Westacott, M., 2010. Letter from the Chair of ACAT. Reformulation, Winter, pp.3-5.
This letter is my last one as your chair. Unbelievably it has been three years since I took over from Mary Dunn and at the next AGM in April my term will have come to an end. It has been quite a journey in many ways and one that I could not have embarked on without the support and encouragement of so many wonderful and inspiring people. Rather than reflect on the past few years though I would rather use this letter to look ahead to try and anticipate what challenges and opportunities might lay ahead for the organisation, particularly as we still seem to be in the midst of rapid political and economic change.
I want to start with CAT training. At this point in time our training courses are in very good health despite ongoing threats from government cuts to funding and a government-backed emphasis on brief technique-based interventions such as IAPT. Part of our current strength is that all of our courses are university accredited and now lead to a joint academic /clinical award. To get to this position has required a great deal of work from many people over a number of years. It is something we should hold on to and develop and hold in check urges to go back to our old position, which can sometimes appear seductively free and independent. Although there are many other therapy organisations who do not have academic accreditation, and indeed some who shun the very word “academic”, the NHS is increasingly restricting its funding of courses to those that lead to an academic award and are thus subject to the quality control processes intrinsic to university accreditation. This is a strong argument for ensuring we maintain our relationship with the university, in addition to the more obvious ones of improved parity of standards across courses, better moderation, and hopefully more satisfied trainees. There is also a further advantage, and this will become clearer with the advent of statutory regulation of our training courses in a few years time. The process of getting our courses approved by the HPC, and maintaining this rating, will now be much more straightforward having gone through the university validation process. It could also mean that we will be less subject to additional quality assurance processes that might be organised by the HPC and have yet to be determined. The ACAT Training Committee will soon need to begin looking at the specific details of HPC course validation process although, as I said, we have done most of the work already for the university and are in a strong position. ACAT as an organisation has also been preparing itself for statutory regulation over the past year, which is why we have recently introduced new policies such as on CPD, Working with Children and Vulnerable Adults and Equality and Diversity. The only area which we still need to review is the ACAT Complaints Procedure which will be looked at by the HPC and may need updating by us beforehand.
The international group, ICATA, is currently working on international standards for training and also on creative ways of delivering CAT training in remote parts of the world. The group recently met in Poland and the success of ICATA is owed to the international group of people, led by Steve Potter, who have taken this vision forward and given CAT a firm international identity beyond the shores of the UK. The development of training courses in the UK needs to be planned in cooperation with ICATA, but as a partnership from which we can both benefit. One development that has already arisen from these discussions is the proposal that we have a modular structure to our training courses so that overlap and repetition can be avoided, as people move from skills to practitioner to psychotherapist or consultant levels of training and trainees can be given credit for previous training. I have recently met trainees who have told me there is too much repetition between their skills levels training and the practitioner one and asked why the earlier course could not in some way count towards the latter, so a new structure would make sense. The move to a modular structure will not be straightforward though, as there will be a number of issues that must be grappled with, such as cohort cohesion, but I think it is a move in the right direction. In addition to the usual route through the psychotherapy course there would be other routes to developing one’s CAT career, such as through the CAT MSc by research, CAT Supervisor training and perhaps accreditation in CAT Organisational Consultancy and even CAT Coaching.
Thinking about training and how long it can seem to get qualified brings me to the current economic situation. Already in ACAT we have started to anticipate reductions in funding in the NHS and the likely impact of this on us. I have been aware recently of other organisations, notably the UKCP, having to cancel conferences, and some CAT courses reporting more trainees self-funding or trainees not being able to accept offered places because of funding being withdrawn. This is a real threat to us, but one that I think we can adapt to if necessary. There are some things ACAT can do to help, such as keeping membership, training and conference costs as low as possible, scaling back our organisational activities as needed, and moving to the modular training structure which should be more cost-effective for people. We will need to keep a close eye on this as the economic forecast for next year remains uncertain. At the moment things look positive for us, so I don’t want you to feel pessimistic. There are very good numbers of trainees on courses and a record number of courses being run around the country. Our membership numbers are increasing and the demand and interest in CAT seems to be as high (even higher) than ever. There are regional differences here, and some battles being fought as I write, but I feel optimistic that we can get through this economic and political storm successfully.
As in my previous letters I need to say something about the HPC and statutory regulation and just hope that you are not by now completely fatigued by this issue. It is pretty certain now that the HPC will become the regulator of psychotherapy and counselling in 2013 or 2014. We are currently in a final consultation phase and the UKCP has recently written a detailed critique of the HPC’s proposed fitness to practice proposals. However, I suspect that the process will begin to move ahead more quickly as we go through next year and organisations such as ACAT will soon be asked whether they want their registers to be transferred. We still have an unresolved issue in ACAT about the transfer of CAT practitioners and the ACAT training committee will be looking at this in the next year when the final Standards of Proficiency are published by the HPC. At present we still do not know for certain whether the HPC register will distinguish between Counsellors and Psychotherapists or whether these terms will in fact be interchangeable (don’t worry, probably not is the answer) so it is difficult for us to make specific plans at this stage.
As you may know, the UKCP is planning on becoming an alternative regulator for those psychotherapists who decide not to register with the HPC (the UKCP calls this APA or Alternative Professional Accountability) and this is going to pose some challenging questions for ACAT, particularly about CAT psychotherapist members who wish to take the APA route. I must admit to the view that APA is completely unacceptable, particularly from the client and public perspective. I also think that it has opened the UKCP to criticism from a number of different positions and had dented the credibility of this organisation. The post-regulation environment will feel very different to the present one and will be one in which ACAT will be a professional body, amongst other professional bodies, and in which there is going to be greater competition and probably some necessary pruning. The role of the UKCP will change dramatically and to some extent we will be in competition with them, bizarre as that may sound to you now. This is one of the reasons we need to continue to develop our services for members and for the public (given that we are applying to become a charity) as the professional body for CAT in the UK. We continue to value our involvement with UKCP, which brings together a diversity of therapy organisations in a way that is uniquely British, but we will need to keep monitoring this relationship and continue only so long as we feel it is of benefit to our members.
A final area that I want to mention is to do with CAT’s influence in the wider world of psychotherapy policy-making. A real difficulty we have faced in recent years is that for some reason we have been relatively marginalized in projects such as IAPT, Skills for Health and various workforce development initiatives. We have not been alone in this as other therapies that have described themselves as “integrative” have had similar problems. Around the country there are various people who have been working on ensuring that CAT has a voice on projects such as New Ways of Working, the National Audit of Psychotherapies, the Savoy Partnership and even IAPT and I am very grateful to them. However, we need to do more of this and the problem is one of how we get representation on these various groups when it is becoming increasingly difficult for our members to get away from work or give up their free and unpaid time to do this. There is no easy answer, but perhaps some of this work needs to be paid, or we focus our efforts even more systematically in future. I don’t think that our relative marginalisation has been intentional, just that the drive to roll brief interventions for anxiety and depression on an industrial scale does not really fit the CAT model and evidence base.
Well, I have now come to end of this, my last letter from the chair. I will be leaving by role in April with a very strong team of experienced people in place. What I have written here, of course, is just some of my own reflections at the end of my term and the new leadership may well take things in a very different direction. ACAT has always felt like my professional home as a therapist and I have learned so much from all of you I have met over the past few years. The relational CAT model and the values that underpin it provide us with a solid bedrock on which to continue to build our CAT community and I am confident that we will successfully navigate the waters that lie ahead.
There are many people who have inspired and supported me over the past few years but a few I want to mention in particular. They have made my job so much easier, so much more interesting and so much more fun. In no particular order, I am forever grateful to Mary Dunn, Annalee Curran, Steve Potter, Virginia West, Susan van Baars, Stephen White, Jon Sloper, Liz Fawkes, Frances Free, Val Fretten, Michelle Reynolds, Cynthia Pollard, Anna Jellema, Sarah Littlejohn, Shirley Akgun, Alison Jenaway, Debby Pickvance, Robyn Vesey, Dawn Bennett, Jason Hepple, Eva Burns-Lundgren, Maddy Jevon, Jessie Emilion, Vicky Richer, Hilary Beard, Hilary Brown, and Inigo Tolosa.
With warm regards,
Chair, ACAT - Winter 2010
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