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Rethinking Audit Cultures: A critical look at evidence-based practice in psychotherapy and beyond

Rethinking Audit Cultures: A critical look at evidence-based practice in psychotherapy and beyond

Lucy King
Christina Moutsou

ISBN 978 1 906254 31 5 (2010)

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•Examines the related demands for audit and ‘evidence-based practice’ in health services, and how these increasingly encroach upon the field of psychotherapy.
•Critically discusses whether the tools used to carry out ‘audit’ and measure ‘accountability’ can possibly relate to, or help reflect the nature of psychotherapeutic practice.
•Suggests why attempts to just extend criteria and methodologies borrowed from medical or other scientific disciplines are likely to obstruct rather than further the development of psychotherapy.
•Looks at possible alternative and positive ways to monitor or audit the work of psycho-therapists.

Rethinking Audit Cultures is a valuable collection of papers exploring the tensions between the evidence-imperative of audit practice and the complex conversational realities of what are called the ‘impossible’ professions. The essays are not only directed to the interests of those engaged directly in psychotherapeutic practice and policy, but also speak to a fundamental ethical and administrative fault-line within the organisation of modern societies. Michael Power, Professor of Accounting, London School of Economics and Political Science


1. Introduction Lucy King and Christina Moutsou

Part I: The Context of Audit Cultures
2. Audit Culture and Illiberal Governance: Universities and the politics of accountability Cris Shore
3. Measurement in Psychotherapy John Heaton

Part II: Auditing Psychotherapy and its dicontents

4. The Sarcophagus of Practice Miles Clapham
5. Dark Times: Auditing the psychotherapy profession Ros Mayo
6. Audit, Audit Culture and Therapeia: Some implications for wellbeing with particular reference to children Del Loewenthal

Part III: Accountability and Constructive Audit
7. Auditing the Unconscious in the NHS Kevin Ball
8. Acceptable Audit? Paul Gordon

The new rhetoric of evidence-based practice and the presence of audit culture have radically changed the landscape of contemporary psychotherapy. In this superb collection of essays, the sources, structure and effects of these discourses are carefully analysed and a powerful critique emerges that cannot be ignored. Darian Leader, Lacanian psychoanalyst and writer

Any psychotherapist who thinks that regulation won’t affect their practice is deluding herself! Just when I thought I knew all the ins and outs of the debates around audit and regulation along comes this rigorous book to unsettle me with its fresh and penetrating ideas. But then that is what psychoanalysis and psychotherapy do best: reveal the secret, primitive, ritualistic, defensive, grandiose and shadow aspects of something that seems so laudably contemporary and beyond critique as ‘protecting the public’ – without losing sight of what might be valuable in such an endeavour. An exemplary fusion of the psychological, political, and ethical dimensions of the problem. Andrew Samuels, Professor of Analytical Psychology, University of Essex

Thoughtfully assemble the thinking of Plato, Kierkegaard, Nietzsche, Heidegger, Foucault and Illich (amongst others), and a devastating case against the ‘audit culture’ and its noxious collateral effects virtually writes itself. We have needed this book for a long time, and now that the ‘evidence-based’ emperor has been comprehensively de-robed, therapists have no excuse for not challenging full on the crass inappropriateness of the all-engulfing auditing mentality. Therapists of every hue simply must read this essential book. Dr Richard House, Research Centre for Therapeutic Education, Roehampton University

Rethinking Audit Cultures is a valuable collection of papers exploring the tensions between the evidence-imperative of audit practice and the complex conversational realities of what are called the ‘impossible’ professions. The essays are not only directed to the interests of those engaged directly in psychotherapeutic practice and policy, but also speak to a fundamental ethical and administrative fault-line within the organisation of modern societies. Michael Power, Professor of Accounting, London School of Economics and Political Science

 

Lucy King

Lucy King

Dr Lucy King trained as a biologist, but after several years of research abandoned the laboratory and microscope and turned to a more directly people-focused occupation. She trained as a psychotherapist with the Philadelphia Association and remains closely involved with its teaching programme. She lives in Cambridge, where she has a private practice as a psychotherapist as well as working for many years in the Cambridge University Counselling Service. She is a founder member of the Cambridge Society for Psychotherapy.

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Christina Moutsou

Christina Moutsou

Dr Christina Moutsou acquired her PhD in Social Anthropology from the University of Cambridge in 1999. She trained as a psychotherapist with the Philadelphia Association and she has worked in one of its houses for over five years. She currenltly works in private practice and as a sessional lecturer of psychoanalysis at Birkbeck College, University of London. She has co-edited Crossing European Boundaries (Bergham Books, 2006) and she is the author of 'Dreaming Anthropology: Unfolding intersubjectivity in complex anthropological research', Irish Journal of Anthropology (2000) and 'When philosophy meets practice: the setting up of a PA therapeutic community household' in Therapeutic Communities for Psychosis (Routeledge, 2008).

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