Do unpaid placements abuse trainee psychotherapists?

I read with interest the article in the April 2014 edition of Therapy Today about bullying in the workplace and specifically when the bully is another therapist. The article by Dr Werner Kierski and Jessica Johns-Green raised a number of important issues which resonated with my own experiences undergoing psychotherapeutic training.

The authors refer to a number of studies including one by Hoosen and Callaghan which reported that 47% of psychiatric trainees had felt bullied in a study at an NHS training provider in the West Midlands.

I was particularly interested in the question as to whether unpaid placements abuse trainee psychotherapists in taking advantage of a highly competitive field to justify unpaid work. Some placement providers use trainees as unpaid labour as part of NHS contracts to deliver an IAPT service, for a fee, for their local health commissioners in GP surgeries. Trainees not only provide their labour for free but are also asked to pay the placement provider for an induction programme on how to use NHS electronic patient record systems and are asked to commit 2-3 days per week to the placement. I know of this practice in SW London and the placement provider advertises seemingly in every edition of Therapy Today for recruits. In this instance I believe that there is potential to view the practice of using trainees to provide an IAPT service as abusive.

Trainees are not uncommonly asked to even pay a fee in order to volunteer at psychiatric centres in order to complete course requirements for psychiatric observational placements. In my experience of working in placements there can be an attitude from the management that the placement providers are doing you a favour by offering you the opportunity to gain placement hours. In this environment, perhaps it is tempting for a bully to abuse their position and manipulate the position that trainees find themselves in. To make a complaint might be seen as a weakness and, in any case, the bully might be the one receiving the complaint.

A study by Eurofound, and co authored by Maija Lyly-Yrjanainen, found that the risk of being subject to bullying in organisations was greater if your manager was female. The authors suggested that this may be because female managers have often spent a long time on a lower rung of the career ladder, and may struggle to handle conflict when given staff supervising responsibilities.

A workplace study into bullying, conducted in the USA by the Workplace Bullying Institute, found that bullying by females on females had risen from 71% to 80%. This is extremely worrying for the therapy profession given that it is predominantly comprised of females.

The Therapy Today article suggests that we as a profession need to have more discussion about the issue of bullying, more research into bullying, more support for victims and that regulatory bodies set clear standards around bullying behaviours. I would support these objectives.

How the profession of counselling and psychotherapy is adequately funded so that trainees are not at risk of being exploited as cheap labour is a debate for another day.

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