Nothing About Us, Without Us

tl,dr http://www.bacp.co.uk/docs/pdf/16237_gender-sexual-relationship-diversity-001.pdf

It gives me a great deal of pleasure to finally be able to say positive things about the British Association for Counselling and Psychotherapy (BACP) which is the UK’s largest therapy organisation, by a long chalk.

Readers of this blog will be familiar with my having been quite critical of the BACP, which a decade ago kindly made me a Fellow of the organisation for my contribution to the field (having helped bring a trilogy of UK textbooks on working with LGBT people to the fruition back in 1996 and 2000, and founding Pink Therapy the organisation. I had hoped that might be the start of a much closer working relationship, but sadly not.  I finally resigned from BACP in March of this year (a year later than I thought I would) as I felt they still hadn’t made any significant progress to address my concerns.

After I resigned, I was gobsmacked that their CEO, Dr Hadyn Williams and their Chair, Dr Andrew Reeves came down to London to ask me more about the reasons for my resignation and dissatisfaction with the organisation.  Having consulted with colleagues, I was able to give them a 12-page document of comments and six significant points of concern of my own:

  1. Lack of Gender, Sexual and Relationship Diversity (GSRD) awareness amongst staff within the profession and amongst accredited courses.
  2. GSRD Counsellors are frequently experiencing a lack of understanding on their training courses which consistently fail to address their training needs or support them.
  3. Uncritical acceptance of highly contested concepts: Sex addiction workshops and porn addiction training are being supported by them when there is no agreement of these ‘conditions’ within the DSM or by WHO.
  4. Minimal curriculum development for courses on GSRD issues.  BACP could be leading the way and setting standards regarding core competencies and the development of teaching resources.
  5. Lacking in loyalty towards its members – not putting counsellors first – regarding their pay and contracts. Continuing to promote employers advertising for very low-paid counselling posts.
  6. Not having secured a way to retain people like Professor Michael Jacobs on the UK Register.  To require someone of his experience and stature to sit the ‘proficiency test’ is an insult to someone who helped build BACP back in the 1980’s.

I felt I was given a decent listening to and we shared some concerns.  They asked me if I’d be willing to be consulted on issues where my experience was relevant, and I eagerly agreed.

I was then somewhat surprised to learn in May that a working group had been set up to write a document on working with GSRD clients.  The membership of it was unknown to me, but I heard on the grapevine that only one of the group had openly declared their sexuality as gay.  It seemed that cisgender, heterosexuals were to be authoring a guide to working with LGBT clients.  It thought that would be unlikely if the guide were to be on working with Black and Asian Clients. It just didn’t make sense not to be approaching my colleagues or me at Pink Therapy and drawing on our expertise in this area.

However, in July, I was formally approached by someone at BACP to take a look at this document which was by now almost ready for publication.  It was so awful, I couldn’t see how it could be re-edited, and I recommended a complete re-writing by someone who had direct experience of the literature and the field of GSRD. I suggested they approach my clinical associate, Dr Meg-John Barker, as they have previously co-authored an excellent book in this area and were planning to revise it.  This field of GSRD therapy is changing so rapidly regarding language and concepts that their original text from 2013 is already in need of revision.

I was so pleased that BACP took my advice and that Meg-John could make time for the re-write.  This occurred just as they were about to have a writing retreat and so the BACP guide got bumped to the top of their list, and they produced what I think is an incredibly rich document.  Meg-John excels at taking a complex and highly nuanced material and making it accessible for people with little to no prior knowledge.

To its absolute credit, BACP accepted the text in its entirety (albeit with some concerns about whether there might be alternative terms which could avoid the use of the ‘f-word’ for fuckbuddy and genderfuck.  So rather than obscuring the offending word with an asterisk, they use the asterisk to state: *this term is the groups preferred identity desciptor [sic]. They also agreed to Meg-John retaining copyright and to make the document available widely and not just restricting it to members only.

So please give it up for BACP and a big round of applause for Dr Meg-John Barker for writing this fantastic document.
Please feel free to share it widely!  I know I will be!

http://www.bacp.co.uk/docs/pdf/16237_gender-sexual-relationship-diversity-001.pdf

BACP Gender Sexual and Relationship Diversity 001_AW (2)

Trans Hate on Sunday

I know many people’s leisurely Sunday was disturbed yesterday by another malicious piece of so-called journalism in the Mail on Sunday. I wonder if the Sanchez Manning the transphobic journalist who wrote for the third consecutive week about trans issues, this sensationalist article in the Mail on Sunday has ever sat with a suicidally depressed trans young person or bothered to explore the impact of transitioning on young trans people’s lives? Gendered Intelligence and Mermaids do masses of work in supporting young people and families in this area, and the YouTube is full of fantastic first-person accounts which offer hope and help save lives. The majority of parents of trans and gender-questioning young people are loving caring folk who are doing their absolute best to support their child.

The article referred to the new Memorandum of Understanding (MoU) which I reported on a couple of weeks ago. The MoU working group were always at great pains to ensure that therapists felt competent to have the difficult conversations about gender with their clients but to do so in a way that doesn’t privilege one decision over the other. Had the journalist and Stephanie Arai-Davies bothered to read the MoU they’d have seen that therapists need to be able to work with ambivalence and uncertainty about gender concerns without bias towards a particular outcome. Therapists support the person finding their answers to what they want to do about reconciling the conflict they feel about the gender they were assigned at birth and how they experience themselves.

The MoU stresses the importance of therapists being trained in working with concerns about gender and sexuality and seeing the quotes from Bob Withers, a member of both British Psychoanalytic Council and UKCP; it seems this part of the MoU is both relevant and necessary.  It seems like Bob Withers has a long history for expressing transphobic comments and this is particularly concerning since the clinic he co-founded in Brighton with his wife claims to work with a large number of LGBTQ clients.  Looking at his self-congratulatory posts and retweeting transphobes on his twitter timeline, I would concerned for any trans clients consulting him and wonder whether he might be in breach of the British Psychoanalytic Council and the UK Council for Psychotherapy’s Codes of Ethics for bringing the profession into disrepute?

Sanchez Manning’s interest in negatively reporting on trans issues is relatively apparent and verging on the obsessive. The week before they wrote another sensationalist piece about puberty-blockers under the headline: “We’ll give our son, 12, sex-change drugs: Parents want NHS to give their boy powerful puberty-halting treatment so he can be a girl” which probably wasn’t anything the parents said, but that didn’t seem to worry Manning, who must have missed the style guide on reporting on trans topics issued by Trans Media Watch. Oh, and publishing Alex Bertie’s photos without consent is SO not cool.

The use of anti-androgens (hormone blockers) is a standard treatment recommended by the World Professional Association for Transgender Health (WPATH) and based on best clinical practice.  It’s only used in exceptional cases after comprehensive and careful assessment, usually taking many months, and often at a time when the rapid changes of puberty make their benefit greatly diminished. The decision to use these medications is made by a multidisciplinary team (MDT) of doctors, therapists and social workers usually along with the parent’s support and the theory is that halting puberty will allow space for reflection, more significant cognitive and social development to occur. It’s not unusual to have other co-occurring mental health problems, and this is one of the reasons why an MDT is necessary. If the young person decides not to progress onto cross-sex hormones (currently at 16), they can stop the treatment at any time and puberty will continue.

Let me make this abundantly clear: An appointment with the Gender Clinic doesn’t mean someone IS going to transition, merely that they have someone who is skilled in helping them explore the issues.

The fact that someone in CAMHS refers a young person for specialist assessment could be seen as (a) how poorly trained most mainstream therapists are around these issues, (b) an entirely appropriate response to working within the limits of one’s competence or (c) a highly proper assessment and referral to specialist services. I would like to think it’s (c) because presenting with concerns about one’s gender identity is pretty standard nowadays for CAMHS staff to deal with although there is still a massive need for adequate training. The fact that a parent is unhappy with the referral needs to be worked with by the therapist, but we need to remember a 15-year-old is likely to be Gillick competent and should with all haste be referred. Research tells us that suicide attempts and self-harm rates for young trans people are running at around 50%. So we need to listen and promptly act when a young person finds the courage to come and talk to a mental health professional about their gender dysphoria.

The week before last, Sanchez Manning reported on sperm and egg preserving of trans young people before taking hormone blockers. Again, a recommendation of best practice laid down by WPATH. But Manning doesn’t seem to be that bothered about speaking to those involved in trans health care. They’re working for the Daily Mail after all which seems to revel in peddling hate and misinformation.

I wonder how a fringe group, Transgender Trend is telling a ‘story’ about youngsters being forced by the NHS into transition when quite the opposite is true. I’ve often felt the process of access to treatment (which may include hormone blockers, but more often simply involves psychological support) is incredibly slow, taking account of waiting times for a referral and then the process of assessment to determine suitability. If it’s agreed the young person should go on blockers, there is a further wait for the endocrinologist to see the young person and assess physical suitability (there is one paediatric endocrinologist working alongside the Tavistock GIDS). It has been known to take up to two years. Physical intervention isn’t a rushed process, and by the time someone starts (depending on where they were in their puberty when they entered the system), the impact of the hormone blockers could be very negligible.

What should concern parents is the bullying of gender-diverse young people.  Stonewall recently reported LGBT Bullying which is still rife in schools despite some progress being made in recent years and schools are doing better to address it.  However, 8 in 10 trans pupils are bullied, 4 out of 5 trans young people report self-harming and 1 in 10 receive death threats, there is clearly much more to do and I wonder whether Sanchez Manning and Transgender Trend think they are contributing to this problem?

The current best practice is to respect where the child or young person is at, to believe them, to help the parents support their child. Yes, some many children will change their mind about their gender after a period of social transition, but they will feel loved and respected whatever they decide to do. Childcare has moved on from the authoritarian days of the pre-1950’s where one was supposed to obey one’s parents at all costs to a more collaborative model of consent led mutual respect and where unconditional love is at the centre of ethical parent-child relationships.

Dominic Davies
CEO – Pink Therapy

 

New Partnership

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I’m pleased to share with you all, that Pink Therapy is partnering up with another online training organisation which therapists who want to specialise in working with the BDSM/Kink Communities.  Kink Knowledgable‘s co-founders Caroline Shabbaz and Peter Chirinos are hugely experienced clinicians and have built a comprehensive series of training courses to help raise the quality of mental health support available for people within the Kink communities.  They are also authors of a brilliant book on Becoming a Kink Aware Practitioner which I recently bought for my iPad Kindle App.

While we will continue to offer some essential BDSM awareness within our curricula, Kink Knowledgeable’s programme will be the place to go for those therapists who aim to specialise in this growing area.

Our partnership means Pink Therapy students will get discounts on undertaking the KK programmes.  We will also augment Kink Knowledgeable’s great faculty with some of our UK Kink Faculty and offer coaching and mentorship to some of their UK and European students.

It will also mean that some of our training courses may be eligible for American Psychological Association (APA) Continuing Education Units (CEU’s)

We plan to collaborate in various ways together, and more announcements will follow on from this one.

Here’s a short video announcement of our partnership:

Leading UK psychological professions and Stonewall unite against conversion therapy

It’s been a very long time in coming and it’s really hard to understand why we had such a battle to extend the provisions of the first Memorandum of Understanding to include people who are gender diverse and asexual.  It has caused ructions of which I’m unable to speak, but I am indebted to the Pink Therapy representatives on the working group: Pam Gawler-Wright, Meg-John Barker and Kris Black.  I also want to name check our allies in COSRT (Julie Sale) and the British Psychological Society (Igi Moon) for their endurance and commitment to ensuring this document comes to light.

It has caused ructions of which I’m unable to speak, but I am indebted to the Pink Therapy representatives on the working group: Pam Gawler-Wright, Meg-John Barker and Kris Black.  I also want to name check our allies in COSRT (Julie Sale) and the British Psychological Society (Igi Moon) for their endurance and commitment to ensuring this document comes to light.

“This document has the potential to change the way therapy is delivered in the UK for future generations, as it requires therapists to be trained to work with gender and sexual diverse clients.”  Dominic Davies – CEO Pink Therapy

The official and agreed media release is below:

An updated memorandum of understanding (MoU) against conversion therapy has been launched today, which makes it clear that conversion therapy in relation to gender identity and sexual orientation (including asexuality) is unethical, potentially harmful and is not supported by evidence. 

Conversion therapy is the term for therapy that assumes certain sexual orientations or gender identities are inferior to others, and seeks to change or suppress them on that basis.

The primary purpose of the 2017 MoU is the protection of the public through a commitment to ending the practice of ‘conversion therapy’ in the UK.  The 2017 MoU updates one released in 2015 at the Department of Health, which focused exclusively on sexual orientation, and is endorsed by the lesbian, gay, bisexual and transgender charity Stonewall.

The MoU also intends to ensure that:

  • The public are well informed about the risks of conversion therapy
  • Healthcare professionals and psychological therapists are aware of the ethical issues relating to conversion therapy
  • New and existing psychological therapists are appropriately trained
  • Evidence into conversion therapy is kept under regular review
  • Professionals from across the health, care and psychological professions work together to achieve the above goals.

Sexual orientations and gender identities are not mental health disorders, although exclusion, stigma and prejudice may precipitate mental health issues for any person subjected to these abuses. Anyone accessing therapeutic help should be able to do so without fear of judgement or the threat of being pressured to change a fundamental aspect of who they are.

You can download the document here.

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Fuming about Funding

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This blog is going to be a rant. It’s based on my observations over the last couple of decades as our sterling third sector organisations (they were called ‘Vol Orgs’ back then) have faced more and more hurdles to survive. The Chief Executives spend the majority of their time writing funding applications late into the night and over the weekends, chasing smaller and smaller grants. That’s less time on strategic planning of service development and even less time supporting the development of their staff and volunteers. It’s all become about chasing the elusive pot of gold at the end of the rainbow.

I was talking with a colleague over the weekend whose community mental health project is looking likely to be losing its funding. The project has been around for decades and is well-established and highly respected. But the process of Clinical Care Commissioning has decided in its infinite wisdom to award funding to a new project based on the medical model. Essentially the privatisation of mental health services – diverting money away from the vital third sector which has worked over the years to build solid relationships with their local community.

I’ve seen this happen time and time again – the most significant examples have been in HIV services in London where well-established organisations like PACE and GMFA lost their funding because capricious HIV Commissioners decided to try innovative (untested) new ways to reach out to at-risk communities. Thriving groupwork programmes at both charities were cut to train volunteer peer health educators to go into gay male social spaces (pubs and clubs) and try to engage them in conversations about their sexual practices and prevention strategies.

Over recent years, the NHS has gone through so many restructures that it’s hard to keep up with the changes. Funding became devolved from one source to another. Projects often need to apply for grants to their Local Councils and the Clinical Care Commissioning Groups and various charitable trusts. Each award comes with its criteria for auditing and monitoring of the relatively arbitrary and frequently unachievable targets that are set. This means that staff have to spend a great deal of time working on the quarterly reports to demonstrate how they’ve met (or otherwise) the targets. I am not arguing against auditing and monitoring of how taxpayers money is spent. Of course, this is necessary. It’s just that it can be so bureaucratic and laborious that it diverts skilled workers away from actually doing the work and creates another layer of paid bureaucrats doing the monitoring!

When the new project fails to meet the targets, funding is withdrawn. By the time this happens the previously well-established group has folded, or staff have moved on, and so our communities are left without the vital work, which had been identified and recognised, undone. Projects are often unable to speak publicly about their funders due to confidentiality clauses, and the threat of having their funding withdrawn makes them as compliant as the man whose dominatrix has a hand firmly gripping their balls.

One of the principal reasons I’ve never applied for external funding is because of the strings attached make one a puppet which dances for many masters. Chasing an ever decreasing pot of gold, competing against well-established services – and ruthlessly undercutting them. I just didn’t have the stomach for it.

We need to speak out and support our third sector organisations and the innovative work they do and challenge cuts to services.

Please support the work of the LGBT Consortium http://www.lgbtconsortium.org.uk/ 

Dominic Davies
CEO – Pink Therapy
16 October 2017

Gay Essentials: A NEW weekly meeting group/workshop in London – for Men Who Love Men!

Good luck to colleagues Nick Field and Gian Montagna and all the men who participate in this interesting group

Nick Field Counselling, Central/South West London

Word Art (1)-1I have recently got together with a colleague of mine, Gian Montagna, to set up and facilitate a new weekly meeting group in London, for gay, bi, trans or questioning men.

Run every Monday evening over a period of 3 months (12 sessions), Gay Essentials will be a weekly space to experiment with and explore connecting in deeper, more open and authentic ways with other gay/bi/trans men.

Gay Essentials will also be an opportunity for men who love men to experience their own rite-of-passage into a more authentic, sexual and relationally diverse adulthood, whilst also sharing this journey with others, in a safe, contained and holding environment.

The issue of a [lack of] proper initiation and rite-of-passage into manhood is particularly relevant for men who have sex with/desire/have romantic or platonic relationships or want to experience a more authentic intimacy with, other men today: From the environment we grew up in, to the…

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