Lack of regulations is endangering mental health

In an industry deluged with people increasingly seeking mental health support, experts are warning over the lack of proper regulation for psychologists in Cyprus and the dangers that come with it.

Currently, the council of registered psychologists (Seps) is tasked with oversight in the field. All professionals must submit their degrees and proof of having carried out 1000 hours of supervised practice in order to be classed as a qualified psychologist by Seps, with a licence to work in Cyprus.

Perhaps absurdly, the legal framework Seps operates in leaves them with very little room to actually carry out disciplinary measures against psychologists who violate the industry’s regulations. Currently, Seps cannot revoke someone’s licence nor can they impose any penalties or fines.

Apparently, it has been a stroke of luck that there have “never been” cases meriting this reaction, however “there’s no guarantee it won’t happen tomorrow,” Seps chairman Louis Hadjithomas told the Sunday Mail.
“The number of psychologists is increasing, it absolutely could happen.”

A source speaking to the Sunday Mail on condition of anonymity said there have absolutely been violations and even criminal offences that have been left unpunished, though they cannot be reported for lack of proof.

Chairwoman of Cyprus psychologists’ association (Cypsa) Evita Katsimicha said that in the past few years, complaints filed to them have increased though statistics could not be provided because they are not kept.

Currently, there are two main professional psychologist groups. The first to be formed was Cypsa in 1980, followed by the Pancyprian society of psychologists (Pasypsy) in 2007. All psychologists (whether members or not) fall under the responsibility of Seps, where they must be registered.

Seps publishes a list of all licensed psychologists in Cyprus which is one of the first things someone should check when considering therapy.

“The most common [complaint filed] is about professionals that are not licensed under Seps and they practise without a licence. Other issues are about unethical practice on the field,” Katsimicha explained.

Hadjithomas stresses the danger is allevaited – somewhat – by the current procedure in place should someone file a complaint against a psychologist to Seps. If the complaint is of a disciplinary nature, a team is set up, headed by a member of the legal service to investigate the matter. If it is of criminal nature, the case is referred to the police.

A similar procedure is carried out by the associations if it is not a criminal matter, who appoint an investigator to listen to both sides (the psychologist and client) and reach a conclusion. The options available there are limited: a potential warning letter or striking them from the professional body – but they can still practise as psychologists without being a member of an association.

Theoretically, the legal service may be able to use the existing legislation to take up the matter, though it has never come to that, Hadjithomas notes. Seps itself however as a regulatory body cannot. The institutional framework in which it should operate is absent, he added. “This is a huge risk to public health.”

Additionally, Seps also lacks the power to properly investigate a psychologist’s credentials. He cites an example where someone could provide a university letter confirming 1000 hours of supervised practice but in cases where Seps dug a little deeper, found out this was just a student monitoring case studies or had received the letter unjustly from a psychologist relative.

In other cases, the supervised hours were not actually compatible with the candidate’s specialty. “The council might do the digging but I don’t want to get dragged into courts if I’m not giving someone their licence.”

Effectively, Hadjithomas explains that while the council tries to be thorough, it also runs the risk of exposing itself to lawsuits if psychologists – or applicants trying to get licensed – get irked.

Seps is now hoping a set of regulations can be set up, though the process will not be fast. The regulations will need to be prepared, rubberstamped by cabinet, head to parliament, likely be discussed at a committee level and then head to plenum. That would be the best-case scenario where revisions will not be necessary – and even that is likely to last for months.

Hadjithomas charges the health ministry had revoked a set of regulations some six years ago, that could have led to Seps now being far ahead of the game. Still lagging, the chairman explains it is a high priority issue for the council.

One glaringly obvious consequence of this, is that members of the public may not feel comfortable filing complaints over psychologists out of fear nothing may be done.

Sometimes, the problem is deeper, explains Dr Marios Adonis, associate professor of clinical health psychology at the University of Nicosia. “Therapy is like magic. It’s extremely difficult for someone to file a report over their psychologist.”

Essentially, what goes on during therapy is deeply personal, with a client often feeling quite vulnerable.
Inevitably, there is also the fear factor. The psychologist has hold of a person’s secrets and an individual may feel frightened of alienating someone that holds this much personal information.

Aware of these concerns, compounded by the fact that Cyprus is also a small country, Katsimicha urges people to file a report anyway.

Adonis stressed information is key: so researching the area of expertise of a psychologist can go a long way, and there shouldn’t be any qualms about asking professionals questions to see whether they seem like they’ll be a good fit.

 

A divisive past for psychology in Cyprus

A 2007 paper detailing the state of psychology in Cyprus published by the American Psychological Association paints a troubling past for the field.

It details the creation of a second association for psychologists that used lobbying power in an attempt to reduce the qualifications necessary for someone to obtain a licence. In fact, this second professional body sought to make a bachelor’s degree sufficient for a psychologist to practise.

According to the paper, it managed to garner much support from a former health minister, MPs and political parties.

“Unfortunately, nothing much has changed since then,” Adonis, who co-authored the paper, told the Cyprus Mail. The issue of qualifications has been finally settled and a masters is absolutely necessary however, disputes between professional groups detailed in the paper are still not fully settled.

“The battles within psychology are especially unfortunate because they keep the profession from attending to other issues that threaten it.

“For example, standards for school counselling are low (school teachers of various disciplines may offer counselling services after a month-long seminar) and psychology teachers do not need to be trained in psychology (for example psychology classes are taught by Greek Literature teachers). Clearly, a need for well qualified school psychologists and teachers of psychology is not obvious,” the profile notes.

Hadjithoma recognises that another glaring issue in the field is the lack of scientific specifications to make clear distinctions between specialisations.

For instance, as Adonis’ paper details, ‘Educational Psychology’ means different things in the US and the UK, which creates a number of issues when trying to streamline issues and clarify expertise.