The complaint against the above individual member/registrant was taken to Adjudication in line with the Professional Conduct Procedure.
The complaint was heard under the BACP Professional Conduct Procedure and the Panel considered the alleged breaches of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy.
The focus of the complaint, as summarised by the Pre-Hearing Assessment Panel, is:
On 29 April Year 1, Ms Bowen agreed to give the Complainant's foster daughter (Ms X) ten one hour sessions of [ . . . ] work, of which three occurred.
The sessions were agreed at the meeting held on 29 April Year 1, between the children's social worker, X1, of Organisation X2, and the Complainant and her husband. It was agreed that there would be ten one hour sessions. There was a further meeting held on 11 June Year 1, at the Complainant's house, with the Social worker and Ms Bowen in attendance. Initially it was agreed that the Complainant would drop Ms X off and pick her up after the session had ended. However, as Ms Bowen did not wish to be alone with Ms X, she allegedly requested that the Complainant attend as an observer.
During the sessions, Ms Bowen encouraged the Complainant to take a more active role, including sitting on the floor and drawing pictures. Ms Bowen rang the Complainant between sessions to give her feedback on her perceptions of how the Complainant had been in the sessions.
After the second session, the Complainant reported her concerns to the Social Worker, who promised to take the matter back to Organisation X2. However, the Social Worker did not get back to the Complainant.
The Complainant could not attend the session on 23 July Year 1, and, with the Social Worker's consent, arranged for her husband to attend. However, Ms Bowen allegedly was unhappy with this arrangement and cancelled the session.
On 19 September Year 1, both Ms X and her [ . . . ] were removed from the Complainant's care. The Complainant alleged that this was as a result of Ms Bowen's reports, either written or verbal, on their meetings as well as false allegations from another carer.
The Complainant asked for copies of reports written by Ms Bowen but was told that no such reports had been written.
She brings this complaint as a client on the grounds that whilst she had not agreed to this that she in effect became a client.
The Panel had to initially consider whether the relationship between Ms Bowen and the Complainant was such that it fell under the jurisdiction of the Ethical Framework for Good Practice in Counselling and Psychotherapy. The Panel referred to the opening statement of the Ethical Framework for Good Practice in Counselling and Psychotherapy and in particular to where it states, "Members of this Association who are providers of services using counselling skills, embedded counsellors, managers and researchers of therapeutic services, are required to be accountable in accordance with the Ethical Framework in ways appropriate to their role and to communicate appropriately the basis of their ethical accountability and expectations." The Panel was satisfied on the information provided that Ms Bowen provided a support service to the Complainant, and that she employed counselling skills in delivering that support. As such the Panel was satisfied that Ms Bowen was accountable to the Ethical Framework for Good Practice in Counselling and Psychotherapy.
The Pre-Hearing Assessment Panel (PHAP), 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 Bowen allegedly failed to clarify and agree the rights and responsibilities of herself as a practitioner and the Complainant as a client; in that it was not clear and agreed as to whether the Complainant was an observer at sessions or as a client where it was necessary for the Complainant to participate in the sessions; in that it was not clear and agreed that there would be phone calls/contact between sessions, nor what might be the purpose of inter-session contact and, in that it was not clear and agreed as to how the ending with the Complainant would take place.
2. Ms Bowen allegedly failed to honour and keep the Complainant's trust in that she passed on to Organisation X2 and the Local Authority information about the Complainant gleaned from the sessions conducted with her, and from their inter-session contact, without discussing it with her first nor informing her that she might disclose her information to another. Further Ms Bowen allegedly failed to respect the Complainant's privacy and dignity in that she disclosed the information without obtaining the Complainant's consent.
3. Ms Bowen allegedly failed to adequately inform the Complainant about the nature of the service being offered to her and obtain informed consent for the work she carried out with her, in that the Complainant was not adequately informed about the process in relation to [ . . . ] work and as to what her involvement and level of participation would entail. Further, in so doing, Ms Bowen allegedly did not respect the Complainant's right to choose whether to continue or withdraw from the service provided by Ms Bowen to her.
4. Ms Bowen's alleged behaviour, as experienced by the Complainant and as identified in the numbered paragraphs referred to above, suggests a contravention in particular of paragraphs 3, 11 and 12 and the ethical principles of Being Trustworthy, Autonomy, Beneficence and Justice of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2010/2013), and showed a lack of the personal moral qualities of Empathy, Sincerity, Respect, Competence, Fairness and Wisdom to which counsellors are strongly encouraged to aspire.
An application was made to submit late evidence on the day of the hearing, by the Complainant. However, after hearing the explanation given by the Complainant for the late submission of evidence, the Panel was not satisfied that the explanation met the requirements set out in the Protocol on Late Evidence and therefore the application was rejected.
Whilst the Professional Conduct Panel noted that the PHAP had already considered the issue of whether or not the Complainant met the definition of ‘client' as set out within the Ethical Framework, it agreed that it also had to consider the same issue, given that it had the benefit of hearing oral evidence from both parties and the written response provided by the Member Complained Against.
After hearing the oral evidence provided, the Panel was satisfied that the Complainant's role in the sessions extended beyond merely an observer, given that she was involved in the icebreaker exercise and Ms Bowen provided feedback on her observations of the Complainant. In addition, in answer to the Panel's questions, Ms Bowen was unable to satisfactorily explain to the Panel the distinction between a therapeutic client in a counselling session and the Complainant. The Panel was therefore satisfied that Ms Bowen did provide a service to the Complainant whereby she used counselling skills. As such, it was satisfied that the Complainant met the definition of client as set out within the Ethical
Framework 2013 edition.
On balance, having fully considered the above, the Panel made the following findings:
1. Ms Bowen in her evidence explained that she worked for Organisation X2 on a contract for service basis, where she was offered work which she could choose to accept or decline. Ms Bowen stated that if she accepted the work, she would arrange a meeting with Organisation X2 to find out more information on the work they had requested her to carry out. Ms Bowen explained that usually a contract was entered into between Organisation X2 and the Local Authority and her understanding was that this contract was then shared with the foster carer.
In her evidence the Complainant stated that she had never had sight of any contract.
Ms Bowen stated that an initial meeting took place on 29 April Year 1, between the Local Authority, Organisation X2 and the Complainant, in which Organisation X2 would have provided information about the services to be offered. Ms Bowen stated that whilst she did not have a written contract with the Complainant, she attended a meeting with the Complainant and the Local Authority on 11 June Year 1, which lasted for approximately 1½ hours. Ms Bowen in her evidence stated that during this meeting, she explained what [ . . .] work was and that it was important that the Complainant be present during the sessions to support Ms X. Ms Bowen relied on her notes of this meeting as evidence of what was discussed. However, the Panel noted that nowhere within these notes was there evidence that Ms Bowen had explained to the Complainant exactly what her role within the sessions was.
The Complainant in her evidence stated that she was unclear what her role was in relation to the sessions and initially thought that she would be acting as a taxi service, dropping off and picking up Ms X from the appointments. Subsequently, following the meeting with Ms Bowen she understood that her role would be merely as an observer, effectively sitting on the side-lines.
Ms Bowen in her evidence stated that she did not regard the Complainant as a client. The Panel accepted the Complainant's evidence that Ms Bowen made observations of her during the sessions and provided feedback, which went beyond merely supporting the Complainant to assist Ms X. The Panel considered that in providing this feedback Ms Bowen was using her counselling skills. Ms Bowen in her own evidence used the analogy that if for example the Complainant spent the session reading a magazine, this would be inappropriate as she would expect the Complainant to engage in the session.
The Panel noted that at no point did Ms Bowen make it clear to the Complainant what she expected of her within the sessions and her notes of the meeting with the Complainant did not support Ms Bowen's assertion that she did.
Despite Ms Bowen's evidence, the Panel found that the Complainant was a client and fell within the definition set out within the Ethical Framework, as it was satisfied that Ms Bowen used counselling skills when working with the Complainant. As such, the Panel agreed that Ms Bowen was responsible for ensuring that the Complainant was aware of exactly what her level of involvement in the sessions would be. The Panel found that Ms Bowen relied on Organisation X2 to provide information to the Complainant and made assumptions that this information had been provided. The Panel agreed that it was Ms Bowen's responsibility to ensure that as the practitioner, she clarified and agreed the rights and responsibilities of her as a practitioner and the Complainant as a client, and to clearly explain to the Complainant her role within the sessions, and not merely rely on Organisation X2 to explain this to the Complainant.
The Panel found that this was particularly so given that the Complainant was unaware that she would be involved in the sessions and be provided with feedback in relation to Ms Bowen's observations of her or be expected to take part in icebreaker exercises. Whilst there was a disagreement between the parties as to precisely what was said to the Complainant during the inter session contact, Ms Bowen accepted that she did provide her observations of the Complainant. In her written evidence Ms Bowen elaborated and stated she would have said words to the effect, you seem to have found the session hard and difficult to engage and things seemed to go better this week. This demonstrated to the Panel that the Complainant was more than an observer. The Panel therefore found that Ms Bowen did not ensure that it was clear and agreed whether the Complainant would be an observer or a client who would be expected to participate in the sessions. This part of the allegation is therefore upheld.
It was accepted by both parties that there was telephone contact in between sessions, however the Complainant stated that she understood the purpose of this contact to be to arrange appointments and she expected this to occur. The Panel therefore accepted that it was agreed between the parties that there would be inter session contact. This part of the allegation is therefore not upheld.
The Panel then went on to consider the next part of the allegation and whether it was agreed what the purpose of the inter session contact was. There was a conflict in the evidence with regard to the purpose of the inter session contact. The Complainant in her evidence stated that she believed the calls were to arrange appointments, but Ms Bowen stated that she made it clear that the calls were to provide advice on managing Ms X and check on the progress of Ms X. The Panel reviewed the note from Ms Bowen's meeting with the Complainant on 11 June, in which she described that the purpose of the inter session contact was to provide support and advice in relation to Ms X and how the Complainant could manage Ms X's behaviour. Ms Bowen accepted that she gave feedback to the Complainant of her (Ms Bowen's) observations of her, and explained that she did this because she was concerned that the Complainant did not seem to be engaged. The Panel found that this feedback went beyond merely providing advice on Ms X and extended into Ms Bowen applying her counselling skills in relation to the Complainant. As the Complainant was unaware that such feedback would be provided, the Panel found that the purpose of the inter session contact was not clear. This part of the allegation is therefore upheld.
Ms Bowen accepted that she did not discuss with the Complainant when the sessions would end as this had not yet been decided. Ms Bowen explained that she herself did not end the sessions, they were ended by the Local Authority. Notwithstanding this, the Panel had regard to the specific wording of the allegation which dealt with whether or not Ms Bowen herself had agreed with the Complainant when the sessions would end. Ms Bowen accepted that she herself did not iscuss the issue of ending with the Complainant as she believed that this would be done by Organisation X2, however, the Panel found that it was Ms Bowen's responsibility as a practitioner to clearly set out the circumstances when therapy would end. Given that this was not discussed, the Panel found that Ms Bowen did not ensure that it was clear and agreed how the ending with the Complainant would take place. This part of the allegation is therefore upheld.
For the reasons stated this allegation is partially upheld, and the Panel agreed that Ms Bowen failed to clarify and agree the rights and responsibilities of herself as a practitioner and the Complainant as a client in respect of the parts of the allegation it upheld.
2. Ms Bowen in her evidence stated that she spoke to the Complainant on the phone on 21 July Year 1, and explained that she would contact the Social Worker to arrange a review meeting and the Complainant agreed to this.
Ms Bowen explained that she suggested a meeting with the Social Worker because she had concerns about the emotional wellbeing of Ms X and felt under an obligation to report these concerns to the Social Worker. Ms Bowen stated that given her concerns, she felt that with or without the Complainant's consent it was her duty to inform the Social Worker, given that in accordance with the Children Act the welfare of the child was paramount.
The Complainant denied that she had given her consent for Ms Bowen to contact the Social Worker. Whilst there was a dispute between the parties as to what was said during this telephone conversation, the Panel accepted Ms Bowen's evidence that she did tell the Complainant that she would contact the Social Worker to arrange a meeting.
However, the Panel was not satisfied that Ms Bowen had obtained consent, explicit or otherwise, from the Complainant to disclose to the Social Worker her observations of the Complainant or made the Complainant aware of the circumstances in which confidentiality may be legitimately breached. Ms Bowen also accepted that at the request of Organisation X2, she attended a meeting where she explained her concerns regarding the Complainant. There was no evidence that Ms Bowen had informed the Complainant that she would be discussing her with Organisation X2 and disclosing information which she had gleaned from the sessions and inter-session contact with the Complainant. The Panel therefore found that Ms Bowen failed to respect the Complainant's privacy and dignity in disclosing information without the Complainant's consent. This allegation is therefore upheld.
3. After questioning both parties, the Panel did not accept that the Complainant was inadequately informed about the process in relation to [ . . . ] Work, as when questioned, the Complainant was able to explain to the Panel what this work involved. The Panel was therefore satisfied that the Complainant was adequately informed of the work in this regard. This part of the allegation is therefore not upheld.
Having heard the evidence provided by both parties and having regard to its finding in paragraph 1 above, the Panel found that the Complainant was not adequately informed about the nature of the services being offered to her, in that the Complainant was unaware that she would have to participate in the sessions, be observed in the sessions and that Ms Bowen would provide feedback on these observations. The Panel therefore found that Ms Bowen did not adequately inform the Complainant as to what her level of involvement and participation would entail. This part of the allegation is therefore upheld.
For the reasons set out above, this allegation is partially upheld.
4. In light of the above findings, the Panel was satisfied that paragraphs 3, 11 and 12 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) and the ethical principles of Being Trustworthy, Autonomy and Beneficence had been breached. It also found that Ms Bowen demonstrated a lack of the personal moral qualities of Empathy, Sincerity, Respect, Competence, Fairness and Wisdom to which all practitioners are strongly urged to aspire.
The Panel did not find that the ethical principle of Justice had been breached.
Accordingly, the Panel was unanimous in its decision that these findings amounted to Professional Malpractice on the grounds that Ms Bowen was incompetent, reckless and provided inadequate professional services, in that the service for which Ms Bowen was responsible fell below the standards that would reasonably be expected of a practitioner exercising reasonable care and skill.
Ms Bowen stated that as a result of this complaint she now ensures that she provides to the parents/carers of foster children, her notes of her meetings with them to ensure that they had a record of what was discussed.
One of the aims of the Professional Conduct Procedure is to protect members of the public. The Panel, in considering what sanction may be appropriate in the circumstances of this case, has taken into account the interests of public protection.
Within one month from the date of the imposition of this sanction, which will run from the expiry of the appeal deadline, Ms Bowen is required to provide her immediate reflections on the areas of the complaint upheld, including what insights she has developed as a result of the findings, and what actions she has taken.
Within six months from the date of approval of the first sanction, Ms Bowen is required to undergo training for a minimum of six hours duration, in the following areas
- Contracting and confidentiality and the application of the Ethical Framework to her practice;
- The Children Act and her responsibilities under the Act when working with children/families for whom she has concerns.
Ms Bowen is required to provide evidence of having attended/completed the above training and within one month of the training, Ms Bowen is required to provide a report detailing what she has learned as a result of the above training.
At the same time as the above report is submitted, Ms Bowen is also required to provide a copy of her contract, which should include the following:
- The rights and responsibilities of Ms Bowen as a practitioner and her clients;
- The services offered by Ms Bowen and her expectations of clients;
- The limits of confidentiality.
These written submissions must be sent to the Registrar by the given deadlines and will be independently considered by a Sanction Panel.
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