Taking up offers of psychological services from unlicensed practitioners is risky for you and for others!
I love innovation. I love creative people who see new horizons and question dogma. I love the rebel who rocks the boat and challenges us to think in new ways, see the world in a different light. Human progress depends on these people who will take the risks and push us, sometimes unwillingly, to embrace new possibilities.
There’s a key point when it comes to innovating and challenging psychological dogma (it applies to other fields too, though I’m focusing on psychology since that’s my ‘thing’). That’s ensuring the safety of your human ‘guinea pigs’.
I still see the potential for serious harm where we fail to draw the line between the work of innovators, creatives and rebels and the people who want to challenge the status quo to further their own ends, either their own need for notoriety or approval, or their desire to make money. That line is the willingness of innovators to operate within a broader framework that keeps everyone as safe as possible from further harm whilst pushing the creative envelope. For example, I love working alongside bright engineers who are pushing the envelope in aeronautical engineering, but I am never getting in an aircraft that’s not been certified as being airworthy!
Working with unlicensed psychological practitioners is the equivalent of getting into an aircraft that’s never been near a certification board. The test pilots who do this dangerous work in the aviation field not only have other checks and balances in place to try and make things as safe as they can be, they’re also paid a ton of money to risk their lives and well-being. There are very few psychological snake oil charmers who will be paying you for the privilege of working with them as they ‘test’ their ideas. Plus, real test pilots only take to the cockpit after a long series of tests and simulations when they have a lot of data to feel assured that there is at least a basic level of safety. They’re not tying themselves to a concrete pipe filled with grenades and two planks for wings, having been told ‘this is the latest innovation in flying machines.’
Ensuring the psychological and emotional safety of the people we work with is the absolute priority for Chartered Psychologists.
My Personal Experience of Imbibing Psychological Snake Oil
Through the work I do, I come into contact with a lot of innovators and people who sell ‘helping’ services to other people – trainers, coaches, even therapists. Someone who was very excited about a ‘new way of coaching people’ that he’d developed contacted me and he asked me if I’d like to try a complementary initial session. Sure, I said. That would be interesting! We started the session and within a short discussion, we had gone from the topic of improving a relationship to the person telling me ‘oh so you think that you killed your mother..’ (Statement, not question). To clarify, I had fairly recently lost my mom and somehow through the series of questions this person posed, we had come to discuss this trauma. I don’t even remember the preceding questions that had led me to share my initial fear that the flu I’d had at the time she died had somehow caused the meningitis that led to her death. The ‘coach’ and I didn’t even get around to discussing the fact that the coroner had explained to us that it was her brain tumour that had caused a non-infective meningitis before the ‘coach’ made that statement to me.
Such is the power of the opportune question and statement at the right moment. To say that was distressing to me is an understatement.
The point is that through training and supervision, licensed psychological practitioners should be aware of the power of questions, the power of statements and they should know when to go there and when not to go there. My mother’s death and my experience of it were not relevant to my desire to have a more effective relationship with a completely different person. It was fertile ground, however, for the salacious desire of an untrained person to feel a degree of power through my distress.
Fortunately, I’m a resilient person and after having talked about my experience with my husband and with my supervisor, who is also a Chartered Psychologist, I embraced the real learning point: it can be very dangerous to work with unlicensed psychological practitioners who are operating outside of any professional charter and beyond appropriate supervision. Even when you’re a psychologist and even when this is ‘coaching’ and even when you’re mentally well at the time. I was lucky in that I wasn’t particularly vulnerable at that point in my life and I had a great support network around me with whom I could talk through my experience. Not everyone is going to be in such a strong position.
Unfortunately, beyond making it clear to this person that his ‘new coaching methodology’ was unacceptably risky and never mind his ideas for the broader applications beyond coaching that he claimed for his approach, there was no one to report him to because he was operating outside of any kind of professional framework. I spoke to him directly and frankly. This person took my feedback very negatively indeed and then wrote to me the next day to explain that my negative reaction had been, in fact, indicative of the effectiveness of his approach… A huge red warning flag, if ever there was one.
It was a deeply unpleasant experience that left a very nasty taste and a creepy, oily feeling all over me.
Nevertheless, it was a big reminder why it’s important to have professional associations and frameworks to limit the ability of such people to practice and harm vulnerable people. I knew the lesson in theory; this experience taught me the lesson ‘in the muscle’, as they say.
However, regulation and licensing can only go so far and there will always be work arounds. As consumers of psychological support services, we have to be savvy as well. Coaching is an unregulated business more or less worldwide and anyone can use the title of coach. Some people use this title as a work around that enables them to advertise therapeutic or other psychological services. There have been cases of even licensed therapists who have been struck off for some reason carrying on their work under the guise of being a ‘coach’. And there will always be people who find a way to operate outside of the regulatory framework. We have to be savvy, ask better questions and know what we’re looking for when we’re choosing to work with someone. My suggestion is that some of the first questions should be around whether that person is licensed to practice. If a practitioner is calling themselves a ‘psychologist’ without wanting to take the time and commitment to train to the National standard for Independent practice, and remain committed to maintaining professional standards by being a member of an appropriate professional body, it should raise questions about their professional integrity.
Whenever you work with a psychological practitioner, the first question should ask is whether they are licensed to practice.
The Potential for Harm
The potential for harm when working with unlicensed psychological practitioners is:
- Receiving unfounded or inaccurate diagnoses. These can limit your ability to get well again and can even increase your psychological distress and worsen your symptoms.
- Receiving recommendations for supplements that can harm you. Just because it’s ‘herbal’ or a vitamin doesn’t mean it’s safe for you to take.
- Developing psychological dependence on your practitioner because they’re touting themselves as being ‘the only one who can cure you’ or the ‘only one who can really help you.’
- Experiencing increasing confusion rather than increasing clarity about your life and your current condition because your common sense is fighting against the warped interpretations the practitioner is trying to get you to believe.
- Taking on the mental disturbances of the unlicensed practitioner – paranoia that others in ‘the system’ don’t really want you to get better and that’s why only this practitioner can help you, for example.
- Feeding the mental disturbances of the unlicensed practitioner – for example, where the practitioner has issues around narcissism, the more they receive attention from their clients, sometimes the more their clients suffer, the more convinced they will become of their personal greatness and prowess.
- Providing unlicensed psychological practitioners with an aura of legitimacy because they now can claim to have a client base, which can lead to others becoming attracted to working with them (‘social proof’ in action).
- Losing your time, money and energy on therapies/approaches that do not work, or do not work as well as other evidence-based therapies.
- Having serious, other underlying illnesses or conditions go undiagnosed and untreated for longer because the unlicensed practitioner is not trained to spot the warning signs that there is something else wrong, something that is even outside of their expertise. This can seriously harm your health because it can mean that effective treatment is delayed.
This isn’t an exhaustive list of problems but it highlights some of the main risks. These risks can be grave.
The Protections Offered by Licensing of Psychological Practitioners
When you work with a licensed psychological practitioner, whether they’re a counsellor, therapist or psychologist, there are certain checks and balances in place to help prevent the above problems. It may not be a perfect system but it’s certainly better than working with someone who is operating outside such a system. Some of the most important protections are as follows:
- Broad, comprehensive education and training, sometimes for more than 7 years full-time, in order to understand the limits of their expertise and when to refer you elsewhere.
- Adherence to a professional code of conduct – you have a means of holding someone accountable for the service they provide to you and preventing them from causing further harm to others if they cause damage to you.
- Supervision on an on going basis to ensure that your practitioner isn’t laying their problems at your door, either consciously or unconsciously.
- A system of continuing professional development to ensure that the person you’re working with is up-to-date in relevant professional knowledge and that you’re more likely to be getting the best support possible.
- Professional insurance so that you have some recourse, again, if you’re damaged by the practitioner’s actions.
Choosing a Psychological Practitioner
As we get deeper into the fourth industrial revolution and the digital world becomes more ubiquitous, we become more focused on assessing people’s credibility according to their online presence. Rather than word-of-mouth, local reputation from other people that we know and trust, we look for other signs of credibility. Do they have testimonials from people who are like me or who I aspire to be like? How many ‘recommendations’ do they have and how senior are the people who are recommending them? Do they have a glossy website? Have they published articles online somewhere? Our favourite search engine can produce all the answers for us!
We should add to that search a question about whether the practitioners we work with are registered and licensed with a credible organisation, preferably one that is State registered, that requires:
- high standards of professional practice, including a broad, comprehensive and appropriate base of expertise.
- professional insurance cover
- on-going, annual professional development requirements
- an effective complaints procedure, should you need it and
- effective supervision of licensed practitioners as well as those who are still in training.
There are some private, commercial organisations that now offer substantial and rigorous standards of accreditation. But beware that not all do, even if they’re expensive to join.
Licensing isn’t a perfect system but it does mean there are some meaningful checks and balances in place to help prevent harm and give recourse where problems arise. If you’re looking to employ a psychological practitioner, please contact your country’s psychological association for recommendations (some web addresses below). If you’re thinking of working with a psychological practioner, please ensure they are operating within a licensing framework that includes professional standards of practice, CPD requirements, supervision and the requirement to hold professional insurance.
Sadly, in the United Kingdom currently, the titles ‘psychologist’, ‘psychotherapist’, ‘counsellor’ and ‘coach’ are not protected at all. Anyone can call themselves any of these terms and the only protection for you, the consumer, is your savvy in asking the right questions about professional accreditation and supervision. However, the titles that ARE protected include:
• Practitioner psychologist
• Registered psychologist
• Clinical psychologist
• Counselling psychologist
• Educational psychologist
• Forensic psychologist
• Health psychologist
• Occupational psychologist
• Sport and exercise psychologist
Any other kind of ‘psychologist’ outside these terms is likely to be unregulated and unqualified.
If you’re in the UK, you can find details of licensed psychological practitioners, either at the British Psychological Society website or the British Association for Counselling and Psychotherapy website.
Psychologists, therapists and counsellors from other nations will be able to provide the details of their respective professional associations.
Wendy Kendall advises corporations and executives to think differently about global talent development. A occupational psychologist for more than 20 years and former senior scientist to the Director of Army Personnel Strategy (UK), Wendy has lived and worked overseas for the last 15 years. She established her own practice in 2003 and worked with nearly 3000 global leaders and managers in that time. Her work focuses on assisting multinational companies and international NGOs to implement global talent development strategies that prepare their future leaders for the 4th Industrial Revolution.