Jhe discipline of psychology is generally underestimated and undermined in Pakistan. The common man thinks of it as either just little more than common sense or a mysterious ability to read other people’s minds. In the public space, psychological analyzes of our socio-political issues have never been sought. In the health sector, the medical model provides the dominant corrective approach, which recommends medication even for psychological and emotional problems. Mental health services are managed and controlled by physicians instead of multidisciplinary teams, of which clinical psychologists are important members. This already intimidated subject, for the moment, seems to deal with an existential crisis in addition to what was already there. It faces two major challenges currently coming from the electrical corridors. One after being foiled their attempt to pass a bill for an independent council and the other being included in the Allied Health Bill. We can have a long debate on the merits of the bill and why psychologists are at this crossroads. However, we generally realize that society, in general, is in great need of psychological support. This explains the proliferation of motivational speakers, unqualified counselors, private counseling services and spiritual healers. At the same time, the threat of a medicalization of mental health problems is looming. Fortunately, the stigma that has marginalized the field is collapsing over time. However, this led to another kind of problem where the verbiage of ill-equipped and uneducated people began to deal with the intricacies of mental health issues. As is evident, these advice sellers not only trivialize the seriousness of the problem, but also implicate mental health issues as the result of religiously and morally iniquitous conduct. In this way, they add insult to injury. These providers use online media to advise the various problems faced by our majority.
We would like to emphasize that psychological support by a clinical psychologist is not just a chat. Rather, it is a scientific mechanism informed by evidence-based scientific knowledge, and it requires extensive knowledge of how the human mind works, extensive training to identify underlying patterns of psychopathology, and skills to address such issues. Our fellowship insists that only highly qualified professionals should be allowed to do psychotherapy and counseling in the country. The provision of such a service by an unqualified person should and must be considered illegal, as it would likely do more harm than good. The qualifications required for a practicing psychologist should be decided by the Board of Psychologists, rather than by bureaucrats, politicians, or doctors for that matter. It should be the prerogative of the Board of Psychologists to decide on the eligibility of a practicing psychologist, as is the case all over the world. At the same time, this council and only this body of professionals should determine the program and the criteria for opening new departments and training centers in psychology.
It is time we had a council of psychologists in Pakistan, the same way the American Psychological Association and the British Psychological Society are working to determine the eligibility and quality standards of psychologists.
The bill for the formation of the psychological council was first adopted by the National Assembly in 2013. It could not be presented to the Senate due to the fall of the government. Therefore, the bill lapsed. Since the author of the bill did not consult stakeholders when preparing the draft, many psychologists have serious reservations about this bill, because some of the clauses proposed in the bill would lower the standard of the discipline of psychology and legalize certain current practices of psychologists that may present a potential risk of harm to the public.
The question is, if the Allied Health Bill is already passed, does a Psychological Counseling Bill still have a chance of being reintroduced? How else do we see the Allied Health Bill improving the standards of psychology teaching, training and practice?
The bill was reintroduced in the National Assembly in 2019 without addressing concerns raised by the body of psychologists regarding the composition of the Council of Psychologists. We recommend changes to increase eligibility for membership (from 16 to 18 years of psychology studies), to include private sector psychologists and to include the clause regarding the inclusion of an MP as a member from the council excluded, in order to constitute a body of qualified professionals.
Despite specific reservations, there is a consensus among psychologists that it should be adopted, so that standards of education and training in psychology can be regulated to meet international standards and outlaw quackery in the name of science of psychology.
The other aspect of the existential crisis was caused by the news that the National Assembly passed the Allied Health Bill, which now includes psychology and counseling (page 21, number 24 on the list).
The question is, if the Allied Health Bill is already passed, does the Psychological Counseling Bill still have a chance of being reintroduced? If not, how do we see the Allied Health Bill improving the standards of psychology education, training and practice?
The Allied Health Bill says: “Allied Health Professionals – [an] AHP is a person who provides diagnostic, therapeutic, preventive, curative or rehabilitative services in the field of health care, in a prescribed manner, and has completed a prescribed course of training at a recognized institution and is registered as an allied health professional by the body trained for that purpose” (page 1).
We want to emphasize here that psychology is a broad discipline and relates to the study of behavior in various contexts, and that not all areas of psychology relate to diagnostic, therapeutic, preventive, curative or rehabilitative services in health care.. We are concerned that if we introduce all psychology here in this bill, we will continue to see malpractice by insufficiently trained psychologists working in the health sector. The discipline of psychology is broad, and psychologists serve the public in many areas outside of healthcare settings, for example, in the corporate/organizational/banking/telecom, educational/academic settings, forensic and criminal investigation and artificial intelligence sectors. Therefore, it would be essential to reintroduce the Psychological Counseling Bill, obviously with suggested modifications, which legislates in all areas of psychology.
Through these recommendations, we try to emphasize that the discipline of psychology must be considered as a science that has its own guiding principles for ethical and professional standards requiring rigor and competence to practice in the field. It can also motivate us to continue to raise the standards of psychology education and training so that those who graduate demonstrate the required skills.
With respect to the bill, our position is that the current government claims to make justice and fairness the guiding principle of all its policies. Therefore, we expect the concerns of psychologists to be taken into account to safeguard the welfare and interests of society. Second, we should be consulted rather than dictated to regulate our services to society.
Prof. Salma Siddiqui is the Dean of School of Social Sciences and Humanities, NUST, Islamabad
Dr. Akhtar Ali Syed is the lead clinician psychologist in Ireland