Academic journal article Perspectives in Psychiatric Care

Establishing the Role of the Nurse Psychotherapist in the United Kingdom

Academic journal article Perspectives in Psychiatric Care

Establishing the Role of the Nurse Psychotherapist in the United Kingdom

Article excerpt

TOPIC. The role of the nurse psychotherapist in the U.K. PURPOSE. To explore the barriers and future possibilities of nurse psychotherapists in the U.K. SOURCE. A review of the literature, communication with nurse leaders in the U.K., the author's own experience. CONCLUSION. There is a body of nurses in the U.K. that has begun to meet regularly and uses psychodynamic theory either in clinical practice or to teach students. The plan is to develop specific standards of training and registration. Key words: Nurse psychotherapist, psychoanalytic theory, psychodynamic theory

The discourse about psychoanalytic nursing practice in the U.K., apart from a few pockets of specialist interest, has not been very robust over the last 30 years. But it has recently been increasingly buoyant, with a number of nurses showing an interest in how psychoanalysis may inform their clinical practice. This current buoyancy owes a great deal to the interest in the work of Hildegard Peplau, who was among several North American nursing theoreticians whose ideas began to noticeably shape nursing in the U.K. from the early 1980s. This growing interest in the U.K. appears to be commensurate with developments elsewhere in Europe. For instance, Professor Martin Teising from Bad Hersfeld, Germany, is using psychoanalytic theory to inform the training of nurses. Recently, he and a group of student nurses visited the U.K. and were especially interested to hear about the application of Peplau's psychodynamic nursing theory because Peplau is taught in the core curriculum in Germany.

The disputation that is emerging in the U.K. as to how much we might adhere to psychodynamic theory in nursing heralds the beginnings of exciting developments in the field of mental health nursing (MHN). I find it particularly interesting to note that Lego's papers (1973, 1980) about the adaptation of psychoanalytic theory in nursing and the role of the nurse psychotherapist in the U.S. demonstrate that the cogitations we are having at the moment in the U.K. were taking place some 30 years ago in the U.S. In presenting my reflections here on the current development of psychoanalytic nursing in the U.K. and my thoughts on developing the U.K. version of the role of nurse psychotherapist, I am mindful there is much that can be learned from the U.S. experience. This article is intended to update the state of psychoanalytic nursing in the U.K., and develop some ideas I have presented elsewhere (Winship, 1995a, b, c).

Over the last two years, two organizations in the U.K. (The British Confederation of Psychotherapists [BCP] and the United Kingdom Council for Psychotherapy [UKCP]) have established registers of psychotherapists. Both groups also have established standards for psychotherapy training and practice. During the establishment of these registers, there was no involvement or discussion with any nursing body. Neither register recognizes nurse training or specialist psychodynamic nursing training as meeting entry criteria for registration. This creates a serious anomaly insofar as the vast majority of psychoanalytic work undertaken in the public sector is done by nurses working at varying levels of psychotherapeutic intensity (Brown & Pedder, 1988). Because there is no formal bridge between nursing and psychoanalytic psychotherapy there is no satisfactory career structure for psychodynamic nurse specialists in terms of status and financial remuneration comparable to other professionals engaged in psychotherapy. To gain registration for psychoanalytic psychotherapy qualifications, recognition, and equitable financial remuneration, nurses must go outside of nursing. There are a few nurses who have gained such qualifications and call themselves Nurse Psychotherapists. However, the role is not defined in academic literature and is not formally recognized. In fact, the term "Nurse Psychotherapist" at the moment might be said to be an ambiguous tag allowing employers to hire nurses to do psychotherapy for less money than they pay psychotherapists in other disciplines. …

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