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 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 in September 2012 the CEO of Milton Keynes City Counselling Centre (MKCCC) retired after 20 years and was replaced by a non-clinical CEO. There was some dissatisfaction, and expressed concerns, but matters came to a head when A, a self-employed counsellor working at the Centre, was sacked in January 2013. A was the [ . . . ]
within the organisation.
A requested that she be allowed to offer 2 endings sessions to her vulnerable clients, but was told that she was not allowed in the building, with immediate effect. The lead supervisor of the [ . . . ], B, appealed this decision but was referred back to the CEO.
However, A's clients allegedly were not informed that A was no longer available, and at least one turned up for an appointment. One client was so distressed that they had a panic attack in reception, and were dealt with by the non-clinical volunteer co-ordinator. The complainants allege that the fact that A's clients were left without a counsellor and without support in place for them is unethical.
A herself wrote to the board of trustees strongly denying that she was unsafe to work with her clients, and stating that both her supervisors were happy to write supportive letters if needs be.
As a direct result of A's sacking, [ . . . ] resigned as he was not consulted prior to A being sacked nor was he informed that she had been sacked. The temporary clinical lead, C, who had covered for him whilst he was sick, was appointed to the position. Allegedly C was not experienced enough for this role, and allegedly, when covering the service, would be in her room, on the phone with the door shut. When asked
direct questions she allegedly was "hesitant and unhelpful".
During this period of change and upheaval, clinical cover was also allegedly provided by the CEO who allegedly lacked appropriate qualifications and experience to provide such cover.
Since that time, there was allegedly very low morale in the organisation. In excess of thirty people are alleged to have resigned from the organisation since October 2012, including the complainants themselves.
The chair of the trustees also supervised counsellors in the organisation, and two other trustees were members of her supervision group. In addition, the chair supervised an MKCCC counsellor for her work outside MKCCC. These matters all allegedly raised ethical questions with regard to the keeping of safe boundaries within the organisation.
The complainants alleged that trust has broken down in the organisation, with particular regard to the support of both clients and counsellors, and those agreements and contracts have not been honoured. This has allegedly left counsellors reluctant to give notice of intention to leave.
The complainants alleged a lack of understanding and commitment of the needs of both counsellors and clients, and that the abrupt endings of client sessions amount to harm.
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. Milton Keynes City Counselling Centre allegedly did not give careful consideration to the limitations of its training and experience and work within these limits, when clinical cover was provided by [. . . ] who lacked the clinical qualifications and experience necessary to provide such cover.
2. In the unusual circumstances of having to contact A's clients following the termination of her contract for services, Milton Keynes City Counselling Centre allegedly did not provide a good quality of care to those clients in that it subsequently failed to contact the clients and to use
the same system of contact as was the custom and practice operated by A to try and contact clients. This, it is alleged, resulted in client distress.
3. Milton Keynes City Counselling Centre allegedly failed to consider the implications of entering into dual roles and failed to avoid entering into multiple dual roles in that the chair of the trustees was allowed to perform both counselling and supervisory roles at the centre including the provision of supervision to fellow trustees and the provision of supervision to a member of staff for private work.
4. Milton Keynes City Counselling Centre allegedly did not avoid nor manage the conflict of interest that arose in allowing a trustee to provide supervision to a member of staff for private work and in allowing trustees to carry out clinical roles within the centre.
5. Milton Keynes City Counselling Centre allegedly did not conduct its professional relationships respectfully and endeavour to enhance good working relationships and systems of communication within the centre, in that the complainants were left with unresolved concerns relating to communication, transparency and arrangements for clinical cover. It is further alleged that Milton Keynes City Counselling Centre, did not conduct its professional relationships respectfully in that the morale of the majority of the counselling team was at an all-time low as a result of the sudden departure of colleagues and the lack of clear and timely communications regarding interim arrangements over clinical support, supervision and management processes.
6. Milton Keynes City Counselling Centre alleged behaviour, as experienced by the complainants, suggests a contravention in particular of paragraphs 1, 2, 4, 51 and 63 and the ethical principles of Being Trustworthy and Beneficence of the Ethical Framework for Good Practice in Counselling & Psychotherapy (2010/2013), and showed a lack of the personal moral qualities of Integrity, Competence and Wisdom to which counsellors are strongly encouraged to aspire.
One of the complainants was not in attendance and gave notice to BACP that she would not be attending and stated that she was happy for the hearing to proceed in her absence. Milton Keynes City Counselling Centre was also not in attendance and its representative notified BACP that it would not be attending as the member organisation had dissolved.
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 and Director of BACP Registers has the power to decide to either:
a) Proceed with the Hearing in the absence of one or both 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 12.6 of the Memorandum & Articles of Association.
The options were carefully considered, and in light of the circumstances, a decision was made to proceed with the hearing in the absence of one of the complainants and Milton Keynes City Counselling Centre.
On balance, having fully considered the above, the Panel made the following findings:
1. The Panel heard evidence from the complainants regarding the procedure adopted in relation to clinical cover. The complainants explained that historically clinical cover was arranged co-operatively between counsellors who had some supervision or management responsibility and was done on a rota basis. Subsequently when the new CEO took over, the role of a single internal clinical lead was created. There was evidence that the CEO had informed staff that any out of hours clinical issues should be referred to her. There was however, no evidence that the CEO herself had provided any clinical cover. Further there was no evidence presented to the Panel that even if the CEO had provided clinical cover, that she lacked the clinical qualifications and experience necessary to provide such cover. The Panel therefore found that there was insufficient evidence to demonstrate that MKCCC did not give careful consideration to the limitations of its training and experience and work within these limits. This allegation is therefore not upheld.
2. The Panel reviewed the copies of client records submitted and accepted that there was evidence that MKCCC had made some attempts to contact the clients of the counsellor whose contract for service MKCCC had terminated. However it considered that those attempts were insufficient in circumstances where a counselling relationship had been ended so abruptly, and were ineffective when one of the counsellor's clients arrived for their session. The Panel heard evidence that this client suffered a panic attack upon discovering that their counsellor was not available and had to be dealt with by the receptionist as there was no clinical cover within the centre to assist the receptionist and attend to the client. The Panel heard that this caused distress to both the client and the receptionist. The Panel found that this resulted in a failure on the part of MKCCC to provide that client with a good quality of care. The Panel noted that a suggestion had been made by the counsellor to have at least two ending sessions with her clients but this request was not permitted by MKCCC. The Panel heard evidence from the complainants in attendance that the normal procedure to follow when notifying a counsellor's client that they would not be in attendance, would be to contact the client by phone and text, if they had opted to receive text messages, and write to the client asking them to contact the centre. If contact with the client could not be established then a supervisor or manager would be on hand to see the client in the event that they turned up for their session so that they could "hold" that client until such time as they could be allocated to another counsellor. Whilst the Panel noted that there was some clinical cover, it considered that as a result of depleting resources, the clinical cover that was in place when the counsellor's client arrived for their session was inadequate since there was no clinical cover at that particular time. The Panel therefore found that MKCC failed to provide a good quality of care to those clients affected by the departure of the counsellor in that it failed to make appropriate contact with the clients affected and failed to use the same system of contact described by the complainants and used by the counsellor in question. This allegation is therefore upheld.
3. The Panel heard evidence from the complainants that whilst the chair of the trustees provided supervision, she did not provide counselling. The Panel accepted the complainants' evidence that the dual role did not become detrimental until problems arose within the organisation. As a result of these problems the Panel heard that counsellors began to use supervision to discuss issues within the organisation rather than their client work. There was written evidence that the chair of the trustees withdrew from the supervision group she provided once her position became untenable, due to the discontent expressed by the counsellors regarding MKCCC. There was no evidence that MKCCC had given any consideration to the implications of its trustees entering into dual roles. By virtue of the fact that the chair of trustees provided group supervision, there was evidence that MKCCC had entered into multiple dual roles. Further, the Panel accepted the written evidence that the chair of trustees also provided individual supervision to trustees and a member of staff regarding their private work, which subsequently became detrimental to that counsellor when issues within the organisation developed. The Panel therefore found that MKCCC failed to consider the implications of entering into dual roles and failed to avoid entering into those multiple dual roles. This allegation is therefore upheld.
4. The complainants stated that a conflict of interest only arose when issues developed within the organisation. The Panel found that MKCCC did not foresee the potential conflict of interest that could arise or avoid or manage the conflict of interest once it developed. The Panel noted that whilst there was evidence that the chair of trustees stepped down as group supervisor, there was no evidence that she ceased providing supervision to other members of staff at the centre. Further, the Panel also accepted that the chair of trustees provided supervision to a member of staff in relation to their private work and that in providing such supervision, the chair of trustees was fulfilling a clinical role, which in the circumstances, became detrimental to the supervisee. The Panel therefore found that MKCCC failed to avoid and manage the conflict of interest which arose. This allegation is therefore upheld.
5. The Panel heard evidence that during the tenure of the previous CEO, it was customary for a newsletter to be produced on a weekly basis which, amongst other things, gave details of staff movement and news about projects, which the Panel heard was the fundamental way of communicating with everyone within the organisation. The complainants stated that when the new CEO took over, there initially was no newsletter and when it was produced, it was no longer produced weekly and did not contain the information which it had previously. The Panel heard evidence that once problems developed within the organisation, staff directed queries to the trustees and the CEO, which were either not fully addressed or in some cases not addressed at all. In some instances counsellors received no reply to their emails. The Panel also heard evidence that whilst a temporary internal clinical lead was put in place to provide clinical cover following the departure of the previous internal clinical lead, this person was not always available and there was no communication to members of staff over the arrangements for clinical cover during this person's absence. The complainants gave evidence that prior to the decision being made to dismiss the counsellor and co-ordinator of one of the services, there was no discussion or consultation with either of the counsellor's supervisors, as would have been the expected procedure. Further, the Panel heard evidence that morale was low and a large number of staff who had been at the service for many years left in view of the issues that had developed as a result of the sudden departure of colleagues, and the lack of clear and timely communications regarding interim arrangements over clinical support, supervision and management processes. This impacted upon the effectiveness of the service that was being provided to clients. The complainants also gave evidence that the external clinical lead for the whole service did not meet the new CEO until 3 months after the CEO had started, that the Drop-in Service had been running without a co-ordinator for some months and that two of the three supervision groups had been without a supervisor for three months. The Panel therefore, found that MKCCC failed to develop its professional relationships respectfully and endeavour to enhance good working relationships and systems of communication within the centre. This allegation is therefore upheld.
6. In light of the above findings, the Panel was satisfied that paragraphs 1, 4, 51 and 63 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) and the ethical principles of Being Trustworthy and Beneficence had been breached. It also found that Milton Keynes City Counselling Centre lacked the personal moral qualities of Integrity, Competence and Wisdom to which all practitioners are strongly urged to aspire. The Panel did not find that paragraph 2 of the Ethical Framework for Good Practice in Counselling and Psychotherapy (2013 edition) had been breached.
Accordingly, the Panel was unanimous in its decision that these findings amounted to Serious Professional Malpractice in that the service for which MKCCC was responsible fell below the standard that would reasonably be expected of an organisation exercising reasonable care and skill. The Panel agreed that in view of the findings, MKCCC was incompetent, negligent, reckless and provided inadequate professional services.
There was no evidence of grounds for mitigation in the written evidence submitted by the Member Complained Against, and the Member Complained Against was not present at the adjudication so no mitigation was presented there on its behalf.
In view of the serious nature of the findings, BACP's remit of public protection and the impact of MKCCC's actions on both clients and counsellors within the centre, the Panel was unanimous in its decision to withdraw membership from MKCCC. The Panel also had regard to the fact that MKCCC as an organisation was now dissolved and therefore no longer existed as a legal entity.