My career as a practicing therapist covers fifty years. During this time, adapting to change has been the perennial feature, and still is. Technology and therapy have taken leaps and bounds since I recorded sessions on my audio cassette machine, and most correspondence was done by letter. 

Over the years I’ve seen perhaps more clients than I can count, from all age groups and various walks of life.  I will however briefly mention a few seminal cases and highlights that maybe track and reflect my continuing professional development and personal growth as a therapist to date. It is important to note that I regard each client as my best resource and invariably advise that I don’t fix people, I help them to fix themselves.

Being trained in group counselling in 1969 was perhaps my first step into the world of counselling and therapy with young offenders. Enabling young people in residential care to verbalise their issues and problems in a safe and confidential group context often facilitated positive behavioural and attitude change. Young people learned to develop useful social skills and bolster feelings of self-worth. This laid the foundation for my groupwork skills for years to come and using roleplay with clients.

Another important highlight for me, in the seventies, was being part of setting up a day attendance centre and leading one of the three multidisciplinary community-based teams that assessed, treated and supported mixed sex young people referred by the juvenile court. Where feasible the twelve-week programmes also involved family and parents.   

The purpose of this day assessment/treatment centre was to deflect young people away from residential care and custody and utilise community-based voluntary and statutory resources in the longer term. In this way many young people were helped to avoid removal from their homes, schools and peers. Some didn’t, but at least every effort was made to divert removal from their communities. 

It was in this context I met my first juvenile court referral for help with a serious problem of persistent exhibitionism. It was highly likely he would end up in gaol If he reoffended. 

This referral presented new challenges for me because it was unprecedented for a juvenile to present with this type of problem. With the expertise and supervision of a well-recognised psychiatrist of the time, Isaac Marks (MD) this case was successfully treated. The referral became enabled to emotionally self-regulate and control his behavioural issues, and I learned about blending talk therapy with behavioural treatment strategies incorporating practical actions. This positive outcome then prompted further referrals from the local hospital’s psychosexual clinic for teenagers.

This case was an important developmental landmark for me because it piqued my curiosity about the effectiveness of cognitive and behavioural approaches and initiated an energy for continuous professional development that continues to this day. The importance of sourcing the appropriate supervision on this occasion and thereafter was an important lesson learned as well.

Raison d’etre

Sometimes therapists choose to ignore personal matters beyond our control because we think our clients won’t manage without us. I had an experience like that in 1986. The surgeon said he was bringing me in on Sunday to perform major surgery on me on the Monday. Initially I said it didn’t suit because I had reports to write and families to see. The surgeon looked me straight in the eye and asked me if I was indispensable? I nearly said yes!

What I learned was that we are all dispensable even though we find it difficult to admit it at times. Therapist self-care is essential if we want to be effective practitioners in the longer-term.  

On reflection, what motivates me to continue working with clients is the large number of successful outcomes that have been facilitated during my lengthy career, using a collaborative approach. This, coupled with networking and sourcing relevant contemporary training to become competent in new and evidence-based adjunctive treatment techniques. is essentially my “raison d’etre”. 

BABCP: a valuable resource

From the outset the British Association for Behavioural and Cognitive Psychotherapies has been a hugely valuable professional and skills resource for me throughout my therapy career. I continue to be a BABCP accredited practitioner.

Having served on the BABCP Executive Committee for several years I was very honoured to be elected as Chair of this large organisation in 1997, and subsequently the Congress Organiser for the European Association for Behavioural and Cognitive Therapies Congress held in University College Cork in September 1998. This Congress proved very popular and was attended by over seven hundred delegates from all parts of the globe.

In 2013, I was delighted to be awarded a Fellowship on behalf of the British Association of Behavioural and Cognitive Psychotherapies in recognition of my “longstanding commitment and significant contribution to BABCP and CBT”.

Chapter two and EMDR

In 1981, in addition to my day job I established my private practice two evenings each week from my home. This became a full-time business when I retired from my day job as Senior Deputy Director and Head of Youth Treatment in 1996. 

October 1996 perhaps marked the start of chapter two of my therapy career. As well as providing a full-time private practice from consulting rooms at my home I also provided three clinics a week in a local health centre from 1997 until 2002.

Being trained in Eye Movement Desensitisation and Reprocessing therapy in 1997 was another very significant landmark in my therapy career. I subsequently became an accredited practitioner in this respect with EMDR Europe, UK and Ireland, and thereafter a fully accredited EMDR Consultant to this day. I have found EMDR to be a superb adaptive information-processing protocol, (AIP), not only for trauma but for many other psychological presentations. Keeping up with and being trained in EMDR adjunctive techniques has also been a stimulating and hugely influential resource in my professional development and practice. Once again supervision continues to be an essential component, both providing and receiving.

Many other public bodies also benefited from my input from that time.  Trauma assessment and treatment for serving police officers from 2007 to 2009 and medically retired officers. Also, referrals from local public transport employees from 2009 to 2017 and in-house psychological treatment for lifer prisoners in a high-security Northern Ireland prison from 2007 to 2012.

In many of these respects, I was assessing and treating clients who were suffering from post-traumatic stress disorder (PTSD) and writing reports for the courts and parole boards.

Through COVID-19 and beyond

Perhaps the biggest challenge of all was coping and positively managing the many issues triggered by the COVID-19 pandemic in 2020. Being unable to see clients face to face was a huge problem, not only for practitioners but especially their clients. 

Fortunately, I had already gained some experience of working remotely with a small number of clients from other countries, and initially, existing clients were very happy for us to revert to the Zoom platform for sessions. 

It was a learning experience for both client and therapist, but everyone adapted well, and I quickly realised that it was possible to use most of my treatment techniques with equally good effect on the remote platform. On-line training in this respect was also accessed and proved very helpful.

I’m pleased to say that by June 2020 my clients were delighted to return to face-to-face sessional work with certain precautions. Social distancing, sanitising, and temperature taking were routine and masks were worn if preferred. It wasn’t long before people realised the extent to which covering the face was a hindrance to effective communication in talk therapy.

A further positive consequence of the pandemic was being able to develop a busy remote platform service for local and offshore clients referred by agencies like BUPA, Axa, and Onebright. This facility is still ongoing.

Why did I become a PPS Trustee?

Being a therapist for clients who seek psychological help invariably makes any therapist very vulnerable and, therefore, it is essential to have good quality insurance to cover any ensuing liability. 

I have been insured with PPS for as long as I can remember and on one occasion, the founder, Sandy Murray came to my rescue when I was blameless, and the client’s solicitor disagreed. I will be eternally grateful for Ewan’s dad’s compassion and patience on behalf of PPS, and the achievement of a sensible outcome. 

Being a practitioner, I am understandably very aware of the risks of others being in those same shoes, so I offered myself as a trustee and was duly elected. In that role, and in the company of other trustees who have been, or still are practitioners, I have been enabled to contribute to the wisdom and quality support I had personally received. I was pleased to continue to contribute when I was elected Chair of the Board at the 2023 AGM.

Sandy would have been proud to know that his son Ewan and his team have done an excellent job of growing and developing PPS and perpetuating the compassionate and positive values his dad embodied.

Having spent many hours reviewing the nature of complaints against members in recent years I would encourage practitioners to be much more mindful of not cultivating client-overdependence, to try to maintain compassionate objectivity, and stay within their skills-set boundaries. If in doubt, then seek additional and appropriate supervision, or forward referral to a suitably qualified practitioner.

Fifty years of PPS success and the progress of therapy

PPS continues to provide invaluable and informed support for members and the fact that it’s about to celebrate its 50^th Birthday is a testament to its credibility, value and potential longevity. The personal and informed touch has perhaps made all the difference to our members.

Therapy will continue to change and develop, and I have a strong sense that the number of complaints against counsellors and therapists will increase over time. This is likely to mean that litigation claims will become more frequent for PPS and the costs of insurance will correspondingly do the same in years to come. 

I am, however, reasonably confident that in my lifetime the demand for face-to-face therapy will increase rather than be replaced by technology.

Fun time to de-stress

All therapists need to consciously plan “downtime” for themselves to continue being effective practitioners in the longer term. To achieve this, we need to make our personal welfare a priority. In this respect, the phrase “physician heal thyself” comes to mind.

In years gone by I enjoyed playing rugby and tennis. My wife Margaret and I have always been devoted Ulster and six nations rugby supporters! Our living room can be very noisy when matches are on the television!

Four years ago, I broke the tip of my femur playing tennis, so I decided to put that on the shelf and savour the memories! I continue to thoroughly enjoy riding my mountain bike every day and taking my daughter’s two blonde German shepherd dogs for a five-mile ride to the shore first thing in the morning when the day is young. 

I exercise every morning, play golf twice each week, and being involved in the lives of my five grandchildren, when I can, gives me huge pleasure. I always have a book on the go on my Kindle and I have a penchant for keeping abreast with new technology. 

Talking about books reminds me I need to finish the one I started to write about four years ago about unusual cases I have worked with during my fifty-year career. It’s not far from completion and with the unstinting support of my part-time personal assistant we plan to finish it in the very near future.

Essentially, I am a social animal who is always up for a party. I can amuse others to some extent when I play my mouth organ but my banjo playing days are numbered!