Not with that lot

Some people raise an eyebrow at the prospect of Alexander Technique teachers being on the same register with this list of therapies*. 'We are not therapists! We are teachers!' comes the cry. Indeed one my first reactions to the news that we were likely to share our regulatory framework with these approaches to health and well-being was 'Not with that lot!' I now recognise that my reaction was a prejudicial gut-reaction based on the perception that being seen in such company would somehow degrade, somehow place the Alexander Technique at a lower-than-deserved value.

Leaving aside the question 'Should the Alexander Technique be listed with therapies?' for a moment, this reaction of mine seriously underestimated the evidence that I already had to hand that these approaches have really helped people who are close to me.

A family member - a real sceptic (ridicule is his trade) - has had huge benefits from the Bowen Technique; my family has had fantastic benefits from homeopathy - me especially, ethnic white Irish (potato white, deeply averse to sun-worshipping activities) have been sun-proofed by a homeopathic remedy; people I know and respect have benefited from, and indeed practice, Reflexology.

So a simple inspection of my personal experience, and the evidence around me should have been sufficient to stop me making such a prejudicial exclamation.

*Aromatherapy, Bowen technique, Cranial Therapy, Homeopathy, Massage, Naturopathy, Nutritional Therapy, Yoga Therapy, Reflexology, Reiki and Shiatsu.

Encouragement and resistance

We had a meeting of our Regulation group (ATVSRG, the 'Alexander Technique Voluntary Self-Regulation Group') last week, at which STAT, ATI, ITM, and PAAT were (as usual) represented. We had an important guest at the meeting - Maggie Wallace, co-chair of the Complementary and Natural Healthcare Council, which is going to start its work as a Regulator in mid-January. (Though for the Alexander Technique, applications to join the register will start around the end of March, beginning of April.)

It was really encouraging to hear from Maggie (and from Ian Cambray-Smith, the representative from the Prince's Foundation for Integrated Health) that, from their perspective, our work as a group is going very well, and that we are clearly on target, and doing all the right things to prepare ourselves for regulation in the first half of next year.

So, the process looks from the outside as if it is going really well. From the inside, it sometimes feels a bit different. The STAT reps tell us, and it is no secret, that many of their members are suspicious of regulation, and some of them are positively, loudly, enthusiastically resistant to the thought of regulation.

The good thing is that we were told explicitly - by both Maggie and Ian - that any lack of willingness on the part of any one organisation would not be allowed to hold the other organisations back. So if STAT, for example, decide that they cannot, or will not, recommend the register to their members, it will not stop the other organisations from doing so.

And anyway, it will be up to individual teachers to decide whether or not to apply to the register, not for professional associations to so decide. So even if STAT as an association decides 'against' the register, individual members of STAT will still be able to apply to the register.

Understanding STAT II - A Federation of Loyalty Units

Many STAT members know nothing about us in the ITM. It is not their fault (for reasons I explain below) and it is not our fault either. But as you get to meet STAT members, it is important to understand 'where they are coming from' if they seem to be un-accepting of our right to exist and un-accepting of our right to practise as fellow Alexander Teachers. I hasten to add that we meet many STAT teachers who do know of us and are accepting of us, but there are some who might express some puzzlement. Here's why they might be puzzled.

STAT itself does not run training courses, but it approves the setting up of training courses, and moderates many of its training courses. And graduates of their (now twenty-one) courses in the UK and Ireland usually become members of STAT once they have earned their training-course certificates. They recognise STAT as the ultimate upholder of standards in the Alexander world. Some (perhaps many) of their members believe that only teachers from STAT approved training courses are legitimate teachers of the Alexander Technique. They are wrong in believing this - there are in fact three other professional associations in addition to STAT that certificate and publish registers of teachers to standards that are at least as high (ATI, ITM, PAAT). And their registers are equally legitimate. But awareness of the legitimacy of other registers is not widespread. Part of the reason for this can be found in the notion of a 'loyalty unit'.

In our regulatory discussions, it has been explained to us that the 'loyalty unit' of STAT members is their training course, not STAT itself. As I mentioned earlier, there are now twenty-one STAT approved training courses, and the characterisation of each training course as a 'loyalty unit' indicates that STAT teachers feel a strong bond to the training course, to their fellow trainees, and to their trainers, rather than a strong bond to STAT itself*. Forgive me for going to that wonderful source of comparisons and similes, the United States of America, to explain further.

It's as if each training course is a state (New Jersey, Nebraska, Ohio) and STAT represents the federal government in Washington. Each citizen is loyal to their state, and regards the citizens of other states as somewhat wierd, less intelligent (Don's home state, Ohio, suffers particularly in this regard) and 'out there' but they nevertheless - perhaps grudgingly - recognise that they are the same sort of entity. Though different in size, history, and demographics, New Jersey Nebraska and Ohio are all states, and their citizens have equal rights.

As well as not thinking well of other states, many US citizens regard the federal government, based in Washington, with suspicion. It is seen as a soaker up of funds, as a source of decision making which is unfair to each individual state, and a source of intrusion on the individual state's and the individual citizen's rights. Nevertheless, the citizens acknowledge the federal government as the ultimate source of authority, and their defender in case of international disputes. When push comes to shove internationally, they rally around the federal government - 'My country right or wrong'. So their perspective, their view of the world, is dominated by the large number of states of equal status, and a federal government with an umbrella role. The size of the USA makes it difficult for many citizens, therefore, to accommodate, in their world view, the notion of countries beyond their borders - there is simply so much of 'America', and so much to 'American-ness' that 'America' occupies almost the whole of their attention. [This is a charicature, I know, Don - sorry honey - but I hope you'll agree there's sufficient truth in it to warrant its use in this comparison]

And this is somewhat the same with the relationship between STAT (federal government) and its training courses (states) and STAT teachers (citizens). On the one hand they love and respect (by and large*) their own training course, have reservations about other training courses, are suspicious of STAT, but on the other hand they acknowledge that the other training courses are legitimate, and accepts STAT's authority over them.

The point to remember is that many STAT members' views of the Alexander world is dominated by STAT. They know nothing about us, and it is our job, when we meet them, to tell them - smilingly, understandingly, sweetly of our existence, and of our right to exist. Because yes, just as the USA is not the only country in the world, STAT is not the only authority on the Alexander Technique. It is the oldest and largest professional association, and if it had not come into existence, there would be no ITM - so they are worthy of our respect and gratitude. But they need to know about us.

*Of course there will always be a few people who graduate from their training courses not feeling well-disposed towards the course they have just left, but these cases do not affect my argument

On 1600 hours as a standard

STAT, for reasons I will explain in a future posting, does not possess a single agreed view of what training standards should be. There are many different opinions. A recent Doctoral Dissertation by Terry Fitzgerald an Australian (ooh! he must be good!) member of STAT has as its title 'The future of Alexander Technique teacher education - Principles, practices and professionalism'.

He terms the 1600 hours 'standard/specification' a 'numerical protocol' of which he states
'... the mandatory time-specific, practices of AT teacher education ... are not only anachronistic, they are also flawed to the extent they ... are devoid of qualitative assessment standards.' (Abstract, p. x)

(I told you he was good!)

Interesting also is the history of deciding on 1600 hours as the specification. It is not (as I had thought) because Alexander's three year course totalled 1600 (Dr Fitzgerald suggests it was closer to 1200).

It was rather that

'STAT specified the minimum weekly attendance time for the three-year course AT training course to be 15 contact hours per week in order to satisfy the British Home Office’s condition for student visas being granted to overseas trainees.' p. 44

His source for this information came from Adam Nott, who he further uses as a source for the suggestion that the 1600 hours requirement 'was partially in response to the London County Council’s consideration of financial grants to students.'

Jeepers.

Sweetly smelling

My favourite walking companion is Tim Kjeldsen. We walk the canals of Birmingham (more sweetly smelling, and less prone to rejoining the sea than those of Venice) and talk about the joys (many) and frustrations (many more) of working on the regulation of the field of the Alexander Technique.

One of the joys is the success Tim had, last year, spending incredible amounts of time and energy in 2007 helping design the Complementary and Natural Healthcare Council. This Council (CNHC) is slowly (actually, rather rapidly) taking shape as you can see by reading this http://www.fih.org.uk/what_we_do/regulation/interview_with_the.html

This Council is very likely to be the one we recommend ITM members to join sometime in 2009. We won't be able to force you to join, but it is likely/entirely possible that we will delegate the regulatory functions of our Professional Association to the CNHC.

I recommend that you keep an eye on the CNHC website at http://www.cnhc.org.uk for developments. As a regulator it appears to us to be more sweetly smelling, and less prone to be swamped by the sea, than any other.

Understanding STAT I - Standards

The word ‘standard’ has a number of different meanings, which tend to get somewhat mixed up in discussions about Alexander Technique training courses. (Not all meanings of the word ‘standard’ are relevant to what I write, but don’t worry, I won’t flag up or make a song and dance about them.)

STAT members, and their published documents, make statements about 1600 hours being ‘the standard’ for training course - and some STAT-trained teachers are genuinely distressed and worried that ITM’s training course might dilute the standards of the profession because it has less than 1600 contact hours. We try to soften their distress and worry, in a number of ways, assuring them that we have high standards of our own. But the word 'standard(s)' means different things. And as you get to meet STAT-trained colleagues in the years to come, you may need to make it clear which meanings of the word 'standard' are in play in such discussions.

The four meanings I want to focus on are:

[1] 'Standard' meaning ‘a level of quality’

In the dictionaries I’ve looked at, this is the first meaning that is listed, and it is probably the first meaning that comes to mind when people hear the word used. In our exams - both written, and teaching - we measure the degree of competence of the teacher-trainee in their knowledge, understanding, and practice of the Alexander Technique. If someone meets the standards of the exams, they qualify as a teacher. In this sense, 'standard' means a qualitative benchmark. Trained examiners can see a passing performance, or read a passing exam paper, and can explain why examinees pass or fail with reference to these benchmarks. In our regulatory discussions, we have referred to this meaning as 'output standard' - it is a measure of the output of training. Our (ITM's) four written exams, and practical teaching exam at the end of the course, are qualitative measures of knowledge, understanding, and practical skills which STAT training courses typically do not have.

[2] Standard meaning ‘a unit of measurement’

'Standard' can also mean a unit of measurement, or an agreed specification which has wide acceptance in an industry or profession. The STAT standards of course-length (1600 hours), weekly rhythm of study (typically four half-days per week, each of four hours in length over eleven/thirteen week terms), and of the relationship between practice and theory (80% practical) are specifications which apply to STAT training courses. These specifications are quantitative, rather than qualitative: they have to do with duration as a property of the training course calendar and timetable, rather than demonstrable skills of the graduate teacher. It is STAT’s experience that graduates of 1600 hour training courses are competent to teach the STAT way - though there are dissenting voices, even within STAT, which would dispute this. In our regulatory discussions we have referred to this meaning as 'input' standards.

[3] Standard meaning ‘a behavioural requirement’

This sense of 'standard' is perhaps the least familiar, but it is important to us, as it could be a component of our Continuing Professional Development programme. The Health Professions Council has recently published standards for its CPD programmes, and these are neither qualitative benchmarks, nor quantitative specifications - they are requirements (labelled standards) which are worded like this ‘You must maintain a continuous, up-to-date and accurate record of their CPD activities’, and ‘You must present a written profile containing evidence of their CPD upon request’.

[4] Standard meaning ‘average’, ‘normal’, or ‘usual’

Lastly there is the meaning of 'standard' as ‘the most usual’ or ‘the normal’ this is standard in the sense of (American) ‘regular’. In the hotel industry this is where ‘standard-room’ means a normal room, at a normal price. STAT courses are standard in this sense, because there are more of them, and they are the norm.

So if you meet a STAT teacher who objects to your ITM training background, and who says ‘STAT is the standard’ or ‘Your ITM standards are inferior to our standards’ you should smile sweetly at them and ask ‘Which sense of the word standard did you have in mind exactly?’

The kinaesthetic effect of latte-ness

[NB The opinions expressed in this, and all other postings in this blog, are my personal opinions, and do not represent ITM policy.]

It is sometimes said that because the Alexander Technique is all about 'regulating the self ' we don't, or shouldn't, need institutional regulation. After all, the argument goes, practising the AT makes teachers better human beings, more in command of themselves, and able to inhibit - better able to stop wrong things from happening. Although you might get a roomful of Alexander teachers nodding in agreement at this, this is the kind of thinking that should set alarm bells ringing, and red lights flashing.

Many groups in the world believe that they are special cases, and that they therefore do not require scrutiny by regulatory agencies, because they believe themselves to be immune to the failings that afflict other human beings. But brief consideration of recent history should indicate how mistaken this view is. Catholic priests are bound by the ten commandments plus vows of poverty, chastity, and obedience - but that hasn't stopped some of them indulging in abusive sexual behaviour with children in their care. Doctors are bound by the Hippocratic oath ('Never do your patient any harm...') but some have harmed, indeed murdered their patients.

Ah yes, you might say, but it's just the very few - a very small fraction of one per cent of the total number - who are a problem, so we don't need the bureaucracy, the outside interference, that independent regulation requires. But let me tell you about my first Alexander teacher.

In our first lessons he had given myself, Estella my wife, and a number of other people wonderful Alexander experiences. I floated around the city (we were working overseas, the other side of the world at the time), with an extreme case of the 'kinaesthetic effect of lightness' for a couple of weeks. It was such a good feeling, that I attributed it to a particularly nice (also) first experience of cafe latte ('kinaesthetic effect of latte-ness') that I had about the same time as my first lesson. Then I reasoned that as Estella had not had the cafe latte experience, but she was feeling great as well, it was probably something to do with the Alexander work.

After our second lessons with him however, it became clear that he was taking advantage of the female pupils he was teaching. Bad news. We cancelled future arrangements with him (we had hosted his visits to our city, and found him premises and students) and we complained to his professional association. This was twenty years ago, and they wrote back apologetically saying that they could not pursue our complaint further, because it would be a case of our word against his, and besides the distance between where we were and their head-office made conducting enquiries impractical.

Three points arise from this experience. First, despite the abusive nature of our early experiences of an Alexander teacher, the power of the Alexander work was such that two of us are now (twenty years later) teachers of the Alexander Technique - so you could argue that he was a great professional. However, we think it regrettable that he is still practising (and, we hear, in much the same way), and we wish that his professional association had had the resources then, twenty years ago, to hear our complaint and to remove him from the register.

Second, this incident illustrates the fact that it is the practitioner who needs to be regulated, not the Alexander Technique itself. The Alexander Technique is not itself dangerous, the potentially 'dangerous' component in the situation are the teachers who are, in a one-to-one situation, in a position to take advantage of pupils - therefore pupils need some protection.

Third, however small a proportion of the total population of Alexander Teachers this person is, he will be for an unknown number of pupils be the first - and in all probability the last - Alexander Teacher that they have. Because many of them, like a number of our friends who were pupils for the first time along with us, will be put off doing any further Alexander work because of his behaviour.

The separation of Regulation and Representation

The joke about homeopaths given at the end of my first blog was delivered by the chairman of a public event at which 20 complementary healthcare professions were represented. It marked a failure on my part - I didn't give the right ITM response. I should have asked for nineteen additional jokes - one for each of the other professions represented. [Darn!]

Which leads me to wonder what jokes we could tell 'against' Alexander Teachers. Here are two attempts, in the form of question-and-answer riddles. At the end of this posting, there is another riddle - which I think is really clever, and which I hope will absolve me of the failure I mentioned above. But please read the central section on regulation and representation first!

Q. What's the difference between a SATNAV and an Alexander Teacher?
A. The SATNAV gives better directions.

Q. Why are Alexander Teachers such good pick-pockets?
A. Because they are so light-fingered.

[If you have others, please email them to me!]

Regulation vs Representation

Another key principle in the regulatory process is that regulation is separate from representation. This means that the professional associations to which we belong (ATI, ITM, PAAT, and STAT) should not run the processes of regulation. This principle follows on from the principle mentioned in my first posting, that of protection of the public. It is not acceptable for a group of professionals, however trustworthy a reputation they have, to regulate themselves. Doctors should not regulate doctors, Alexander teachers should not regulate Alexander teachers. The reasons may be obvious, but they are worth spelling out.

When it comes to making judgements about whether a fellow professional has transgressed in some way, those making the judgements may actually be over-considerate, or may be perceived to be over-considerate, of their fellow professional who is under investigation. They may be inclined to harbour feelings of understanding for the teacher under investigation which might out-weigh their judgments of whether or not the teacher is guilty of wrong-doing. They might feel 'There, but for the grace of God, go I.' Or, they may be perceived, by outsiders - the public, and other stakeholders - to have been vulnerable to feeling such sentiments as they reached their judgements.

So, in the regulatory process we are designing, there will be a majority of lay-people involved, who will take advice from our profession (where for example a complaint is made against an Alexander teacher), but the judgement will be made by a panel of independents.

So what is the role of our professional associations in all this? Well at present, our ITM regulation team of Don, myself, and Tim Kjeldsen are helping design the regulatory structures, and when they are set up, we shall be co-operating with the other Alexander Technique professional associations [ATI, STAT, PAAT] to offer advice, when necessary, to the regulator.

Our professional associations will retain their representative functions - they are (and will remain) organisations to which we belong, which run summer-schools, which run continuing professional development activities (Teacher Training Workshops), they cuddle us, they mother us, they support us. Precisely because of the cuddling, mothering, and supporting they disqualify themselves from sitting in judgement.

In the unfortunate case where one of us might be brought to a hearing in front of the regulator, it would be the function of your professional association to support you and advise you through the process.

KEY PRINCIPLE - The Separation of Regulation and Representation.

Final riddle

Question: What is Don's second favourite question?
Answer: What is Don's favourite question?

[Think about it]

Regulation and Protection of the Public

This is the first of a regular (unofficial) blog about regulation of the Alexander Profession, directed at fellow members of the Interactive Teaching Method Association. I try to check out that everything I assert as true, is true. But I might be wrong now and then. For diplomatic reasons I cannot be entirely straight and honest with you - but I'll try to make them readable. One (or two) points per posting, plus (at least) one joke.

I was at a party of school-friends the week-end (no, this isn't the joke paragraph) after the ATEAM backpain trial was published. There were several medics at the party who had heard of the trial, and were keen to know more about it. They were impressed - and they immediately asked 'How are Alexander Technique teachers regulated - how can we find a list of teachers that we can trust?' [The current answer is that there are four registers: ATI, ITM, PAAT, and STAT - but that's not my point]

My point is that their question demonstrates how much regulatory issues are in the forefront of the thinking of those professionals - such as General Practitioners - that we Alexander teachers might well be working with closely soon. Because there is a huge impetus now, in the medical sector, to get regulation 'right'. The Shipman case has resulted in reports which have great implications for the protection of the public, and will result in a grand tidy-up of the mish-mash of different systems and standards of regulation that different medical professions have.

And regulation will have one over-riding purpose: protection of the public. Being on a 'pukka' register will be a guarantee that the practitioner will: have a qualification that his/her profession recognises; have insurance; be signed up to a code of conduct; be obliged to do Continuing Professional Development; and will be subject to independent disciplinary procedures if a complaint arises.

POINT TO REMEMBER - Regulation is about Protection of the Public.

Regulation is not in itself a guarantee of efficacy of the discipline being regulated. In theory, if I invented a healthcare practice called Kilkee Inspiration of Sea-air Therapy (KIST) and in ten years many people paid to have it, and it seemed to have a good effect - then it would be eligible for regulation, provided the profession could do its part in demonstrating that its qualifications are responsibly structured and earned, its members are insured etc.

POINT TO REMEMBER - Regulation is not about efficacy of Practice - being regulated does not come with a badge of effectiveness. [But your profession would not be regulated if there were not at least some evidence that it is effective].

APPALLINGLY INAPPROPRIATE JOKE
Someone chairing a regulatory meeting attended by 20 Complementary Healthcare Professions, after lunch was over, and the second half of the meeting was beginning said: 'Did you hear the one about the homeopath who drank a glass of water and died of an overdose?'