Bureaucrats make aiding women in crisis harder

The Eastern Regional Health Authority (ERHA) may well yet be awarded the Blundering Bureaucratic Diktat of the Year award. At a time of serious and careful dialogue about abortion, the ERHA has managed to undermine and demoralise those who have done most in practical ways to support women in crisis pregnancies. It has made volunteer pregnancy counsellors feel as if their efforts are not just unappreciated but substandard. The ERHA has also annoyed some social workers by implying that their hard-earned qualifications do not constitute sufficient training to counsel women who find themselves unexpectedly pregnant.

With no prior consultation or warning, the ERHA circularised all the counselling agencies which it funds. All those who offer counselling must in future be accredited members of a professional body, either the Irish Association of Counselling and Therapy (IACT) or the Irish Council of Psychotherapy (ICP). If all the counsellors are not accredited within two years, these agencies will lose State funding. This has massive implications for voluntary pregnancy counselling agencies in particular.

If this is a response to the Aadam's Women's Centre debacle, it could not not have been more spectacularly useless. In the Aadam's Women's Centre, highly questionable and manipulative techniques were used with vulnerable young women. But this demand that all counsellors be professionally qualified will apply only to those who receive ERHA funding. Maverick clinics can still be set up and operate with impunity.

An intolerable burden is being placed on mainstream reputable agencies which rely on volunteers, who will find it impossible to comply within two years, or indeed ever, with this diktat.

In order to become an accredited member of IACT, these volunteers would have to do a recognised full-time course of a minimum year's duration. They must have 100 hours of supervised individual client work, 350 course hours, and from 2002, undergo 50 hours of personal therapy before they can counsel anyone. ICP is even more demanding.

Would someone please get real! Does a volunteer really need to undergo 50 hours of personal therapy before she can listen in a non-judgmental way to a distressed woman and gently sort out what she feels?

The irony is that if CURA loses State funding and is forced to operate a less comprehensive service, under the present legislative framework the ERHA could simply shrug its shoulders and say, "not an agency we fund, so not our responsibility".

Mairead Curran, CURA's national co-ordinator, has called for a sensible method of accrediting pregnancy counsellors. On its own initiative, CURA has planned and implemented many of the criteria now demanded by the EHB. Government funding facilitated higher levels of training.

But having all counsellors accredited members of a professional body is absolutely unworkable and unnecessary. Recruiting and retaining trained volunteers is difficult enough without demanding that volunteers reach the same level of qualification as a paid professional and then go on working for free.

CURA is by far the biggest dedicated provider of pregnancy counselling services in the State. The Well Woman Centres, the IFPA and Cherish do offer free Government-funded pregnancy counselling, but have only 13 counsellors between them.

Ironically, these 13 will not be affected by the ERHA decree because they are either qualified paid employees or are contracted on a session basis. Because they are small, the Well Woman centres, for example, can guarantee to provide an appointment only within four days. For a person in crisis, that is a long, long time.

In contrast, CURA, which has 380 volunteers and 17 centres, can see people immediately. CURA volunteers give up their time to do a counselling course of some 70 hours. After that, they undergo supervision and have to do a follow-up course within six months. These volunteers steal time from work and families so that women with crisis pregnancies will have somewhere to go where they will be given space to come to terms with what is happening to them. Voluntarism is the key to what they do. They are specialists in pregnancy-related crisis counselling, which by definition is short term. CURA volunteers are crystal clear and adamant that anyone with more deep-seated issues to deal with must be referred elsewhere to someone more qualified.

The ERHA does not seem to understand either voluntary organisations or the nature of pregnancy counselling. For example, the ERHA does not require those who do telephone counselling to be qualified. Yet the telephone is often the first point of contact - and sometimes the only contact. This first contact will determine whether people in crisis will be willing to come into a faceto-face encounter, or even whether they will be willing to explore the options open to them in a calm fashion.

Nor does the ERHA seem to recognise that volunteers are in this not as a career option but because they want to be of service to people. In contrast, the Department of Social, Community and Family Affairs is much more realistic and supportive. This Department grant-aids marriage and bereavement counselling, which is also mostly delivered by volunteers. It recognises that voluntarism is a social good and that volunteers need encouragement, not ultimatums. While demanding high standards, it does not find it necessary to demand that volunteers be accredited like professionals.

Cost alone is a huge factor. Take an organisation such as Life, which has about 50 volunteers in seven centres and which delivers 160 counselling hours per week. Counselling courses can cost between £1,000 and £2,500 a year per person. So to get its current volunteers accredited would cost anywhere between £50,000 and £125,000. In all voluntary organisations people come and go, so you could invest thousands in someone who can volunteer only for a year. That would patently be madness. As Julia Heffernan, PRO for Life, points out, money will be invested to acquire a broad spectrum of counselling skills, most of which are not directly relevant to pregnancy counsellors.

PACT, a counselling and support service for unplanned pregnancies and also an adoption society, does not use volunteers. However, it has been told that its highly experienced social workers are not qualified to counsel.

Hazel Douglas of PACT points out that it is offering an extensive social work service, which encompasses but goes far beyond counselling. To demand that they also obtain a counselling qualification on top of their four-year professional social work qualification (NQSW or CQSW) implies that counselling has a greater value than anything else which they do.

Regulation of counselling agencies is overdue, but not in this hamfisted way. Instead of asking how it could be more supportive, the ERHA has delivered a slap in the face to hardworking volunteers and professionals. If CURA, Life and PACT are forced to forgo funding and greatly reduce their services, who will pay the millions of pounds it will take to replace them? Ultimately, Irish women in crisis will be the real losers.

bobrien@irish-times.ie