‘Psychotherapy’ law angers mental health workers

Maltese psychologists are fearing a new law regulating the profession could actually bar them from being employed to carry out psychotherapy.

Both the Chamber of Psychologists (MCP) and the Association of Psychiatry (MAP) raised concerns with this newspaper on the new law. The Chamber says it is particularly concerned by a clause in the law that would bar employers from employing psychologists to do the job of psychotherapy. “This is very strange and it worries us,” MCP president Roberta Farrugia Debono said.

“We’re a profession which has been regulated for many years, with a board which regulates with its own ethics board. But then we found that this law not only regulates the title, but also the practice, which is highly unusual [for a law].”

While the Chamber was initially in favour of regularising which professional could qualify to call themselves a psychotherapist, the ‘unusual’ law also regularises what psychologists can and cannot do.

The crux of this debate concerns the fact that all psychologists are trained in psychotherapy during their professional training. Since their warrants cover what they are allowed to practise, the Chamber says the new law is encroaching on what they are already doing.

As Dr Etienne Muscat, president of the Malta Association of Psychiatry, explained, psychotherapy is a technique and not a profession in itself. “Psychotherapy is used broadly in mental health care, and does not belong to any group.”

Indeed, psychotherapy employs various methods falling in the field of psychology, and practitioners of the techniques include mental health professionals such as psychiatrists, psychologists, clinical social workers, marriage and family therapists, or professional counsellors.

And, on this basis, Muscat argues that counsellors, therapists, psychologists and social workers all need to be on the same page for the benefit of patients and mental health in the country.

“We want an exception in the law to state that psychologists can practise according to their warrant, ideally through a discussion involving psychotherapists and the people pushing for this law,” Dr Farrugia Debono said.

“We are only asking for a minor amendment, which would keep psychotherapists happy without restricting our conduct and practice.”

The European Federation of Psychologists’ Associations (EFPA) is supporting MCP’s objections, according to Farrugia Debono, who was in Prague attending a council meeting that has the Maltese law on the agenda as an urgent matter.

Even the Maltese Association of Psychiatry (MAP) does not support the new law. MAP president Etienne Muscat said he was not in favour of fracturing the alliance between different professionals working in mental health, an alliance he said is a requirement in the field.

“We are worried that the law does not achieve what it has set out to do. It appears that [the law] is not concerned with regularising therapists, but with regularising psychotherapy.”

Muscat is concerned that patients might suffer as a result of the law, since it does not take into consideration how more complex cases might require more specialised methods of care.

“When it comes to mental illness, different layers of expertise are required, whereas the focus of the new law is limited to one type of professional,” Muscat said.

“Regulating which professionals can safely practice is within the scope of law, but it is highly inappropriate for the law to regulate the practice of psychotherapy. While supporting the efforts to regularise therapists, MAP does not support the new law, for it will control what a professional does. That would be problematic because the law is not appropriately versed in the job of a mental health professional.”