Domestic Abuse Bill — House of Lords, 2021-02-08
Topic: Health
Ilora Gillian Finlay (Crossbench, Unknown): My Lords, this important amendment seeks to include controlling and coercive behaviour by a psychotherapist or counsellor in the Bill The noble Lord, Lord Marks, and the noble and learned Lord, Lord Garnier, clearly laid out the reality of very unscrupulous practices. When working as they should, psychotherapists are generally trained to work over a long period of time with more complicated mental health issues, whereas counsellors are generally trained to work in the shorter term with life issues such as bereavement and relationships—although in practice there is huge overlap A problem arises for the person whose world is in tatters, who feels at sea and is desperate for some help. How do they have any idea whether the person they have been referred to or had suggested to them to see is a charismatic charlatan or an excellent counsellor who will help them to restabilise their life? In this process, they are even more vulnerable than prior to the consultation—a vulnerability that is exploited by the unscrupulous and by sects, as we have heard. They go to speak to a stranger, often paying for the privilege, and as they tell their story, they reveal their vulnerabilities and are often retraumatised by remembering the abuse as they relate events. This is psychological intimacy, and the person is certainly profoundly psychologically connected to their victim As we have heard, only the titles "clinical psychologist" and "counselling psychologist" are professionally restricted and must be registered with the Health and Care Professions Council. By contrast, the terms "therapist", "psychotherapist" and "counsellor" are not protected; courses in these subjects are unregulated and vary very widely, which leaves unregistered and poorly trained people wide open to engaging in controlling and coercive behaviours Reputable employers providing counselling services, such as Women’s Aid, will expect an employee to have undertaken professional training. Often membership of a relevant professional body, such as the British Association for Counselling and Psychotherapy, the UK Council for Psychotherapy or the National Counselling Society, is required to ensure continuing professional development and ongoing supervision to enhance practice. All these bodies stipulate certain standards and ethical codes Proposed new subsections (1) and (2) set out what constitutes an offence and emphasise that controlling and coercive behaviour can be both physical and psychological. However, given the lack of regulation, I wonder whether this important amendment sets too high a bar, even for registered and well-trained professionals Proposed new subsection (4) raises a concern for me, but I am sure that it can be sorted out. It states that it is a defence to show that, when engaging in the behaviour in question, the psychotherapist or counsellor was acting in the person’s best interests. Here I declare my interest as chair of the National Mental Capacity Forum. As your Lordships know only too well, the term "best interests" is laid out in the Mental Capacity Act If a person has capacity to consent freely to whatever is proposed, there seems no rationale to make a best interests decision for them, and no form of controlling or coercive behaviour would be in their best interests. The person must have had the capacity to be able to consent to the counselling session. If the person lacks capacity to consent to a particular decision at a particular time, that decision should be deferred until they regain capacity for that decision. If restrictions of any sort have to be put in place in a person’s best interests because they cannot consent to the proposal, a formal best interests decision-making process, as laid out in statute, must be undertaken. A deprivation of liberty safeguard procedure or safeguarding may be required. I am worried that this defence, as written in the amendment, actually lessens the safeguards of a vulnerable person. I am sure that that is not what it aims to do.