23 November 2007

Lay counsellors and the law

Do new health regulations mean that lay counsellors will be breaking the law if they do their jobs?

The Department of Health's proposed new health regulations have alarmed and confused the world of complementary therapists and lay counsellors.

Some believe that the regulations imply that no-one bar allopathically trained medical personnel, and formally qualified psychologists, will in future be allowed to operate in South Africa – with the implication that massage therapists, counsellors, homeopaths and so forth will effectively be outlawed.

Yehuda Tagar, president of the International Association of Psychophonetics Practitioners (IAPP) is one of these: "These new regulations are unconstitutional and draconian and we will challenge them and have this act changed," he said.

He indicated he would be taking the matter before Parliament, and declared he was already lobbying for it to be brought before the Constitutional Court.

Others believe this is an overreaction.

What's at issue?
The regulations defining the scope for the profession of medicine are aimed at medical and dental doctors and limit them to performing only physical examinations, the prescribing of medicines, advising a patient on their health and 'any other act pertaining to the medical profession based on the education and training of medical practitioners as approved by the board from time to time'.

The regulations defining the scope of the profession of psychology state that acts including evaluation of behaviour, mental and personality, any method used to aid, adjust or interpret these and the use of tests to determine intellectual abilities, aptitude, psycho-physiological functioning and so forth, must be carried out by a registered psychologist.

It further states that the use of any psychotherapeutic method/technique to rectify or change personality, emotional, behavioural or mental deficiencies, or the use of any psychological counselling to 'prevent personality, emotional, cognitive, behavioural and adjustment problems must also be carried out by a registered professional.

The regulations were published on October 19 and the deadline for objections was on November 19.

The confusion
There is much confusion about what they actually mean to alternative therapists and professional counsellors.

Amongst those who aren't concerned, is Debbie Drake-Hoffman of the Allied Health Professions Council.

"As there is specific mention that the intended regulations will not prohibit complementary practitioners (professions registered under the council only) from practising their scope of practice," she says, "the council is of the opinion that there is little or no impact of the regulations on allied health professions."

She is of the opinion that counsellors at organisations such as LifeLine and Rape Crisis are unlikely to be affected.

Drake-Hoffman was backed up by Michaela Collett, head of the Natural Health Teaching Services. "We see it as an internal classification of rules and don't believe it is meant to extend any further than the disciplines mentioned in the regulations. We also don't think they can apply it to us," she said.

Where's the threat?
However, there are many who feel threatened, and who are of the opinion that the proposed regulations are unjust and unconstitutional.

In a letter sent out by Tagar to the many alternative therapists who had contacted him since the new regulations were made public, he stated that "according to this Act everyone who works as a professional practitioner of human development in this country, apart from the 6 275 registered psychologists and their interns, is a criminal."

Tagar insisted that anyone involved in alternative therapies would be affected by the new regulations and has urged them to take it seriously.

He claimed he would be challenging what he called the "fundamentally unconstitutional curtailing of people's freedom of choice, of speech and of trade."

"We are all professionals and adhere to a strict code of conduct and ethics, and we are providing a service to people that is very much needed in this country," he said.

He added that in his opinion, the new regulations violate several constitutional rights of not only the practitioners of various therapeutic methods, but also the rights of the public to choose a form of healing according to their personal belief systems.

He concluded that all the new regulations have done is highlight the restrictive nature of the 1974 act and insisted, "this is not in the interest of the people of the country, and if there is any real reason why the government wants to restrict and control us, then we want it to be presented it us."

'Lay counsellors have nothing to fear'
However, Rini Prinsloo, general manager of skills and services at LifeLine Southern Africa, said that 'Lay counsellors need not see these regulations as a threat'.

"LifeLine as an organisation makes no claims that we are in the profession of psychology, in as much we are not in the profession of social work, the ministry, education, law and many more. If we should use registered people from these fields for specialised activities we are of course bound by their professional rules and ethical codes" she said.

Prinsloo explained that LifeLine did not do acknowledge psychotherapeutic interventions (psychotherapy) as defined by the profession of psychology as they rather do promotion of emotional wellness and emotional supportive work with volunteers who get training in communication and helping skills.

"Our volunteers are known as peer/lay counsellors because we acknowledge openly that they do not claim to be professionals in the sense of carrying a registration with the Board of Psychology. A voluntary, NGO environment does not in any way compete or claim the same kind of work professionals do and should not; otherwise it becomes a costly and competitive affair," she said.

She added that the LifeLine services to the public carry no costs to the client and adhere to a strong ethical code of conduct for the organisation to protect the public and the volunteer.

"I need to stipulate that as mentioned the act is for individuals and not organisations.Our target audience sits with largely with people needing emotional support and empowerment towards life choices."

She concluded that in light of this LifeLine Southern Africa supported the need to "protect professions and the public in the health and mental care fields against charlatans making fraudulent claims in regards to their interventions or using false claims to titles they are not entitled to. That is criminal behaviour."

"There is a qualification in the pipeline for counselling work on a level four/ five which will be beneficial to so called lay counsellors and other people needing helping and communication skills, but will still not give them the right to call themselves psychologists. To be that they will have to comply with the professional board regulations and get the qualifications that pertain to the title. They can therefore not work for their own account without complying with these regulations," she said.

What the Department of Health says
Yet, according to a statement issued by Sibani Mngadi, spokesman for the Ministry of Health they claim they do not want to 'undermine alternative therapies in the delivery of health services'.

"The Ministry of Health notes the concerns that have been raised by some groupings with regard to the draft regulations defining the scope of practice of the profession of psychology and encourages all concerned parties to submit their comments which will be afforded due consideration in the process of finalising these regulations," the statement reads.

He added that, "The Ministry of Health promotes diversity and individual choices in accessing health care and will therefore not engage in a process that may undermine alternative therapies in the delivery of health services."

Sources: Sibani Mngadi, spokesman for the Department of Health;

Yehuda Karabo Tagar, sirector, Persephone Institute of Psychophonetics(Int.); president, International Association of Psychophonetics Practitioners (IAPP)

Debbie Drake-Hoffman, Allied Health Professions Council;

Michaela Collett, head of the Natural Health Teaching Services;

(Amy Henderson,, November 2007)


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