Counselling regulation : a qualitative study of the perceptions and experiences of NHS primary care counsellors

The NHS is the largest employer of counsellors in this country and directives from the Department of Health relating to effectiveness, quality control, evidence-based practice and accountability are relevant to their work. NHS counsellors also have to adhere to local policies related to clinical governance and are subject to inspection by statutory bodies. Although at present these issues relate only to the NHS, with the Government's stated intention to regulate the talking therapies, there are possible implications for the wider counselling world, including the voluntary sector. Using data from 6 semi-structured interviews, this study explores primary care counsellors' perceptions and experiences of regulation. The data were transcribed and analysed using the constant comparative method of qualitative analysis. Although this study does not propose any 'universal truths' about the possible impact of statutory regulation, it demonstrates a varied awareness of regulatory issues amongst counsellors and confirms that working within current NHS policies does affect counsellors' practice and how they feel as practitioners. The main finding of the study is that counsellors' creativity appears to be adversely affected by regulatory policies within the NHS, which are experienced as intrusive to the therapeutic endeavour and contribute to low job satisfaction, feelings of isolation and vulnerability, and a sense that something fundamental to counselling is being lost, leading to a desire to work elsewhere. The regulation debate so far in the UK has focused mainly on its practical implementation; this study suggests that the potential impact upon the intra-personal experiences of counsellors is also relevant and one that invites further research