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A Therapist’s Duty of Care…

Sarah Waters is an adult psychotherapist who also specialises in Dyadic Developmental Practice (DDP) 1 which is attachment focused family therapy.  She is a member of  HART Group 2 (Health Advisory Recovery Team) and is on the steering group of Therapists for Medical Freedom3. Both include psychological experts that share concerns about policy and guidance relating to the COVID-19 pandemic.

The following is a story presented in a particular form of narrative research, where findings from the therapy room are presented in a fictional format to explore clinical processes and ethical dilemmasall of the characters and the situation itself is entirely fictitious – no client confidentiality has been compromised.

Within the piece, Sarah has explored what it might have been like to encounter the behaviours and rituals required by COVID-19 health advice & mandates in a world before COVID-19. What would we have made of them in 2019 as counsellors and therapists? If you were to strip away the fear of a virus and the media-led normalisation of the bizarre rituals that have now become part of our everyday landscape – what might our reaction have been to encounter a fixation with mask-wearing, germs, constant handwashing, testing, surveillance and enforced social distancing?

Without the endless media messaging which links the behaviours to virtue and safety, might we have been able to see more clearly the profound harms being caused by the measures, and been more honest with ourselves as a profession about the way they can be detrimental to both client and therapist in the relational work we do?

These are important questions to sit with as you read the following piece:


A therapist’s duty of care……

It is January 2019, and I am waiting in my therapy room for a new client, Daisy, who is 12 years old and being brought in by her mother. I am an experienced therapist, working for a charity supporting children and adults who are affected by Domestic Abuse:  

When they arrive, I am startled and alarmed to see them both wearing masks, plus mum has brought her 6-month-old baby with her.  Daisy looks pale, thin and her eyes are full of fear. They both seem terrified to take their masks off when I gently ask if they would like to. They sit down on the small sofa opposite me and huddle together.

The masks create a barrier and I find it very difficult to hear what Mum is saying, let alone start to forge a therapeutic relationship, as face coverings are so alien to human interaction and psychological safety4.

Daisy sits quietly and holds the baby whilst mum explains why she feels her daughter needs support. Daisy was once lively and vibrant, Mum says, but has lost her joyful zest for life. She spends most of her days in her room either behind a screen, or listlessly, lying on her bed. Even when she is ‘allowed’ out Daisy feels fearful being around other people, in case she infects them.

“Infects them with what?” I gently ask her. Daisy looks down, lacking the confidence to speak. Mum explains that her partner, J, has increasingly become obsessed with illness and dying, demanding that they all wear masks and stay away from people. J says they must sanitise everything they touch and test ourselves repeatedly with some plastic, test kits that had been ordered from China.

J expects all in the family to stick these tests up their noses and down the back of their throats, sometimes every day.  Mum is worried that Daisy is now starting to show signs of OCD and health anxiety. Mum also explains that she’s concerned about what is in the test kits5, and whether they even worked? Some days they tested positive but had no symptoms at all and on other days if one of the family had a cold or felt a bit unwell, the tests would show a negative result. Mum sounded so very confused by it all….

As the story unfolds, I become more concerned by the minute.  I’ve done a lot of Domestic Abuse, Attachment and Trauma training over my 20 plus years of working as a therapist and all my alarm bells were ringing, very loudly. The description of their daily lives just gets worse:

..J, who before this had been outwardly trustworthy and caring, insists it is for their own good and that if they don’t follow the rules they might die or kill others. J told them that the illness didn’t really affect young people6, but that Daisy could pass it on easily, particularly to the elderly, even if she didn’t have symptoms herself. Mum explained how bewildering it all was, as she had never known of an illness before that could be passed on if you didn’t have any symptoms. However, Mum and Daisy have always trusted J, so they go along with what they are told to do, even though it was damaging Daisy’s mental health and was making Daisy’s asthma much worse.

The fear messaging never stops, Mum continues, it is repeated, every day, all day. Life is dangerous, they must follow the rules or very punitive measures would be put in place. Posters have been put up in the house telling them what to do, they couldn’t get away from it.  The messaging has been going on and on for months and months without break. Neither Mum nor Daisy are allowed to speak to any friends or family who don’t believe in the illness. J even tracks their phones to make sure they don’t go anywhere or speak to anyone who doesn’t think like they do – it is a living nightmare.

Several things are running through my mind at this point as I try to understand the story that comes tumbling out, muffled behind the white paper mask. Is this a case of Factitious Disorder Imposed on Another7 (Which used to be known as Munchausen’s by Proxy) in which a parent fakes or induces illness in their child? Or is this a form of narcissistic abuse8, in which reality distorting, isolation and learned helplessness are well-known hallmarks and something I hear about on a day-to-day basis? My heart goes out to Daisy and the baby, who should surely be protected from this abuse, and to her mother, who seems completely hypnotised9 by her partner.  A web has been spun around them all, justified to keep them and others safe:

Mum goes on to explain that J is a good person, has provided for them financially and has always seemed to have their best interests at heart. Plus, J speaks with such urgency and conviction. Mum had trusted this person for so long and yet now many things just do not make sense. Why would J want to harm her and her two daughters after looking after them so well for so many years?

I wonder how Daisy’s mum can allow this to happen and not see the terrible damage that it is doing to her daughters. Her fear levels are so high she doesn’t seem to be able to rationalise what’s going on. I remember a video I watched the week before about the reptilian brain10 and how being in fear limits being curious, open, and engaged. It keeps us stuck in survival mode. I also know how difficult it is for those subjected to narcissistic abuse to have a real grasp on reality.

Even if there is an illness out there that affects mainly the elderly, treating a young person like this must surely be a form of child abuse?  What I am witnessing feels so manipulative that Daisy and her mum are oblivious to the fact they are experiencing abuse at all. The more I think about it and the more Daisy’s mum speaks – I know that this is a very clever form of narcissistic abuse. However, the physical masking and constant testing is something I have never heard of before. It does chillingly remind me of Baderman’s Chart of Coercion11. This describes communist methods for eliciting individual compliance used by the Chinese and Koreans against the American soldiers in the 1950’s. It is so cruel and potentially damaging on every level of development – both physical and emotional. Treating a young person like this is just not acceptable in the year 2021, surely?

My trauma training (and intuition) emphasises the necessity for safety, love, acceptance, connection, close relationships, play, empathy and most importantly, the absence of fear. All these are necessary for healthy emotional development. What I am witnessing here is the total opposite of that. Bowlby, plus all child development experts that have followed him, have emphasised time and time again that children are extremely vulnerable, but they must be resilient to survive. I can’t help thinking that he would be turning in his grave! Poor Daisy and her baby sister are clearly adapting in various ways to the hostile environment they are in, to ensure their own survival.  They may be permanently damaged by this. I feel sick to my stomach.

Looking at the confused face of the baby as it searches its sister’s and mother’s masked faces for comfort, my mind flits to the attachment workshop that I attended a few years before and I remember watching the video of the Still Face Experiment12. It showed the devastating effects, in a very short time, on a baby whose mother stops smiling at it for only a few minutes.  This poor baby would have great difficulty in determining what facial expressions J, Daisy and Mum would be exhibiting behind their masks which surely will present severe challenges for it as it grows up. Babies particularly depend on their parent’s facial expressions, coupled with tone and/or voice to regulate their reactions toward others.

I wonder if J understands the potential effects of prolonged mask-wearing? Or has thought about the potential long-term impact on the baby’s development? Maybe the threat of getting ill overrode all these concerns, but in my book, this is just not good enough. Surely baby’s emotional development must come first. The room soon fills with crying as the baby becomes completely dysregulated and inconsolable, unable to feel safe in the room, as it cannot read the cues of its mother’s blank and expressionless face.  A baby’s worst nightmare has, it seems, come true.

I switch my concern from the baby to Daisy, common sense telling me that wearing a mask all day, or even for a few hours, could surely not be good for her13, emotionally or physically. It must be restricting her breathing and reducing her oxygen intake plus possibly infecting her with expelled germs. Goodness knows how it will be affecting her immune system. On top of this, not being allowed out much to breathe fresh air and being separated from her friends and family, is a complete and utter recipe for disaster. With the persistent use of toxic sanitiser and being full of fear, I can’t think of a worse breeding ground for sickness.

My mind is racing about all the physical consequences that it hardly has space to think about the emotional. What must this poor child be going though? Surely her emotional development will also be affected, especially as her mother and partner are also wearing the masks. My mind flits to Steven Porges Polyvagal Theory14 – a subconscious system for detecting threats and safety and what he terms ‘neuroception’. Poor Daisy’s sympathetic nervous system must be being constantly activated by the fear messaging she is subjected to, day in day out.  The potential long-term consequences of this make me shudder.

Surely this is not all being done on purpose I think to myself – no one could be so cruel, surely?

I now recall my knowledge around narcissistic abuse and emotional blackmail. It is another tell-tale sign that I know from experience is intended to elicit feelings of fear, guilt, and compliance.  This is precisely how Daisy, and her mum are feeling. They are being gaslighted, which leaves them second-guessing, doubting reality, and their own judgements or perceptions. It sounds highly psychologically abusive, and dangerous to me. J is trying to isolate the family by keeping them away from others and demanding they stay 2 meters apart if they do meet anyone.

I know from my experience that this gives abusers a sense of control and power. It describes the split and alienation the narcissist will create to set their victims apart from others. This is often done through division and bullying. This serves to weaken and isolate leaving it easier for the narcissist to maintain control in the dynamic of the relationship. Abusive partners (or governments), aim to achieve this in a variety of ways. These include: trying to be seen to have another person’s best interests at heart, but through negative judgements and manipulation, slowly aiming to keep them away from loved ones. This creates an unhealthy over-reliance/dependence on the perpetrator.  This behaviour instils a form of trauma bonding15that is very difficult to break. The conditions for this to take place are to be threatened with, and to believe, that there is a real danger. This is coupled with harsh treatment interspersed with very small kindnesses, isolation from other people’s perspectives and a belief that there is no escape.

Everything Daisy’s mum is pouring out to me in our session suggests to me that this is what is going on.

Judging others is another defence mechanism commonly seen in narcissistic abusers: they will comment, both negatively and harshly, on other people’s actions, choices, speech, and beliefs. Passing judgement on others serves to make them feel better about themselves and helps them to maintain a position of superiority. I am thinking about this at the same time Mum is telling me that J had more recently started criticising everyone outside the family that doesn’t believe in what J is saying and about the illness. Apparently, J is making out that everyone that doesn’t follow the same safety practices as them are are unclean, spreading germs and should be locked up! The list of narcissist characteristics goes on and on. Finger-pointing, lying, projecting, not taking any responsibility, slander and withholding. This is really one of the worst cases of psychological abuse I had ever heard about.

As we come to the end of our session, I gently ask Daisy’s Mum if she has thought about leaving J and taking her daughters with her. From her passive response, it is obvious that she is in a state of learned helplessness16.  This occurs when an individual continuously faces a negative, uncontrollable situation and stops trying to change their circumstances, even when they could do so. I gently explain to her that I will have to report what she has told me to the local safeguarding team as a matter of urgency.  This is my duty as a therapist when told about any form of abuse towards a child or young person. She was informed of our safeguarding policy prior to our appointment so is aware that confidentiality is waived in such circumstances. She looks at me with her large, fearful eyes and I can see that deep down she knows that what is happening is very, very wrong.  I can sense she feels grateful and relieved, as finally a trained professional is now going to take charge and call out the abuse.

Mum, Daisy and the baby leave the session and I immediately pick up the phone, my inner supervisor telling me this must be done straight away, no questions asked. I make the call and it is recorded.  I am assured that it will be dealt with as a matter of priority. The trained social worker at the other end of the phone is as shocked as I am. At last, I reassure myself, this young family will now get the help and support they deserve in the face of such shocking violations of everything it is to be human.


Covid Rules are blamed for 23% dive in young children’s development – with face mask rules among possible culprits17

Only six healthy children died of Covid in a year, but lockdowns fuel a youth health timebomb.6

The damage of masking children could be irreparable.13


REFERENCES

  1. https://ddpnetwork.org/about-ddp/dyadic-developmental-practice/
  2. https://www.hartgroup.org
  3. https://www.therapists4medicalfreedom.org
  4. https://onlinelibrary.wiley.com/doi/full/10.1111/1460-6984.12578
  5. https://www.steris-ast.com/techtip/overview-ethylene-oxide-residuals/
  6. https://www.telegraph.co.uk/news/2021/11/11/six-healthy-children-died-covid-year
  7. https://www.psychologytoday.com/us/conditions/factitious-disorder-munchausen-syndrome
  8. https://www.psychologytoday.com/gb/blog/toxic-relationships/201709/how-spot-narcissistic-abuse
  9. https://www.youtube.com/watch?v=uLDpZ8daIVM
  10. https://www.youtube.com/watch?v=XSXhpailcs0&list=WL&index=5
  11. https://safeguardingchildren.salford.gov.uk/media/1438/biderman.pdf
  12. https://www.youtube.com/watch?v=apzXGEbZht0
  13. https://brownstone.org/articles/the-damage-of-masking-children-could-be-irreparable/
  14. https://static1.squarespace.com/static/5c1d025fb27e390a78569537/t/5ccdff181905f41dbcb689e3/1557004058168/Neuroception.pdf
  15. https://paceuk.info/child-sexual-exploitation/what-is-trauma-bonding/
  16. https://www.psychologytoday.com/us/basics/learned-helplessness
  17. https://www.dailymail.co.uk/news/article-10247315/Face-masks-harm-childrens-development-Study-blames-significantly-reduced-development.html

An Open Letter to the Professional Bodies of Counsellors and Psychological Therapists in the United Kingdom: BPC, BACP, BABCP, BPS, HCPC, NCS and UKCP

17th February 2022

We write as a group of registered counsellors, psychotherapists and psychologists in clinical practice in the United Kingdom.

We are contacting you to express our grave concerns around Vaccines as a Condition of Deployment (VCOD) mandates for health and social care professionals, and the implications that these could have for our profession.

Whilst we welcome the recent suspension of the NHS vaccine mandate [1]We use the terms COVID-19 vaccines/vaccinations, injections and jabs interchangeably throughout this open letter. Whilst the COVID-19 jabs do not represent traditional vaccine technology and many of us consider the term ‘vaccine’ ethically problematic, we have used it here for clarity. to allow space for further public consultation, we are also aware that Sajid Javid, the Secretary of State for Health and Social Care, has made it clear that the debate on mandatory vaccination is far from over. He was quoted in The Times on 7th February as demanding that medical regulators send the “clear message” that healthcare workers must be vaccinated against coronavirus. [2]https://www.thetimes.co.uk/article/sajid-javid-tells-medical-regulators-to-insist-staff-get-jabs-q5z6wzv2f

The implication here is that the onus of enforcing and policing the vaccination status of healthcare workers could be shifted from employers to professional/regulatory bodies. We are concerned about the silence of our professional bodies on this matter and now seek urgent clarification on their positions.

We call upon our professional bodies to publicly reject any policy of mandating COVID-19 vaccines as a condition of registration and/or deployment amongst their membership – either now or at a future point. Furthermore, we urge them to commit to protecting the right to informed consent and bodily autonomy, both for their professional membership and the clients we serve.

In particular, we would like the professional bodies to consider and respond to our professional concerns on the following points:


1. Mandatory vaccination policies conflict with our professional ethics as counsellors and psychological therapists.

One of the core principles common to the Ethical Frameworks of all our professional bodies is that of upholding client autonomy and their right to informed consent to treatment.

As health practitioners, we rightly understand that no medical or clinical intervention can be considered universally safe. We know from our own practice that even authorised, regulated and ethically sound medical treatments can still pose significant risks and have the potential to cause harm at an individual level.

As such, suitability for any medical treatment needs to be assessed on a case-by-case basis and can only be authorised with informed consent from the client (so long as they have the capacity to do so), after they have been given full and accurate information around any potential risks.

This principle of informed consent is not only vital to our ethical practice, it is upheld as a central principle within wider medical ethics and international human rights law. For example, in the UK all medical interventions in the NHS must be fully voluntary and in line with this principle of informed consent:

The decision to either consent or not to consent to treatment must be made by the person, and must not be influenced by pressure from medical staff, friends or family… If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected. [3]NHS: Consent to Treatment – https://www.nhs.uk/conditions/consent-to-treatment/

In March 2015, a significant judgement about the nature of informed medical consent was made in the UK Supreme Court. [4]Montgomery v Lanarkshire Health Board The court clarified that doctors must: “take reasonable care to ensure that the patient is aware of any material risks involved in any treatment,” in which, “a reasonable person in the patient’s position would be likely to attach significance to the risk, or the doctor is aware that the particular patient would be likely to attach significance to it”. 

The court ruled that UK doctors can no longer rely on simply sharing the consensus of a body of medical opinion (‘the Bolam test’) as a basis for a patient’s informed consent, but a personalised risk assessment must be given. In the case of COVID-19 mandates, this means that generic claims that ‘the science is settled’ or ‘vaccines are safe and effective’ – cannot be used to justify their safety for an individual. [5]https://www.supremecourt.uk/cases/uksc-2013-0136.html

The public and professional discourse on COVID-19 vaccination mandates are an example of how social pressure can be exerted on individuals to have a particular health intervention, even without a full individual risk assessment or any long-term safety data. As such, mandates can be considered medically coercive and in direct violation of the legal principle of informed consent.  

We call on our professional bodies to recognise that coercion does not equal informed consent.


2. COVID-19 vaccines are far from universally ‘safe and effective’.

COVID-19 vaccinations use novel technologies which have been in widespread use for little more than a year, are still in clinical trials and for which by definition no long-term safety data is available.

Since the start of the vaccine rollout, we have already seen a significant shift from the COVID-19 jabs being promoted as being ‘safe and 100% effective’ [6]BEST SHOT: AstraZeneca Covid vaccine is 100% effective against serious disease, US trial shows: https://www.thesun.co.uk/news/14414291/astrazeneca-covid-vaccine-effective-us-trial/[7]Pfizer vaccine ‘safe and 100% effective’ in children as young as 12: https://news.sky.com/story/pfizer-vaccine-safe-and-100-effective-in-children-as-young-as-12-12261697[8]Pfizer and BioNTech Confirm High Efficacy and No Serious Safety Concerns: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-confirm-high-efficacy-and-no-serious[9]Pfizer vaccine for 12-15 year olds: Your questions answered: https://www.bbc.co.uk/newsround/57389353.amp – to a recognition that there can be serious, even fatal side effects for a small minority of people. Their overall efficacy, especially in reducing transmission and preventing the spread of Coronavirus, is also far from what was originally hoped for.

Furthermore, since their general release, some COVID-19 injections have now been discontinued for use within certain demographics due to safety concerns. For example, the AZ and Moderna vaccines have been discontinued for young people in several countries after safety concerns arose around the risks of blood clots, following several high-profile deaths. In more recent months there have been emerging scientific studies showing the risks, particularly to younger males, of serious side effects such as myocarditis and pericarditis following vaccination, as well as ongoing concerns about the impact of vaccines on the female menstrual cycle. Both concerns have led to the commissioning of major safety investigations through additional clinical trials.

Whatever the outcome of these investigations, the fact remains that our understanding of these novel COVID-19 vaccines and the risks they pose to human health is far from comprehensive or complete.

Whenever there is risk of significant harm from a medical intervention, especially when the treatment is newly developed and those harms could be life-threatening, it is imperative that there is free choice for the individual to refuse that treatment without fear of negative consequences.

For professional bodies to require mandatory vaccination as a condition of professional registration, for acceptance on professional training courses, or as a condition of employment, would amount to unethical coercion of its professional members. To do so would place the professional bodies in direct violation of the principle of informed consent.

We ask that the professional bodies join us in speaking out against the unethical nature of mandatory vaccination policies, and publicly affirm their commitment to the ethical principle of informed medical consent.


As counsellors and therapists, we recognise that assessing the safety profile of a specific intervention is only one aspect of the complex decision-making process that informs our consent to medical treatment.

An individual’s moral, spiritual and political beliefs, as well as their cultural practices, life experiences and approach to managing their health, will also have an impact on their willingness to give, or withhold, informed medical consent.

Many of us take a holistic, person-centred approach to working with our clients. As such, we believe in the validity, authority and importance of these broader factors that can be drawn upon to inform medical consent. We see these wider factors as valuable, essential and equal; individuals have a right to refuse a medical treatment on wider grounds than its official safety profile or potential side effects. We are particularly concerned about the impact of mandates on those who have complex health conditions, those who have prior experiences of being harmed by medical treatments, those who favour their natural immunity, and those with religious or ethical concerns about the development process of the vaccines.

Current government guidelines for vaccine mandates only grant ‘medical exemption’ to staff with a tiny number of officially permitted medical conditions [10]UK Government COVID-19 Vaccination Medical Exemption Guidance: https://www.gov.uk/guidance/covid-19-medical-exemptions-proving-you-are-unable-to-get-vaccinated, with no allowance for many broader concerns that could be central to someone deciding not to consent to a COVID-19 injection. We believe that the government has no lawful right or moral authority to draw up a set of very limited medical criteria and then insist that these are the only permitted circumstances in which someone can be officially ‘exempted’ from vaccine mandates without facing redeployment or job loss.

As counsellors and psychological therapists, we uphold the right of every individual to make an informed choice about whether to take a COVID-19 vaccination, or indeed any other medical intervention, based on their own personal circumstances and medical history. We call on our professional bodies to uphold that right for practitioners and the clients we serve.


4. Professional bodies are failing in their duty of care to members who are affected by NHS vaccination mandates.

It would be incongruent for professional bodies to enshrine the principle of informed consent within their ethical codes of conduct for working with clients, whilst their professional members are not permitted to make autonomous decisions about their own medical treatment.

Mandatory vaccination policies, and the loss of the right to informed medical consent, is causing significant psychological distress to many UK counsellors and therapists, especially those working in the NHS. Many of these affected practitioners have been loyal, paying members of their respective professional bodies for decades. The silence and seeming lack of engagement from our professional bodies around this issue is both disturbing and disappointing given how severe the consequences are for members who face job loss. 

The exact number of counsellors and psychological therapists who stand to be affected by NHS vaccine mandates is uncertain, as to our knowledge, there has been no formal consultation process around this issue by any of the professional bodies.

However, Therapists for Medical Freedom have now facilitated numerous free, volunteer-run support workshops for affected therapists, which have often been full to capacity. We have also had hundreds of communications from distressed members who are under significant stress from the vaccine mandate process. Many have complained to us about experiencing an utter lack of clarity, guidance or support from their professional body.

Professional bodies have a duty to represent the interests of their paying members, especially at times where their human and employment rights are under threat in a professional context.

Therapists affected by vaccine mandates deserve better treatment and representation than they are currently getting from professional bodies. This situation must change, and we appeal to professional bodies to address this with the utmost urgency.


5. Vaccine mandates will have negative consequences for clients accessing therapeutic services.

NHS England estimated that had the vaccine mandate policy been implemented in April as planned, this would have left the NHS down by at least 80,000 staff, as many planned to leave the profession rather than comply with the policy. [11]Covid vaccine mandate: 80,000 NHS workers still completely unvaccinated against Covid: https://inews.co.uk/news/health/covid-vaccine-nhs-workers-lose-jobs-jab-mandate-1415486. This number would increase exponentially if vaccines were mandated as part of the professional registration process, thereby affecting health professionals working outside of NHS services, which applies to most therapists and counsellors in the UK.

To lose a significant number of counsellors and therapists at a time of national crisis could pose significant harm to clients. COVID-19 and the wide-ranging impact of restrictions on the population has left a legacy of new and worsening existing mental health problems. The Centre for Mental Health estimates that 8 million adults and 1.5 million children will need mental health support in the years following the pandemic. [12]Covid-19: understanding inequalities in mental health during the pandemic: https://www.centreformentalhealth.org.uk/sites/default/files/2020-07/CentreforMentalHealth_CovidInequalities_0.pdf

Those of us who have worked to provide psychological therapies throughout this challenging time are now seeing an unprecedented rise in demand for NHS and voluntary sector counselling and therapy services, to the point where people in need now face dangerously long waiting times. [13]Strain on Mental Health Care leaves 8 Million people without help: https://www.theguardian.com/society/2021/aug/29/strain-on-mental-health-care-leaves-8m-people-without-help-say-nhs-leaders Across the UK, even private therapy services and individual practitioners are in short supply, with many having to make difficult decisions to turn away people in need because they simply do not have the resources to treat them. At a time of increased mental health need, vaccine mandates would therefore be detrimental for current and future clients.

We call upon the professional bodies to provide reassurance that clients’ access to therapeutic support will not be restricted based on vaccination status, either now or in the future. We also call on them to reject policies that will risk the loss of experienced practitioners, put further strain on existing services and staff, and potentially dissuade others from training to enter the field.


6. It is essential to consider the wider context to mandatory vaccination policies and to remember the lessons of history.

As counsellors and psychological therapists, when faced with an ethical dilemma, we are encouraged to look beyond the issue itself and consider the wider field and context – including any relevant historical, sociological and political factors. Therefore, when considering the ethics of vaccine mandates, we must consider more than just the risk posed by COVID-19 vs the benefits and risks of vaccination.

When we step back and consider the wider socio-political context, we can clearly see that:

In the context of our collective history, as ethical health practitioners, we have a responsibility to ask difficult questions if we see draconian policies such as vaccination mandates being introduced in our society. We must continue to think critically about who would profit and benefit most from such policies. Might there also be vested interests, whether in government, science and medicine or the pharmaceutical industry, that could stand in the way of open and transparent discussion? [29]Ten richest men double their fortunes in pandemic while incomes of 99 percent of humanity fall: https://www.oxfam.org/en/press-releases/ten-richest-men-double-their-fortunes-pandemic-while-incomes-99-percent-humanity[30]Meet the 40 New Billionaires who got rich fighting COVID-19: https://www.forbes.com/sites/giacomotognini/2021/04/06/meet-the-40-new-billionaires-who-got-rich-fighting-covid-19/

It is not the terrain of ‘conspiracy theory’ for therapists and other health professionals to demand that government and medical experts are scrutinised and held to account for the policies they impose upon the public. As a profession, we must make room for alternative perspectives and difficult questions without these legitimate concerns being dismissed or slandered as ‘anti vax’, ‘dangerous disinformation’ or even more alarmingly, as ‘far-right extremism’.

It is not acceptable for our Professional Bodies to simply dismiss or silence any dissenting voices within their membership, or to ignore these difficult questions. Nor is it acceptable for heavy-handed policies such as COVID-19 vaccine mandates to be supported and justified by our professional bodies on the sole basis that they are acting in line with ‘official legislation or government guidance’ without any independent analysis of the actual effectiveness, ethics, or impact of the guidelines – or any acknowledgement that governments do not always act solely in the public interest.

Our professional bodies have a duty to carefully scrutinise any mandated public health measures that compromise our medical autonomy. They must not be accepted on face value as being in the public interest simply based on the assurances of government and its approved health advisors, or pharmaceutical companies with vested interests.


It is time for the professional bodies who represent counsellors and psychological therapists in the UK to show courage and break their collective silence on the issue of mandatory vaccination in our profession.

In light of all the above, we call on our professional bodies to:

  1. Uphold the values that are written and protected within their own ethical codes by publicly affirming their commitment to protecting the right of therapists and clients to freely give or withhold their consent to medical treatment without fear of coercion or punishment.

  2. Affirm that their commitment to upholding the right to informed consent will stand regardless of the emergence of new future variants, waves of disease or novel medical treatments.

  3. Engage with Therapists for Medical Freedom and other groups of concerned professionals in a process of dialogue around the ethics and legality of vaccine mandates in our profession.

  4. Pledge to protect the rights of therapists and clients who have exercised their lawful right to informed consent to refuse COVID-19 vaccinations.

  5. Use their authority as professional membership bodies to prohibit the implementation of discriminatory policies around COVID-19 vaccinations within their organisational membership and associated training institutes – and to publicly speak out against such discriminatory practices in the wider field.

  6. Remind their members that we each have an ethical responsibility to think critically for ourselves when assessing any government health advice, especially when it is mandated. Professional bodies should help facilitate this broader risk assessment process within their membership, especially the potentially negative impact that any existing or future public health advice might have on practitioners and clients. 

  7. Take into account the broader historical, social and political context when assessing the ethics of mandatory health interventions. We cannot forget the harm that has been caused to human health and civil liberties when the right to refuse medical treatment has been denied to populations at other times in history.

We await to hear your considered responses on these important matters of professional ethics, legislation and human rights, and look forward to beginning a process of dialogue with you.

Yours sincerely,

Therapists for Medical Freedom


Principal Signatories:

Jennifer Ayling, Psychotherapeutic Counsellor, UKCP

Clare Beatson, Counsellor, BACP

Elizabeth Bentley, Psychotherapist, BACP

Paula Charnley, Counsellor, BACP

Ben Harris, Psychotherapist, MBACP

Julie Horsley, Counsellor, NCS

Frances Kandler-Singer, Psychotherapist, BACP

Naintara Land, Psychotherapist, UKCP

Rachel Maisey, Counsellor, BACP

Kate Morrissey, Psychotherapist, BACP

Melanie Pickles, Counsellor, BACP

Dr. Bruce Scott, Psychoanalyst, UKCP & CP-UK

Dr. Gary Sidley, Clinical Psychologist (Retired)

Deborah Short, Psychotherapist, UKCP

Elizabeth Smith, Psychotherapist, Pre-Accred

Leanne Ward, Clinical Psychologist, HCPC

Sarah Waters, Psychotherapist, MBACP


Supporting Signatories:

Dr. Elena Alexandrou, Clinical Psychologist, HCPC

Marc Allen, Trainee Therapist, Pre-Accred

Emily Barber, Psychotherapist, BACP

Dr. Alison Bates, Clinical Psychologist, HCPC

John Bates, Psychotherapist, UKCP

Tonya Bathe, Psychotherapist, BABCP & BACP

Dr. Faye Bellanca, Clinical Psychologist, HCPC

Stephen Biggs, Clinical Psychologist, HCPC

Paul Birch, Psychotherapist, UKCP

Vanessa Blackmore, Psychotherapist, BACP

Dr. Claire Bone, Clinical Psychologist, HCPC

Rosemary Boon, Psychotherapist, APS

Anne Booth, Counsellor, BACP

Antoine Bowes, Counsellor, BACP

Matthew Bowes, Psychotherapist, UKCP

Jacqueline O’Brien, Psychotherapist, (retired)

Jeremy Brooks, Psychotherapist, BACP & UKCP

Jo Bull, Psychotherapist, BABCP

Sheila Burchell, Clinical Psychologist, HCPC

Johann Burton, Counsellor, NCS

Charles Campbell-Jones, Psychotherapist, BPC & BACP

Ruby Chance, Psychotherapist, UKCP

Liz Cobb, Psychotherapist, BACP

Dr. Theresa Comer, HCPC, Clinical Psychologist

Jo Conrad, Counsellor, BACP

Dr. Jo Coombs, Clinical Psychologist, HCPC

Kim Cooper, Counsellor, BACP

Helen Cowan, Counsellor, BACP

Danielle Crawshaw, Psychotherapist, UKCP

Kate Dalton, Psychotherapist, BACP

Gemma Davies, Psychotherapist, BACP

Emma Davis, Psychotherapist, UKCP & HCPC

Kadi Debbah, Counsellor, BACP

Vagelis Dimitriou, Counsellor, BACP

Miriam Donaghy, Psychotherapist, UKCP

Laura Driesen, Clinical Psychologist, HCPC

Dr. Timothy Dunne, Clinical Psychologist, Associate Fellow of BPS

Davina Elsen, Counsellor, BACP

Gillian England, Psychotherapist, BACP & BABCP

Audrey Elliot, Counsellor, BACP

Dr. Erika Filova, Clinical Psychologist, HCPC

Zac Fine, Psychotherapist, BACP

Katherine Franklin-Adams, Psychotherapist, BACP

Angela Gilchrist, Clinical Psychologist, BPS & HCPC & ACP-UK

Gemma Gilham, Trainee Therapist, CPCAB

Sara Godoli, Psychotherapist, UKCP

Dr. June Golding, Psychotherapist, UKCP

Mr. John Gordon, Psychotherapist, BCP

Heather Graham, Counsellor, BACP

James Graham Corscadden, Clinical Psychologist, BPS

Dr. Nicola Graham-Kevan, Counsellor, BPS

Dr. Tracey Grant Lee, Clinical Psychologist, HCPC

Dr. Federica Graziano, Clinical Psychologist, HCPC

Dr. Diane Griffiths, Clinical Psychologist, HCPC

Jan Haghverdi, Counsellor, BACP

Sarah Harber, Psychotherapist, Pre-Accred

Renata Harris, Clinical Psychologist, HCPC

Andy Halewood, Psychotherapist, BACP & BPS

Andrew Harry, Counsellor, UKPTA

Mark Hartshorn, Psychotherapist, BACP

Andrea Hazlett, Trainee Therapist, FHT

Susan Hayes, Psychotherapist

Laurie Hole, Counsellor, NCS

Michael Horgan, Trainee Therapist, Pre-accred

Jessica Horton, Counsellor, BACP & BPS

Ruth Hoskins, Psychotherapist, UKCP

Isla Hunter, Psychotherapist, BABCP

Leiah Ikafa, Retired Therapist

Miranda Jenkins, Counsellor, BACP

Rebecca Jesty, Counsellor, BACP

Andrea Jordan, Counsellor, RCM

Natasha King, Psychotherapist, HCPC

Lena Kornyeyeva, Clinical Psychologist, EATA

Cabby Laffy, Psychotherapist, UKCP & CORST & NCP

Gabrielle Lake Mitchell, Trainee Therapist, BACP

Rosey Lawrence, Trainee Therapist, Pre-Accred

Sophie Leader, Psychotherapist, BACP

Maggie Leathley, Psychotherapist, BACP

Jane Lewis, Psychotherapist, UKCP

Dr. Samantha Lewis, Clinical Psychologist, HCPC

Jane Lindsay, Psychotherapist, UKCP

Maya Mamish, Clinical Psychologist, BPS

Jane Margerison, Psychotherapist, BACP

Jonathan Martin, Psychotherapist, UKCP

Rufus May, Clinical Psychologist, HCPC

Fiona McAlister, Psychotherapist, BACP

Conor McCafferty, Psychotherapist, BACP

Gary McKeever, Counsellor, BACP

Fiona McNally, Psychotherapist, BACP

Aysem Mehmet, Psychotherapist, BABCP

Maria Michalakopoulou, Counsellor, MBACP

Jason Middleton, Psychotherapist, BACP

Caroline Montanaro, Psychotherapist, UKCP

Suzanne Moore, Psychotherapist, BABCP

Christopher Morris, Psychotherapist, BACP

Anne Murphy, Counsellor, BACP

Dr. Naomi Murphy, Clinical Psychologist, HCPC & A-CP

Mark Murray, Counsellor, NCS

Anna Murray Preece, Psychotherapist, UKCP

Dr. Rachel Newton, Clinical Psychologist, HCPC & BPS

Katie Neylan, Psychotherapist, BACP & BABCP

Malgorzata Paliszewska, Clinical Psychologist, HCPC

Lauren Parker, Trainee Therapist, Pre-Accred

Sue Parker Hall, Psychotherapist, UKCP

Kay Parkinson, Psychotherapist, UKCP

Darshna Patel, Psychotherapist, BABCP

Dr. Helen Payne, Psychotherapist, UKCP & ADMP UK

Dr. Nicholas Peckham, Clinical Psychologist, HCPC

Dr. Kirsten Perkins, Clinical Psychologist, BPS & HCPC

Carolyn Polunin, Psychotherapist, UKCP

Livia Pontes, Clinical Psychologist, BPS, HCPC & BABCP

Dr. Kate Porter, Clinical Psychologist, HCPC

Rob Preece, Psychotherapist, UKCP (retired)

Rebecca Quick, Clinical Psychologist, PBS

Dr. Andrew Rayner, Clinical Psychologist, HCPC

Sasha Reay, Counsellor

Tracy Rees, Trainee Therapist, Pre-Accred

Becky Ridgewell, Psychotherapist, MBACP

Marijke Roberts, Counsellor, NCS

Dr. Helen Ross, Clinical Psychologist, HCPC

Antonella Russo-Ball, Psychotherapist, UKCP & MBACP

Jane Sanders, Psychotherapist, UKCP

David Scott, Clinical Psychologist, HCPC

Paige Sessions, Psychotherapist, BABCP

Jeremy Slaughter, Clinical Psychologist, HCPC

Leah O’Shaughnessy, Counsellor, BACP

Sara Simon, Psychotherapist, HCPC

Regina Sinkovicz, Psychotherapist, BACP

Dr. Helen Startup, Clinical Psychologist, HCPC & BABPC

Karen Sturch, Counsellor, BACP

Eileen Sullivan, Counsellor, BACP

Cath Sunderland, Psychotherapist, UKCP

Patricia Taddei, Psychotherapist, UKCP

Vicky Talbot, Psychotherapist, BABCP

Angela Taylor, Counsellor, BACP

Lori Thackham, Counsellor, BACP & NCS

Gem Thomson, Psychotherapist, BABCP

Marsha Towey, Clinical Psychologist, BPS & HCPC & BACP

Dr. Lucie Turner, Clinical Psychologist, HCPC

Philippa Vaizey, Psychotherapist, UKCP

Marc Venner, Counsellor, BACP

Dionne Ward, Counsellor, BACP

Dr. Alice Welham, Clinical Psychologist, HCPC

Anna Westwood, Counsellor, BACP

Georgia Whyte, Trainee Therapist, BABPC

Debbie Williams, Psychotherapist

Tracy Williams, Counsellor, BACP

Robert Wills, Counsellor, BACP

Lee Wilkes, Counsellor, BACP

Tracy Wood, Counsellor, BACP

Sarah Worth, Counsellor, ACC

Dominique Wynn, Psychotherapist, (Retired)

Dr. Clare Young, Clinical Psychologist, HCPC


Sign the Open Letter

Are you a Counsellor, Psychotherapist or Clinical Psychologist based in the UK who is concerned about the impact of vaccine mandates on the profession? (whether you are personally vaccinated or not).

If so, please sign the letter below along with your professional body and we will add you to our public list of signatories:

Professional Bodies Open Letter

165 signatures

References[+]

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