As part of our work to protect the public and promote high standards of practice we launched the What complaints tell us about …. resources in 2022. These resources are about different themes within therapy where complaints have been upheld. We are now continuing that work by introducing quarterly reviews from published complaints and looking at common themes to support members in identifying any common mistakes and helping clients understand what is and isn’t best practice.

The main allegations upheld against BACP members for the period of January to March 2023 can be summarised as follows:

Confidentiality

  • unnecessary disclosure to a third party such as another professional or someone known to the client, without the client’s consent
  • discussing a former client with a current client

Competence and fitness to practise

  • the therapist interrupting the client
  • not making the client the focus of attention
  • not attending to therapist’s self-care and mental health
  • practicing whilst intoxicated

Therapeutic interventions and behaviour

  • making personal judgements
  • making inappropriate comments
  • giving own opinion, interpreted as diagnosis
  • failing to consider the power imbalance
  • frequent clock-watching during the session
  • not acknowledging the client’s distress

Boundaries

  • counselling a friend
  • failing to maintain the boundary between two clients known to each other
  • meeting outside the therapy
  • offering the client drugs
  • adding kisses to text messages
  • having a sexual relationship with a current client
  • having a sexual relationship with a former client without careful consideration

All the above complaints might have been avoided if the members concerned had been more familiar with the BACP Ethical Framework. On becoming members of BACP, they would have agreed to abide by it, not only as a general commitment (Good Practice, point 4), but specifically to discuss it in supervision regularly (Good Practice, point 69).

BACP’s Good Practice in Action resources provide another form of guidance which would have supported members in providing a professional therapeutic service, rather than practising in such a way as to lead to a complaint being upheld.

Several of the complaints upheld in this three-month period might have been averted if the therapist had maintained client confidentiality, contracted more clearly with the client at the outset, kept more accurate records or admitted making a mistake or an error of judgement (personal moral quality of candour). These all underline the importance of regular supervision.

What is particularly concerning, in some cases, is the apparent lack of awareness of the power imbalance in operation within therapy. The therapist will be finding out much about the client, but the disclosure is largely one-way. The client is coming out of a sense of need, and therapists should be aware of the danger of abusing their position of power, giving due consideration and respect to the client’s position of vulnerability.

Perhaps the most surprising finding in the January to March period is the number of complaints regarding boundary violations, with the therapeutic relationship turning into a sexual one, either concurrently or at a later stage. Therapists should not exploit their clients by using them to meet their own needs for friendship or intimacy. Lasting damage may be caused, negating whatever therapeutic benefits clients may have previously gained.

In the words of the Ethical Framework:

To keep things in perspective, it should be acknowledged that the number of members having a complaint upheld against them is relatively small. It's hoped that these blogs will help members avoid repeating the same mistakes, instead promoting best practice across the profession.

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