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Hearing Findings, Decision & Sanction


May 2015: Jan Bardua, Reference No: 678116, Essex SS0

The complaint against the above individual member/registrant was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that in June 2011, the Complainant undertook an addiction assessment at the [ . . . ], which was facilitated by Mr Jan Bardua.  Mr Bardua then became the Complainant's group addiction counsellor for the 6 weeks (September-October 2011) that she was an in-patient.

Following her discharge from the [ . . . ] in October 2011, the Complainant stated that she was invited to return to the hospital for several months as an "unofficial peer supporter", by the team of which Mr Bardua was a member.

The Complainant stated that from December 2011, Mr Bardua became her personal counsellor. They met once a week and later twice a week, for two hours each session, at Mr Bardua's home.  In addition, from October 2012 to May 2013, the Complainant stated that she and two other clients of Mr Bardua met together for group therapy once a week for one and a half hours per session at Mr Bardua's home. The Complainant alleged that Mr Bardua labelled their relationship as both friendship and also that of client and counsellor and alleged that during the time that she was in therapy with him, she socialised with not only Mr Bardua but with his family as well.

In June 2012, the Complainant stated that she became aware that a complaint had been made against Mr Bardua.  However, Mr Bardua and his wife allegedly told her that the complaint was wrong and the Complainant chose to believe Mr Bardua as she had placed so much trust in their relationship.

The counselling relationship ended in May 2013, and allegedly on Mr Bardua's recommendation, the Complainant continued counselling with another counsellor, who was also Mr Bardua's supervisor.  The Complainant stated that it was during the course of this work that she realised that Mr Bardua had acted inappropriately towards her.  In addition, the Complainant stated that she discovered that Mr Bardua had not discussed his relationship with her, in supervision.  As a result, Mr Bardua's supervisor, who was then the Complainant's counsellor allegedly terminated her supervision relationship with Mr Bardua.

Mr Bardua and the Complainant met to discuss what had happened and Mr Bardua allegedly apologised and admitted that he had acted inappropriately and made various promises to the Complainant during this meeting.  Mr Bardua also allegedly agreed to cease counselling the Complainant's step-father and offered to and eventually did cease counselling the Complainant's mother.

The Complainant stated that the situation with Mr Bardua has caused her great stress and has had an impact on her family relationships and her college work.  The Complainant further stated that she has also suffered depression, anxiety and shame as a result of these incidents.

In accepting this complaint, the Pre-Hearing Assessment Panel was concerned with the following areas, and in particular these are:

1. Mr Bardua allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met her needs in that he:

a) Encouraged, initiated and participated in extensive out of session contact with the Complainant and used language of an inappropriate and intimate nature in the text exchanges between them,

b) Failed to deal with sufficiently or at all, the depression and suicidal ideations expressed by the Complainant,

c) Interrupted his sessions with the Complainant to answer the phone and the door, take cigarette breaks, use the toilet, eat food and talk to one of his children,

d)   Embraced the Complainant during their sessions and agreed to see members of the Complainant's family whilst he was still counselling her,

e)   Shared personal problems with her in sessions, asking for her advice and perspective. 

2. Mr Bardua allegedly failed to give careful consideration to the limitations of his training and experience and work within these limits and take advantage of available professional support, in that he did not deal with appropriately or at all the depression and suicidal ideation exhibited by the Complainant.  

3. Mr Bardua allegedly failed to clarify and agree the rights and responsibilities of both him as a practitioner and the Complainant as a client, in that he did not make it clear to the Complainant what his role as a counsellor would be and did not define the boundaries of their relationship.  

4. Mr Bardua allegedly entered into a dual relationship with the Complainant, in that he was her counsellor and was involved in a personal relationship with her, which was to her detriment.  

5. Mr Bardua allegedly failed to review his need for professional and personal support and obtain appropriate services for himself, in that he did not disclose to his supervisor the full extent of his relationship with the Complainant.

6. Mr Bardua allegedly failed to respect the Complainant's privacy and dignity, in that he entered into late night text exchanges with the Complainant and had telephone contact with her whilst she was on holiday.

7. Mr Bardua allegedly failed to respect the Complainant's privacy and dignity, in that he allowed one of his children to enter the counselling room whilst he was in a counselling session with her.

8. Mr Bardua allegedly failed to pay careful attention to client consent and confidentiality, in that he discussed the Complainant with another client and discussed the Complainant's step-father and mother, who were also his clients, with the Complainant.

9. Mr Bardua allegedly failed to ensure that the Complainant was adequately informed about the nature of the services being offered to her, in that he increased the length and frequency of the sessions without discussing it with the Complainant.

10. Mr Bardua allegedly failed to think carefully about and exercise considerable caution before entering into a personal relationship with the Complainant.

11. Mr Bardua allegedly abused the Complainant's trust in order to gain sexual, emotional, financial or any other kind of personal advantage in that he:

a)   Engaged in hugs with the Complainant, one of which was for approximately 15 minutes,

b)   Put his tongue in her ear and kissed her,

c)   Allowed, encouraged and initiated text contact with the Complainant, which included kisses and inappropriate language such as telling the Complainant that he loved her,

d)   Introduced the Complainant to his family and friends and socialised with her,

e) Agreed to provide therapy for the Complainant's family whilst he was still counselling the Complainant, allegedly charging them all a total of approximately £1200 a month for services, thereby abusing the Complainant's trust for financial gain,

f)    Told the Complainant that he trusted her with his life.

12. Mr Bardua allegedly failed to respect the Complainant's privacy and confidentiality, in that he discussed her with other clients, permitted one of his children to interrupt their counselling session and discussed her step-father, who was also one of his clients. 

13. Mr Bardua allegedly failed to monitor and maintain his fitness to practise at a level which enabled him to provide an effective service, in that he failed to make adequate use of supervision.

14. Mr Bardua allegedly failed to discuss with his supervisor or other experienced practitioner, the circumstances in which he may have harmed the Complainant in order to ensure that the appropriate steps had been taken to mitigate any harm to her and avoid any repetition.

15. Mr Bardua allegedly failed to avoid and foresee the conflict of interest which could arise in counselling the Complainant and members of her family.

16. Mr Bardua's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 2, 3, 4, 7, 11, 12, 17, 20, 40, 43 & 63 and the ethical principles of Being Trustworthy, Autonomy, Beneficence, Non-Maleficence and Self Respect of the Ethical Framework for Good Practice in Counselling & Psychotherapy   (2013), and showed a lack of the personal moral qualities of Empathy, Integrity, Respect, Resilience, Humility, Competence and Wisdom to which counsellors are strongly encouraged to aspire.

Findings

On balance, having fully considered the above, the Panel made the following findings:

1. In considering the allegation that Mr Bardua failed to provide the Complainant with a good quality of care and competently delivered services which met her needs, the Panel made the following findings:

(a)  In written evidence, the Panel noted the trail of texts that included comments of a very personal nature sent to the Complainant by Mr Bardua, and also heard oral evidence in which Mr Bardua admitted that he had encouraged, at times initiated and participated in extensive out of session contact with the Complainant, and used considerable inappropriate language.  The Panel found that this undermined the Therapeutic Relationship and that his conduct at times was rash and impetuous.  Therefore this part of the allegation is upheld.

(b)  The Panel considered the written and oral evidence from Mr Bardua which addressed the issues of depression and suicidal ideation when working with the Complainant. The Panel accepted that strategies were in place should issues arise about the Complainant's safety if such ideation were to be expressed by her. The Panel was not satisfied, on the evidence presented, that Mr Bardua had failed to deal with, sufficiently or at all, the Complainant's depression and suicidal ideations.  This part of the allegation is therefore not upheld.

(c)  In both his oral and written evidence Mr Bardua, admitted that he had allowed counselling sessions with the Complainant, to be interrupted, by taking a telephone call, taking breaks and to talk to one of his children.  Therefore this part of the allegation is upheld.

(d)  (i)In his oral evidence Mr Bardua admitted that he did embrace the Complainant during sessions and assumed it was acceptable to her without discussing his pattern of behaviour with her by way of review.  The Panel found that it was Mr Bardua's responsibility to check with the Complainant that she found his actions acceptable and were for her benefit. This he failed to do and therefore this part of the allegation is upheld.

(ii) Both the Complainant and Mr Bardua accepted that Mr Bardua agreed to and then began to see members of her family for counselling whilst still the Complainant's counsellor. In her oral evidence, the Complainant spoke about the negative effect and impact this had on her and continues to have to this day, describing the way that his failure to provide a good quality of care has affected her relationships with her family. She explained that, at the time, she trusted Mr Bardua's judgement about this concurrent work. The Panel noted that whilst Mr Bardua stated that he had discussed with the Complainant, the decision as to whether to also see other members of the Complainant's family whilst counselling the Complainant, and whilst she did not object at the time, he failed to consider the impact that this might have on her.  The Panel therefore upheld both elements of allegation 1(d).

(e)  The Panel noted that within the text trail there were references to some personal information, but accepted that on the evidence before it, there was insufficient evidence to substantiate the allegation, that Mr Bardua discussed, or sought advice and perspective on his personal issues during therapeutic sessions.  This part of the allegation is therefore not upheld.

For the reasons stated above, allegation 1 is upheld in part.

2. The Panel noted that Mr Bardua came from a background of previous experience and knowledge, in particular, in dealing with clients who had experienced depression and suicidal ideation and had systems in place to address such risks.  Mr Bardua stated in his oral evidence that on receipt of texts from the Complainant, where she had expressed such thoughts, he would follow up with a call to the Complainant to discuss the issue.  There was insufficient evidence presented to the Panel to suggest that Mr Bardua failed to take these issues seriously and therefore this allegation is not upheld.

3. The Panel noted Mr Bardua's written and verbal evidence that the boundaries of their multiple relationships had initially been clarified. However, he admitted that these roles subsequently became blurred, and that this was as a result of his failing to ensure that these boundaries were reviewed and sufficiently clarified throughout.  Mr Bardua also accepted that in hindsight, it was unwise to work with the Complainant in his private practice directly after working with her in a different therapeutic setting.  Therefore, the Panel upheld this allegation.

4. Mr Bardua accepted, both in his written and oral evidence, that a number of dual relationships existed between himself and the Complainant.  Namely as counsellor/client, family friendship, personal friendship and Fellowship friendship.  He stated that these were discussed prior to the Complainant becoming his private client and re-discussed at a later stage.  Mr Bardua stated that both he and the Complainant believed initially that they would be beneficial to the Complainant if properly managed.  The Panel heard evidence from the Complainant as to the detrimental impact that these dual relationships had had on her.  The Panel concluded that there was sufficient evidence presented before it to demonstrate that the Complainant did not benefit from the dual relationships, and therefore upheld this allegation.

5. In his oral evidence, Mr Bardua stated that "in his innocence", he never considered the need to disclose to his supervisor the full extent of his relationship(s) with the Complainant.  The Panel found that it was Mr Bardua's responsibility to recognise and deal with issues, such as taking on a client from one setting to a private client setting, and that as a professional counsellor, he would be expected to review his need for professional support and use supervision to its fullest.  The Panel therefore upheld this allegation.

6. The text trail evidenced that Mr Bardua had entered into late night text exchanges with the Complainant.  Whilst the Panel heard evidence presented, that it was the Complainant who requested contact whilst she was on holiday, the Panel considered that the nature of the texts were beyond a client/counsellor relationship and were wholly inappropriate and intrusive.  For these reasons, the Panel found that Mr Bardua had failed to respect the Complainant's privacy and dignity and therefore this allegation is upheld.

7. In his written and oral evidence, Mr Bardua accepted that he allowed one of his children to enter the counselling room during a session with the Complainant.  The Panel found that regardless of the fact that the Complainant did not object at the time, this interruption was not respectful.  The Panel therefore upheld this allegation.

8. The Panel noted that there was some evidence that Mr Bardua had discussed the Complainant's step-father and mother, who were also his clients, with the Complainant.  However, the Panel considered that it was not unreasonable in the circumstances and that there was  insufficient evidence that the substance of the sessions was discussed such that it would amount to a breach of confidentiality.  In respect of
the allegation that Mr Bardua also discussed the Complainant with another client, the Panel noted that there was no evidence presented to it to substantiate that this did occur.  This allegation is therefore not upheld.

9. The Panel heard evidence from both parties that the length and frequency of sessions between Mr Bardua and the Complainant was discussed.  The Complainant stated that at the time she believed that this was to her benefit and agreed to the increase.  This allegation is therefore not upheld.

10.   Mr Bardua accepted, both in his written and oral evidence that he did enter into a personal relationship with the Complainant.  The Panel heard and accepted the evidence from the Complainant as to the detrimental impact that this had had on her, in that she and her family were still in a state of conflict. The Panel therefore found that Mr Bardua had failed to think carefully and did not exercise considerable caution before becoming the Complainant's counsellor and also entering into a personal friendship with the Complainant. The Panel therefore upheld this allegation.

11. In considering whether Mr Bardua abused the Complainant's trust in order to gain sexual, emotional, financial or any other kind of personal advantage, the Panel examined all aspects of the allegation including that listed from (a) to (f);

(a) Whilst there was a conflict of evidence with regard to the length of time of one of the hugs, Mr Bardua admitted that he engaged in hugs with the Complainant.

(b) In his oral evidence, Mr Bardua conceded that he might have engaged in what he considered as horseplay, which was foolish.  The Panel also heard clear evidence from the Complainant with respect to this action and was satisfied on balance that this occurred as described by  the Complainant.

(c) Mr Bardua admitted that he engaged in texts of an inappropriate nature and referred to the finding at 1(a) above.

(d) Mr Bardua admitted that he did introduce the Complainant to his family and socialised with her.

(e) There was insufficient evidence presented to the Panel to establish whether the cost of £1200 per month for counselling 3 members of the same family was unreasonable in the circumstances.

(f)  Mr Bardua admitted that he did say that he trusted the Complainant with his life.  The Panel accepted the evidence of Mr Bardua and his witness that this expression originated in the fellowship context and the reason for its use.

However, in the context of counselling and given her issues, the Panel considered that it was unwise to use such an expression.

The Panel was therefore satisfied, given its findings with regard to the constituent elements of allegation 11, save for (e), were such that Mr Bardua had gained an emotional advantage, by creating a culture of dependency on him and control over the Complainant.  The Panel therefore upheld this allegation.

12.  The Panel was not satisfied on the evidence presented that Mr Bardua had discussed the Complainant with another client.  The Panel heard evidence in respect of what matters were discussed with the Complainant's step-father and was not satisfied that the nature of the conversation was such that it amounted to a breach of confidentiality.  This part of the allegation is therefore not upheld.  In his written and oral evidence, Mr Bardua accepted that he allowed one of his children to enter the counseling room during a session with the Complainant, thereby failing to respect the privacy and confidentiality of his client.  This part of the allegation is therefore upheld.

For the reasons stated above, this allegation is upheld in part.

13.  In his oral evidence Mr Bardua admitted that he did not make adequate use of supervision, in that he failed to take issues to supervision, which were linked to his counselling of the Complainant.  He also stated that at some point he felt at the edge/limit of his skills in relation to the issues that the Complainant was presenting and that the work had become "stuck".  It was after this, that a referral was made and the Complainant began to work with Mr Bardua's supervisor, now his ex supervisor. The Panel found that Mr Bardua failed to monitor and maintain his fitness to practice at a level which enabled him to provide an effective service to the Complainant by discussing fully his work with his supervisor and that it was Mr Bardua's responsibility to have done so.  Mr Bardua stated that it was now his practice to discuss all aspects of his work with his current supervisor. The Panel therefore upheld this allegation.

14.  When Mr Bardua received a text from the Complainant, in February 2013, requesting he contact his supervisor, he did arrange a  meeting for supervision. In his oral and written evidence Mr Bardua spoke of his shock on hearing the concerns, expressed by his supervisor and stated his willingness to address how he might have harmed the Complainant and the steps he would be taking to mitigate that harm.  However, having begun the discussion, this was the final supervision session with his supervisor as she ended the supervisory relationship with him at that meeting. The Panel found that whilst Mr Bardua had failed to use supervision adequately as detailed in allegation 13 above, Mr Bardua did, when notified by the Complainant of the harm he had caused, discuss this specific issue in supervision; therefore this allegation is not upheld.

15.  The Complainant gave evidence in which she described the issues which arose both during and after the counselling relationship, within her family, and the impact of Mr Bardua's decision to take on three members of the same family.  Whilst the Panel also heard evidence from both parties, with respect to the discussions that took place between them, about Mr Bardua's decision to take on as clients the  Complainant's mother and step-father, the Panel found that it was Mr Bardua's responsibility to give due consideration to the inherent risks of taking on, as clients, members of the same family.  The Panel found that Mr Bardua had failed to avoid and foresee the risk of a conflict of interest and therefore this allegation is upheld.

16.  In light of the above, the Panel was satisfied that Mr Bardua's alleged behaviour, as experienced by the Complainant, and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 3, 4, 7, 11, 12, 17, and 40 of the Ethical Framework for Good Practice, and the Ethical Principles of Being Trustworthy, Autonomy, Beneficence, Non-Maleficance and Self-Respect.  The Panel also found that Mr Bardua lacked the Personal Moral Qualities of Integrity, Respect, Resilience, Humility, Competence and Wisdom to which counsellors are strongly encouraged to aspire.  The Panel did not find a contravention of paragraphs 2, 20 or 43 of the Ethical Framework for Good Practice in Counselling & Psychotherapy.

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice in that the service for which Mr Bardua was responsible fell below the standards that would reasonably be expected of a practitioner exercising reasonable skill.  The Panel found that Mr Bardua was incompetent, reckless and provided inadequate professional services.

Mitigation

Mr Bardua confirmed that he had entered into personal therapy to process and understand the issues raised by the complaint.

He provided evidence of courses he had attended, since the complaint, addressing boundary issues.  Mr Bardua had also apologised both in his written and oral evidence, with regard to the failings which he had admitted.

Sanction

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Mr Bardua should provide a written submission, which evidences his immediate reflection on, learning from and understanding of, the issues raised in this complaint. 

In addition, in not less than 6 months and no more than 18 months from the date of imposition of this sanction, Mr Bardua is required to provide three separate, written reports based on his current client work, which are as follows:

1. A case study, showing how he contracts with clients and clarifies rights and responsibilities with clients generally.  Mr Bardua should present evidence that this has been discussed in supervision.

2. A report demonstrating a profound understanding of dual relationships, the significance of these relationships, their impact and the possible harm to clients that may be caused by them.  Mr Bardua should support the study with reference to literature available about dual relationships and present evidence that this has been discussed in supervision. 

3. A report evidencing Mr Bardua's reflections on the use of supervision, with examples from his clinical work and how he has used supervision to improve his practice.  Mr Bardua should present evidence that this has been discussed in supervision.

His current supervisor should sign off all these three reports and verify that the content of these reports has been discussed in supervision.

Mr Bardua's accreditation is suspended until the sanction above has been considered as satisfactorily completed by a Sanction Panel.

These written submissions must be sent to the Interim Registrar by the given deadlines, and will be independently considered by a Sanction Panel.

(Where ellipses [ . . . ] are displayed, they indicate an omission of text)

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May 2015: Susan Campbell, Reference No: 541500,  Sheffield S8 

The  complaint against the above individual member/registrant was taken to Adjudication in line with the Professional Conduct Procedure.  The decision of the professional conduct panel was appealed and subsequently considered at an Appeal Hearing.

The complaint was heard under the BACP Professional Conduct Procedure and the Panels considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, was that the Complainant was invited with her husband to meet Ms Campbell, who had seen her husband as a client at a previous session.  They attended in October 2013.  The Complainant believed this was a one-off meeting, and stated that it was not made clear to her what the purpose of the session was; but she had not expected it to be couple's counselling. 

The Complainant stated that at the beginning of the session, Ms Campbell did not introduce herself, nor explain the purpose of the session, or seek the Complainant's agreement to proceeding with what the Complainant perceived as couple's counselling.  The Complainant stated that the session was poorly facilitated and that various statements she herself made about her medical conditions were not  nderstood by Ms Campbell, or were treated judgmentally, as Ms Campbell was allegedly dismissive in her responses. 

The Complainant experienced Ms Campbell as giving her no opportunity to explain about some of her physical problems.  Ms Campbell also allegedly suggested the couple massage each other, although this would have aggravated the Complainant's psoriasis.  

The Pre-Hearing Assessment Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting a contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular are as follows:

1. Ms Campbell allegedly failed to provide the Complainant with a good quality of care in that she failed to introduce herself at the commencement of the session and did not make clear the type of therapy that the Complainant was receiving. 

2. Ms Campbell allegedly failed to give careful consideration to the limitations of her training and experience in that when the Complainant was discussing the side effects from her medical treatment Ms Campbell dismissed these side effects as being the result of the treatment going wrong and also recommended that the Complainant and her husband massage each other with baby oil without being aware of the effect that this would have on the Complainant's psoriasis. 

3. Ms Campbell allegedly failed to be attentive to the quality of listening and respect offered to the Complainant in that she did not listen to the Complainant's attempts to explain how her medical conditions affected her. 

4. Ms Campbell allegedly failed to adequately inform the Complainant about the nature of the service that was being offered to her in that the Complainant was unaware of whether she was attending couples counselling or attending to explain how her husband's behaviour was affecting her.   

5. Ms Campbell allegedly failed to ensure that her services were delivered on the basis of the Complainant's explicit consent in that she did not seek the Complainant's consent to participate in couple's therapy. 

6. Ms Campbell allegedly failed to clarify the terms on which her services were being offered to the Complainant, in that she did not provide any written or verbal information to the Complainant in advance of or during the course of the session that the Complainant attended,  explaining the nature of the services she was providing. 

7. Ms Campbell's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 2, 11, 12, 13 and 59 and the ethical principles of Being Trustworthy, Autonomy, Beneficence and Non-Maleficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Empathy, Respect, Competence and Wisdom to which counsellors are strongly encouraged to aspire.   

Findings and decision of the professional conduct panel 

On balance, having fully considered the above, the Panel made the following findings: 

1. Ms Campbell accepted on questioning that she did not introduce herself to the Complainant when  both she and her husband arrived, as she had assumed that the Complainant's husband had already told the Complainant who she was.  The Panel found that it was unwise for  Ms Campbell to have made such an assumption and accepted the Complainant's evidence that she felt uncomfortable as a result of Ms Campbell not introducing herself.  The Panel agreed that this amounted to a failure to provide a good quality of care.  This part of the  allegation is therefore upheld.

There was a difference of opinion between the parties as to whether Ms Campbell had made it clear the type of therapy that the Complainant was receiving.  The Complainant stated that it did not become apparent to her that she was receiving couples therapy until approximately 30-40 minutes into the session.  The Panel found that Ms Campbell, having already seen the Complainant's husband individually, had  discussed with him in detail the nature of the couples counselling that she provided and had again made assumptions that the Complainant's husband would relay this information to the Complainant.  The Panel found that it was Ms Campbell's responsibility to ensure from the outset that it was made clear to the Complainant the type of therapy that was being provided to her.  The Panel found that in failing to introduce herself to the Complainant and making it sufficiently clear to the Complainant the type of therapy she was receiving, Ms Campbell failed to provide the Complainant with a good quality of care.  This part of the allegation is therefore upheld.  For the reasons stated above the entirety of this allegation is upheld.

2. There was a sharp disagreement between the parties as to whether Ms Campbell had dismissed the Complainant's side effects as being the result of her treatment going wrong.  Ms Campbell gave verbal evidence of her qualifications, training and experience and the Panel found that none of these would have equipped Ms Campbell to make pronouncements on the side effects of medical treatment.  However, there was insufficient evidence that Ms Campbell had made such an assessment.  The Panel therefore did not find that Ms Campbell failed to give careful consideration to the limitations of her training and experience in this regard.  This part of the allegation is therefore not upheld.

It was accepted by both parties that Ms Campbell had made a suggestion to the Complainant and her husband that they massage each other at home.  This suggestion was made without any assessment of the potential negative effects that this could have on the Complainant's psoriasis.  Whilst Ms Campbell stated that she did not specify the type of oil that the Complainant should use, the Panel accepted the Complainant's evidence that baby oil was the type of oil she had understood to be recommended by Ms Campbell.  The Panel
found that Ms Campbell did not possess the required expertise to recommend that the Complainant and her husband massage each other with oil of any kind.  The Panel therefore found that Ms Campbell failed to give careful consideration to the limitations of her training and experience in this regard.  This part of the allegation is therefore upheld.

3. The Complainant in her evidence stated that she did not feel heard when she was discussing the impact of her medical conditions with Ms Campbell. However both parties accepted that a great deal of the session was spent with a focus on the Complainant's medical conditions.  The Panel found that there was insufficient evidence that Ms Campbell failed to be attentive to the quality of listening and respect offered to Ms Campbell in this regard, particularly when there was evidence that the Complainant's medical conditions were discussed.  This allegation is therefore not upheld.

4. There was disagreement between the parties in relation to this allegation.  Ms Campbell stated that she explicitly referred to couples counselling at various points during the session but the Complainant stated that it did not become apparent that she was receiving couples counselling until approximately 30-40 minutes into the session.  The Panel found that given that this was the first time that Ms Campbell had seen the Complainant and that she was unaware of what, if any, information the Complainant had been provided with prior to the session, it was Ms Campbell's responsibility to make it sufficiently clear to the Complainant at the outset, the purpose of the session and to check with the Complainant that she understood that couples therapy was what was being offered.  The Panel therefore found that Ms Campbell failed to adequately inform the Complainant about the nature of the service that was being offered to her.  This allegation is therefore upheld.

5. Ms Campbell accepted in evidence that at no point during the session did she seek the Complainant's explicit consent to participate in couples counselling and assumed that her attendance was evidence of the Complainant's implicit consent to participate.  The Panel found that Ms Campbell failed to obtain adequately informed consent from the Complainant and in failing to seek the Complainant's explicit consent, paid insufficient attention to the Complainant's autonomy.  The Panel therefore found that Ms Campbell failed to ensure that her services were delivered on the basis of the Complainant's explicit consent.  This allegation is therefore upheld.

6. Ms Campbell in her evidence stated that she had provided information about her services, including a contract, to the Complainant's husband when she saw him individually.  Ms Campbell stated that following this individual session the Complainant's husband contacted her for couples counselling.  Ms Campbell accepted that she did not provide any information to the Complainant about her services as she assumed that the Complainant's husband would share the contract that she had provided to him with the Complainant and explain the therapy that was being provided.  The Complainant stated that she herself was not provided with any information about the services that Ms Campbell was providing either before or during the session.  The Panel also heard evidence from both parties that the session started latebut the Complainant and her husband still received a full hour of therapy.  The Panel found that Ms Campbell should have herself directly provided the Complainant with either written or verbal information setting out the nature of the services she was providing, which would have enabled the Complainant to make an informed decision about whether or not to participate in the therapy.  The Panel therefore, found that Ms Campbell failed to clarify the terms on which her services were being offered to the Complainant.This allegation is therefore upheld. 

7. In light of the above findings, the Panel was satisfied that paragraphs 1, 2, 12, 13 and 59 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) and the ethical principles of Being Trustworthy, Autonomy, Beneficence and Non Maleficence had been breached.  It also found that Ms Campbell lacked the personal moral qualities of Empathy, Respect, Competence and Wisdom to  which all practitioners are strongly urged to aspire.  The Panel did not find that paragraph 11 of the Ethical Framework had been breached. 

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice in that the services that Ms Campbell provided fell below the standards that would reasonably be expected of a practitioner exercising reasonable care and skill.  In particular, the Panel found that Ms Campbell was incompetent, reckless and provided inadequate professional services.   

Mitigation 

Ms Campbell stated that she will work on a couples' contract and will now ensure that she introduces herself to new clients when they arrive.  Further Ms Campbell stated that she would spend more time clarifying the nature of her services and check that both parties in couples' counselling consent to it.  Ms Campbell informed the Panel that she would also have made it clearer to the Complainant that they would spend more time talking about her medical conditions in the Complainant's individual session.    

Sanction 

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Ms Campbell is required to provide a written submission, which evidences her immediate reflections on, learning from and understanding of, the issues raised in this complaint. 

In addition, within 6 months from the date of imposition of this sanction, Ms Campbell is required to provide a detailed written report which covers the following areas: 

-  The importance of boundaries in relation to time keeping regarding the length of the session. 

-  The information that should be given to clients at the outset of the assessment session concerning the type of therapy that is being provided, the format of the therapy and the rights and responsibilities of Ms Campbell as a practitioner and of the client;

- The importance of a good contract and how therapeutic interventions can affect those with medical conditions;

- Meeting and greeting clients; 

Within the report, Ms Campbell must give examples of how she deals with the above areas in her client work. 

The above report should be countersigned, by an experienced supervisor (more than five years practice as a supervisor) who is outside of her current supervision network, to confirm that the matters referred to within the report have been discussed in supervision.  The supervisor must also confirm how long they have been supervising.    

Ms Campbell is also required to provide a copy of her couples' contract which is not restricted to but should cover the following areas:

-  Confidentiality

-  Payment of sessions

-  The Procedure in relation to missed sessions and lateness  

In addition to the above, Ms Campbell is also required to provide copies of all written information that she gives to clients both before and during therapy. 

Within 8 months from the date of imposition of this sanction, Ms Campbell is required to appear for interview before the Sanction Panel, where she will be required to further demonstrate how she applies the above topic areas of the sanction to her work with clients and how her practice has improved in view of these findings. 

Ms Campbell's accreditation will be suspended pending the successful completion of the sanction, after which time Ms Campbell may apply to have her accreditation restored.  

Following the Professional Conduct Hearing, Ms Campbell lodged an appeal under clause 6.5 (a) and (b) in that: 

(a)  the facts were found against the weight of evidence and; 

(b)  the sanction is disproportionate to the findings and decision of the Professional Conduct Panel and is unjust in all the circumstances. 

The grounds of appeal were independently assessed in accordance with clause 6.2 of the Professional Conduct Procedure and the appeal was accepted to go forward to an appeal hearing on ground 6.5(a) in that the facts were found against the weight of evidence. 

The Appeal Panel reviewed the findings of the Professional Conduct Panel, and made the following findings; 

1.   The Appeal Panel agreed with the findings and decision of the Professional Conduct Panel that Ms Campbell did not provide the  Complainant with a good quality of care by failing to introduce herself at the start of the session.  The Appeal Panel noted that Ms Campbell admitted in evidence that she did not do so; having assumed that the Complainant's husband had already given her the information.  Therefore the Appeal Panel upheld this part of the allegation. 

The Appeal Panel found that there was a conflict of evidence in that the Complainant stated that it was not made clear to her until approximately halfway through the session that she was in a couples counselling session, whereas Ms Campbell stated that she had referred to 'Couples Therapy' right at the start of the session.  However, Ms Campbell conceded, in oral evidence before the Appeal Panel, that there was a blurring in moving from individual therapy with the Complainant's husband, to couples counselling.  On balance, the Appeal Panel considered that it was Ms Campbell's responsibility to explain to the Complainant the type of therapy, which the Complainant was being offered.  The Appeal Panel also considered that Ms Campbell should have given careful attention to contracting individually with the Complainant and re-contracting with her husband so that they understood clearly, the purpose of the session, particularly as the  Complainant's husband had previously been an individual client.  The Appeal Panel therefore also dismissed this part of the appeal for the reasons stated and upheld this part of the allegation.  The Appeal Panel therefore agreed with the findings and decision of allegation 1 in its entirety. 

2.   The Appeal Panel did not find that Ms Campbell failed to give careful consideration to the limitations of her training and experience.  The Appeal Panel agreed with the findings and decision of the Professional Conduct Panel that there was insufficient evidence to support the allegation that Ms Campbell expressed the opinion that the Complainant's medical side effects were the result of her treatment going wrong.  This part of the allegation is therefore not upheld. 

The Appeal Panel agreed with the decision of the Professional Conduct Panel that Ms Campbell failed to give consideration to the limitation of her training and experience.  It was accepted by both parties that Ms Campbell had made a suggestion to the Complainant and her husband that they massage each other at home.  Ms Campbell stated that she did not specify the type of oil that the Complainant should use, however, the Complainant's evidence was accepted that baby oil was the type of oil she had understood to be recommended by Ms Campbell.  Whilst the Appeal Panel was satisfied that Ms Campbell did not possess the required expertise, it did not consider that this amounted to Ms Campbell making a 'recommendation'.  However, the Appeal Panel was satisfied that Ms Campbell made a 'suggestion' that the Complainant and her husband massage each other with oil and that this suggestion was made without any assessment of the potential negative effects that this could have on the Complainant's psoriasis.  The Appeal Panel therefore dismissed the appeal and upheld this part of the allegation.

3. The Professional Conduct Panel found that there was insufficient evidence that Ms Campbell failed to be attentive to the quality of listening and respect offered to the Complainant and noted that there was evidence that the Complainant's medical conditions were discussed.  The Appeal Panel agreed with the findings and decision of the Professional Conduct Panel in its entirety.  This allegation is therefore not upheld.  

4.   The Appeal Panel agreed with the decision of the Professional Conduct Panel and made the following findings.  The Appeal Panel heard oral evidence from Ms Campbell that she should have thought more carefully and had not checked enough that the Complainant fully understood the nature of the service she was being offered.  So whilst there was a conflict of evidence in that the Complainant stated that it was not made clear to her until approximately halfway through the session that she was in a couples counselling session whereas Ms Campbell stated that she had referred to 'Couples Therapy' right at the start of the session, the Appeal Panel reiterated the reasons outlined in allegation 1 above, that it was Ms Campbell's responsibility to clarify the type of therapy which the Complainant was being given.  Additionally, the Appeal Panel considered that Ms Campbell should have given careful attention to re-contracting with both the Complainant and her husband so that they understood clearly the purpose of the session, particularly as the Complainant's husband had previously to this session, been an individual client.  The Appeal Panel therefore dismissed the appeal and upheld this allegation. 

5.   The Appeal Panel agreed with the Professional Conduct Panel's findings and decision regarding this allegation in their entirety.  Further the Appeal Panel noted that Ms Campbell had accepted in evidence that at no point during the session did she seek the Complainant's explicit consent to participate in couples counselling and assumed that her attendance was evidence of the Complainant's implicit consent to participate.  Ms Campbell also failed to obtain adequately informed consent from the Complainant and in failing to seek the Complainant's explicit consent, paid insufficient attention to the Complainant's autonomy.  The Appeal Panel also noted that Ms Campbell had relied on the implicit consent of the Complainant, in that she presumed the Complainant's husband had told her that the session was, and assumed the Complainant had consented to couples therapy.  The Appeal Panel found that Ms Campbell had failed to ensure that her services were delivered on the basis of the Complainant's explicit consent.  The Appeal Panel therefore dismissed the appeal and this allegation is therefore upheld. 

6.   The Appeal Panel agreed with the Professional Conduct Panel's decision regarding this allegation.  However, the Appeal Panel noted that there was an error concerning which paragraph of The Ethical Framework (2013) this allegation related to and confirmed that it was paragraph 12 and not 59, this is reflected in 7 below.  The Appeal Panel also substituted the finding as follows: Ms Campbell in her evidence before the Professional Conduct Panel had stated that she had provided information about her services, including a contract, to the Complainant's husband when she saw him individually.  Ms Campbell stated that following this individual session the Complainant's husband contacted her for couples counselling.  Ms Campbell accepted that she did not provide any information to the Complainant about her services as she assumed that the Complainant's husband would share the contract that she had provided to him with the Complainant and explain the therapy that was being provided.  The Appeal Panel found that whilst Ms Campbell may have talked generally in the session, it was not satisfied that Ms Campbell had adequately informed the Complainant of the service being offered sufficiently clearly to enable the Complainant to choose whether she wished to continue with the session or withdraw.  Notwithstanding the error relating to the paragraph to which this allegation related, the Appeal Panel dismissed the appeal and the allegation is upheld.   

7.   In light of the above findings, the Appeal Panel was satisfied that paragraphs 1, 2, 12 and 13 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) and the Ethical Principles of Autonomy, Being Trustworthy and Beneficence had been breached.  It also found that Ms Campbell lacked the Personal Moral Qualities of Competence, Empathy, Respect and Wisdom to which all practitioners are strongly urged to aspire.  The Appeal Panel did not find that paragraphs 11, 59 had been breached.  The Appeal Panel also considered that the Ethical Principle of Non Maleficence had not been breached.  The Appeal Panel considered that in the circumstances, whilst Ms Campbell had been unwise to make the suggestion she did, as outlined in allegation 2 above, no actual physical harm was caused.  The Appeal Panel considered that Ms Campbell was attempting to be 'solution focussed' and was not satisfied there was evidence of contravention of the Ethical Principle of non-maleficence.  

Appeal Decision 

Accordingly, the Appeal Panel was unanimous in its decision that these findings amounted to Professional Malpractice in that the services that Ms Campbell provided fell below the standards that would reasonably be expected of a practitioner exercising reasonable care and skill.  In particular, the Panel found that Ms Campbell was incompetent and had provided inadequate professional services.    

The Appeal Panel upheld the appeal in so far as it considered that the findings were not of sufficient severity that Ms Campbell was reckless, as defined by the Oxford English Dictionary.  

Mitigation 

Ms Campbell evidenced some modification to her practice in that she stated that she now has a written contract which clients are required to sign.  Ms Campbell also demonstrated some evidence of beginning to reflect on her practice, specifically with regard to how she will manage a situation where individual counselling transitions to introducing another person.  She also indicated that she would ensure explicit re-contacting in such circumstances.  

Sanction 

Within one month from the date of imposition of this sanction, Ms Campbell is required to provide a written submission, which evidences her immediate reflections on, learning from and understanding of, the issues raised in this complaint.  

In addition, within 6 months from the date of imposition of this sanction, Ms Campbell is required to provide a detailed written report which covers the following areas:

- Incorporating the Ethical Principle of Autonomy in practice with client work and the importance of clear and appropriate contracting in relation to working with individual clients, couples counselling and any transition from individual to couples counselling

- The information that should be given to clients at the outset of the assessment session concerning the type of therapy that is being provided, the format of the therapy and the rights and responsibilities of Ms Campbell as a practitioner and of the client; 

Within the report, Ms Campbell must give examples of how she deals with the above areas in her client work. 

The above report should be countersigned, by an experienced supervisor to confirm that the matters referred to within the report have been discussed in supervision.   

Ms Campbell is also required to provide copies of all written information, relating to both individual and couples work, that she gives to clients both before and during therapy. 

These written submissions must be sent to the Registrar by the given deadlines, and will be independently considered by a Sanction Panel. 

Conclusion  

In conclusion the Appeal Panel did allow the appeal in part, which is reflected in the decisions made and the sanction imposed.

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May 2015:  Carol Gordon, Reference No: 519410,  Surrey CR0

The complaint against the above individual member/registrant was taken to Adjudication in line with the Professional Conduct Procedure. 

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy. 

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant stated that she participated as a supervisee in a supervision group led by Ms Carol Gordon (also known as Jazz) whilst working as a trainee counsellor at the counselling organisation A, from September - December 2013. The Complainant stated that she felt supervision was going well and had voiced this to the placement directors prior to the final session on the 9 December 2013. The Complainant alleged that the final supervision session in December started in the normal manner, however although one member was absent due to 'running late', it was decided to commence as Ms Gordon wished to discuss something with the group.  

The Complainant alleged that Ms Gordon said she was unhappy with the group and that she felt 'disrespected' by the group members, although the Complainant alleged that this quickly became more personal and that Ms Gordon stated that she felt disrespected by the Complainant, especially during the November session when the Complainant spoke over her when she had not finished speaking. The Complainant admitted that this did occur, but that she apologised when this was pointed out and that it was a 'complete accident'. The Complainant alleged that she reminded Ms Gordon that she had apologised during the November session, but that Ms Gordon stated she was unable to respond to this apology as she was ill. 

The Complainant alleged that Ms Gordon continued to give further examples of how she had felt disrespected by the group in November 2013, in that when Ms Gordon had ended the group, the supervisees left the group without saying goodbye to her, but stood 'chatting' to each other in her hallway for '7 minutes'. The Complainant further alleged that Ms Gordon stated that she found some people domineering within the group and then further focussed this by stating 'actually [ complainant's name] I'm talking about you'. The Complainant alleged that when she asked Ms Gordon about why this was aimed at her, Ms Gordon replied that it was how she felt. 

The Complainant stated that following this exchange she felt very victimised and felt that she was being attacked and  got up, informed the group and Ms Gordon that she was leaving the group and left. The Complainant alleged that Ms Gordon said 'OK bye when the Complainant stated her intention to do this, but did not suggest talking the issues through within the group. 

The Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular as follows: 

1. Ms Gordon allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met the  Complainant's needs, in that she failed to be willing to resolve the issues with the Complainant, against the advice of her supervisor.   

2. Ms Gordon allegedly failed to be attentive to the quality of respect offered to the Complainant and failed to communicate in a way which was courteous, in that she had an unprofessional encounter with the Complainant during group supervision.

3. Ms Gordon allegedly failed to maintain and enhance good practice and acquire the attitudes, skills and knowledge required by her in that role in that she adopted a challenging approach towards the Complainant in group supervision.  

4. Ms Gordon allegedly failed to monitor and maintain her fitness to practise at a level which enabled her to provide an effective service, in that she allowed her work with the Complainant and the supervision group to affect her health. 

5. Ms Gordon allegedly failed to remedy any harm she may have caused to the Complainant by issuing an apology, when she became aware that things had gone wrong. 

6. Ms Gordon allegedly failed to ensure that her work did not become detrimental to her health or well-being and seek appropriate professional support in the form of supervision when she encountered difficulties with the Complainant.   

7. Ms Gordon's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 8, 11, 34, 40, 42 and 64 the ethical principles of Being Trustworthy, Beneficence, Non-Maleficence, Justice and Self-Respect of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Empathy, Respect, Integrity, Humility, Competence and Wisdom to which counsellors are strongly encouraged to aspire. 

The Complainant did not attend the hearing and confirmed in an email sent on 5 February 2015 that she would not be attending the hearing in Rugby and therefore, the matter was referred under paragraph 4.9 of the Professional Conduct Procedure, which states: 

Where a Complainant or Member Complained Against fails or refuses to attend a Professional Conduct Hearing, the Registrar has the power to decide to either:

a) Proceed with the Hearing in the absence of one or both of the parties; or 

b) Adjourn the Hearing to a date not less than 28 days in advance; or 

c) Terminate the proceedings; or  

d) Refer the matter for consideration under Article 12.6 of the Memorandum & Articles of Association. 

The options were carefully considered, and in light of the circumstances, a decision was made to proceed with the hearing in the absence of the Complainant.   

It would have been of assistance to the Panel to have the benefit of questioning both parties in relation to their evidence to assist it in making a determination in respect of the findings.  However, in the absence of the Complainant, the Panel had to base its decision on the written evidence provided by both parties and the verbal evidence of the Member Complained Against on the day. 

Findings 

On balance having fully considered the above the Panel made the following findings: 

1. Ms Gordon ran a supervision group in which the Complainant was a participant.  The Complainant joined a supervision group in September 2013, which had two participants from an original group.  Ms Gordon initially found the Complainant a refreshing addition to the group.  In October 2013, another person joined the group and Ms Gordon claimed that there was a substantial shift in group dynamic and she had concerns about the group and more in particular about the Complainant, which she took to clinical supervision on 7 November 2013.  Ms Gordon stated that it was agreed that she would convey her observations to the group and challenge the Complainant within the group.  Ms Gordon did not raise her issues  with the supervision group at the November session and further experienced the session negatively.  Ms Gordon took her issues to peer supervision on 12 November 2013.  The next group supervision was scheduled to take place on 9 December 2013.  Prior to it taking place, Ms Gordon gave two months' notice to the organisation contracting her services that she would be ending with the supervision group, and would see the supervisees on the 9 December 2013, with the last meeting to take place with the group on 6 January 2014.  Ms Gordon, in reference to the issues she experienced with the group, communicated to the organisation that she had taken the issue to peer supervision and had "decided that it's not worth my time attempting to resolve this issue as I suspect any possible adherence of basic boundaries and respect will not be congruent anyway".  Ms Gordon raised her issues with the group on 9 December 2013,and stated in her written evidence that the session "did not go well", with the Complainant leaving the session prematurely in a distressed state.  One of the witness statements stated, "we did book the next session in hope of reconciliation........", and Ms Gordon in her evidence indicated that she would have aimed to achieve as much reconciliation as possible and would have done so in the next session, which would have been the final session.  However, the final session never took place as the contracting organisation suspended any further sessions Ms Gordon may have had planned.  On the balance of probabilities the Panel was not satisfied that it was proven that Ms Gordon had failed to be willing to resolve the issues with the Complainant.  The Panel concluded that the allegation that Ms Gordon failed to provide the Complainant with a good quality of care and competently delivered services which met the Complainant's needs, in that she failed to be willing to resolve the issues with the complainant, against the advice of her supervisor was not proven and the allegation is therefore not upheld. 

2. On the 9 December 2013, Ms Gordon and the supervision group met for a session.  One of the 4 supervisees was running late and not present when Ms Gordon informed the group that she had something to discuss with them.  Whilst Ms Gordon had previously consulted with her individual and peer supervisor and her own CPD group about raising issues with the case supervision group and was advised by her supervisor of the type of reaction she might receive, Ms Gordon had not formulated a plan with her supervisors about how she would raise and manage her agenda with the group.  Ms Gordon agreed with the group on the day that she would discuss her issues before dealing with client work, as one of the supervisees indicated that she would find it difficult to focus on client work wondering at what Ms Gordon might wish to share.  Ms Gordon informed the group that she had handed in her notice to end her work with the group.  Ms Gordon also informed the group of a number of concerns she had with the group. 

Ms Gordon communicated to the group that she felt disrespected by the group and cited some examples of how she had felt disrespected.  She  informed the group of her concern about the group dynamic, also indicating to the group that she had experienced an element of disruptiveness in the group.  As the conversation developed, the focus of Ms Gordon shifted from the group to the Complainant.  Ms Gordon spoke to the Complainant about an issue that occurred in the November session, for which the Complainant had already apologised.  One of the supervisees questioned Ms Gordon as to whether she had been experienced as domineering in the group.  Ms Gordon responded by saying "well actually [name of Complainant] I'm referring to you."  The Complainant became upset and indicated that she was going to leave and Ms Gordon responded by saying, "ok bye", which the Panel found to be dismissive towards the Complainant.  Ms Gordon indicated in her evidence that she had intended for the issues she raised to be dealt with within the group.  However, she had also thought it was likely that she would need to name the Complainant and decided that she did need to name the Complainant.  Ms Gordon stated in her evidence that, "I am totally clear that I did not name [Complainant's name] as being the root of disruption in the group until after [another supervisee] began questioning whether she had been experienced as domineering in the group.  Whilst there is evidence that Ms Gordon did not raise her voice, appear aggressive or use derogatory language, the Panel was satisfied that the communication with the Complainant was accusatory and failed to be courteous and respectful to the Complainant who was singled out by Ms Gordon in front of the group causing the Complainant to feel humiliation and upset.  The Panel found that Ms Gordon had acted unfairly and unprofessionally in singling out the Complainant and in dealing with her in an accusatory manner in front of her peers.  It was clear to the Panel from  the evidence submitted that the session had become very uncomfortable and emotionally charged with the Complainant leaving the session in an upset and distraught state.  The Panel found that Ms Gordon failed to be attentive to the quality of respect offered to the Complainant and failed to communicate in a way which was courteous, in that she had an unprofessional encounter with the Complainant during group supervision and therefore concluded that the allegation was upheld. 

3.   Whilst the Panel recognised challenge can occur legitimately in a respectful way in the therapeutic context, the Panel was not satisfied that the challenging approach adopted by Ms Gordon related to challenge in the therapeutic context or that it was appropriate.  Ms Gordon admitted that she had "acted un-artfully at times" when working with the Complainant and that her intervention was "clumsy", but maintained that she never acted unprofessionally.  The Panel was not satisfied that Ms Gordon had appropriately and competently managed the session with the Complainant on the 9 December 2013.  The Panel found that Ms Gordon had adopted a challenging approach in confronting the Complainant in an accusatory manner in front of her peers and singling her out.  The Panel was not satisfied that Ms Gordon's behaviour exhibited good practice in that it was not satisfied that her challenging approach towards the Complainant modelled the attitude, skills and knowledge required in her role.  On the balance of  probabilities, the Panel found that Ms Gordon had failed to maintain and enhance good practice and acquire the attitudes, skills and knowledge required by her in that role in that she adopted a challenging approach towards the Complainant in group supervision.  The Panel therefore upheld this allegation. 

4. On questioning, Ms Gordon denied this allegation and clarified with the Panel that she managed her self-care.  The clarification was supported by her supervisor's statement.The Panel was not satisfied that it was proven that Ms Gordon failed to monitor and maintain her fitness to practise at a level which enabled her to provide an effective service, in that she allowed her work with the Complainant and the supervision group to affect her health.  Therefore, this allegation was not upheld. 

5. Whilst Ms Gordon did not accept that she had done anything wrong to the Complainant and did not believe that she had caused her any harm, Ms Gordon accepted that things did go wrong with the Complainant at the 9 December session and that the Complainant experienced the session negatively and left in a distraught state.  Following that session, Ms Gordon did not provide the Complainant with an apology.  The Panel was satisfied that Ms Gordon had confronted the Complainant and singled her out in the session, and that the Complainant left the session in a distraught state and that Ms Gordon was aware that the session did not go well.  The Panel found on the evidence, that Ms Gordon failed to remedy any harm she may have caused to the Complainant by not issuing an apology when she became aware that things had gone wrong and therefore this allegation was upheld. 

6.   The Panel was satisfied on the evidence that Ms Gordon had consulted with her supervisor when she encountered difficulties with the Complainant and that she was attentive to her self-care.  The Panel therefore did not find that Ms Gordon failed to ensure that her work did not  become detrimental to her health or well-being and seek appropriate professional support in the form of supervision when she encountered difficulties with the Complainant.  Therefore, this allegation was not upheld.   

7. In light of the above findings, the Panel was satisfied that paragraphs 11, 34, and 42 and the ethical principles of Being Trustworthy, Beneficence, Non-Maleficence and Justice of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013) had been breached but not paragraphs 1, 8, 40 and 64 nor the ethical principle of Self-Care.  It also found a lack of the personal moral qualities of Empathy, Respect, Humility, Competence and Wisdom to which counsellors are strongly encouraged to aspire but did not find a lack of the moral quality of integrity. 

Decision 

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice on the grounds of the provision of inadequate professional services and incompetence.  

Mitigation 

The Panel was not satisfied that there was evidence of mitigation.  

Sanction 

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection together with the educative aspect.  

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Ms Gordon is required to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint.

In addition, in no less than three months and no more than six months from the date of imposition of this sanction, Ms Gordon is required to provide a detailed and comprehensive case study based on the issues that arose from this complaint related to the upheld findings.  This case study should address her learning and pay particular attention to the following areas;

1.   Communicating and managing feedback within a supervision group session, 

2.   Managing conflict in a group situation within a limited timeframe, 

3.   Attending to the needs of group members. 

Ms Gordon is also required to describe, in-depth, how she might have done things differently with regard to this case. 

These written submissions must be sent to the Interim Registrar by the given deadlines, and will be independently considered by a Sanction Panel.

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May 2015: Joseph Cullen, Reference No: 525916, Newcastle Upon Tyne NE15


The complaint against the above individual member/registrant was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel is that the Complainant was a trainee counsellor at organisation A, a counselling agency registered under the Industrial and Provident Societies Acts 1965-1978, where the Member Complained Against, Joseph Cullen, at that time was the Treasurer and a part of the management team. 

The complainant was a trainee counsellor from September 2008 to December 2009, and while she remained at the organisation as a qualified counsellor from January 2010 to June 2010, Mr Cullen was her supervisor.  Further from September 2010 to July 2011, Mr Cullen acted as her mentor when she registered on a teaching qualification course until July 2011.  Mr Cullen was also simultaneously the complainant's work colleague within the agency from June 2009, when at his request she took on the role as volunteer fundraiser for the agency in return for a promise from him of paid employment in the future once the organisation was financially sustainable.

The focus of this complaint is the alleged unprofessional and unethical behaviour of Mr Cullen towards the complainant in his role as her supervisor, and to a lesser extent in his subsequent role as her mentor.  Once the supervisory relationship was established, allegedly as a result of Mr Cullen's suggestion, the complainant alleged that Mr Cullen embarked on a series of initiatives designed primarily to keep her in the organisation in order to use her experience of fundraising in order to realise the vision and ambition he had for the organisation.  In addition to his request that she become a volunteer fundraiser for the organisation with the prospect of permanent paid employment, the complainant alleged that Mr Cullen fostered a close personal relationship directly with her and also between members of their respective families.  The complainant alleged that the supervision boundaries became increasingly blurred through, for example, Mr Cullen picking her up from home, driving her to the supervision location and then home again, with frequent stops for coffee, shopping, and visits to galleries, together with increasing socialising with her and between both of their families.  Over time, the complainant alleges that Mr Cullen, while appearing to be supportive, fostered a deliberate dependence by her on him through what she refers to as his "power and control dynamic".  He allegedly actively disregarded her welfare as a trainee counsellor through a "series of discouragements", including discouraging her from topping up her Foundation Degree to an Honours Degree, putting her off registering for a PhD, and inhibiting her from taking up a placement opportunity with Barnardos.  The complainant alleged that Mr Cullen was able to gain information from her through the supervisory process about her lack of family support and present vulnerability and the abuse she experienced in childhood and then to misuse that information through inappropriate disclosure outside supervision to further his control over her.

The complainant summarises Mr Cullen's unethical behaviour as a supervisor by setting out his modus operandi in the following way:

-  He would allegedly first target a volunteer or trainee counsellor and allocate himself as their supervisor

-  He would provide 1 to 1 supervision free of charge.

-  Using that relationship he would allegedly gather information on the supervisee in order both to use that supervisee to sustain his vision for the organisation and to meet his own emotional needs for his dynamic of power and control.

-  Having assessed the individual's needs and vulnerabilities he would allegedly make them special with promises of roles and tasks within the agency.

-  He would allegedly establish trust through emotional intimacy and support, only then to isolate that supervisee through a process of manipulating their thoughts and behaviours and discarding them if and when they became a threat, replacing them with new students from local colleges.

While the complainant suggested that this was his typical way of working, she alleged that all of it was experienced specifically by her throughout the duration of their supervisory relationship, which she describes as a process of "grooming", manipulation of vulnerabilities and the deliberate fostering of dependence upon him for malign ends.  Thus she alleged he abused her trust by using his position of power to choose her clients without listening to her concerns; reinforcing his control by heightening her vulnerabilities; and undermining her own personal therapy.

The complainant stated that she eventually was able to end the supervisory relationship in June 2010, against Mr Cullen's wishes, following which she experienced lengthy "blanking" by him within the organisation as they continued to work together and a series of "passive aggressive behaviours".  As Mr Cullen then moved from being her supervisor to becoming her mentor when she registered on a teaching course, she alleged that he proceeded to use the confidential information gained from her during supervision within the agency as their personal and professional relationship deteriorated, leaving her to feel "totally disrespected....and manipulated".  She eventually dispensed altogether with his mentoring services in September 2011 until, after he made sexually explicit remarks to her, she gave in her notice in November 2011.

The Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular are as follows:

1. Mr Cullen allegedly failed to provide the complainant with a good quality of care and competently delivered services which meet her needs, in that he built up the complainant's dependence towards him by offering free supervision to gain her trust, to meet the needs of the organisation rather than the complainant's needs and would not allow the complainant to see the complaint which a client had made against her and instead offered to increase their Supervision sessions.

2. Mr Cullen allegedly failed to provide the complainant with a good quality of care and competently delivered services which met her needs, in that he did not enable the complainant to explore fully issues she was experiencing with her client work in supervision.

3. Mr Cullen allegedly failed to provide the complainant with a good quality of care and competently delivered services which met her needs, in that he suggested in supervision that the complainant had been sexually abused and entered into a discussion about her sexual self and drew the complainant into a discussion about her family life, which made her feel uncomfortable.

4. Mr Cullen allegedly failed to provide the complainant with a good quality of care and competently delivered services which met her needs, in that when the complainant wanted to discuss terminating their supervisory relationship, Mr Cullen would not enter into a meaningful discussion about it.

5. Mr Cullen allegedly failed to clarify and agree the rights and responsibilities of both him as a practitioner and the complainant as a client, in that he did not make it clear to her the circumstances in which supervision could end and when the complainant broached the subject of terminating therapy, did not provide reviews or set out the supervision process or clarify the roles that he would be performing in relation to her.

6. Mr Cullen allegedly held a dual relationship with the complainant which was to her detriment, in that he was concurrently a supervisor, manager, colleague and friend and then subsequently mentor, manager, colleague and friend. Further Mr Cullen allegedly failed to consider the implications of these dual relationships.

7. Mr  Cullen allegedly failed to keep appropriate records of his supervision and mentoring work with the complainant.

8. Mr Cullen allegedly failed to be attentive to the quality of listening and respect offered to the complainant in that he allegedly 'groomed' the complainant and used their supervisory/mentor relationship for his own needs and for the benefit of the organisation rather than the complainant's own needs. Further Mr Cullen allegedly did not listen to the complainant when she was explaining to him things that were going wrong in their relationship.

9. Mr Cullen allegedly failed to pay careful attention to client consent and confidentiality in that he used material gained from his supervisory relationship with the complainant in their working relationship as colleagues

10.  Mr Cullen allegedly failed to respect the complainant's right to choose whether to continue or withdraw from supervision or mentoring, in that each time the complainant raised the issue of terminating supervision he acknowledged it but there would be no initiation of an ending process.

11.  Mr Cullen allegedly failed to ensure that his services were delivered on the basis of the complainant's explicit consent in that he continued providing supervision to the complainant when she made him aware that she wished to cease supervision.

12.  Mr Cullen allegedly failed to be willing to respond to the complainant's requests for information about the way in which he was working in that he would not permit the complainant to explore a complaint that had been made against her by the client with him in supervision.

13.  Mr Cullen allegedly abused the complainant's trust in order to gain emotional and personal advantage in that he used his supervisory relationship with the complainant to develop a series of discouragements, including discouraging her from topping up a Foundation degree to an Honours degree, putting her off studying for a Ph.D. and inhibiting her from getting experience with Barnardos.

14.  Mr Cullen allegedly failed to respect the complainant's privacy and confidentiality in that he paid frequent visits to the bistro run by the complainant's husband during the time the complainant was his supervisee/mentor and used information gained from his supervision sessions with the complainant within the organisation.

15.  Mr Cullen allegedly failed to provide supervision/consultative support, i.e. mentoring to the complainant independent of any managerial relationships.

16.  Mr Cullen allegedly failed to respond promptly and appropriately to the complainant's complaint when she raised concerns regarding their supervisory relationship.

17.  Mr Cullen allegedly failed to ensure that his relationships were conducted in a spirit of mutual respect and attain good working relationships which enhance services, in that he sent an email to a colleague which referred to the complainant in a less than positive way.

18.  Mr Cullen allegedly failed to treat all colleagues fairly and to foster equality of opportunity in that Mr Cullen exploited the complainant's ethnic background to gain connections for him and the organisation.

19.  Mr Cullen allegedly failed to avoid the conflict of interest which developed between him and the complainant, in that he was initially her supervisor, manager, colleague and friend and then subsequently her mentor, manager, colleague and friend.

20.  Mr Cullen's alleged behaviour, as experienced by the complainant and identified in the paragraphs above suggests contravention in particular of paragraphs 1, 3, 4, 5, 11, 12, 13, 16, 17, 20, 33, 41, 51, 52 and 63 and of the ethical principles of being Trustworthy, Autonomy and Beneficence of the Ethical Framework for Good Practice (2008- 2013), and showed a lack of the personal moral qualities of sincerity, integrity, respect and fairness to which counsellors are strongly encouraged to aspire.

Findings

On balance, having fully considered the above, the Panel made the following findings:

1. In his oral evidence, Mr Cullen stated that all volunteer trainee counsellors at organisation A were offered free supervision.  The Panel found that by offering free supervision, Mr Cullen did build up a dependency, however the Panel was satisfied that this was not a deliberate attempt to meet the organisation's needs rather than the Complainant's, although this may have been an unintentional consequence.  This part of the allegation is  therefore not upheld. 

Whilst there was a conflict of evidence as to whether or not there was a written complaint made against the Complainant by a client, there was, nevertheless a complaint.  The Complainant was not shown the complaint but instead was offered extra supervision, and in this regard, the Panel found that Mr Cullen had failed to provide the Complainant with a good quality of care and competently delivered services which meet her needs.  Therefore this part of the allegation is upheld.

For the reasons stated above, this allegation is upheld in part.

2.   In her oral evidence, the Complainant talked of bringing client work to supervision and in particular discussed one of her clients with Mr Cullen where he had suggested there may be a dynamic issue.  There was no evidence brought to demonstrate that in general, the Complainant was not able to explore fully issues in her client work and therefore the Panel found that Mr Cullen did not fail to provide the Complainant with a good quality of care and competently delivered services which met her needs in this regard and therefore this allegation not upheld.

3. Mr Cullen, in his oral evidence stated that he did not recognise the account of the conversation as evidenced in the Complainant's written and oral evidence.  The Panel considered that there was a conflict of evidence about whether or not Mr Cullen suggested in supervision that the abuse the Complainant had suffered in childhood amounted to sexual abuse.  The Panel  found that there was insufficient evidence brought to substantiate the allegation and therefore this allegation is not upheld.

4. In her oral evidence, the Complainant accepted that she had not formally broached the subject of terminating the supervisory relationship.  Therefore this allegation is not upheld.

5. In oral evidence, when asked if he had clarified the rights and responsibilities in relation to the supervision relationship, Mr Cullen stated the Complainant would have been given the organisation A "Supervision Policy Sheet" which had been submitted as evidence.  However, the Panel found that this sheet on its own was not sufficient as a clarification.  When closely questioned, Mr Cullen's responses demonstrated that he was hazy about how and whether he had clarified the rights and responsibilities of himself as a practitioner and the Complainant as a client within their supervision sessions.  Mr Cullen stated that he had carried out reviews whilst the Complainant was a student, but that he had not done so in the eighteen months or so after she was qualified.  This allegation is therefore upheld.

6. Mr Cullen accepted, in both his written and oral evidence, that he had had multiple roles with the Complainant.  These included being a family friend, a regular customer of the Complainant's husband's café, colleague, counsellor and supervisor.  Mr Cullen also had a personal friendship with the Complainant, was her line manager in her capacity as volunteer counsellor and a mentor.  When questioned by the Panel, Mr Cullen could not provide any evidence of having considered the implications of these dual relationships or the detrimental impact they might have on the Complainant, despite having said that he had discussed them in supervision.  The Panel noted that Mr Cullen demonstrated a lack of reflection, both at the time and since the events occurred.This allegation is therefore upheld.

7. Mr Cullen gave contradictory evidence of his keeping of appropriate records, first stating that he had not kept records and then stating that he had done so whilst the Complainant was a student.  In oral evidence, Mr Cullen stated that processes and systems had not always been in place.  The Panel found that the contradictions indicated that his records, if kept, were not kept in an appropriate manner.  Therefore this allegation is upheld. 

8. The Panel found that there was insufficient evidence brought to corroborate the allegation that Mr Cullen had 'groomed' the Complainant for his own interests or for the benefit of the organisation.  In her evidence, the Complainant accepted that she did not tell Mr Cullen in a straightforward way, that things were going wrong in their relationship.  This allegation is therefore, not upheld.

9. The Panel noted the emails that contained information Mr Cullen had gained from the supervision sessions with the Complainant and which he had sent to a mutual colleague, Ms D.  Mr Cullen stated, in oral evidence that the emails had been taken 'out of context'; however he accepted that he had written them and stated that 'they looked bad'.  The Panel found that, whilst Mr Cullen stated that the emails were only meant for Ms D's eyes, they did contain material taken from his confidential knowledge of the Complainant and as such should not have been passed to a third party. Therefore this allegation is upheld.

10.  The Complainant stated in her oral evidence, that she had not directly raised the issue of terminating supervision within her supervisory sessions.  Therefore the Panel did not uphold the allegation that Mr Cullen failed to respect the Complainant's right to choose whether to continue or withdraw from supervision or mentoring.

11.  The Complainant stated in her oral evidence, that she had not directly raised the issue of terminating supervision within her supervisory sessions.  Therefore the Panel did not uphold the allegation that Mr Cullen failed to ensure services were delivered on the basis of the Complainant's explicit consent.

12.  The Panel noted that there was a conflict of evidence as to whether there had been a written complaint by a client, however, there was evidence of a complaint about the Complainant being late for a client, which she had not been allowed to fully explore in supervision.  The Panel found that, whilst Mr Cullen had brought up complaints made against the Complainant in supervision, he had not given her full information about them.  Therefore this allegation is upheld.

13.  In written evidence, Mr Cullen had stated that the Complainant had pursued two courses which had been paid for by the organisation. Mr Cullen denied that he had discouraged the Complainant and on the contrary, stated that he would have supported the Complainant had she pursued a PhD.  The Panel noted that there was a conflict of evidence as to whether Mr Cullen had discouraged the Complainant from pursuing a PhD and therefore the allegation that Mr Cullen abused the Complainant's trust is not upheld.

14.  In both his written and oral evidence Mr Cullen accepted that he had frequently visited the Complainant 's husband's Bistro, and stated that this was 'to support them and because the food was good'.  The Panel found that in so doing, Mr Cullen did not respect her privacy and confidentiality.  This part of the allegation is therefore upheld. 

The Panel found that there was insufficient evidence brought to substantiate the allegation that Mr Cullen used information gained from supervision sessions within the Bistro.  Therefore this part of the allegation is not upheld.

For the reasons stated above, this allegation is upheld in part.

15.  Mr Cullen accepted in both his written and oral evidence that he had been in multiple relationships with the Complainant.  However, when questioned he was not able to reflect on the possible detrimental issues that these multiple relationships may cause.  The Panel found that his  supervision and consultation was not independent from any managerial relationship.  Therefore this allegation is upheld.

16.  The Panel noted that there was no evidence brought to demonstrate that the Complainant had raised a complaint against Mr Cullen, prior to the allegations made to BACP; therefore this allegation is not upheld.

17.  Mr Cullen accepted in both his written and oral evidence that he had sent an email to a colleague, which referred to the Complainant in a less that positive way.  Mr Cullen stated that this email was purely for the recipient and was not intended to be seen by the Complainant.  However, the Panel found that sending an email describing the Complainant in such unflattering terms to a mutual colleague was disrespectful and harmful to working relationships.  Therefore this allegation is upheld.

18.  The parties agreed that the Complainant had attended a meeting with an MP at Mr Cullen's request, however, there was insufficient evidence brought to substantiate the allegation that this was done to exploit the Complainant's ethnic background.  Therefore this allegation is not upheld.

19.  It was accepted by both parties that Mr Cullen sent cards to the Complainant and her family.  In his oral evidence however, Mr Cullen did not accept that the multiple relationships he had with the Complainant created a conflict of interest.  In her oral evidence, the Complainant stated that she was confused by the multiple relationships.  The Panel also noted that the relationships had extended beyond her time at the organisation.  The Panel found that Mr Cullen had failed to avoid a conflict of interest developing and indeed noted that Mr Cullen failed to acknowledge that a conflict of interest had developed.  This allegation is upheld.

20.  In light of the above, the Panel was satisfied that Mr Cullen's alleged behaviour, as experienced by the Complainant, and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 3, 4, 5, 11, 16, 20, 33, 51 and 63 of the Ethical Framework for Good Practice in Counselling & Psychotherapy and the Ethical Principles of Being Trustworthy and Autonomy.  The Panel also found that Mr Cullen lacked the personal moral qualities of Integrity, Respect, and Fairness that practitioners are strongly urged to aspire. 

The Panel did not find a contravention of paragraphs 12, 13, 17, 41 and 52 of the Ethical Framework for Good Practice in Counselling & Psychotherapy, and the Ethical Principle of Beneficence.  Nor did the Panel find a lack of the personal moral quality of Sincerity.

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice in that the service for which Mr Cullen was responsible fell below the standards that would reasonably be expected of a practitioner exercising reasonable skill.  The Panel found that Mr Cullen was incompetent, reckless and provided inadequate professional services.

Sanction

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.

Within one month from the date of imposition of this sanction, which will run from the expiration of the Appeal deadline, Mr Cullen is required to provide a written submission, which evidences his immediate reflection on, learning from and understanding of, the issues raised in this complaint.

In addition, in not less than 6 months and no more than 18 months from the date of imposition of this sanction, Mr Cullen is required to provide three separate, in-depth, case studies, which evidence the following:

1. The 'dual relationships' that he and the complainant were involved in over the years and demonstrate a profound understanding of the significance of these relationships and the possible harm that may be caused by them to this complainant in particular.  Mr Cullen must also:

                     
I.       Support the case study with reference to the literature available about dual relationships;                    
II.      present evidence that this has been discussed in supervision and;                    
III.     The case study should be signed off by a supervisor who also evidences that he/she is a) outside of Mr Cullen's current network and b) evidence that he/she has not been and is not currently involved in any other relationship with Mr Cullen.

2.  The understanding of the meaning of 'conflict of interest' and demonstrate a profound understanding of the significance of how a conflict of interest may arise within organisation A.  Mr Cullen must also:

                    
I.       Support the case study with reference to the literature available about conflict of interests within a counselling arena;                    
II.      present evidence that this has been discussed in supervision and;                    
III.     The case study should be signed off by a supervisor who also evidences that he/she is a) outside of Mr. Cullen's current network and b) evidence that he/she has not been and is not currently involved in any other relationship with Mr. Cullen.

3. The importance of keeping consistent and clear records and the importance of being thorough and consistent in his record-keeping as above.

                    
I.       Support the case study with reference to the literature available                   
II.      present evidence that this has been discussed in supervision and;                    
III.     The case study should be signed off by a supervisor who also evidences that he/she is a) outside of Mr. Cullen's current network and b) evidence that he/she has not been and is not currently involved in any other relationship with Mr. Cullen.

Mr Cullen's accreditation is suspended until the sanctions above have been considered as satisfactorily completed by a Sanction Panel.

These written submissions must be sent to the Interim Registrar by the given deadlines, and will be independently considered by a Sanction Panel.

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May 2015: Connie Johnson, Reference No: 524513, Edinburgh EH10


The complaint against the above individual member/registrant was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy. 

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel is that the Complainant stated that he was in therapy with Ms Connie Johnson from September 2003 to July 2006. The Complainant accepted that there was a significant therapeutic effect from working with Ms Johnson but he also believed that she reinforced his [ . . . ], and undermined his relationship with his wife, who she met on at least two occasions. 

Prior to beginning work with Ms Johnson, the Complainant had had six psychotherapy sessions with a different therapist, in a counselling service of which Ms Johnson was allegedly the manager.  When the Complainant requested further sessions, allegedly Ms Johnson refused, instead taking him into her private practice. The Complainant stated that Ms Johnson was his personal therapist between August/September 2003 to July 2006 and then became his supervisor from February 2007 until April 2010.  The Complainant stated that in July 2009 Ms Johnson visited his house to discuss a business deal.

The Complainant accepted that the move to supervision was at his instigation, but alleged that, as he still had significant attachment issues, it was Ms Johnson's responsibility to warn him of the possible effects of their not having a clean ending. 

During the time in which they worked together the Complainant stated that Ms Johnson did not discuss the process between them, nor discuss how they were working together. The Complainant alleged that Ms Johnson often could not follow him, particularly when he used physics metaphors. The Complainant stated that Ms Johnson "stopped trying" to understand him and that as a consequence he stopped talking about how he felt in sessions. 

The Complainant stated that when he and Ms Johnson worked in a supervisory relationship, Ms Johnson was out of her depth, and worked in ways that were inappropriate. In particular, in their final supervision session the Complainant stated they only spoke of the ending of their relationship in the
last two minutes.  

After their supervisory relationship ended, Ms Johnson allegedly accepted a gift of a fine art photograph with a value of approximately £150. The Complainant stated that there was a discussion about the gift and how it should be delivered, and the Complainant eventually went to Ms Johnson's house to deliver it. In March 2011 the Complainant stated that he and Ms Johnson met for coffee.  

In October 2011 whilst in therapy with another therapist, following a short [ . . . ] break, the Complainant became aware that his therapy with Ms Johnson had allegedly been of a damaging nature. The Complainant stated that he needed to process what happened before he went further and in 2013 he attempted to contact her to discuss his complaints but Ms Johnson refused to meet with him  

The Pre-Hearing Assessment Panel firstly had to consider whether or not this complaint could be accepted given that the complaint was not submitted within three years of the end of the professional relationship.  The Panel therefore considered the timescales for submitting a complaint as set out within the Professional Conduct Procedure. The Panel noted that the Complainant was submitting his complaint under paragraph 1.5 b) of the Professional Conduct Procedure and accepted the Complainant's evidence that he was unaware until October 2013 that he had a complaint to make.  The Panel considered those reasons to be good and sufficient. 

The Pre-Hearing Assessment Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular as follows:  

1. Ms Johnson allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met his needs, in that she failed to ensure that that she ended both the therapeutic and supervisory relationships appropriately. 

2. Ms Johnson allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met his needs in that she did not recognise or manage the dependency/attachment that the Complainant had towards her. 

3. Ms Johnson allegedly failed to give careful consideration to the limitations of her training and experience and work within these limits, in that Ms Johnson could not follow and/or understand some of the things the Complainant was talking about during their counselling sessions which resulted in the Complainant choosing not to talk about his feelings. 

4. Ms Johnson allegedly failed to give careful consideration to the limitations of her training and experience and work within these limits in that she provided supervision for the Complainant's coaching work, which she had no or insufficient knowledge of. 

5. Ms Johnson allegedly failed to clarify and agree the rights and responsibilities of her as a practitioner and the Complainant as a client, in that there was no verbal or written contract relating to their therapeutic and supervisory relationship which set this out and the Complainant was unclear as to whether he was receiving supervision or personal development from Ms Johnson. 

6. Ms Johnson allegedly entered into a dual relationship with the Complainant which was to his detriment and failed to consider the implications of entering into such a relationship with him, in that she was his therapist/supervisor and entered into a personal relationship with him, whereby Ms Johnson visited the Complainant at his house and they engaged in out of session contact which did not relate to their therapeutic/supervisory relationship.    

7. Ms Johnson allegedly failed to think carefully about and exercise considerable caution before entering into a personal or professional relationship with the Complainant, in that following the end of their therapeutic relationship, Ms Johnson provided supervision/ personal development to the Complainant for his client work and discussed setting up a series of workshops with the Complainant, and also attended his house and offered to meet him for coffee.  

8. Ms Johnson allegedly abused the Complainant's trust in order to gain emotional or personal advantage in that she accepted gifts from the Complainant, including a photograph which the Complainant arranged to frame for her. 

9. Ms Johnson allegedly failed to respond promptly or appropriately to the Complainant's complaint when she received it, in that she refused to meet him to discuss it and did not respond to his complaint.  

10.  Ms Johnson allegedly failed to remedy any harm she may have caused the Complainant or apologise when she became aware of his complaint.

11.  Ms Johnson allegedly failed to mitigate any harm she caused to the Complainant and prevent any further harm from occurring, in that when she became aware of his complaint, she did not meet him to discuss it. 

12.  Ms Johnson allegedly failed to inform the Complainant of the existence of the Professional Conduct Procedure when she became aware of his complaint.    

13.  Ms Johnson allegedly failed to ensure that she avoided a conflict of interest or prevent one from arising with the Complainant in that she offered to take him on as a client immediately after he had a session with another therapist, who worked in the same organisation as her. 

14.  Ms Johnson's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 2, 3, 4, 18 and 55 and the ethical principles of Fidelity, Autonomy. Beneficence and Non-Maleficence of  the Ethical Framework for Good Practice in Counselling & Psychotherapy (2002), and showed a lack of the personal moral qualities of Empathy, Wisdom and Competence to which counsellors are strongly encouraged to aspire and further suggests a contravention of paragraphs 1, 2, 3, 4, 17, 41, 42, 43, 46 and 63 of the Ethical Framework for Counselling For Good Practice in Counselling and Psychotherapy 2010 and the ethical principles of Being Trustworthy, Autonomy, Beneficence and Non-Maleficence and showed a lack of the personal moral qualities of Empathy, Wisdom and Competence.    

Findings 

On balance, having fully considered the above, the Panel made the following findings: 

1. There was disagreement between the parties as to when the therapeutic relationship began, but the Panel found that the therapeutic relationship existed from at least 2004 until 2010, with a short break in between.  The Complainant in his evidence stated that he decided to end the therapeutic relationship after attending a coaching seminar which talked about endings.  He explained that there was no prior discussion about ending the relationship, prior to what turned out to be the last session, as the decision was made by him in the  moment.  The Complainant stated that he also provided Ms Johnson with a gift of a photograph to mark the ending of their therapeutic relationship.  The Panel took note of the email sent by the Complainant to Ms Johnson in May 2010, in which the Complainant stated that he saw no reason to have another session.  The Panel found that the therapeutic relationship therefore ended at the instigation of the Complainant.  Ms Johnson stated that in view of her Person Centred modality, each session is considered as an ongoing contract where the client decides whether or not they will come back as the client is self-directing.  As such, Ms Johnson said that she accepted the  Complainant's decision to end their therapeutic relationship without further discussion or providing an opportunity for processing the  decision.  In view of Ms Johnson's way of working within the Person Centred Approach, the Panel did not find that Ms Johnson failed to provide a good quality of care and competently delivered services which met the Complainant's needs by failing to ensure that the ending of the therapeutic relationship was managed appropriately.  The Panel having heard the evidence of both parties was not satisfied that there was a supervisory relationship between the parties, for the reasons set out in finding 4 below, and found that the relationship that existed between the parties, which was described as Personal Development, was still a therapeutic one.  The Panel therefore did not find that Ms Johnson failed to end the supervisory relationship appropriately.  This allegation is therefore not upheld.

2. Whilst Ms Johnson in her evidence stated that she recognised the attachment/dependency the Complainant had towards her, the Panel found that Ms Johnson did not manage this dependency appropriately in that she blurred the boundaries of the relationship by entering into a personal  relationship with the Complainant by attending his house during the time that she was providing Personal Development to him, and having coffee with him, in a non-therapeutic setting.  The Panel therefore found that Ms Johnson failed to provide the Complainant with a good quality of care and competently delivered services which met his needs in not managing the attachment/dependency the  Complainant had towards her.  This allegation is therefore partially upheld. 

3. The Complainant recounted one session in which he used metaphors to describe his [ . . . ] process, but realised that the subject that he wanted to discuss was not going to be addressed in therapy with Ms Johnson.  Ms Johnson in her evidence stated that she recalled one session in which she said that she did not understand a physics metaphor which the Complainant was describing, but she informed the Complainant of this.  On questioning, the Complainant accepted that he was able to continue working with Ms Johnson but he chose to edit some of the things he said.  There was no evidence to suggest that in failing to understand a metaphor the Complainant used during one session, Ms Johnson failed to give careful consideration to the limitations of her training and experience and work within these limits.  This allegation is therefore not upheld.

4. Ms Johnson was clear in her evidence that she was not providing supervision to the Complainant.  The Complainant stated that he was confused as to what was being provided to him.  The Panel accepted Ms Johnson's evidence that the Personal Development she was providing to the Complainant was of a therapeutic nature and was intended to enhance his own self development in relation to his work and personal life.  The Panel heard evidence that the description of their work together as being 'Personal Development' came at the request of the Complainant.  As such, the Panel found that Ms Johnson did not provide supervision for the Complainant's coaching work.  The Panel therefore did not find that Ms Johnson failed to give careful consideration to the limitations of her training and work within these limits in providing supervision for the Complainant's coaching work, as it found that no supervision was provided to the Complainant.  This allegation is therefore not upheld.

5. On questioning, Ms Johnson was unable to explain clearly enough to the satisfaction of the Panel what was discussed with the  Complainant as part of her verbal contract.  Ms Johnson stated that the contract with the client was flexible and ongoing and the progress of the client was judged by what the client tells her.  The parties accepted that they had a discussion around whether Ms Johnson could supervise the Complainant's coaching work and at the end of the discussion the Complainant stated that he believed that he was receiving high performance supervisory input, but that it was convenient to label what he was receiving on the invoice as Personal Development.  Ms Johnson stated that she could not recall when the focus of her work with the Complainant changed but the Complainant decided that he wanted to do personal development to enhance his own self development, which Ms Johnson still regarded as therapy.  The Panel found that there was a lack of clarity for the Complainant as to whether he was receiving Personal Development or Supervision.  Whilst the Panel accepted that there was a verbal contract in relation to their therapeutic work, it was not satisfied that this contract sufficiently set out the rights and responsibilities of her as a practitioner and the Complainant as a client, given the lack of clarity which the Complainant experienced.  The Panel however accepted that there was no supervisory relationship.  This allegation is therefore partially upheld. 

6. Ms Johnson accepted in her evidence that she visited the Complainant at his house, where his wife and children were also present and that this visit had taken place during their therapeutic relationship.The Complainant in his evidence stated that the purpose of Ms Johnson attending his home was to meet with him and another person to discuss setting up a workshop and was not for therapeutic purposes.  In the written evidence, the Panel noted that the Complainant was delayed in returning home and Ms Johnson was therefore left in his house with his wife and children for some time.  In their next session, Ms Johnson stated that the Complainant said he was angry with her.  The Panel found that in attending the Complainant's house to discuss matters not related to their therapeutic relationship, Ms Johnson entered into a personal relationship with the Complainant at a time when she was still his therapist, which was to the detriment of the  Complainant.  The Panel accepted that there was no supervisory relationship  between the parties.  The Panel therefore found that Ms Johnson entered into a dual relationship with the Complainant which was to his detriment, and failed to consider the implications of this in that she was the Complainant's therapist and entered into a personal relationship with the  Complainant in visiting his house for purposes which did not relate to their therapeutic relationship.  This part of the allegation is therefore upheld. 

The Panel found that with the exception of the visit to the Complainant's house, as referred to above, there was no other evidence that Ms Johnson engaged in out of session contact whilst in a therapeutic relationship with the Complainant.  The Panel noted that the Complainant requested to meet Ms Johnson for coffee, in an email sent the day after his final session on 19 May 2010.  Ms Johnson accepted this offer, by email on 31 May 2010.  Ms Johnson stated that this acceptance of the Complainant's request was made to bring the therapeutic relationship to a close as there had not been a final review session.  Ms Johnson stated that the Complainant had contacted her almost a year later and they had met for coffee in March 2011.  The Panel found no evidence that this was a formal review session.  The Panel found that meeting for coffee 10 months after the last formal session did not indicate that Ms Johnson was still in a therapeutic relationship with the Complainant and this part of the allegation is not upheld.

7. The Panel accepted that Ms Johnson did not provide supervision to the Complainant but did provide Personal Development to him, which was an  extension of their continuing therapeutic relationship.  The parties accepted that the Complainant discussed his client work within the sessions labelled as Personal Development.  The Panel accepted the Complainant's evidence that when Ms Johnson visited him at his house, they discussed setting up a series of workshops.  The Panel found that by discussing setting up workshops with the Complainant, the Complainant believed that Ms Johnson was prepared to negotiate a different working relationship with him.  The Panel found that Ms Johnson did not give sufficient consideration to what her visiting the Complainant's house would mean to the Complainant.  The Panel therefore found that Ms Johnson entered into a personal relationship with the Complainant in attending his house and discussing setting up a series of workshops, and failed to think carefully about and exercise considerable caution before doing so.  This part of the allegation is upheld.  

There was written evidence that Ms Johnson had agreed to meet the Complainant for coffee in an email dated 31 May 2010 following his request but the Panel was satisfied that Ms Johnson herself had not made the offer to the Complainant.  This part of the allegation is therefore not upheld.

8. The parties accepted that the Complainant provided Ms Johnson with a photograph, which he arranged to be framed for her.  Further, the parties accepted that the Complainant provided Ms Johnson with a DVD.  The Panel found that although Ms Johnson did not give sufficient consideration to what the gifts the Complainant provided meant to him, there was no evidence that in accepting these gifts, Ms Johnson abused the Complainant's trust in order to gain emotional or personal advantage.  This allegation is therefore not upheld.

9. The Panel found that Ms Johnson did respond promptly to the Complainant when he indicated that he wished to make a complaint.  Ms Johnson stated that she suggested that they meet with a third party to discuss his concerns but the Complainant did not want to take up this offer.  The Panel accepted Ms Johnson's evidence that she sought appropriate advice when considering whether or not to meet the  Complainant and that in  considering this advice, decided that it was more appropriate for the Complainant's complaint to be put in writing.  In the Complainant's written complaint, he made it clear that he did not want Ms Johnson to respond to it.  As such, Ms Johnson stated that she thought that it would be more appropriate for the complaint to be dealt with by BACP.  In the circumstances, the Panel considered that Ms Johnson acted appropriately both in responding to the complaint and not meeting the Complainant to discuss it.  This allegation is therefore not upheld.

10. The Panel accepted Ms Johnson's evidence that she offered to meet with the Complainant with a third party present, but the  Complainant did not accept this offer.  Further, when the Complainant sent Ms Johnson a draft of his complaint, he made it clear that he did not want her to respond.  In the circumstances, the Panel found that Ms Johnson was placed in a position where it was difficult for her to remedy any harm or apologise to the Complainant.  This allegation is therefore not upheld.

11. The Panel accepted that Ms Johnson initially offered to meet with the Complainant with a third party present and that subsequently after  receiving advice, acted appropriately in taking the decision not to meet the Complainant to discuss his complaint and instead suggest that he put his  complaint in writing.  Given that the Complainant stated within his draft complaint to Ms Johnson that he did not wish her to respond, and did not agree to attending a meeting with a third party present, the Panel found that Ms Johnson was not given an opportunity to mitigate any harm she caused to the Complainant and to prevent any further harm.  This allegation is therefore not upheld.

12. The Panel noted from the written evidence that the Complainant messaged Ms Johnson on 8 November 2013, indicating that he wished to meet with her to discuss a complaint.  Ms Johnson responded by suggesting that they have a third party present and when the  Complainant rejected this suggestion, Ms Johnson did not respond until some days later.  The Panel found that at the point when Ms  Johnson became aware that the Complainant wished to raise a complaint, i.e. on 8 November 2013, she should have made the Complainant aware of the existence of the  Professional Conduct Procedure.  This allegation is therefore upheld.  

13. Ms Johnson stated that it was her role within the organisation where she previously worked, to carry out assessments of clients so that they could be allocated to a therapist.  Ms Johnson stated that she carried out the Complainant's assessment and he was allocated to another therapist within the organisation.  Once those sessions ended, Ms Johnson stated that the Complainant approached her to request that she provide therapy to him.  Ms Johnson stated that she explained to the Complainant that there was a waiting list to see her at the agency but the Complainant could see her privately if he did not want to wait.  The Panel accepted Ms Johnson's evidence that as there was no policy against this within the agency, and that she took advice from her supervisor and colleague before deciding for herself to see the Complainant privately.  The Panel was not satisfied that there was evidence of a conflict of interest present and therefore did not find that Ms Johnson failed to avoid or prevent a conflict of interest arising in taking on the Complainant as a client when he had finished his sessions with his allocated counsellor.  This allegation is therefore not upheld. 

14.  In light of the above findings, the Panel found that Ms Johnson had breached paragraph 1 and the ethical principle Autonomy of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2002, and showed a lack of the personal moral qualities of Wisdom and Competence.  The Panel found that paragraphs 1, 2, 4, 18 and 55, the ethical principles of Fidelity, Beneficence or Non-Maleficence of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2002 had not been breached and nor had the personal moral quality of Empathy.  With regard to the 2010 Ethical Framework, the Panel found that Ms Johnson had breached paragraphs 1, 3, 4, and 46 of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010 and the ethical principles of Being Trustworthy, Autonomy and Non-Maleficence and showed a lack of the personal moral qualities of Wisdom and Competence.  The Panel was not satisfied that paragraphs 2, 17, 41, 42, 43 and 63 had been breached nor had the ethical principle of Beneficence and the personal moral quality of Empathy. 

Decision 

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice on the basis of incompetence and the
provision of inadequate professional services, in that the service for which Ms Johnson was responsible fell below the standards which would reasonably be expected of a practitioner exercising reasonable care and skill.  

Mitigation 

Ms Johnson stated that having reflected on her practice, she would now not agree to meet a client at their home. 

Sanction 

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.  

Within one month from the date of imposition of this sanction, which will run from the expiration of the Appeal deadline, Ms Johnson is required to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint. 

Further, Ms Johnson is required to provide a written report within three months from the date of the imposition of this sanction, which will run from the expiration of the Appeal deadline, which evidences her reflections on the following areas: 

  • How she would manage attachment and dependency in a therapeutic relationship, using a Person Centred approach and how she would change her practise to reflect this.
  • The importance of contracting in the context of a therapeutic relationship in setting out the rights and responsibilities of the client and practitioner, the matters to be included in the contract and how she would ensure that the client understood what the contract involved.
  • The importance of setting and maintaining of boundaries in a therapeutic setting and how Ms Johnson would ensure that this is done.
  • The impact on a client of entering into a personal relationship with that client and the possible consequences that this may have on the client/counsellor  relationship.
  • The thought process that should be adopted when considering the appropriateness of entering into a personal relationship with a client and what support systems that she would utilise to determine whether it is appropriate to do so. 

These written submissions must be sent to the Interim Registrar by the given deadlines and will be independently considered by a Sanction Panel. 

(Where ellipses [. . . ] are displayed, they indicate an omission of text).

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May 2015: Christine Usher, Reference No: 573333, Bishop's Stortford CM23 

The complaint against the above individual member/registrant was taken to Adjudication in line with the Professional Conduct Procedure. 

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy. 

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that in September 2011, the complainant saw Ms Usher for family therapy, having found her leaflet at a doctor's surgery, and having been recommended to look for family therapy by a CBT therapist.  The reason for needing therapy was that the complainant was feeling sad, in part due to being unable to breast-feed her baby, and was also experiencing  problems in her relationship. 

It was agreed that sessions should take place at 2pm on Saturdays.  The complainant states that whilst this suited her partner, she found it difficult to find childcare.  The complainant alleged that this issue was discussed in therapy but that Ms Usher did not appear to consider this a problem.  The complainant therefore attended only three sessions, the last one on her own.  During therapy, Ms Usher allegedly assured the complainant that she was not depressed, but the complainant stated that this made her more confused and ashamed about her feelings and she felt unable to communicate, and carried on hoping to feel differently. 

The complainant stated that her partner continued to see Ms Usher on a Saturday.  The complainant alleged that during his therapy, her partner changed from loving the complainant to distrusting and hating her.  The complainant became increasingly overwhelmed, lonely and resentful as she needed her partner's help and support and this was made worse by his being out of the house on Saturdays.  On one occasion the complainant stated that she insisted that her partner take the baby to therapy with him, so that the complainant could take her older child to a party. When she picked up Mr P later, from therapy, he refused to get in the car with her. 

In February 2012, the complainant decided to make changes to her life, in particular, giving up smoking.  As she had allegedly been told by both Ms Usher and her mother-in-law that she was not depressed, she was put on Chamonix. (Ms Usher had allegedly told the complainant that the complainant felt threatened by her mother in law).  The complainant stated that she became depressed and suicidal and the medication was changed. Around this time, the complainant's partner allegedly began to insult and humiliate her, and also to video-record her.

Ultimately, in March 2012, the couple split up, allegedly in part because Ms Usher encouraged the complainant's partner to decide whether or not to leave the family home.  The separation was very acrimonious and there was a court case.  The complainant was aware that her partner had had therapy before and was anxious that he may be susceptible to the influence of his therapist.  She therefore, rang Ms Usher to ask what kind of therapy her partner was having, but Ms Usher allegedly told her to, "ask him yourself" and put the phone down. 

On 25 May 2012, Ms Usher wrote an "expert witness" statement on behalf of the complainant's now ex-partner.  The statement referred to the sessions held with the complainant and discussed what she had said within the sessions, and Ms Usher's opinion of what was said by the complainant.   

The complainant stated that this report was in the end not used in court, however, alleged that the writing of this report was a breach of her confidentiality, and that all the information given about her was untrue.  Specifically, the complainant denied that she had suggested to Ms Usher that her partner had a mental illness. 

The complainant alleged that Ms Usher had not listened to anything that she said, that her written evidence is distorted, and that Ms Usher teamed up with her partner to bully the complainant. 

The Pre-Hearing Assessment Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular as follows:  

1. Ms Usher allegedly failed to provide the complainant with a good quality of care and competently delivered services which met her needs, in that she suggested that the complainant was not depressed, when she was not qualified to make such a comment.

2. Ms Usher allegedly failed to provide the complainant with a good quality of care and competently delivered services which met her needs in that she did not appreciate or take into consideration how the difficulties that the complainant had regarding child care would affect her attending the sessions.

3. Ms Usher allegedly failed to provide the complainant with a good quality of care and competently delivered services which met her needs in that she prepared a report which was to be disclosed to third parties, in which she referred to the complainant and information obtained from the therapy sessions without her knowledge or consent. 

4. Ms Usher allegedly failed to give careful consideration to the limitations of her training and experience and work within these limits in that she told the complainant that she was not suffering from post-natal depression when she was not qualified to make such an assessment and prepared a report in relation to the complainant and her partner in which she gave opinions about the mental state of the complainant's partner which she was not qualified to provide. 

5. Ms Usher allegedly failed to give careful consideration to the limitations of her training and experience and work within these limits in that she prepared a report in relation to the complainant and her partner in which she made statements and gave opinions which she was not qualified to make. 

6. Ms Usher allegedly failed to clarify and agree the rights and responsibilities of her as a practitioner and the complainant as a client in that she did not make it clear to the complainant that she would be preparing a report relating to her and submitting it to third parties or that she would be making assessments in relation to whether or not the complainant was depressed. 

7. Ms Usher allegedly failed to ensure that the complainant was adequately informed about the nature of the services being offered to her and obtain adequately informed consent from the complainant in that she did not inform the complainant that she would be preparing a report in relation to matters which she and her partner had discussed in therapy and disclosing it to third parties and did not seek the complainant's consent to refer to her or what she had discussed in therapy within the report.  

8. Ms Usher allegedly failed to pay careful attention to client consent and dignity in that she prepared a report which referred to the complainant which could be used in court, without seeking the complainant's consent. 

9. Ms Usher allegedly failed to respect the complainant's privacy and confidentiality in that she referred to matters, which the complainant had disclosed to her in therapy, in a report which was to be submitted to third parties, without seeking the complainant's consent.  

10.  Ms Usher allegedly failed to ensure that she was accountable to the complainant for the management of confidentiality in that she disclosed information in a report relating to the complainant without her consent. 

11.  Ms Usher allegedly failed to ensure that she clarify the terms on which her services were being offered in that she did not make it clear to the complainant the limitations of confidentiality or that she would be submitting a report which referred to the complainant or matters she had disclosed in therapy. 

12.  Ms Usher allegedly failed to take particular care over the integrity of presenting her qualifications and professional standing in that she gave opinions in relation to the mental state of the complainant and her partner, within therapy, and within her report, which she was not qualified to make.

13.  Ms Usher allegedly failed to foresee or avoid the conflict of interest which could arise in agreeing to see the complainant's partner as an individual when she had previously seen both the complainant and her partner as a couple. 

14.  Ms Usher's alleged behaviour, as experienced by the complainant and identified in the paragraphs above, suggests a contravention in particular of paragraphs 1, 2, 3, 11, 12, 20, 24, 59, 61 and 63 and of the ethical principles of Being Trustworthy, Autonomy, Beneficence, Non-maleficence and Justice of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Empathy, Integrity, Respect, Competence, Wisdom, Fairness and Humility to which counsellors are strongly encouraged to aspire. 

Findings  

On balance, having fully considered the above, the Panel made the following findings: 

1. There was a sharp conflict in the oral evidence presented by both parties.  The Complainant in her evidence stated that she told Ms Usher that she had been assessed and diagnosed as suffering from Post Natal Depression (PND), but that Ms Usher had dismissed this diagnosis and stated that the Complainant did not have PND.  Ms Usher denied this and stated that she would never be dismissive of a diagnosis of a mental health illness and would work with whatever issues the client presented, including depression.  Ms Usher stated that she was not qualified to make a medical diagnosis.  The Panel noted that there were communication issues between the Complainant and Ms Usher in view of the language barrier and agreed that it was likely that this led to misunderstandings between the parties.  In the absence of any corroborating evidence, the Panel accepted the evidence of Ms Usher and did not find that Ms Usher failed to provide a good quality of care and competently delivered services in suggesting that the Complainant was not depressed when she was not qualified to do so.  This allegation is therefore not upheld.

2. The Complainant in her evidence accepted that she and her former partner had agreed the time that the session would take place.  Whilst both parties accepted that the Complainant described the difficulties that she had with child care, the Complainant accepted in her evidence that she did not make a request to Ms Usher to change the timing of the session.  On questioning both parties, there was no evidence of any other option for an appointment time other than a Saturday afternoon.  The Complainant stated that her former partner worked Monday to Friday and Ms Usher stated that she did not offer evening appointments and had already been flexible in agreeing to see the Complainant and her former partner on a Saturday afternoon.  Further, the Complainant stated that she had hoped that she would be able to make child care arrangements so that she could attend the session on a Saturday afternoon, but she had been unable to do so.  The Panel therefore did not find that Ms Usher failed to provide a good quality of care and competently delivered services in not taking into account how the difficulties that the Complainant had in arranging child care would affect her attending the sessions.  This allegation is therefore not upheld.

3. Ms Usher accepted in both her written and oral evidence that she did not have the Complainant's consent to refer to her within the report she submitted on behalf of the Complainant's former partner.  The Panel therefore found that Ms Usher failed to provide the Complainant with a good quality of care and competently delivered service which met her needs in preparing a report that she disclosed to third parties, which referred to the Complainant and information obtained during her therapy sessions with the Complainant, without her knowledge or consent.  This allegation is therefore upheld.

4. The Panel accepted Ms Usher's evidence that she did not tell the Complainant that she was not suffering from post-natal depression, as referred to in allegation 1.  The Panel therefore did not find that Ms Usher failed to give careful consideration to the limitations of her training and experience and work within these limits in relation to this part of the allegation.  The first part of this allegation is therefore not upheld. 

With regard to the second part of the allegation, Ms Usher accepted that whilst she did have experience of working within the mental health arena, she did not have any medical qualifications which would enable her to provide any diagnoses.  In preparing a report in which Ms Usher gave opinions regarding the mental state of the Complainant's former partner which she was not qualified to provide, the Panel found that Ms Usher failed to give careful consideration to the limitations of her training and work within these limits.  This part of the allegation is therefore upheld. 

For the reasons stated above, this allegation is upheld in part.

5. Ms Usher accepted that she prepared a report in relation to the Complainant and her former partner in which she made statements and gave opinions which she was not qualified to make.  The Panel therefore found that Ms Usher failed to give careful consideration to the limitations of her training and experience and work within these limits.  This allegation is therefore upheld.

6. The Complainant in her evidence stated that she was unaware of the existence of the report that Ms Usher had prepared until her solicitor informed her.  Ms Usher accepted that did not make the Complainant aware that she would be preparing a report in relation to her and submitting it to third parties.  In relation to this part of the allegation, the Panel found that Ms Usher failed to clarify and agree the rights and responsibilities of her as a practitioner and the Complainant as a client.  This part of the allegation is therefore upheld. 

The Panel accepted that Ms Usher did not make any assessments in relation to whether or not the Complainant was depressed and therefore could not fail to clarify and agree the rights and responsibilities with the Complainant in this regard.  This part of the allegation is therefore not upheld. 

For the reasons stated above, this allegation is upheld in part.

7. Ms Usher in her evidence stated that whilst she sought consent from the Complainant's former partner to prepare the report, she did not seek consent from the Complainant.  Further, the Complainant stated that she was unaware of the existence of the report until her solicitors brought it to her attention.  The Panel therefore found that Ms Usher failed to ensure that the Complainant was adequately informed about the nature of the services being offered to her and obtain adequately informed consent from the Complainant to prepare a report detailing what was discussed in therapy and disclose it to third parties.  This allegation is therefore upheld.

8. Ms Usher accepted that she prepared a report in which she referred to the Complainant and submitted it to the solicitors of the Complainant's former partner for use in court proceedings, without the Complainant's consent.  The Panel therefore found that Ms  Usher failed to pay careful attention to client consent and dignity in this regard.  This allegation is therefore upheld.

9. Ms Usher accepted that within the report she prepared for the Complainant's former partner, she referred to matters that the Complainant had discussed with her in the session which she attended alone and did not seek the Complainant's consent to do so.  The Panel therefore found that Ms Usher failed to respect the Complainant's privacy and dignity in this regard.  This allegation is therefore upheld.

10. The Panel found that in preparing a report, which referred to the contents of the Complainant's session without her consent, Ms Usher failed to ensure that she was accountable to the Complainant for the management of confidentiality.  This allegation is therefore upheld.

11. Both parties accepted in evidence that the issue of confidentiality was discussed during the initial assessment session as part of the verbal contract, but the Complainant denied that she was informed of the limitations of confidentiality and the circumstances in which this could be breached.  Further, Ms Usher accepted in her evidence that given the language barrier, she should have revisited the matters discussed in the verbal contract in subsequent sessions to ensure that the Complainant understood.  Ms Usher accepted that she did not make the Complainant aware that she would be submitting a report which referred to the Complainant and the matters she discussed in therapy.  The Panel therefore found that Ms Usher failed to clarify the terms on which her services were being offered in not making it clear the limitations of confidentiality.  This allegation is therefore upheld.  

12. Ms Usher accepted in evidence that she did not have any medical qualifications which would enable her to offer any diagnoses and further accepted that this was the first time that she had prepared a report in this manner.  The Panel noted the expert's declaration section of the report in which Ms Usher claimed to be an expert, when she was not.  Ms Usher stated in evidence that the report was a template she used to insert the content of her report.  Whilst the Panel accepted that Ms Usher did not offer opinions in relation to the mental state of the Complainant, the Panel found that in preparing a report in which Ms Usher gave opinions relating to the mental health of the Complainant's former partner which was to be submitted for use in court proceedings, Ms Usher failed to take particular care over the integrity of presenting her qualifications and professional standing.  This allegation is therefore upheld in part.

13. Ms Usher stated in her oral and written evidence that during the time that she was counselling the Complainant and her former partner, there were issues in her personal life which were parallel to the issues the Complainant and her former partner were going through.  Ms Usher stated   that on reflection she felt protective of the Complainant's former partner and his plight and saw her role as his protector and experienced a level of transference.  Ms Usher stated that this served to cloud her judgment and in hindsight she should have taken some time off work to deal with her personal issues.  Ms Usher accepted that it was a conflict of interest to agree to see the Complainant's former partner individually when she had been  counselling him and the Complainant as a couple.  The Panel therefore found that Ms Usher failed to foresee or avoid the conflict of interest which could arise, and as such this allegation is upheld.

14. In light of the above findings the Panel was satisfied that there was a contravention of paragraphs 1, 2, 3, 11, 12, 20, 24, 59, 61 and 63 and the ethical principles of Being Trustworthy, Autonomy, Beneficence and Non-maleficence and Justice of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013).  The Panel also found that Ms Usher showed a lack of the personal moral qualities of Integrity, Respect, Competence, Fairness, Humility and Wisdom to which all counsellors are strongly encouraged to aspire. 

The Panel was not satisfied that Ms Usher showed a lack of the personal moral quality of Empathy. 

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice in that the service which Ms Usher provided fell below the standard which would reasonably be expected of a practitioner exercising reasonable skill and care, in that she was incompetent and reckless.   

Mitigation 

Ms Usher made a full and frank admission and acknowledged her failings.  Ms Usher states that she now ensures that she provides her clients with a written contract as opposed to a verbal contract and has changed her supervisor, which has given her the opportunity to reflect on the transference that occurred in this case.  Further, Ms Usher stated that it was now her practice never to see one half of a couple as an individual.

Sanction 

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.  

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Ms Usher is required to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint. 

In no less than six months and no more than 12 months, Ms Usher is required to undertake training on working with couples from different cultural backgrounds of one day's duration and must provide documentary evidence of her attendance on the course within the same time frame. 

In addition, at the same time as submitting evidence of her attendance on the above course, Ms Usher is required to provide a written report reflecting on what she learned on the training course and how this has influenced her practice.  Further Ms Usher is required to demonstrate how she uses supervision and has changed or made improvements to her practise in respect of the following areas: 

  • Working with clients cross culturally where there are language barriers;
  • Maintaining boundaries within the therapeutic relationship; 
  • Monitoring and maintaining her self-care; 
  • Foreseeing and avoiding conflicts of interests; 
  • Managing confidentiality within a therapeutic setting.  

The above report must be countersigned by Ms Usher's supervisor, who must confirm that the above matters have been discussed in supervision. 

These written submissions must be sent to the Interim Registrar by the given deadlines and will be independently considered by a Sanction Panel.

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May 2015: Valerie Collins, Reference No: 574652, Derbyshire DE56


The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant met with Ms Collins for an individual counselling session in August 2013, which was arranged prior to a joint counselling session with Ms Collins together with his ex-wife, from whom he was separated.  The joint session took place on 9 September 2013.

The complainant stated that his ex-wife had been seeing Ms Collins for individual counselling, and Ms Collins had allegedly offered to see the two together as an alternative to them attending Relate.  Since his then wife had already had sessions for individual counselling with Ms Collins, the Complainant alleged that Ms Collins was already biased in his ex-wife's favour and could not be neutral. He alleged that Ms Collins and his ex-wife demonstrated a friendliness that excluded him.  He alleged that he had to be insistent in putting across what he wished to say and that Ms Collins gave preference to his wife's agenda and that she and his ex-wife at times had verbal exchanges when he was talking.  He alleged that Ms Collins stated that she saw no point in him going over unresolved issues even though they were still relevant to him.  He alleged that she blamed him for not moving on.  When he became upset he alleged that Ms Collins said he was being aggressive, and made a connection to him at work, even though she allegedly knew nothing of that aspect of his life.  The Complainant  alleged that he tried to leave the session early and that he was bullied into staying.  He alleged that he twice intimated that he felt suicidal at the end of the session, and that Ms Collins made no attempt to respond to this, and did not follow up after the session to check how he was, yet allegedly suggested to his ex-wife that she should keep in touch with her.  The Complainant alleged that he experienced the session as abusive and that it exposed him to psychological harm.  The Complainant alleged that Ms Collins knew from his one-to-one session with her that he was psychologically vulnerable.  He alleged that he sent a text to Ms Collins early on the day following the joint session, and that she did not respond to it, and that she did not respond to him until he lodged his complaint with BACP, which she sent to his workplace email.

The Pre-Hearing Assessment Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular as follows:

1. Ms Collins allegedly failed to provide the Complainant with a good quality of care in that she offered to provide joint counselling to the Complainant and his ex-wife, in place of Relate, when she had already provided individual counselling to the Complainant's ex-wife.

2. Ms Collins allegedly failed to provide the Complainant with a good quality of care in that she failed to ensure that the joint session was equal and balanced given that she already had a pre-existing counselling relationship with the Complainant's ex-wife.

3. Ms Collins allegedly failed to ensure that she was attentive to the quality of listening and respect offered to the Complainant in that, during the joint session, she did not allow the Complainant to fully discuss certain issues that he wished to raise, talked over him and  engaged in discussions with the Complainant's ex-wife whilst he was talking.

4. Ms Collins allegedly failed to ensure that she obtained adequately informed consent from the Complainant and respect his right to choose whether to continue or withdraw, in that she placed pressure on the Complainant to continue with the joint session when he stated that he wanted to leave. 

5. Ms Collins allegedly failed to be alert to the possibility of conflicting responsibilities concerning the Complainant  and his ex-wife and provide the Complainant  with a good quality of care, in that when he expressed suicidal ideations at the conclusion of the session, Ms Collins failed to ensure that the Complainant  was in a sufficiently safe state to leave the session, failed to make a referral to his GP or other professional and failed to follow up with the Complainant  following the session to check whether he still posed a risk of harm to himself. 

6. Ms Collins allegedly failed to respect the Complainant's privacy and confidentiality in that she sent an email to the Complainant at what she believed was his work address, when it was in fact not, when the Complainant had only provided his personal email address to Ms Collins for her to contact him.

7. Ms Collins allegedly failed to respond appropriately to the Complainant's complaint when she received it, in that she did not sufficiently address the issues raised in his email.

8. Ms Collins allegedly failed to endeavour to remedy the harm that she had caused the Complainant in not issuing an apology.

9. Ms Collins allegedly failed to foresee and avoid the conflict of interest which could arise from her providing joint counselling to the Complainant and his ex-wife and providing individual sessions to the Complainant's ex-wife. 

10.  Ms Collins alleged behaviour, as experienced by the Complainant  and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs  1, 11, 12, 14, 20, 41, 42 and 63 and the ethical principles of Being Trustworthy, Autonomy, Beneficence, Non Maleficence and justice of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Empathy, Respect, Competence, Fairness and Wisdom to which counsellors are strongly encouraged to aspire.

The Complainant was not in attendance and confirmed in an email sent on 7 February 2015 that he would not be attending this hearing and therefore, the matter was referred under paragraph 4.9 of the Professional Conduct Procedure, which states:

Where a Complainant or Member Complained Against fails or refuses to attend a Professional Conduct Hearing, the Registrar has the power to decide to either:

a) Proceed with the Hearing in the absence of one or both of the parties; or

b) Adjourn the Hearing to a date not less than 28 days in advance; or

c) Terminate the proceedings; or

d) Refer the matter for consideration under Article 12.6 of the Memorandum & Articles of Association.

The options were carefully considered, and in light of the circumstances, a decision was made to proceed with the hearing in the absence of the Complainant. 

The Panel would have liked the opportunity to question the Complainant in relation to his complaint and the allegations but in the absence of the Complainant, it was able to question the Member Complained Against and examine the written evidence. 

Findings

On balance, having fully considered the above, the Panel made the following findings: 

1. Ms Collins in her evidence denied that she had offered joint counselling in place of Relate to the Complainant and his ex-wife.  Ms Collins stated that it was the Complainant's ex-wife who had made the suggestion of joint counselling and Ms Collins agreed to provide this if the  Complainant was also in agreement.  Ms Collins stated that the Complainant subsequently contacted her and they arranged an individual session, followed by a joint session.  Ms Collins accepted that she had seen the Complainant's ex-wife for three individual sessions prior to seeing the Complainant and his ex-wife for a single joint session.  Ms Collins in her evidence stated that the Complainant's ex-wife had told her that she did not want to go to Relate as she had no wish to reconcile with the Complainant.  The Panel accepted that Ms Collins did not offer to provide joint counselling in place of Relate as the Complainant's ex-wife had never agreed to attend Relate.  The Panel therefore  found that Ms Collins did not fail to provide the Complainant with a good quality of care in offering to provide joint counselling to the Complainant and his ex-wife in place of Relate, when she had already provided individual counselling to the Complainant's ex-wife.  This allegation is not upheld.

2. Ms Collins in her evidence stated that she had discussed with the Complainant and his ex-wife in their individual sessions what their agenda for the joint session was and restated this agenda at the commencement of the joint session.  Ms Collins in her oral evidence said   that she had also set the boundaries and made it clear that one person was to talk while the other listened and they agreed who would talk first.  Ms Collins stated that she did her utmost to ensure that the session was equal and balanced but neither the Complainant nor his ex-wife followed the agenda which they had agreed.  As the Complainant was not in attendance to be questioned in more detail regarding this allegation, on the balance of probabilities, the Panel accepted the evidence of Ms Collins and did not find that she failed to provide a good quality of care in failing to ensure that the joint session was equal and balanced given her pre-existing relationship with the Complainant's ex-wife.  This allegation is therefore not upheld.

3. Ms Collins stated that she discussed in advance with the Complainant and his ex-wife in their individual sessions, what their agenda for the joint session was and reiterated this again at the commencement of the joint session.  Ms Collins stated the Complainant was at times angry and on those occasions she intervened to calm him down.  The Panel agreed that it was reasonable to have intervened in these circumstances. Ms Collins also accepted that she encouraged the Complainant to move on when his ex-wife could not or would not answer his questions.  The Panel agreed that in the circumstances, it was reasonable to have made this suggestion.  Ms Collins stated that the Complainant and his ex-wife each had an opportunity to speak during the session and the Complainant spoke for the larger part of the session.  In the absence of any oral evidence from the Complainant, the Panel found that there was insufficient evidence to demonstrate that Ms Collins was not attentive to the quality of listening and respect owed to the Complainant and talked over the Complainant and engaged in discussions with the Complainant's ex-wife whilst he was talking.  Further, the Panel accepted Ms Collins evidence that on the occasions when she did intervene, it was reasonable for her to have done so for the reasons stated above.  This allegation is therefore not upheld.  

4. Whilst Ms Collins accepted that she suggested that the Complainant stay when he said that he wanted to leave the joint session, she denied that she pressured him to stay.  Ms Collins in her evidence stated that when the Complainant indicated that he wanted to leave, he was upset and angry and she was concerned that he was not in a sufficiently safe state to leave.  Ms Collins said that whilst she could not recall exactly what she had said to the Complainant, she did not force him to stay, but merely suggested it, and the Complainant then chose to stay.  In the absence of being able to question the Complainant further in relation to this allegation, the Panel accepted Ms Collins evidence and was not satisfied that she failed to ensure that she obtained adequately informed consent and respect the Complainant's right to choose whether to continue or withdraw in pressuring him to continue with the joint session.  This allegation is therefore not upheld.

5. Ms Collins in her evidence said that she had carried out an assessment of the Complainant in his individual session where he stated that he had had suicidal thoughts for the past 6 months but had no intention of acting on these thoughts.  During this session Ms Collins said that  the Complainant also told her that he was under the care of his GP.  Ms Collins said that by the end of the joint session the Complainant seemed calmer than he had been and when she asked him how he was, he stated that he was about the same as he was the last time.  Ms Collins said that she took this to mean that he still had no plans to act on the thoughts that he had been having for the past 6 months and did not take this to mean that he was having suicidal ideations.  Ms Collins stated that she saw no evidence that the Complainant was at risk of harming himself and there was nothing to suggest that the thoughts that he was experiencing were any more prevalent than they were when she spoke to him during his individual session.  Ms Collins stated said if there had been evidence of an imminent risk she would have  contacted the Complainant's GP with his consent or suggested that he do so.  The Panel therefore did not find that Ms Collins failed to be alert to the possibility of conflicting responsibilities and failed to provide the Complainant with a good quality of care in failing to ensure that he was in a sufficiently safe state to leave the session and failing to make a referral to the Complainant's GP or other professional and failed to follow up with him after the session.  This allegation is therefore not upheld. 

6. Ms Collins said that during the individual session she took the Complainant's contact details which included his temporary address and telephone number.  Ms Collins stated that the Complainant emailed her from his work email address in January.  Ms Collins said that she initially emailed the Complainant on his personal email address but when that bounced back, she emailed him using what she thought was the work email address he had provided her.  Ms Collins stated that the Complainant did not state that he did not want her to respond to his work email address, and the Panel found that given that the Complainant's email address was the email he had sent to Ms Collins, it was reasonable for her to use it.  The Panel therefore did not find that Ms Collins failed to respect the Complainant's privacy and confidentiality in emailing the Complainant in what she believed to be his work email address.  This allegation is therefore not upheld.

7. Ms Collins in her evidence stated that she was unclear about how she should respond to the Complainant's complaint and therefore sought guidance from BACP, her insurers and her supervisor where she received conflicting advice.  Ms Collins stated that the Complainant  in his email to her said that he did not want her to respond to him and she was also aware from his email that he had already submitted a   complaint to BACP.  As such Ms Collins stated that she responded to say that it was not appropriate for her to enter into a discussion with the Complainant given that he had initiated a complaint to the BACP.  Given the circumstances, the Panel found that Ms Collins responded  in the most appropriate way that she could to the complaint.  The Panel therefore did not find that Ms Collins failed to respond appropriately to the complaint in failing to sufficiently address the issues raised, for the reasons stated above.  This allegation is therefore not upheld.

8. There was written evidence that Ms Collins did apologise to the Complainant for the experience that he had and suggested that as he had initiated a complaint to BACP that this would be a better forum within which to resolve his issues.  The Panel therefore did not find that Ms   Collins failed to endeavour to remedy the harm that she caused to the  Complainant in not issuing an apology. This allegation is therefore not upheld.

9. On questioning, Ms Collins stated that she did not believe that there was a conflict of interest in her seeing the Complainant's ex-wife for three individual sessions and seeing the Complainant and his ex-wife for a joint session.  Ms Collins stated that it was her intention to provide a one off joint session to enable the Complainant and his ex-wife to discuss the matters that they wished to go through.  The Panel found that Ms Collins already had a pre-existing relationship with the Complainant's ex-wife as she had provided her with three individual sessions of therapy, and whilst the focus of these sessions was not about her relationship with the Complainant, the Complainant was discussed during these sessions.  As such the Panel found that the Ms Collins already knew information about the Complainant through his ex-wife.  Further, Ms Collins knew more about the Complainant's ex-wife than she did about the Complainant by virtue of the individual sessions she had with the Complainant's ex-wife. The Panel found that Ms Collins failed to foresee that this could create a conflict of interest and did not discuss with her supervisor the wisdom of providing a one off joint session, particularly as she was aware the Complainant's ex-wife did not wish to reconcile.  The Panel found that it was unlikely that a one off session would have given the Complainant and his ex-wife sufficient time to discuss all the issues which they wanted to discuss, given that Ms Collins accepted that each of them wanted to focus on different areas.  Although the Panel accepted Ms Collins' evidence that she did not see the Complainant's ex-wife again, it did hear evidence that the Complainant's ex-wife did contact Ms Collins some time after the joint session had ended.  The Panel therefore found that Ms Collins failed to foresee and avoid the conflict of interest which could arise from her providing joint counselling to the Complainant and his ex-wife and also providing individual counselling to his ex-wife.  This allegation is therefore upheld.

10.  In light of the above findings, the Panel was satisfied that Ms Collins' behaviour suggests a contravention in particular of paragraph 63 of
the Ethical Framework for Good Practice in Counselling and Psychotherapy 2013 and the ethical principles of Autonomy and Beneficence, and also showed a lack of the personal moral qualities of competence and fairness. 

The Panel was not satisfied that paragraphs 1, 11, 12, 14, 20, 41 and 42 of the Ethical Framework for Good Practice in Counselling and
Psychotherapy 2013, nor the ethical principles of Being Trustworthy, Non-Maleficence and Justice had been breached nor did the Panel find a lack of the personal moral qualities of Empathy, Respect and Fairness. 

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice on the grounds of incompetence and the provision of inadequate professional services in that the service for which Ms Collins provided fell below the standard that would reasonably be expected of a practitioner exercising reasonable care and skill.

Mitigation

Ms Collins said in her oral evidence that she had taken on additional supervision as a result of this complaint, had engaged in therapy, suspended couples work and attended CPD courses.

Sanction

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.

Within one month from the date of imposition of this sanction, which will run from the expiration of the Appeal deadline, Ms Collins is required to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint.

In addition, Ms Collins is required to provide a written report demonstrating her in-depth learning and understanding about how a conflict of interest could arise when working with couples, how she would define a conflict of interest, identify a conflict of interest, develop strategies for avoiding where possible, and otherwise manage and resolve that conflict, providing examples where possible from her practice.  This report should be countersigned by Ms Collins' current supervisor who should confirm that the contents of the report have been discussed in supervision.  This report is required to be submitted in no less than two months and no more than six months from the date of imposition of this sanction.

These written submissions must be sent to the Interim Registrar by the given deadlines and will be independently considered by a Sanction Panel.

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May 2015: Laurel Morgan, Reference, No: 708437, Denbighshire LL18  

The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure. 

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy. 

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant was in receipt of counselling from the Member Complained Against, Laurel Morgan, from January 2011 until December 2012.  In March 2013, the Complainant submitted a formal complaint to Service A at [ . . . ] Council concerning the quality of the service she had received, commenting that: "While I am grateful to Laurel and believe that she had the best of intentions I feel I have been let down by the service and had I been fully consented and informed of what the process entailed I most definitely would not have gone ahead with the process."

The Council conducted an investigation, which partially upheld a number of the Complainant's allegations while dismissing others.  Those that were partially upheld were largely on the basis of a failure to record actions taken on the council's electronic "Paris" record keeping system.  A final Stage 3 Independent Complaints Panel partially upheld three allegations against the Council whilst commenting that: "The Panel does not find Laurel Morgan at fault, as the general view was that she was attempting to help the Complainant in whatever way she could, but rather this was a system fault on behalf of the LA (Local Authority) in supervising and monitoring the activities of its staff...."

On 30 December 2013, the Complainant submitted a formal complaint to BACP against the MCA commenting that: "I believe that Laurel's intent was to help me, she was extremely kind and patient and some of her interventions have helped me a lot, she taught me how to regulate my feelings and I now understand myself better but unfortunately I believe the price I have had to pay for this has been too high and there was no need to delve into my past." 

The Complainant's allegations may be summarised as follows: 

- The Complainant was never asked to consent to this therapy and did not feel confident enough to question Ms Morgan.

- Throughout the therapy, Ms Morgan maintained only very weak boundaries, often, for example, talking about Ms Morgan's issues with her own mother; praising the Complainant for not going to see her own mother and having little contact with her family; and making disparaging comments about the Complainant's husband.

- Ms Morgan was an inexperienced student who was not qualified to deliver counselling services to the Complainant and worked well beyond the limits of her competence. 

-  Ms Morgan provided a poor quality of care to the Complainant as evidenced by: 

-  The work having no time scale  

-  Making the Complainant feel disempowered 

-  Creating an imbalance of power and fostering dependence on Ms Morgan

-  Creating confusion as to what was going on in the counselling sessions 

-  Making the Complainant feel constantly scared that Ms Morgan was going to terminate counselling

-  Failing to explain what the counselling entailed  

-  Failing to review the progress being made. 

- Ms Morgan failed to provide an appropriate ending to the counselling & did not assess the appropriateness of the ending, given she was aware that the Complainant was suicidal. 

In accepting this complaint, the Pre-Hearing Assessment Panel was concerned with the following areas, and in particular these are:

1. Ms Morgan allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met her needs, in that she fostered the Complainant's dependence on her, made the Complainant feel disempowered within the relationship and created confusion for the Complainant as to what was going on within the counselling sessions.

2. Ms Morgan allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met her needs, in that she failed to provide a timescale for the therapy and failed to provide an appropriate ending to the counselling relationship.

3. Ms Morgan allegedly failed to give careful consideration to the limitations of her training and experience, in that she enabled the Complainant, who was a vulnerable client, to foster a dependence on her by increasing the frequency of the session and did not  appropriately manage the  Complainant's suicide risk.  Further Ms Morgan failed to set appropriate boundaries within the counselling relationship or provide a framework for the therapy.

4. Ms Morgan allegedly failed to clarify and agree the rights and responsibilities of both her as a practitioner and the Complainant as a client at appropriate points in their relationship, in that an agreement setting out the limits on confidentiality was not introduced and agreed until near the end of the therapy in June 2012.

5. Ms Morgan allegedly failed to keep appropriate records of her work with the Complainant.

6. Ms Morgan allegedly failed to provide the Complainant with competently delivered services which were periodically reviewed, in that she failed to review the appropriateness of increasing the frequency of the counselling sessions, failed to review the progress that was being made in therapy, failed to ascertain whether the Complainant consented to continuing with therapy and failed to clarify the rights and responsibilities.

7. Ms Morgan allegedly failed to pay careful attention to client consent and confidentiality in that she disclosed details relating to the Complainant to the Complainant's husband.

8. Ms Morgan allegedly failed to adequately inform the Complainant about the nature of the services she was offering at appropriate points during their counselling relationship.

9. Ms Morgan allegedly failed to ensure that her services were delivered on the basis of the Complainant's explicit consent in that Ms Morgan failed to check at appropriate points in the relationship whether the Complainant wished to continue with the therapy.

10. Ms Morgan allegedly failed to respect the Complainant's privacy and confidentiality in that she disclosed information concerning the Complainant to the Complainant's husband.

11. Ms Morgan allegedly failed to ensure that she received supervision/consultative support independently of any managerial relationships.

12. Ms Morgan allegedly failed to endeavour to remedy any harm she may have caused to the Complainant and prevent any further harm when it became apparent that things had gone wrong.

13. Ms Morgan's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 2, 3, 5, 6, 11, 12, 13, 20, 33 and 42 and the ethical principles of Being Trustworthy, Autonomy,  Beneficence and Non-Maleficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2010-2013), and showed a lack of the personal moral qualities of Empathy, Integrity, Respect, Humility, Competence and Wisdom to which counsellors are strongly encouraged to aspire. 

Findings 

On balance, having fully considered the above, the Panel made the following findings:  

1.  The Panel gave careful consideration as to whether Ms Morgan created confusion as to what was going on within the counselling sessions. 

The Panel noted that Ms Morgan was a student counsellor and that the Complainant was her first client.  The Panel also noted that Ms Morgan had opted to do her required placement hours within Service A, the service she worked for as a social worker. 

In her oral evidence Ms Morgan stated that prior to her first introduction to the Complainant, the Complainant's children's social worker discussed the referral to the Service A.  The Panel understood that when Ms Morgan initially attended the Complainant's home she attended with another social worker.  

The Complainant stated in her evidence that she needed strategies, not counselling, and thought Ms Morgan was going to help her with her children.  The Panel considered the written records from Social Services that indicated that the Complainant's social worker had noted that 'Ms X (the Complainant) feels strongly she does not need counselling....but would benefit from solutions to support her in her caring role'.  It was also noted in the referral to Service A, that the intended outcome was 'to provide strategies and tools to the family....'  In her oral evidence, the Complainant stated that she had had regular counselling from another agency in 2010 and that she did not want more counselling.  The Complainant also stated that Ms  Morgan explained that she would be unable to access the services of Service A unless she (the Complainant) had a social worker, and that Ms Morgan could make the referral as she was the Complainant's social worker.  The Complainant was adamant, both in her oral and written evidence, that Ms Morgan did not tell her that she was a counselling student.  

The Panel found that it was not made clear to the Complainant, at the outset, in what capacity Ms Morgan was attending.  It appears that subsequently a counselling relationship was embarked upon.  The Complainant stated in her oral evidence that the relationship with Ms Morgan was not like the previous counselling relationship, and that she was in too deep before she realised what was going on and that no-one had informed her, from the outset, that she was receiving counselling.  The confusion was furthered by the absence of a clear contract, which set out the nature of the relationship and role of Ms Morgan.  

The Panel noted from both the written and oral evidence, that throughout the relationship, Ms Morgan and the Complainant interacted with each other on a twice weekly basis, each session lasting between 1 and 2 hours.  The sessions took place predominantly at the Complainant's home.  Service A encouraged texting between client and worker between sessions and this enabled the Complainant to text Ms Morgan.  Whilst there were boundaries relating to the times the Complainant could use this contact, the Complainant stated she would use texting to contact Ms Morgan every day.  The Panel found that the combination of support offered, led the Complainant to become dependent on Ms Morgan.  

The Complainant stated that after a few months, Ms Morgan told her that she had a secured attachment to her (Ms Morgan).  In her oral evidence, Ms Morgan admitted that an attachment had developed.  Ms Morgan also acknowledged that she experienced difficulty in keeping sessions to one hour as she was mindful of the Complainant's stress at the end of sessions.  The Panel noted that Ms Morgan, as a student counsellor, did not consider herself to be inexperienced in counselling practice.  Ms Morgan stated that she was aware that an attachment was occurring and discussed this with her supervisor.  As a result, the length of sessions was reduced to an hour.  Ms Morgan also stated that whilst the text service provided by Service A was withdrawn for other Service A clients, it was continued for the Complainant, as she was resistant to change.  Ms Morgan stated that she resisted the 'rescuer role' and explored this objectively with the Complainant.

The Panel found that reducing the time of the sessions, leaving the Complainant in receipt of less support on one hand, but continuing the access to the text service on the other, furthered the dependency that had been created.  Whilst the Panel was satisfied that Ms Morgan eventually brought the issue of attachment to her supervisor, it was not satisfied that Ms Morgan had recognised the issue earlier and discussed it at an earlier stage, which may have alleviated or avoided the Complainant's feeling of disempowerment.   

The Panel therefore found that Ms Morgan had failed to provide the Complainant with a good quality of care and competently delivered service which met her needs and had fostered the Complainant's dependence on her, made the Complainant feel disempowered within the relationship and created confusion for the Complainant as to what was going on within the counselling sessions.  This allegation is therefore upheld.  

2.  The Panel considered the oral and written evidence provided by both parties.  It also noted the written documents provided, which demonstrated that Ms Morgan had discussed the timescale for therapy and in particular when it would come to an end.  The Panel noted that the Complainant's submitted material evidenced that she had chosen the date of the last counselling session, had given thought to it and had reflected on the ending of the therapy.  The Panel therefore found that Ms Morgan had provided a timescale for the therapy and did provide an appropriate ending to the counselling relationship, and further had done so, in conjunction with the Complainant.  Therefore this allegation is not upheld. 

3.   The Panel referred to allegation 1 above where it found that it was a combination of the place, the timing and frequency of sessions which led to the Complainant's dependency.  The Panel also considered the oral and written evidence provided by both parties where it was clarified that frequency of sessions was not increased, but had begun on a twice weekly basis, after the initial introduction meeting.  The Panel therefore found this part of the allegation was not substantiated.  With reference to managing the Complainant's suicide risk, the Panel  gave careful consideration to the written evidence, in particular the notes where Ms Morgan had discussed and agreed with the Complainant how this risk would be managed.  The Panel further noted that a 'Safety Plan' was put in place and agreed by both Ms Morgan and the Complainant. This allegation is therefore, not upheld. 

4.   Ms Morgan stated that Social Services have a corporate confidentiality policy which is explained verbally to all clients, which incorporates legal requirements in relation to confidentiality and processing of information.  Further Ms Morgan stated that the Complainant was explicit in her instruction that she did not want notes of the sessions recorded, as she was concerned about confidentiality as she was an employee of the [ . . . ].  To alleviate these concerns, an agreement was reached that only attendance and engagement would be recorded on the electronic recording system.  Ms  Morgan also stated that the document which was produced in June 2012 was to deal specifically with the Complainant's suicide risk and formed part of the 'Safety Plan' put in place, ensuring that the Complainant consented to her confidentiality being breached in circumstances where her safety was at risk.  The Panel noted the written evidence which supported Ms Morgan's oral submissions and was satisfied that Ms Morgan had clarified I issues surrounding confidentiality with the Complainant.  This allegation is not upheld.

5.   The Panel referred to allegation 4 above where it accepted Ms Morgan's written and oral evidence in relation to the Complainant's request not to have notes of sessions recorded.  This allegation is therefore not upheld. 

6.   The Panel referred to allegation 3 above in which it was found that frequency of sessions was not increased.  The Panel also noted the written evidence provided by both parties and the documents produced of supervision meetings undertaken by Ms Morgan.  The Panel was therefore satisfied that Ms Morgan had periodically reviewed the progress being made by the therapy, both with the Complainant and in supervision.  The  Panel also noted that at no time did the Complainant indicate that she did not want to continue therapy but rather, actively engaged in the sessions.  The Panel therefore did not uphold this allegation. 

7.   Ms Morgan stated that she had given due consideration to the Complainant's consent to breach confidentiality with respect to the suicide risk that she presented in June 2012.  Safety strategies were discussed with the Complainant.  Subsequently a disclosure document was introduced to allow disclosure of information to her husband, which was discussed and signed by the Complainant.  The Panel therefore found that Ms Morgan had paid respect to the Complainant's' privacy and confidentiality and therefore this allegation is not upheld. 

8.   The Panel noted the written documentation supplied and the evidence presented by Ms Morgan, that she did review the work she was undertaking at appropriate points.  Ms Morgan stated that the Complainant was very dynamic and engaged in reviewing what work would be done at relevant stages.  Ms Morgan also took regular supervision with respect to the work carried out with the Complainant.  The Panel noted that the Complainant herself kept reflective journals of the work undertaken within the sessions which demonstrated a collaborative relationship with regard to reviewing the therapy.  The Panel therefore did not uphold this allegation.  

9.   In her oral and written evidence Ms Morgan contended that at the initial meeting with the Complainant, a written contract of the relationship, a 'working agreement', would have been completed and signed by both herself and the Complainant.  However, Ms Morgan was unable to produce the contract as it has been lost.  The Complainant, in her oral evidence, stated that she could not remember signing a 'working agreement'. The Panel was presented with a conflict of evidence with regard to the issue of explicit consent at the outset of the relationship and therefore did not uphold this part of the allegation.  In respect of the second part of the allegation the Panel referred to its decision in 6 above, where it was noted that, at no time did the Complainant indicate that she did not want to continue therapy but rather, actively engaged in the sessions. The Panel therefore considered that the issue of consent to continuing with therapy had not arisen.  This allegation is therefore not upheld. 

10. The Panel noted that this allegation (10) was a duplication of allegation 7 above, inserted in error.  

11. Ms Morgan presented clear evidence that she had received supervision/consultative support independently of any managerial relationships.  The Panel noted that the supervision forms submitted in evidence, indicated what type of supervision she was receiving and the context of what was discussed.  The Panel noted that Ms Morgan received social work supervision and counselling supervision, in distinctly separate sessions.  Whilst her supervisor at the relevant time was also her line manager, a supervision contract was in place outlining her and her supervisor's responsibilities.  The Panel was satisfied that there was a distinct and independent relationship with regard to supervision and management and therefore did not uphold this allegation.  

12. The Panel accepted Ms Morgan's evidence that as an employee of the Local Authority, she was placed in a position whereby she was not able to respond to the Complainant's concerns, or attempt to remedy any harm she may have caused to the Complainant, once a complaint had been sent to Social Services and was being dealt with through the internal complaints process.  This was supported by evidence submitted in relation to the complaints process in place at the Local Authority concerned.  This allegation is therefore not upheld. 

13. Ms Morgan's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraph 1 of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2010-2013), and showed a lack of the personal moral quality of  Competence to which counsellors are strongly encouraged to aspire. 

Decision 

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice in that the service that Ms Morgan provided to the Complainant fell below the standards that would reasonably be expected of a practitioner exercising reasonable care and skill.  The Panel found that Ms Morgan's actions amounted to incompetence and the provision of inadequate professional services 

Mitigation 

The Panel noted that Ms Morgan was a social worker training to be a therapeutic counsellor and that the Complainant was her first counselling client.  The Panel further noted that since this complaint, Ms Morgan had reflected on her practice and has taken steps to continue her professional development.  Ms Morgan has also used supervision as a tool to reflect on her learning generally and specifically with regard to this case. 

Sanction 

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Ms Morgan is required to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint and what changes she has made to her personal clinical practices. 

These written submissions must be sent to the Registrar and Director of BACP Registers by the given deadlines, and will be independently considered by a Sanction Panel.

(Where ellipses [ . . . ] are displayed, they indicate an omission of text)

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May 2015: Raymond Stevens,  Reference No: 521492, Kent TN14

The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant was referred to Mr Stevens by his GP around January 2012.  The first sessions were in the GP surgery and they then moved to the Complainant's home.  The Complainant and Mr Stevens met every couple of weeks for approximately two years.

On 22 November 2013 the Complainant stated that he overheard a phone conversation between his mother and his sister-in-law in which his mother allegedly said that she had met with Mr Stevens and discussed the Complainant with him.

On 24 November 2013 the Complainant stated that he checked his mother's cell phone and discovered that there were 15 logged calls from Mr Steven's cell to his mother and 34 calls from his mother to Mr Stevens.

The Complainant allegedly challenged Mr Stevens saying that he knew that Mr Stevens had discussed him with his mother but Mr Stevens denied that he had done so.

On Monday 25 November the Complainant sent Mr Stevens several messages asking for a further explanation but Mr Stevens had refrained from replying.

The Pre-Hearing Assessment Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting a contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular as follows:

1. Mr Stevens allegedly failed to clarify and agree the rights and responsibilities of both himself as a practitioner and the Complainant as a client in that some of the sessions took place at the GP's surgery and then moved to the Complainant's house.  The Complainant was not made aware of the
nature of the services that were being provided to him at his house.

2. Mr Stevens allegedly failed to have respect for the Complainant's privacy and dignity in that Mr Stevens talked to the Complainant's mother about the Complainant, without his consent.

3. Mr Stevens allegedly did not ensure that the Complainant was adequately informed about the nature of the services being offered to him and that adequate consent was obtained from him in that Mr Stevens did not inform the Complainant of the nature of the services that were being provided to him at his home. 

4. Mr Stevens was allegedly not clear about his commitment to being available to the Complainant in that some of the sessions took place at the GP surgery and other sessions took place at the Complainant's home and the Complainant was unclear about the nature of the services being provided to him.

5. Mr Stevens allegedly failed to respect the Complainant's privacy and confidentiality in that Mr Stevens discussed the Complainant with his mother, without the consent of the Complainant.

6. Mr Stevens allegedly failed to ensure that he endeavoured to remedy the harm that he may have caused to the Complainant when he became aware that the Complainant had concerns regarding the service he provided.

7. Mr Stevens allegedly failed to notify the Complainant of the existence of the Professional Conduct Procedure when the Complainant notified him of his concerns.

8. Mr Stevens alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 3, 11, 12, 19, 20, 42 and 46 and the ethical principles of Being Trustworthy and Autonomy of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Wisdom and Sincerity to which counsellors are strongly encouraged to aspire.

Findings

On balance, having fully considered the above, the Panel made the following findings: 

1. Both parties agreed that the Complainant had at least three counselling sessions at the GP surgery, before the sessions moved to the Complainant's mother's house.  There was disagreement between the parties as to the nature of the services that were being provided to the  Complainant at his mother's house.  The Complainant believed that the sessions at his mother's house were a continuation of the counselling sessions he had received from Mr Stevens at the GP practice and Mr Stevens stated that he was providing friendly support to the Complainant, as he was aware that that the Complainant was isolated in this country.  There was further disagreement between the parties as to how the sessions at the Complainant's mother's house arose.  Mr Stevens stated that the Complainant had received his allotted sessions at the surgery but had failed to turn up for a session, so he went to the Complainant's house and offered to come and see him every few weeks so they could talk.  The Complainant stated that the suggestion to move the sessions to his home was made during the counselling sessions at the GP's surgery.  Mr Stevens accepted in his evidence that he did not explicitly tell the Complainant that he was not providing counselling services to him at his home.  The Panel found that it was the responsibility of Mr Stevens to be clear about the services that he was providing for the Complainant at home and given that there was disagreement as to what those services were, the service provided was unclear and the parties were at cross purposes.  As such, the Panel found that Mr Stevens failed to clarify and agree the rights and responsibilities of him as a practitioner and the Complainant as a client in failing to making it clear the purpose of the sessions at the Complainant' mother's home and in having some of the sessions take place at the GP surgery and then moving them to his house.  This allegation is therefore upheld.  

2. Mr Stevens denied that he had discussed the Complainant with the Complainant's mother.  The Complainant stated that he had overheard a telephone conversation between his mother and a member of his family and based on parts of the conversation he heard, he concluded that Mr Stevens had breached his confidentiality.  The Complainant was unable to say what Mr Stevens had said to breach his confidentiality.  The Panel therefore found that there was no evidence to suggest that Mr Stevens had failed to have respect for the  Complainant's privacy and dignity and discussed the Complainant with his mother without the Complainant's consent.  This allegation is therefore not upheld.

3. Based upon the evidence given by both parties, the Panel found that there was a lack of clarity as to the nature of services that Mr Stevens believed he was providing and what the Complainant believed he was receiving.  The Complainant stated that the services being provided to him at  home were an extension of the counselling sessions Mr Stevens provided at the GP's surgery and Mr Stevens stated that he was providing the Complainant with friendly support and helping him to find a job.  The Panel accepted the Complainant's evidence that the services being provided to him at his home were an extension of the counselling sessions and took note of the professional reference which Mr Stevens had provided for the Complainant wherein he referred to the fact that the Complainant was a patient and had been  referred to him for counselling and psychotherapy, signing the letter indicating that he was a member of BACP and providing his BACP membership number.  Mr Stevens accepted that he may have been "over-egging the cake" in providing such a letter.  The Panel found that, as the parties were at cross purposes as to the nature of the services being offered, the Complainant could not consent to the service which Mr Stevens stated that he was providing, which he stated was friendly support and helping the Complainant to find a job.  This allegation is therefore upheld.

4. The parties accepted that there were at least three sessions that took place at the GP's surgery and all of the remaining sessions took place at the Complainant's mother's house.  The parties agreed these sessions were held regularly over two years, apart from a period when the Complainant was abroad, and confirms Mr Stevens' commitment to him. This part of the allegation is therefore not upheld.  Although Mr Stevens was clear in his own mind that the meetings at the house were to support rather than to offer counselling, the Panel accepted that the Complainant believed he was being offered counselling.  Since the nature of the service offered to the Complainant was unclear, this part of the allegation is therefore upheld. 

For the reasons stated above, this allegation is upheld in part.

5. Mr Stevens denied that he had discussed the Complainant with the Complainant's mother.  The Complainant stated that he suspected that his confidentiality was breached based upon a telephone conversation he heard his mother having with a member of the family.  The Complainant was however unable to tell the Panel what Mr Stevens had said to breach his confidentiality.  The Panel found that there was insufficient evidence to demonstrate that Mr Stevens failed to respect the Complainant's privacy and confidentiality in discussing the Complainant with his mother.  This allegation is therefore not upheld.

6. Mr Stevens in his evidence accepted that he did not respond in as much detail to the text message the Complainant sent expressing his  dissatisfaction as he should have.  He explained that he was concerned that he would make an already toxic situation between the Complainant and his mother worse.  The Panel found that Mr Stevens had a responsibility to the Complainant and did not offer to meet the Complainant to discuss his concerns or take sufficient steps to mitigate any harm to him.  The Panel therefore found that Mr Stevens failed to ensure that he endeavoured to remedy the harm that he may have caused to the Complainant.  This allegation is therefore upheld. 

7. Mr Stevens in his evidence stated that when the Complainant visited him at the GP surgery he told him that he was a member of BACP.  Mr Stevens stated that he was aware from the text messages sent by the Complainant expressing his dissatisfaction that he was aware of the existence of the Professional Conduct Procedure and as such, he did not need to notify him of its existence.  The Panel found that whilst Mr Stevens did not notify the Complainant of the existence of the Professional Conduct Procedure, it was clear from the Complainant's text messages that the Complainant was already aware of its existence.  Given that the Complainant was already aware of the existence of the Professional Conduct Procedure, the Panel did not find that Mr Stevens failed to notify him of its existence.  This allegation is therefore not upheld.

8. In light of the above findings, the Panel was satisfied that Mr Stevens' behaviour showed a contravention of paragraphs 3, 12, 19 and 42 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) and the ethical principle of Autonomy.  It also found that Mr Stevens lacked the personal moral quality of Wisdom to which all practitioners are strongly urged to aspire. 

The Panel did not find a contravention of paragraphs 11, 20 and 46 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) or the ethical principle of Being Trustworthy and nor did it find a lack of the personal moral quality of Sincerity.

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice in the provision of inadequate professional services, in that the services for which Mr Stevens provided fell below the standards that reasonably be expected of a practitioner exercising reasonable care and skill.

Mitigation

Mr Stevens accepted that he realised too late the dilemma that he was in by seeing both the Complainant and his mother and accepted that in hindsight, his boundaries with the Complainant were unclear.  Mr Stevens stated that he acted out of a wish to help the Complainant and apologised to the Complainant.

Sanction

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Mr Stevens is required to provide a written submission, which evidences his immediate reflections on, learning from and understanding of, the issues raised in this complaint.

In addition, Mr Stevens is required to provide a written report in which he deals with the following:

- The difference between a counselling relationship and a supportive relationship and how he would make it clear to the person receiving the service what service he was providing;

- The importance of client consent in ensuring that the client is adequately informed about the nature of the services being provided and how he would ensure that he obtained such consent.

- How he would set and maintain boundaries with clients and agree the rights and responsibilities of him as a practitioner, including what those rights and responsibilities are and how he would ensure that the client understood this.

- How, in the event that something goes wrong, he would ensure that he remedied the harm to the client.

The above report is to be submitted no later than three months from the date of imposition of this sanction.

These written submissions must be sent to the Interim Registrar, by the given deadlines, and will be independently considered by a Sanction Panel.

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May 2015: Robert Black, Reference No: 700524, Norfolk NR2


The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure. 

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy. 

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant and his wife attended two sessions of counselling with Mr Black, on 2 and 9 December 2013.  

The Complainant was of the impression that everything said would be in confidence, particularly as the Counselling Service had the name [ . . . ].  However, after he had disclosed some issues around 30 minutes into the first meeting, Mr Black allegedly announced that he would have to take it further.  The Complainant stated that had Mr Black told him prior to, or at the beginning of the session, that some issues might not be in confidence, he would have left the office at that point. 

Mr Black allegedly only provided the Complainant and his wife with any paperwork at the end of the first session, and did not ask the Complainant or his wife to sign the paperwork or to see the paperwork again during the second session. 

The Complainant stated that following his disclosure in the therapy session, Mr Black allegedly insisted that he report that person to the authorities, against the Complainant's wishes. 

As a result of this first session, the Complainant stated that he was very upset.  He stated that he had to take "rushed and ill-thought-through action" to prevent harm to third parties. 

In the second meeting, the Complainant stated that he explained to Mr Black that if he took the action that was proposed, the consequences for the Complainant would be devastating.  Mr Black allegedly said that he would take advice and get back to the Complainant. 

Mr Black later informed the Complainant that he had contacted BACP, and alleged that he was told that he did not have to take the matter further.  He informed the Complainant of his decision and the Complainant therefore, withdrew the complaint that he had initially submitted to BACP, though he subsequently changed his mind and re-submitted his complaint. 

The Complainant alleged catastrophic damage was caused to his life as a result of the behaviour of Mr Black, which he stated included alienation from his family demands from his sisters that he be removed from the enduring power of attorney for his father and being removed from his father's Will. 

In accepting this complaint, the Pre-Hearing Assessment Panel was concerned with the following areas, and in particular these are:

1. Mr Black allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met his needs in that he did not make it clear to the Complainant before the first session the circumstances in which confidentiality could be breached.

2. Mr Black allegedly failed to clarify and agree the rights and responsibilities of both him and as a practitioner and the Complainant as a client at appropriate points in their working relationship, in that he did not make it clear to the Complainant at the outset of their working relationship, the limitations of confidentiality and the circumstances in which it would be necessary to breach this. 

3. Mr Black allegedly failed to ensure that he provided the Complainant with competently delivered services in that he did not adequately inform the Complainant about the limitations of confidentiality. 

4. Mr Black allegedly failed to ensure that he kept the Complainant's trust or paid careful attention to client consent and confidentiality in that he insisted that the Complainant report a disclosure that he had made during therapy to the authorities and stated that he would need to consider whether he himself would need to make a disclosure to the relevant authorities against the Complainant's wishes. 

5. Mr Black allegedly failed to ensure that the Complainant was adequately informed about the nature of the services being offered to him in that he was not adequately informed about the limits of confidentiality or that Mr Black may be required to disclose information revealed during therapy to third parties. 

6. Mr Black allegedly failed to ensure that the services he delivered were on the basis of the Complainant's explicit consent in that he instructed the Complainant to report information he had disclosed during therapy to third party organisations against the Complainant's wishes. 

7. Mr Black allegedly failed to ensure that the Complainant was provided with a good quality of care that was respectful to the Complainant's capacity for self-determination in that he directed the Complainant to report a party to the authorities against his wishes and suggested that if the Complainant did not report the third party, he may have to. 

8. Mr Black allegedly failed to respect the Complainant's privacy and confidentiality and respect the Complainant's autonomy in that he failed to notify him of the limitations of confidentiality and the circumstances in which it could be breached and directed the Complainant to report someone whom the Complainant had referred to in therapy, against his wishes.    

9. Mr Black allegedly failed to ensure that any communications he proposed making to a third party were made on the basis of the Complainant's consent. 

10.  Mr Black failed to ensure that information about his services was honest, accurate and avoided unjustifiable claims in that the name of the organisation [ . . . ] implied to the Complainant that anything he disclosed during therapy would be kept confidential when this was not the case. 

11.  Mr Black's alleged behaviour, as experienced by the Complainant and identified in the paragraphs above, suggests a contravention in particular of paragraphs 1, 3, 6, 11, 12, 13, 14, 20, 21 and 60 and of the ethical principles of Being Trustworthy, Autonomy, Beneficence and Non-maleficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Empathy, Respect Competence, Fairness and Wisdom to which counsellors are strongly encouraged to aspire. 

The Complainant confirmed that he would not be attending this, or any other hearing that may be organised and therefore, the matter was referred under paragraph 4.9 of the Professional Conduct Procedure, which states: 

Where a Complainant or Member Complained Against fails or refuses to attend a Professional Conduct Hearing, the Registrar has the power to  decide to either: 

a)   Proceed with the Hearing in the absence of one or both of the parties; or 

b)   Adjourn the Hearing to a date not less than 28 days in advance; or 

c)   Terminate the proceedings; or  

d)   Refer the matter for consideration under Article 12.6 of the Memorandum & Articles of Association. 

The options were carefully considered, and in light of the circumstances, a decision was made by the Registrar and Director of BACP Registers to go ahead with the hearing in the absence of the Complainant.

It would have assisted the Panel greatly to have had the opportunity to question the Complainant.  However, in the absence of the Complainant, the Panel considered the written evidence submitted by both parties and the oral evidence presented by the Member Complained Against at the Hearing.   

Findings 

On balance, having fully considered the above, the Panel made the following findings:  

1. Mr Black admitted, both in his written and oral evidence, that he had failed to provide the Complainant with a good quality of care and competently delivered services which met his needs in that he did not make it clear to the Complainant before the first session the circumstances in which confidentiality could be breached.  Therefore the Panel upheld this allegation. 

2. Mr Black admitted, both in his written and oral evidence, that he failed to clarify and agree the rights and responsibilities of both him as a practitioner and the Complainant as a client at appropriate points in their working relationship, in that he did not make it clear to the Complainant at the outset of their working relationship, the limitations of confidentiality and the circumstances in which it would be necessary to breach this.  Therefore the Panel upheld this allegation. 

3. Mr Black admitted, both in his written and oral evidence, that he failed to ensure that he provided the Complainant with competently delivered services in that he did not adequately inform the Complainant about the limitations of confidentiality.  Therefore the Panel upheld this allegation. 

4. The Panel, considered whether Mr Black failed to keep the Complainant's trust and pay attention to the issue of confidentiality, in insisting that the Complainant make a disclosure to the relevant authorities against his wishes; and found as follows:  

(i) Mr Black stated in both his written and oral evidence that he did not insist that the Complainant report the disclosure personally.  Mr Black stated that there was a discussion in which he made it clear that due to the gravity of the disclosure it had to be reported, and a discussion ensued about the process of reporting, and who would make the report.  Mr Black also stated that he used language which he thought was clear and was not intended to be threatening when explaining that he may have to report it, if the Complainant did not.  The Panel accepted that during discussion Mr Black gave the Complainant a choice about whether he took the initiative and reported it himself or left the responsibility to Mr Black.  On the evidence available, the Panel therefore found this part of the allegation is not upheld.   

(ii)In both his written and oral evidence, Mr Black stated that the Complainant brought with him to the first session, a telephone number for reporting the disclosure.  This evidence was uncontested and therefore the Panel found that there was insufficient evidence to support the allegation that the Complainant objected to the disclosure being reported or that it was against his wishes.  The Panel found that the Complainant himself chose to report it.  Therefore this part of the allegation is not upheld. 

For the reasons stated above, the Panel therefore found that allegation 4 was not upheld in total. 

5. Mr Black admitted, both in his written and oral evidence, that he had failed to ensure that the Complainant was adequately informed about the nature of the services being offered to him in that the Complainant was not adequately informed about the limits of confidentiality or the circumstances in which Mr Black might be required to disclose information revealed during therapy to third parties.  Therefore the Panel upheld this allegation. 

6. In considering whether Mr Black failed to ensure that the services he delivered were on the basis of the Complainant's explicit consent in that he instructed the Complainant to report information he had disclosed during therapy to third party organisations against the Complainant's wishes, the Panel found that it was not whether information should be disclosed that was discussed, but who would take responsibility for disclosing it (Mr Black or the Complainant).  As outlined in finding 4(ii) above, the Panel did not find that Mr Black instructed the Complainant to report information to a third party against his wishes.  Mr Black stated in his oral evidence, that the information brought to him by the Complainant was allegedly of such seriousness, that had it been necessary, he would have taken the initiative to report it, whether or not his client wished him to do so.  In the exceptional circumstances in this case, the Panel accepted that had Mr Black reported the matter he would have had adequate and reasoned justification to do so as the circumstances of the disclosure were of such gravity.  However, the Panel noted that the Complainant himself reported the matter in any event.  The Panel, therefore did not uphold this allegation.  

7. In considering whether Mr Black failed to provide a good quality of care that was respectful to the Complainant's capacity for self-determination, the Panel referred to its finding in 4(i) above and reiterated that it did not find that Mr Black had 'insisted' that the Complainant report the disclosure.  Mr Black stated in his oral evidence that he wanted to empower his client and give him a choice as to who should report the disclosure.  The Panel accepted Mr Black's evidence that he gave the Complainant a choice.  The Panel was satisfied on the evidence available that Mr Black had explored options with the Complainant, thereby respecting the Complainant's capacity for self-determination.  This allegation is therefore not upheld. 

8. Mr Black admitted both in his written and oral evidence, that he failed to respect the Complainant's privacy and confidentiality and respect his autonomy, in that he failed to notify him of the limitations of confidentiality and the circumstances in which it could be breached.  The Panel therefore upheld this part of the allegation.  The Panel referred to its findings in 4(i) and (ii) above in respect of the allegation relating to Mr Black insisting that the Complainant report the matter against his wishes and therefore did not uphold this part of the allegation.  Therefore this allegation is partially upheld. 

9. Mr Black stated in his written and oral evidence that he considered a disclosure needed to be made and that he would have done so in the event the Complainant did not.  The Panel found that given that the Complainant made the relevant report and informed Mr Black that he had done so,  there was no disclosure made to a third party, by Mr Black.  The Panel therefore considered that the issue of consent did not arise and this allegation is not upheld.

10.  The Panel found that as Mr Black was an employee of the organisation, the name [ . . . ] was out of his control.  Therefore the Panel did not uphold this allegation.

11.  Mr Black's alleged behaviour, as experienced by the Complainant and identified in the numbered paragraphs above, suggests a contravention in particular of paragraphs 1, 3, 6, 12, and 20 and of the ethical principles of Non-maleficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Competence, Fairness and Wisdom to which counsellors are strongly encouraged to aspire.  

The Panel found that Mr Black had not contravened paragraphs 11, 13, 14, 21 or 60 or the ethical principles of Being Trustworthy, Autonomy and Beneficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), nor had he shown a lack of the personal moral qualities of Empathy and Respect. 

Mitigation 

Mr Black found himself in a very difficult and pressured situation and had not encountered a case of such seriousness before.  Mr Black admitted he made an error in not making explicit the limits of confidentiality at the start of the session.  The Panel noted that Mr Black had apologised from the outset for the distress caused to the Complainant.  He attributed his failings to his inexperience in dealing with such situations, his mild panic and his lack of specialist training in a challenging area of law concerning confidentiality.  The Panel noted that Mr Black had subsequently engaged in collaborative work with his colleagues to ensure that the organisation could deliver a well-informed service for clients.  He had also explored the issues in supervision to reflect on the process and to assist him in putting into practice a clear explanation of the limits of confidentiality at the outset of engagement with a client.  The Panel further noted that Mr Black had implemented, both in his private practice and in the organisation for which he previously worked, documented processes to ensure all clients are given clear information with regard to confidentiality and the limitations on confidentiality. 

Decision 

Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice on the grounds of inadequate professional services, in that the service for which Mr Black was responsible fell below the standards that would reasonably be expected of a  practitioner exercising reasonable skill.  

Sanction

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.  

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Mr Black is required to provide a written submission, which evidences his immediate reflection on, learning from and understanding of, the issues raised in this complaint. 

Mr Black should also provide copies of written documents that he provides to his clients within his private practice, relating particularly to the  information given to his clients on confidentiality and the limits of confidentiality. 

These written submissions must be sent to the Registrar and Director of BACP Registers by the given deadlines, and will be independently considered by a Sanction Panel. 

(Where ellipses [ . . . ] are displayed, they indicate an omission of text)

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May 2015: North East Counselling Services CIC (NECS), Reference No: 132619, Tyne and Wear NE8 1BG

The complaint against the above organisational member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel  considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel was that the Complainant began working as a volunteer counsellor with North East Counselling Services (NECS) in April 2013.  In the course of his work with NECS he offered complementary therapy to the partner of one of his clients, and was visited at his garage by another of his clients to whom he was giving away some furniture. The Complainant disclosed these two incidents to his NECS supervisor on June 1st because he was unsure whether he had done the right thing.  His supervisor allegedly stated that he had no problems with the Complainant's actions and complimented him on raising the issues voluntarily. His supervisor allegedly subsequently had concerns about the Complainant's actions, and sought advice from another NECS Supervisor, a move that the Complainant alleged was a breach of the contract between his supervisor and himself. The contract stated that confidentiality would only be broken if a supervisee described any practice which was unsafe, unethical or illegal. The Complainant alleged that his actions were not harmful to his clients and one of the clients involved had rated the counselling he had received highly.

Following the supervisor's discussion with another supervisor a director of NECS, Mr A, called a meeting on June 6 2013 at which the Complainant's actions were discussed with him and the supervisor director. Mr A allegedly opened the meeting by saying that it was not a disciplinary meeting. At that meeting the issues were discussed, and a summary was sent to the Complainant by Mr A. The Complainant was not satisfied that the summary was complete. He sent a letter on June 16th to Mr A expressing his concerns: that he was not properly briefed as to the purpose of the meeting; that the question of his supervisor's alleged breach of confidence was glossed over; and that the Complainant did not feel he was treated with dignity and respect. He stated that he had lost confidence in the NECS. Mr A replied to that letter on July 3rd stating that the Complainant's actions with the two clients was a breach of NECS policies and the BACP code of ethical practice, and requiring the Complainant to leave NECS. The Complainant sent a letter questioning Mr A's reasoning and asking why he had been dismissed from the agency. He followed this up with a letter to the supervisor director, complaining about Mr A, and the failure of NECS to uphold its own policies on complaints. He asked for a meeting with NECS managers to try and resolve his complaint. In response he was offered a meeting by the founding director of NECS, which he declined on the grounds of his experience of the 6 June meeting. He was then sent an email on July 31st by the founding director stating that his volunteer relationship with NECS was ending with immediate effect and that his clients would be so informed. The Complainant alleged that NECS failed to conduct a complaints procedure in accordance with their policies and that he was unfairly dismissed.

The Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular as follows: 

1. The North East Counselling Services allegedly did not provide a good quality of care to the Complainant in its alleged poor handling of the situation following the Complainant's disclosure about his practise within his supervision and in so doing also failed to honour the Complainant's trust.  

2. The North East Counselling Service allegedly failed to respond promptly and appropriately to the concerns raised by the Complainant failing to follow its own procedure. 

3. The North East Counselling Service allegedly failed to remedy any harm that may have been caused to the Complainant by the alleged poor handling of the situation following his disclosure and in the lack of appropriate response to his concerns. 

4. The North East Counselling Service allegedly failed to respect the Complainant's privacy and confidentiality in that information gleaned from supervision was disclosed in a forum outside supervision in contravention of the organisation's policies and in so doing failed to honour the Complainant's trust.

5. The North East Counselling Service's alleged actions and behaviour as experienced by the Complainant suggesting a contravention in particular of paragraphs 1, 11, 20, 41 and 42 of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010/2013 and the ethical principles of Being Trustworthy, Beneficence and Justice.  It also suggests a lack of the personal moral qualities of fairness, respect and integrity to which counsellors and psychotherapists are strongly encouraged to aspire.  

Findings

On balance, having fully considered the above, the Panel made the following findings: 

1.   In both the opening summary and the oral evidence given by Ms B, (on behalf of NECS), it was accepted that the NECS had breached the Complainant's confidentiality contrary to the Supervision Contract between the Complainant and his supervisor.  It was also accepted that the NECS did not handle the situation well in relation to the disclosure of his confidence.  The Panel found that in the circumstances, the NECS had failed in its duty to provide a good quality of care to the Complainant in that it handled the situation poorly and had neglected to follow its own procedures. NECS accepted that the procedures were not robust.  The Panel found that NECS had failed to honour the Complainant's trust and therefore upheld this allegation.

2.   When questioned with reference to the alleged failure to respond to the Complainant's letter in which he raised specific concerns, Ms B stated that the NECS had responded to his specific concerns as far as it could.  Ms B further stated that Mr A had acknowledged the letter promptly, but had not responded substantively to it.  Ms B stated that she made telephone and email contact with the Complainant, on her return from annual leave, with a view to discussing it with him face to face.  The Complainant responded to Ms B, expressing his reluctance to attend a meeting without clarifying its purpose.  Two days later, Ms B sent an email to him, dismissing him from the NECS.  Ms B accepted that the NECS policy in relation to complaints raised by staff was not robust enough.  The Panel therefore found that whilst NECS did respond promptly, it failed to address the Complainant's concerns and therefore did not respond appropriately.  The Panel found that NECS was negligent in that it had failed to follow its own procedures.  This allegation is therefore upheld in part.

3.   In the opening summary, Ms B stated that the NECS did not consider the Complainant's actions as being anything other than altruistic and acknowledged that he had volunteered the disclosure during a supervision meeting.  The Complainant's disclosure was brought to the attention of his Line Manager, by his supervisor, without his knowledge.  Further, as upheld in allegation 2 above, there was a failure to respond appropriately to the Complainant's concerns.  In oral evidence given by the witness, Ms C, she stated that she considered the disclosure to be "outside of the norm" and so the normal process was not followed as set out in the Supervision Contract.  The Panel found, on the balance of probabilities, that the NECS had failed to remedy the harm or recognise the impact that may have been caused to the Complainant, by the breach of contract, and the failure to address his concerns appropriately.  This allegation is therefore upheld. 

4. In her oral evidence, Ms B conceded that the Complainant's confidentiality had been breached.  She also stated that the NECS policies were not robust.  Ms C stated in her oral evidence that she considered that it was her and the Complainant's supervisor's responsibility to inform a Director about the disclosure, as the disclosure was deemed to have fallen outside of the norm.  This led to a discussion in an informal meeting between the Finance Director, Ms C and the Complainant.  The Panel found that the NECS had failed to respect the Complainant's privacy and confidentiality by discussing information from the supervision meeting, in a forum outside the supervision setting and that information was further disclosed by the clinical supervisor to the Director.  In so doing, the Panel found that the NECS had failed to honour the Complainant's trust by failing to follow its own procedures and the volunteer contract with regard to disclosures made in a Supervision setting.  This allegation is therefore upheld.

5.   In light of the above findings, the Panel was satisfied that the NECS alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 11, 20, 41 and 42 of the Ethical Framework for Good Practice (2013) and the ethical principles of Being Trustworthy, Beneficence and Justice.  It also found that the NECS lacked the personal moral qualities of Fairness, Respect and Integrity to which all practitioners are strongly urged to aspire.  

Decision

Accordingly, the Panel was unanimous in its decision that NECS was negligent and incompetent and that these findings amounted to Professional Malpractice in that the service for which the NECS was responsible fell below the standards that would reasonably be expected of a practitioner exercising reasonable skill. 

Mitigation

The Panel noted that as a result of this situation, the NECS had reviewed its internal policies.  The NECS had taken appropriate advice to ensure its revised policies were robust.  The organisation had also appointed a new Director to the Board who had relevant Human Reource experience.  Ms B had also accepted that the NECS had not handled this particular situation well.  Ms B also stated that whilst NECS accepts the Complainant's confidentiality was breached, NECS staff had acted in good faith for the protection of NECS clients.

Sanction 

The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.  

The Panel therefore required NECS to nominate the CEO as the named individual to submit the information detailed below, within three months from the date of imposition of this sanction, which will run from the expiration of the appeal deadline; 

To provide: 

a)all revised procedures and protocols with a written report on the specific changes made.  NECS is to also provide a report of the learning from this experience. 

b)   clear evidence of the organisational structure, roles and accountability responsibilities of clinical and management staff. 

c)   details of how the NECS will ensure year round cover both of management and clinical staff 

d)   The NECS should also provide information confirming staff have been informed on the revised processes and policies together with details of how these policies will continue to be disseminated and understood within the organisation in the future. 

These written submissions must be sent to the Registrar and Director of BACP Registers by the given deadlines, and will be independently considered by a Sanction Panel.

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April 2015: Linda Bretherton, Reference No: 589825, Cheshire WA4

The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical  Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant, allegedly as a result of her therapist taking her work with the Complainant for supervision to Ms Bretherton, then was invited to see Ms Bretherton for two three-hour sessions in February and March 2013. 

In the first session, where Ms Bretherton was assisted by the Complainant's therapist and one other therapist, the Complainant alleged that she was
physically held by Ms Bretherton, whom it is alleged kept calling the Complainant 'sweetheart' and 'darling'.  The Complainant allegedly told Ms Bretherton that she found such loving remarks too much to handle.  Ms Bretherton allegedly then asked the second therapist to look into the Complainant's eyes and show love and compassion, an action which the Complainant states she found extremely difficult.  Ms Bretherton allegedly
offered the Complainant for all three therapists to bathe the Complainant in another session, an invitation which the Complainant refused.  At the second session the Complainant was allegedly kept waiting.  In the course of that session Ms Bretherton allegedly made loud breathing noises in close
proximity to the Complainant and encouraged the other therapists to make similar sounds, which the Complainant stated made her writhe and shake, since the noises reminded her of the abuse that she had suffered when younger.  Ms Bretherton allegedly used the Emotional Freedom Technique, consisting of tapping the Complainant's face, which again caused her to writhe.  The Complainant alleged that Ms Bretherton had not made any effort to take her history as she alluded to incidents of abuse in the Complainant's past that had not occurred.

Three weeks after these two sessions, the Complainant stated that she suffered from physical effects, which included shock, shame and anxiety, she was crying every day, had nightmares and felt sick.  The Complainant stated that as a result of being subjected to a therapy which she considered to be wild, unorthodox and re-traumatising, she experienced what had happened to her in the sessions as extremely damaging, repeating the effects of
the abuse she had experienced when younger.

Between the two sessions, the Complainant stated that she was invited by her own therapist to attend a Shamanic weekend that was to be facilitated by Ms Bretherton.  Ms Bretherton allegedly knew that the Complainant's own therapist would also be present at the weekend, yet in the second session allegedly encouraged the Complainant to attend.  Upon later deciding not to attend the Shamanic  weekend, the Complainant alleged that in an email in April 2013, Ms Bretherton put undue pressure on her to attend, concluding the email with the words 'much love' and in another email concluding with the words 'lots of love'.

The Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular are as follows:

1. Ms Bretherton allegedly failed to provide the Complainant with a good quality of care in that she allegedly encouraged her to attend a Shamanic weekend when she knew that the Complainant's therapist would be attending as a participant, without considering the implications of the dual relationship which may arise between the Complainant and her therapist and the impact that this would have upon the Complainant.

2. Ms Bretherton allegedly failed to provide the Complainant with a good quality of care in that she inferred facts about the Complainant's history which were not true.

3. Ms Bretherton allegedly failed to provide the Complainant with a good quality of care and competently delivered services which met her needs, in that Ms Bretherton allegedly took insufficient note of the discomfort the Complainant experienced when Ms Bretherton was voicing expressions of love towards her.

4. Ms Bretherton allegedly failed to provide the Complainant with a good quality of care in that she placed undue pressure on the Complainant to attend a Shamanic weekend; and when the Complainant emailed Ms Bretherton explaining the reasons why she would not be able to attend, Ms Bretherton failed to respect the Complainant's wishes and sent an email to the Complainant stating "Whatever is going on for you, whatever your reason/excuse
does not matter".

5. Ms Bretherton allegedly failed to provide a contract or information to the Complainant to clarify and agree the rights and responsibilities of both her as a practitioner and the Complainant as a client, either at the outset of the therapy or during the course of the therapy.

6. Ms Bretherton failed to ensure that the Complainant was adequately informed about the nature of the services that she was offering, in that the Complainant was unaware of the type of therapy that she was receiving.

7. Ms Bretherton allegedly failed to ensure that her services were delivered on the basis of the Complainant's explicit consent, in that she failed to tell the Complainant the type of therapy that was being provided to her, to enable her to decide whether or not she would consent to having that particular type of therapy.

8. Ms Bretherton allegedly held a dual relationship with the Complainant which was to the Complainant's detriment, in that she was providing therapy to the Complainant whilst simultaneously acting as the supervisor for the Complainant's therapist.

9. Ms Bretherton allegedly failed to be attentive to the quality of listening and respect offered to the Complainant in that when the Complainant told Ms Bretherton that she was uncomfortable with the loving comments Ms Bretherton was making towards her, she continued to do so.  Further, when the Complainant tried to explain the reasons she would find it difficult to attend the Shamanic weekend, Ms Bretherton did not listen to the explanation given and instead focused on the number of therapists the Complainant would have on the weekend to assist her.

10.  Ms Bretherton allegedly failed to respond to the Complainant's request for information about the way in which she was working, in that when the Complainant questioned the type of therapy that was being provided to her, Ms Bretherton did not confirm this. 

11.  Ms Bretherton allegedly abused the Complainant's trust in order to gain emotional or personal advantage in that when the Complainant told Ms Bretherton that she would be unable to attend the Shamanic weekend, Ms Bretherton sent an email pressuring the Complainant to attend.

12.  Ms Bretherton allegedly failed to remedy any harm that was caused to the Complainant when she became aware that the Complainant was unhappy with the service that she had provided.

Ms Bretherton's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 3, 4, 11, 12, 13, 16, 17, 41 and 42 and the ethical principles of Being Trustworthy, Autonomy, Beneficence and Non-Maleficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Empathy, Integrity, Respect, Competence and Wisdom to which counsellors are strongly encouraged to aspire.

Findings

On balance, having fully considered the above, the Panel made the following findings: 

1. In both her written and oral evidence Ms Bretherton accepted that she encouraged the Complainant to attend the Shamanic weekend, both verbally and in an email of 7 April 2013.  Ms Bretherton also accepted that she was caught up in a "web" of dual relationships and that boundaries became blurred.  However, she claimed that it was the responsibility of the Complainant's long-term therapist to deal with the dual relationship issues rather than herself.  The Panel found that in these circumstances where Ms Bretherton was the lead therapist in the two sessions involving the Complainant, and also the organiser of the Shamanic weekend, Ms Bretherton had a responsibility to consider fully the Complainant's position and address the issue of dual relationships which her attendance at the Shamanic weekend would have involved.  In abrogating this responsibility and in encouraging the Complainant's attendance, the Panel found that Mrs Bretherton failed to give due consideration to the potential for a detrimental impact the Complainant and thus did not offer a good quality of care.  Therefore this allegation is upheld.

2. When questioned about inferring facts about the Complainant's history which were not true, Ms Bretherton denied making the statement that the Complainant alleges was made to her during the session.  In light of the conflict of evidence, and without any corroboration, the Panel was
unable to uphold this allegation.  Therefore this allegation is not upheld.

3. In her oral evidence, the Complainant stated that she had not expressed discomfort even though she had experienced it.  Ms Bretherton stated that she checked regularly with the Complainant that she was happy to continue the session.  Ms Bretherton also denied voicing the expressions of love stated by the Complainant, although in her oral evidence she did accept that the words "compassion" and "love" may have been used in the session.  The Panel found that Ms Bretherton, in regularly asking the Complainant if she was willing to continue, had done all that could be reasonably expected of
her.  Therefore this allegation is not upheld.

4. Ms Bretherton stated in both her written and oral evidence that the Complainant had shown a strong desire to attend the Shamanic weekend.  Ms Bretherton encouraged her believing that it would be of benefit for the Complainant to attend.  However, when the Complainant changed her mind and wrote cancelling her place, Ms Bretherton sent an email dated 7 April 2013, which on reflection she accepted was wrong and that the language used was strong and could have been kinder.  She also accepted, when questioned, that her email could have been read as bullying.  The Panel found that the  email had put undue pressure on the Complainant.  The Panel therefore upheld this allegation.

5. Ms Bretherton stated in her oral evidence that her  usual practice would be for therapeutic/counselling clients to complete a Client Confidentiality form, which would include personal details and any medical information.  However she had not done so with the Complainant as she did not consider the Complainant to be a therapeutic /counselling) client.  Ms Bretherton also accepted that she did not provide a contract, either written or oral, which would have set out the roles and responsibilities of her as a practitioner and the Complainant as a client.  The Panel found that the Complainant was a client as defined in the Statement of the Ethical Framework for Good Practice in Counselling and Psychotherapy and that Ms Bretherton was a practitioner. 
The Panel therefore considered that failing to define roles and responsibilities or take any information from the Complainant was reckless.  The Panel therefore upheld this allegation. 

6. Ms Bretherton accepted that she had not given any information to the Complainant prior to the first session.  She believed that the Complainant's long-term therapist had done this.  However, Ms Bretherton stated until she had actually met the Complainant, she would have been unable to determine precisely the type of help she would offer to her.  Ms Bretherton stated that she had discussed with the Complainant what would happen at the beginning of each of the two sessions.  In her oral evidence the Complainant accepted that she may have forgotten being given information.  The Panel found that Ms Bretherton, as the person delivering the service, should have taken the responsibility and care to ensure that the Complainant had received and understood the correct information prior to the first session rather than relying on a third party (The Complainant's long-term therapist).  In her reliance on a third party, the Panel found that Ms Bretherton was reckless.  In particular, it was not clear whether the Complainant was to be offered intensive therapy or self-help techniques.  The Panel therefore upheld this allegation. 

7. Ms Bretherton, in her oral evidence, accepted that it was possible that the Complainant had been given the wrong information about the nature of the sessions.  Ms Bretherton stated that it was the long-term therapist's responsibility to pass on the information.  Ms Bretherton accepted in her oral evidence that she had not planned anything specific prior to meeting the Complainant.  The Panel found that in relying on the Complainant's long-term therapist to impart information to the Complainant, Ms Bretherton had abrogated her responsibility to gain explicit consent.  In particular, the Panel found that the Complainant ought to have been given prior notice that Ms Bretherton would make a last minute decision as to the type of therapy she would offer.  The Panel therefore upheld this allegation. 

8. Ms Bretherton stated, both in her written and oral evidence, that she was not the Supervisor of the Complainant's long term therapist.  However, she accepted that the Complainant's long-term therapist was a trainee at her centre and she was therefore her trainer in this regard.  The Complainant also provided evidence that Ms Bretherton had been involved in a peer supervision relationship with the Complainant's long-term therapist.  

The Panel was satisfied on the weight of the evidence, that there was a dual relationship, specifically in regard to the peer-supervision, which was to the detriment of the Complainant because it was not made clear to the Complainant who had primary responsibility for her therapy.  Therefore this allegation is upheld.  

9. Ms Bretherton, both in her written and oral evidence, denied making loving comments.  In her oral evidence Ms Bretherton stated that she would never use such terms with a client.  She stated that she was friendly but not loving.  The Panel found that there was insufficient evidence to uphold this part of the allegation. 

Ms Bretherton stated that she addressed the issue of the Complainant needing a single room at the Shamanic weekend but there was no evidence provided to say that she had addressed the issue of the Complainant's discomfort with loud noises.  Whilst the Complainant did provide evidence that the number of therapists that would be present at the Shamanic weekend was mentioned by Ms Bretherton, the Panel found that there was insufficient evidence to support the allegation that the focus had been solely on the number of therapists.  The Panel found that there was insufficient evidence to uphold this part of the allegation. 

Therefore this allegation is not upheld.

10.  The Complainant accepted in her oral evidence that she had not explicitly made a request for information directly to Ms Bretherton.  The Panel found that there was no evidence brought to substantiate this allegation and therefore this allegation is not upheld.

11.  Ms Bretherton accepted in her written and oral evidence that she thought it would benefit the Complainant to attend the Shamanic weekend.  She also sent an email on 7 April 2013, seemingly pressuring the Complainant to attend.  The Panel found that the wording of that email amounted to an attempt to pressurise the Complainant into attending the Shamanic weekend and that the tone of the email suggested that Ms Bretherton was attempting to create a culture of dependency by manipulating the Complainant into attending the Shamanic weekend, therefore gaining an emotional or personal advantage.  The Panel therefore upheld this allegation.

12.  Ms Bretherton stated in her oral evidence that the Complainant had not complained directly to her and indeed had expressed happiness with the work.  Ms Bretherton stated that she had only known of alleged harm when she received the complaint  from BACP in late November 2013.  However, the Complainant provided evidence that Ms Bretherton must have known about the Complainant's dissatisfaction with her treatment by August 2013.  At this point, Ms Bretherton had contributed statements in support of the other therapists in their disciplinary proceedings, in particular, Ms Bretherton had referred to accusations made about her by the Complainant.  The Panel found that although the Complainant did not complain directly to Ms Bretherton,
she had known that the Complainant had referred to complaints about her and that she should have responded at this stage.  Therefore this allegation is upheld. 

13.  In light of the above, the Panel was satisfied that Ms Bretherton's alleged behaviour, as experienced by the Complainant, and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 1, 3, 4, 11, 12, 13, 16, 17, and 42 of the Ethical Framework for Good Practice (2013) and the ethical principles of Being Trustworthy, Autonomy, Beneficence and Non-Maleficence had been breached.  It also found that Ms Bretherton lacked the personal moral qualities of Empathy, Integrity, Respect, Competence and Wisdom to which all practitioners are strongly urged to aspire.  The Panel could not make a finding with regard to paragraph 41 of the Ethical Framework as there was no specific allegation cited in relation to it and considered that this paragraph had been inserted in error. 

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to serious Professional Malpractice in that the service for which Ms Bretherton was responsible fell below the standards that would reasonably be expected of a practitioner exercising reasonable skill.  The Panel found that Ms Bretherton was incompetent, reckless and provided inadequate professional services. 

Mitigation

The Panel noted that Ms Bretherton had shown some insight in that she accepted in hindsight that she should have done things differently.  She accepted that she had worded the email of 7 April 2013 badly.  She also accepted that she could have been clearer about the nature of the work that she did with the Complainant. Ms Bretherton accepted that there were risks in boundaries becoming blurred and that she should have considered this more carefully at the time.  She also accepted that she should have completed a Client Confidentiality form for all of her clients.  

Sanction 

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.  

The Panel therefore required Ms Bretherton, within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint. 

In addition, within six months from the date of imposition of this sanction, Ms Bretherton is required to provide a report that evidences the following:  

  • A statement that demonstrates her increased understanding of the nature of the work that she does and its possible therapeutic impact on all clients whether in therapy or at workshops or in any other context.  This should include her renewed understanding of the supervisory relationship, how to address dual relationships and the importance of clear boundaries in supervision and other therapeutic relationships.
  • Ms Bretherton should also reflect on the wisdom of accepting a referral from another therapist without meeting directly with the client and explain what she would do differently if presented with a similar situation. 

These written submissions must be sent to the Registrar and Director of BACP Registers by the given deadlines, and will be independently considered by a Sanction Panel.

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March 2015:   Debbie Walker, Reference, No: 571328, Herts EN6

The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice
in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the complainant began individual counselling with Ms Walker in approximately August 2013 and continued for 4 sessions, prior to the date of the complaint on 21 November 2013. 

The complainant alleged that Ms Walker did not display appropriate empathy or understanding within the counselling relationship.  Furthermore, the complainant alleged that Ms
Walker put immense pressure upon him when he was unable to attend a session and subsequently threatened to withdraw counselling.  The complainant reported that his non-attendance was due to a serious panic attack.

During the session following the complainant's non-attendance, the complainant alleged that Ms Walker did not allow him to discuss what he wished to bring to the session, and furthermore was extremely condescending, unempathic, and derogatory, displaying no degree of care or understanding of his considerable anxiety.  Following the session, the
complainant alleged that the impact of the session led him to self-harm, and subsequently led to him attending the Accident and Emergency department.

The complainant alleged that in the following week, he was informed two hours before his next session was due to commence, that the session with Ms Walker was cancelled due to her unavailability.  The complainant alleged that he was told that Ms Walker was attending training and would be unavailable to meet with him for 2 weeks.  The complainant alleged that Ms Walker had been aware that she would not be able to meet with him during this period for over a month prior to the booked session, however had not informed him of this.  The complainant alleged that due to this oversight on Ms Walker's behalf, he had arranged transport to the session and subsequently had to pay the full cost due to the short notice of
cancellation.

The complainant also alleged that during his first meeting with Ms Walker, she informed him that she was the manager of the service, but that he was subsequently informed that this was not the case.

The complainant alleged that he did not have any further contact with Ms Walker following the notification that she was undertaking training, but was duly informed that she had left the
organisation.  The complainant alleged that Ms Walker left the organisation without offering him any notice or closure regarding counselling.

The Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in
Counselling and Psychotherapy 2013, and those in particular as follows:

1. Ms Walker allegedly failed to provide the complainant with a good quality of care and competently delivered services which met his needs, in that she did not allow the complainant to discuss the issues that he wanted within the sessions.  Nor did she display sufficient understanding of the issues he discussed and threatened to withdraw counselling when the  complainant was unable to attend due to suffering from a serious panic attack.

2. Ms Walker allegedly failed to provide the complainant with a good quality of care in that she failed to notify the complainant until shortly before the session, that she would be unable to attend the counselling session(s) because she would be in training, when she had known for some time that she would be unable to attend. Furthermore she failed to put alternative arrangements in place for the complainant to see another counsellor.

3. Ms Walker allegedly failed to provide the complainant with a good quality of care and competently delivered services which met his needs, in that she did not appropriately deal with the anxiety the complainant displayed during their counselling session which left him feeling distressed and to subsequently self-harm.

4. Ms Walker allegedly failed to provide the complainant with a good quality of care in that she failed to give him any notice that she would be terminating the counselling relationship and failed to provide him with a closing session.

5. Ms Walker allegedly failed to clarify and agree the rights and responsibilities of her as a practitioner and the complainant as a client in that she failed to make it clear the circumstances in which counselling would be terminated and the circumstances in which appointments would be cancelled.

6. Ms Walker allegedly failed to be attentive to the quality of listening and respect offered to the complainant in that she did not allow him to discuss the issues that he wanted within the counselling session, threatened to withdraw counselling, and failed to notify him until shortly before their session that she was unable to keep their appointment.

7.   Ms Walker allegedly failed to adequately assess and manage the risk the complainant posed to himself in that she failed to appropriately address the distress exhibited by the complainant during their session, which resulted in him subsequently self-harming.

8. Ms Walker allegedly failed to ensure that her services were delivered on the basis of the complainant's explicit consent in that she put pressure on him to continue to attend the sessions when he stated that he was no longer able to attend and she then threatened to withdraw counselling.

9. Ms Walker allegedly failed to be clear about her commitment to be available to the complainant in that she was aware that she would be unable to attend some of their counselling sessions but failed to make the complainant aware of this until shortly before his appointment.

10.  Ms Walker allegedly failed to clarify the terms on which her services were offered in that she failed to make the complainant aware that she would be unable to attend their sessions, until shortly before his appointment, resulting in the complainant incurring financial expenses. 

11.  Ms Walker allegedly failed to ensure that information about her services was honest, accurate and avoided unjustifiable claims, in that she told the complainant that she was the manager of the service when she in fact was not.

12. Ms Walker's alleged behaviour, as experienced by the complainant and as identified in the numbered paragraphs referred to above suggests a contravention in particular of   paragraphs 1, 3, 11, 13, 14, 19, 59 & 60 and the ethical principles of Non-maleficence, Autonomy, Beneficence and Being Trustworthy of the Ethical Framework for Good Practice in   Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Empathy, integrity, respect, competence, wisdom to which counsellors are strongly encouraged to aspire.

The complainant did not attend the hearing and the matter was referred for consideration under paragraph 4.9 of the Professional Conduct Procedure, which states:

"Where a complainant or member complained against fails or refuses to attend a Professional Conduct Hearing the Registrar has the power to decide to either

(a)     proceed with the hearing in the absence of one or both of the parties or

(b)     adjourn the hearing to a date not less than 28 days in advance or

(c)     terminate the proceedings or

(d)     refer the matter for consideration under article 4.6 (now known as 12.6) of the Memorandum and Articles of Association

The options were carefully considered and in light of the circumstances, a decision was made by the Registrar to proceed with the adjudication hearing in the absence of the complainant.

It would have been of assistance to the Panel to have the benefit of questioning both parties in relation to their evidence to assist it in making a determination in respect of the findings. 
However, in the absence of the complainant, the Panel had to base its decision on the written evidence provided by both parties and the verbal evidence of the member complained against.   

Findings

On balance having fully considered the above the Panel made the following findings:-

1.   Having considered all the evidence, the Panel was not satisfied that Ms Walker had on the balance of probabilities prevented the complainant from speaking about his issues in the sessions.  The Panel was further not satisfied that she had not displayed sufficient understanding of the issues the complainant had discussed in his sessions.  Ms Walker explained the organisational policy around non-attendance of sessions to the Panel.  Her evidence indicated that when the complainant was unable to attend a session, he contacted her and she spoke to the complainant about the policy and the potential implications of non-attendance of counselling sessions.  While one of the potential consequences of non-attendance of sessions was the withdrawal of counselling, the Panel was not satisfied that that Ms Walker had threatened to withdraw counselling from the complainant, preferring her evidence in that regard.  On the balance of probabilities, the Panel was not satisfied with regard to this particular allegation that Ms Walker had failed to provide the complainant with a good quality of care and competently delivered service and did not find this allegation to be upheld.

2.   Following contact with the complainant, Ms Walker stated that she made a booking with the complainant for counselling without having checked the office diary.  Ms Walker had double booked her time, as the counselling appointment clashed with a training commitment, which Ms Walker accepted was an oversight.  There is a difference in the evidence of how far in advance Ms Walker would have known about the training commitment, but the Panel accepted Ms Walker's evidence that she had booked the training session some time ahead and that it had been confirmed as a definite commitment for about two weeks.  The Panel accepted that Ms Walker had made some unsuccessful attempts to contact the complainant by telephone prior to the counselling session, until finally a message was left for him shortly before the session.  The Panel was not satisfied that Ms Walker had made sufficient effort to advise the complainant that the session would not proceed prior to the day of the appointment.  In the absence of being able to confirm by telephone with the complainant that the session would not proceed, Ms Walker should have sent the complainant a letter informing him of the situation.  The Panel was satisfied that Ms Walker did not provide the complainant with a good quality of care in her failure to notify him of the situation until shortly before the session.  This part of the allegation is therefore upheld.

Ms Walker, in her evidence, communicated that the policy within the organisation for whom she worked was that a counsellor's clients would not be seen by another counsellor when their own counsellor could not make the session.  The Panel accepted Ms Walker's evidence and was satisfied that in the circumstances it would not have been appropriate for alternative arrangements to have been made by Ms Walker for the complainant to see another counsellor.  This aspect of the allegation is not upheld.  The Panel concluded that the allegation was
upheld in part. 

3. Ms Walker, in her evidence, explained to the Panel the strategy adopted by her to deal with the complainant's anxiety, which included the use of breathing/grounding techniques that he could use outside the counselling session to help him relax without assistance.  The Panel accepted Ms Walker's evidence and on the balance of probabilities was not satisfied that Ms Walker had dealt inappropriately with the complainant's anxiety during session in a manner that caused him distress or to self-harm following the session and in this respect did not find that she had failed to provide the complainant with a good quality of care and competently delivered service.

4. Ms Walker did not give notice to the complainant that she would be terminating her counselling with him nor did she provide him with a closing session.  During the Panel's questioning of Ms Walker, she described the circumstances surrounding the ending of her employment with her employer including what was negotiated with her employer.  The Panel was satisfied that in the particular circumstances described by Ms Walker, it would have been impractical and unrealistic for Ms Walker to have made contact with the complainant or to
provide him with a closing session, when she was no longer an employee of the organisation.  It was not satisfied that in this regard that Ms Walker had failed to provide a good quality of care and in conclusion, the Panel did not uphold this allegation. 

5. Ms Walker had a verbal contract with the complainant.  Ms Walker stated that in the initial assessment, she communicated her employer's non-attendance policy to the complainant
with regard to missing counselling sessions, although she did not give him any document explaining the policy as none was available for clients.  However Ms Walker stated that her employer had a strict policy about non-attendance which was explicit about the circumstances in which counselling would be withdrawn if a client missed counselling sessions.  Ms Walker in her evidence indicated that clients frequently cannot take in the content of the policy at the assessment stage and the consequences of missing appointments, which could result in the termination of the counselling.  During the counselling when the complainant had begun to miss counselling sessions, the Panel was not satisfied that Ms Walker took the opportunity to reinforce with the complainant the content of the non-attendance policy.  On the balance of probabilities, the Panel was satisfied that Ms Walker had not clarified the rights and responsibilities of both herself and the complainant and that she did not check and ensure that the complainant had understood the content of the policy.  The Panel further accepts that whilst it was not possible in the assessment session to predict and identify all the circumstances in which counselling sessions would be cancelled, in the circumstances of this case, once Ms Walker became aware of the double booked sessions, the Panel was satisfied that she took insufficient action and had failed to clarify and agree the rights and responsibilities of
both herself and the complainant with regard to the cancellations. The Panel fully upheld this allegation.

6. The Panel was not satisfied that Ms Walker had not allowed the complainant to discuss the issues that he wanted within the counselling nor that she threatened to withdraw counselling (see finding1).  The Panel found that Ms Walker had failed to notify the complainant until shortly before their session that she was unable to keep their appointment (see finding 2).  However, the Panel was not satisfied that this in itself amounted to a failure on the part of Ms Walker to be attentive to the quality of listening and respect offered to the complainant.  The Panel did not uphold this allegation. 

7.   The Panel accepted Ms Walker's evidence that she had adequately assessed and managed the risk in session related to the complainant.  The Panel was not satisfied that it was
evidenced that as a result of any particular session that the complainant self-harmed.  The Panel did not uphold this allegation.

8. The Panel accepted Ms Walker's evidence that she explained the circumstances to the complainant in which it might be in his best interests to attend, leaving the decision to choose whether to attend or not, with him.  The Panel was not satisfied that Ms Walker had threatened to withdraw counselling or put pressure on the complainant to attend.  The Panel did not uphold this allegation.

9. Ms Walker by her own admission was aware of her double booked sessions for at least two weeks prior to the counselling session.  Once she was aware of her double booking, she
was not clear with the complainant about her commitment to be available.  It was only some time later, shortly before their appointment, that she communicated her unavailability.  The Panel therefore, upheld this allegation. 

10.  Whilst Ms Walker did not make the complainant aware of the cancelled session until shortly before the appointment, the Panel was not satisfied that there was evidence of the complainant having incurred financial expense due to the late notification of the cancelled appointment or that there was a foreseeable cost on the part of Ms Walker.  As such the Panel did not uphold the allegation.

11.  The Panel was not satisfied that it was proved that Ms Walker had claimed to be the manager of the service when she was not.  As such the allegation is not upheld. 

12.  In light of the above findings, the Panel was satisfied that paragraphs 1, 3 and 19 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) and
the ethical principle of Autonomy had been breached but not paragraphs  11, 13, 14, 59 and 60 nor the ethical principles of Non-Maleficence, Beneficence and Being Trustworthy.  It also found a lack of the personal moral quality of wisdom to which all practitioners are strongly urged to aspire but did not find a lack of the moral qualities of empathy, integrity, respect and
competence.

Mitigation

The Panel found that there was significant mitigation, accepting Ms Walker's evidence that she endeavoured to use her professional skills in a thoughtful way to address the complainant's presenting issues and to ameliorate his distress in the counselling sessions she had with him, whilst working within very difficult organisational constraints. 

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice on the grounds of the provision of inadequate professional services.

Sanction

One of the aims of the Professional Conduct Procedure is to protect members of the public.  The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection together with the educative aspect.

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Ms Walker is required to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint.

Within four months from the date of imposition of this sanction, Ms Walker is required to provide a report of not less than 1500 words, which should address her learning and the changes she has made in the following areas;

1. Explicit contracting

2.   Cancellation of counselling sessions

3. Missed appointments

Ms Walker is also required at the same time to present a case study of no more than 1000 words, describing how she might have done things differently with regard to this case, given the client's issues and the organisational constraints under which she was working.

These written submissions must be sent to the Registrar and Director of BACP Registers by the given deadlines, and will be independently considered by a Sanction Panel.




                                 

  

  

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June 2014: Kerry North, Reference No: 585063, Doncaster DN7

  

The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the complainant began individual counselling with Miss North in May 2011 and continued on a regular basis, (usually weekly) until 6 November 2012. 

The complainant alleges that he felt a strong connection with Miss North from an early stage in the counselling relationship, which felt more like a friendship than a counselling relationship, in part due to their alleged informal discussions around spirituality, her alleged self- disclosure about her life and her informal approach.

The complainant alleges that on 13 June 2012, Miss North sent him a series of unsolicited texts of a personal nature.  The complainant was aware that this breached ethical boundaries and felt that their relationship had moved to one of friendship.  The complainant alleges that as the relationship developed he felt more loved and wanted than he had ever previously felt in his life.

During the period between 13 June 2012 and the last session in November 2012, the complainant alleges that each session ended with a hug and during this period the complainant alleges that the venue of the meetings moved to his home, with the agreement of his wife, or on occasion the home of Miss North.  The complainant alleges that he paid extra for their sessions to reflect the additional travel time and petrol costs, as Miss North was allegedly experiencing financial difficulties.  The complainant also alleges that during this latter period, text messaging became a feature of their relationship, in which a fun rapport developed, and subsequently the complainant alleges that he was able to declare his love for Miss North, which was allegedly reciprocated by text by Miss North.

Towards the end of their relationship in November 2012, the complainant alleges that Miss North started to withdraw from the friendship and steer the relationship back to a more professional stance.  The complainant alleges that he challenged this change in focus and was left devastated when the sessions ended on 6 November 2012, in an unplanned manner.  The complainant alleges Miss North offered to refer him on but that he did not want to start the process over again.

Following the last session, the complainant alleges that he wrote a number of letters to Miss North to ask for an explanation of her behaviour, which culminated in a further two and half hour meeting at her home on 15 March 2013, in which Miss North allegedly offered the complainant the opportunity to revisit her after a few months.

Following the meeting on 15 March 2013, the complainant alleges that later on the same day and again the following day, Miss North texted him with an opportunity to work together in a spiritual group with one of her friends.  The complainant alleges that he was pleased by this response and contacted her friend.  The complainant alleges that Miss North was displeased by his contact with her friend and disengaged from her  original suggestion.

Following this period of counselling the complainant alleges that he was left feeling rejected, taken advantage of, used and discarded.

The Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular as follows:

1. Ms North allegedly failed to provide the complainant with a good quality of care in that she abruptly terminated therapy, leaving the complainant feeling unsafe.

2. Ms North allegedly failed to provide the complainant with a good quality of care and maintain appropriate boundaries in the counselling relationship by engaging in extensive out of session text and telephone contact and contacting the complainant, in distress and seeking his guidance, causing the complainant to believe that she had feelings for him and that he was special.

3. Ms North allegedly failed to provide the complainant with a good quality of care in that she failed to manage appropriately or at all, the
issue of transference/counter-transference when the complainant declared his love for her and instead allegedly confirmed via text that his love for her was reciprocated and then allegedly subsequently told the complainant that she was projecting her feelings for her ex-husband onto him.

4. Ms North allegedly failed to clarify and agree the rights and responsibilities of both her and the complainant in that she allegedly:

a) did not make the complainant aware of the circumstances in which therapy would end;

b) was not clear where therapy would take place, some of the sessions occurring at Ms North's house and others at the complainant's;

c) failed to be clear about what charge would be made for these sessions, resulting in the complainant paying over and above the agreed rate on occasion;

d) did not carry out any reviews in relation to the progress the complainant was making with regard to the therapy;

e) did not discuss the issue of confidentiality and the circumstances in which information relating to him would be disclosed.

5. Ms North allegedly entered into a dual relationship with the complainant as a friend and counsellor through engaging in regular out of session text messages and telephone calls, sharing personal details, inviting the complainant to form a spiritual group with her, referring to the  complainant as "big bro" in her text messages, concluding her text messages with an x, denoting a kiss, and through allegedly meeting the complainant regularly on a social basis. 

6. Ms North allegedly failed to honour the trust of the complainant by discussing him with others, thereby failing to respect his privacy and confidentiality.

7. Ms North allegedly failed to respond to the complainant's request for information, in that she did not respond to his request for access to his notes and the details of her supervisor.

8. Ms North allegedly abused the complainant's trust in order to gain emotional and financial advantage by; hugging him at the end of   sessions, suggesting that they set up a spiritual group, taking money from the complainant which was not in respect of the counselling work they were doing and entering into a personal relationship with the complainant, which led him to feel loved and subsequently misled emotionally when the relationship ended.  

9. Ms North allegedly did not exercise caution before entering into a personal relationship with the complainant.

10. Ms North allegedly failed to maintain her fitness to practise in that she contacted the complainant in distress and spent some of the   counselling sessions discussing her own personal issues.

11. Ms North allegedly failed to notify the complainant of the existence of the Professional Conduct Procedure when she became aware that he was dissatisfied with the counselling.

12. Ms North was allegedly not honest, straightforward and accountable to the complainant in respect of all financial matters, in that she allegedly took money from the complainant for a meeting which was in the guise of a counselling session, accepted money which was for her personal benefit and not in respect of counselling, and accepted additional money for the therapy sessions over and above the usual fee.

13. Ms North allegedly failed to ensure that the way that she undertook her work was as safe as possible and that she sought professional support when needed, in that she allegedly contacted the complainant in distress and used the therapy sessions and their social meetings to discuss her own personal problems.

14.  Ms North's alleged behaviour, as experienced by the complainant, suggests a contravention in particular of paragraphs 1, 3, 4, 11, 16, 17, 40, 46, 62 and 64 and the ethical principles of Being Trustworthy, Autonomy, Beneficence, Non-Maleficence and Justice of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013), and showed a lack of the personal moral qualities of Sincerity, Integrity, Humility, Competence and Wisdom to which counsellors are strongly encouraged to aspire.

Findings

On balance having fully considered the above the Panel made the following findings:-

1. The Panel found on the basis of the evidence that Miss North did not provide the complainant with a good quality of care in that she abruptly terminated therapy in or about 11 November 2012 following an incident where the complainant had hugged and kissed her at the end of the session. Miss North, in her verbal evidence to the Panel said that she had been shocked by the incident and had made an excuse, telling the complainant that she would not be able to continue the counselling sessions at his home, stating that she did not want to drive in the dark and had family demands. The Panel therefore found that Miss North had left the session abruptly and that this abrupt exit had left the complainant feeling unsafe.

This allegation is therefore upheld.

2.   Miss North accepted that she exchanged frequent text messages with the complainant, had telephone contact with him and contacted the complainant when she was in a distressed condition seeking his guidance.  The Panel further found that as a result of this contact the complainant believed that Miss North had feelings for him and that he was special.  On the basis of this evidence the Panel found that Miss North had failed to provide the complainant with a good quality of care and maintain appropriate boundaries.

This allegation is therefore upheld.

3.   The Panel found that on the basis of the evidence Miss North had failed to manage the issue of transference/counter transference in that following text messages and emails from the complainant where he declared his love for her, Miss North confirmed by text to the complainant that his love for her was reciprocated. The Panel found that this amounted to a failure to provide a good quality of care in that Miss North had failed to maintain appropriate boundaries in the counselling relationship.

The Panel further found that Miss North had told the complainant, in a phonecall on 13 November 2012, that she had projected her feelings about her ex-husband onto the complainant.

The allegation is therefore upheld.

4.   The  Panel made the following findings.

a)  It was conceded in evidence by the complainant that he was told at the commencement of the counselling contract of the circumstances in
which counselling would come to an end.  This part of the allegation is therefore not upheld.

b)  It was conceded by the complainant that some sessions took place at Miss North's home and others at the complainant's home.  The
complainant conceded that he was content with this arrangement.  This part of the allegation is therefore not upheld.

c)  The Panel found that there was agreement between Miss North and the complainant that payment had been discussed and made clear and that Miss North had accepted additional payment for sessions from the complainant. The complainant stated that he had been happy to pay over and above the agreed rate on occasion to help Miss North who he knew to be in strained financial circumstances. This part of the allegation is therefore not upheld.

d)  The Panel further found that on the basis of the evidence reviews were carried out by Miss North regarding the progress the complainant was making with therapy.  This part of the allegation is therefore not upheld.

e)  The Panel found, having heard the evidence, that Miss North did discuss issues of confidentiality, and the circumstances in which information relating to him would be disclosed with the complainant at the beginning of their counselling relationship.  This part of the allegation is therefore not upheld.

In view of the above findings, this allegation is not upheld.

5.   The Panel found that Miss North did enter into a dual relationship with the complainant as a counsellor and a friend through engaging in regular out of session texting, phonecalls and emails and the sharing of personal details.  This dual relationship was evidenced by the text and email communications that passed between the complainant and Miss North outside counselling sessions where she referred to the complainant as "big bro" and ended texts with an x denoting a kiss. Miss North admitted in her written evidence that she had a social relationship with the complainant and that she had used him as a support friend when distressed. In addition the Panel found that in her written and verbal evidence Miss North admitted that she had invited the complainant to form a spiritual group with her.

The allegation is therefore upheld.

6.   The Panel found that Miss North did discuss the complainant in supervision and that this was normal practice, and accepted that Miss North did not disclose his name. The Panel therefore found that Miss North had not failed to respect the complainant's privacy and confidentiality. The Panel further found that Miss North did not discuss the complainant with any other person. The Panel found that it was the complainant himself who had spoken to Miss North's friend [ . . . ] to introduce himself to her.

This allegation is therefore not upheld.

7.  Following Miss North's admission that she had not sent the complainant his records or the details of her supervisor as requested by him, the Panel did accept her evidence that she had not done so as she had taken advice and had been told that she was not obliged to do so.

The Panel were however concerned that Miss North had not sufficiently taken into account her responsibilities and her client's rights under the data protection legislation.

This allegation is therefore upheld.

8.   The Panel found that Miss North by entering into a dual relationship and by accepting money for sessions which focussed on her issues rather than on the complainant's needs did gain emotional and financial advantage.  The Panel found that Miss North hugged the complainant at the end of counselling sessions and entered into a personal relationship with him which led him to feel special.

The Panel found that Miss North suggested setting up a spiritual group in March 2013 in an attempt to temporarily provide support for the  complainant. The  Panel found that this was more for Miss North's immediate benefit than the complainant's.

The Panel found that there was no evidence to suggest that Miss North had imposed any boundaries upon the counselling relationship and that in fostering a personal relationship had emotionally misled the complainant to believe he was loved.

The allegation is therefore upheld.

9. The Panel found that Miss North had phoned the complainant in distress in June 2012 when her personal life was in crisis and that this contact led the complainant to believe that she was seeking his help as a friend. The Panel found that this contact indicated the start of the personal relationship between Miss North and the complainant and that by phoning the complainant under such circumstances evidenced that Miss North did not exercise caution before entering into a personal relationship with the complainant.

This allegation is therefore upheld. 

10. The Panel found on the basis of the evidence that Miss North had contacted the complainant in distress following an argument with her partner in or about June 2012 and that time had been spent in counselling sessions discussing her personal issues rather than those of the complainant.As such the Panel found that Miss North had failed to monitor and maintain her fitness to practise. 

This allegation is therefore upheld.

11.  The Panel found that Miss North did notify the complainant in June 2012 of the Professional Conduct Procedures. The complainant in evidence stated that he could not remember whether this had occurred or not. 

The Panel accepted the evidence given by the Member Complained Against and as such this allegation is therefore not upheld.

12. The Panel found, on the basis of Miss North's written and verbal  evidence that monies were paid by the complainant to Miss North which were not in payment of counselling sessions for the complainant but which were for her own personal benefit and that she had accepted money in addition to the normal counselling fee.  Therefore the Panel found that Miss North was not honest, straight forward and accountable to the complainant in respect of all financial matters.

This allegation is therefore upheld.

13.  The Panel found that Miss North had contacted the complainant in distress, had used his therapy sessions and social meetings for her
personal problems and that she had failed to seek professional support for these issues. Miss North admitted in evidence to the Panel that she had had regular supervision but that she had not used it appropriately because she believed her supervisor was stressed. Miss North admitted that she had undertaken the supervision knowing it was inadequate and did not meet her needs in respect of her work with the complainant and that she had failed to ensure that the work she undertook with the complainant was safe. 

This allegation is therefore upheld.

In the light of the above findings the Panel was satisfied that there was a contravention of paragraphs 1, 3, 4, 16, 17, 40, 62 and 64 of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013). 

The Panel found that there was no breach of paragraphs 11 and 46 of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013). 

The Panel found that the ethical principles of Being Trustworthy, Beneficence and Non-maleficence had been breached.  The Panel found that the ethical principles of Autonomy and Justice contained in the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013) had not been breached. 

Further the Panel found that Miss North showed a lack of the personal moral qualities of Sincerity, Integrity, Humility, Competence and Wisdom to which counsellors are strongly encouraged to aspire.

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice in that Miss North's practice fell below the standards expected of a practitioner exercising reasonable care and skill.  In particular, she provided the complainant with an inadequate professional service and further demonstrated incompetence and recklessness.

Mitigation

The Panel considered in mitigation the fact that Miss North had apologised unreservedly both through her barrister at the hearing and also personally to the complainant. 

The Panel also took into consideration that Miss North had taken no new private clients from Christmas 2012 and had undergone a brief 2 hour training on boundaries. 

The Panel further took into consideration the fact that Miss North was having personal therapy and in the light of the matters forming these
allegations she had changed her supervisor. 

The Panel also took account of her statement that she recognised the breaches as being serious and had sought assistance from the Panel during the hearing as to how she could remedy those breaches. 

The Panel also took account of Miss North's declaration that she would not work again in private practice without undertaking a substantial amount of further training.

The Panel also took cognisance of the testimonials that had been filed with the other documentation for the purposes of the hearing.

Sanction

The Panel decided on the following sanctions:

  • Within one month from the date of the imposition of this sanction, which will run from the expiration of the Appeal deadline and in the
    event of an appeal on exhaustion of the appeals process. Miss North is required to provide a written submission of no less than 2000 words, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint.
  • Within 12 months from the date of the imposition of this sanction, Miss North is required to attend training courses covering the topics listed below, each course of 6 hours duration and provide evidence of completion of same:-
  • The principles, practicalities and ethics of working in private practice.
  • The maintenance of boundaries and their importance in counselling relationships.
  • Transference, counter-transference and erotic transference in counselling relationships

Miss North will be required to demonstrate her learning from the above trainings in a written submission of no less than 2000 words. This submission to be made within 3 months of the completion of the training.

These written submissions must be sent to the Deputy Registrar and Deputy Director of BACP Registers by the given deadlines and will be independently considered by a Sanction Panel.

(Where ellipses [...] are displayed, they indicate an omission of text) 

       

  

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November 2013: Susannah Lee, Reference No: 719337, Surrey KT12

The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under BACP Professional Conduct Procedure 2010 and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the complainant had been having counselling/psychotherapy for five months with Ms Lee when on 23 August 2012 Ms Lee handed him a letter which included the suggestion that they end counselling. The complainant alleged that this came as a total shock to him as there had been no earlier hint of Ms Lee's intention to suggest this. The complainant alleged that Ms Lee gave her lack of experience as her reason for ending counselling with him, despite the fact that he had at that stage already had 19 sessions with her and that allegedly at no stage during those sessions had the process been reviewed with him, even though information on her website indicated that sessions would be reviewed every six weeks. The complainant alleged that Ms Lee had behaved inappropriately during their last session, commenting, for example, that he was manipulating the situation by crying, and suggesting that he sees a psychiatrist; acting in a condescending manner by suggesting that he need not worry as he would not have to pay for that final session; and showing no regret or sorrow for ending the counselling, declining even to shake his hand. The complainant alleged that by ending the counselling in this way, and contrary to information in the counselling contract signed by the client where she requested two weeks' notice from him should he wish to end counselling in order to "offer us both an opportunity to fully address the ending of our therapeutic relationship and any issues of support or further referrals", Ms Lee had acted unprofessionally. The complainant further alleged that Ms Lee had discussed his case with the complainant's GP without his knowledge or consent and had thereby breached his confidentiality. Finally the complainant alleged that his subsequent attempts to persuade Ms Lee to explain why she chose to end counselling with him went unanswered by her. In response to a request by the PHAP for copies of email and other correspondence with the complainant, and her notes for the three sessions prior to and including 23 August 2012, Ms Lee stated that the email box and notebook she used via her website had been cancelled and that she no longer had access to the emails from the complainant nor to her notes of the sessions with him.

The Pre-Hearing Assessment Panel (PHAP), in accepting this complaint, was concerned with the allegations made within the complaint suggesting a contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular are as follows:

1. Ms Lee allegedly failed to provide a good quality of service to the complainant in that she allegedly failed to manage the ending of the counselling relationship which ended abruptly, failing to meet the complainant's needs

2. Ms Lee allegedly failed to give careful consideration to her own competency limits, and failed to work within those limits, in that, after 19 sessions with the complainant, she allegedly concluded that she should end counselling with him because of her own lack of experience

3. Ms Lee allegedly failed to deliver a good service to the complainant in that allegedly she did not ensure that the rights and responsibilities of both herself and the complainant were clarified and agreed by them both so that the complainant could have a clear understanding of what he could reasonably expect from her in their counselling relationship

4. Ms Lee allegedly failed to keep appropriate records of her work with the complainant without a good or sufficient reason in that she allegedly cancelled her email box and notebook, which she had used via her website, resulting in her no longer having access to her notes of the sessions with the complainant

5. Ms Lee allegedly failed to deliver a competent service, which was periodically reviewed by her in consultation with the complainant, in that allegedly no such review was conducted at any stage during 19 sessions with him

6. Ms Lee allegedly failed to keep the trust of the complainant in that she allegedly failed to pay sufficient attention to the quality of listening and respect she offered to the complainant at and immediately after their final session

7. Ms Lee allegedly failed to respond to the complainant's request for information concerning her assessment, allegedly expressing to his GP, that he was becoming emotionally attached/dependent on her

8. Ms Lee allegedly failed to respect the complainant's right to privacy and confidentiality in that she allegedly discussed his case with his GP without notice to him and without his consent to do so

9. Ms Lee allegedly failed to respond promptly or at all to the complainant's request for information concerning the reason for her decision to terminate his counselling in that she allegedly failed to respond to a text message and two email messages from the complainant requesting such information and explaining its importance for him

10. Ms Lee allegedly failed to endeavour to remedy the harm allegedly caused to the complainant through her alleged failure to respond to his requests for information as to the reasons for her termination of counselling with him

11. Ms Lee's alleged behaviour as experienced by the complainant suggests a lack of the personal moral qualities of Integrity, Respect and Competence to which all practitioners are strongly urged to aspire; a contravention of paragraphs 1, 2, 3, 5, 6, 11, 16, 20, 41 and 42 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2010 edition); and the ethical principles of Being Trustworthy, Non-maleficence and Autonomy.

Findings

On balance, having fully considered the above, the Panel made the following findings:

1. There was a sharp difference of opinion between the parties in relation to this allegation.  The complainant stated that he was unaware before the final counselling session, that this was to be his last session.  Ms Lee however, stated both in her oral and written evidence that she gave notice to the complainant on 2 August, that 23 August 2012 would be their final session.  Whilst the Panel found that the quality of care provided to the complainant fell short of what was expected, given that Ms Lee was not appropriately supported by a supervisor, it was unclear whether or not the counselling had ended abruptly.  There was therefore, insufficient evidence for the Panel to make a determination in relation to this.  This allegation is not upheld.

2. Ms Lee, in her evidence stated that the complainant was her first client and admitted that at the time that she saw the complainant and throughout their counselling relationship, she did not have a supervisor in place.  The Panel found that given the complainant's medical condition and the fact that he had previously undergone counselling, for which he had fulfilled the quota of sessions that he could have with the previous organisation, it should have been apparent to Ms Lee that the counselling relationship would be a difficult one to manage.  The Panel agreed that Ms Lee was reckless in not having supervision in place, neither before she began her counselling work nor at any point during their counselling relationship.  Ms Lee admitted that she did not seek any guidance from an experienced practitioner before deciding that she could not work with the complainant and felt compelled to take the decision not to work with the complainant, as she thought it would be better for the complainant to work with a more experienced practitioner.  Ms Lee also admitted in evidence that she felt trapped and bullied by the complainant. The Panel therefore, found that Ms Lee did not give careful consideration to her competency limits and failed to work within those limits, and terminated counselling as a result of her own lack of experience.  This allegation is therefore, upheld.

3. The Panel questioned both parties in detail in relation to this allegation. Ms Lee's counselling contract with the complainant stated that she would discuss the complainant with her supervisor, when in fact she knew at the time that she entered into this contract, that she did not have a supervisor.  The complainant stated in his oral evidence that had he known that Ms Lee was working with him without supervision this would have caused him concern as he understood the importance of a counsellor having supervision.  Given that Ms Lee was a practicing counsellor and stated within her contract that she would discuss the complainant with her supervisor, the Panel found that the complainant could reasonably expect that Ms Lee would be supported by a supervisor, and at no point did Ms Lee clarify with the complainant that she was not in fact receiving supervision.  The Panel therefore, agreed that Ms Lee failed to provide a good quality of care to the complainant in that by failing to undergo the supervision she led the complainant to believe she was receiving, she failed to clarify the rights and responsibilities of both herself and the complainant, so that he could understand what he could expect from their counselling relationship.  This allegation is therefore, upheld.

4. Ms Lee admitted in her oral evidence that as a result of her closing down her website, she no longer had access to the complainant's records and did not have any back up records.  The Panel agreed that the explanation for the loss of the complainant's records was not good or sufficient, and Ms Lee had therefore, failed to keep appropriate records of her work with the complainant. The allegation is therefore upheld.

5. Ms Lee stated in her evidence that reviews with the complainant were carried out at sessions 6, 13 & 18.  Although Ms Lee did not have the complainant's notes to refer to, she relied upon the annotations that she had made upon the receipt stubs, which she denoted as "RV", to signify that a review had taken place.  The complainant admitted on questioning that a review did take place in session 6, but disagreed with Ms Lee's evidence that any further reviews had been carried out.  As both parties agreed that at least one review had been carried out, the Panel did not find that no review was conducted at any stage during the 19 sessions.  This allegation is therefore, not upheld.

6. The complainant in his evidence stated that he was shocked at the decision to end counselling and in the final session, asked Ms Lee to explain the reasons to him.  The complainant asserts that Ms Lee should have been more understanding of why he was upset at what he regarded as the sudden and abrupt ending of counselling.  The complainant stated at the end of the final session when he offered to shake Ms Lee's hand, she seemed reluctant to do so.  Ms Lee stated in her evidence that it is her practice to always wait for the client to offer their hand before she shakes it.  Ms Lee stated that she listened attentively to the complainant, notwithstanding her evidence that she felt intimidated and wanted the relationship to end.  Whilst the Panel accepted that Ms Lee was attentive to the quality of listening she offered to the complainant, it did not accept that Ms Lee was respectful to the complainant as she did not respond to the complainant's anxieties concerning his mental health needs, instead suggesting that he be referred to a psychiatrist.  Furthermore, the Panel considered it likely that the complainant picked up on the discomfort that Ms Lee was experiencing as a result of her feeling bullied.  The Panel therefore, found that the level of respect offered to the complainant fell below an acceptable level, and as a result Ms Lee failed to pay sufficient attention to the quality of respect offered to the complainant.  This part of the allegation is therefore upheld.  The Panel did not find that Ms Lee failed to pay attention to the quality of trust that she offered to the complainant.  This part of the allegation is therefore, not upheld.

7. In both her oral and written evidence, Ms Lee accepted that she did not respond to the complainant's request for further information regarding her assessment of him.  Ms Lee stated that at the last session the parties had agreed that there would be no further contact between them and stated that she thought that it may make matters worse to engage in correspondence with the complainant.  The Panel found that given that the complainant had indicated that he would be making a complaint to BACP and in view of her professional responsibility to the complainant, Ms Lee did fail to respond to the complainant's request for information regarding her assessment of him.  This allegation is therefore, upheld.

8. The complainant stated at the commencement of the hearing that he wished to withdraw this allegation, as he accepted that Ms Lee did have his consent to contact his GP.  It could therefore, not be said that Ms Lee failed to respect the complainant's privacy and confidentiality in this regard.  This allegation is therefore, not upheld.

9. Ms Lee stated in her oral evidence that she did not respond to the complainants request for information regarding her decision for terminating therapy.  Ms Lee stated that one of the requests made by the complainant was in relation to whether or not she had spoken to his GP.  Ms Lee stated that as this was a matter between her and the complainant's GP, she did not consider the need to discuss this with the complainant.  Further, Ms Lee stated that they had agreed at the last session not to have any contact with each other.  The Panel did not find the explanation given by Ms Lee satisfactory.  The Panel noted that Ms Lee's decision was made without any consultation with an experienced practitioner and no explanation was given by her to the complainant as to why she was not responding to his requests for information.  The Panel therefore, found that Ms Lee did fail to respond promptly or at all to the complainant's request for information.  This allegation is therefore, upheld.

10. Ms Lee admitted in evidence that she failed to respond to any correspondence from the complainant, from which it was clear that he was upset, seeking clarification from her as to the reason that she terminated therapy.  In failing to respond, the Panel found that it was clear that Ms Lee failed to remedy any harm caused to the complainant.  This allegation is therefore, upheld.

11. In light of the above findings, the Panel found that Ms Lee had breached the ethical principles of being trustworthy, non-maleficence and autonomy and paragraphs 1, 2, 3, 5, 11, 16, 41 and 42 of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010, and showed a lack of the personal moral qualities of integrity, respect and competence. The Panel found that paragraphs 6 & 20 of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010 had not been breached. 

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice on the grounds that Ms Lee was incompetent, reckless, negligent and provided an inadequate professional service with this client which fell below the standard that would reasonably be expected of a practitioner exercising reasonable care and skill.

Mitigation

Ms Lee stated in her oral evidence that she accepted the need to have adequate supervision in place, and when she returned to private practice, she would ensure that she had a supervisor in place.

Ms Lee also stated that in the future she would ensure that she would record her notes in a book and keep the book in a locked cupboard.

Sanction

Within one month from the date of imposition of this sanction, which will run from the expiration of the Appeal deadline, Ms Lee is required to provide a written submission, which evidences her immediate reflection on, learning from and understanding of, the issues raised in this complaint.

Ms Lee is also required to undergo 6 sessions of supervision of a minimum of an hour and a half per session with a supervisor who is a BACP accredited member, or equivalent, and has at least 5 years' experience.  Ms Lee is required to provide proof of the supervisor's qualifications and experience.  Within these sessions Ms Lee should deal with the following:

  • Her in-depth understanding of how the quality of her interactions with the complainant and her lack of experience, led to the complaint.
  • Her new and increased understanding of what she has learnt about herself and her internal processes.

Ms Lee is required to provide a signed letter from her supervisor confirming that she has undertaken at least 6 sessions of supervision and that the above areas have been dealt with in supervision.  Such evidence is required to be provided in no less than 6 and no more than 18 months.

Ms Lee is also required to provide a further written report detailing her further in-depth learning and understanding as a result of the complaint and the supervision that she has undertaken above.  This report should be countersigned by Ms Lee's supervisor.  This report is due within no less than 6 months and no more than 18 months, and in any event after she has undergone the 6 sessions of supervision.

Ms Lee is further required to provide a written undertaking to BACP, at the same date as her first submission, i.e. within one month from the expiration of the appeal deadline, confirming that she will provide written notification to BACP of the date that she intends to re-commence work with clients, before she undertakes such work.  

Following the completion of the written part of the sanction, Ms Lee is required to attend an interview arranged by BACP, where she will be required to demonstrate a satisfactory and improved understanding of the importance of supervision for counsellors and psychotherapists.  

  

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July 2013: Francis Jacob, Reference No: 590709, Lichfield WS13  

The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure.

The complaint was heard under BACP Professional Conduct Procedure 2010 and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant was referred to Mr Jacob for counselling by her GP and that counselling commenced on 3 June 2009.  The number of sessions to which the Complainant was entitled, was extended after the involvement of the Community Mental Health Team (CMHT).  The Complainant's counselling with Mr Jacob ended on 15 July 2010.

The Complainant alleges that Mr Jacob transgressed professional boundaries in relation to the counselling services he provided for her, including allowing sessions to overrun, escorting her from the building, giving her tea, biscuits and cake, discussing his own personal issues, including the implications for the Complainant if he set up a private practice and having coffee with her in a social setting and meeting in a pub. 

The Complainant alleges that Mr Jacob communicated with her by text using his personal phone and also by email, out of hours and at weekends and that she used these ways of communicating with him heavily, which allegedly increased her sense of dependence on him.

The Complainant alleges that Mr Jacob made fun of her and said abusive and insulting things and threatened to withdraw therapy.  The Complainant alleges that Mr Jacob made comments indicating that he was sexually attracted to her and he gave her a kiss on the cheek, after spending an afternoon with her.  At the next appointment, Mr Jacob allegedly behaved in a hostile and critical way towards the Complainant.  Allegedly when the Complainant challenged Mr Jacob about his behaviour via email, he threatened to withdraw therapy if she spoke of the matter again.

The Complainant alleges that Mr Jacob expressed his disagreement about the medical diagnosis made regarding her psychological problems, commenting that consultants only gave out medication.  The Complainant further alleges that she requested a referral to a Community Psychiatric Nurse but that Mr Jacob did not pursue her request despite her increasing mental instability but continued to take responsibility for her care and then went to Canada for 3 weeks leaving her unsupported.

The Complainant alleges that Mr Jacob refused to see her with her Care Co-ordinator for a closure meeting but subsequently sent her text messages which did not make sense or were incomplete.

The Pre-Hearing Assessment Panel, in accepting this complaint, was concerned with the allegations made within the complaint suggesting a contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy, and those in particular are as follows:

1. Mr Jacob allegedly failed to provide the Complainant with a good quality of care in that he: -

i. Often allowed the Complainant's counselling session, which was the last appointment in the evening, to overrun, which risked undermining any sense of containment for the Complainant.

ii. Escorted the Complainant from the building at the end of her session through the car park, which allegedly blurred boundaries.

iii. Provided cups of tea, cakes and biscuits during counselling sessions, which risked undermining the professional nature of the relationship.

iv. On 15 February 2010, went to a pub to discuss the Complainant's issues and thereafter spent the afternoon with her socially, risking undermining the therapeutic work and professional nature of the counselling relationship.

v. Talked to the Complainant during the meeting referred to above, about his own significant personal issues rather than the Complainant's, which allegedly emotionally affected the Complainant, altering the nature of the counselling relationship and the potential for the Complainant to focus on her own needs, which was to her detriment.

vi. On 1 July 2010, had a social meeting with the Complainant, lasting 2 hours, which covered issues linked to the Complainant's therapy as well as a discussion about significant events in Mr Jacobs personal life and his feelings towards the Complainant.  The content of this encounter allegedly undermined the professional counselling relationship and the potential for the Complainant to focus on her own needs during counselling, which was to her detriment.

vii. Discussed with the Complainant the threat to her if he set up in private practice and commented that she was getting a good deal in getting him on the NHS for nothing, which the Complainant allegedly found disturbing and threatening.

viii. Failed to explore with the Complainant the possible impact on the therapeutic work, the fact that Mr Jacob and the Complainant knew people mutually and that they talked about them during therapy, which allegedly caused the Complainant to feel confused.

ix. Used his personal phone for texting the Complainant and suggested the use of email for out of session contact, including weekends, which allegedly increased the Complainant's sense of dependency on Mr Jacob as she made extensive use of this facility.

x. Encouraged the Complainant to write a narrative, which was part of his work for a university, and for his own benefit, blurring boundaries and having the potential of being exploitative.

xi. Sent the Complainant two unexplained empty/incomplete text messages after counselling had ended, despite the fact that he had been instructed by his employer to have a separate work mobile and delete her details from his personal phone which resulted in the Complainant feeling very distressed. 

2. Mr Jacob allegedly failed to maintain competent practice in that he: -

i. Told the Complainant that he had not talked to his supervisor about whether he had crossed boundaries in his work with the Complainant, such as asking her to go for a coffee.

3. Mr Jacob allegedly failed to keep the Complainant's trust in that he: -

i. Showed a lack of respect and courtesy towards the Complainant in the way he spoke to her on occasions, making fun of her, saying that she paraded herself in front of men, interpreting her flushing when wearing a low summer top as an indication of a sexual attraction for him, allegedly called her a dirty bitch, and asking repeatedly what message she put across to guys.

ii. Abused the Complainant's trust to gain sexual and emotional advantage by:

  • a) Saying in February 2010, that therapy sessions felt like they were having an affair.
  • b) On 15 February 2010, saying to the Complainant after spending an afternoon with her, that he should kiss her on the cheek as they had met socially and then doing so when they parted company.
  • c) On the date referred to above, saying to the Complainant that he wanted her and if he was not married, he would "go for it".
  • d) On 1 July 2010, when he asked the Complainant to have coffee with him and they talked about the sexual attraction between them, using phrases such as "if he wanted to get his leg over" and saying that the connection between them could be "purely carnal".
  • e) On other occasions, saying to the Complainant that she had a special place in his heart, that he thought of her outside of therapy and that he would not forget her.

4. Mr Jacob allegedly failed to respond appropriately when things were going wrong in the counselling relationship, in that he: -

i. On 18 February 2010, blamed the Complainant for what had occurred on 15 February, mainly in relation to an incident in the pub, and was hostile towards her and threatened to end counselling.

ii. Failed to pursue a request made by the Complainant that she be referred to a Community Psychiatric Nurse despite her increasing mental instability but continued to take responsibility for her care.

iii. Went to Canada for 3 weeks without making any arrangements for the Complainant, despite his alleged agreement with the Mental Health Crisis Team to take responsibility for her care, with a care plan that included referral to a psychiatrist and speaking to the GP about her medication.

iv. Told the Complainant on his return from Canada when the Complainant checked what he had done in relation to the care plan, that "it was not what he had signed up for." 

v. Failed to take any responsibility for the breakdown of the counselling relationship with the Complainant.

vi.After counselling ended abruptly in July 2010, did not respond to requests for him to attend a meeting to try to achieve closure for the Complainant.

5. Mr Jacob allegedly failed to work in a respectful and collaborative way with colleagues to enhance the services available to the Complainant in that he:

i. Questioned the medical diagnosis that the Complainant had been given, criticised psychiatrists for prescribing medicines and the competence of other agencies involved in her care, thereby reducing her trust in other professionals who might have enhanced her care and increasing her dependence on him.

ii. Failed to work in a collaborative way with other agencies which might have assisted in the Complainant's care or worked in parallel with him and failed to refer the Complainant to a CPN and her Psychiatrist in a timely way, which was to her detriment.

6. Mr Jacob's alleged behaviour, as experienced by the Complainant, showed a lack of the personal moral qualities of integrity, sincerity, respect and competence to which practitioners are strongly encouraged to aspire, as outlined in the Ethical Framework for Good Practice in Counselling and Psychotherapy 2007/2009 & 2010.  It also suggests a contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2007/2009 and in particular paragraphs 1, 2, 7, 11, 18, 33, 34, 43 and 46 and the ethical principles of fidelity, autonomy, beneficence and non-maleficence and the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010 and in particular, paragraphs 1, 2, 7, 11, 17, 41, 42, 51 and 54 and the ethical principles of being trustworthy, autonomy, beneficence and non-maleficence.

Findings

On balance, having fully considered the above, the Panel made the following findings:

1. In relation to the allegation that Mr Jacob failed to provide the Complainant with a good quality of care, the Panel made the following findings:-

i. Mr Jacob accepted in both his oral and written evidence that he allowed the counselling sessions with the Complainant to overrun because the Complainant was often in an emotionally unsatisfactory state, and it would take time to get her to a place where she was stable.  The Panel was of the opinion that Mr Jacob should not have let the pattern of overrunning form and should have sought to wind down the counselling session sooner, to deal with this issue.  This allegation is therefore upheld.

ii. The Panel accepted Mr Jacob's evidence that it was the practice within the GP practice that all clients had to be escorted out of the building.  The Panel accepted Mr Jacob's evidence that he did not walk the Complainant through the car park, and this part of the allegation is therefore not upheld.  Mr Jacob stated that there were three occasions when as he was walking to Tesco to collect his car, the Complainant walked with him.  This part of the allegation is therefore upheld.

iii. Mr Jacob admitted that there were occasions when he provided the Complainant with a cup of tea, but this was prior to the commencement of the counselling sessions, and not during.  Mr Jacob advised that he did this out of courtesy as he was making himself a cup of tea and had to walk past the Complainant in the waiting room to access the tea making facilities.  Both parties accepted that cake was offered to the Complainant on one occasion.  The Panel was not satisfied, on the evidence, that this had occurred during the session.  This allegation is therefore not upheld.

iv. Mr Jacob accepted that he went to the pub with the Complainant, but stated that when he did so, he was still in "therapeutic mode".  The Panel found that Mr Jacob was trying to rescue the Complainant from her distress and that by meeting the Complainant in this way, Mr Jacob risked undermining the therapeutic work and professional nature of the counselling relationship.  This allegation is therefore upheld.

v. There was conflicting evidence from both parties in relation to the allegation that Mr Jacob had talked about his own personal issues rather than the Complainant's, to her detriment.  On balance the Panel was not satisfied that there was sufficient evidence for it to uphold the allegation and therefore this allegation is not upheld.

vi. Mr Jacob accepted that a meeting took place with the Complainant on 1 July 2010 in a café in a shopping centre.  There was disagreement between the parties about the length of this meeting.  Mr Jacob accepted that it was a mistake to meet with the Complainant in a shopping centre.  Mr Jacob admitted that he did disclose personal information to the Complainant at this meeting, but this was of a limited nature, to add authenticity to the issue of abandonment that they were discussing.  Mr Jacob denied that this was a social meeting but an ad-hoc therapeutic session.  The Panel found that this type of setting was wholly inappropriate for a counselling session and that such a meeting had the effect of altering the context of the therapeutic relationship, to the Complainant's detriment.  The allegation is therefore upheld. 

vii. Although the parties agreed that there was some discussion about Mr Jacob setting up in private practice, there was a difference of opinion about what was discussed.  In particular, Mr Jacob denied that he had made any threat.  The Panel had insufficient evidence to make a determination, and this allegation is therefore not upheld.

viii. There was a difference of opinion between the parties as to who instigated a discussion in relation to people who were known to both parties. The Panel had insufficient evidence to make a determination. This allegation is therefore not upheld.

ix. Mr Jacob admitted that he used his personal phone for all of his clients at the practice, because he had not been provided with a business phone.  Both parties accepted that out of session contact took place by email and text message, and that Mr Jacob encouraged the Complainant's use of email.  The Panel was satisfied on the evidence that this had encouraged dependency and this allegation is therefore upheld.

x. Mr Jacob denied that he had encouraged the Complainant to write a narrative as part of his work for a University.  He stated that he provided the Complainant with a book on narrative psychology to assist her in providing more structure to her writing.  On balance this allegation is therefore not upheld.

xi. Mr Jacob accepted in his oral and written evidence that two empty text messages were sent by accident to the Complainant after counselling had ended but that this was a mistake.  Mr Jacob apologised for it and accepted that this would have caused the Complainant distress.  This allegation is therefore upheld.

2. In relation to the allegation that Mr Jacob failed to maintain competent practice, the Panel made the following findings:-

i. While Mr Jacob did not say that he would never discuss the issue of boundaries with his supervisor, he accepted that he did say to the Complainant that he would not speak to his supervisor at that time.  In this, Mr Jacob failed to maintain competent practice and this allegation is therefore upheld.

3. In relation to the allegation that Mr Jacob failed to keep the Complainant's trust, the Panel made the following findings:-

i. Whilst Mr Jacob accepted that he called the Complainant "a dirty bitch", he stated that he did so in a joking way with no intention of disrespect towards the Complainant.  Mr Jacob accepted that it was inappropriate to use language such as this.  This part of the allegation is upheld.  Mr Jacob denied that he had said that the Complainant paraded herself in front of men, or interpreted her flushing as sexual attraction towards him.  Further, he stated that he only asked the Complainant in one session what message she thought she was putting across to guys, and did not do this repeatedly.  He further provided the context in which he had made the statement indicating that it was not intended in a disrespectful way.  This part of the allegation is therefore not upheld.

ii. With regard to allegations 3 ii a-c, there was insufficient evidence to support those allegations and they are therefore not upheld.

With regard to allegations 3 ii d) and e), the Panel made the following findings:-

d) Mr Jacob stated that he did discuss the Complainant's sexual attraction to him at this meeting and admitted that he used the term "get his leg over", but stated that he did this in an attempt to convey to the Complainant that they were not involved in a personal relationship. Mr Jacob wholly accepted that he should not have used this terminology and that it was inappropriate. This part of the allegation is therefore upheld. There was no evidence that Mr Jacob had said that the connection between them was carnal. This part of the allegation is therefore not upheld.

e) Mr Jacob gave evidence that he told the Complainant that he thought about all of his clients outside of therapy, and that in general there were clients that he would never forget.  This allegation is therefore partially upheld.

4. In relation to the allegation that Mr Jacob failed to respond appropriately when things were going wrong in the counselling relationship, the Panel made the following findings:-

i. Mr Jacob denied that he was hostile or blamed the Complainant for the incident in the pub.  Mr Jacob stated in his evidence that he apologised to the Complainant for this incident.  The Panel accepted Mr Jacob's evidence that he advised the Complainant that counselling could not continue if boundaries were not maintained.  Mr Jacob however denied that he made any threat to end counselling.  This allegation is therefore not upheld.

ii. The Panel found that Mr Jacob did not support the Complainant, in his absence, by ensuring that there were adequate resources in place to support her in relation to her mental instability.  The Panel also found that Mr Jacob did not interact with the Mental Health Team and instead suggested that the Complainant contact her GP for a referral to a Community Psychiatric Nurse.  Mr Jacob in his evidence said that he did not know of the range of services that may have been available to the Complainant, and had his clinical line manager, who was on long term sick leave, been available he would have made enquiries about the range of services on offer.  The Panel found that Mr Jacob had responsibility for the Complainant and that he failed to respond appropriately to ensure sufficient cover was put in place.  In the absence of his clinical manager, Mr Jacob should have sought guidance elsewhere.  The Panel were therefore of the view that Mr Jacob had a duty of care to the Complainant, which he failed to honour.  This allegation is therefore upheld.

iii. Mr Jacob admitted on questioning, that the Mental Health Crisis Team "handed" the Complainant back to him, after she had sought their services.  Mr Jacob in his evidence stated that he did not know what this meant but, before he went away to Canada he gave the Complainant a card with the contact details of the Mental Health Crisis Team.  In failing to check with either the Mental Health Crisis Team or the GP what this meant, the Panel found that Mr Jacob failed to make adequate arrangements for the Complainant.  This part of the allegation is therefore upheld.  The Panel found no evidence that there was any agreement between Mr Jacob and the Mental Health Crisis Team.  This part of the allegation is therefore not upheld.

iv. The Panel found insufficient evidence to support the allegation that Mr Jacob had told the Complainant that he had not signed up to a care plan, and this allegation is therefore not upheld.

v. Mr Jacob stated that counselling with the Complainant was terminated by the Mental Health Team, and not by himself, after the Complainant became ill.  There was insufficient evidence to support the allegation and it is therefore not upheld.

vi. Mr Jacob stated in evidence that in compliance with instructions from the GP practice not to contact the Complainant, he agreed not to do so to comply with the policy and procedures of the practice.  Furthermore, Mr Jacob stated that the Complainant was still contacting him after the termination of counselling and he therefore did not consider it appropriate to attend a meeting with the Complainant.  This allegation is therefore not upheld.

5. In relation to the allegation that Mr Jacob allegedly failed to work in a respectful and collaborative way with colleagues to enhance the services available to the Complainant, the Panel made the following findings:-

i. Mr Jacob stated in his evidence that he accepted the diagnosis that the Complainant had been given, but drew to the Complainant's attention the problems that could be caused when people are labelled.  Mr Jacob denied that he had criticised other agents and psychiatrists or the competence of their care.  This allegation is therefore not upheld.

ii. The Panel accepted the Complainant's evidence that she had asked Mr Jacob to make a referral to a Community Psychiatric Nurse, and Mr Jacob failed to do this.  The Panel found that Mr Jacob was unaware of the work that the other agencies were doing with the Complainant and failed to refer the Complainant back to the Mental Health Team, which might have assisted the Complainant.  Mr Jacob stated that he was not aware of, or involved in any meetings relating to the care of the Complainant and was not party to her care plan.  This allegation is therefore upheld.

6. In respect of the above findings, the Panel found that Mr Jacob showed a lack of the personal moral qualities of integrity, sincerity, respect and competence to which all practitioners are strongly encouraged to aspire. The Panel also found that Mr Jacob had breached the ethical principles of fidelity, beneficence and non-maleficence as set out within the Ethical Framework for Good Practice in Counselling and Psychotherapy 2007/2009, and paragraphs 1, 2, 11 and 43. The Panel found that the ethical principle of autonomy and paragraphs 18, 33, 34, and 46 had not been breached.

In relation to the 2010 Ethical Framework for Good Practice in Counselling and Psychotherapy the Panel found that Mr Jacob had breached the ethical principles of being trustworthy, beneficence and non-maleficence and paragraphs 1, 2, 11, 42 and 51, but the ethical principle of autonomy and paragraphs 7, 17, 41 and 54 had not been breached.

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice in the provision of inadequate services and incompetence.

Mitigation

The Panel were of the opinion that there were systemic failings within Mr Jacob's working environment, namely that the Complainant was not matched to Mr Jacob's competence and was not appropriately assessed before being transferred to him.

The Panel noted Mr Jacob's line manager was absent during an important stage within the counselling relationship.

Mr Jacob seemed to be unaware as to whom he was accountable and the Panel accepted that there appeared to be confusion regarding to whom Mr Jacob was accountable within the Primary Care setting.

Mr Jacob accepted that he acted outside of his level of competence and accepted that he should have dealt with the issue of boundaries in a more robust way.  Further Mr Jacob accepted that on occasion the choice of words that he used with the Complainant was not appropriate and that he should have been more open and explicit with his supervisor when discussing the boundary issues with her.

Sanction

Within one month from the date of imposition of this sanction, which will run from the expiration of the Appeal deadline, Mr Jacob is required to provide a written submission, which evidences his immediate reflection on, learning from and understanding of, the issues raised in this complaint.

Within 12 months from the date of imposition of this sanction, Mr Jacob is required to attend courses covering the topics below, each course of 6 hours duration, and provide evidence of completion of the same:

  • Training in mental health issues in counselling
  • Transference and erotic transference
  • Maintenance of boundaries in counselling relationships

Within 12 months from the date of imposition of this sanction, Mr Jacob is also required to provide a written report, of no less than 2,000 words demonstrating his in depth learning and understanding of the following:

Ø Erotic transference and its impact and management in the counselling relationship,

Ø The maintenance of boundaries and their importance in counselling relationships,

Ø The cultivation of dependency in counselling relationships and the impact and consequences for clients.

Upon completion of the above, and in no less than 12 months and no more than 18 months, Mr Jacob will be required to appear for interview, before a Sanction Panel, to give verbal evidence of sufficient learning from and understanding of, the issues raised in this complaint.

These written submissions must be sent to the Deputy Registrar and Deputy Director of BACP Registers by the given deadlines, and will be independently considered by a Sanction Panel and at the interview.