Ideology and Politics in the Struggle to Regulate the Talking Therapies: The rise and fall of the HPC plans, 2006-2011

This thesis is a post-structuralist – ‘logics’/discourse analytic – account of the 2006-2011 struggle over plans to make the Health Professions Council (HPC) statutory regulator of the field of counselling and psychotherapy. I contextualise the plans in relation to the Government’s parallel Improving Access to Psychological Therapies (IAPT) programme and the Skills for Health (SfH) project to map competencies within the field. These projects, along with HPC regulation, promised to render practice safe and effective. However, the HPC plans were seen by some as a threat to diversity within the field and were met with resistance from the (especially formed) Alliance for Counselling and Psychotherapy Against State Regulation.I assess these competing evaluations and argue that the HPC plans would have advanced a ‘transactional’ orientated regime, in which the field would have been assimilated to a more ‘consumerist’ and ‘transactional’ mould, and that in contrast, the Alliance were seeking to defend a more ‘contextual’ and ‘relational’ conceptualisation of practice in which expertise tends to be seen as co-created between client and practitioner. The HPC adopted a series of bald strategies to marginalise opposition voices, conditioned in part by structural features of the policy making process and supported by a ‘problem minority’ narrative in which inherent uncertainties about what counts as good and effective talking therapy are eclipsed from view by a near-exclusive focus on a minority of unethical and incompetent practitioners. The Alliance, for its part, I argue tended at times to espouse a position close to talking therapy ‘exceptionalism’, thus eclipsing similarities with more contextual healthcare imaginaries. Policy implications for regulation and policy making process are drawn out. More broadly my account contributes to literature which questions both the democratizing credentials and the often supposed ‘inevitability’ of the highly calculative forms of regulation and audit which are installed across the health and social care professions and which have constituted the so called rise of the regulatory state in recent decades.