Is psychology a sexist discipline? Reflections on The Patient Gloria

In 1964, Gloria Szymanski was recruited by her therapist, Everett Shostrom, to take part in a series of films demonstrating psychotherapy. Shostrom also recruited three leading psychotherapists: Carl Rogers, creator of ‘person-centred therapy’ (widely known as ‘counselling’), Fritz Perls, creator of ‘Gestalt therapy’ and Albert Ellis, creator of ‘Rational Emotive Behaviour Therapy’. Shostrom told Szymanski the videos would be used solely for education purposes. He lied. He later turned the videos into a motion picture, ‘Three Approaches to Psychotherapy’ which was shown in cinemas and on TV. You can still watch it on YouTube today. Szymanski took legal action, but it was unsuccessful.

Last week, I went to see “The Patient Gloria” at Traverse Theatre; a production based on the videos and Szymanski’s experiences. The play combined re-interpretations of the therapy scenes with narration, music and dancing. It took a highly sceptical view of the therapies, highlighting each therapist’s stereotyped interactions with Szymanski (“Rogers is paternal, Perls aggressive and Ellis is predatory”, an information sheet handed out before the play explained). Gina Moxley played all three therapists and also narrated the play, comparing her own experiences of harassment and negative treatment by men with Szymanski’s experiences at the hands of Shostrom and the therapists.

The Patient Gloria

The play was, I think, intended to provoke thought about gender issues; about relationships between men and women and how the ill-treatment of women is often overlooked. As a Clinical Psychologist, my thoughts moved in a slightly different direction. Mainly I was struck by one thing: all three therapists in The Patient Gloria were men. They were therapists I was familiar with, though not the ones who created Cognitive Behaviour Therapy, the psychological approach I use. No: that therapy was created by another man, Aaron Tim Beck. In fact the more I reflected, the more I realised that male views have had a disproportionate impact on the field of psychology. I found this most troubling because psychology is a female-dominated discipline: 80% of undergraduates and around 85% of Clinical Psychologists are women. I began to wonder: is psychology sexist, and is the discipline disproportionately influenced by male views?

In brief: yes

A quick look at the statistics concerning men and women in education and academic psychology would suggest this is the case. While around 80% of psychology undergraduates and Master’s students are women, this drops to 69% at PhD level. It drops further to 63% at Lecturer level and then to 33% at Professor level*. I also did an analysis of the male:female ratio of heads of psychology departments at Russell Group universities (for my advanced spreadsheet, see below). Similar with the ratio of Professors, this suggested that only 36% Of current UK psychology department heads are women. This pattern is a classic version of the “leaky pipeline”: women seem to get lost along the career progression trajectory, until only a minority remain in the most senior positions.

psychology heads of school

No bias in education and training

To be clear, there does not appear to be any bias at the point of enrolling students into educational courses. For example, with undergraduates, females tend to be slightly more successful than males at the application stage, and this has been attributed to females achieving higher grades overall. Similarly, for psychology graduates seeking to enrol onto a competitive Clinical Psychology Doctorate programme, the statistics show no evidence of an anti-female gender bias.

A complex picture

So, when and how do women get lost along the way? The Athena Swan Charter was created in 2005 to address issues of gender inequality in higher education, and academic schools now monitor and report their action on gender equality in order to gain awards (Bronze, Silver, Gold). Some of these reports are available online, and show that the issues are not straightforward. As the School of Psychology at the University of Birmingham reported in their Athena Swan Silver Application, they have tended to receive far more applications for professorial positions from men than women. In fact, over a 3-year period, they reported receiving 3 applications from women, compared with 29 from men.

Part of a wider academic problem?

One possibility is that the inequalities seen in psychology are part of a wider gender bias in academic outcome indicators. For example, an analysis of grants submitted to the Gates Foundation found that those led by women were 16% less likely to get funded than those led by men. Furthermore, where grants are awarded to women, they tend to be for smaller amounts of money. An analysis of funding awarded by the Engineering and Physical Sciences Research Council (EPSRC) found that on average, grants awarded to women were 40% smaller than those awarded to men. There is also some evidence to suggest that research papers written by women are less likely to be accepted by journals.

Part of a wider societal problem?

Another possibility is that the gender patterns present in psychology careers simply reflect patterns present in wider society. For example, an analysis of the Foreign and Commonwealth Office found that women were overly represented in junior grades; only 30% of employees in senior management were women. Furthermore, those women who were employed in senior management earned on average 6.5% less than men in the same category of job. Nationwide, the hourly wage gender pay gap for full-time employees has been estimated to stand at around 8.6%. About 40% of the pay gap between men and women is unexplained, indicating that it could be due to bias.

What has all of this got to do with Gloria Szymanski?

The three approaches to psychotherapy demonstrated in The Patient Gloria involved four prominent men: Carl Rogers; Fritz Perls, Albert Ellis and the instigator, Everett Shostrom. All men benefited in having their ideas broadcast worldwide, gaining international recognition for their work. Szymanski, the only woman in the equation, paid a high price for their gain. Her personal views and experiences were laid bare for public dissection. Furthermore, none of this was necessary. I have made several successful videos on YouTube which aim to demonstrate therapeutic techniques; these have been viewed over a million times and are now used by healthcare organisations and universities internationally. Crucially, none of these has sought to demonstrate therapy with a real patient. ALL of the demonstration videos have used actors. Contrary to the concept behind the Gloria videos: most people can’t tell. If you don’t believe me, just read the number of comments underneath where someone is asking if the clients are real. So the question I am left with is: if the gender balance of leading psychologists was more equal, would Szymanski have suffered in the way that she did? Furthermore: would the videos have been created and promoted, at all?

 

The Patient Gloria is showing at Traverse Theatre in Edinburgh until August 25th.

 

*I have taken these statistics from the Athena Swan Gold application submitted by the School of Psychology at Queen’s University Belfast. While the report said it took the figures from 2014-15 HESA data, I was unable to locate the original data online, and so have relied upon second-hand reporting of these.

How to become a psychological therapist without completing an undergraduate psychology degree

It’s not unusual to choose to become a psychological therapist later in life, perhaps as a second career. For example, in 2017, 395 of the applications to the UK Doctorate in Clinical Psychology came from candidates aged over 35. However, most training courses in psychological therapy require an undergraduate psychology degree. What are your options if you don’t have this? Here I offer three routes you might want to consider, depending on your current situation.

  1. You have an undergraduate degree in something else? Do a psychology conversion course

If you have an undergraduate degree in any other area, you can ‘convert’ your degree by completing a psychology conversion diploma (PGDip) or MSc course.

The key thing is to check that your chosen course is accredited by the British Psychological Society (BPS) and will provide you with Graduate Basis for Chartered Membership (GBC). The BPS currently lists 171 such courses nationally. The entry requirements for these vary, so it’s worth checking these on their websites and contacting them directly with any queries you might have. Two to consider are:

  1. Birkbeck, London’s ‘evening university’. Birkbeck offers two accredited psychology conversion courses, the Postgraduate Diploma and the Psychology MSc, both of which are designed for candidates with an undergraduate degree in another area. Both courses can be completed in a year full-time or two years part-time and involve attending lectures 4 or 2 evenings a week. I spoke to the admissions tutor, Dr Eddy J Davelaar, who is a Reader in Cognitive Science about Birkbeck’s entry requirements. He said “While the course is designed for non-psychology graduates, it is a postgraduate course. A certain level of pre-existing knowledge in research methods is needed. Where applicants have no such background, they may be made a conditional offer dependent upon their passing an online entrance exam in research methods. They will need to pass at 60% (if applying to study full-time) or at 50% (if applying to study part-time)”. However, if this is you: don’t panic. Birkbeck will assist you in identifying relevant courses (online or at the university) or practice materials to help you prepare for the entrance exam.john-schnobrich-520019-unsplash
  2. If you’re looking for a distance learning course, check out the MSc/PgDip Psychology (Conversion) courses offered by Manchester Metropolitan University. These can be completed in 12 months full-time or around 2 years part-time (21 months for the PgDip; 24 months for the MSc). These courses are taught entirely online, requiring no attendance at the Manchester campus. In terms of entry requirements, pre-existing psychology credits are needed for the PgDip route but not for the MSc. Further guidance on the qualities the course looks for in prospective candidates are outlined on their website and include commitment and motivations, IT skills and the ability to study independently.

Once you have your conversion degree, you can choose to pursue any psychology career which appeals to you, such as Clinical Psychology, Counselling Psychology or Forensic Psychology. Each of these requires further study, but there are opportunities for paid employment and development within these training routes. For example, once you have your degree, you can apply for Assistant Psychologist roles within the NHS which are usually appointed at Band 4 or Band 5 and provide further experience for subsequent psychology career specialties. Sign up to jobs.nhs.uk for alerts. You can also apply for research assistant posts at universities, which offer paid experience for psychology graduates interested in pursuing research-related careers. Sign up to jobs.ac.uk for updates. For further info on therapy-related psychology careers, see my previous blog.

  1. You have a background in mental health from a non-psychology discipline? Train in Cognitive Behaviour Therapy

An alternative to traditional psychology specialisms is to train as a Cognitive Behaviour Therapist. Cognitive Behaviour Therapy is an evidence-based, goal-oriented, time limited therapy. It is the most commonly delivered therapy in the NHS and the main focus of the Increasing Access to Psychology Therapies (IAPT) initiative, which delivers psychological therapies in primary care settings.

Perhaps the most interesting thing about this route is that it isn’t accredited by the BPS, but by the British Association for Behavioural and Cognitive Psychotherapies (BABCP). As such, you don’t need a psychology degree to start training. Instead, you need to have a background in one of the listed ‘Core Professions’, which include Mental Health Nursing, Occupational Therapy and Social Work, amongst others. If you have one of these core professions, you already hold the basic entry requirement for further training to become an accredited CBT therapist.

If you are choosing to self-fund your CBT training, check out the BABCP list of accredited ‘Level 2’ courses. Completing one of these will make you eligible for registration as a CBT Therapist and able to apply for Band 7 CBT posts in the NHS. Courses are 1 or 2 years long and involve supervised CBT practice on placement and attending teaching at university. You can apply directly to universities such as Birmingham and Bucks New University. Entry requirements vary between courses, but most stipulate that 2 years’ experience of working in mental health is a pre-requisite. Self-funded applicants are expected to have a pre-arranged placement where they can undertake supervised CBT practice to gain the relevant experience they need. At Birmingham, this is stipulated as 3 days a week for a year. At New Bucks, this is stipulated as 200 hours in total.

There is also the option to pursue paid training routes in CBT. For less experienced mental health professionals, this may initially involve training and working as a Psychological Wellbeing Practitioner (PWP) in Primary Care. These posts are usually appointed at Band 4 and promoted to Band 5 once training has been completed. PWPs deliver low-intensity CBT interventions, such as guided self-help and psychoeducation groups. To then train as a CBT therapist (termed ‘High Intensity Therapists’ or ‘HITs’), you apply directly to services for specific roles, rather than to universities. HITs train on a Band 6 and can apply for Band 7 roles once qualified. For training opportunities in both roles, search nhs.jobs.uk for ‘trainee’ positions.

you've got this

  1. Looking for a third way? Consider a career in counselling or psychotherapy

While the BPS is the accrediting body for psychological therapists and the BABCP is the accrediting body for Cognitive Behaviour Therapists, the BACP accredits counselling and psychotherapy courses. They all share similar letters, so beware of confusing them!

Counsellors can train in a range of therapy modalities, from Freud’s psychoanalysis to Roger’s person-centred (or ‘humanistic’) counselling. Once qualified, they can work independently, for the NHS or for third sector organisations. Training courses usually focus on one of these therapy modalities in particular, but the BACP suggests that counsellors may use a mix of techniques if they think a client would find this helpful.

Counselling training pathways exist separately from psychology or CBT training routes, and as such, no background in either of these is needed. Instead, the training involves 3 stages:

Stage 1: An introductory course lasting 8-12 weeks, usually run as evening courses at local Further Education colleges.

Stage 2: The Certificate in Counselling Skills, a year-long part-time course also usually run at local colleges.

Stage 3: The core practitioner training at diploma, undergraduate, postgraduate or doctorate level.

For Stage 1 and 2 courses, the BACP recommends contacting local colleges and education centres. However, for the core practitioner training, check their website for accredited courses. A wide variety of options are available, from weekend courses run by independent training centres to university-run MSc degrees. For an example of an independent training centre, see the South Manchester for Psychotherapy, which offers a 4-year, part-time Diploma in psychotherapy. For an example of university-run core practitioner training, see the University of Salford which runs both a postgraduate diploma and an MSc. These courses run part-time, with the diploma last 2 years and the MSc lasting 3 years.

This article was first posted on the Psychreg blog on 23rd May 2019.