"The Psychologist", 'False Memory Syndrome', Academic freedom and censorship, Board of Trustees, Expulsion of President-Elect, Gender, Governance, Identity Politics, Memory and the Law Group, Prescribing Rights

Legal storm clouds over the BPS

David Pilgrim posts….

For those new to the chaos in the BPS, its organisational vulnerability today is multi-layered. The Charity Commission has, until very recently, been ‘engaged’ with the Society about lack of compliance concerning governance arrangements. Slowly, maybe resentfully, the leadership in Leicester has tinkered around the edges. 

The Society’s ‘Board of Trustees’ has been a phoney structure since the 1960s, but now a few public invites are to be issued, to appoint nominally independent members. All trustees in a charity should have no conflicts of interest, not just a couple of tokens. As with other matters, the BPS leadership seems to lack insight about even the most basic principles of organisational probity (see below).

But compliance with charity law is the least of the problems for the current BPS leadership or, note, past leaders with their ongoing legacy liability. We were told via YouTube, when Nigel MacLennan was expelled kangaroo-court-style, that this has been a ‘challenging year’. This of course was special pleading from those running the Society. The wider membership had been kept completely in the dark about the corruption and misgovernance, so they experienced the lock down, oblivious to any personal pain suffered by the leadership, with its ‘challenges’.  

This glib ‘challenging year’ trope in BPS propaganda has persisted, both vague in its detail and directed at sympathy from anyone taking it seriously. Covid-19 had been a safe cover story of collective bad luck and victimhood. Whichever way the challenges in Leicester are spun to the outside world, the reality is that the BPS is in serious legal trouble.

Three imminent legal threats to the reputation of the BPS

Here are three points to consider seriously:

Nigel MacLennan’s Employment Tribunal will require that the BPS must now take the dirty washing it has stuffed in a bin bag and put in a cupboard somewhere, and empty it out on to the floor of the courtroom for all the world to see. The evasions and snail-pace adjustments, which might have worked in response to the Charity Commission, will not be tolerated in a court (which is the formal status of an Employment Tribunal). Much more could be said on this, but a sub judice caution comes into play here, so I am just reporting the material fact of what is about to happen in 2023.

Post-Cass Review and Post-GIDS closure, the BPS guidance on gender has now been withdrawn. The leadership are not responding, in a timely manner, to a dilemma shockingly new to them. In the autumn of 2019 criticisms I made of Tavistock Clinic GIDS were censored by the BPS. In the summer of 2020, representations from many BPS members about the serious inadequacies of the 2019 guidelines on gender were simply ignored. In the autumn of 2020, a detailed formal complaint concerning the form, content and context of 2019 revision of the gender guidelines was made but not upheld. Also in autumn 2020, further representations about the risks of extending prescribing rights to psychologists (which would have included hormones) were ignored by BPS leaders. In the spring of 2022, yet another multi-signed letter to BPS leaders about the risks posed to the public by the gender guidelines was simply ignored. This did not even receive an acknowledgment, let alone a considered response.

Only when the world outside was telling Leicester in stereo, and at full volume, that the game was up on the ‘affirmative model’, was action triggered. Over the recent years, its own members had been treated with total contempt, when lobbying for the withdrawal of the trans-captured gender document. The wise have kept a copy of the policy document now removed. It cannot be deleted from history, no matter how convenient that would be for all of those, from the Board of Trustees and the Practice Board to the ‘Comms Team’ and The Psychologist, who were complicit actors in a flawed policy.  

The credibility of their group-think will now fracture in the full public glare of legal scrutiny. Recently The Times reported an incipient class action, involving up to a thousand ex-patients of the Tavistock Clinic (in truth that figure may be larger or smaller). Whatever their number, the legal bill will be picked up by the NHS Litigation Authority (NHSLA). Its work is supported by top-sliced money from constituent local Trusts, so it is supplied ultimately by the tax payer. 

The Tavistock Clinic will survive, albeit embarrassed. It will be rid of a capricious historical deviation, which held the proven tradition of cautious exploratory psychological therapy in complete contempt, confusing a passing and modish social trend with a genuine ‘social revolution’. The medical sterilisation of healthy children is shaping up to be yet another ‘great and desperate cure’ in the murky biomedical history of psychiatry (and now, more importantly, psychology) (Valenstein, 1986). These children, who cannot vote, give consent to sex, buy alcohol or even have a piercing or tattoo at their own request, has been put forward by adult identity politics activists as a harbinger of social progress. 

In the censored exchange in 2019 and noted above, between me and Dr Bernadette Wren, that assumption of political and ethical worthiness was debated. As a champion of the now discredited GIDS, Wren actually described the explosion in referrals as reflecting a ‘social revolution’ (sic). I am sure she believed that, but history will surely not vindicate her position, given that her claim is already unravelling and there is a service policy push back, here and in other countries, about the ‘affirmative model’. Social contagion, yes. Social revolution, very doubtful. A passing postmodern phase of anti-realist madness, most probable.

Many liberal and left leaning people (this is not just a Daily Mail editorial frothing at the mouth) simply never bought the GIDS progressive claims. Nor did they fail to spot the trans-capture in the BPS and elsewhere, including in the Royal medical colleges, which should have known better. For example, a group have just written to The Observernoting how the leadership of the Royal College of Psychiatrists had fended off representations, similar to our own in the BPS (see under heading Trans Concerns) https://www.theguardian.com/theobserver/commentisfree/2022/aug/14/why-surprise-when-wealthy-capitalist-makes-large-donation-to-oxford-college

This span of dissenting voices has now been vindicated.  Complex existential challenges, each with their unique biographical context, cannot be cured by crass interference with the body, but it seems that mental health professionals are still slow learners. Their organisational leaders, fawning for popular support in an age of identity politics, have for now often lost their rational capacity to assess evidence or accept material realities that are immutable (Pilgrim, 2022). 

Faced with this historical moment of reckoning, the BPS does not have the luxury of a legal fund, like the NHSLA, to fall back on. The grateful medical negligence lawyers, who are now welcoming ‘regretters and detransitioners’ through their shiny doors, will inevitably take an interest in the professional advice that supported the ‘affirmative model’, now defunct at the Tavistock. The cabal in Leicester would be wise to take their own legal advice about what is in the pipeline.  It will of course be paid for by members’ fees. It may well entail very large amounts of money.

3 And then there is the contentious memory and law group, which has been the other main arena of policy capture, afforded by weak governance. The enmeshment of the BPS and the British False Memory Society is now clear (Conway and Pilgrim, 2022). However, in 2014, the editor of The Psychologist made this definitive and untenable statement: “Neither The Psychologist nor The British Psychological Society has links with the British False Memory Society.” 

This denial was at odds with the fact that the Chair (now deceased) of the BPS Memory and the Law Group was on the Advisory Board of the British False Memory Society, during the time that Elizabeth Loftus was on the International Panel of Associate Editors of The Psychologist.  She was also an advisor to the US and British False Memory Societies (The first was closed down after the Jeffrey Epstein case.) Loftus testified in defence of both Ghislaine Maxwell in 2021 and Harvey Weinstein in 2020. In the first case she asserted, with no evidence, that the prospect of financial gain could distort the memories of complainants. This line of speculation in legal settings is not peculiar to Loftus. It has been used by convicted individual abusers, as well as those claiming that child sexual abuse is a moral panic.

In this context of the serious legal considerations of sexual abuse, the biases in the BPS policy to date are very important, as is the supportive role of The Psychologist.  In May 2014, its editor provided a short hagiographic account of his interview with Loftus (he met at a conference dinner), who had ‘been voted the most influential female psychologist of all time’. It goes on, ‘Her wit and creativity shone through as she rattled through real-life stories, wrongful convictions and ingenious research that all illuminate the faulty nature of memory…. One thing seems undeniable: whatever the future brings for memory research and practice, Professor Loftus will be at the forefront of it for many years to come.’  

Because the BPS is an organisation without a memory, others have to recall the origins of its partisan policy focus. The BPS line, from their highly biased report, considering only the matter of false positive decision making, has fed defence teams hired by those accused of sexual abuse. It has offered absolutely no balancing advice about false negatives, in order to support prosecution teams. Those in the BPS, who have been concerned to expand the policy on memory, to include evidence of the social epidemiology of child sexual abuse and its proven mental health impacts (e.g. Cutajar et al. 2010) have been systematically excluded from a new working group looking at the topic. 

This scandal of biased policy formation then is ongoing. It is not just a part of BPS history, now regretted. The group recently appointed to update the document remains shadowy and has only included (unnamed) so called ‘memory experts’, from the closed system world of experimental psychology. All attempts by those BPS members interested in the clinical and epidemiological evidence (an open system feature of the world outside of the laboratory) to join the group have been blocked repeatedly. Moreover, all attempts to ascertain who exactly is on this group have been met with refusals on grounds of data privacy. It seems that the older biases to consider false positive decision making may well remain. The implausible claim that the BPS is guided by the organisational principle of transparency is also obvious here. 

Meanwhile, the BPS, as with now withdrawn gender document, seems to have no capacity to reflect on the child protection implications entailed in a lop-sided and partisan, form of policy formation.  The only sop that excluded critics have been offered is to submit papers to a minor journal, which is under the editorial control of FMS supporters. As with the case of the gender document, the temporary capture of a weakly governed Society, by a particular interest group, has to await external scrutiny to expose its bias and the dangers this poses to the public. Once again, internal dissent has been quashed at the expense of both membership democracy and academic integrity.

As the evidence now accumulates from historical inquiries into child sexual abuse, both in the UK and Australia, the BPS policy is a new potential target for angry survivors, seeking personal justice. Their lawyers will have spotted that line of attack. The current BPS position, to date, has colluded with the idea that child sexual abuse has been a trivial moral panic. The truth of the matter is that its scale has been strongly under-estimated, as is now becoming clear, in both the statutory inquiries and clinical research (Pilgrim, 2018; Children’s Commissioner’s Report, 2016).

Conclusion

The BPS leaders are in for another ‘challenging year’. Hiding in the dark, under the security blanket of group-think, will not make the lawyers disappear by magic. They will still be there, rubbing their hands, when the blanket it whisked away. Critics of all the three forms of BPS failing, noted above, may have been easy to ignore by the cabal. The rule of law is a different matter. If those in Leicester are not worried by now about imminent legal threats to the reputation of the Society, then they clearly do not understand what is going on.

References 

Children’s Commissioner’s Report (2016) Barnahus: Improving The Response to Child Sex Abuse in EnglandLondon: UK Children’s Commissioner’s Office 

Conway, A. and Pilgrim, D. (2022) The policy alignment of the British False Memory Society and the British Psychological Society Journal of Trauma & Dissociation, 23:2, 165-176, 

Cutajar, M. C., Mullen, P. E., Ogloff, J. R. P., Thomas, S. D., Wells, D. L., and Spataro, J. (2010). Psychopathology in a large cohort of sexually abused children followed up to 43 years. Child Abuse and Neglect 34(11), 813–22.

Pilgrim, D. (2022) Identity Politics: Where Did It All Go Wrong? Bicester: Phoenix Books.

Pilgrim, D. (2018) Child Sexual Abuse: Moral Panic or State of Denial? London: Routledge.

Sutton, J. (2014). BPS – obsessed with the false memory syndrome? Editor’s reply. The Psychologist 27, 5, 303.

Valenstein, E. (1986) Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Radical Treatments for Mental Illness New York: Basic Books.

Administrator’s note

All of these topics have been subject to comments on the blog. By clicking on the category immediately above the title you will find the relevant posts.

"The Psychologist", 'False Memory Syndrome', Academic freedom and censorship, Expulsion of President-Elect, Gender, Governance, IAPT, Memory and the Law Group, Prescribing Rights

The British Psychological Society: Failing the Public

Pat Harvey posts….

Because of their acknowledged expertise, Psychologists enjoy professional autonomy; responsibility is an essential element of autonomy. Psychologists must accept appropriate responsibility for what is within their power, control or management. Awareness of responsibility ensures that the trust of others is not abused, the power of influence is properly managed and that duty towards others is always paramount.

Statement of values: Psychologists value their responsibilities to persons and peoples, to the general public, and to the profession and science of Psychology, including the avoidance of harm and the prevention of misuse or abuse of their contribution to society.

BPS Code of Ethics and Conduct, 2018.

A dysfunctional Society

The British Psychological Society’s serious governance dysfunction, the central concern of BPSWatch (1) has important consequences, not only for the way it behaves towards its own membership, but ultimately in how it functions in relation to its responsibilities to the wider community. A Royal Chartered Charity, (2) its formal Objects may not explicitly state that it has that latter duty and responsibility to wider society, but the second Object requires it to have a Code of Ethics and Conduct (3). That Code includes the statement shown above and only a legal weasel or a BPS bureaucrat might, if pushed into a corner, attempt to deny that the Charter does not require a duty to the public at large. 

The growing awareness of the organisational dysfunction and the wilful withholding of information about this brought us together to form BPSWatch and the associated Twitter account @psychsocwatchuk. Whilst we and others have as yet failed to create sufficient pressure to see the ongoing involvement of the Charity Commission with the BPS over its governance problems escalate into a full Statutory Inquiry, we have helped to get information out into the mainstream and other media: The Times, The Telegraph and Third Sector. They will no doubt renew and sharpen their interest as anticipated legal cases become public. Meanwhile the individual concerns initially brought to us about specific policy topics which have been mishandled remain unresolved. It is our contention, and that of the complainants who have contacted us, that each of these is a matter of public concern and public protection.

 Unbalanced Views and Member Complaints

Psychology is, and should always be, alive and comfortable with controversy and debate. Members have a right to expect an open facilitative climate, where the best of psychological research, practice and policy formation would be supported and discussion promoted.  We, and others, think the BPS is failing to do this and efforts to complain about such failures have led to our focus on the actual suppression of viewpoints and the active censorship of controversies including  

Gender

Memory-Based Evidence

Prescribing Rights

IAPT

These impact directly on practitioners and the people and services they work with, but they also impact upon discussion in public life. They are matters of concern to the mental well-being of individuals who are vulnerable and finding themselves in threatening situations in their communities, in a clinic or in court. They are psychological matters still open to alignments of differing viewpoints.  We believe the BPS has a duty to address these, elucidate their conflictual aspects, review and weigh the evidence base and its adequacy, and specify remaining questions. 

Since this has not happened, members have tried to complain. They have often been ignored or met resistance.  A network of disparate, dissatisfied complainants discovered each other by word of mouth and email chains, and we were encouraged by this to set up BPSWatch.  The writer came into this originally due to what I believed to be grossly inadequate and incomplete BPS guidelines on gender for practitioners (4) which I had discovered in connection with a high profile childcare case which went to court.  I considered the guidelines totally unfit for purpose and was minded to complain. I then came across a statement made by a key player in their construction. This person’s formal presentation as an expert psychologist was recorded at an academic forum which was posted in an online video. They made a categoric statement that, based on what they held to be definitive research findings, the question of psychological outcomes of gender reassignment surgery was closed, stating “…the debate is shut. There is not a debate about that anymore…”. This is not a statement that any Chartered Psychologist should be making either in form or in content. It constitutes what will be taken by audience and viewer as authoritative summation of the current evidence base on outcomes of surgery. It misrepresents how psychologists should talk about scientific enquiry, and is actually untrue. It is, therefore, unethical. Furthermore, as a ‘take-away message’ in that forum and online, with the implied weight of the British Psychological Society behind that person’s position and reputation, it is seriously irresponsible. That message had the potential to impact directly, if heard, upon people making life-changing choices.

The BPS complaints team batted the complaint about the statement away. The first response (stage 1), was a blithe and ironic “…we are a broad church…”. I persisted, with references, and this aspect of my complaint, whilst taken more seriously and addressed in more detail, was rejected. They stated “…Although there will always be some dissenting voices, the idea that this represents a real schism in the scientific community [note, this misrepresents my precise concern] … is incorrect…”. In fact, subsequent reputable research publications (5) have strongly supported my contention that the jury was still out on this, and the debate is, and should, remain open. Uncertainty about those outcomes remains, and needs to be the subject of much more adequate data collection, follow-up and methodologically sound research. The psychologist I complained about was peddling certainties, taking a protagonist/activist position in the guise of the science, and the BPS was wrong to continue to support that. Vulnerable people, their families and their rights are ill-served by false certainties coming from supposedly highly authoritative sources, backed by the BPS

Conflict Avoidance

I have cited the above to illustrate not only the tortuous experience of trying to make a complaint to the BPS but also to illustrate how poor is the quality of the Society response. In the case of another of the topics listed above, Memory-Based Evidence, the BPS took a different tack – they dumped the challenge half-way through. The BPS’s previous out-dated guidance on this area was deemed to have been skewed at the time (2008, 2010) by the impact of the false memory/recovered memory lobby (6). The BPS had seemed, over the years and in the pages of The Psychologist, to have had stars in its eyes around a famous and foremost proponent, Elizabeth Loftus (7). She had been made an Honorary Fellow of the Society and lauded for her subsequent awards. Not all members were happy about this (8). For the interest of the reader, an admirable and informative account of the journalistically styled ‘Memory Wars’ can be found outside the pages of academic journals and The Psychologist in the link below (9). Such informed coverage puts the BPS house journal to shame. During the of writing this article, a US jury have shown limited sympathy with the defence case for which Loftus gave her usual form of evidence (10) and Robert Durst has been found guilty of a murder committed 20 years ago.

 A BPS-appointed Task and Finish group was set up to revise their outdated guidance. There was a good deal of demand for this from practitioners who appear in court in connection with many kinds of trauma, particularly in the context of historical child abuse allegations.  Well into its work, the working group was unexpectedly closed down (11). The Psychologist published a statement from the Chair of the Research Board suggesting this was an amicable and consensual decision – we have been directly informed by participants it was not.  As one comment amongst the many to The Psychologist stated “…I am a member of the Memory Based Evidence Group and I would like the right of reply to respond about some of what has happened in this Group, which was tasked on writing a document on Memory and the Law. I am unhappy about the Research Board’s decision to disband the group, and I do not think that there has been a satisfactory answer to why such a decision was made; this decision was made without consultation with the group members, nor with the wider Society….“(11). The announcement in The Psychologist was made with this statement “Unfortunately, the standards of evidence for the report and the need for consensus and a convergence of evidence from experimental work and clinical practice, [my emphasis] as defined within the Terms of Reference for the group, could not be met.”. (11)

Contained within this statement, one which might immediately raise the questions: “Who set those terms of reference?” and “Isn’t the contentiousness the very reason for these guidelines?” is a clue to where some of the underlying and poorly managed tensions may originate. Academic/practitioner conflicts have dogged other psychological associations; for example the American Psychological Association and the Association for Psychological Science in the USA (12). As someone from a practitioner background, my view would be that there are serious drawbacks to research which sets out to answer questions arising from the clinical environment using crudely artificial analogues. Memory based evidence is one topic illustrating the drawbacks in using research set up in staged non-personal settings to discredit the opinions (in the legal sense) of practitioners working in non-analogous trauma related circumstances.  If you have any doubts about the dire need for an authoritative dispassionate view on this particular controversy to protect individuals on both sides in an adversarial court environment, consider what the absence of that psychological balance does – it leaves courts wide open to the machinations of the British False Memory Society. How it actually goes about doing its work is described in detail in this video (13).  A balanced view from the BPS could surely weigh the concerns about false positives and false negatives within the context of BFMS strategies, the applicability of academic research to traumatic memory, and social context of the serious underreporting of child sexual abuse (14). This would greatly assist in the court setting which itself attempts, as does a practitioner, a case-by-case assessment of veracity. The BPS Research Board have in effect kicked the revision of the guidelines into the long grass, the old guidelines having been archived.  These, however, are still available to be cited and used on the uninformed if you know where to look online. 

The BPS Working for the BPS?

Further discussion of these topics, and also of the implications of the BPS failings on Prescribing Rights and IAPT, can be found in specific articles on the blog (15, 16, 17). They illustrate a systematic failure to conduct proper consultation over key concerns in service provision models and health service professional practice. Why and how is this happening? 

The BPS, it seems, has an opaque system and uses equally opaque criteria for choosing its preferred advisors and for what policies are to be discussed with government departments and the NHSE. Feedback to members is minimal or non-existent. We have been reliably informed that a BPS CEO felt quite free to negotiate with NHSE without the presence of any psychologist. This leaves the room for a Society with an ever more rapacious in-house business agenda to be sucked into any government ideology where a shared vested interest may appear. The wider views of members working in the field may well be sidelined or completely ignored. The alleged current government agenda on privatising health care/moving to insurance models is open to facilitation by the self-interest of particular voices who manage to gain favour. In that context, note the latest BPS attempts to convince the NHSE and PSA that the Society can regulate an influx of less qualified younger members who will bring in fees and subscriptions to swell the coffers. There is little reason to think this will go well. In contrast to welcoming ever wider groups for membership, senior members seem to be regarded as a nuisance – maybe more trouble than they are literally worth, unless they are securely corralled within the system’s tent and staying ‘on script’ with the assistance of the Society’s Comms team – being one of the ‘cronies’.

Cronyism and Its Ills

We arrived at the term ‘serial office holder’ to describe how some psychologists have made a parallel career from being a BPS ‘apparatchik’. These psychologists move from one office to another over years (sometimes decades), sometimes elected, sometimes appointed. They make a virtue of their extended contributions. They are able to use the BPS logo on their websites and list the many impressive offices they have held on their CVs. Thus their BPS career is likely to enhance their professional reputation. They like to give each other honorary lifetime memberships and even when that is done in an AGM on Zoom in 2021, you may be expected to stamp your feet under your desk in approval.

 It would seem highly likely that a regime where cronyism is a norm will lead to complacency, lack of critical reflection, closing ranks, and resistance to newcomers taking important roles. An extreme example of this was the opposition to, and the action taken against, the President Elect 2020-21, Dr Nigel MacLennan. He was elected on a reforming mandate and then expelled. The expulsion was heralded in a vilifying YouTube video for all to see even before he had chance to appeal. We know many members thought that horrible and immoral, and one can only shudder at the extent to which living in the BPS bubble has distorted the judgement and the personal morality of those implicated in, and complicit with, show trial tactics. The person chosen to conduct his ‘appeal’, far from being independent of the previous proceedings and personnel involved, described himself in an interview with The Psychologist, on assuming his own presidential office, as “…a BPS Junkie since 1984…”. He has been around the corridors, real and virtual, of the BPS for more than 30 years, the BPS and he being ‘in each others’ DNA’ so to speak. 

Not all serial office holders are treated well in the BPS, however, particularly if they start to question how things are being done. They too may be attacked and threatened like MacLennan. We have heard how some become very distressed, visibly so in meetings, but then increasingly conform; others resist but remain peculiarly defensive of some idealised notion of the organisation and its capacity for change despite all evidence of its malign dysfunction. These patterns are reminiscent of what has been called Stockholm Syndrome. It is pertinent to consider how an unhealthy organisational environment where the main focus is self-perpetuation might allow for another form of organisational capture, by activism. Any would-be activist moles would be well-advised to get their feet under the table by not rocking the organisational boat and to volunteer for taking on work others don’t want. Then they just need to wait for their policy agenda to float into view and haul it in.

Psychologists, Psychology and Activism

The writer has been a lifelong political activist and vigorously supports, in her personal life, action on climate change, poverty, inclusivity and world peace. I took to the streets in the 1970s when my town elected National Front/National Party councillors. I was part of the making of a World In Action TV programme on that racist environment. Those passionate views had to be put on mute in my clinical work. I currently hold strong views about many of the contentious topics in psychology, but our focus at BPSWatch is to ensure that no partisan view – including my own – within an area of ongoing scientist/practitioner debate captures the BPS. Some activists had assumed because we criticised BPS bias that we supported their ‘side’ of a particular argument, hence we have revisited and set out our agenda (19) – good governance, not certain ‘causes’.

We argue in BPSWatch that gender, memory-based evidence, prescribing rights and IAPT are amongst the topics that have been captured by a particular viewpoint and its activists. What follows capture is that debate is shut down, information restricted. Certain topics are being precluded from teaching and some psychologists are being maligned. Deeply unfair accusations of transphobia, sexism, racism, classism (the list grows daily) are never challenged by the BPS. This is aided and abetted by The Psychologist which actively fails to give balanced coverage to all legitimate views. Members have told us how their contributions have summarily been spiked in the in-house publications. It is not for the BPS to enter party politics and campaign, for example, on specifics such as Universal Credit. Rather, it should be making available the best research on poverty in relation to child development, adult mental health, crime and suchlike, and vigorously bringing this to the attention of politicians and decision makers. The same applies, as with the topics covered above and numerous others, to public awareness of the best evidenced range of views within which individual people are making the kinds of choices that many face and which will often change the course of their lives. This does not include rushing to be a signatory to a range of worthy campaigns (and how is the decision to sign – or not – made?). These psychological matters are serious.

The Results of Misgovernance are Failing the Public

The well-staffed, wealthy but seriously misgoverned charity that is the current British Psychological Society continues to fail its members and the public on the most crucial of standards, and for this we will continue to hold it to account.  We have hoped to see moves for radical change which would enable open communications with the large membership, bottom-up consultations and an inflow of new actively welcomed volunteers.  We hope to see new healthy structures at the top of the organisation, independent lay people as trustees. We believe it is only then that the BPS will serve the membership and the public as it should. Sadly, it just is not happening and there are no signs, despite the recent talk of ‘crossroads’, change programmes and tinkering with governance, that the change will come from genuine reflection within. Perhaps, therefore, it must come from without.

**************

Notes and Links

  1. Why the blog and why now? Charity Commission to Blog Author: “We are currently engaging with the society over a number of issues and have found deficiencies in some areas of operation” https://bpswatch.com/2020/11/20/why-the-blog-and-why-now/ 
  2. https://www.bps.org.uk/sites/www.bps.org.uk/files/How%20we%20work/BPS%20Royal%20Charter%20and%20Statues.pdf
  3. https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20Files/BPS%20Code%20of%20Ethics%20and%20Conduct%20%28Updated%20July%202018%29.pdf
  4. https://www.bps.org.uk/news-and-policy/guidelines-psychologists-working-gender-sexuality-and-relationship-diversity 
  5. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.1778correction 

“The results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts in that comparison. Given that the study used neither a prospective cohort design nor a randomized controlled trial design, the conclusion that “the longitudinal association between gender-affirming surgery and lower use of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them” is too strong”.

  1. https://thepsychologist.bps.org.uk/volume-30/august-2017/positives-negatives-and-empirical-reasoning 
  2. https://thepsychologist.bps.org.uk/volume-26/edition-5/news
  3. https://thepsychologist.bps.org.uk/volume-30/february-2017/no-congratulations-here
  4. https://www.thecut.com/article/false-memory-syndrome-controversy.html 
  5. https://www.courttv.com/title/8-4-21-the-jinx-murder-trial-intense-cross-examination-of-memory-expert/
  6. https://thepsychologist.bps.org.uk/volume-34/april-2021/not-good-look 
  7. https://behavioralscientist.org/long-winding-road-125-years-american-psychological-association/ 
  8. See Dr. Kevin Felstead, Communications Director, British False Memory Society reveal their strategy at I hour 4 minutes in https://www.youtube.com/watch?v=1WsY-AqM4Y8 
  9. https://www.theguardian.com/society/2021/sep/02/millions-children-religious-groups-vulnerable-abuse-england-and-wales
  10. https://bpswatch.com/category/false-memory-syndrome/
  11. https://bpswatch.com/category/prescribing-rights/
  12. https://bpswatch.com/category/iapt/
  13. https://bpswatch.com/2021/09/07/bps-bullshit/ 
  14. https://bpswatch.com/2021/09/14/what-this-blog-is-about-a-re-statement/ 
Prescribing Rights

A challenge to the BPS on Prescribing Rights for psychologists.

Pat Harvey writes…

The BPS position on prescribing rights for psychologists is controversial and the Society has not carried out adequate consultation. The communication below has been sent to chairs of Divisions and Faculties, accompanied by the copy of a letter (below) signed by 102 psychologists last October


Letter to Chairs of Divisions and Faculties of the British Psychological Society 20 March 2021

Dear Colleague

I am contacting you in your capacity as an elected office holder of a Division or Faculty within the BPS. I write on behalf of a group of around 20 clinical psychologists who are seriously concerned about the recent BPS decision to recommend to NHS England that some psychologists should have prescribing rights. 

We understand that NHS England will not be taking further action on this matter until the COVID crisis has resolved. The problem that we wish to draw to your attention is that the Division of Clinical Psychology has made little or no attempt to survey its members in a thorough, fair and transparent manner.  We are concerned that you and your members may be unaware of the position that the BPS is now adopting on this crucial issue for our future professional roles. We see this interim period as now giving an important opportunity to conduct a full, accurate and impartial survey of all BPS members, especially those who belong to the Divisions and Faculties that are most likely to be affected. A poll of a small number of counselling psychologists was carried out, but as far as we know, no other Divisions or Faculties have formally consulted with their members. 

To give a brief history: A group of clinical psychologists and service users expressed their concerns about extending prescribing rights in Nov 2019 in an open letter to the BPS. It outlined the many problems with the BPS discussion paper which was used as the basis for further consultation by the BPS Task and Finish group on Prescribing Rights.

Here is further information:  https://www.madintheuk.com/2019/11/prescribing-rights-psychologists-cautious/

No response was ever received to the letter, although the authors were told that it had informed the subsequent discussions. The Task and Finish group on Prescribing Rights then proceeded, in our view on a flawed basis, to further discussion leading to its final conclusion, in which the BPS recommended to NHS England that developing a policy for prescribing rights for some psychologists should be pursued. Along the road to this point, a number of other very serious concerns about biased and misleading information, failure to consult, and extremely poor process, emerged. These were summarised in a letter with over 100 signatories (attached below minus signatures) sent to senior BPS staff on 6 October 2020. Despite chasing this up, the issues raised in this letter have never been directly addressed, and the recommendation went forward. 

In contrast, the ACP (the Association of Clinical Psychologists in the UK) carried out a survey of 439 people and found that the majority (58%) did not want prescribing rights for themselves and also had concerns about other CPs being able to prescribe. They found that 17% want to prescribe themselves, 16% were uncertain and 9% did not want to prescribe themselves but had no concern about other CPs prescribing. 

We have reason to suppose that there are other agendas are driving the current conclusions, but we hope you agree that the overriding priority is to have a fair and transparent discussion in which we can consider what will ultimately be best for clients and service users and for the unique contribution our professions can make.

Please let me know if you would like to discuss this further with one of the core group of 20 clinical psychologists who have been involved in trying to ensure fair process. If you wish to discuss the issue more generally Professor Peter Kinderman has agreed to be contacted via email on profpeterkinderman@gmail.com  If you receive any further feedback from members it would be helpful if you could let me know. 

Best wishes

Pat Harvey Consultant Clinical Psychologist, Psychology and Counselling Service Manager (retired) BPS No. 4810

Copy of email letter sent 6 October 2020 to Hazel McLaughlin, BPS President, copied to Sarb Bajwa, Kathryn Scott and Esther Cohen Tovee. Heading: ‘Urgent expression of concern about prescribing rights consultation process.’ Signed by 102 psychologists.

hazel.mclaughlin@bps.org.uk DCPUKChairDrEstherCohen-Tovee@ntw.nhs.uk Sarb.Bajwa@bps.org.uk Kathryn.Scott@bps.org.uk

Dear Hazel McLaughlin,

We write to express our grave concerns about the proposal to extend prescribing rights to some psychologists, and about the process through which the BPS view is being decided. This decision has the potential to produce major changes in how psychology and the BPS are seen by the general public and in the ways in which psychologists work with people referred to them, as well as how they work alongside other professionals. An open letter to the BPS outlined many other serious concerns, including the growing awareness of overprescription and withdrawal problems in antidepressants, and the overuse and misuse of psychiatric drugs in people with learning disabilities and older adults https://www.madintheuk.com/2019/11/prescribing-rights-psychologists-cautious/ . Equally complex issues are raised by the prospect of prescribing in other proposed settings, all of which deserve careful consideration in their own right.

All of this has serious, undiscussed implications for our core professional roles and independence. Particularly in mental health settings, there is a risk of jeopardising our specialist expertise and the psychological perspective that is so important and already under-represented, thus reducing rather than increasing service user choice. The requirement for prescribing psychologists to use diagnostic categories directly contradicts the DCP Position Statement on Classification (2013) which called for a move away from functional psychiatric diagnosis, and the DCP Good Practice Guidelines on Psychological Formulation (2011), which describe formulation as an alternative to, not an addition to, psychiatric diagnosis. The gravity of the implications in already highly controversial areas, and the strong opinions held on both sides of the argument, demands a thorough consultation process which is open and transparent, balanced and unbiased. It needs to be based on sound methods and evidence and to ensure that BPS members are fully informed about the issues and implications. None of this has happened. This at the very least risks reputational damage to the BPS.

We understand that the Prescribing Rights Task and Finish group is submitting a document to the Practice Board for a final recommendation this week. If the Practice Board agrees, as seems likely, then NHS England will be informed that psychologists want prescribing rights to be extended to some psychologists. Yet there has been no adequate consultation of members. On the contrary, the initial discussion document was mainly based on extremely small numbers and convenience samples from two conferences. The only professional group specifically consulted at this stage was counselling psychologists, in spite of the fact that clinical psychologists are likely to be seriously affected. This document also failed to inform members of many of the issues and evidence relevant to the prescribing rights proposal, as set out in responses to the consultation. What appears to have been the final stage of consultation consisted of a BPS online event which can only be described as a travesty. It was originally set up as a debate between two panels for and against the proposals, so that members could be presented with a wide range of views. Twenty-four hours beforehand, the ‘against’ panel found out that that the format had been changed, on spurious grounds, to a question-and-answer session with members of the task and finish group and one of their nominees (a psychologist prescriber from the US.) As a result, the ‘pro’ discussants outnumbered the ‘anti’ one by five to one.

It is essential that further discussion and consultation takes place, as happened with previous issues. For example, when the clinical supervisor role was first mooted, the DCP conducted a survey garnering 681 responses which were published before any decision was taken. In contrast, this consultation process has been grossly inadequate in the following ways:

  • Lack of adequate discussion across the BPS membership (and indeed psychologists who are not members of the BPS). An informal poll on the UK Clinical Psychology Facebook site resulted, a few hours later, in over 550 people saying they were unaware of the consultation.
  • An initial consultation document based on ‘how’ not ‘whether’ prescribing rights should be granted; was poorly evidenced; and failed to highlight many of the key issues. For example, the article cited to support the likelihood of psychologists of ‘de-prescribing’ (Linda & McGrath, 2017), actually found that on the “last full day of patient care” prescribing psychologists in the US had decreased medications in an average of 2.18 of cases but increased them in an average of 2.93 of cases. In addition, over the previous 12 months, 83% of the patients were given a prescription, only 16.33% were seen for therapy alone, and 29.3% were seen for medication alone (Linda & McGrath, 2017).
  • Failure so far to involve affected divisions, particularly the DCP, which represents the largest group of psychologists in the BPS.
  • Strong opposition from significant numbers of psychologists (as evidenced by the many unanswered concerns raised in the online discussion; the strong reservations expressed on the UK Clinical Psychology Facebook site; and the open letter to the BPS in 2019 https://www.madintheuk.com/2019/11/prescribing-rights-psychologists-cautious/).
  • Failure to involve service users adequately.
  • Lack of clarity about aspects of the proposals (such as the need for supervision by consultant psychiatrists or other medical specialists; the requirement to use a diagnostic framework).
  • Biased representation in the Task and Finish group, as acknowledged by chair of theProfessional Practice Board Alison Clarke in her article in The Psychologist https://thepsychologist.bps.org.uk/volume-33/march-2020/more-debate-prescribing-rights
  • Pressure on members of the Task and Finish group to agree to the proposals.
  • The decision not being taken at the appropriate level of the BPS, given the very major implications for our practice and our professional identity
  • Additional serious questions about the consultation process, including but not limited to:
  • –  the fact that most questions raised by the audience in the online BPS event were aboutconcerns, but only 3 out of 70 were responded to
  • –  the biased public BPS video on prescribing rights, in which only 5 seconds out of 3 and a halfminutes were devoted to possible disadvantages of the proposal
  • –  the marked failure to clarify the process by which the decision would be made – for example, the precise role that the debate, the email responses and the public consultation will play in the outcome.

We are aware that the Task and Finish Group believes it has already considered all the relevant issues. Clearly, not only has appropriate and serious attention to the many issues involved not been given, but also the process of discussion, consultation, dissemination of information to members and others, and decision making has been shockingly poor. We have been contacted by many colleagues, service users and others who are quite rightly deeply concerned. We fear an exodus of these psychologists from the BPS.

We look forward to a very prompt reply to this issue, given that a decision is due to be rushed through this week. We hope to hear that the process has been suspended so that genuine consultation and debate can take place. We will be pleased to provide any further information you may need. Please can you let us know that you have received this letter.

Reference

Linda, W. P., & McGrath, R. E. (2017). The current status of prescribing psychologists: Practice patterns and medical professional evaluations. Professional Psychology: Research and Practice48(1), 38-45.

Gender, Governance, Memory and the Law Group, Prescribing Rights

Why the blog and why now?

Charity Commission to Blog Author: “We are currently engaging with the society over a number of issues and have found deficiencies in some areas of operation”

The editors of this new blog, who are identified in the About Section above intend to try to inform members of the BPS about the issues of concern and generate a forum for discussion and disagreement. It is our contention that in this culture of a failing bureaucracy and resistance to scrutiny, the British Psychological Society had been subject to institutional capture by psychologists who are activists within frameworks of identity politics and by the cronyism of an in-group of psychologists. 

The results of this are serious and betray the Royal Charter and the fundamental purpose for which the Society was founded.

The current President Elect’s  election statement began with proposing that whilst the comment “For far too long it appears that the BPS has been run by paid staff for paid staff at the expense of members”…is  “…not the case, but it feels true because members’ and volunteers’ experience is that the service they pay for is not as it should be”. It is believed by the editors of this blog that the President Elect has received specific resistance from staff and trustees of the Society in the process of his taking up elected office.

Psychologists who complain to the Society find their communications are at worst repeatedly ignored or, if they get a response, their complaints are not properly investigated. A recent complainant who identified what they considered to be a serious breach of the Society’s Code of Conduct was merely told “we are a broad church”. The Society’s own complaints procedure is patently not followed by the anonymous “Complaints Team”. There have been instances where the mechanism for investigating a complaint against the CEO or senior staff has seemingly been for their juniors to deal with the complaint!

Psychologists with recognised professional and academic standing who have attempted to debate controversial areas of applied psychological practice have been censored and there has been interference with editorial decisions.

A recent letter signed by over 100 practicing psychologists disputing the conduct of a consultation process supposedly advising the NHS about prescribing rights has been completely ignored.

Guidelines relating to practice in complex and controversial areas have been produced which are totally unfit for purpose in that they are a polemic for one assessment and treatment approach and ignore serious ethical considerations. A clarification has been issued, not via a revision of the guidelines but by an unattributed BPS statement in The Psychologist. A group which had been reconvened to revisit another controversial issue has been wound up by the BPS on the grounds that “due to the high level of debate…. It hasn’t been possible to reach the consensus needed… after careful consideration the BPS Research Board has made the difficult decision to bring the work of the Memory Based Evidence Task and Finish Group to a close”. We believe shutting down is the opposite of what the members, the courts and the public have a right to expect from a Learned Society.

There will follow a series of posts looking in detail at serious problems surrounding the functioning of the British Psychological Society.

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Pat Harvey (Guinan)

BPS member No. 4810