Counselling for Depression: a response to counselling education in the twenty-first century. Ethical conflicts for a counselling approach operating within a medicalised bureaucratic health service

ABSTRACT

In this article, we consider the ethical issues arising from training counsellors in ‘Counselling for Depression’ in the UK. We describe Counselling for Depression (CfD), a competency-based approach to counselling accredited by the Improving Access to Psychological Therapies (IAPT) agenda in the National Health Service in the UK. We question whether creating a career path for counsellors in the NHS within IAPT compromises the values of the CfD approach and whether the person-centred and experiential approach and the counsellors providing it are able to survive intact. We consider the inherent conflicts within the value bases of CfD and IAPT and discuss how we address these conflicts within the training for CfD. We also describe the ongoing ethical conflicts we live with and what supports us to continue to engage in these conflicts.

KEYWORDS:

• Counselling
• IAPT
• training
• education
• ethics
• values
• conflicts

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Dr Gillian Proctor is a Clinical Psychologist registered with HCPC. Lecturer at Leeds Metropolitan University. Gillian is a member of the BPS and BAPCA. She worked in the NHS for 22 years before taking voluntary redundancy at the end of 2013. During this time, she worked with a wide range of client groups and services, from forensic services to primary care, finishing in an IAPT service. She was responsible for service evaluation and research and for introducing outcome measures to the primary care service in advance of IAPT. As well as providing psychotherapy and clinical supervision, she also developed services, in particular, the Self Injury service, providing medical treatment in primary care. This service won the Health Service Journal prize for primary care innovation and was highly commended by the Secretary of State. Gillian is also a research supervisor and trainer, with a particular love of facilitating encounter groups. She has a particular interest in values and ethics, which is the theme of her latest book, ‘Values and ethics in counselling and psychotherapy’ (Sage, 2014). She loves writing and has published extensively. See www.gillianproctor.co.uk

Catherine Hayes is an assistant professor in counselling, University of Nottingham. Catherine qualified as a person-centred therapist and trained as a trainer with Professor Brian Thorne at the University of East Anglia in 1995. Catherine is a registered accredited member of BACP and has trained in person-centred supervision and has the Counselling for Depression License. She has been a lecturer, tutor and facilitator over the last 20 years and has been working as a person-centred therapist in the voluntary sector for 20 years. Catherine has written articles for Therapy Today and the HPC Journal and contributed to various books including Implausible professions (House and Totton 2nd edition 2012, PCCS Books), The beginners guide counselling and psychotherapy (Stephen Palmer 2nd edition, Sage 2015), Contemporary theory and practice in counseling and psychotherapy (Howard, E. A. Tinsley, Suzanne, H. Lease, & Noelle, S. Giffin Wiersma (Eds.), Sage, 2016). She made a training video ‘The Cost of Integrity’ with Professor Brian Thorne that is widely used by person-centred trainers.