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FROM 2010

CSS seeks new direction for Self Regulation

CSS (The Cranio Sacral Society) is the practitioner organisation for Upledger CranioSacral Therapy. For over seven years CSS training standards representatives have worked with other cranial practitioner groups to find a commonly agreed basis for self regulation.

Following a sudden change in direction which emerged in 2006 via the Princes Foundation for Integrated Health, involving what amounts to the imposition of an external structure somewhat on the lines of the HPC (Health Professions Council), the CSS board decided to withdraw. This was offered as a “federal” structure, but as it required the merging of different groups offering the same named therapy, most associations would be eliminated, and differences in approach lost, diminishing public and practitioner choice.

Says CSS chairman John Page “We believe we must avoid attempts at regulation by those who do not understand what we do. Both the public and our own interests are best served by practitioners alone being responsible under the law for regulating themselves, with up-to-date and transparent procedures”. The CSS will continue to work for a model that will satisfy the public, the NHS and the health insurers while ensuring the future of the UK's liberal environment in which the public benefit from an expanding choice of continually developing alternative and complementary approaches.

The CSS welcomes contacts from other associations who are keen to explore structures for practitioner-owned self-regulation. Please contact Jonathan Gore CST on (01209) 211078, or

Self-regulation - CSS Pursues Options

By Maggie Gill and John Page

For the past 5-plus years the board of the Cranio Sacral Society and the Society's Education group have been involved with other groups of cranial practitioners in preparing for the possibility of Voluntary Self- Regulation. Members have been kept abreast of developments. There have been long periods of work without any clear external support or guidance, and therefore few visible changes. However, matters now appear to be gathering pace. The available options are starting to become clearer, and one official body with whom the CSS and the other cranial groups are working says it will soon publish and “consult” on standards of competence.

“Hang on a minute,” we hear you cry, “what are you guys committing us to?” You're quite right to ask, and we'll lay down some background here. First, what we are engaged in affects chiefly Qualified Members of the CSS present and future, although there will be implications for any practitioner who wants to openly offer cranial techniques. For this reason it is right that everyone involved in cranial work knows what's going on.

Second, the options for regulation are still evolving. This is a new exercise for both Complementary and Alternative Medicine (CAM) in the UK and for Government. So the CSS and their cranial colleagues, who meet and work as the Cranial Forum, and equivalent bodies representing other CAM trades, have had to develop certain elements required for regulation before they can consult their members. So it has been and still is a largely delegated process.

The trick for all of us is to do the development work with clarity and focus while making sure we end up with a formula that takes care of the legitimate needs of both our Members and the public. This means that the individuals doing the drafting and negotiation must be able to assume some degree of authority on members' behalf, and that when wider discussion is appropriate, when there is something tangible and intelligible to show you, we get your views.

Third, there remain four options for the CSS:

A federal approach. This would mean the Cranial Forum entering into a joint arrangement with a number of other therapy groups (currently 9), e.g. Healers, Shiatzu, Massage, and sharing a common formula of standards, codes of practice and rules. All the professional associations and societies may become subservient to a controlling body, possibly under the Prince of Wales' Foundation for integrated Health (PWFIH). Obviously each group would have still to evolve its own core curriculum that sets its speciality apart. The benefits are cost saving, although we don't quite understand how, and one-stop registration for practitioners who are multiply qualified. The price would be loss of autonomy, and probably an unwieldy bureaucracy.

Pursuing the current path. This would require Upledger practitioners to share some core standards, and public perception, with members of all other groups within the Cranial Forum – chiefly the Craniosacral Therapy Association of the UK.

The CSS breaking from the Forum and going solo for self-regulation. This would require most in terms of cost and effort, but not, as far as we can tell, by a large margin. It would also require us to develop an identity for what CSS members practice that efficiently distinguishes it from other cranial or craniosacral approaches.

We withdraw from the whole process and forget self-regulation.

Finally by way of background we understand that compulsory regulation is not foreseen. Continuing to practise under current common law arrangements, as in 4) above, is not anticipated to become illegal. However, and it's a big “however”, as time goes by we would be likely to be put at an increasing disadvantage vis-à-vis not only any other cranial practitioners who do become regulated, but also the whole CAM sector and, indeed, the rest of the health provision industry. Self-regulation will mean we will be seen to set ourselves standards of competence that meet criteria set by externally recognised bodies. You could say our qualifications will become “recognised”, a hitherto much misused and misunderstood notion because there has been and is no “recognised” qualification for what we and most other CAM practitioners do. Flowing from this recognition would, we are told, be benefits including greater acceptance by health insurers, better access to our services via the NHS, access to more training finance in some cases, and even VAT exemption for our services, though this is never known up front. Over all the public would feel more comfortable seeking our services. We would become respectable, closer to the mainstream.

So the CSS board are taking the view that some form of recognisable self-regulation is what we should continue to pursue, and this has been the main objective of the Society. But it is right to question the whole process, and this brings us to consultation.

Pretty much all the work the Forum has done is necessary for options 2 and 3 above and would probably be useful for option 1.

The latest piece of work, which is being drafted with the help of Skills for Health, is the revised standards of competence (National Occupational Standards or NOS) for cranial therapies. Skills for Health is the Sector Skills Council. We understand it is answerable to the Qualification and Curriculum Authority. Once the draft standards for cranial therapies are available Skills for Health intends to publish them on its website and to run a series of regional consultation workshops. Our NOS will be the basis upon which the competencies needed to practise cranial therapies are defined and described, a kind of publicly accessible reference point.

Consultation Workshops organised by Skills for Health February 2006

These were designed solely to discuss and review the draft National Occupational Standards for Cranial Therapies, and were intended to be focused and, at a fairly basic level, technical.


Holiday Inn London-Bloomsbury Friday 28 April 2006, 2.30 pm

The aim of this special open consultation meeting, on the same day as the AGM, was to address all aspects of voluntary self-regulation, as this may affect practitioners wishing to offer “cranial” work as all or part of their practices.

Various practitioner groups, including some covering “cranial” approaches, are actively pursuing regulation. The Prince of Wales Foundation for Integrated Health has taken the Department of Health-backed role of sponsor and overall organiser of this process. Completion is targeted for 2008.

The eventual form of self-regulation has been the subject of much speculation and anxiety. The process, being new, is still evolving, and there is as yet no clear view of where this may take us.

But after nearly six years of work some elements and options are becoming more fixed, and it is time they benefited from wider discussion and contribution.

The CSS Education Group is interested in hearing feedback from anyone who attended this meeting.

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