A 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 over a five-year period the Complainant experienced the therapy that she received from Ms McDermott as damaging and unsafe. The Complainant alleged that the ending by Ms McDermott was abrupt, unilateral and detrimental. The Complainant alleged that throughout the five years: Ms McDermott failed to maintain the fidelity and beneficence of the therapeutic relationship and abused the Complainant's trust by not holding clear, consistent boundaries around her practice, specifically; inadequate therapeutic agreements, inappropriate extension of agreed time boundaries, inappropriate contact outside sessions by telephone, email, letter and text and ending the relationship without care and respect for the Complainant's well-being. In addition, the Complainant alleged that Ms McDermott conducted inappropriate financial agreements, and further alleged Ms McDermott accepted being nominated by the Complainant as an executor and named beneficiary to her will. The Complainant alleged Ms McDermott worked beyond her competence throughout the relationship, ignoring the advice of other professionals, specifically the Complainant's psychiatrist and her own supervisor. It is also alleged that Ms McDermott failed to protect the Complainant's confidentiality from Ms McDermott's partner and showed a lack of professional judgement in criticising colleagues known to the Complainant. Ms McDermott allegedly paid insufficient attention to her own fitness to practice and failed to recognise at an early stage the depth of her unprofessional and emotional attachment to the Complainant. Ms McDermott allegedly abused the power dynamics of the therapeutic relationship by gratifying her own personal need for an emotional attachment and compounding the difficulties by making increasingly inappropriate personal disclosures and intimate expressions of love and care for 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:
• Ms McDermott's alleged unprofessional and gross abuse of the therapeutic relationship and the Complainant's trust, for her own emotional gratification, to the detriment of the Complainant.
• The alleged precipitate ending by Ms McDermott, to a long period of therapy, without meaningful discussion with the Complainant, against the explicit advice of other health professionals including the Complainant's psychiatrist, and without sufficient care for the Complainant's continuing well-being.
• The alleged gross failure by Ms McDermott, to provide a good quality of care and maintain the essential and appropriate boundaries around the management of her work, including financial arrangements and the security of records, the conduct of the therapy, and the therapeutic relationship.
• That although Ms McDermott offered an initial formal contract, this allegedly was not amended when changes were introduced in therapy and she did not offer adequate reviews that took the Complainant's needs into account.
• The alleged lack of adequate contracting with the Complainant by Ms McDermott, without due care and attention to the ending of the therapeutic relationship.
• The alleged inappropriate and damaging personal disclosures by Ms McDermott, together with intimate expressions of love and care, attributable to her, and her lack of awareness of its impact on the Complainant.
• The alleged lack of care given to client records and sensitive information, leading to the Complainant's confidentiality being breached.
• That Ms McDermott allegedly nurtured a dependence on herself by the Complainant, which she was subsequently unable to manage or resolve, to the alleged detriment of the Complainant.
• That Ms McDermott allegedly failed to monitor and maintain her fitness and competence to practise at a level that enabled her to provide an effective service to the Complainant.
• Ms McDermott's alleged behaviour, as described by the Complainant, suggesting a contravention of the Ethical Framework, and in particular clauses: 1, 2, 3, 6, 8, 9, 11, 12, 13, 18, 20 and the ethical principles of Fidelity, Autonomy, Beneficence, Non-Maleficence and Self-respect.
On balance, having fully considered the above, the Panel made the following findings:
• That Ms McDermott had fostered a relationship of attachment and dependence between herself and her client, which was to her client's detriment. Ms McDermott failed to recognise the depth of her unprofessional and emotional attachment to the client and this was evidenced by the sharing of inappropriate personal disclosures and expressions of love and care for the client. The Panel found that this was unprofessional and a gross abuse of the therapeutic relationship and the client's trust.
• That in fostering a relationship of anti-therapeutic attachment and dependence, Ms McDermott failed to provide the safe boundaries required for effective therapy.
• Ms McDermott admitted that after a long period of therapy, the ending was abrupt, badly managed and without sufficient discussion.
• That Ms McDermott showed a reckless disregard for the advice given by her supervisor and other professionals at several points during the 5 year period of therapy, including advice on the ending of therapy.
• Ms McDermott failed to provide a good quality of care or maintain appropriate boundaries around the management of her work in that she admitted to over-running sessions, agreeing to meet in the client's home, and giving presents.
• That whilst there was a lack of clarity and some confusion surrounding the financial arrangements in respect of the payment and refunding of monies for sessions, this did not amount to an abuse of trust for financial gain.
• Ms McDermott had accepted being nominated as an executor of the client's will. However, on learning that she was to be a beneficiary in the will, she sought to withdraw from the agreement. The Panel found that Ms McDermott had not exercised sufficient caution in entering into this agreement, and failed to recognise the implications for her standing and that of the profession.
• Whilst Ms McDermott kept locked records, there were lapses in relation to the security of her counselling records. Confidentiality was breached in that Ms McDermott admitted that her partner had sight of printed therapeutic material.
• Ms McDermott admitted that the conduct of therapy was often against the flow of standard practice and outside the conventional boundaries of counselling and psychotherapy.
• Whilst there were contracts for counselling in the first two years of therapy, the attempts that were made to offer re-contracting after this time were insufficient and not sustained. Ms McDermott agreed that there was a lack of clarity in the contracting, which the Panel found to be inadequate.
• Ms McDermott and the client agreed that they had attempted to review the work on a number of occasions and that two reviews had taken place with the client's psychiatrist. However, these reviews were not adequate insofar as they did not bring about effective management of the therapeutic process.
• Ms McDermott admitted that she had made inappropriate and damaging personal disclosures; had written and given the client poetry; and had sent emails and letters which made reference to her regard and love for her client. This correspondence was sustained over a long period of therapy and was evidenced in the exchange of over 2000 emails.
• Ms McDermott admitted that she had been advised in supervision to curtail this email activity in order to maintain proper boundaries, but she failed to do so.
• Ms McDermott had failed to recognise that allowing this sustained correspondence to continue would have had a significant impact on the client.
• Ms McDermott agreed that she had criticised colleagues known to the client and, in doing so, had shown a lack of professional judgement.
• Ms McDermott failed to adequately monitor and maintain her fitness and competence to practice, in that she edited what she took to supervision and came to believe that she was the only person who fully understood what was happening in the therapy with the client.
• That Ms McDermott had adequately obtained informed consent to work with the client.
• There was no evidence to suggest that Ms McDermott overrode the client's wishes or worked without her explicit consent.
Ms McDermott admitted to much of her behaviour in this case and made a full apology to the client. Ms McDermott indicated that she had reflected on issues connected to this case, ceased private practice, undertaken personal therapy, taken further training, sought further supervision and made more use of supervision. However, the Panel was not satisfied that, at this time, Ms McDermott had demonstrated adequate learning.
The Panel was unanimous in its decision that these findings amounted to serious professional malpractice in that Ms McDermott acted recklessly in her conduct and management of the therapeutic process with this client; that she worked well beyond her competence; and that she failed to provide adequate professional services that would reasonably be expected of a competent practitioner.
Accordingly, the Panel decided that Ms McDermott's membership of this Association should be withdrawn with immediate effect.
Any future application for membership of BACP would be considered under Article 4.3 of the Memorandum & Articles of Association.