August 2008: Penny Emmett - Reference No: 549325 - Bolton BL7

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 2002, (revised 2007) and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, was that the complainant was in receipt of regular counselling for a period in excess of 20 months from Ms Emmett and alleged that during that time Ms Emmett breached several areas of the Ethical Framework for Good Practice in Counselling & Psychotherapy.  Within the complaint there were complex and detailed accounts of the complainant’s perception of the counselling sessions, and allegations that Ms Emmett’s actions resulted in the complainant becoming confused as to the professional role of the counsellor.  The complainant also identified an alleged lack of defined boundaries set by Ms Emmett both during counselling sessions and outside of counselling sessions.  Details of an alleged breach of confidentiality by Ms Emmett giving personal information to another family member without gaining consent from the complainant were also included within the complaint.  The alleged actions by Ms Emmett were considered by the complainant to have had a serious and detrimental impact upon her emotional health.

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:

• The alleged breach of confidentiality by Ms Emmett in divulging information to the complainant’s father.

• The alleged inadequately maintained boundaries as reflected in unplanned extra sessions being arranged at short notice; frequent telephone conversations between sessions and arrangements to introduce the complainant to a female friend.

• The alleged inappropriate disclosures of Ms Emmett’s own personal details and information to the complainant during therapy.

• The alleged nurturing of dependency by Ms Emmett as experienced by the complainant within the counselling process.

• The alleged creation of confusion for the complainant, by Ms Emmett, regarding the theoretical approach used by Ms Emmett in the counselling process.

• The alleged detriment to the complainant’s emotional health as a result of her experiences whilst working with Ms Emmett.

• The alleged inconsistency in the recording and documentation of the counselling sessions by Ms Emmett, compared to the complainant’s recollection of those sessions.

• Ms Emmett mentioned supervision within the counselling notes but the notes allegedly do not demonstrate follow up in this regard.

• The alleged poor handling of the ending of the counselling relationship and process and lack of onward referral.

• The alleged lack of attempt at resolution of the complaint by Ms Emmett with the complainant.

Findings

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

• Ms Emmett accepted that, in an effort to protect the complainant, she made inappropriate disclosures to the complainant’s father, which in hindsight she regrets.  However she maintains that it was in the complainant’s best interests that her family was informed.

• Ms Emmett accepted that introducing two clients to each other, in order to attempt to decrease their social isolation, was a mistake and not one that she will repeat.

• Ms Emmett accepted that, in retrospect, she had not reflected sufficiently on how her reading of the complainant’s letters, outside of the therapeutic hour, encouraged and reinforced a growing dependency.

• Ms Emmett also accepted that she had made far too many personal and inappropriate disclosures.  She told the Panel that she would be more limited and discriminating in this regard in the future.

• The Panel found that Ms Emmett’s latitude around boundaries, including the inappropriate disclosures referred to above, amounted to a nurturing of dependency.

• Whilst Ms Emmett did use a variety of theoretical approaches, the Panel was satisfied that this was an acceptable strategy, given the presenting problems.

• Whilst the Panel accepted that the complainant experienced emotional turmoil, there was insufficient evidence to determine whether this was caused by the counselling process itself, as opposed to the ending of the counselling, which was not entirely within Ms Emmett’s control.

• Whilst there were some inconsistencies in the recording and documentation of the sessions, the Panel accepted Ms Emmett’s explanations for these.

• The Panel was satisfied that Ms Emmett had followed the advice of her supervisor, even if her case-notes did not reflect this.

• The Panel accepted that some aspects of the ending were outside of Ms Emmett’s control.  However, she did not confront the issue of referral clearly enough, even when she realised that the benefits of the counselling, in the second period were, at best, erratic.  There should have been a more managed ending at an earlier stage.

• An attempt was made at resolution, which failed.  Other attempts, such as they were, were then outside of Ms Emmett’s control.

Decision

Accordingly, the Panel was unanimous in its decision that these findings amounted to professional malpractice, in that Ms Emmett’s behaviour, in this instance, fell below the standards that would be expected of a practitioner exercising reasonable care and skill.

Mitigation

Ms Emmett has reflected, at length, on every aspect of her practice in this case.  She gave the Panel verbal examples of how she was working both with the agency and within her own practice to make changes to issues that she has already identified.

Sanction

Ms Emmett is required to produce evidence of the policies and procedures she is already revising/developing, and also of their implementation.

These policies and procedures, as described by Ms Emmett, are:

• Written contracts.

• Processes for referring on.

• Implementation of training for herself and other staff re the onset of mental health conditions and dealing with these appropriately.

• Written reviews and evaluations.

• The development of an “at risk “programme for young people.

These should be submitted in not less than three months and not more than six months from the date of imposition of this sanction.

In addition, Ms Emmett is required to submit a written document explaining how these policies and procedures, had they already been in place, would have changed the way she worked with this client.  In particular, this should include a detailed account of her (new) understanding of the creation of dependency, and how that could be used with reference to future clients.

This should be submitted within one month from the date of imposition of this sanction.

All written submissions under this sanction will be considered by the Sanctions Panel. 

June 2008: Catherine Pulē - Reference No: 567141, Hereford HR4

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 2002, (revised 2007) 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 Ms Pulē worked as a counsellor for an organisation between July 2006 and April 2007, when she resigned during an internal disciplinary enquiry into her professional competence.  It is alleged that in December 2006 Ms Pulē once overslept and missed an appointment she had made with client (A), without agency consultation and outside office hours, leaving client (A) waiting on the doorstep.  In April 2007, it is further alleged that two clients complained that Ms Pulē had accused them of lying.  She also continued to see Client A as a private client without informing the organisation.  Evidence has also been submitted alleging that Ms Pulē had been contacting the helpline of an external organisation, on behalf of Client A, on a number of occasions, including being named as the ‘emergency contact’.  Client A returned to the original organisation in September in distress and it is alleged that Ms Pulē had ended the counselling precipitately and without concern for her essential continuing care.
 
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:
 

• The alleged imposition of Ms Pulē’s personal prejudices and disregard for the clients’ autonomy.
• The alleged breach of Ms Pulē’s clients’ trust
• The alleged failure to provide a good standard of care for a vulnerable client, particularly in ending the relationship.
• The alleged lack of respect for the employing organisation’s organisational requirements.
• Ms Pulē’s alleged confusion of boundaries between counselling and taking action on behalf of Client A on a number of occasions.

Findings

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

• There was insufficient evidence brought to demonstrate that Ms Pulē had imposed her personal prejudices on clients.
• Ms Pulē knew, or should have known, that she should not see clients when she was neither alone in the building, nor outside of the normal working hours at the offices of the employing organisation.
• Ms Pulē chose to act unilaterally in deciding to see a client at lunchtime and, later, in taking an Agency client into private practice without informing the Agency.  The Panel was satisfied, on the evidence provided, that she must have known that supervisory and managerial support were available but that she chose not to access them.  The Panel found that this behaviour was not respectful toward the Agency and did not promote good working relationships that would have enhanced client services.
• Ms Pulē provided written evidence whereby she stated that she was drawn into a relationship with client A in which she “crossed boundaries”, particularly in relation to talking to agencies over the phone.  The Panel found that the extent of this behaviour risked encouraging dependency and did not promote the client’s autonomy.
• The Panel was satisfied, both by the organisation’s evidence, and by the evidence of Ms Pulē’s own written statement, that she had failed to reflect sufficiently on her own practice.  In addition, she failed to consult with colleagues or managers on a range of issues such as moving into an advocacy role with client A.
• Because Ms Pulē elected not to attend the Hearing, the Panel was frustrated in its efforts to ascertain certain facts and, therefore, had to reach its own conclusions on the basis of her written response.
• Members of BACP are required to take part in the professional conduct procedures of the Association, in accordance with paragraph 42 of the Ethical Framework for Good Practice in Counselling and Psychotherapy; additionally, under paragraph 1 of the same document, practitioners are also required to be accountable for their practice.  The Panel considered Ms Pulē’s failure to respond to correspondence or to attend the Hearing, demonstrated that she did not fully accept her responsibility to either her employing organisation, or the Association.

Decision
Accordingly, the Panel was unanimous in its decision that the findings amounted to professional malpractice on the grounds that Ms Pulē’s services had fallen below the standards expected of a reasonably competent practitioner.
 
Sanction
Ms Pulē is required to write a detailed reflection of her learning from this case, in particular, she should reflect on what she has learned about working with colleagues, boundary issues and the use of supervision.  This should be linked to a theoretical understanding of the above concepts, and must demonstrate significant (retrospective) understanding of her own unconscious processes during the entire period that she worked for the employing organisation, and with Client A, in particular.

This report should be received by the Head of Professional Conduct no later than three months from the date of the imposition of this sanction.

All written submissions under this sanction will be considered by the Sanctions Panel.

June 2008: Samantha Haley - Reference No: 533595, Newcastle upon Tyne NE20

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 © 2007, and considered allegations of breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy © 2002/2007.

The focus of the complaint as summarised by the Pre-Hearing Assessment Panel was that the Complainant, an organisation, considered that damage had occurred to the organisation, caused by Ms Haley’s allegedly unprofessional conduct, involving the sending of an allegedly defamatory e-mail about the organisation.  The Complainant also believed that Ms Haley has no intention of making reparation to resolve the matter.

The Pre-Hearing Assessment Panel, in accepting the 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:

Ms Haley’s actions and behaviours related to the ‘Working with Colleagues’ section of the Ethical Framework, particularly clauses 43, 44, and 46.  These clauses are as follows:

43: Professional relationships should be conducted in a spirit of mutual respect.  Practitioners should endeavour to attain good working relationships and systems of communication that enhance services to clients at all times.

44: Practitioners should treat all colleagues fairly and foster equality of opportunity.

46: Practitioners must not undermine a colleague’s relationships with clients by making unjustified or unsustainable comments.

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

• Ms Haley accepted full responsibility for sending an inappropriate e-mail, containing unsubstantiated allegations against the organisation, and against an individual working at the organisation.
• Ms Haley fully acknowledged that the sending of this e-mail was both unprofessional and an error of judgement
• Ms Haley further acknowledged that great distress was caused to both the organisation and the individual as a result of this e-mail.
• The Panel found that the e-mail was not fair to either the organisation or to the individual concerned.
• Professional relationships were not conducted in a spirit of mutual respect, in that Ms Haley did not contact the organisation with her concerns.
• Whilst the Panel was satisfied that Ms Haley had shown some learning from this matter, it was not satisfied that she had shown sufficient insight into the implications of her actions either for the organisation, or for the individual concerned.
• When questioned by the Panel, Ms Haley agreed that, in responding to the original e-mail, she had acted outside of the remit of the post she held at that time.

Decision
The Panel was unanimous in its decision that these findings amounted to professional malpractice, in that Ms Haley did not act competently with this matter, particularly in that she made no effort to substantiate allegations which she referred to in her e-mail; nor did she follow an investigative process.  The Panel viewed these actions as reckless in that Ms Haley did not take sufficient care as to the consequences of her actions in writing and sending the first e-mail.

Mitigation
Ms Haley had made both a written and verbal apology to the organisation and the individual concerned, and made further verbal apologies during the course of the Hearing. Ms Haley did outline some learning as a result of her actions, in that she stated she would:

• not act on concerns immediately;
• not send e-mails in haste;
• investigate unsubstantiated concerns appropriately.

However, the Panel was not satisfied that this learning was of sufficient insight or depth.

Consequently the following sanction was imposed:

Sanction
Ms Haley must present a written account of her learning from these events; in particular this should focus on the following:

• A detailed understanding of the effects unsubstantiated allegations might have on individuals and organisations;
• Evidence that she has support systems in place, both personal and professional, to mitigate against future lapses of judgement.

All written submissions under this sanction will be considered by the Sanctions Panel.

June 2008: Derby Women’s Centre - Reference No: 102585, Derby DE1 2HE

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

The complaint was heard under the BACP Professional Conduct Procedure © 2007, and considered allegations of breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy © 2002/2007.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, was the alleged deterioration in the quality of care being offered by Derby Women’s Centre, (hereinafter referred to as DWC), to vulnerable clients.  The Complainant was involved with DWC from 2000 as a volunteer counsellor. She joined the Board of Trustees in June 2004 and became Chair in January 2005 then Deputy Chair in 2007 before resigning on 16 October 2007.  She also worked in a voluntary capacity for the Centre as Counselling Service Facilitator and Client Assessor from 2004.  Her concern was that the delivery of counselling services offered by the organisation had deteriorated and was not sufficient or adequate for competent ethical practice.  This allegedly included: client confidentiality not being maintained; clients being given inappropriate help and advice; essential communications about clients being poor; a lack of respect for vulnerable service users (men allowed on the premises without concern for the women clients); cancellation of client assessments; management meetings which were not minuted; and lack of response by the Board of Trustees to the concern expressed by the Counselling Sub-committee.

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:

• The alleged inadequate observance of procedures for client confidentiality and support.
• The alleged offering of inappropriate help, qualified advice and support to clients.
• The alleged poor communications between staff, particularly about clients.
• The alleged poor communication between staff and clients resulting in unrealised expectations from DWC Services.
• The alleged lack of respect for the vulnerable women clients in the use of posters in public areas and in allowing men into the premises without discussion.
• The alleged withdrawal of client assessments.
• The alleged lack of observance of management protocols including altered Minutes, un-Minuted meetings, and a lack of response to the Counselling Sub-committee’s written concerns by the Board of Trustees.
• The alleged failure to uphold the ethical principles of beneficence, non-maleficence and justice.

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

• There was some agreement between the parties as to the facts.
• Both parties agreed that there had been a lack of observance of client confidentiality through the messaging book system held at the Centre.  The Complainant admitted that during her tenure as Chair of the Board of Trustees at the Centre, (January 2005 to June 2007) there had been a lack of appropriate observance of client confidentiality within the Centre’s system of message recording.  The representatives of DWC admitted that from June 2007 to October 2007 the Centre Manager had used the same system and that there had not been appropriate observance of client confidentiality.
• There was agreement that the withdrawal of client assessments had been instigated by members of the Counselling Sub-Committee and not by DWC and this complaint was withdrawn.
• The Board of Trustees appointed a Centre Manager in April 2007.  Confirmation of the appointment was subject to a satisfactory completion of a period of probationary service of six months.  The Board of Trustees appointed a line manager from its ranks to monitor and support the Centre Manager during the probationary period.  The Panel found that the period of probation was inadequately line managed and that there was a failure to arrange line management meetings.  Issues and concerns that were raised during the period were not addressed.  This situation was exacerbated by changes in line management personnel through maternity leave and resignation.
• A new Chair of the Board of Trustees was appointed in June 2007.  Several Trustees who were new to DWC were also appointed at this time.
• There was a breakdown in communication between the Centre Manager and the Counselling Sub-Committee and some of the volunteer counsellors during the summer of 2007.  This breakdown in communication resulted in a series of messages and instructions being left in the Centre’s messaging book.  The Centre’s policies for resolving issues were not adhered to.
• There was insufficient evidence to indicate that this breakdown in communication had a detrimental effect on clients.  There was no evidence from clients to demonstrate that this had been the case.
• During the summer of 2007 the Counselling Sub-Committee held a number of meetings to discuss concerns about the communication in the Centre and the actions of the Centre Manager in respect of the counselling service.  These concerns were addressed directly to the Chair of the Board of Trustees.
• The Chair of the Board of Trustees raised these concerns with the line manager in June 2007 but did not take adequate responsibility to ensure proper handling of the matter over the summer months.
• Subsequently members of the Counselling Sub-Committee sent a report about their concerns in the form of a complaint to the Board of Trustees on 24 September 2007.  The majority of the Trustees were unaware of the difficulties in the Centre prior to this date.
• The Board of Trustees acknowledged the report and its contents and informed the Counselling Sub-Committee that the complaint would be investigated.  The Counselling Sub-Committee was asked to provide further information by 1 October 2007; this request was not complied with due to concerns about client confidentiality.
• On 16 October 2007 the Counselling Sub-Committee resigned and the Complainant sent a formal complaint, dated 17 October 2007, to BACP.
• The Centre Manager met with a potential counselling client on 25 July 2007 and with a distressed client on 29 August 2007 in the course of her role as Centre Manager.  There was insufficient evidence to indicate that these clients were given inappropriate help, advice or support, or that this contact led to unrealistic expectations of the services of DWC.
• There was insufficient evidence provided for the Panel to decide whether the placing of a particular poster in a public area demonstrated a lack of respect for vulnerable women clients.  There was no evidence provided from clients to demonstrate that this had been the case.
• The Panel found that an incident where a man had entered the premises was adequately and appropriately handled in the circumstances and that discussion could not have taken place.
• The serious breakdown in essential communication between members of the Counselling Sub-Committee and the Centre Manager was at the heart of this complaint.
• There was a lack of observance of management policies, procedures and protocols by the Centre Manager in that there was a failure to raise issues with her line managers or the Chair of the Board of Trustees, and in taking such issues to an external funding body without prior discussion or agreement.
• The Chair of the Board of Trustees (June to October 2007) failed to take adequate responsibility for the effective running of the Centre and did not sufficiently inform the full Board of Trustees of issues which needed attention.
• Once informed of the concerns of the Counselling Sub-Committee, the Board made appropriate and timely responses.
• There was no evidence available to demonstrate a failure to uphold the ethical principles of beneficence, non-maleficence and justice.

Decision
The decision of the Panel is that the complaint is upheld in part.

Accordingly, the Panel decided that the above findings amounted to professional malpractice on the grounds of incompetence in that there was a failure to manage some of the staff and volunteers in a professional manner.  The Board of Trustees failed to ensure that the Centre’s policies, procedures and protocols were adequately adhered to.  In addition, the DWC failed to ensure appropriate levels of client confidentiality in internal communication systems.

Mitigation
In mitigation, the Panel found that the new Board of Trustees, which was formed in October 2007, did not manage DWC during the timescale under consideration in this complaint.  Representatives of the current Board of Trustees acknowledged that there were errors and failings at that time, but impressed upon the Panel their intention to improve the Centre’s policies, procedures and protocols in partnership with its local funding authority.  A Counselling Co-ordinator has now been appointed and the Panel took note of the new draft documents presented in late evidence.

Furthermore, the Panel noted that the Complainant was, in fact, in a position of authority and responsibility during her period as Chair of the Board of Trustees and in other roles held by her at that time.  She was therefore accountable for some of the failings in observance of procedures during this time.

Sanction
In recognition of the above, the following sanction is imposed:

In not more than twelve months, Derby Women’s Centre is required to provide the Head of Professional Conduct with the complete portfolio of policies, procedures and protocols used in the Centre to ensure the competent and professional delivery of its services, together with a written undertaking confirming that they have all been fully implemented.

All submissions under this sanction will be considered by the Sanctions Panel.

June 2008: Janet Fitt - Reference No: 541060, Shipley BD17

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 © 2007, and considered allegations of breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy © 2002/2007.

The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, was that the Complainant was referred to Ms Fitt, for generic counselling, by a therapeutic resource team of a primary care trust in early 2006.  Ms. Fitt then changed this contract, on 27 April 2006, to one for Eating Disorders counselling, for which she had a separate contract within the primary care trust.  The counselling continued until May 2007.  The Complainant alleged that she was not informed of the changes to the contract or advised of the detail of some of the communications between Ms Fitt and her GP.  In the months that followed, the Complainant alleged that Ms Fitt treated her in an increasingly personal and unprofessional manner, including unsolicited physical contact, making derogatory and culturally disrespectful comments about her husband and family, and addressing her in a manner more appropriate to a friend, both in person, text and telephone.

While the Complainant alleged that there was no specific contract for the many texts and telephone calls that were exchanged, and has provided verbatim transcripts as evidence, Ms Fitt recorded that she verbally contracted for text and telephone calls between sessions to support the Complainant.

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:

• The alleged lack of clarity about the initial contract for services provided by Ms Fitt and the subsequent changes to that contract without the Complainant’s informed consent.
• The alleged lack of formal and explicit contracting between Ms Fitt and the Complainant about text and telephone contact.
• The Complainant’s allegations that Ms Fitt made inappropriate physical contact with her which allegedly changed the relationship from a counselling relationship to a more personal one.
• The Complainant’s allegations that many of Ms Fitt’s communications became increasingly culturally disrespectful and professionally inappropriate.
• The adequacy of Ms Fitt’s records.
• The alleged breaches of the principles of fidelity and autonomy in relation to the Complainant.
• The alleged probity of Ms Fitt’s practice, particularly in relation to clarifying the terms on which the service was offered to the Complainant and information about the service provided.

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

• Ms Fitt confirmed that she had offered a verbal contract to the Complainant but agreed that the terms of this verbal contract were not made sufficiently clear to the client.
• When the counselling changed from a generic counselling contract to one more focused on eating disorders, these changes were not made formally nor explicitly with the client.  Ms Fitt could not provide any evidence to demonstrate that she had gained the client’s informed consent for this change.
• There was a disagreement between the two parties about the number of occasions when hugs took place.  There was also a disagreement about the nature of the physical contact (i.e. whether or not this included the stroking of the client’s hair).  However, both parties agreed that hugging had taken place at the end of the session held on 8 December 2006.  The Panel was satisfied that the client had agreed to the hug in this instance.
• The Panel was not satisfied that the examples put forward by the Complainant illustrated cultural disrespect on the part of Ms Fitt.  However, the Panel was satisfied that some of the comments made in the text messages and in the transcript of a telephone call, were disrespectful and professionally inappropriate.
• The Panel found that Ms Fitt kept adequate records.
• There was insufficient evidence brought to demonstrate that the ethical principle of fidelity had been breached.  However, the Panel did find that the ethical principle of autonomy was breached in that the contracting was unclear.
• Ms Fitt did not adequately clarify the terms and conditions under which counselling was being offered.

Decision
Accordingly, the Panel was unanimous in its decision that these findings amounted to professional misconduct in that Ms Fitt was found to have contravened the ethical and behavioural standards that should reasonably be expected of a member of this profession.

Mitigation
The Panel accepted that Ms Fitt was working within the aegis of an organisation at the time when seeing the Complainant, which did not require written contracts.  However, Ms Fitt stated that she now accepts that the lack of a clear written contract led, in part, to the difficulties arising with this client.  She stated that she will now provide written contracts for all clients regardless of context.

Furthermore, the Panel was satisfied that Ms Fitt will be more aware of time boundaries in the future. 

Sanction
Within one month of the imposition of this sanction, Ms Fitt will submit a written account of her learning from the issues that gave rise to this complaint, paying particular attention to the use of texts, telephone calls and of the importance of setting and maintaining appropriate boundaries within the therapeutic relationship.

Within six months of the imposition of this sanction, Ms Fitt should provide evidence of integrating theory and practice in a way that demonstrates beneficial and effective outcomes for clients.

All written submissions under this sanction will be considered by the Sanctions Panel.

JUNE 2008: Glenis Eden - Reference No: 502741, Bristol BS48

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 © 2007, and considered allegations of breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy © 2002/2007.

The focus of the complaint, as alleged by the Complainant and summarised by the Pre-Hearing Assessment Panel, was the alleged breach of trust between Ms Eden and her client while she was working as an affiliate counsellor for an organisation where the Complainant was the Head of Counselling.  Ms Eden was contracted by the organisation to offer six sessions of counselling to a client in July 2007. The client asked to be reassigned to another counsellor after four sessions alleging that Ms Eden had pressured him to join a religious group that met at her house and had introduced him to members attending a meeting immediately after his session.  Ms Eden also allegedly made an inappropriate self-disclosure.  Although the Complainant addressed the issue with Ms Eden, who allegedly admitted the events had occurred, the Complainant was not convinced that her response indicated appropriate awareness and concern for the damage done to the client, resulting in the organisation terminating her contract.

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:

• The alleged breach of trust between Ms Eden and her client;
• Ms Eden’s alleged disrespect for the client’s dignity and personal choice; 
• Ms Eden’s disregard for appropriate professional boundaries;
• The alleged breach of the ethical principles of fidelity, autonomy and non-maleficence.

Findings

Having fully considered the aforementioned, the Panel found that:

• Ms Eden readily accepted, and regretted, that she had made serious mistakes with regard to the matters being considered at the Adjudication Hearing.
• Ms Eden, partly out of anxiety when told of the client’s conversation with the Complainant, had not responded satisfactorily to the Complainant’s attempts to invite her to reflect on what harm might have been caused to her client by her errors of judgement.
• The Complainant had hitherto received satisfactory reports from previous clients that Ms Eden had referred to her from the Complainant’s organisation.
• Ms Eden, although with regret, acknowledged that her behaviour was an attempt to rescue the client.  However, she did not demonstrate sufficient insight into why her errors of judgement might have caused difficulty for the client. 
• When questioned on how she thought her conduct was likely to have been experienced by the client, Ms Eden’s responses did not demonstrate sufficient depth of empathic understanding, nor that she had the capacity to challenge herself adequately, even when she had recognised her errors.

Mitigation
The Panel acknowledged Ms Eden’s willingness to own her errors of judgement and accepted that she has already taken action in an attempt to address this in both personal therapy and in supervision.  This was considered and has been reflected in the Sanction imposed. 

Decision
Having fully considered the above, the Panel made a finding of professional malpractice, inasmuch as Ms Eden failed to provide an adequate professional service for her client, and failed to satisfy the standard of self-reflection which is expected of a senior accredited and experienced counsellor.

Sanction
Accordingly, the following sanction is imposed:

That Ms Eden, through fortnightly supervision starting within one month of receipt of the findings, particularly concentrates upon the following issues:-

• Her analysis of what went wrong in her work with the client and how she might have managed the therapeutic relationship differently, giving her reasons.
• Consider those occasions when she feels anxious about a client and examine how that anxiety can lead to impulsive responses that are not appropriate.
• Learn how, when working with clients, to make space to think, in order to frame more appropriate interventions.

And that after six months, she submits a report of her learning, to be signed and confirmed by the supervisor as an accurate record of that learning.

The written submission must be sent to the Head of Professional Conduct and will be considered independently by the Sanction Panel.

All written submissions under this sanction will be considered by the Sanctions Panel.

August 2007: Joan Smith - reference no: 530702 – Great Yarmouth NR31

A 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 © 2002, and allegations of breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy © 2002 were considered. This was followed by an Appeal Hearing. The appeal was denied apart from two issues, with the Professional Conduct Appeal Panel incorporating amendments into the decision of the Professional Conduct Panel.

The focus of the complaint, as alleged by the Complainant and summarised by the Professional Conduct Panel, was that between April 2005 and February 2006, the counselling service that was provided by Mrs Smith was inadequate for various reasons and these were summarised by the Pre-Hearing Assessment Panel as set out below:

• professional and personal boundaries were mismanaged;
• the client’s autonomy in consenting to contact the client’s GP was disrespected;
• diagnosis was offered which was beyond Mrs Smith’s level of competence;
• Mrs Smith’s fitness to practice was at times questionable;
• termination of the counselling relationship was mismanaged.

Findings

Having fully considered the aforementioned, the Professional Conduct Panel found that:

• there was little agreement between the parties as to the facts;
• there was evidence of an exchange of gifts between Mrs Smith and the Complainant which blurred professional and personal boundaries;
• Mrs Smith, as a psychodynamic counsellor, failed to adequately recognise the powerful transferences and the significance of the gifts or the degree and intensity of the idealisation of her by the Complainant;
• the Appeal Panel amended the finding about ’idealisation’, finding that Mrs Smith, even though she had taken the issue to supervision, gave evidence that demonstrated that she was not able to handle the concept in this particular relationship; she admitted that she had been ’overwhelmed’ and ’sucked in’ by this client, even after trying to implement stricter boundaries;
• Mrs Smith agreed that she had made personal disclosures during ’small talk’ at the beginning and/or end of counselling sessions and this included information about her own daughter. Mrs Smith also disclosed information about her husband;
• the Complainant had information about Mrs Smith’s medical history which on balance, could only have been disclosed by Mrs Smith. The giving of this information was inappropriate and not beneficial to the client;
• Mrs Smith was inconsistent in the way that she worked with material produced by the Complainant in between sessions and sent to her; sometimes Mrs Smith would refer to it in the counselling sessions and sometimes she would not;
• Mrs Smith made significant changes to her way of working with the Complainant at the end of September 2005 following the appointment of a new supervisor. However, whilst these changes to the work were appropriate, Mrs Smith did not advise the client of these changes and/or review the way of working with the Complainant to ensure that she had a proper understanding of the change in approach;
• there was insufficient evidence to conclude that Mrs Smith offered a diagnosis of the client’s condition;
• Mrs Smith agreed that she had limited knowledge of and limited training with regard to the client’s condition;
• Mrs Smith failed to sufficiently inform herself about the serious nature of the client’s disclosed condition in early January 2006;
• the Appeal Panel amended the finding about ’recklessness’, finding that while Mrs Smith should have done more to properly inform herself, her actions did not amount to recklessness. ;
• in the particular circumstances of this case, and specifically given the nature of the client’s issues, Mrs Smith failed to understand how the client would be affected by her announcement, in late January 2006, of the termination of her private therapy practice in July 2006 and consequently failed to properly prepare the client for the ending of the therapeutic relationship. The Appeal Panel considered that the mismanagement of the termination of the counselling relationship was a serious matter. The Appellant demonstrated a lack of awareness and ability in the early stages of the therapeutic relationship to recognise signals which should have raised her level of concern, such as: the content of the client material; the reluctance of the client to complete paperwork; and the idealisation in all its manifestations. All these signals should have led to an earlier decision to make an appropriate referral and terminate the counselling relationship at a much earlier stage;
• Mrs Smith made appropriate contact with the client’s GP in February 2006 when she became concerned about her client’s condition;
• Mrs Smith failed to make it clear to the client, in January 2006, that in continuing to counsel her she was working beyond her level of competence;
• Mrs Smith had evidence, throughout the case, that the client had issues in relation to engaging and disengaging from the counselling process. Mrs Smith failed to make adequate use of this evidence and seriously mismanaged the termination of the counselling. Mrs Smith did not make any attempt to make an appropriate supportive referral;
• although Mrs Smith took this case to supervision, the selected case records did not offer evidence of adequate reflection on her work with the client following discussions with her supervisors.

Decision

Accordingly, the decision of the Panel is that the complaint is upheld in part.

With regard to the findings, the Panel decided that the conduct of Mrs Smith amounted to professional malpractice on the grounds that during the period April 2005 to February 2006 Mrs Smith offered inadequate professional counselling services; that she worked beyond her level of competence and should have done more to properly inform herself of the client’s condition.

In addition, the Panel found that Mrs Smith failed to reach the standards expected of a reasonably competent psychodynamic counsellor.

Sanction

The following sanction is imposed:

Mrs Smith is required to write and submit a report that evidences/demonstrates the following:

• her learning from and understanding of her work with this client in relation to the blurring of professional and personal boundaries that took place through the exchanging of gifts, disclosure of personal information and medical history;
• her understanding of the psychological dynamics between herself and the client in this case;
• her understanding of transference and idealisation in psychodynamic counselling and its impact in the work with this client;
• her understanding and ownership of the professional responsibilities owed to clients in the proper management of the termination of counselling and appropriate supportive referrals;
• how she would indicate to clients in future work that she would be unable to continue therapy because she would be working beyond her competence.

Mrs Smith is required to have additional supervision which expressly focuses on the maintenance of professional boundaries and the proper management of the termination of counselling. A signed statement must be submitted by Mrs Smith, which is duly countersigned by her supervisor, which confirms the amount of additional supervision received and which confirms that this work has been undertaken with a satisfactory outcome.

Mrs Smith must undertake a minimum of eight hours of recognised further training in understanding the type of conditions affecting the client and its treatment and provide BACP with evidence of attendance certificates of this continuous professional development.

All of the above are to be completed and submitted to the Head of Professional Conduct within no less than six months and no more than 12 months from the imposition of this sanction.

All written submissions under this sanction will be considered by the Sanctions Panel.

May 2007: Stephen Will - reference no: 530723 – Fareham PO17