the practised (rather than expressed) values of individual counsellors, training facilities and placements.Striving for the fair and adequate provision of counselling and psychotherapy services.
One source of information about the performance and behaviour of counsellors is clients, the people most directly affected. A lot of research has been done on clients – what variables affect their continuation in therapy, how their personalities change, compliance in rehabilitation – but I could find very little on what clients actually said rather than what the researcher thought they were saying. Further, psychotherapy publications tend not to focus on the clients experience of the world but on ways of managing the client.
Although there has been a steady interest in the client’s point of view it is still unusual to begin an investigation into the nature of counselling and therapy by looking at the world from the perspective of the client. Traditionally, one starts by describing the theoretical position of the therapist, or one begins by outlining the basis on which the client and her or his difficulties can be explained and treated.Howe 1993:2