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Hearing Findings, Decision & Sanction

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(c) terminate the proceedings or

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

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

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

Findings

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Mitigation

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

Decision

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

Sanction

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

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

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

1. Explicit contracting

2.Cancellation of counselling sessions

3. Missed appointments

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

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





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 adual relationship with the complainant as a friend and counsellor throughengaging in regular out of session text messages and telephone calls,sharing personal details, inviting the complainant to form a spiritualgroup with her, referring to the complainant as "big bro" in her textmessages, concluding her text messages with an x, denoting a kiss, andthrough allegedly meeting the complainant regularly on a social basis.

6. Ms North allegedly failed tohonour the trust of thecomplainant by discussing him with others,thereby failing to respect hisprivacy and confidentiality.

7. Ms North allegedly failed torespond to the complainant's request for information, in that she did notrespond to his request for access to his notes and thedetails of her supervisor.

8. Ms North allegedly abused thecomplainant's trust in order to gain emotional and financial advantage by;hugging him at the end of sessions, suggesting that theyset up a spiritual group, taking money from the complainant which was notin respect of the counsellingwork they were doing andentering into a personal relationship with the complainant, which led himto feel loved and subsequently misled emotionally when the relationship ended.

9. Ms North allegedly did notexercise caution before entering into a personal relationship with thecomplainant.

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

11. Ms North allegedly failed tonotify the complainant of theexistence of the ProfessionalConduct Procedure when she became aware that he was dissatisfied with the counselling.

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

13. Ms North allegedly failed toensure that the way that sheundertook her work was as safe as possible and that she soughtprofessional support when needed, in that she allegedly contacted thecomplainant in distress and used thetherapy sessions and their social meetings to discuss her ownpersonal 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 allegationis therefore not upheld.

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

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

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

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

The allegation is therefore upheld.

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

This allegation is therefore not upheld.

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

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

This allegation is therefore upheld.

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

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

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

The allegation is therefore upheld.

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

This allegation is therefore upheld.

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

This allegation is therefore upheld.

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

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

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

This allegation is therefore upheld.

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

This allegation is therefore upheld.

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

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

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

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

Decision

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

Mitigation

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

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

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

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

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

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

Sanction

The Panel decided on the following sanctions:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Findings

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

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

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

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

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

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

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

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

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

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

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

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

Decision

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

Mitigation

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

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

Sanction

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

viii. Failed to explore with the Complainant the possible impact on the therapeutic work, the fact that Mr Jacob and the Complainant knew people mutually and that they talked about them during therapy, which allegedly caused the Complainant to feel confused.

ix. Used his personal phone for texting the Complainant and suggested the use of email for out of session contact, including weekends, which allegedly increased the Complainant's sense of dependency on Mr Jacob as she made extensive use of this facility.

x. Encouraged the Complainant to write a narrative, which was part of his work for a university, and for his own benefit, blurring boundaries and having the potential of being exploitative.

xi. Sent the Complainant two unexplained empty/incomplete text messages after counselling had ended, despite the fact that he had been instructed by his employer to have a separate work mobile and delete her details from his personal phone which resulted in the Complainant feeling very distressed.

2. Mr Jacob allegedly failed to maintain competent practice in that he: -

i. Told the Complainant that he had not talked to his supervisor about whether he had crossed boundaries in his work with the Complainant, such as asking her to go for a coffee.

3. Mr Jacob allegedly failed to keep the Complainant's trust in that he: -

i. Showed a lack of respect and courtesy towards the Complainant in the way he spoke to her on occasions, making fun of her, saying that she paraded herself in front of men, interpreting her flushing when wearing a low summer top as an indication of a sexual attraction for him, allegedly called her a dirty bitch, and asking repeatedly what message she put across to guys.

ii. Abused the Complainant's trust to gain sexual and emotional advantage by:

  • a) Saying in February 2010, that therapy sessions felt like they were having an affair.
  • b) On 15 February 2010, saying to the Complainant after spending an afternoon with her, that he should kiss her on the cheek as they had met socially and then doing so when they parted company.
  • c) On the date referred to above, saying to the Complainant that he wanted her and if he was not married, he would "go for it".
  • d) On 1 July 2010, when he asked the Complainant to have coffee with him and they talked about the sexual attraction between them, using phrases such as "if he wanted to get his leg over" and saying that the connection between them could be "purely carnal".
  • e) On other occasions, saying to the Complainant that she had a special place in his heart, that he thought of her outside of therapy and that he would not forget her.

4. Mr Jacob allegedly failed to respond appropriately when things were going wrong in the counselling relationship, in that he: -

i. On 18 February 2010, blamed the Complainant for what had occurred on 15 February, mainly in relation to an incident in the pub, and was hostile towards her and threatened to end counselling.

ii. Failed to pursue a request made by the Complainant that she be referred to a Community Psychiatric Nurse despite her increasing mental instability but continued to take responsibility for her care.

iii. Went to Canada for 3 weeks without making any arrangements for the Complainant, despite his alleged agreement with the Mental Health Crisis Team to take responsibility for her care, with a care plan that included referral to a psychiatrist and speaking to the GP about her medication.

iv. Told the Complainant on his return from Canada when the Complainant checked what he had done in relation to the care plan, that "it was not what he had signed up for."

v. Failed to take any responsibility for the breakdown of the counselling relationship with the Complainant.

vi.After counselling ended abruptly in July 2010, did not respond to requests for him to attend a meeting to try to achieve closure for the Complainant.

5. Mr Jacob allegedly failed to work in a respectful and collaborative way with colleagues to enhance the services available to the Complainant in that he:

i. Questioned the medical diagnosis that the Complainant had been given, criticised psychiatrists for prescribing medicines and the competence of other agencies involved in her care, thereby reducing her trust in other professionals who might have enhanced her care and increasing her dependence on him.

ii. Failed to work in a collaborative way with other agencies which might have assisted in the Complainant's care or worked in parallel with him and failed to refer the Complainant to a CPN and her Psychiatrist in a timely way, which was to her detriment.

6. Mr Jacob's alleged behaviour, as experienced by the Complainant, showed a lack of the personal moral qualities of integrity, sincerity, respect and competence to which practitioners are strongly encouraged to aspire, as outlined in the Ethical Framework for Good Practice in Counselling and Psychotherapy 2007/2009 & 2010. It also suggests a contravention of the Ethical Framework for Good Practice in Counselling and Psychotherapy 2007/2009 and in particular paragraphs 1, 2, 7, 11, 18, 33, 34, 43 and 46 and the ethical principles of fidelity, autonomy, beneficence and non-maleficence and the Ethical Framework for Good Practice in Counselling and Psychotherapy 2010 and in particular, paragraphs 1, 2, 7, 11, 17, 41, 42, 51 and 54 and the ethical principles of being trustworthy, autonomy, beneficence and non-maleficence.

Findings

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

1. In relation to the allegation that Mr Jacob failed to provide the Complainant with a good quality of care, the Panel made the following findings:-

i. Mr Jacob accepted in both his oral and written evidence that he allowed the counselling sessions with the Complainant to overrun because the Complainant was often in an emotionally unsatisfactory state, and it would take time to get her to a place where she was stable. The Panel was of the opinion that Mr Jacob should not have let the pattern of overrunning form and should have sought to wind down the counselling session sooner, to deal with this issue. This allegation is therefore upheld.

ii. The Panel accepted Mr Jacob's evidence that it was the practice within the GP practice that all clients had to be escorted out of the building. The Panel accepted Mr Jacob's evidence that he did not walk the Complainant through the car park, and this part of the allegation is therefore not upheld. Mr Jacob stated that there were three occasions when as he was walking to Tesco to collect his car, the Complainant walked with him. This part of the allegation is therefore upheld.

iii. Mr Jacob admitted that there were occasions when he provided the Complainant with a cup of tea, but this was prior to the commencement of the counselling sessions, and not during. Mr Jacob advised that he did this out of courtesy as he was making himself a cup of tea and had to walk past the Complainant in the waiting room to access the tea making facilities. Both parties accepted that cake was offered to the Complainant on one occasion. The Panel was not satisfied, on the evidence, that this had occurred during the session. This allegation is therefore not upheld.

iv. Mr Jacob accepted that he went to the pub with the Complainant, but stated that when he did so, he was still in "therapeutic mode". The Panel found that Mr Jacob was trying to rescue the Complainant from her distress and that by meeting the Complainant in this way, Mr Jacob risked undermining the therapeutic work and professional nature of the counselling relationship. This allegation is therefore upheld.

v. There was conflicting evidence from both parties in relation to the allegation that Mr Jacob had talked about his own personal issues rather than the Complainant's, to her detriment. On balance the Panel was not satisfied that there was sufficient evidence for it to uphold the allegation and therefore this allegation is not upheld.

vi. Mr Jacob accepted that a meeting took place with the Complainant on 1 July 2010 in a caf 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:

Erotic transference and its impact and management in the counselling relationship,

The maintenance of boundaries and their importance in counselling relationships,

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.