Outcome of Complaints

PA00P02

OUTCOME : REMOVAL OF MEMBERSHIP – NON COMPLIANCE with Conditional Membership sanction

Assessment Panel: February 2019

Appeal Panel: July 2019

Outline of complaint:

In September 2018 the Society received a client complaint upon the breakdown of counselling relationship with the registrant and the client’s request to end their counselling contract.

In line with the 2018 NCS Code of Ethics and in accordance with the Society’s complaints procedures the NCS Public Protection Officer referred the complaint to the Society’s Assessment Panel to consider evidence around the following:

• The registrant’s communications with his client
• Compliance with Supervision requirements
• Consideration of terms and conditions of membership relating to the complaint process
• Consideration of registrant response to a guidance Learning Point issued in May 2018.

Assessment Panel

Decision

The panel found that the registrants’ actions had not reflected the NCS ethical standards or guidance in communication with the complainant

The complaint considered written and reported communications between the registrant and complainant only. The NCS has no authority to engage in financial requests.

The Panel were informed of a ‘guidance learning point’ received by the registrant in June 2018 which directed him to implement an appropriate procedure if he was required to cancel client appointments at short notice.

Overview Finding

The Panel’s finding was that the registrant did not offer a respectful, professional, ethical service when communicating with the complainant. Messages surrounding an unfortunate emergency cancelation portrayed expectation of deference, include inappropriate, unnecessary personal disclosure and highly emotive, persuasive language. These were later compounded by accusations and emotive texts by the registrant which placed an emotional burden on his client.

It was the view of the Panel that had the registrant followed the previous NCS guidance learning point, it would have assisted him in this situation.

The Panels view was that in his responses to the complaint the registrant had failed to display reflective understanding of the therapeutic relationship within context of a business contract. Or offer appropriate reflective insight into his behaviour and the importance of professional boundaries in counselling arrangements.

Contrary to the following sections of the Ethical Framework:

Fundamental principals

Working towards the good of clients and doing no harm (Beneficence and Non-maleficence)

Practitioners hold the welfare of clients central to their work and so commit to avoiding harm.

Being trustworthy and responsible (Fidelity)

Practitioners endeavour to establish trust with their clients and the community in which they work. Therefore, practitioners not only honour the trust placed in them by their clients and the community but also act in a respectful, professional and ethical manner when representing their profession.

All Practitioners undertake to:

Offering a Service

5. Respect the autonomy of clients to choose whether or not to avail themselves or continue to avail themselves of the service offered.

Delivering a Service

1. Work in ways that promote client autonomy and well-being and that maintain respect and dignity for the client.

4. Decline with explanation, inappropriate gifts, gratuities or favours from a client. Examples include, but are not limited to financial gifts, event or discount vouchers, objects of substantial monetary value. The offering of any gift in therapy is an important event in the therapist-client relationship, and its implications should be discussed with the client and considered in supervision.

6. Be consistent with the welfare and expressed wishes of the client and never protract treatment unnecessarily and to terminate treatment at the earliest moment consistent with the welfare and expressed wishes of the client.

General Conduct

5. Ensure that they maintain the highest level of communication with clients (avoiding abbreviation and shorthand) whether by telephone; email; text or any other social media messaging service (Facebook; WhatsApp). See (Appendix C)

The panel found that the Registrant had not adhered to Supervision requirements

The registrant did not provide details of a supervisor or any supporting evidence that he had met with the Society’s Supervision requirements at the time of being in a contracted therapeutic arrangement with the complainant.

The Panel raised a concern that the registrant had not properly considered his fitness to practice responsibilities with reference to supervision, particularly at a time of stress or impactful personal-life events.

Contrary to the following sections of the Ethical Framework:

Fundamental Principles

A practitioner of NCS will need to demonstrate that they have considered these principles in their ethical practice and decision making, especially discussing them with their supervisor.

Justice

Practitioners are aware of their own judgements based on their own experiences, and need to take precautions (supervision) to provide a service that is not restricted by their own prejudice and limitations of experience

Delivering a Service

All Practitioners undertake to:

7. Remain aware of their own limitations and wherever appropriate, be prepared to refer a client to another practitioner or medical adviser who might be expected to offer suitable treatment.

Ensure that clients with presenting issues outside of a practitioner's scope of ability, are discussed in supervision and where appropriate referred to another practitioner.

Supervision

all practitioners undertake to:

1. Have formal one to one supervision in place and obtained from a properly qualified and trained supervisor. Attendance should be commensurate with practice hours.

1. Ensure a written contract is provided from the supervisor.

1. Keep a record of supervision hours.

Terms and conditions of NCS membership

The panel were informed that the terms and conditions of Society membership require a registrant to fully participate with the complaint’s procedure.

The registrant in his responses to the NCS repeatedly questioned the validity of the complaint being accepted and investigated.

The registrant did not declare that he was ‘not fit for practice’ until pressed for information by the NCS PPO with regards to the complaint. The Panel found that the registrant did not declare that he was ‘not in practice’ appropriately.

Findings:

Conditional Membership Sanction

The Panel noted that the registrant is currently marked as ‘not in practice’ but had expressed plans for his return to practice in early 2019.

Conditional Membership Sanction

Prior to his return to counselling, The registrant was ordered to produce:

An immediate update to the NCS with regards to his counselling practice.

• Evidence of Supervision and Insurance
• A written statement to demonstrate reflection and learning in relation to the complaint and details of preparation for his return to practice after a break

Following 6 months practice:

Registrant to provide a report from his Supervisor, showing that he has fully understood and put into practice the issues relating to:

• Importance of and proper use of supervision

• Relevance of guidance learning issued by complaints panels for the NCS

• Registrant’s understanding of the client/therapist relationship

• Improvements in standards of Communication with his clients

• Professional Insight and developmental learning displayed by the registrant and awareness of his duty of compliance with the requirements of membership

Appeal

On 25^th April 2019 the registrant exercised his right to apply for Leave to Appeal.

The Grounds for Appeal were that:

The facts were found against the weight of evidence

New evidence was available.

Application was granted.

The registrant was offered 2x time extensions by the Panel to submit further evidence. In July 2019 the Panel had not received further communication from the registrant.

Appeal Decision

The Appeals Panel conclude that:

• The Assessment Panel’s decision was not made against the weight of evidence
• No new evidence had been received.

The Appeal was therefore not upheld.

Overview Summary

The Appeals Panel re-considered the sanctions previously imposed by the Assessment Panel.

The Appellant had stated that he would return to practice early in 2019. As at July 2019 the Panel were aware that the registrant had an active website soliciting clients and an active Counselling Directory listing

The sanctions issued by the Assessment Panel were amended as follows:

Conditional Membership Sanction

To maintain his registered status, the Registrant must: Within one month of the date of receiving the decision supply:

• Evidence of current Supervision (copy of contract and supervisor qualifications)

• Insurance certificate

• A substantial and satisfactory written statement (minimum 2500 words) to demonstrate reflection and learning in relation to this complaint.

Entitled “An account of my reflection and learning in relation to this complaint and its outcome” specifically addressing the following subjects:

• The importance of clear and appropriate contracting in counselling
• The value of clinical supervision in counselling
• How inappropriate communication with clients outside sessions can damage the therapeutic relationship

It must also reference to at least 3 relevant books, journal articles or online resources, as well as the NCS Code of Ethical Practice

Following 6 months practice:

Registrant must provide a report from his Supervisor, evidencing that he has fully understood and put into practice reflective learning from issues relating to:

• Importance of and proper use of supervision
• Relevance of guidance learning issued by complaints panels for the NCS Registrant’s understanding of the client/therapist relationship

This decision of the Appeals Panel is final and will be published on the NCS website.

SB00P28

OUTCOME: CONSENSUAL DISPOSAL OFFER
FINAL OUTCOME : REMOVAL OF MEMBERSHIP

Assessment Panel Hearing: April 2018

Outline of compliant

In December 2017 the society received evidence, submitted by a third party, relating to an inappropriate relationship between the registrant and an un-named client.

In accordance with the societies complaints procedures, following investigation the Public Protection Officer referred the complaint to the Society’s Independent Assessment Panel.

Outline for consideration by the Panel:

• The registrants professional conduct in relation to sexualised communication and inappropriate behaviours.
• Failure to bring professional boundary issues to supervision

Having considered the evidence submitted, the Panel found serious and significant breaches of the following NCS 2017 Code of Ethics:

• Client welfare (sections 1, 2 & 8)

Practitioners work in ways that:

1. Promote client autonomy and well being, maintain respect and dignity for the client

2. Remain aware of their own limitations and wherever appropriate, be prepared to refer a client to another practitioner or medical adviser who might be expected to offer suitable treatment.

8. Refrain from using position of trust to cross boundaries appropriate to the counsellor client relationships or exploit the client emotionally, sexually, and financially or in any way. NB clarification on dilemmas experienced by therapists should be sought from their supervisor.

• General Conduct (section 1)

1. All practitioners undertake to conduct themselves in accordance with their professional status, and in such a way as neither undermines the public confidence in the profession nor brings it into disrepute

• Supervision (sections 1,5)

1. Meetings with a colleague to discuss ongoing cases and issues arising from them and to work through any personal matters that might affect their own position or ability to practise. Most usual are either personal one to one supervisor or participation in a peer support group.

5. Suitable personal growth and development, including seeking counselling where appropriate

Outcome of findings from the Panel

Accordingly, the Panel made an offer to the Registrant for Consensual Disposal of the complaint, whereby the Registrant would admit his breaches of the code of ethics and accept removal from the Society’s register.

Mr Simon Brodie has accepted this offer and is hereby removed from the NCS register.

He is now bound to the Society’s publication and re-admission policies.

NCS19-08489

Outcome: Voluntary Removal from Register 19th April 2021

Outline of complaint

The complaint focussed on a planned therapeutic session whereby Matt Coe changed the nature of the therapeutic session to the detriment of his client. The complaint also focussed on the communications between Matt Coe and his then client following the session.

Assessment Panel Findings

The Assessment Panel found that Matt Coe had committed the following breaches of the NCS Code of Ethics.

Delivering a Service section, paragraph 3 “Refrain from using their position of trust and confidence to:

1. Cross the boundaries appropriate to the therapeutic relationship.”

Delivering a Service section, paragraph 1. “Work in ways that promote client autonomy and well-being and that maintain respect and dignity for the client”.

Delivering a Service section, paragraph 7 “Remain aware of their own limitations and wherever appropriate, be prepared to refer a client to another practitioner or medical adviser who might be expected to offer suitable treatment.”

Fundamental Principle 3. “Respect for the dignity and rights of the client (Autonomy)”

Fundamental Principle 2. Being trustworthy and responsible…..which requires registrants to “ act in a respectful, professional and ethical manner when representing their profession”.

Fundamental Principle 1 “Working towards the good of clients and doing no harm (Beneficence and Non-maleficence) Practitioners hold the welfare of clients central to their work and so commit to avoiding harm”.

Assessment Panel Decision

The Assessment Panel found that there may have been serious and substantive breaches of the Code of Ethics such that the registrant could be removed from the Society’s Accredited Register. The Assessment Panel decided that the case would be referred to the Independent Complaints Panel. The Assessment Panel also offered Matt Coe the option of agreeing to Voluntary Removal from Register thus saving the emotional stress of a hearing for both parties whilst still providing protection to the public.

Matt Coe admitted to the Breaches of the Code of Ethics as set out by the Assessment Panel Findings and has agreed to be Removed from the NCS Accredited Register.

Assessment Panel December 2022

Outcome: Removal From Membership

In September and October 2021, the National Counselling Society received 3 formal complaints relating to Non-registrant Member, Jon-Pierre Dubois and the counselling he had provided. During the investigation period, it was noted that the non-registrant member was advertising his services on a public directory whilst declaring his membership of NCS- in contravention of the signed terms and conditions submitted by the member. During the course of enquiries into the complaints, the Professional Conduct Officer requested copies of Insurance and evidence of CPD which the non-registrant member did not provide. In addition, the non-registrant member declined to provide the name of a Supervisor.

Findings:

Terms and Conditions of Membership

The Panel finds that the member is in breach of the following Terms and Conditions of Membership:

• Failure to provide evidence of supervision as part of a complaints process

• Failure to provide evidence of insurance as part of a complaints process audit

• Failure to provide evidence of CPD as part of a complaints process audit

• Utilizing non-registrant membership of the Society in advertising with a public directory in contravention of the signed T&C submitted by the member

• Practising counselling using an online only qualification deemed insufficient for safe, competent and ethical practice by the Society

Complaints

The three complaints received allude to multiple alleged breaches of the Code of Ethics, including but not limited to:

• Breaches of confidentiality (Code of Ethical Practice: Confidentiality, Maintenance of Records and Recording of Sessions section)

• Inappropriate and unboundaried therapy (Code of Ethical Practice: Delivering a Service section 3)

• Failure to respect client autonomy (Code of Ethical Practice: Fundamental Principle 3)

• Failure to act in respect of client welfare (Code of Ethical Practice: Fundamental Principle 1)

The Assessment Panel found the evidence presented was extensive and detailed and included text messages in addition to allegations concerning what was said during sessions. The text messages demonstrate that it is likely the member was aware of the boundary and transference issues mentioned in the allegations.

The Assessment Panel noted that the member’s refutation of the complaints rested primarily on a claim that the allegations are simply untrue.

The Panel took the view that a full Independent Complaints Panel hearing would be necessary to deal appropriately with these complaints should consensual disposal not be accepted.

The Panel took into account three main factors:

• Non cooperation with complaints

• Violation of T&C in advertising

• The substantive nature of the client complaints

The Panel’s decision was that membership should be terminated forthwith.

Consensual disposal

The member was offered admission of the above findings and voluntary removal from Society membership.

Jon-Pierre Dubois did not respond to the findings and therefore is removed from the membership.

KE00P115

OUTCOME : REMOVAL OF MEMBERSHIP – NON COMPLIANCE with Conditional Membership sanction
Assessment Panel Hearing: December 2018

Outline of compliant: In August 2018 the society received a client complaint relating to alleged unprofessional conduct.

In line with the 2018 NCS Code of Ethics and in accordance with the Society’s complaints procedures the NCS Public Protection Officer referred the complaint to the Society’s Independent Assessment Panel to consider:

• The registrants professional conduct in relation to communication and behaviours.
• Failure to comply with NCS membership terms and conditions around supervision

OUTCOME

The panels’ view was that a lack of Professional Boundaries and Supervision had proven detrimental to both the client and the registrant in this case and have imposed membership sanctions.

Supervision

FINDING: The registrant failed to seek necessary and appropriate supervision.

Upon receipt of the complaint the registrant informed the NCS that his supervisor had sadly passed away 3 months prior. There is therefore no opportunity for the Panel to obtain a written report regarding his supervision or further insight into the therapeutic relationship with his client. The registrant describes his supervision as a continuous peer relationship and had not at the time of responding to the NCS engaged with a new supervisor.

The panel note that the registrant has indicated that the complainant was infrequently mentioned in supervision, whilst also offering insight into examples of communications from his client which were demonstrative of emotional vulnerability.

Contrary to: Continuing Professional Development (CPD) and Supervision sections 1,2, and 3

1. Have formal one to one supervision in place and obtained from a properly qualified and trained supervisor. Attendance should be commensurate with practice hours
2. Ensure that clients with presenting issues outside of a practitioner's scope of ability, are discussed in supervision and where appropriate referred to another practitioner.
3. Ensure a written contract is provided from the supervisor.

FINDING: The registrant has not taken appropriate precautions (supervision) to assist him to provide a service that is not restricted by his personal experiences

The registrant and complainant have in their submissions to the panel offered detail around their personal explorations and emotional responses to the therapy.

Contrary to: Section 4 of the NCS Code of Ethics Fundamental Principles

Justice: Practitioners are aware of their own judgments based on their own experiences and need to take precautions (supervision) to provide a service that is not restricted by their own prejudice and limitations of experience.

FINDING: The registrant is offering a supervision service without adequate supervision in place for his own counselling practice.

In his response to the panel the registrant has stated that he is engaged in Supervising trainee Counsellors.

Contrary to: Section 1 of the NCS Code of Ethics, Offering a Service

1. To Provide a service to clients solely in areas in which they are trained and competent to do so.

Boundaries

FINDING: The registrant did not evidence a clear understanding of the importance of contracting/reviewing contracts with his client, particularly relevant given the lengthy and intermittent therapeutic relationship outlined in the complaint.

The registrant and complainant have offered the panel lengthy and detailed insight into the structure of their meetings and communication. It was noted that the service offered had understandably evolved over the long term therapeutic relationship and that it is a client-led reactive service. However, it is the panel’s opinion that it is the registrant has not ensured client understanding of changes around expectation of service.

Contrary to: Sections 3 and 9 and of the NCS Code of Ethics, Offering a Service

3. Discuss with clients’ realistic outcomes and limitations of the service offered.

9. Agree clear and transparent contracts and/or terms and conditions, in writing where appropriate, which do not use unreasonable terms or restrict the statutory rights of clients

FINDING: The registrant provided personal counselling services to members of his client’s family.

The registrant and complainant have advised the panel that the registrant engaged in separate counselling client contracts with close members of the complainant’s family, whilst the complainant was a client.

Contrary to: Section 5 of the NCS Code of Ethics, Delivering a Service

5. Should any relationship (i.e. any enduring personal or professional connection other than the clinical relationship between client and therapist) occur or develop between either counsellor or client, or members of their respective immediate families, the therapist should consult their supervisor at the earliest opportunity. It is likely to be appropriate to cease accepting fees, work towards terminating the counselling relationship in an appropriate manner and arranging a carefully considered referral to another suitable therapist at the earliest opportunity.

FINDING: The panel offer a general concern regarding the registrants understanding and lack of implementation of professional boundaries in this therapeutic relationship.

The registrant and complainant have provided different and disputed accounts of their last communications and face to face meeting. However, the panel’s opinion is that it was a significant factor at this time that the registrant had made minimal efforts to engage with a distressed client or to formally end the counselling arrangement.

Contrary to: Section 2 of the NCS Code of Ethics Fundamental Principles

Being trustworthy and responsible (Fidelity): Practitioners endeavour to establish trust with their clients and the community in which they work. Therefore, practitioners not only honour the trust placed in them by their clients and the community but also act in a respectful, professional and ethical manner when representing their profession.

Contrary to: Sections 1 and 4 of the NCS Code of Ethics General Conduct

1. Conduct themselves at all times in accord with their professional status and in such a way as neither undermines public confidence in the process or profession of counselling, nor bring it into disrepute, being aware of professional and personal boundaries.

4. Ensure that they maintain the highest level of communication with clients

OUTCOME: SANCTIONS upon membership

Registrant Keith Elvin to provide a written 2-part report:

Part 1.

• A written reflective report exploring personal learning in respect to the findings of the panel. Specifically, the panel are seeking evidence of learning and development of the registrant’s practice in respect to:
• The need for clear contractual arrangements (written when perceived necessary) with respective parties
• The importance of professional boundaries
• A rigorous self-examination on his work and practice in light of this case and his adherence to the NCS Code of Ethics.
• Identification and List of related CPD for 2019

Part 2.

• A written report of supervision arrangements that includes:
• Registrant to engage an appropriately qualified supervisor as an urgent priority.
• That regularity of the supervision is appropriate to the volume of client practice and in line with the NCS guidance.
• Regarding Provision of Supervision to trainee counsellors, the registrant must submit evidence of his supervision qualifications and details of his supervision practice.

Mr Elvin’s Supervisor to provide a separate report:

Specifically, the panel are seeking evidence of the registrant’s learning and development in respect of:

Adherence to the NCS Code of Ethics and guidance.

How learning in this case has been communicated in practical improvements and engagement with supervision

Nb it is recommended that if the registrant’s choice of new supervisor does not appear on the NCS list of approved supervisors, that he checks with the NCS to confirm their qualifications conform to NCS guidance.

These reports are to be written no earlier than one month and no later than 3 months from the date Mr Elvin receives the Panel’s report.

NCS16-03665

Assessment Panel Date: 04/11/2022

Outcome: Conditions On Membership

Outline of Complaint:

A complaint was raised by a former client of Laura Hansing relating to therapy received over 5 sessions. The complainant stated that the therapy, provided by telephone, took place when the client was in unsuitable surroundings. The complainant considered, after a period of reflection, that it was the Registrant’s responsibility to ensure the safety of continuing sessions when it was clear the client was in unsuitable surroundings.

Assessment Panel Findings:

Breaches of the NCS Code of Ethical Practice 2021

The Panel found that there was evidence that the following clauses of the Code of Ethical Practice had been breached.

Fundamental principle

“1.Working towards the good of clients and doing no harm (Beneficence and Non-maleficence)

Practitioners hold the welfare of clients central to their work and so commit to avoiding harm”.

The apparent lack of consideration given to this case in supervision constitutes a minor breach of this principle.

Offering a service:

“All Practitioners undertake to:

2. Ensure that the premises where counselling takes place and all facilities offered to clients are suitable, appropriate for the service provided and respectful of the clients need for privacy”

Delivering a Service

“All Practitioners undertake to:

10. Take all reasonable steps to ensure the safety of the client and any person who may be accompanying them”

Assessment Panel Decision:

The Panel agreed that continued registration should be subject to a satisfactory demonstration of reflection on and learning from this episode.

The Panel offered the Registrant Consensual Disposal of the above via

1) Admitting the breaches of the Code as set out above

2) Undertaking the following sanction which constitutes a condition on registration

1. Produce a satisfactory written report of not less than 2500 words whereby she accounts for and clarifies the mistakes in this case as notified to her and what learning she has taken from this experience. In particular, the Panel is seeking evidence of learning and development of practice in respect of:

• The importance of clear and consistent boundaries where the conduct and management of sessions is concerned.
• How supervision could have been more effectively used in this case

This report is to be submitted no earlier than one month and no later than two months from the date of accepting Consensual Disposal.

The Registrant accepted the offer of Consensual Disposal. She has admitted the breaches of the Code of Ethics as set out above and states that she will submit a written report.

Sanction Met 09/01/2023

AH00P18

Outcome of Complaints:

Voluntary Removal from Register 5^th August 2021

Outline of Complaints:

In April 2021, the NCS received a complaint regarding Alison Hill and there was sufficient evidence for the case to be progressed to Assessment Panel. The complaint centres on the fact that the Registrant began a therapeutic relationship with a client but failed to provide boundaries. The Registrant shared, unsolicited, intimate details of her own life and personal problems and it is demonstrated she corresponded with the complainant in a manner more akin to personal friendship as opposed to the therapy the client was paying for. This caused significant distress to the client. In addition, it was evidenced that Alison Hill attempted to pursue a business venture with the client.

In May 2021, The NCS received a second complaint relating to a historic therapeutic relationship which concluded in 2018. There was evidence that the Registrant attempted to embark on a business venture with the client after building a friendship into their therapeutic relationship. The Complainant, having had time to reflect on the therapy they received, felt aggrieved and distressed that professional boundaries had been crossed in such a way.

Assessment Panel Findings:

The Assessment Panel found that Alison Hill had committed the following breaches of the NCS Code of Ethics:

Regarding Complaint 1:

Fundamental Principles

Working towards the good of clients and doing no harm (Beneficence and Non-maleficence) Practitioners hold the welfare of clients central to their work and so commit to avoiding harm.

And

Being trustworthy and responsible (Fidelity)

Practitioners …….act in a respectful, professional and ethical manner when representing their profession.

And

Integrity and self-responsibility

Practitioners work to be as honest, truthful and accurate as possible. They are also responsible for looking after their own needs and health. So, a practitioner will only commit to a practice that they can offer being aware of own expertise, training, health and wellbeing and let the client know if anything changes.

Delivering a Service

All Practitioners undertake to:

1. Work in ways that promote client autonomy and well-being and that maintain respect and dignity for the client.

3. Refrain from using their position of trust and confidence to:

a. Cross the boundaries appropriate to the therapeutic relationship.

5. Should any relationship (i.e. any enduring personal or professional connection other than the clinical relationship between client and therapist) occur or develop between either counsellor and client……….the therapist should consult their supervisor at the earliest opportunity.

7. Remain aware of their own limitations and wherever appropriate, be prepared to refer a client to another practitioner or medical adviser who might be expected to offer suitable treatment.

General Conduct

All Practitioners undertake to:

1. Conduct themselves at all times in accord with their professional status and in such a way as neither undermines public confidence in the process or profession of counselling, nor brings it into disrepute, being aware of professional and personal boundaries.

6. Ensure that they maintain the highest level of communication with clients (avoiding abbreviation and shorthand) whether by telephone; email; text or any other social media messaging service. See (Appendix C)

Appendix C: Communications and Social Media

However, before providing counselling or advice/suggestions via any online platform/text messaging/email the practitioner should have considerations in place to deal with the following:

• Crisis prevention planning and frequency of contact etc. along with practical matters such as charge structure within the original contract.

• The danger that a client may believe he or she has 24-hour accessibility to the therapist.

• The potential for a lack of time for reflection on either party before responding to each other.

• Awareness of potential professional and personal overlap by the careful and restrained use of social media such as Twitter, Facebook etc.

Regarding Complaint 2:

Delivering a Service

All Practitioners undertake to:

3. Refrain from using their position of trust and confidence to:

a. Cross the boundaries appropriate to the therapeutic relationship.

5. Should any relationship (i.e. any enduring personal or professional connection other than the clinical relationship between client and therapist) occur or develop between either counsellor and client……….the therapist should consult their supervisor at the earliest opportunity.

Assessment Panel Decision

The Assessment Panel stated that the Registrant’s conduct during and after her work with Complainant 1 and her apparent lack of insight or concern about its potential consequences,  suggests that the Registrant poses a serious risk to the public and to the profession. They also considered that Complaint 2 suggests that there may be a pattern of behaviour on her part where the maintenance of appropriate boundaries with clients is concerned.

The Assessment Panel found that there were serious and substantive breaches of the Code of Ethics such that the Registrant could be removed for the Society’s Accredited Register. The Assessment Panel decided that the case would be referred to the Independent Complaints Panel. The Assessment Panel also offered Alison Hill the option of agreeing to Voluntary Removal from the Register thus saving the emotional stress of a hearing for both parties whilst still providing protection to the public.

Alison Hill admitted to the Breaches of the Code of Ethics as set out by the Assessment Panel Findings and has agreed to be removed from the NCS Accredited Register.

NCS13-00234

Assessment Panel: December 2019

Outcome: non-compliance with Conditional Membership sanctions

Outline of complaint:

The complainant and registrant met through an online dating service. The complainant, the complainant’s family and ex-partner all were offered individual therapy services by the registrant.

The panel considered extracts from single source social media messages between the complainant and registrant. These contained detail of private and social matters as well as professional therapy arrangements.

It was noted that the therapy service itself was viewed favourably by parties to the complaint and that the registrant offers a wide range of therapeutic services. Cleansing Therapy was referred to by the panel as an additional service, appearing to be a physical rather than a therapeutic therapy.

Overview

In line with the 2018 NCS Code of Ethics and in accordance with the Society’s Complaints Procedures, the NCS Public Protection Officer referred the complaint to the complaint Assessment Panel to consider:

• If the registrant had behaved in a manner which was in line with NCS requirements around Professional boundaries, conduct, communication and confidentiality.
• If the registrant had complied with NCS supervision requirements.

Assessment Panel

Decision: Conditional Membership Sanctions

The Panel outcome statement contains considered, collective concerns, with particular emphasis on the written statements received from the registrant in response to the complaint. Outcome decision includes an immediate action order with regard to supervision (no client work to be undertaken prior to this being in place) and learning and development conditions of membership to address professional conduct and self-awareness.

Self-Awareness

The Panel found that the registrant had displayed limited self-awareness around professional boundaries, dual relationships and the importance of having professional supervision in place.

Professional Boundaries/Dual relationships

The registrant stated in correspondence “I would like it noted please that X was not just a client. We had been on dates prior to me offering .. therapy and had become good friends before any therapy took place. This wasn’t a usual client/therapy relationship. I helped out as a friend.”

Affectionate and emotive language was used throughout messaging evidence, with no clear professional boundary between personal and business communication.

Contrary to the following NCS Code of Ethics:

Fundamental principles:

Being trustworthy and responsible (Fidelity)

Practitioners endeavour to establish trust with their clients and the community in which they work. Therefore, practitioners not only honour the trust placed in them by their clients and the community but also act in a respectful, professional and ethical manner when representing their profession

Delivering a Service

All Practitioners undertake to:

• (1) Work in ways that promote client autonomy and well-being and that maintain respect and dignity for the client.
  
• (3) Refrain from using their position of trust and confidence to: Cross the boundaries appropriate to the therapeutic relationship. This includes but is not limited to having sexual relationships with or behaving sexually towards clients, supervisees or trainees; maintaining the confidentiality of counselling as far as the law allows; or by exploiting them emotionally, financially or in any other way whatsoever.
  
• (4) Decline with explanation, inappropriate gifts, gratuities or favours from a client. Examples include, but are not limited to financial gifts, event or discount vouchers, objects of substantial monetary value. The offering of any gift in therapy is an important event in the therapist-client relationship, and its implications should be discussed with the client and considered in supervision.
  
• (5) Should any relationship (i.e. any enduring personal or professional connection other than the clinical relationship between client and therapist) occur or develop between either counsellor and client, or members of their respective immediate families, the therapist should consult their supervisor at the earliest opportunity. It is likely to be appropriate to cease accepting fees, work towards terminating the counselling relationship in an appropriate manner and arranging a carefully considered referral to another suitable therapist at the earliest opportunity.
  
• (7) Remain aware of their own limitations and wherever appropriate, be prepared to refer a client to another practitioner or medical adviser who might be expected to offer suitable treatment.

General Conduct

All Practitioners undertake to:

• (1) Conduct themselves at all times in accord with their professional status and in such a way as neither undermines public confidence in the process or profession of counselling, nor brings it into disrepute, being aware of professional and personal boundaries.

Confidentiality

The registrant discussed clients with clients (in writing). In the Panels view this offers a lack of awareness with regards to the essential requirement of client confidentiality.

Contrary to:

Confidentiality, Maintenance of Records and Recording of Sessions

All Practitioners undertake to:

(1) Maintain strict confidentiality within the client/counsellor relationship, always provided that such confidentiality is neither inconsistent with the therapist’s own safety or the safety of the client, the client’s family members or other members of the public, nor in contravention of any legal action (i.e. criminal, coroner or civil court cases where a court order is made demanding disclosure) or legal requirement

General Conduct

All Practitioners undertake to:

• (5) Ensure that they maintain the highest level of communication with clients (avoiding abbreviation and shorthand) whether by telephone; email; text or any other social media messaging service (Facebook; WhatsApp). See (Appendix C)

Appendix C: Communications and Social Media

Before providing counselling or advice/suggestions via any online platform/text messaging/email the practitioner should have considerations in place to deal with the following:

• The danger that a client may believe he or she has 24-hour accessibility to the therapist.
• The potential for a lack of time for reflection on either party before responding to each other.
• Awareness of potential professional and personal overlap by the careful and restrained use of social media such as Twitter, Facebook etc.
• When using Facebook or other social media platforms, personal accounts must be kept private from public viewing by making use of privacy levels according to the specific social media platform. Additional and separate user accounts for professional purposes and use, should be used.

Supervision

The registrant provided no evidence to the NCS about her Supervision, despite repeated requests having been made.

In the view of the Panel a qualified supervisor would likely have ‘nipped in the bud’ all of the concerns noted.

The panel considered the registrant’s statement “I have not taken this to Supervision as yet, however I have spoken to my peers in my peer support group. These peers are highly qualified, successful and professional therapists….”

(It is noted that this arrangement is not accepted as adequate supervision under the NCS Code of Ethics).

Contrary to:

supervision, all practitioners undertake to:

• (1) Have formal one to one supervision in place and obtained from a properly qualified and trained supervisor. Attendance should be commensurate with practice hours.
  
• (2) Ensure that clients with presenting issues outside of a practitioner's scope of ability, are discussed in supervision and where appropriate referred to another practitioner.

• (3) Ensure a written contract is provided from the supervisor.

• (5) Not engage in any dual relationship when seeking supervision. Examples of dual relationship can be found in the members area of the website.

Contrary to: Society Terms and Conditions of Membership:

Conditions of Registration:

• · “I have supervision appropriate to the amount of clients that I am seeing”
• “I monitor my safety to practice at a level that enables me to provide an effective service and seek advice from my supervisor if there are any health or personal circumstances which could impair my effectiveness”

Contrary to: Society Membership guidance:

…It is important that the Supervisor is properly qualified.

Peer and group supervision is acceptable, in addition to formal one-to-one supervision (not in place of), and is dependent upon your own level of experience and the client group you are working with…

DECISION: Fitness to practise sanctions

The registrant must provide evidence of the following:

Supervision:

• · Registrant to immediately engage a suitably qualified and experienced Supervisor and must not see clients until this is in place. To notify NCS once a contract has been agreed.
• · The Supervisor must provide a comprehensive fitness to practise report to the NCS after 12 months of working with the registrant.

Reflective Report:

• Registrant to produce a Reflective Report. This should be received by the NCS on a date that falls after 3 months and prior to 9 months from receipt of the Panel’s decision.

1. The report must be over 2000 words.
2. It should demonstrate understanding of the following: Professional Boundaries, Dual Relationships, why Supervision is essential and learning through supervision (upon having explored this complaint outcome with a new supervisor).

CPD:

• Registrant to complete the NCS Code of Ethics CPD within 3 months of receipt of this outcome.
• Registrant to complete a CPD training on the topic of professional boundaries, within 6 months of receipt of this outcome

Personal Therapy:

• Registrant to attend a minimum of 6x sessions of Personal Therapy to explore her awareness and wellbeing in relation to the compliant. Personal learning and insight gained should be included in the reflective report.

OUTCOME

Upon receipt of the Panel Outcome report, the registrant contacted the NCS to resign her membership and declared a refusal to engage in further contact with the Society. As an immediate action Sanction had been ordered by the Panel, the Registrant was therefore not compliant with conditions of membership.