Call for NHS therapists to "educate" clients - British Association for Behavioural and Cognitive Psychotherapies (BABCP)

[BridgetYourFortyDaysAreUp]

From Nick Wallis' GenderBlog today:

Call for NHS therapists to “educate” clients – GenderBlog

The British Association for Behavioural and Cognitive Psychotherapies (BABCP) has proposed requiring its therapists to “actively promote inclusion” during therapy sessions and “ensure that any discriminatory attitudes and behaviours are challenged” when expressed by patients.

The BABCP regulates psychotherapists and BABCP accreditation is considered important for any Cognitive Behavioural Therapist (CBT) working in the NHS. It has more than 23,000 members. The new requirements are part of a proposed overhaul to the BABCP’s Standards of Conduct, Performance and Ethics, which, if approved, will come into force later this year....

Susan Forbes is a BABCP member and has been a psychotherapist for 25 years. She has worked with detransitioners and individuals with what she calls “gender distress”....

Forbes calls the proposed ban on challenging beliefs “dangerous”, because “it makes it impossible for the therapist to work in the client’s best interest. We cannot offer effective therapy if we treat every aspect of their self-concept as immune from therapeutic examination or change....”

….............................

I wonder if this is just another of BABCP's "ideas" or if they are trying to get ahead of the Conversion Bill failing? Or trying to get ready for a successful Conversion Act?

The few comments on the blog are interesting. It appears that BABCP's consultation received a few hundred responses out of some 23,000 members. Did the other members not respond because they didn't know about the consultation, didn't care to respond, or were they afraid to respond?

Exactly this. “Reframe your trauma” you’re not being an acceptable victim.

"Challenging beliefs" - ?!

Being trans isn't a belief, or a choice. It's who someone is.

My child has had therapy after being bullied and experiencing dysphoria. Like many trans people, he reported that the therapist was clueless as to what being trans was, and he had to explain all the way through.

Education is badly needed, and conversion therapy is evil.

No adult in a position of authority has the right to abuse that power. They need to listen, respect and encourage the patient to find their own way through. To help them.

Not impose their own bigotry.

Jfc. Would you send a gay person to someone who thought being gay was a fashion statement? Or a cis woman to an avowed misogynist? Asexual people to JK Rowling?

Like many trans people, he reported that the therapist was clueless as to what being trans was, and he had to explain all the way through.

You seriously can't see the insanity in that, your daughter went to therapy for help and she ended telling them what she wanted to hear, what they needed to tell her, instead of listening to the people she had turned to. No wonder she didn't get any help from therapy.

I wonder if it went that way, or did she just not listen because she didn't want to hear what they were trying to tell her.

Which is why therapy needs to focus on what will help the person in need not just pander to whatever problem brought them to therapy in the first place.

CBT is not indicated for treatment of anyone struggling to accept something situationally.

CBT does challenge beliefs but these are directly related to the anxiety or depression that are based on a cognitive approach and not a system of faith/beliefs

Imagine being a therapist expected to challenge a discriminatory comment in session when you or your family are directly affected by that type of discrimination….. it’s a mind field and therapist need to be protected also

If someone needs to explore a difficulty or working to accept an occurrence they need to access counselling not CBT in TT. Some areas have specialist services for transitioning individuals.

The only way that maybe used to challenge this is be asking a client to consider alternative perspectives but not ‘challenge’ in the usual sense of a ‘faulty belief’ like ‘If I don’t wash 10 times I will get ill and die’

Its not the therapist business and it assumes a huge range of knowledge and neutrality in approach

Obviously we weren't at the therapy sessions but my take on reading that was a variation of your observation: I wonder if the therapist was using the Socratic method of asking questions i.e a way that comes across as not knowing anything so that the person opens up and feels comfortable. From listening to an account of your child's experience with the therapist, @TransParentlyAnnoyed , do you think that's a possible explanation?

Nobody likes to feel out of control, particularly when they are exposing their inner thoughts and worries. I'm not a therapist but I could see that being a good way of approaching a conversation with someone who is very distressed and has come in with strong feelings about who they really are.

I've seen it used in work situations by managers/leaders (the ones that already have experience in the subject matter) to get their team to open up. It can come across as being clueless but it's a deliberate method. Teachers do it sometimes too with children in their class e.g. by pretending not to know the outcome of a science experiment and looking at the null hypothesis through the same lens as the children are experiencing it.

It's scary to think that this child's experience is potentially one similar to "many trans people" where (potentially) using this method to unpick someone's feelings about themselves could be off limits unless accompanied by unquestioning affirmation.

“Like many trans people, he reported that the therapist was clueless as to what being trans was, and he had to explain all the way through.”

Anyone logical can see the risks in this. A child learns, on the internet, from other people who share the same feelings or delusion, and presents that as reality. Given that many doctors and WPATH members driving this also have the same, likely false, beliefs about “what being trans was” this is where we end up, with falsehoods being propagated as fact.

Very dangerous.

When speaking about asexuality, pssd is never spoken about enough and whether the asexual person is also on/had been on antidepressants. The other examples are ridiculous.

This.

It would completely undermine my trust in dealing with any health care professional if they weren't prepared to listen and understand where im coming from on an individual level and instead had an agenda of their own.

It's setting up vulnerable people with people who potentially see the job as an opportunity to spread their beliefs and exploit vulnerability.

This is exactly the tactic some religious groups and cults use.

This is a safeguarding concern because of the power imbalance going on here.

What does inclusion mean?

We are back to definitions here and how they are important

There are many examples where this is a nonsense or it doesn't think about how this impacts in unintended ways.

It should be equality promoted as in line with the actual law. Not this fuzzy undefined subjective idea of inclusion.

And yes trans people should be challenged on this point because of what this means in practice and because regardless of how they feel about their body there are limitations to how much they can change their body and this doesn't change their sex. And yes they do need to come to terms with this conflict between their desires and the achieve abilities of that. Otherwise you send them down the trap of chasing the impossible, spending a fortune and always being dissatisfied. You need a honest conversation about the expense and the addictive nature of this even if you are supportive of their identity.

And yes people should be challenged about what is identity and how that is important but only to a point and what is unreasonable behaviour because as the delightful group from Aberdeen demonstrate really well is where it's going off the rails and isn't good for them and isn't good for society because they fail to recognise the validity of other people's boundaries because yep they've taken it beyond it just being about themselves and their true authentic self and it's become antisocial controlling behaviour that wants to change other people's legal and reasonably held beliefs.

Obviously your dont challenge their beliefs but you should be challenging behaviour because in the above scenario, yes it absolutely is negatively impacting on those men and everyone else around them.

This is a minefield and one that's dangerously ill thought through if they just talk about 'inclusion' as set values which might not reflect a range of experiences and seek to understand unacceptable behaviours directed at clients so and by clients in line with other legal parameters.

Asexuality is completely different to having a low sex drive, as is being aromantic.

And the other examples are entirely valid. Sending a minority or cishet female child to someone you know they can't trust, is abuse.

Trans children are often highly vulnerable because of dysphoria and very significant bullying - most of it sexual. Sending them to someone they can't trust risks their life

Therapists must be informed, impartial and trustworthy. And not so ignorant they think someone can be argued out of being trans.

@TransParentlyAnnoyed

Education is badly needed, and conversion therapy is evil.

I watched a documentary about a young person who had thought of themselves as gay for many years, then after discovering a group online now describes themselves as straight. They didn’t seem entirely happy at the end, but seemed even more distressed to be reminded of the time before.

Will you join me in utterly condemning this evil and the ideology that stands behind it?

PSSD is completely different to having a low sex drive and iatrogenic harm ought to be taken more seriously

The BABCP has proposed requiring its therapists to “actively promote inclusion” during therapy sessions and “ensure that any discriminatory attitudes and behaviours are challenged” when expressed by patients.

I read that and thought it was a good idea - if a racist bigot goes for counselling, surely it is a good thing if the counsellor challenges their beliefs?

But, on second thoughts, is a counselling session the right place for this? Being challenged is likely to be counter productive as it will drive the client away from attending, and the issues for which they attended (such as anxiety or whatever) will become more entrenched, alongside their racism being more entrenched, and they are likely to be prejudiced against counselling going forward.

Plus, as others have said, who gets to decide? I'm sure we can all agree that racism is bad, but what about any number of other 'inclusion' issues which are disputed? Gender is only one such issue.

Susan Forbes [...] calls the proposed ban on challenging beliefs “dangerous”
This is confusing because the first paragraph says the proposal is to compel challenges by the therapist, whereas Forbes is saying the proposal is to ban challenges. There seems to be a bit of the discussion or context missing.

I assume that Forbes is interpreting the proposal as compelling challenge of gender critical thought, and therefore banning challenge of gender ideology, but that is not what the proposal appears to say. Is she over-reacting and reading into the proposal something that isn't there?

If a person attended counselling to confusion and distress over their 'gender', does the requirement to promote inclusion and challenge any discriminatory attitudes really prevent the counsellor from discussing the problem from a gender critical perspective, e.g. telling the client that they cannot change sex and discussing what they think 'gender identity' really is?

We cannot offer effective therapy if we treat every aspect of their self-concept as immune from therapeutic examination or change....”
Yes, the idea of therapy is to promote examination and change - but perhaps only of those matters pertaining to the reason for the therapy. So to use the previous example of a racist with anxiety, you want to help the client change the anxiety, but as a therapist it is not your job to change their racism (unless the latter is causing the former of course).

So what about someone like me?

Being trans isn't a belief, or a choice. It's who someone is.

It's predicated on a belief that everyone has a gender identity that is separate from their body - a "gendered soul" if you like.

To anyone who holds a belief in this existing it's possible to "be cis", where the person's perceived gender identity and sex match each other or to "be trans" (including non-binary) where there isn't a match.

Obviously challenging someone's beliefs head-on isn't going to result in a good therapeutic relationship. For example if a Christian is dead-set on sacrificing their life for spiritual reasons (like in Jonestown in the 1960s), telling them that god doesn't exist is clearly not going to work.

However, it's possible to carefully unpick why someone feels they have to act a certain way because of their belief.

In the case of people who believe themselves to be trans, this might include asking why it's so important that everyone uses opposite-sex pronouns for them, asking them to consider whether that's fair (especially if they aren't believers in gender identity) and whether their are other ways they can explore their belief.

Equally, just as with what happened in Jonestown, ideally someone should be able to follow their belief without it requiring them to do something that could harm their physical health.

No, it isn’t a good idea. It would mean women having counselling for being raped as children by grooming gangs being lectured about Islamophobia.

I wasn’t aware JKR had set up as a counsellor?

Or someone like me being told to “reframe” my trauma.

hard no.

I will not call a man a woman and I do not want them in single sex counselling spaces for women. No. The word is no. Men need to learn to respect that.

Absolutely agree.

My OP has excerpts, hence the ellipses.

Nick Wallis' blog post and embedded links provide the context in full. I think if you read the whole thing, not just my post, the issues are clear.

I'd hope you'd get a therapist who respected, listened to and supported you. And didn't try to impose their beliefs, whom you could trust.

Who didn't harm you. As you deserve.

How do you square that with this new guidance?

I don’t want to have to call any man she.

if the man who raped me decided to identify as female tomorrow that’s what I’d be expected to do.

and that’s a hard no.

I get that right.

challenging me on that and making me call a man she will harm me. It will harm me tk have a man in a female counselling space.

why can’t men accept the word no?

Hopefully what TPA means here is that if a therapist believes that TWAW, this should never be imposed on you and you should never be shamed by the therapist for not holding that belief yourself or for refusing to behave like you do.

I appreciate that you do believe that TWAW, @TransParentlyAnnoyed but can you clarify that this is what you meant with your post? Do you agree that it would be wrong for the therapist to impose their own belief in gender identity on Tatzoy in such a situation? (Or on anyone else for that matter).

I don’t see how that can happen with this new guidance and it’s terrifying me.

Agreed. Irrespective of whether the therapist believes that TWAW or not, the guidance obligates them to get you to accept this belief as a fact. It's appalling and I can only begin to imagine how distressing it would be if you found yourself in that position. Having to "reframe your trauma" to accommodate what is either someone else's belief or their fetish/feigned belief.

Ignoring the guidance, TPA's comment to you made sense: no therapist should impose their own belief on you.

What's significantly missing from both the guidance and TPA's posts is any recognition that not everyone believes that we all have a gender identity. That lack of belief is being positioned as both bigotry (which is a bigoted view, ironically) and lack of educational awareness. It's a very dangerous, activist-informed approach to therapy.