reimagining therapy

The field of therapy and coaching is a HOT MESS right now.

Two well known therapists with hundreds of thousands of followers - one of whom has a doctorate, a book out, and has created her own modality - got into a very ugly public spat on Instagram, showing that you may be able to buy a PhD, but you cannot buy empathy.

In addition, Dr. Hayley Kelly, clinical psychologist and host of the Therapists Rising podcast has been banned and removed from LinkedIn (yet another woman to be silenced) following a viral post that clearly ruffled some feathers, where she expressed concerns over the level of burnout in mental health professionals and proposed that the field of therapy needs to change in order to survive.

I have been watching - popcorn in hand - numerous threads on LinkedIn with arguing and infighting in between coaches, therapists and psychologists about what is therapy, what is coaching, and who is qualified to do what.

In the helping professions, we have a tangle of near-impenetrable qualifications and certifications which practitioners can hardly get their head around, and potential clients even less so - leaving the public ill informed about who they can trust. Certifications and regulatory bodies abound but aren't legally enforced, leading to a heap of voluntary complexity in an industry that is completely unregulated

If you, as a client, are looking for a therapist, you might Google "therapist in [city]"

But did you know that ANYONE can call themselves a therapist, a coach, or even a psychologist. None of these terms are regulated. (Whereas specific titles like "clinical psychologist", "counselling psychologist", "occupational psychologist" and "coaching psychologist" are legally protected and can only be used by registered members of the HCPC (the Health and Care Professionals Council)).

But the term psychologist on it's own is not a protected title - and so people can call themselves a psychology consultant or a psychologist without breaking the law.

Similarly, there are zero limitations as to who can call themselves a psychotherapist, a counsellor, or a coach.

Zero.

These professions are not subject to a statutory regulator. There are plenty of voluntary governing bodies - the International Coaching Federation, the European Mentoring and Coaching Council, the Association for Coaching, the British Association for Counselling and Psychotherapy, the United Kingdom Council for Psychotherapy, the National Counselling and Psychotherapy Society, and so on...

Are you getting tired yet?

It goes on.

These voluntary governing bodies have different standards. The ICF doesn't agree with the EMCC or the AC. The UKCP differs from the BACP and the NCPS and so on. In the psychotherapy world, there are ongoing attempts to unify this disjointed and overly complicated regulatory maze with a new collaborative network called the Partnership of Counselling and Psychotherapy Bodies (PCPB). But again, it is voluntary.

It's even more complicated if you straddle multiple worlds - a hybrid coach-therapist could be registered with both the ICF and the BACP with opposing guidance around ethical guidelines, leaving them in muddy waters when it comes to serving clients who need both.

Meanwhile, you might assume that someone with the title 'Coaching Psychologist' can do therapy (this is one of the legally protected titles under the British Psychological Institute) - however despite the word psychologist, the practitioners under this title are coaches, not therapists.

How is a client seeking therapy to make sense of all of this?

No wonder potential clients are confused and liable to pay some shmuck on Instagram £2,000 for a 'somatic trauma healing program'.

The irony is that the extortionately high fee services tend to come not from those who have studied in their field and gained recognised qualifications in therapy, psychology or coaching, but from those with bagfulls of bravado and an eye for marketing.

Meanwhile we have licenced therapists who have studied for four, five years and upwards in despair and frustration about the state of the industry where someone who self-declares as a 'coach' is able to charge twice, ten times as much, as they do.

So what's the answer?

Some may say the answer is more regulation - but in order for that to happen, there would need to be changes in the UK legislation, because as said previously, the regulatory bodies are voluntary, meaning they have no legal enforcement powers. In addition, there are so many different modalities of helping people that to cram everything into one framework risks suppressing innovation. For example, some of the cutting edge therapies at the moment, like Internal Family Systems and Somatic Experiencing are not 'accredited' but have achieved global credibility and are widely used by reputable therapists.

Accreditation in itself is not a guarantee of quality - two of the absolute worst therapists I have had have been "accredited" by big names, and I have heard many similar horror stories.

What none of these things take into account is the human element, the healing power of being in relationship, of connection, and of the practitioner as an embodied human being with their own lived experience, not a blank slate.

I have 25 years of experience in the mental health field - from the side of both patient/client and practitioner. 13 of those years were inside the system - navigating hospitalisations and treatment for anorexia, bipolar and 'borderline personality disorder' (that latter term is a rant for another day).

The subsequent 12 years of my experience have been dedicated to service - firstly as a peer support worker for those with bipolar and BPD, then studying a diploma in counselling skills, qualifying as a coach (ICF accredited, if anyone cares), followed by recovery coaching, trauma-informed coaching, root cause therapy, and now, going into my final year of my diploma in therapeutic counselling.

My path is a patchwork quilt.

And I know that all of this is what makes me valuable to my clients. My lived experience, the depth and broadness of my modalities. As a client said to me recently - "you have range".

And that is the thing with being human - we can bring the depth and breadth of our experience - and that is something that can't be contained within a certification.

Numerous studies have shown that the quality of the therapeutic relationship is the most important element of successful therapy - not the modality, not the letters after someone's name.

And I fear that - well-intentioned as the regulations are - that they are missing the mark and going over the heads of those who actually need our services. Most clients - and actually many counselling students themselves - wouldn't know the BACP or the UKCP if it hit them in the face.

All too often, we are preaching to the choir, policing each other, while the unscrupulous ones in this unregulated industry come away laughing, posting viral reels dancing on a beach in Bali preaching 'emotional regulation and nervous system healing' (for only £3,333!)

There has got to be something better than regulating ourselves into paralysis, or going completely off the map and doing whatever wild thing we can sell to the unsuspecting public.

I feel that hidden within this mess is an opportunity - an opportunity to find out what really matters to the people we serve, to shape what it means to be ethical and competent practitioners, and to empower those seeking help to make fully informed choices.

I won't end with any straight answers, but instead a call to action.

I'm impatient - I am not going to watch on the sidelines while infighting, dodgy ethics and reeeeally poor communication leave people suffering, unable to navigate finding suitable help, or becoming victims of predatory marketers who use terms like 'trauma-informed' without depth.

I am not going to sit silently while I watch fellow therapists and coaches struggle through the maze of how to help people, throwing thousands of pounds at the next certification to see if this one is 'the answer', while their brilliantness is held back from those who need them right now.

I don't believe in easy answers, but in the words of poet Antonio Machado:

"Caminante, no hay camino, se hace camino al andar."

(Walker, there is no path, the path is made by walking")

We can be spectators, or we can be active, we can be a lightning bolt that shoots out, seeking solid ground, forging new shapes, new dimensions, re-envisioning the field of helping humans.

It is time to reimagine therapy.

Will you walk with me?

P.S. In an age of so much regurgitated, bloated, AI crap, I want to emphasise that ChatGPT was not used to write this article. This piece and all it's imperfections are real, created by my human hands and human heart.