United we stand?
An umbrella body for health professionals in Aotearoa?
I think it is time to review the direction of allied health services in Aotearoa.
I believe most health practitioners would agree that any dilemma, be it physical, emotional, mental, relationship centred, spiritual or culturally based, affects the whole person.
It follows that people are entitled to assistance which weaves knowledge together and approaches the pathway to health by offering them a wide perspective. A wide perspective is fashioned by colleagues within each discipline working and talking together in team settings.
To facilitate that vision, I suggest the NZAP focuses on bringing health practitioners together by inviting allied practitioners into an all-inclusive Association.
(Perhaps allied health professionals and their associations might also be interested in supporting what is written here regarding an umbrella organisation.)
The NZAP is, in my view, a health related body well suited and well informed enough to promote inclusiveness. As I understand psychotherapy it is not meant to be divisive, rejecting, territorial, or convinced there is ever a 'right way'. It follows there is no reason to promote psychotherapy above other health-related professions.
I envisage an Association named something along the lines of 'Health Practitioners Aotearoa'. (The title would need substantial debate via hui with our cultural partners.)
Each professional or practitioner body may wish to keep their own structure, training base and ethos. Psychotherapists may wish to do that too and thus preserve the body known as the NZAP, Te Rōpū Whakaora Hinengaro. But the overall body would be the main focus for members.
In that regard, there is precedent for practitioners to divide themselves into separate structures even within the NZAP. Psychoanalysts have separate functioning groups. Modalities have also separated their functioning. Notably most of those separate bodies have members who have stayed within the NZAP. Allied bodies also have divisions within their overall organisation. So divisions could exist within an umbrella association.
Psychologists Counsellors and Psychotherapists might invited as a first step adding others at a later stage.
If we moved in this direction we would need to keep firmly focused on the needs of people in the community, most of whom have no interest in what we call ourselves. I think we could all stop competing with our allied colleagues, whether we are psychologists, psychotherapists, counsellors, medics or other health professionals.
Each profession has the skills to be non-argumentative, open, patient and visionary. We practise those skills with clients, we would just need to approach colleagues in the same manner.
I joined the NZAP to be 'associative'. Along the way I very much appreciated colleagues who were steeped in what was named as 'psychotherapy' and 'psychoanalysis'. Their teachings informed my practice. Additionally, our NZAP conferences used to have speakers who were poets, novelists, dramatists, politicians, lawyers and scientists.
My practice was informed just as much by following words and ideas from speakers who were not psychotherapists. In those early days we seldom heard from tangata whenua. Their significant and welcome perspective was yet to come, and, when it was shared, my approach to people was developed in new ways by paying attention to mātauranga Māori.
I have belonged to four professional bodies in my time and each approach to helping people has informed my practice. I enjoyed practising psychotherapy alongside other skills gained as a former clergyperson, social worker, counsellor and teacher. Teaching alongside psychologists and supervising within the DAPAANZ offered more insights.
I see all health practitioners contributing to what we decide we know and what we have yet to discover.
Since 1984 I have belonged to this caring, stimulating and progressive Association which is learning how to honour Te Tiriti O Waitangi and whose members have helped thousands of people to feel healed. It is a privilege to belong. I would like all the colleagues I have taught and engaged with when in teaching and in practice to conference with the NZAP, research and write papers with us and weave new knowledge from psychology, medicine, spirituality, academia, social work, artistry and culturally based communities.
Additionally, imagine the impact a combined health professionals body might have with regard to convincing politicians the health system needs an integrated focus which puts the needs of people first.
The challenge would be to cease competition amongst allied health practitioners. It would mean listening in the way we listen to 'clients', following narratives carefully before challenging them, assuming that allied colleagues have good intent in the same way we assume that is present in our clients and being prepared to question the theories and approaches to practice formats we adhere to. All health professionals are well positioned to carry out those steps. In our practice rooms we do it every day. Whenever I’ve had long conversations with colleagues whom I imagined were very different from me, we have found that ‘solid good intent’ and creative ideas were shared by both of us.
My motivation comes from people in communities all around Aotearoa who cannot find a wrap-around service that takes their 'whole of life' situation into account. People who are referred from one individual health practitioner to another. People who find a good individually-based practitioner but don't know how to access help for family and community relationships.
People who are not aware their therapist could be talking to their general practitioner, their physiotherapist might also assist with their emotional struggles, or that interdisciplinary team-based discussions might be the key to enlightenment.
I'm concerned people are offered psychologists, counsellors, and psychotherapists as separate opportunities without knowing how to choose because they don't know what each professional title means. I'm also concerned that 'problems' are 'treated' in separate settings and practitioners make diagnoses from one professional perspective.
I believe we know how to change the health sector so that holistic health becomes the foundation. I am firmly of the view that all professional bodies hold the key to the knowledge and practical steps which would need to be employed.
My dream is that in every community there would be health centres where multidisciplinary teams offer people the chance to have their dilemmas shared in confidence by professionals who integrate their knowledge.
I know I’m suggesting a long complex journey into the future and all kinds of barriers already leap to mind, but it is perhaps worth nurturing as a visionary project. The first step could be a national multidisciplinary conference, perhaps hosted by the NZAP.
A. Roy Bowden, March 2024