Manifesto
Over the past 20 years, counselling and psychotherapy, as provided by the NHS and charities, has been reorganised into an assembly line of formulaic, ‘medical model’ diagnosis and treatment, backed by misleading statistics.
Since 2008, IAPT (the Improving Access to Psychological Therapies service) has monopolised funding for therapy provided in the public and third sectors. IAPT is based on a pseudo-scientific model of ‘evidence-based’ short-term CBT (cognitive behavioural therapy). It is increasingly provided digitally rather than face to face with a therapist.
Most IAPT practitioners share the same ethical and professional values as other counsellors and psychotherapists. However, the dominance and rigidity of the IAPT model and its managerial and political priorities is currently constraining the creative potential of therapeutic relationships for clients and practitioners alike. Both have become cogs in the machinery of the government’s management of the country’s mental health.
For practitioners, the pay and working conditions of counsellors and psychotherapists in the public and charity sectors has been deteriorating for years. Many therapists are currently working for very low pay, long hours, sometimes on part-time, gig-economy contracts. At the same time, many trainee and newly-qualified therapists are working for no pay at all as so-called “volunteers”, a growing army of free labour in a health sector desperately understaffed.
Meanwhile, for people looking for therapy, IAPT offers very little choice – of therapist, therapeutic approach or setting. However, people are different. Behavioural and short-term therapies are not right for everyone. Many would benefit from a therapist who takes one of the many other approaches available in the rich field of counselling and psychotherapy. All of this may help explain why two-thirds of referrals to the IAPT service never complete a course of treatment.
We are campaigning for people to have access to a wide range of counselling and psychotherapy in the NHS, and for it to be available through local community services and charities, as well as in schools and colleges. We want services to respond to the needs of local communities and to be client-led rather than provider prescribed.
We also want therapists to be made available to work with community groups across a range of settings where their skills and experience can facilitate peer-led initiatives in support of mental health. This is because we also respect the capacity individuals and communities have to support each other with the empathy and emotional wisdom of their everyday lives – independently of professional services.
The campaign for universal Access to Counselling and psycho Therapy (uACT) is working for fundamental change in the organisation of support for people experiencing emotional suffering and distress.
We want this support to be organised around the following principles:
- community led, not provider led
- client led, not diagnosis led
- client need, not imposed time frames
- lasting changes, not quick fixes
- client/counsellor relationships, not manuals or websites
- listening to clients, not telling them
- life changes, not short-term goals
- emotional depth, not positive thinking
- understanding people, not collecting statistics
- benefit for clients, not benefit for service funding
- relational approach to assessing progress, not tick-box number crunching
uACT 
This is a good idea, I hope people will sign up and say something about what is happening in their neighbourhood.
Thanks for the support and encouragement, Janet
Dear Paul (I think?) and anyone,
I wonder if this may link with the PROCAPA idea I initiated on facebook, looking at regulation or professionalisation in the UK based on a core relational model for all counselling/psychotherapy.
Mark Harrison
(This may have already appeared due to my struggling with wordpress)
Thanks for this Mark. The PROCAPA project looks really interesting. Can we have an email exchange or call to give me a better idea of your thinking? I’ll mail you. Paul
I look forward to discussion.
I think that GPs should be free to choose who to refer to too. They must often feel that their patients don’t get the right psychological care but can’t do anything about it.
Definitely agree, Helen
This is an excellent and necessary change in direction for counselling and psychotherapy. I wholeheartedly support this life changing and life saving approach. In my view meaningful work cannot be achieved in the space of a few sessions, it has to be client led with a collaborative aspect.
I am really glad to see this campaign, having previously worked in an IAPT service. But how is it going to be possible to achieve this change within the NHS, as the new NHS Bill is likely to lead to further reductions in mental health services: https://www.youtube.com/watch?v=GJdZDorj5s4
You’re right Sue, it is not going to be easy to change the current situation at all. So it is a political campaign, hopefully working with KONP and other NHS campaigns to respond to what is happening and argue for what should be happening. There will be no magic! But taking a stand for what people need will hopefully keep us going in relatively dark times.
I am in total agreement of all that has fore mentioned. I am also frustrated in that every therapy job is monopolised by BACAP membership. We are all very diverse therapists in this global community yet have to be funnelled into a slot. I trained for 20 years got my Bsc and MSc in counselling and psychology in the USA but yet this is still not deemed good enough. Many countries are licensed and regulated. But here jobs I am overqualified for I can’t apply for because of the “ foreign” university( quote) I studied in. I know many who have been in this situation. With such a huge need accessible therapist things need to change in this country. One shoe does not fit all
Dear Paul,
This is a great initiative!
Perhaps it could help to compare the service offered in the UK to other countries? For example, in Germany, the public health system offers anything between 12 to 300 hours of paid therapy support with a therapist of the client’s choice.
With best regards,
Anja
This is a fantastic campaign and idea. I completely adhere to it.
It’s another really important, no, essential campaign. I’m at the tail end of my journey as a psychotherapist and counsellor but agree with the aims, purpose and necessity for this after some pretty dark years. I don’t have loads of energy and time to put in but I’ll be there on Saturday.