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Hearing Findings, Decision & Sanction


July 2014: Fiona Legh-Ellis, Reference No: 505641, Worthing BN11


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 on 9 November 2012, the complainant attended an appointment with Ms Legh-Ellis, who was working predominantly with her daughter, but also saw the complainant, her husband and son on occasion.  The complainant alleges that she was disturbed to see her husband's car there, which made her feel very distressed.  The complainant alleges that Ms Legh-Ellis escorted her to a room she had not been in before, left her there, and then returned with some people she did not know.  The complainant alleges she was very frightened and tried to leave the room but was forcibly detained.

The complainant alleges that she remained very frightened and distressed but was detained in the room with a policeman and a lady from social services.  The complainant alleges that she was eventually able to calm down but was concerned that she was being arrested.  The policeman and representative from social services allegedly assured her they were not there to arrest her, but there to help her and to talk.  After approximately one hour the complainant alleges that they left her to talk to her husband and daughter who were in another room at the same premises.

The complainant alleges that Ms Legh-Ellis then returned to the room, but that she was very angry with Ms Legh-Ellis and left the building feeling betrayed and broken.

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 Legh-Ellis allegedly failed to provide the complainant with a good quality of care, by failing to notify her that the Police and Social Services would be arriving to speak to her during a pre-arranged counselling session, instead taking her into a room in which she had never been before, causing the complainant to feel trapped and scared.

2.        Ms Legh-Ellis allegedly failed to give consideration to the limitations of her training in that it appeared that she had no experience of dealing with child protection issues. 

3.        Ms Legh-Ellis allegedly failed to clarify the rights and responsibilities of both the practitioner and client, with the complainant, in that she did not discuss with the complainant that the Police and Social Services would be attending during her counselling session.

4.        Ms Legh-Ellis allegedly failed to ensure that her records were kept securely and were adequately protected from unauthorised disclosure, by keeping information relating to the complainant in her kitchen.

5.         Ms Legh-Ellis allegedly failed to ensure that she communicated with the complainant in a way which was courteous and clear, in that she failed to notify the complainant, either before or at the time of her visit, that the Police and Social Services would be attending.

6.        Ms Legh-Ellis allegedly failed to ensure that her services were delivered on the basis of the complainant's explicit consent, by not seeking the complainant's consent as to whether or not she wished to talk to the Police and Social Services.

7.        Ms Legh-Ellis allegedly failed to respect the complainant's privacy and confidentiality in that she informed the complainant's husband of her appointment and allegedly failed to ensure that the complainant's personally identifiable information was securely stored.

8.        Ms Legh-Ellis allegedly failed to remedy the harm she may have caused to the complainant in that she did not apologise to the complainant following the visit from the Police and Social Services.

9.        Ms Legh-Ellis allegedly failed to foresee and manage the conflict of interest which could arise as a result of her providing counselling/psychotherapy related services to the complainant, her husband and their daughter.

10.      Ms Legh-Ellis' alleged behaviour, as experienced by the complainant, suggests a contravention in particular of paragraphs 1, 2, 3, 5, 11, 13, 20, 42 and 63, 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 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 that Ms Legh-Ellis was not aware until the Police and Social Services arrived that they wished to speak to the complainant, and accepted her evidence that she had been told by the complainant's then husband that they were there to see him and his daughter.  It could therefore not be said that Ms Legh-Ellis failed to notify the complainant that the Police and Social Services would be arriving to speak to her.  The Panel therefore, did not find that Ms Legh-Ellis failed to provide a good quality of care to the complainant in this regard. 

This part of the allegation is therefore not upheld.

The Panel heard evidence from both parties that the complainant was taken into a room in which she had never been before but accepted that this was because other rooms in the house were occupied.  The complainant stated that she had not felt trapped or scared by being taken into
the room. It was being confronted by representatives of the Police and Social Services entering the room with the purpose of speaking to her which made her feel trapped and scared. 

This part of the allegation is therefore not upheld.

2)        The Panel accepted the evidence of Ms Legh-Ellis that she had experience of child protection issues and that in her practice she had dealt with such issues on three or four occasions.  The complainant accepted that Ms Leigh Ellis had experience in this area.

The Panel therefore, did not find that Ms Legh-Ellis failed to give consideration to the limitations of her training in this instance.

This allegation is therefore not upheld.

3)        The Panel found that Ms Legh-Ellis did clarify the rights and responsibilities of both herself and the client with the complainant and that she provided her with a leaflet setting out those rights and responsibilities at the commencement of their contractual relationship.  Further
the Panel, having heard the evidence of Ms Legh-Ellis, accepted that she did not know that the Police and Social Services were coming to her house until shortly before the complainant had arrived at the house for her appointment and at the time of her arrival there was not an appropriate time or sufficient opportunity for Ms Legh-Ellis to advise her of the arrival of the representatives of the Police and Social Services.

This allegation is therefore not upheld.

4)        The Panel heard from Ms Legh-Ellis evidence as to how she kept her records.  Ms Legh-Ellis in her evidence stated that the only records that were kept in her kitchen were address cards, which contained the contact details of her personal and professional contacts, including clients.  She confirmed in evidence to the Panel that no confidential and personal information had been lost or subject to any unauthorised disclosure and that it would not be possible to determine from the address cards which of them were her clients.  Further, the complainant in her evidence stated that she was satisfied that her personal information had not been subjected to unauthorised disclosure.

This allegation is therefore not upheld.

5)        The Panel found that there was no evidence available that Ms Legh-Ellis failed to communicate with the complainant in a way that was courteous and clear.  Further, as in Allegation 3, and having heard the evidence, the Panel concluded that Ms Legh-Ellis did not know when the
representatives of the Police and Social Services were coming to her house until shortly before the complainant had arrived at the house for her
appointment and that there was not an appropriate time or sufficient opportunity for Ms Legh-Ellis to advise her of the arrival of the representatives of the Police and Social Services. 

This allegation is therefore not upheld.

6)        The Panel heard evidence that Ms Legh-Ellis was initially not aware that the representatives of the Police and Social Services wanted to speak to the complainant.  It was only when she went downstairs to let the representatives of the Police and Social Services into the house that she became aware that they wanted to speak to the complainant.  The representative from the Police said that they would go upstairs and  introduce themselves to the complainant.  However, the Panel found that, given that it was Ms Legh-Ellis' house and that the complainant was there to see her, that she should have gone upstairs alone and advised the complainant that the Police and Social Services wanted to speak to her and find out from the complainant if she was prepared to meet with them.

Therefore Ms Legh-Ellis failed to ensure that her services were delivered on the basis of the complainant's explicit consent and therefore, this allegation is upheld.

7)        The Panel found that due to the nature of the counselling services provided by Ms Legh-Ellis to the complainant and her family, the work provided was not covered by a confidentiality agreement and no explicit instructions had been given by the complainant to Ms Legh-Ellis that she could not talk to her then husband about her appointment times.  In the circumstances, Ms Legh-Ellis was entitled to inform the complainant's then husband of her appointment.

This part of the allegation is therefore not upheld.

Further the Panel found that personal information relating to the complainant was not kept in an unsecure way.  The Panel heard that the
complainant's name and contact details were kept on an index card, which was stored in a box in her kitchen and her records were kept in a locked filing cabinet.  The Panel further heard that although the index cards had got mixed up, they had not been lost.

This part of the allegation is therefore not upheld.

8)        The Panel found that Ms Legh-Ellis did not apologise to the complainant following the visit of the representatives of the Police and Social Services.  Although Ms Legh-Ellis was not aware that the Police and Social Services would arrive at the same time as the complainant, nevertheless it was her house, and she may reasonably have been expected to contain the situation, or to acknowledge the distress caused subsequently. Therefore, the Panel found that given all the circumstances of the visit to the house by the representatives of the Police and Social Services, Ms Legh-Ellis should have apologised to the complainant.  Further the Panel considered that Ms Legh-Ellis could have apologised to the complainant during the course of the Professional Conduct Hearing, which the Panel noted she did not do despite spending a considerable period of time during the Professional Conduct Hearing in the same room as the complainant with more than adequate opportunity to do so.

This allegation is therefore upheld.

9)        The Panel found from the evidence that there was a conflict of interest.  The Panel found that a counsellor should not work with a person "making a disclosure" and the party about whom "that disclosure is made", as had occurred in this case.  The Panel further found from the evidence that Ms Legh-Ellis failed to foresee that such a conflict could arise in her working relationship with the complainant's family.  The Panel found that if Ms Legh-Ellis had trained as a family therapist she would have learnt to deal with these matters.  Although the Panel accepted
that Ms Legh-Ellis was not offering family therapy, but support, she accepted in her oral evidence that the distinction was unclear and that these incidents involving the complainant and her family were such that she was acting outside her sphere of competence.  The Panel found that she
should have acted earlier to cancel her appointment with the complainant in the knowledge of the report that was going to be made by the complainant's then husband to the Police and Social Services. 

This allegation is therefore upheld. 

10)     In light of the above findings the Panel was satisfied that there was a contravention of paragraphs 13, 42 and 63 and the ethical principles of Autonomy, Beneficence and Non-maleficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013).  The Panel also found that Ms Legh-Ellis showed a lack of the personal moral qualities of Humility, Competence and Wisdom to which all counsellors are strongly encouraged to aspire.

However, the Panel was satisfied that there was no contravention of paragraphs 1, 2, 3, 5, 11, and 20 or the ethical principle of Being Trustworthy of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2013).  The Panel also found that Ms Legh-Ellis did
not show a lack of the personal moral quality of Integrity.

Decision

In light of these findings and the allegations that were upheld, the Panel was unanimous in its decision that these amounted to professional malpractice on the grounds of inadequate professional services.

Mitigation

The Panel accepted the evidence of Ms Legh-Ellis that she no longer provided family support services and in particular that Ms Legh-Ellis no longer worked with complex families.

Ms Legh-Ellis stated that she had changed her record keeping and had further changed her procedures.

The Panel further accepted that on the day in question, which founded the basis of these allegations, it was a complex situation and Ms Legh-Ellis was overwhelmed by events.

Ms Legh-Ellis stated that there were things that she could have done better with the benefit of hindsight and she had acknowledged that she should have done things differently.

Sanction

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Ms Legh-Ellis 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 six months from the date of imposition, Ms Legh-Ellis should provide a statement setting out her overall understanding of the events, and in particular her increased understanding of the significance of the need to remedy harm and apologise to clients who allege harm. 

Within the above statement Ms Legh-Ellis is required to confirm that she has discussed in supervision these issues with her supervisor and her supervisor is required to countersign the statement confirming such discussions did take place. 

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.

  

  

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June 2014: Johnathan Pease, Reference No: 551637, Hertfordshire CM23


The complaint against the above individual member was taken to Adjudication in line with the Professional Conduct Procedure followed by an Appeal Hearing.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the complainant and her partner began couples counselling with Johnathan Pease in 2006, at his practice premises.  The central issue that they wished to discuss was that, whilst the complainant wished to have children, her partner did not, and this disagreement was having a negative impact on their relationship.

The complainant alleges that, because they had difficulties in engaging with therapy as a couple, Mr Pease suggested that he see them separately.  The complainant's partner allegedly attended for four weeks of individual counselling and then the complainant attended on her own for around a year.  The complainant alleges that she was initially keen on Mr Pease's suggestion of individual counselling as she felt that she was at an impasse with her partner and this may assist, but that she assumed that her and her partner would eventually enter back into couples therapy.  However, the complainant states that having undergone training to become a therapist herself, she would be extremely cautious of couples undergoing individual counselling sessions whilst they were already undergoing couples therapy.  The complainant also alleges that seeing her and her partner individually, deepened the divide between them, and therefore Mr Pease was not working in their best interests.

By June 2006, the complainant had allegedly developed strong feelings, amounting to an infatuation for Mr Pease, which she allegedly disclosed to him during a counselling session.  The complainant alleges that she suspected that Mr Pease had taken this issue to supervision as
Mr Pease allegedly offered to refer the complainant on to a colleague, but she expressed a preference to continue working with him and they therefore continued their sessions. 

Mr Pease allegedly complimented the complainant on her clothing, and encouraged them to hug at the end of sessions.  In addition, he allegedly commented on how much he enjoyed her texts, which the complainant saw as a sign that he had feelings for her. 

The complainant allegedly arrived early for one session, and interrupted Mr Pease's session with another client.  Mr Pease's alleged attitude at this, upset the complainant, and as a result she left the premises and did not respond to Mr Pease's pleas for her to come back for her counselling session.  The complainant instead went to the supermarket where Mr Pease allegedly arrived a short time later.  Allegedly sensing that the complainant was shocked, Mr Pease hugged the complainant in the public car park, where people who knew the complainant and her partner could potentially have seen this display. 

Around autumn 2006, Mr Pease moved his practice premises to his home.  At this time, the complainant allegedly noticed a shift in their relationship and alleges that Mr Pease was "grooming" her.  She alleges that he was playing into the disclosures that she had made around her sexual issues by allegedly talking to her about helping other clients who had sexual issues and, specialising his practice into practical sexual help.  Mr Pease also allegedly disclosed that he had entered into sexual relationships with women to help overcome their frigidity. 

During the period leading up to Christmas 2006, Mr Pease allegedly disclosed that he rarely received Christmas cards from clients. 
In an attempt to please, the complainant allegedly made a special trip to Mr Pease's premises to deliver a Christmas card to him.  However, during the Christmas break the complainant allegedly decided to end her counselling relationship with Mr Pease. 

In January 2007, the complainant allegedly emailed Mr Pease asking if it was all right to contact him and sought reassurance that no-one else had access to his emails.  Mr Pease allegedly confirmed that no-one other than him had access to his emails and encouraged the complainant to continue to make contact with him.  Mr Pease allegedly met the complainant in a pub, where the complainant alleges that she felt  uncomfortable with Mr Pease's authoritarian stance and felt distinctly uncomfortable when Mr Pease allegedly started touching her leg.  The
complainant alleges that they subsequently left the pub and went to her car where they cuddled and kissed.  

On another occasion, around a week after allegedly meeting in the pub, the complainant alleges that she met Mr Pease at his house, where allegedly he masturbated her, explaining that this was the first stage of his sexual programme.  

The complainant alleges that the following day she texted Mr Pease, but he did not reply.  The complainant alleges that she texted Mr Pease again, and he replied saying that he did not feel that he could continue, but she could contact him in 6 months, if she still wanted a relationship.  The complainant was allegedly devastated and heartbroken by this. 

In 2009, whilst studying for her Certificate in Counselling, the complainant allegedly became re-traumatised during a module which focused on client abuse in therapy.  At this stage, the complainant believed that she should report the matter, but was reluctant to do so because of the possible impact on her relationship with her partner.  She therefore, remained silent for three years, but in September 2012 she allegedly told her partner what had happened.  She then felt able to report the matter to BACP.

The complainant also alleges that Mr Pease lacks integrity and moral principles as his website gives the impression that he is part of a company whereas in fact he is a sole trader. 

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 Pease allegedly failed to provide a good quality of care and demonstrated a lack of wisdom by taking both the complainant and her partner into individual therapy after having previously seen them as a couple. 

2.    Mr Pease was allegedly not working in the complainant' best interests nor providing her with a good quality of care when he commented favourably on her clothing, encouraged them to hug at the end of counselling sessions, and encouraged text contact from the complainant outside of the counselling sessions, knowing that she had developed a strong erotic transference towards him. 

3.    Mr Pease allegedly failed to respect the complainant' privacy and confidentiality and honour her trust by arriving at the supermarket where the complainant normally shopped following a refusal by the complainant to attend a counselling session and then proceeding to follow her to the public car park and hug her.  

4.   Mr Pease allegedly abused the trust the complainant placed in him, in order to gain sexual advantage, by hugging and kissing her and having other sexual contact with her. 

5.    Mr Pease allegedly failed to exercise caution by having sexual and personal contact with the complainant following the end of the counselling sessions. 

6.    Mr Pease allegedly did not act with integrity, nor respect the client, in that he "boasted" to the complainant that he had engaged in sexual relationships with women to help overcome their sexual frigidity and disclosed conversations that he had allegedly had with a friend about offering his services to women with sexual inhibitions.

7.    Mr Pease allegedly did not provide the complainant with a good quality of care, in that he terminated contact with the complainant, stating that "he did not feel that he could continue", and advised the complainant to contact him in 6 months if she wanted a relationship, leaving the complainant heartbroken and devastated.

8.    Mr Pease allegedly failed to provide a good quality of care in failing to deal appropriately with issues of transference (erotic feelings towards the therapist) directed towards him from the complainant. 

9.  Mr Pease's alleged actions and behaviour, as alleged by the complainant, suggests a contravention in particular of paragraphs 1, 4, 11, & 18 of the Ethical Framework for Good Practice in Counselling and Therapy 2002-2009.  It also suggests a contravention of the ethical principles of fidelity, autonomy, beneficence, and non-maleficence, and showed a lack of the personal moral qualities of integrity, humility, respect, competence and wisdom to which counsellors and psychotherapists are strongly encouraged to aspire. 

Professional Conduct Findings 

The decision of the Professional Conduct Panel was as follows: 

1. Mr Pease explained in both his written and oral evidence that the purpose of moving from couples counselling to individual counselling, was to break the cycle that the complainant and her partner found themselves in, whereby they were repeating the same arguments.  Both parties accepted that the continuation of individual sessions for the complainant arose because the complainant's partner decided that he no longer wanted to continue therapy, either as an individual or a couple.  The Panel found that Mr Pease made a thoughtful and appropriate judgement based upon his experience of working with the complainant and her partner.  The Panel found that in the circumstances, it was legitimate to hold individual counselling sessions, for a brief period, to enable the couple to work through an impasse. The Panel, therefore, did not find that Mr Pease failed to provide a good quality of care or demonstrated a lack of wisdom in making this decision.  This allegation is therefore, not upheld.

2. Mr Pease accepted that he commented favourably on the complainant's clothing, on one occasion, when the complainant arrived for a session dressed as if to go out after the session.  The Panel noted that this comment was made before the complainant disclosed her feelings of attraction to Mr Pease.  The Panel found that this comment was made merely as an observation of the complainant and did not amount to a failure to act in the complainant's best interests or a failure to provide her with a good quality of care.  This part of the allegation is therefore, not upheld.   

In relation to the hugs, the complainant's evidence, which was disputed by Mr Pease, is that hugs took place at the end of each session.  Mr Pease accepted that hugs took place, and accepted that one of these hugs took place at the end of counselling session.  Mr Pease, however,
stated that hugs only took place on two occasions.  Whilst there was a dispute over the number of hugs, there was agreement that there were at least two hugs, one of which took place after Mr Pease was explicitly aware of the complainant's feelings towards him.  The Panel found that in engaging in these hugs, Mr Pease was not working in the complainant's best interests or providing her with a good quality of care. This part of the allegation is therefore, upheld.   

There was insufficient evidence to satisfy the Panel that Mr Pease encouraged any text contact from the complainant.  Mr Pease stated that it was his normal practice to acknowledge any messages he received from a client, but not enter into any discussion with his clients in relation to their messages, until the counselling session.  The complainant's own evidence in relation to this is that Mr Pease responded to her texts in a
professional manner.  On questioning, the complainant was unable to detail exactly how Mr Pease had encouraged contact from her.  This part of the allegation is therefore, not upheld.  For the reasons stated above, this allegation is upheld in part. 

3. Mr Pease explained that the circumstances surrounding the incident at the supermarket were that the complainant had arrived approximately 25 minutes early for her session, interrupting Mr Pease's session with another client.  Mr Pease stated that he asked the complainant to return at her allotted time.  The complainant, however, became upset as she deduced that Mr Pease was angry with her for arriving early, and left, saying that she would not return for her session.  Mr Pease stated that it was common practice for him to visit the supermarket after work, but on this occasion when he arrived at the supermarket he came upon the complainant at the entrance to the supermarket.  Mr Pease accepted that he hugged her, to reassure her that he was not angry with her.  The Panel accepted Mr Pease's evidence that his encounter with the complainant was accidental and was not premeditated.  The Panel, however, found that it was not prudent for Mr Pease to have hugged the complainant.  The Panel noted that the hug occurred in a public area and accepted that this occurred where people who knew the complainant and her partner could have witnessed this.  The Panel found that in hugging the complainant, and particularly in this public setting, Mr Pease failed to respect the complainant's privacy and confidentiality and honour her trust.  This part of the allegation is therefore, upheld.   

The Panel did not find that Mr Pease's presence at the supermarket was as a result of following the complainant and therefore, did not find that in going to the supermarket Mr Pease failed to respect her privacy and confidentiality and honour her trust.  This part of the allegation is therefore, not upheld.  For the reasons stated above, this allegation is upheld in part. 

4. There was a sharp difference of accounts between the parties in relation to this allegation.  Whilst Mr Pease accepted that he hugged the complainant on two occasions, he did not accept that he had kissed the complainant or had sexual contact of any kind with her.  The Panel accepted that this hug was not an abuse of trust or evidence of Mr Pease taking sexual advantage of the complainant.  The complainant described an incident, which she stated took place in Mr Pease's car, when she alleged there was sexual contact.  Mr Pease denied that the complainant had ever been in his car and that such an incident had ever taken place.  In the absence of any evidence to corroborate the complainant's version of evidence, there was insufficient evidence available to the Panel to uphold this allegation.  The Panel therefore, did not find that the parties engaged in kissing or any other sexual contact and therefore, Mr Pease did not take sexual advantage of the complainant or abuse her trust.  This allegation is therefore, not upheld.   

5. There was again a sharp difference of accounts between the parties in relation to this allegation.  Mr Pease denied that any sexual contact had taken place between him and the complainant following the ending of the counselling sessions, the last one being 4 December 2006, or at all.  There was insufficient evidence to prove that there was sexual and personal contact between the parties and therefore it could not be said that Mr Pease had failed to exercise caution.  This allegation is therefore, not upheld.

6. Mr Pease denied that he had ever engaged in any sexual relationships with women to help overcome their sexual difficulties or that he had told the complainant that he had.  Mr Pease further denied that he had any conversations with a friend about offering his services to women with sexual inhibitions, or disclosed any such conversations to the complainant.  There was insufficient evidence available to the Panel to find this allegation.  The Panel did not find that Mr Pease had failed to act with integrity or respect, and therefore, this allegation is not upheld.

7. Mr Pease admitted that he told the complainant when she contacted him in January 2007, following the end of their counselling relationship, which the Panel accepted was in effect on 4 December 2006, that there would have to be a gap of a minimum of 6 months from the end of the counselling relationship and the start of any other type of relationship but, made it clear that he would not engage in a sexual relationship with her following a gap of any length of time.  Mr Pease accepted that he managed the situation badly and should not have responded to the complainant giving her any time frame, when his intention was not to have any further contact with her.  Mr Pease stated that he hoped that by making this comment it would deter the complainant from contacting him any further.  The Panel therefore, accepted that whilst Mr Pease did make reference to a period of 6 months, he did not state that they could have a relationship once this period had expired.  Further, the Panel accepted Mr Pease's evidence that he did not state that, "he did not feel that he could continue", as the counselling relationship had already ended on 4 December 2006, and therefore, there was nothing to be continued.  Whilst Mr Pease's comment was not prudent, the Panel did not find that this amounted to a failure to provide a good quality of care.  This allegation is therefore, not upheld.

8. Mr Pease stated in evidence that following the complainant's disclosure in late August early September 2006 of her feelings towards him, he increased his supervision and re-set the boundaries with the complainant.  The Panel noted that Mr Pease was aware that the complainant was  demonstrating obsessive behaviour towards him, such as memorising his number plate and peeking out at him from behind a shelf in a supermarket and that she had disclosed to him that she wished to have a sexual relationship with him.  The Panel accepted Mr Pease's evidence that he did talk to the complainant about her disclosure and that he also had periodically checked with the complainant as to whether she wished to stay in counselling with him, or not.  The Panel was not satisfied that, given the feelings expressed by the complainant towards him and the power dynamic in the relationship, Mr Pease had sufficiently respected the complainant's ability in being able to decide whether to continue in counselling with him or to be referred.  The Panel was further not satisfied that when Mr Pease had considered ending the      counselling relationship, following the disclosure, that part of his reasoning, in not ending the counselling, was because of fear of a complaint to BACP, rather than focused solely on the best interests of the complainant.  The Panel agreed that Mr Pease was under a duty of care to act in the best interests of the complainant and manage an appropriate ending of the counselling relationship and refer her on to another therapist.  In  failing to act sufficiently in accordance with his duty of care, the Panel found that Mr Pease failed to provide a good of quality of care in dealing  with the issue of transference and the complainant's erotic feelings towards him.  This allegation is therefore, upheld.

9. In light of the above findings, the Panel was satisfied that paragraphs 1 and 11 of the Ethical Framework for Good Practice in Counselling and Psychotherapy and the ethical principles of fidelity, autonomy and beneficence, had been breached.  The Panel was not satisfied that  paragraphs 4 and 18 and the ethical principle of non-maleficence had been breached.  The Panel also found that Mr Pease lacked the personal moral quality of wisdom but did not lack integrity, humility, respect and competence.  

Professional Conduct Panel Decision 

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

Mitigation 

Mr Pease admitted that he should not have hugged the complainant and stated that he has now changed his practice regarding physical contact and although he previously hugged some of his clients, he now ensured that he did not hug any client.   

Mr Pease also stated that he had undertaken two courses following the conclusion of counselling with this client, one of which was to help him to better understand the feelings the complainant had towards him and how to handle the situation, should it arise again in the future.  Further, Mr Pease used supervision extensively to deal with the issues presented by the complainant and increased his supervision to assist him in this.

Mr Pease accepted that he did not manage the contact with the complainant appropriately and accepted that he should not have told the complainant that there could be no contact between them for 6 months. 

Sanction 

Within one month from the date of imposition of this sanction, which will run from the expiration of the Appeal deadline, Mr Pease is required to provide a written submission, which evidences his immediate reflection on, learning from and understanding of, the issues raised in this complaint and the changes that he has made in his practice as a result.   

In addition and within three months from the date of imposition of this sanction, again running from the expiration of the Appeal deadline, Mr Pease is required to write a dissertation of no less than 2,000 words on erotic feelings in counselling relationships and their management and the issues that need to be considered when making appropriate referrals.  

Appeal 

Following the Professional Conduct Hearing, Mr Pease lodged an appeal under clause 6.5 in that: 

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

b)   the sanction is disproportionate to the findings and decision of the Professional Conduct Panel and 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 decision of the Professional Conduct Procedure was made against the weight of the evidence.  

The purpose of the Appeal Panel is to consider the appeal in light of ground 6.5a), and examine all the written and oral evidence presented by both parties to decide whether the appeal should be upheld, or not, which included 

a)   the Appellant's reasons as to why the appeal should be allowed; and 

b)   the Complainant's reasons as to why the appeal should be denied.   

Appeal Panel findings 

The Appeal Panel reviewed the findings of the Professional Conduct Panel, and made the following decision in respect of the findings: 

1. The Appeal Panel agreed with the decision of the Professional Conduct Panel. 

2. The Appeal Panel agreed with the first proposition of the Professional Conduct Panel namely: 

Mr Pease accepted that he commented favourably on the complainant's clothing, on one occasion, when the complainant arrived for a session dressed as if to go out after the session.  The Panel noted that this comment was made before the complainant disclosed her feelings of attraction to Mr Pease.  The Panel found that this comment was made merely as an observation of the complainant and did not amount to a failure to act in the complainant's best interests or a failure to provide her with a good quality of care.  This part of the allegation is therefore, not upheld.   

In relation to the second part of the Professional Conduct Panel's findings which related to the hugs, the Appeal Panel found as follows:

The Appeal Panel noted that there was a dispute between the parties as to the number of hugs that took place.  It was the complainant's evidence that at the end of each session both she and Mr Pease engaged in a hug.  Mr Pease's evidence was that there had only been two hugs, one of which occurred after the counselling session.  In considering the specific form of words set out in the allegation, the Appeal Panel was not satisfied that there was sufficient evidence to establish that Mr Pease had encouraged the complainant to engage in hugs after each session, such that it created a pattern of behaviour.  Of the two hugs which were accepted by the parties, the Appeal Panel accepted Mr Pease's evidence that one of the hugs took place before the complainant disclosed the strong erotic transference towards him.  The Appeal
Panel therefore, concluded that it could not be said that this hug took place at a time when Mr Pease was aware of the erotic transference.  Further, whilst the Panel accepted Mr Pease' evidence that the second hug which took place at Tesco did not take place after a counselling session, the Appeal Panel agreed that the hug nevertheless took place in the context of a client/counsellor relationship.  However, the Appeal  Panel agreed that there was insufficient evidence that Mr Pease encouraged the complainant to engage in this hug, and accepted his evidence that the hug was provided to console the complainant, who appeared to him to be distressed and was provided in what Mr Pease believed to be her best interests.   

For the reasons stated above the Appeal Panel did not find that Mr Pease's actions in relation to the hugs amounted to a failure to provide a good quality of care or act in the best interests of the complainant.  The Appeal Panel agreed that this part of the finding was made against the weight of the evidence and should be allowed on the basis of paragraph 6.5a) of the Professional Conduct Procedure.  

The Appeal Panel agreed with the finding reached by the Professional Conduct Panel with regard to the texts that: There was insufficient  evidence to satisfy  the Panel that Mr Pease encouraged any text contact from the complainant.  Mr Pease stated that it was his normal
practice to acknowledge any messages he received from a client, but not enter into any discussion with his clients in relation to their messages, until the counselling session.  The complainant's own evidence in relation to this is that Mr Pease responded to her texts in a professional manner.  On questioning, the complainant was unable to detail exactly how Mr Pease had encouraged contact from her.  This part of the allegation is therefore, not upheld.  

3. The Appeal Panel, having considered the findings made by the Professional Conduct Panel and the  written and oral evidence of the parties concluded as follows: 

Mr Pease accepted that he hugged the complainant at the entrance to the Tesco store as the complainant appeared to be in distress.  Mr Pease in his evidence stated that when he encountered the complainant and saw her in distress, he hugged her to reassure her that he was not angry with her.  

Mr Pease in his evidence stated that he had set boundaries with the complainant, as he did with all of his clients, at the commencement of the counselling relationship.  As part of those boundaries Mr Pease had agreed that he would not acknowledge the complainant if he saw her in public, to avoid the complainant having to explain who he was.  Mr Pease accepted on questioning by the Appeal Panel that in hugging the complainant in a public setting and thereby acknowledging the complainant, he breached the boundaries, which he himself had set and in doing so failed to honour the trust, which the complainant had placed in him and had acted unwisely.  

The Appeal Panel agreed with the remainder of the finding reached by the Professional Conduct Panel that, The Panel did not find that Mr  Pease's presence at the supermarket was as a result of following the complainant and therefore, did not find that in going to the supermarket Mr Pease failed to respect her privacy and confidentiality and honour her trust.  This part of the allegation is therefore, not upheld.  For the reasons stated above, this allegation is upheld in part. 

As such the Appeal Panel did not consider that this finding was made against the weight of the evidence and agreed that the appeal on the basis of paragraph 6.5a) should not be allowed. 

4. The Appeal Panel agreed with the decision of the Professional Conduct Panel.

5. The Appeal Panel agreed with the decision of the Professional Conduct Panel. 

6. The Appeal Panel agreed with the decision of the Professional Conduct Panel.

7. The Appeal Panel agreed with the decision of the Professional Conduct Panel.

8. The Appeal Panel, having considered the findings made by the Professional Conduct Panel and the written and oral evidence of the parties, concluded as follows: 

Mr Pease in his evidence stated that as soon as the complainant made him aware of the strong erotic transference she had toward to him, he took the matter to supervision and increased the length of his supervision to assist him in dealing with this disclosure.  Further, Mr Pease stated that he discussed the matter with the complainant in therapy, re-set the boundaries and gave the complainant the option of being referred to another practitioner, but she elected to stay with him.  The Appeal Panel accepted that Mr Pease gave consideration to whether or not it would be safe to terminate counselling in view of the complainant's disclosure, but after consideration and discussion with his supervisor concluded that this would not be in the best interests of the complainant.  Mr Pease stated that the complainant presented to him as someone who was able to make an informed decision about whether or not she wanted to continue in therapy with him and there was nothing to suggest him that he should override her known wishes in this regard and insist upon a referral.  The Appeal Panel also accepted Mr Pease's evidence of previous occasions when he had managed erotic transference within the counselling relationship with the assistance of supervision.  The Appeal Panel therefore agreed that Mr Pease dealt appropriately with the issues of erotic transference the complainant displayed towards him and did all that he could to act in the client's best interests.  The Appeal Panel therefore did not agree that Mr Pease failed to provide the complainant with a good quality of care in failing to deal appropriately with the issues of transference.  The Appeal Panel therefore agreed that the decision of the Professional Conduct was made against the weight of the evidence and the appeal should be allowed on the grounds of paragraph 6.5a).

In view of the findings, the Appeal Panel found that Mr Pease had not breached paragraph 1 of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2002-2009, nor had he breached the ethical principles of autonomy and beneficence.  The finding made by the
Professional Conduct Panel that Mr Pease lacked the personal moral quality of wisdom is upheld.  The findings made by the Professional Conduct Panel in relation to paragraph 11 of the Ethical Framework for Counselling and Psychotherapy 2002-2009 and the ethical principle of fidelity are also upheld.  

Decision

Having fully considered the above, the Appeal Panel concurs with the Professional Conduct Panel's finding of professional malpractice in the provision of inadequate professional services.    

Sanction  

As part of the appeal was allowed, the sanction has been amended in order to reflect this.  The Sanction is now as follows: 

The Appeal Panel carefully considered what sanction, if any, would be appropriate and proportionate in the circumstances.  The Appeal Panel noted that Mr Pease accepted that he had made a lapse in judgement in hugging the complainant at Tesco and accepted that he had breached the boundaries that he had set with the complainant.  Further, following the complainant's disclosure Mr Pease increased the length of his supervision sessions and underwent additional training in order to better understand the feelings of the complainant.  In view of the learning and
understanding demonstrated by Mr Pease, the extra supervision he received and the training courses he attended, the Appeal Panel agreed that would it be disproportionate to impose a sanction.  The Appeal Panel therefore concluded that the most appropriate sanction was that there be no sanction against Mr Pease. 

In conclusion, the Appeal Panel allowed the appeal in part in accordance with the findings as set out above.

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June 2014: Linda Henderson, Reference No: 522038, London SE3 

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 sought counselling with Ms Henderson on 29 November 2012.  Ms Henderson agreed to see her on Monday 3 December but pointed out to her that she was shortly to go on a  retreat and that as a consequence after this first session there might have to be a break for 3 weeks.  At this first and only session, the complainant alleged that Ms Henderson responded to her inappropriately, did not give her the opportunity to divulge information as she wanted, fired questions at her that she did not allow her to answer, and "upset her greatly".  By the end of the session, the complainant stated that she felt "very low indeed; that she was in tears and that she felt like stepping out in front of cars in the dark and rain."  In particular, the complainant
alleged that Ms Henderson failed to address the vulnerable state she was in, having been told by the complainant that she wanted her cancer to return and take her life.   

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

1.   Ms Henderson allegedly failed to provide a good quality of care in that the service she delivered to the complainant during this first session, and in particular the alleged challenging approach she adopted at that early stage of counselling, did not sufficiently address the complainant's needs arising from her vulnerability at that time. 

2.   Ms Henderson allegedly failed to adequately assess and manage the risk the complainant posed to herself in that she failed to appropriately address the manifest distress exhibited by the complainant during that session, which she recorded in her notes as "Death wish", and failed to question whether she was in a sufficiently fit state of mind to leave the session without some follow up action on her part. 

3.   Ms Henderson's alleged behaviour as experienced by the complainant suggests a lack of the personal moral qualities of Empathy and Wisdom to which all practitioners are strongly urged to aspire; a contravention of paragraphs 1 and 14 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2010 edition); and the ethical principle of Beneficence. 

Neither the complainant nor Ms Henderson attended the Hearing. 

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 Head of Professional Conduct (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 to proceed with the adjudication hearing in the absence of both parties. 

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 both parties, the Panel had to base their decision solely on the written evidence provided by both parties.      

Findings  

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

1. On the basis of the notes provided by the Ms Henderson, there was no evidence to suggest to the Panel that an assessment of the needs of the complainant had been carried out, that any explanation had been given to the complainant about the process that would be followed during the counselling session and there was no evidence that a contract was discussed.  The Panel found that there was evidence within the notes submitted that Ms Henderson had adopted a challenging approach to the complainant and had made an immediate assessment of her, which did not sufficiently address the complainant's needs.  This was particularly so given the complainant's vulnerable state, which was recorded within the notes, and the fact that this was the complainant's first session with Ms Henderson.  The Panel noted the references within the notes to the complainant "finding it difficult to connect to her real feelings" and the complainant "feeling happy at the thought of dying of cancer".  The Panel found that Ms Henderson failed to address the needs of the complainant that arose during the single counselling session in that she did not pursue either the opportunity of referral or provide any offer of further support following the disclosures made by the complainant, other than a book that she had ‘dipped in to'.  The Panel agreed that this offered a wholly inadequate service to the complainant which did not sufficiently address her needs and therefore, found that Ms Henderson failed to provide a good quality of care to the complainant.   

This allegation is therefore upheld.  

2.   There appeared to the Panel to be a lack of a thorough and rigorous assessment and management of the risk the complainant posed to herself, in that there was nothing within the written evidence provided by Ms Henderson to suggest that she appropriately addressed the manifest distress exhibited by the complainant, and evidenced within her notes.  The written response provided by Ms Henderson registered her shock regarding the points described within the complainant's written complaint in which the complainant described her emotional state both within and following the single counselling session.  The Panel was concerned that within the notes submitted by Ms Henderson, there was evidence to suggest that she had failed to recognise and act upon the degree of distress that was being displayed by the complainant and failed to ensure that the complainant was in a sufficiently fit state of mind to leave the counselling session.  Further there was nothing within the written
evidence provided to suggest that Ms Henderson offered the complainant any further support or offered other ways in which she could obtain help, particularly in light of the fact that Ms Henderson was leaving to go on a 3 week retreat.  The Panel found that these elements all contributed to an inadequate assessment and management of the complainant's concerns.                                                                         

This allegation is therefore upheld.                                                                             

3.   In light of the above findings, the Panel was satisfied that paragraphs 1 and 14 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2010 edition) and the ethical principle of beneficence had been breached.  It also found a lack of the personal moral qualities of empathy and wisdom to which all practitioners are strongly urged to aspire.   

Mitigation 

The Panel found that there was no mitigation, in that Ms Henderson was not in attendance and did not provide any evidence within her written response that reflected any mitigation given that there was a complete denial of the allegations. 

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. 

Sanction 

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

At the same time as submitting her immediate reflections, Ms Henderson is required to provide details of her supervisor to BACP, to include name, qualifications and how long the supervisor has been supervising Ms Henderson. 

Within six months from the date of imposition of this sanction, Ms Henderson shall provide a reflective diary that she has kept of not less than 2000 words dealing with the issues raised in this complaint.  This diary must be counter signed by the Ms Henderson's supervisor to confirm having read its content. 

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.

  

  

  

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June 2014: Michael Rivers, Reference No: 537825, Ipswich IP4

  

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 first started psychotherapy with Mr Rivers in June or July 2005, in a surgery.  She had 5-6 sessions before Mr Rivers moved the location to his own house.  The psychotherapy allegedly ended according to the complainant in October 2010; however, Mr River states in his letter dated 28 March 2013 that the therapy ended in February 2011.  The complainant alleges that from the time of the move to Mr Rivers' home he dressed scruffily, was laid back, and saw her in a disorganised environment.  She alleges that Mr Rivers was forceful in his opinions, shared details of his private life and cancelled sessions without putting alternative support in place.  The complainant also alleges that Mr Rivers did not keep her records securely in that some of his records were allegedly destroyed.  She alleges that her sessions were frequently interrupted by him on occasion speaking to his daughter, on another speaking to a client who had arrived early and in others taking phone calls in the course of sessions, He allegedly showed a lack of understanding of the way the complainant's mother's cancer affected her and her family.  Mr Rivers also allegedly phoned the complainant at a time when her husband could have overheard their conversation.  When the complainant first eft messages for Mr Rivers in October 2012 and in early 2013 he allegedly did not acknowledge them.  In a letter dated 28 March 2013, in reply to a letter delivered by the complainant to Mr Rivers, he asked her not to contact him further and said that he regarded her contact with him as harassment.  This reply was
perceived by the complainant as threatening and unpleasant.

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.    Mr Rivers allegedly failed to provide the complainant with a good quality of care in that he allegedly made inappropriate comments  regarding his personal life, his appearance was ‘scruffy', his house where the therapy sessions took place was chaotic resulting in the complainant having to negotiate around the bare floorboards, and on one occasion left their session to speak to his daughter.

2.    Mr Rivers allegedly failed to provide the complainant with a good quality of care which met her needs, in that as a result of Mr Rivers allegedly closing down the sessions too early, she regularly felt depressed and anxious following the sessions.  He allegedly cancelled some
sessions due to illness and holiday commitments and failed to ensure that there was sufficient support in place for the complainant during these times.

3.    Mr Rivers allegedly failed to give careful consideration to the limitations of his training and work in that he was allegedly unable to give the complainant sufficient support or tools to cope with the complainant's bereavement.

4.    Mr Rivers allegedly failed to ensure that his records were kept securely and were adequately protected in that his patient records were allegedly destroyed as a result of an incident at his house.

5.    Mr Rivers allegedly failed to be attentive to the quality of listening and respect offered to the complainant, in that he was allegedly very opinionated and overpowering with his comments in their sessions.

6.    Mr Rivers allegedly failed to respect the complainant's right to privacy and confidentiality in that he would listen out in case his daughter arrived unannounced at the house and also called the complainant at home to re-arrange an appointment when it was possible that her husband may overhear the conversation.

7.    Mr Rivers allegedly failed to respond promptly and appropriately to the complaint raised by the complainant in that he did not respond to the telephone messages she left and in response to her letter of complaint told her not to contact him anymore, stating that in the event that she did, he would inform the Police.

8.    Mr Rivers allegedly failed to remedy the harm that he may have caused to the complainant and issue an apology.

9.    Mr Rivers allegedly failed to inform the complainant of the existence of the Professional Conduct Procedure when he became aware that she wished to complain about the service that she had received. 

10.  Mr Rivers alleged behaviour, as experienced by the complainant, suggests a contravention of the Ethical Framework for Counselling
and Psychotherapy (2009-2013) in particular of paragraphs 1, 2, 5, 11, 33, 34 & 38 and the Ethical Principles of Fidelity Beneficence, Non-Maleficence and Autonomy of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2009), and showed a lack of the personal moral qualities of Empathy, Competence, Wisdom and Respect to which counsellors are strongly encouraged to aspire; and paragraphs 1, 2, 5, 11, 41, 42 and 46 and the ethical principles of Being Trustworthy,  Beneficence, Non-Maleficence and Autonomy of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2010-2013), and showed a lack of the personal moral qualities of Empathy, Competence, Wisdom and Respect to which counsellors are strongly encouraged to aspire.

The complainant did not attend the hearing and a decision was made in accordance with paragraph 4.9 of the Professional Conduct Procedure to proceed with the hearing in her absence. 

Findings

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

1)    Mr Rivers explained in his evidence his reasons for self-disclosure and indicated that the complainant had found that helpful and had thanked him. Mr Rivers also provided a rationale for his intervention supported by research and references.  The Panel was satisfied that his
self-disclosures were part of his therapeutic approach and that they were thought out, considered and appropriate.  There was no evidence to demonstrate that Mr Rivers was scruffy.  Further, there was no evidence to demonstrate that his house was chaotic.  Mr Rivers accepted that the floor boards were bare but indicated that they were in "exceptional condition".  Mr Rivers accepted that he left the session to talk to his daughter but stated that he apologised for this and had dealt with this in the session.  As such the Panel did not find Mr Rivers failed to provide the complainant with a good quality of care and the allegation is not upheld.

2)    Mr Rivers stated that he kept to time boundaries in his sessions, but on occasion he indicated that he extended sessions through mutual consent to meet his client's needs.  The Panel was satisfied that Mr Rivers had offered alternative support when he had to cancel sessions.  The Panel also accepted Mr Rivers' evidence where he indicated that when he would be absent due to holidays that this would have been discussed in advance with the client.  As such, the Panel did not find Mr Rivers failed to provide the complainant with a good quality of care and the allegation is not upheld.

3)    There was no evidence brought to demonstrate that Mr Rivers had insufficient training nor that he was working outside of his competence.  The Panel was satisfied that Mr Rivers had provided evidence of his training.  Mr Rivers further provided evidence of the support he had given the complainant in dealing with her grief work together with the tools that he used in so doing.  As such, the Panel was satisfied that the allegation was not proven and therefore the allegation is not upheld.

4)   Mr Rivers described his arrangements for storage of his counselling records, which he described as being stored in a locked filing cabinet. 
Due to an unforeseen flooding incident the files were accidentally destroyed.  Mr Rivers described measures he had taken since that incident to avoid a recurrence of such an incident.  However, the Panel was satisfied on the evidence that Mr Rivers had kept his records securely both pre
and post the flooding incident.  As such, the Panel was satisfied that the allegation was unproven and therefore the allegation is not upheld.

5)   There was no evidence brought to demonstrate that Mr Rivers was opinionated or overpowering in his comments in the sessions nor that he failed to be attentive to the quality of listening and respect offered to the complainant.  The personal references submitted by Mr Rivers further do not support a picture of Mr Rivers congruent with the allegation.  As such, the Panel was satisfied that the allegation was unproven and therefore the allegation is not upheld.

6)   Mr Rivers gave evidence that when his daughter did interrupt a session he had been careful to protect the complainant's privacy and confidentiality.  He also gave the complainant the opportunity to discuss any feelings that she might have had about the interruption.  In this respect the Panel was not satisfied that Mr Rivers failed to respect the complainant's right to privacy and confidentiality.  The complainant had
given Mr Rivers her land-line number and it was therefore not unreasonable for him to use that number to contact her.  The Panel accepted Mr River's evidence that when he rang he asked her if it was inconvenient and negotiated a time to ring back.  The Panel was satisfied that in this regard Mr Rivers had not failed to respect the complainant's privacy and confidentiality.  The Panel was satisfied that the allegation was unproven and therefore the allegation is not upheld.

7)    Mr Rivers accepted that he did not respond appropriately to the complaint and would do it differently having reflected.  The therapy had ended after they had made a no contact agreement.  Mr Rivers indicated that three weeks after therapy ended, the complainant sent him a text, to which he responded and received an aggressive text in reply.  Subsequently, on the advice of his supervisor, he did not reply to the complainant's intermittent texts.  The complainant sent two letters to Mr Rivers detailing her complaint.  The first letter was delivered on 4 March 2013 with the second letter delivered on 25 March 2013.  Mr Rivers says that he was formulating a response to the first one when the second one arrived.  He then contacted his supervisor and his insurers, resulting in sending the complainant his letter of 28 March 2013.  However, the Panel was not satisfied that the response had been prompt or an appropriate response to the complainant's complaint.  As such, the Panel found the allegation proven and therefore the allegation is upheld.

8)    Mr Rivers stated that when things went wrong in sessions he did apologise and attempt to remedy harm.  He also offered regular reviews.  He provided evidence that the complainant had said that the therapy was helpful.  When the complainant sent two letters detailing her complaint, Mr Rivers contacted his supervisor and his insurers, resulting in his letter of 28 March 2013 in which he did not address her grievance and further asked her not to contact him.  The Panel was satisfied that at that time, he had failed to address any distress that the complainant may, as a result, have had experienced or to issue an apology.  As such, the Panel found the allegation proven and therefore the allegation is upheld.

9)    When Mr Rivers received the complaint, he indicated that he regretted not directing the complainant to BACP at that time, but he also indicated that he was working on the advice of his insurers.  While Mr Rivers had not informed the complainant of the existence of the Professional Conduct Procedure again at the time that he became aware of her wishing to make a complaint, the Panel was satisfied that he had previously made the complainant aware of the existence of the Professional Conduct Procedure during their initial private consultation.  The Panel was also satisfied that there was no evidence that the complainant had asked for further information about the procedure at the time of the complaint.  On the evidence, the Panel was not satisfied that Mr Rivers had not informed the complainant of the existence of the Professional Conduct Procedure or breached the Ethical Framework for Good Practice in Counselling and Psychotherapy in this regard and therefore the allegation is not upheld.

10) In light of the above findings, the Panel was satisfied that paragraphs 41 & 42 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2010-2013) had been breached and that there was a lack of the personal moral quality of wisdom to which counsellors are encouraged to aspire. 

The Panel was not satisfied that there was a breach of the Ethical Framework for Counselling and Psychotherapy (2009-2013) in respect of paragraphs 1, 2, 5, 11, 33, 34 & 38 and in respect of the Ethical Principles of Fidelity, Beneficence, Non-Maleficence and Autonomy of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2009).  Neither was the Panel satisfied that there was a lack of the personal moral qualities of Empathy, Competence, Wisdom and Respect to which counsellors are strongly encouraged to aspire under the
Ethical Framework for Good Practice in Counselling and Psychotherapy (2009).  The Panel was not satisfied that paragraphs 1, 2, 5, 11 and 46 and the ethical principles of Being Trustworthy, Beneficence, Non-Maleficence and Autonomy of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2010-2013) had been breached.  Neither was the Panel satisfied that there was a lack of the personal moral qualities of Empathy, Competence, and Respect to which counsellors are strongly encouraged to aspire under the Ethical Framework for Good Practice in Counselling and Psychotherapy (2010-2013).

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice in that Mr Rivers' practice fell below the standards expected of a practitioner exercising reasonable care and skill.  In particular, he provided the complainant with an inadequate professional service in that he did not appropriately handle her complaint. 

Mitigation

Mr Rivers demonstrated to the Panel that he had sought advice from his supervisor and insurers.  He also indicated that he has had regular supervision.  He has had personal therapy since these events and provided evidence that he has reflected deeply on these events.  He indicates that he now has a written contract and further indicated learning as to how he would approach the situation now with the benefit of hindsight.

Sanction

The Panel noted Mr Rivers' thoughtful and thorough reflections from both his written and oral evidence, which were compelling.  Mr Rivers documented in detail his reflections around how he would face the situation if it were to arise again and outlined the detailed steps he would
take to deal with such a situation.  He demonstrated to the Panel a deep awareness and strong evidence of learning.  The Panel, in considering
sanctions, took into consideration what sanction may be appropriate with regard to public protection and practitioner development in light of the
findings.  The Panel was satisfied that Mr Rivers had demonstrated considerable reflection and evidence of substantial learning.  The Panel was also satisfied that Mr Rivers had demonstrated how he would behave differently in the future.  As such the Panel decided that given the evidence of reflection, learning and change provided by Mr Rivers, that no sanction would be imposed in this case.



 

June 2014: Averil Wilkinson, Reference No: 551194, Buckinghamshire MK18

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's daughter, A, commenced counselling with Mrs Wilkinson, a school counsellor, in [ . . . ] 2011. The presenting issue was self-harm following a break-up with her then
boyfriend.

The complainant stated that her daughter was never provided with a written contract, shown any policies or procedures relating to the counselling, nor told what her rights were with regard to any notes written about her.  The complainant further stated that her daughter was not informed of any complaints procedure, and that this information was not forthcoming even when requested.

The complainant alleged that her daughter says the counselling was not helpful, as whilst Ms Wilkinson listened to her, she did not structure the sessions nor offer help or guidance, and neither did she inquire at any stage as to whether the sessions were of use to A.

In [ . . . ] 2013, A went on maternity leave, having become pregnant by her new boyfriend.  On discovering the pregnancy, the parents of her boyfriend allegedly insisted the couple marry before the birth.  A wedding was allegedly planned in [ . . . ], and safe houses arranged, with the aim of A not seeing her parents again.  The operation was allegedly code-named "[ . . . ]." 

The complainant alleged that A told Mrs Wilkinson about this plan, and that she also confided in teachers at the school.  When the staff members denied that A had disclosed information about safe houses or code-names to them, A turned to Mrs Wilkinson for corroboration but Mrs Wilkinson responded by saying that she had destroyed her session notes.  The complainant alleged that the notes should not have been shredded without A's permission as she was still in school, and therefore could return to counselling should she wish.  As a result, A's  confidence in the counsellor was shaken and she did not wish to return to see her.

The complainant alleged that Ms Wilkinson failed in her duty of care to A in that neither she nor the school implemented child-protection procedures.

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

1.         Mrs Wilkinson allegedly failed to provide A with a good quality of care which met her needs, in that she did not provide any structure to the therapy sessions and failed to take seriously the disclosures being made.

2.         Mrs Wilkinson allegedly failed to clarify and agree the rights and responsibilities of the practitioner and client, in that she did not provide A with any pre-counselling literature prior to commencing counselling, provide her with a contract or tell her how long her counselling notes would be kept.

3.         Mrs Wilkinson allegedly failed to keep appropriate records of her work with A in that she shredded the notes of her counselling session with A, which allegedly contained details of the disclosure A made in relation to the arranged marriage.

4.         Mrs Wilkinson allegedly failed to provide A with competently delivered services that were periodically reviewed, in that she did not carry out a review of the counselling sessions to ascertain whether A found them helpful.

5.         Mrs Wilkinson was allegedly not aware of and did not understand legal requirements concerning her work, in that when A disclosed the details of the arranged marriage, Mrs Wilkinson did not take any action in relation to her duty of care, such as reporting the matter or acting in accordance with child protection policies.

6.         Mrs Wilkinson allegedly failed to notify A of the existence of the Professional Conduct Procedure or inform her how she could obtain further information regarding her procedures.

7.         Mrs Wilkinson allegedly did not act in A's bests interests when she destroyed the counselling notes from the sessions very shortly after the final session, and without making A aware either that the notes had been destroyed or of the procedure concerning the destruction of notes.

8.         Mrs Wilkinson's actions and behaviour, as alleged by the complainant, suggest a lack of the personal moral quality of wisdom to which
practitioners are strongly encouraged to aspire, a contravention of paragraphs 1, 3, 5, 6, 10 and 46 of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2013, and the ethical principles of being trustworthy, non-maleficence and beneficence.

Findings

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

1.        Taking into account the evidence of Mrs Wilkinson and A, it appeared that there was some structure to the therapy sessions A attended.  As such it could not be said that there was no structure to any of the sessions and that A was not provided with a good quality of care in this regard. 

The Panel therefore found that this part of the allegation is not upheld.

The Panel found that A made her disclosure about the forced marriage to the school staff on [ . . . ] 2012, which was her last day in school for that term. A in her evidence stated that she did not see Mrs Wilkinson on that day and did not see her until she returned for counselling after the summer break.  The Panel accepted Mrs Wilkinson's evidence that when A returned to counselling following the summer break, no subsequent disclosure was made to her during their counselling sessions to indicate that the threat of a forced marriage was still imminent.

The Panel therefore found that on the balance of probabilities no disclosure was made by A to Mrs Wilkinson at the counselling meeting in [ . . . ] 2012 such as would have been sufficient for a legal duty to be triggered requiring Mrs Wilkinson to notify the Child Protection Officer at the school so that Child Protection measures could be introduced/put in train.  It therefore, could not be said that Ms Wilkinson failed to take seriously the disclosure that had been made and failed to provide a good quality of care in respect of this allegation.

The second part of this allegation is not upheld.

2.        The Panel found that A was not told by Mrs Wilkinson at the outset of their counselling relationship for how long her notes would be kept.  The Panel found that the initial discussions were centred around confidentiality and the requirement on Mrs Wilkinson's part for people outside the counselling session to be advised should certain matters be told to her by A in the counselling session such as would require her to break the confidentiality. 

The Panel further found that Mrs Wilkinson did not provide A with any pre counselling literature or a contract and did not clarify or agree with A her rights and responsibilities and/or boundaries. 

The Panel found that this allegation is upheld.

3.       The Panel found that A did not make a disclosure to Mrs Wilkinson at the counselling session in [ . . . ] 2012 in relation to the forced marriage.  Mrs Wilkinson in her evidence stated that she could not recall whether she did take any notes at this meeting and stated that if notes had been taken she would have destroyed them in accordance with her normal practice.  The Panel found that there was insufficient evidence available to it to conclude that notes were not taken, nor to suggest that if notes were taken they contained details of any disclosure made by A, and nor that any such notes if they were made were shredded.

The Panel therefore did not find that Mrs Wilkinson failed to keep appropriate records of her work and that this allegation in its entirety is not upheld.

4.         Mrs Wilkinson in her evidence stated that she did not carry out formal reviews nor did she check with A what were her perceptions of their sessions and the progress they had made.  The Panel therefore, found that Mrs Wilkinson did not carry out reviews of the counselling sessions to ascertain whether they were helpful to A, nor did she seek to check with A what her perception of the counselling sessions was.  The Panel therefore found that in failing to carry out any reviews, Mrs Wilkinson failed to deliver to A competent services.

The Panel found that this allegation is upheld.

5.        The Panel found that Mrs Wilkinson who had trained as a Child Protection Officer was aware of the legal requirements and of her duty of disclosure had any disclosure been made to her.  The Panel found that A made no direct disclosure to her of a forced marriage and herefore the requirement to take action did not arise.

The panel found that this allegation is not upheld.

6.         The Panel found that Mrs Wilkinson was unaware of a complaint being made by A or by her Mother, the Complainant, or that they were at all dissatisfied with the services she had delivered to A.  The Panel found that the duty to notify A of the existence of the Professional
Conduct Procedure arose at the time when Mrs Wilkinson was first made aware that something had gone wrong with the counselling.  The Panel found that the sole letter written by A to Mrs Wilkinson requesting a copy of her notes contained no evidence or indication whatsoever of a complaint and was not sufficient to trigger Mrs Wilkinson's duty to notify her of the existence of a Professional Conduct Procedure and the Complaints Procedure thereunder. 

The Panel therefore found that this allegation is not upheld. 

7.        The Panel found that it was wrong and not in A's best interests for Mrs Wilkinson to destroy A's notes at the end of year [ . . .]. A then was only 16 years old and had the right to return to the school to continue her education beyond that age.  A had originally been referred to Mrs Wilkinson as a vulnerable adolescent by the school's Child Protection Officer and at the end of Year [ . . . ] Mrs Wilkinson was aware of her
pregnancy.  Further the Panel found that A should have been told at the beginning of the counselling sessions in [. . . ] 2011 the procedure adopted by Mrs Wilkinson in regard to her notes, why there were taken and when they would be destroyed.

The Panel found that this allegation is upheld.

8.         In light of the above findings, the Panel found that paragraphs 3 and 6 and the ethical principle of beneficence of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2013 had been breached. 

The Panel further found that Mrs Wilkinson lacked the personal moral quality of wisdom to which practitioners are strongly encouraged to aspire. 

The Panel found that paragraphs 1, 5, 10 and 46 of the Ethical Framework for Good Practice in Counselling and Psychotherapy and the ethical principles of being trustworthy and non-maleficence had not been breached.

Mitigation

The Panel found that Mrs Wilkinson had contributed much to the drafting and implementation of the counselling policies adopted by [ . . . ] School subsequent to the events which form the basis of this complaint.  Further the Panel found that up until that stage Mrs Wilkinson was following the policies that had been adopted by the school albeit they had not been reduced into writing. 

Decision

In light of these findings and the allegations that were upheld, the Panel was unanimous in its decision that these amounted to professional malpractice in that Mrs Wilkinson provided inadequate professional services. 

Sanction

Within one month from the date of imposition of this sanction, which will run from the expiration of the appeal deadline, Mrs Wilkinson 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, Mrs Wilkinson shall provide a written statement setting out how she has addressed the changes required in her practice, which have been brought about by the allegations that have been found proved by this Adjudication Panel.  

In particular the changes the Panel would wish to see addressed by her are principally concerned with the contract, whether oral or written, which Mrs Wilkinson makes with her pupil clients and what she says to pupils at the first counselling session dealing with such
matters as:-

  • The clarification of responsibilities of both parties throughout the counselling relationship
  • What notes are made, how they are kept, what they are used for and when they are destroyed
  • The frequency of reviews concerning the effectiveness of the counselling during the counselling period
  • The duty of confidentiality and how it could affect vulnerable clients
  • What clients should do if they have issues regarding the counselling sessions and how they should raise them with the counsellor

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.

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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.

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April 2014: Elizabeth Blissett, Reference No: 521582, Leicestershire LE16

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.  

Ms Blissett, despite being invited to attend the hearing, did not do so.  However, a decision was made by the Registrar pursuant to paragraph 4.9 of the Professional Conduct Procedure, to proceed in the absence of Ms Blissett. 

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is that the Complainant allegedly made a telephone call on 23 April 2012 to Ms Blissett after she obtained information from a website about the [ . . . .] Counselling Service, run by Ms Blissett.  The Complainant had allegedly already completed an online contact form, asking for information about the costs of counselling and what the next steps would be.

After obtaining some details, such as name and address, Ms Blissett allegedly asked the Complainant what her issues were, which took the Complainant by surprise. 

The Complainant began to talk about her personal issues and reluctantly mentioned that she had had a termination.  Speaking about this issue was very upsetting for her.  Ms Blissett made a number of comments, which the Complainant found distressing including allegedly the assertion that the  Complainant had feelings of guilt because this was a child and that there was no getting round the fact that she had killed her child.  

The Complainant alleges that Ms Blissett made unwanted suggestions about how she might deal with such guilt and asked her if she had a faith.  Ms Blissett allegedly commented that those who had faith could normally deal with such an issue, through their faith.  Ms Blissett allegedly made other comments based on her own religious beliefs and informed the Complainant that during counselling sessions, the option of faith could be discussed.

There was then allegedly a discussion about another counsellor who would be asked to contact the Complainant, and Ms Blissett also gave the Complainant directions about how to get to the offices in [ . . . ].  

When the Complainant came off the phone, she felt stunned and distressed, and checked the website of the [ . . . ] Counselling Service and allegedly found no mention that the service was aimed at those with a faith but advertised their purpose as being, "available to provide counselling to all irrespective of age, gender, culture, beliefs or disability."  

The other counsellor then allegedly phoned her and the Complainant told her how distressing her conversation with Ms Blissett had been.  The Complainant allegedly said that she did not realise that it was a Christian counselling service and was told by this counsellor that it was not.

Later that day, the Complainant allegedly received a text message from Ms Blissett containing an apology, which the Complainant did not consider appropriate or adequate given how hurtful and damaging she felt her comments had been. 

The following day, the Complainant allegedly asked her sister [ . . . ] to contact Ms Blissett to discuss her concerns.  Ms Blissett then had a conversation over the phone with the Complainant's sister, in which Ms Blissett allegedly discussed the Complainant's issues in depth, without having first contacted the Complainant to confirm the identity of the caller or seek the Complainant's consent to speak with the caller. 

The Pre-Hearing Assessment Panel considered the issue whether Ms Blissett was in the role of Practitioner and the Complainant in the role of client, during the telephone conversation that took place on 23 April 2012.  The Panel was satisfied that Ms Blissett did engage in counselling with the Complainant and was in the role of ‘practitioner' from the point when she allegedly asked the Complainant what her issues were.  The Complainant was in the role of ‘client' and that a counselling relationship existed thereafter to which the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010 applied.  The Panel also considered that dealing appropriately with a prospective client enquiring about the service is a part of the counsellor's professional role.

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

1.    Ms Blissett allegedly failed to provide a good quality of care by asking the Complainant in her initial telephone call what her issues were and putting the Complainant under pressure to answer questions, without giving the Complainant any choice about whether she wanted to discuss such matters there and then and failing to ensure that she was adequately informed and that she had consented, before doing so.

2.    Ms Blissett allegedly failed to provide a good quality of care by continuing to question the Complainant and make comments in an inappropriate way on the telephone, despite the Complainant's distress and by allegedly failing to contain the conversation.

3.    Ms Blissett allegedly failed to provide a good quality of care by asking intrusive questions of a sensitive nature, such as whether the Complainant knew what was the sex of the baby.  

4.    Ms Blissett allegedly failed to provide a good quality of care, lacked empathy and was judgmental by saying that the Complainant should have feelings of guilt and there was no getting round the fact that she had killed her child.

5.    Ms Blissett allegedly failed to provide a good quality of care and lacked wisdom and sensitivity by referring to the experience of other clients who had
undergone terminations with knitting needles in the past. 

6.    Ms Blissett allegedly failed to provide a good quality of care and lacked sensitivity and respect, by suggesting to the Complainant that she named the
child and asked its forgiveness by writing it a letter or sending off some balloons without first exploring that advice of this kind was wanted or needed.

7.    Ms Blissett allegedly failed to provide a good quality of care by allowing her personal and religious views to prejudice the relationship with the Complainant and by allegedly saying that the Complainant should feel guilt, that she had killed her child and believed that you reap what you sow and by asserting that you knew God forgave her for what she had done.

8.    Ms Blissett allegedly showed a lack of respect and undermined the Complainant's trust by allegedly questioning her inappropriately about whether she had faith or believed in a higher power.

9.    Ms Blissett's alleged emphasis on her own personal and religious beliefs caused the Complainant to assume that the counselling service was aimed specifically at those with faith and to question the accuracy of the advertising statements on the website, thereby undermining the Complainant's trust and sense of autonomy. 

10.  Ms Blissett allegedly breached confidentiality by discussing the Complainant's issues in depth with her sister on the phone without first checking with the Complainant the identity of the caller or that she had her consent to do so. 

11.  Ms Blissett's alleged behaviour, as experienced by the Complainant, suggests a lack of the personal moral qualities of empathy, respect, competence and wisdom to which practitioners are strongly encouraged to aspire, as outlined in the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010, a contravention of paragraphs 1, 3, 11, 12, 13, 18, 20 and 60 and the ethical principles of being trustworthy, autonomy and non-maleficence.

Findings

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

1. There was agreement between the parties that Ms Blissett did enquire of the Complainant as to the issues she wished to discuss.  The Panel      found that Ms Blissett did not provide the Complainant with a choice as to whether she wished to discuss her issues or not at the time of the      telephone conversation, putting pressure on the Complainant to respond to her questions.  Ms Blissett admitted that she had not sought the Complainant's consent with regard to whether she wished to disclose to Ms Blissett detailed information about her issues and discuss them with her over the telephone.  The Panel was further satisfied that Ms Blissett did not provide adequate information to the Complainant as to why      she was asking questions about the Complainant's issues, or about her choice as to whether she answered those questions or about  her consent to the disclosure of sensitive and detailed information. The Panel thus found that Ms Blissett had not provided a good quality of care in this regard and upheld the allegation.
 

2. The Panel found that at the point of referring the Complainant to another counsellor called [ . . . ], Ms Blissett should have terminated the conversation with the Complainant.  The Panel found that instead of doing so, Ms Blissett continued to have the conversation with the client by asking probing questions and making comments which were inappropriate and left the Complainant feeling exposed and vulnerable.  The Panel further found that Ms Blissett, in so doing, failed to contain the conversation.  The Panel thus found that Ms Blissett had not provided a good quality of care in this regard and upheld the allegation.
 

3. Ms Blissett admitted that she may have "stepped over the line" in asking intrusive questions of a sensitive nature such as whether the Complainant knew what was the sex of the baby.  The Panel found that in asking such questions, Ms Blissett failed to provide the Complainant with a good quality of care and upheld the allegation.
 

4. The Panel, on the evidence, found that whilst Ms Blissett may have said "I feel you have feelings of guilt" or words to that effect, she did not say that the Complainant should have feelings of guilt.  As such, the Panel did not uphold this part of the allegation.  There was a sharp disagreement between the parties as to whether Ms Blissett said that there was no getting around the fact the Complainant had killed her child.  The Complainant was adamant that Ms Blissett had said those words and Ms Blissett strongly refuted having said those words.  On the balance of      probabilities, the Panel found that during the telephone conversation, in which Ms Blissett had referred to examples of other clients' issues, Ms     Blissett had likened termination to child killing and that the Complainant had reason to believe those remarks were aimed at her.  However, the Panel was not satisfied that it was proven that Ms Blissett had said that there was no getting around the fact that the Complainant had killed her child.  As such the Panel did not uphold the allegation. 

5. Ms Blissett recognised that her comments could have lacked wisdom and sensitivity and that in hindsight there were other ways of handling it.  The Panel found that Ms Blissett failed to provide a good quality of care and lacked wisdom and sensitivity by referring to the experience of other clients who had undergone terminations with knitting needles in the past, and therefore, this allegation is upheld. 

6.   Ms Blissett denied that she suggested the Complainant name the child but confirmed that she said that some women had done this and the various suggestions of letters etc were how some people said goodbye.  Ms Blissett further denied that she mentioned forgiveness.  The Panel was satisfied that Ms Blissett, during her conversation with the Complainant about her issues, had specifically referred to other clients' issues relating to terminations and how they dealt with those issues thus raising these matters in the Complainant's mind.  On balance, the Panel was satisfied that in raising these matters with the Complainant, Ms Blissett was in effect making suggestions to the Complainant on how she may deal with her own issues.  The Panel found that Ms Blissett should not have proceeded so far as to make suggestions without first checking whether her advice was sought and in so doing, Ms Blissett had failed to provide a good quality of care and lacked sensitivity and respect.  As such, the allegation is upheld. 

7.  The Panel, on the evidence, was not satisfied that Ms Blissett had said that the Complainant should feel guilt and that she had killed her child (refer to finding 4).  As such, the Panel did not uphold this part of the allegation.  The Panel was not satisfied that there was sufficient evidence to prove that Ms Blissett had asserted that she knew God forgave the Complainant for what she had done.  However, there was agreement between the parties that the phrase "you reap what you sow" was said by Ms Blissett.  The Panel did not accept Ms Blissett's assertion that the phrase was said by her prior to her learning of the Complainant's termination.  The Panel preferred the Complainant's evidence asserting that this was said after mention of the termination.  The Panel found that the phrase "you reap what you sow" in the context used was a judgemental statement demonstrating a lack of a good quality of care.  As such this allegation is partially upheld.

8.   Ms Blissett did not have the Complainant's consent to talk about deeper issues at the time of the telephone conversation.  The Panel found that Ms Blissett showed a lack of respect and undermined the Complainant's trust by questioning her inappropriately about whether she had faith or believed in a higher power.  This allegation is therefore, upheld. 

9.    The Panel was not satisfied on the evidence that it was proved that the advertising statements on the website were inaccurate.  The Panel was further not satisfied on the evidence that Ms Blissett had placed sufficient emphasis on her own personal and religious beliefs to suggest that the counselling service was aimed at Christians.  As such this allegation is not upheld.

10. Ms Blissett was contacted by the Complainant's sister.  The Complainant gave her sister consent to contact and speak with Ms Blissett.  The
Complainant accepted when questioned that it was likely that her sister may not have allowed Ms Blissett to "get a word in edgeways" when her sister spoke to Ms Blissett.  The Panel was not satisfied that there had been a breach of confidentiality and as such this allegation is not upheld.

11. In light of the above findings, the Panel was satisfied that paragraphs 1, 3, 11, 12 and 13 and the ethical principles of being trustworthy and autonomy of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010 had been breached but not paragraphs 18, 20 and 60 or the ethical principle of non-maleficence.  Ms Blissett also demonstrated a lack of the personal moral qualities of respect, competence and wisdom.  The Panel found that whilst Ms Blissett had intended to be empathic, the Complainant did not experience her in this way for much of the conversation and as such the Panel found that Ms Blissett lacked the personal moral quality of empathy.  

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.  The evidence further suggested that the member's standard of practice fell far below that expected of a reasonably competent practitioner, exercising reasonable care and skill. 

Mitigation

Ms Blissett made a number of apologies, including apologising with regard to "stepping over the line" and deeply apologising for any upset caused to the
Complainant.  She also accepted some responsibility for her actions.   

Sanction

Within one month from the date of the imposition of this sanction, which will run from the expiration of the Appeal deadline or the exhaustion of the BACP Appeal process, Ms Blissett 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 she would now do differently, in particular initial contact and the sensitive issues associated with a termination.  This submission must be between one and three thousand words. 

Ms Blissett is required to write and submit a second report within 6 months from the date of the imposition of this sanction.  Ms Blissett is required to
have this report countersigned by a supervisor outside of her current network.  In this report, Ms Blissett is required to address comprehensively the following areas:

Ø  Provide evidence that she has undertaken an extended case study with regard to this complaint, with a supervisor outside of her current network, examining in-depth how each of her comments may have had an impact on the client and also how, in retrospect, she may have ameliorated that within the conversation.                                                                                                            

Ø  Provide evidence that she has comprehensively examined how her attitudes to faith may have an impact on client material and demonstrate consideration of whether she can identify client groups with which she should not work.  

Ø  Detail her reflection and learning on the importance of the initial contacts by any client to a counselling service.

Ø  Provide evidence of her learning on how to contain, manage and facilitate the initial contact of a prospective client.

Ø  Detail her learning with regard to the disclosure of examples of clients' issues when speaking to a different client.  

Ø  Provide evidence, in conjunction with either a supervisor outside her current network or a consultant, that she has reviewed her assessment procedures as to fitness or purpose both in theory and practice and detail and show evidence of any revision to her assessment procedures. 

Ms Blissett will be required to attend an interview with a Sanction Panel within 8 months of the imposition of the sanction.  At this interview, Ms Blissett
will be required to demonstrate her further in-depth learning and understanding of the issues raised in this case.

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. 

(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: Sharareh (Sherry) Keyani, Reference No: 555782, Exeter EX2

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 commenced counselling with Ms Keyani on 26 April 2010.  The Complainant ended the counselling relationship following the session on 13 Dec 2010.

The Complainant allegedly informed Ms Keyani in the first session that she had engaged with counselling on previous occasions, that she wanted help in overcoming unhelpful coping strategies;, that she had a preference for solution focused therapy and did not find it helpful to go over the past. 

The Complainant alleged that Ms Keyani took phone calls during her counselling sessions and that often the sessions started late, sometimes by as much as half an hour and on other occasions were allowed to overrun.  The Complainant further alleged that she was unclear about the number of sessions she was being offered after the first four assessment sessions, which then seemed to go from a fixed to an unfixed number, without an explanation.

The Complainant alleged that in the first session Ms Keyani raised an issue about the appropriateness of the Complainant being allocated to her for counselling, as she had allegedly told the Complainant that she normally dealt with complex cases rather than regular clients.  In the penultimate session on 6 December 2010, Ms Keyani allegedly expressed the view that the Complainant was "stage 4" in terms of counselling need and eligible for referral to a psychologist but intended to continue working with her.  The Complainant alleged that she found this very confusing.

The Complainant alleged that she made clear to Ms Keyani her requirements regarding confidentiality in the first session, because of a past negative experience which had affected her trust and that it was agreed that only the dates and times that she attended sessions would be recorded in her medical notes.  However, the Complainant alleged that she realised that this agreement had been breached when she saw her medical records covering the period that she was in counselling with Ms Keyani.  The medical records did include observations about the Complainant's mood and the content of some of the counselling work.

The Complainant alleged that Ms Keyani persisted in using a life line as a therapeutic tool, week after week, and did not seem interested in talking about the positive aspects of her life, which resulted in her having to keep going over difficult times in the past and not having space to explore her present issues.  The Complainant alleged that she was criticised for avoidance and resistance and Ms Keyani emphasised how long it would take to work through the past events.  When the Complainant talked about a painful memory, she alleged that Ms Keyani did not give her time to explore it satisfactorily by saying that they would come back to the issue and immediately asked what the next significant event was that she remembered, which she found distressing.

The Complainant alleged that on 6 December 2010, she told Ms Keyani that she had spoken to her GP about difficulty sleeping and a very low mood with thoughts of wanting her life to end that she was clear she would not act on.  Ms Keyani allegedly responded by emphasising the importance of getting on with the life line.

The Complainant alleged that during the course of therapy, Ms Keyani expressed personal opinions, which she found undermining and disempowering; that the Complainant should not do [ . . . ], work [ . . . ], which was the focus of the Complainant's work.

On 13 December 2010, the Complainant alleged that she told Ms Keyani that she had had a very hard week, but this was not acknowledged and that Ms Keyani stated that if the Complainant could not remember the details, it could not have been that bad.  The Complainant allegedly said that she did not want to use the life line but Ms Keyani stated that she wished her to complete it, so that the Complainant could see how she sabotaged counselling when she got close to something.  The session allegedly became increasingly difficult and exhausting for the Complainant and ran over by half an hour.

On 13 December 2010 the Complainant further alleged that Ms Keyani speculated that the Complainant had been involved in something she could not remember by repressing childhood memories about an issue concerning [ . . . ].  Ms Keyani allegedly asserted that the Complainant had admitted in a previous session, [ . . . ].  The Complainant stated that these accusations were false and alleged that she found the statements so grossly inaccurate and upsetting that she needed immediate support from her line manager at work, after the session ended.  The Complainant then terminated the counselling relationship.

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 Keyani allegedly failed to provide a good quality of care and competently delivered services by taking telephone calls without prior discussion with the Complainant, thereby interrupting her sessions, including taking routine calls such as being notified of the arrival of another client.

2. Ms Keyani allegedly failed to provide a good quality of care and competently delivered services by not adequately managing the time set aside for the Complainant's counselling sessions that sometimes started late or were allowed to overrun.

3. Ms Keyani allegedly failed to provide a good quality of care and competently delivered services by not being explicit about the number of sessions being offered or discussing this issue at appropriate stages as counselling progressed, with the result that the Complainant was unclear about whether the number of sessions was finite or not and any criteria that would influence this.

4. Ms Keyani allegedly failed to provide a good quality of care and competently delivered services by speculating about whether the Complainant's issues amounted to a complex case or not and whether she was the right person to work with her, thereby undermining the Complainant's trust and confidence.

5. Ms Keyani allegedly failed to provide a good quality of care and competently delivered services by deliberating about her competence to work with a 'level 4' client and suggesting the Complainant was entitled to a referral to a psychologist but nevertheless, choosing to continue to work with the Complainant.

6. Ms Keyani allegedly undermined the Complainant's trust and autonomy in failing to have an informed discussion with the Complainant about her options and giving her mixed messages about working with her.

7. Ms Keyani allegedly failed to provide a good quality of care and competently delivered services by paying insufficient attention to clarifying the Complainant's therapeutic goals and preference for working with present issues.

8. Ms Keyani allegedly failed to provide a good quality of care and competently delivered services by taking insufficient account of the Complainant's previous experiences of counselling and the Complainant's wish not to go over the past, which had influenced her choice of solution-focused therapy. Ms Keyani allegedly persisted with the use of the life line which involved looking at past issues, despite a reference to the Complainant's low mood and possible link to the life line exercise in the medical notes dated 29 Nov 2010.

9. Ms Keyani allegedly did not meet the client's needs or pay careful attention to the client's consent to her methodology, over-riding the Complainant's wishes and sense of autonomy in working with the Complainant using the life line, week after week, despite the Complainant's objections and criticising the Complainant for sabotaging the therapeutic work by not wanting to use the life line in the final session.

10. Ms Keyani allegedly failed to respect the Complainant's right to be self-directing by expressing personal opinions about her suitability for working in certain areas, which she found undermining and disempowering.

11. Ms Keyani allegedly failed to provide a good quality of care by stating that the Complainant was repressing childhood memories and by asserting that in the course of therapy, she had admitted [ . . . ].

12. Ms Keyani allegedly broke the confidentiality agreement that she made with the Complainant at the start of counselling, that only dates and times of sessions would be recorded in the medical notes, by making additional comments about the Complainant arising out of the content of the counselling sessions and observations about her generally, which were recorded.

13. Ms Keyani's alleged behaviour, as experienced by the Complainant, suggests a lack of the personal moral qualities of empathy, respect, competence and wisdom to which practitioners are strongly encouraged to aspire, as outlined in the Ethical Framework for Goof Practice in Counselling and Psychotherapy 2010, a contravention of paragraphs 1, 2, 3, 6, 11, 12, 13 and 20 and the ethical principles of being trustworthy, autonomy and beneficence.

Findings

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

1. Ms Keyani's oral evidence was that she gave advance notice to her client that the phone in her office may ring. Ms Keyani said that her phone seldom rang but admitted on questioning that there were at least 2 occasions when it rang when the Complainant was present. Whilst the Panel accepted that Ms Keyani did discuss with her client the possibility that her phone may ring, it found no evidence that Ms Keyani considered the impact that this would have upon the Complainant. The Panel found in failing to consider this, Ms Keyani failed to provide the Complainant with a good quality of care and competently delivered services. This allegation is therefore, upheld.

2. Both parties accepted on questioning that sessions started late or overran. The Complainant in her evidence stated that she never knew when her sessions would start or finish. The Panel found that a competent therapist would ensure that sessions began and ended on time. Therefore, in not maintaining time boundaries within the counselling relationship, Ms Keyani did not provide a good quality of care and competently delivered services. This allegation is therefore, upheld.

3. The Panel found a sharp difference of opinion as to whether Ms Keyani had been explicit about the number of sessions that the Complainant would receive. On the balance of probabilities, the Panel found that Ms Keyani did confirm the number of counselling sessions that would be offered and had been explicit in this regard. This part of the allegation is therefore, not upheld. In Ms Keyani's written evidence however, the Panel found that there was only evidence of one review having been carried out. The Panel considered this to be insufficient, given that it had heard from both parties that Ms Keyani referred to the Complainant as a "complex case" and discussed a referral to a psychologist on more than one occasion. The Panel therefore, found that Ms Keyani did not discuss the number of sessions at regular intervals, and this part of the allegation is therefore, upheld.

4. In her oral evidence, the Complainant stated that the trust and confidence in the counselling relationship declined over time, that it was not the result of one particular incident, and that it finally reached an unacceptable level as a result of the incident that occurred in the penultimate and last sessions. The Panel also heard from the Complainant that Ms Keyani never speculated as to whether or not she was the right person to work with, as Ms Keyani was clear that she was the right person to work with her. The Panel therefore, did not find the Complainant's trust and confidence was undermined as a result of Ms Keyani stating that the Complainant was a complex case or whether she was the right person to work with her. This allegation is therefore, not upheld.

5. Ms Keyani admitted on questioning, that on more than one occasion she routinely told the Complainant that she could be referred to a psychologist. Ms Keyani stated that she gave the Complainant the option of being referred, but each time the Complainant chose to continue to work with her. The Panel accepted that Ms Keyani discussed the referral with her supervisor, who agreed that she could continue to work with the Complainant. Ms Keyani in her evidence stated that she was the only counsellor in the GP practice who was able to work at level 3/4 of the stepped care model and deal with clients with moderate, severe and psychotic disorders of depression. Whilst the Panel noted that the Complainant may not have appreciated the significance of being classified as a level 4, the Panel found that in this instance, Ms Keyani did not fail to provide a good quality of care and competently delivered services. This allegation is not upheld.

6. The Panel found that Ms Keyani failed to carry out a sufficient assessment with the Complainant to determine whether they were suitable to work together. During the assessment that did take place, the Panel found no evidence that the Complainant's goals for counselling had been set or discussed. This was particularly so, given Ms Keyani stating in her verbal evidence that the Complainant had been vague about her goal for counselling in the first session but at the second session, proceeding to set the Complainant the task of preparing a lifeline. In doing this without defining the Complainant's goals for counselling, the Panel found that Ms Keyani undermined the Complainant's trust and autonomy. This allegation is therefore, upheld.

7. The Panel found that in failing to carry out a sufficient assessment where the therapeutic goals were set and having regard to the Complainant's needs, which, based upon the Complainant's clear evidence, the Panel accepted were to deal with her present issues in therapy, Ms Keyani failed to provide a good quality of care and competently delivered services. This allegation is therefore, upheld.

8. The Panel accepted that whilst Ms Keyani did take into account the Complainant's previous experience of counselling, she admitted on questioning, that she had not known of these experiences in any depth. Ms Keyani stated that she was unaware that the Complainant had previously done a lifeline in her other counselling relationships and therefore, Ms Keyani did take insufficient account of the Complainant's previous counselling experience. Ms Keyani in her oral evidence stated that she had not agreed to do solution focused therapy, as this was not something that she did. The Panel found that the uncertainty between the type of therapy that was being offered and that which was provided had an impact on the quality of care and services delivered to the Complainant, which may have been discovered if sufficient account had been taken of the Complainant's previous experience of counselling. This part of the allegation is therefore, upheld. There was agreement between both parties that when the Complainant said that she did not want to work on the lifeline, Ms Keyani did not persist in her doing so. This part of the allegation is therefore, not upheld.

9. The Panel questioned Ms Keyani in detail about her methodology and found her lacking in her ability to explain her methodology. Given that Ms Keyani could not satisfactorily explain her methodology to the Panel, the Panel found that it was reasonable to accept that the Complainant was not in a position to consent to Ms Keyani's methodology and know what it would involve. The Panel heard evidence from Ms Keyani that the lifeline was introduced in the second session with no prior discussion or preparation of the client. This part of the allegation is therefore, upheld. Ms Keyani denied that she had criticised the Complainant for not wanting to do the lifeline, and on the balance of probabilities, the Panel found there was insufficient evidence to prove anything to the contrary. This part of the allegation is therefore, not upheld.

10. Ms Keyani stated in both her oral and written evidence that she suggested that the Complainant look at something other than [ . . . ] as a career. Ms Keyani stated that suggesting other occupations was something she routinely did with her other clients to encourage them to explore their options. However, the Panel found that the Complainant interpreted this encouragement as a judgment on her ability. Whilst the Panel accepted that Ms Keyani had the Complainant's best interests at heart, the way in which Ms Keyani had expressed this encouragement was open to interpretation. The Panel, however, concluded that there was insufficient evidence for it to find that Ms Keyani had failed to respect the Complainant's right to be self-directing. This allegation is therefore, not upheld.

11. Whilst there was a sharp difference of opinion between the parties as to the version of events of this session, the Complainant categorically denied that she had disclosed to Ms Keyani that [ . . . ]. The Panel explored this allegation at length, and the Complainant accepted that what she had actually said could have been misinterpreted by Ms Keyani, although the Complainant further stated that Ms Keyani should have sought to clarify the statement that was made. Ms Keyani, however, was adamant that she had not misheard or misinterpreted the Complainant's statement. The Panel, on questioning both parties, was not satisfied that Ms Keyani had checked with the Complainant her understanding of what was said during the session. The Panel preferred the evidence of the Complainant in this regard and on the balance of probability found the allegation to be upheld.

12. There was disagreement between the parties as to what had been agreed regarding confidentiality. Ms Keyani was clear in her evidence that she had advised the Complainant that she would record some information on her medical records to give an indication of the purpose of her visit, but would not disclose what Ms Keyani termed as anything of a personal incident. Whilst the Panel found that Ms Keyani had failed to check with the Complainant that she fully understood what would be recorded, the Panel did not find that Ms Keyani had breached confidentiality. This allegation is therefore, not upheld.

13. In not clarifying certain statements made by the Complainant, Ms Keyani failed to demonstrate the personal moral qualities of empathy and respect. The Panel found that in this case Ms Keyani failed to demonstrate the competence and wisdom expected of a qualified counsellor and member of BACP, in not clarifying and reviewing regularly with a client whom she deemed to be "complex".

14. In respect of the above findings, the Panel found that Ms Keyani had breached the ethical principles of being trustworthy, autonomy and beneficence and a breach of paragraphs 1, 2, 3, 6, 11, 12, 13 of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010. The Panel did not find paragraph 20 had been breached.

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice in the provision of inadequate professional services and the member was incompetent, in that the service that she was responsible for fell below the standard that would reasonably be expected of a practitioner exercising reasonable care and skill.

Mitigation

Ms Keyani demonstrated some evidence of learning.  She stated that she now recognised the importance of having a written contract and the need to maintain boundaries regarding her time. 

Sanction

Within one month from the date of the imposition of this sanction, which will run from the expiration of the Appeal deadline, Ms Keyani 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 Keyani is required to undergo work with a supervisor, outside of her current network, who is a senior accredited counsellor or psychotherapist, for a minimum of 1½ hours per month to cover the period of the sanction.  This should be a minimum of 6 sessions.  Details of this supervisor should be supplied at the same time as the first submission is submitted.

Ms Keyani is required to provide a written contract within three months from the date of the imposition of the sanction which should contain the following:

  • A clear statement of an acceptable form of limits on confidentiality
  • A clear statement of the length of the sessions
  • The extent of the notes that will be taken and who will and can have access to these
  • The particulars of any assessment that is offered, including what is involved in the assessment and approximate number of sessions that it will last for

This contract submission must be countersigned by the supervisor.

Ms Keyani is further required to submit a detailed and evidenced case study of no less than 3,000 words and no more than 5,000 words addressing the following:

  • Her methodology and core modality, which describes her rationale for her chosen method of working with clients and gives an in-depth knowledge of at least one theory and how she uses other theories.
  • A demonstration of her ability to make a clear contract.
  • Her ability to make clear goals for the clients and set clear reviews at regular intervals.
  • A demonstration of how she now manages her time boundaries in both her private practice and in an organisational setting.

The case study is to be submitted within no less than 6 months and no more than 12 months of the date of this report, and must also be countersigned by the supervisor.

Ms Keyani is required to provide a supervision log, detailing all of the above supervision sessions, signed by Ms Keyani and also countersigned by the supervisor.  This log should be submitted with her case study, within the timeframe above.

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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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.