New Beginnings Therapy


Dr. Madalina A. I. Day


November 2021: Mental Health Funding in the UK​. Who cares?



True to my word, I continue promoting one of my textbooks - Strategies and Self-help from Counselling and Psychotherapy available at Waterstones and Amazon amongst other outlets:

 November 2021  article is going to cover Chapter 5 Access and Communication in Psychotherapeutic Professions. 

I have selected a citation from the British Association for Counselling and Psychotherapy (BACP) of good guidance for private practitioners in private practice, and discussed the  extract with several of my colleagues. I am hoping that some formal answers will come forward by the end of the month. 

Selection in question as follows:

4 Therapists and private mental healthcare

“Therapists in private practice may be employed by the NHS (under a contract of service) or they may be commissioned to work on a self-employed basis (under a contract for services) as part of an NHS team for the holistic healthcare of a patient. The contract in either case will usually bind the therapist to work within the boundaries relevant to the NHS, and their actions will then be subject to the appropriate regulations and government guidance. The therapist will be expected to share information with the healthcare team on a need-to-know basis in accordance with the Caldicott guidelines (Department of Health, 2013) (https://www.gov.uk/ government/publications/the-information-governance-review). Therapists in private practice may work with a client who is in private mental healthcare (e.g. a private residential care home); the client will be referred to them by local medical practitioners or psychiatrists, but the therapy will be under a private contract with the client. In this case, the therapist should discuss and enter into a contractual agreement with the client about the agreed conditions of work, including confidentiality, records, referrals, and information sharing. In the case of private practice work, if there is concern about the safety or welfare of the client or others, apart from making an appropriate referral where necessary, the therapist is less likely to be involved in any subsequent mental health decision-making process concerning the client, unless invited to do so by the national mental health services”.

References:

BACP. (2019), Good practice in action 029. Legal Resource. Mental health law within the counselling professions in England and Wales. Published by the British Association for Counselling and Psychotherapy, BACP House: Leicestershire. Pages. 1 – 62; retrieved from

Mental health law within the counselling professions in England and Wales (bacp.co.uk)

Extract used in this article concerns page 24. Therapists and private mental health care


In above reference there are several policies and actions that a private therapist (a general term including psychotherapist, counsellor, psychologist, psychiatrist, mental health worker, social worker if trained in a specific therapeutic modality and accredited, a nurse practicing and trained in mental health) may and/or must consider when practicing in private practice if not associated to the NHS ; and as such, I have formulated several questions and points of reference for my colleagues in private practice (independently of not being associated to the BACP) for all possible implications to their practice and their client's wellbeing. 


Through my practice I am aware of a different way of working in private practice: in that of being completely independent and/or  part of an independent  private practice and networking. As much and as far such a statement is an absolute, there are ethical guidance for each individual professional body and an assimilation of legislation that can be applied in all instances. 

The above extract is actually out of context, and it may read quite simplistic and im(practical). 

The very fact is that a private practitioner within the UK is the sole responsible owner of their practice in reference to a private client. A private practitioner not only that is not bound to respond or collaborate with the NHS , but if (legally) challenged/invited/requested to do so  - a private specialist can still refuse to respond unless it is evidenced that his/hers/their clients are involved in terrorist activity and/or present a risk to themselves and others. Essential to remark that respective private practioner can only respond only if  they agree with presented evidence. If their interpretation of the case differs to evidence presented - than, a private practioner can opt for a non-response and ultimately they will not participate (there is no case).


One needs to read very carefully the above practice guidelines (my interpretation  coupled with the BACP's ethical guidance), because are very serious implications in private practice and training required to assume such responsibilities. A private mental health specialist is not shielded by any organisation, and they are not protected in any way BUT, equally, they  do not respond to anyone except the law and only when there is an agreed stance on evidence against their clients and/or malpractice. There is no bias involved because when a private mental health expert sees risk* - that risk is also their risk and everyone will respond accordingly. It is fair to note, that there are insurance (professional and public safety liabilities) complexities for any professional, but such insurances strands are only active when: a) a private mental health practioner makes such assessments, b) professional makes an assessment, but clients act against it  and, and  as such, a private practitioner would respond legally as a matter of defence (potentially c). To have the ability and reason to act in all above possibilities, anyone (including the state) needs to have evidence, and by evidence I mean facts and not suppositions. 

Human Rights Act 1998  and Equality Act 2010 are legislative Acts that can and will stand as Applicable in all instances and to all, hence the extract from the BACP is rather absolutely non-sensical if not read coupled with the BACP Ethical Guidelines for Practice (Good Practice); I believe it is updated every few years  


My answers to all such hypothetical conundrums are to be found in chapter 5 ACCESS AND COMMUNICATION / STRATEGIES AND SELF-HELP FROM COUNSELLING AND PSYCHOTHERAPY BY MADALINA DAY 

available at WATERSTONES , AMAZON AND WORLDWIDE IN PAPERBACK , eBook AND AUDIOBOOK.