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Inquest exposes self-help dangers

The Australian/August 15, 2009

By Drew Warne-Smith and Etan Smallman

The self-development program The Turning Point boasts that it transforms the life of those who attend.

"It is a unique insight into a new way of living and loving," the website declares. "Come home to yourself."

But as NSW's Coroner's Court heard this week, Sydney woman Rebekah Lawrence appeared to be far from herself after attending The Turning Point program in December 2005.

Two days later, the normally shy, polite and gentle 34-year-old had hurled abuse at her work colleagues, stripped naked, shouted "I love you, David" (her husband) and then jumped to her death from a CBD office building.

Lawrence had no history of mental illness, and there were no drugs or alcohol in her system.

Her case has shone a light on the dangers of self-help courses, a largely unregulated but flourishing industry in Australia in which the practices of counselling, life-coaching and alternative medicine collide.

Lawrence attended The Turning Point for five consecutive days, often for more than 12 hours at a stretch.

She yelled at partners to practise "assertiveness", she pummelled a gym mattress to release pent-up emotion, she visualised forgiving her enemies and she was encouraged to regress to her childhood, to nurture her "inner child".

The experience left her raw. At about 4am on the day of her death, she left a voicemail message with one of the course volunteers, saying: "I feel I may have been too open."

According to Ian Hickie, the executive director of Sydney's Brain and Mind Research Institute, such high-intensity courses are a classic "tipping point" for acute psychiatric illnesses.

"These courses are known to do harm. They run over a number of days, long hours, they involve sleep deprivation, sensory deprivation and intense emotions.

"You're asking for trouble," Professor Hickie said.

In testimony this week, the director of The Turning Point, Geoff Kabealo, who owns People Knowhow, the company behind it, conceded that the course had "inadequate" processes to screen clients for mental health problems, and to check on them afterwards.

The screening amounted to a two-page questionnaire in which participants declared whether they had any addictions or were seeing a doctor or therapist.

No registered psychologist or psychiatrist is on staff, and none of the teachers or support team provided to Lawrence during or after her sessions was qualified in psychotherapy or counselling. They were her peers; they were fellow graduates.

According to Professor Hickie, providing the expertise of a mental health professional should be part of the operators' duty of care.

"Even television programs like Big Brother and Australian Idol provide experienced clinical psychologists and healthcare professionals for participants. They recognise and try to minimise the risks, as they should," he said.

The law does not demand self-development courses do the same. Both the federal and NSW departments of health confirmed they were unable to regulate self-development courses.

While NSW introduced a code of conduct for unregistered health practitioners last year to strengthen the powers of the Health Care Complaints Commission, limitations remain.

"Unfortunately, they fall through the cracks," a spokesman for NSW Health said yesterday. "They're not actually medical or healthcare professionals, so we can't regulate. It is a problem."

Those running self-help programs can call themselves counsellors without any formal qualifications. It is an issue that has plagued the mainstream counselling and psychotherapy industry, which has tried to distance itself from groups such as The Turning Point.

The Australian Register of Counsellors and Psychotherapists has been set up in an attempt to self-regulate the industry, maintain standards and lobby the federal government to recognise the field.

However, of 16,000 Australians who call themselves counsellors, just 5000 are accredited with ARCAP.

"Until now - and perhaps until this coronial case - the government was inclined to say there is no danger in psychotherapy, so we don't need to do anything in terms of statutory registration," said Tim Johnson-Newell, a director of ARCAP.

"But we don't think so. We think it's very important this field is regulated - it is a potentially dangerous profession."

Neither People Knowhow's Mr Kabealo nor Lawrence's teacher, Richard Arthur, are registered with ARCAP, although The Turning Point does offer a course in Somatic Psychotherapy (therapy that involves body movement and physical awareness) in conjunction with the Australian College of Contemporary Somatic Psychotherapy.

Since June, the college - which trained another of Lawrence's instructors, Joanna Woutersz - has removed all reference to People Knowhow from its website.

Clearly, the level of clinical mental health expertise is not a primary concern for the tens of thousands of people yearning for happiness and transformation who flock to such programs.

About 40,000 have attended The Turning Point in Australia, New Zealand and Britain since it began in 1980 in Australia.

The Weekend Australian independently contacted another graduate of the program, Cecilia Persson, an art director and mother who raved about the course and the level of support she was provided.

"It gave me lots of clarity around who I am, and my potential and what drives me in life," Ms Persson, 41, said.

But even advocates such as Ms Persson agree the courses are not for those who are vulnerable, or unstable.

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