Medics often brand themselves as illness specialists: we suffer because we’re ill; a bit of us is broken, we’ll fix that by cutting something off or adding a pill; if you’re lucky, you’ll be cured. I polarise, of course, and many medics such as Joanna Moncrieff and David Zigmond (see his blog post in the BMJ) are highly attentive to these issues. Psychologists often take a critical approach too these days, rejecting such reductionism and fundamentalism in favour of context and the biopsychosocial. This proves problematic in the NHS though, a system where patients and other professionals are socialised to demand of the psychologist ‘what’s wrong with me?’ and ‘how are you going to make it better?’
While my career has led me to become a trainer in counselling psychology, my training was in clinical psychology. My colleagues and I had rarely encountered counselling psychologists, apart from the occasional supervisor or office mate on placement. It seemed hard to work out the difference between us. The best we could come up with where the observables: we got paid to train, did psychometrics and CBT and finished in three years. They worked for free, had mandatory therapy, did counselling and seemed to take ages to qualify. After training though, they seemed to do the same as us.
Counselling psychologists that I supervise tell me that image is a problem. They feel subordinate, misunderstood, and out of place. When I ask ‘what makes you unique as a counselling psychologist?’ they either don’t know or say the same things that I say as a clinical psychologist. I have the same problem, I say. I am a clinical psychologist, training as a psychoanalyst. I tried to bring these together by working as a trainer in counselling psychology. It just got messier!
Clinical psychologists were once specialists in brains and behaviour: their branding was as psychometricians and behaviour modifiers. Hardly surprising given the profession was born alongside psychiatrists in the asylum, where assessment and evaluation, categorisation and medical intervention was the order of the day. Not for nothing did we attract the label of ‘handmaidens if psychiatry’. When the training became doctoral, clinical psychologists labelled up as experts in mental health research. Where to go with once there are no asylums; behaviour and other therapy is routinely carried out by inexperienced, barely trained, cheaper graduates; and psychological research is only permitted if it confirms with the ‘evidence base’. Other forms of therapy, particular those dealing with the complexities of human relationships and their, often unconscious, underlying processes, are treated with suspicion and contempt.
So what place for the counselling psychologist in this? What is its brand? Not medicine. Counselling? Counsellors do that. Psychological therapy? Clinical psychologists do that. Research? Not many counselling psychologists are really into that (see my post on this). Pluralism? Clinical psychologists. Relational approach? Psychoanalysts. Humanism? Counsellors. A mix of them all? Fine, but eclecticism really isn’t in vogue. Where’s the evidence for it? …
In her article in the New York Times, Lori Gottlieb discusses ‘branding’ herself to generate referrals to her practice. Do counselling psychologists need to do the same? More importantly, can they? I’d love to hear your thoughts and comments; and if you want supervision on these issues, get in touch!
Dr Russel Ayling
http://www.russelayling.co.uk
London Counselling Psychologists 
I am still learning all the psycho speech so I may be way off bade here. But for me, I live in the US, I just want someone who is going to listen and help me. Whether that be with medication or without, with taking the time and pushing me. I want to be better, if in deed that is possible. And I have found it very hard to find, especially generic counselors that even want to concede that I may actually have a mental illness. I have found myself defending my life and my illness like I am a drama queen and want something to be wrong with me. I went to a psychologist to get my testing done, and if she wasn’t so far from me I would go to her for my therapy as well. But alas, I’m probably going to need medication, but I don’t want that to be the only answer. And don’t want to get stuck with trying to depend on that to have my life be better. Anyway, for me personally as with anything else. I look for someone that I can trust and that is honest. Whatever form that comes in. It does not matter the title to me. If you arent a compassionate and knowledgable doctor I will no longer be your patient. Sorry, if this doesn’t make much sense. Thanks for sharing, I enjoyed reading this. Be blessed!!!
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Great article re ‘branding’, much to say, but I was humbled and spent some time reflecting after the comment from learningtobebipolar. Their point is vital and challenging; a client centred focused is really all that matters, regardless of title. For me that’s what Counselling Psychology is all about, if other professions do that too, great, lets work together to put cients’ needs at the heart of care.
Re ‘branding’, it depends why we want to brand. Big name brands do so to get consumers to buy them, in this instance the NHS / commisioners needs to buy our brand. This is why we need equal status with HCPC as practitioner psychologists, as we already have. We then need for jobs to be advertised for competencies so that we aren’t discrimated against – believe me I’ve just been through the NHS recruitment process that was at times so discouraging and others fantastic as people valued my skills. I can’t wait to start my new job amongst people that want me as part of their team.
Regarding our branding to clients – well that’s different – I agree with learningtobebipolar we need to stand for compassion to be knowledgable and skilled. Clients find all the different titles difficult to negotiate, so back to core values of client centred care, to be self-reflective with appropriate skills, should be our focus.
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A really interesting article and a pervasive challenge for us as counselling psychologists. I am a counspsych and see trainees in my private practice. I find it slightly depressing to see the same issues coming round again and again. The trainees I see tend to come from the college I attended and the themes seem not to have changed in a decade: disorganisation in the course, moving the qualification goalposts, political in-fighting, the course feeling too difficult or not difficult enough. AND – those age old bugbears – having to attend therapy when clinspsychs don’t, and having to find and fund placements. When I trained there was a strong rhetoric that we were ‘as good as’ clinpsychs and that we should be proud of our special skillset, whilst the process of battling for placements (I remember it being called ‘character building’ at the time) and juggling work and course requirements undermined any feelings of quality. You really had to love the work to do the course (not a bad thing) – it certainly wasn’t for the kudos or the conditions! The trouble is perhaps that Counselling Psychologists share about 80%+ of their DNA with Clinical Psychologists. Counspsychs seem doomed to spend eternity comparing themselves to clinpsychs in order to define themselves and this doesn’t seem to have shifted (I’ll happily be proved wrong). There does seem to be a fundamental lack of confidence in Counselling Psychology as a whole and I agree with the writer that maybe the job title doesn’t fit the discipline. It makes sense to me that at some point Clinical and Counselling Psychology should merge as a discipline and define themselves through their specialities alone, but why does that seem so daring?
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I hate to buck a trend or anything but I wouldn’t think to compare myself to a clinical psychologist and wouldn’t expect them to compare themselves to me. Most of ‘us’ feel like we concentrate more on ‘doing’ more psychotherapy than ‘them’ and ‘we’ seem to have more choice in the services we work in. It is the difference between being ‘us’ rather than ‘them’ not to mention ‘everyone else’ which really appealed to me. Not all are thwarted CPs nor do all go in blind in unpaid placements, most seem to work PT and see it as a good test of commitment and a degree of freedom of practical direction. I have never quite had the identity angst I feel I should have had. I admire pretty much most of my colleagues / psychotherapists / counsellors no matter what their origin or training route. Our common goal is we work with people, for the benefit hopefully of people, based on trust, compassion and genuineness. Another myth perhaps, is it really true ‘we’ are not into research. I’m not so sure that’s the case but I’m not going to lose sleep over it! I am ok with others choosing their path and me mine. Our therapy helps us I hope to value being over doing. I completed exponentially way over the hours a CP would have done in their training, I guess that’s fairly typical, so we’re different, it’s a diverse world we inhabit for better or worse.
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