Hypnotherapy Possible Self-Regulation

HypnosisAustralia, May 2007

By Dr Tracie O'Keefe DCH, Clinical Hypnotherapist, Psychotherapist & Counsellor
Editorial Director of HypnosisAustralia Online.

The next step forward for the counselling, psychotherapy and hypnotherapy professions in Australia now clearly looks like self-regulation; but exactly how that will come about is currently a matter of debate and controversy. The 2006 rejection of many allied health professions by the government for Medicare rebates has shocked those professions into a considerable amount of self-examination.

The Coalition of Australian Governments (COAG) in 2006 looked at carefully formulated policies for a pan-Australian recognition of certain professions so that professionals would not have to train again or separately register in other states. The very ethos of the federal government could, one might think, give rise to the opportunity for the hypnotherapy community to formulate the separate profession of hypnotherapy. Many obstacles to that, however, stand in its way and the question is: Can hypnotherapy as a separate discipline emerge from counselling, psychotherapy, psychology or psychiatry?

Sure, eventually in years to come, counselling and psychotherapy may be registered professions, even if that is decades away, but will hypnotherapy be a subsection of those disciplines or have to find a different home?

A further question is: Will hypnotherapy be categorised as a section of the complementary medicine sector?

There is little doubt that the Medicare bid by the counselling, psychotherapy and hypnotherapy associations failed in 2006 because standards of training were not considered high enough. Those standards were not seen as being in line with the mental heath competency standards. Also, the government did not see the three professions as being sufficiently organised to deal with in any coherent way.

In 2003 the Australian Counselling Association (ACA) approached the Department of Human Services (DHS), Victoria with regard to a research grant that had been awarded to the Psychotherapy And Counselling Federation of Australia (PACFA) to investigate the issue of self-regulation for counselling and psychotherapy. From the outset of this project the ACA protested that they had been excluded and to date, after the final report, ACA still maintains that they were not properly consulted as a major industry stake holder. (Armstrong, 2006).

It seems the author of the research, Professor Margot Schofield, an officer of PACFA concluded that counselling and psychotherapy (which would include members of the hypnotherapy section of PACFA, ACA, very possibly ATMS and other hypnotherapy organisations by default) should be regulated in Australia under the overseeing direction of PACFA. As the reader can imagine, this went down with the ACA like a lead balloon. While it is true that PACFA probably does represent a greater diversity of counselling and psychotherapy practitioners, in reality, numbers are the only thing that counts when talking to governments about any kind of regulation, self or otherwise.

The current territory war between PACFA and the ACA, both of whom represent some hypnotherapists, is doing the professions no favours, and while Rome burns, insults prevail. This is nothing new, but part of the political growing pains that all professions seem to go through on a journey to unification. Eventually both associations will need to amalgamate or learn to live with each other and work together.

I spoke to Simon Tatz of the Mental Health Council of Australia (NHMC) a non-government body representing the Australian mental health sector. NHMC says its members include and have representatives from mental health service consumers, carers, special needs groups, clinical service providers, public and private mental health service providers and state/territory mental health peak bodies.

Tatz said, "Recognising government-registered practitioners is easy because they are on a government register but when it comes to practitioners that aren't on a government register, that can be very difficult. I am sure there are many non-government-registered practitioners who may be very experienced but in reality, the NMHC has absolutely no way to determine that.

"The situation of the chicken and the egg and which one came first is surely where counselling, psychotherapy and hypnotherapy training standards are situated in Australia at the moment. The government does not know what standard to set for recognition of such professions and does not seem to want to be involved in setting a standard. However, the government does not want to recognise those professions unless a standard is set by the professions themselves and even then it would only do so at a push of perceived imminent danger to the public from untrained practitioners."

One model of self-regulation that hypnotherapists could usefully look at is the one that is currently used by naturopaths. There are no laws governing naturopaths in Australia at moment. They are, however, subject to two kinds of regulation. The first is that some states are now putting in place the ability for government departments to hear complaints against unregistered healthcare practitioners made by members of the public. Any naturopath who finds themselves in this position, and is not a member of a major naturopathic organisation, will find themselves very vulnerable during such investigations because they lack the peer review recognition.

Naturopathy indirect regulation is also currently operating federally with a form of self-regulation, namely GST exemption, and full private health fund rebates. In general, naturopaths have to qualify to at least Advanced Diploma level of training and many have degrees.

I spoke to Raymond Khoury from the Australian Traditional Medicine Society that represents a large number of naturopaths and he commented, "Even though a form of self-regulation exists within Australia for naturopaths, self-regulation has largely been only partly successful. In order to get GST relief and other benefits a naturopath must be a member of a professional association but unfortunately the associations are still a number of scattered collectives. The cohesion we have been hoping for over the years has not happened.

"The problem with national registration and even self-regulation is that all the states have their own agendas. Victoria wants to regulate but NSW absolutely does not and the other states have their own issues. It's the old states versus federal situation and even though all the states have Labor governments, they all have different policies.

"When the concept of GST purchase tax was being formed and implemented in Australia the different naturopathy organisations made representations for GST relief separately to the federal government. Even though there was no cohesion, the different associations managed to establish at the beginning of the introduction that naturopaths would be GST-exempt. The law, however, is now established and for counselling, psychotherapy and hypnotherapy to get GST relief at this stage in the game it will take a considerable effort and the associations would have to work concertedly together because the tax department is not going to give up that tax easily."

If hypnotherapy is to become a separate discipline with its own governing body, many associations will need to give up sovereignty and collaborate with a central body to represent the whole of the profession. So this would mean some personalities who have made their living from being prominent as association leaders stepping down and allowing a more centralised approach to self-regulation to take place. This process in itself may be like guiding a porcupine around a balloon factory but it can be the only solution. Too many chiefs and not enough Indians does not a well-run campaign make.

The ATMS is the only organisation that represents hypnotherapists which has the long-term history to understand the complexities of working with the different state goverments. However, many hypnotherapists would not want to join the ATMS because they have made great investments in joining and operating out of other associations.

The ACA is currently undergoing legal restructuring so its board will be elected members but again as an organisation it is unlikely that it can represent the needs of hypnotherapy as a separate profession. The needs of clinical hypnotherapists are ultimately different from those of counsellors or psychotherapists, even though those professions could work together for greater recognition and many hypnotherapists may also be counsellors or psychotherapists.

So getting all the representatives of the hypnotherapy community around a table would be the first order of the day. The recent formation of the Council of Clinical Hypnotherapists has shown that immediate surrender of power by those hypnotherapy community leaders will not happen easily. What could be feasible is if they all join a national committee for the consolidation of the hypnotherapy profession. This could include associations and schools but what must be remembered is that schools are generally in the private sector and are for-profit enterprises. Associations, on the other hand, should always be a not-for-profit corporation and must always be separate from the interests of schools and not just alumni organisations.

What that committee would be called is at this stage irrelevant as the most important elements are cooperation between all major hypnotherapy organisations. The establishment of a national register is very important but that will require some major figures in the industry to be very cooperative. Trust among organisations will only happen if absolute, complete transparency is the first order of the day with issues such as:

Minimum Standards of Training

Open Elections of Association Officers With Fixed Terms

Clinical and Ongoing Supervision Requirements

Ongoing Education Requirements

Complaints Procedures

Ultimately a National Register

The past disputes between different organisations have to be left behind us as hypnotherapy practitioners. Not only must all practitioners on a national register have access to information about the way the register is run but the public must also be able to access the information at the drop of a hat on the web as can be done with the APS or the AMA. Respect, trust and recognition will only ever be acquired by the Australian hypnotherapy profession through complete transparency and public accountability, and at this very moment in time no one single organisation fulfills those criteria.

Bibilography

Armstrong, Phillip, Self Regulation In Counselling, Counselling Australia. Australian Counselling Journal, Volume 6 no 3, Spring 2006.
http://www.theaca.net.au/journals/journ_archive/ACA%20Mag%20Vol6%20No3%20Spring%2006.pdf

©HypnosisAustralia, May 2007

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