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Recognising prior learning in psychotherapy training:

A critical appraisal

Author - Aine O’Reilly

 

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A critical exploration raises uncomfortable questions about what accreditation means for psychotherapy training, rather than – or as well as – what RPL policy means for professional and academic training providers. Perhaps, even, where RPL is seen as a contested site, a place where tensions become visible, then critical examination of the issues it raises can be a useful if uncomfortable project for all of us involved in higher education. What, if any, differences lie between national and European standards and the values and beliefs of any educational programme? Are we measuring and marking – and thereby rendering visible – that which we consider to be the fundamental essential outcomes and processes of our education and training? What might we be leaving out of our programmes of education – and thereby rendering invisible – as a result of our focus on standards? How does this focus on standards and on processes and procedures shape our training provision and how does this shaping play out in the lives of our learners? These questions are not, perhaps confined to the psychotherapeutic domain, or even the higher education domain, but have resonance throughout education.

Formal recognition of psychotherapy training: an uncomfortable project

Formal academic accreditation of systemic psychotherapy training is problematic. It requires the shaping of training discourses and practices by external systems of meaning and valuing that at times do not fit with the meaning-making and valuing of the theories of psychotherapy. Systemic psychotherapy has undergone a period of challenge, critical self-reflection and change over the last three decades (Parker 1999). It has found its own claims to knowledge and expertise questioned not only from within (Guilfoyle 2006) but also from other regimes of knowledge production and professional practice such as academic accreditation processes, funding agencies, the courtroom, the medical centre, not to mention the novel, film and radio talk show. The questions of how psychotherapeutic knowledge is produced, who may lay claim to it, and the consequence of the practices based on this knowledge have become particularly significant, prompting an interrogation of the profession’s past (Rose 1985; Rose 1999) and its current knowledges and practices (Guilfoyle 2006; White and Epston 1990). Alongside the evidence-based questions common to any profession that lays claim to a scientific base and with it public funds – such as how effective is our practice, do we provide value for money, can we demonstrate a positive outcome from therapy, what standards are required of our profession? – lie ethical, theoretical, professional questions such as: What are the links between therapeutic practices and macro socio-cultural process and institutions? (See Rose 1985; Rose 1991; Guilfoyle 2006.) What are the implications of therapy’s tendency to construct and reproduce a particular value-laden version of personhood? (See Sampson 1989; Parker 2000.) How does therapy contribute to the maintenance and reinforcement of dominant oppressive structures? (See Rose 1999.) What are the implications of the construction of the individual as a local site for diagnosis and intervention? (See Simon 1998.) The evidence-based and theoretical/ethical questions are not unrelated; indeed their interrelationship provides another interactional layer of questioning: How does the acceptance of outcome measures for therapy or training, the measurement of effectiveness and efficiency and all the other regulatory processes that we are embedded in, impact on the ethical and theoretical positioning of psychotherapy? To what extent does the question of an evidence base for our practice highlight or obscure the relationship between therapy and macro socio-cultural processes? Or indeed to what extent do assessment of standards based on national frameworks shape the training of psychotherapists, giving value to some areas of therapist accomplishment (such as knowledge, skills, competence) and rendering invisible and without value others (such as being with another; critical reflexivity; ethical and personal reflections) (Larner 2004).

Challenges from within and without the systemic field have impacted upon the way the profession and its practices are constructed (see Boston 2000). With the postmodern turn in psychotherapy, totalising expert narratives are opened to interrogation, and the local, personal knowledges of clients, service users and consumers of services are given recognition previously unheard of. ‘[T]he power and privilege ascribed to those who were presumed to possess knowledge has been undermined, with the perspectives of all individuals understood as having validity in terms of personal truth’ (Sexton, Weeks and Robbins 2003: 6). Personal truth, local knowledge, the obscured and silenced tellings of history and stories become not only valued telling in the therapeutic domain; they are also challenges to the knowledge and practices of psychotherapy, acts of resistance to a psychotherapeutic grand narrative that shapes the client and indeed the modern self (Madigan 1999).

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