What is abusive and negligent counselling and psychotherapy?

By Victoria Thackstone, Litigation Executive, Professional and Therapy Abuse 

Abusive and negligent counselling and therapy can occur in both a private and NHS setting. The abusive practitioner does not have to be someone junior or inexperienced. At Switalskis, we specialise in legal issues relating to abusive and negligent treatment by a wide range of mental health professionals, including many claims against “senior” professionals.

The most common types of professionals we have pursued claims against are: counsellors, psychotherapists, mental health social workers, mental health support workers, key workers, psychiatrists, psychologists and community psychiatric nurses. We have also acted for clients in claims involving GPs, hypnotherapists, occupational therapists, gynaecologists, breast surgeons, acupuncturists, osteopaths, and GUM health advisors.

Types of abusive or negligent acts

The common thread throughout all of the practitioner/patient relationships, is the imbalance of power in favour of the professional and a breach of the trust the client puts in the professional.

Most of our cases involve either a healthcare professional breaching their boundaries, or the professional providing other negligent treatment; sometimes they involve a combination of both.

The cases classically relate to an erosion of the appropriate boundaries over a period of time, which sometimes (but not always) results in a personal or sexual relationship between the patient and the practitioner.

We have also dealt with claims where for a long time the treatment seemed “okay” but then something happened which called in to question all of the treatment.

Whether the abusive and negligent acts were sexual or not, in our experience, the breach of trust causes the most harm.

Boundary crossing

The erosion of boundaries usually occurs over a period of time (weeks, months or even years).

There are a number of ways in which a practitioner can cross the appropriate boundaries, such as:

  • Being over-friendly
  • Revealing personal details and discussing his/her own life experiences
  • Allowing sessions to go on for too long
  • Moving sessions to the end of the working day (for example when you and the practitioner are the only ones in the building)
  • Holding sessions at inappropriate venues (for example a coffee shop or public house)
  • Encouraging telephone, text or e-mail contact between sessions
  • Sexual innuendo or disclosing their own sexual exploits and preferences
  • Making inappropriate comments, for example commenting on your appearance or dress
  • Sitting inappropriately close to you during sessions, holding hands, hugging and kissing
  • Social contact outside sessions
  • Breaching your confidentially by discussing details with a third party, or breaching someone else’s confidentially by discussing them with you
  • Inviting you to enter into a business relationship with them. For example, if you have a marketing background, the professional may suggest that you deal with their marketing needs in exchange for a reduction in the therapy fees
  • Entering into an intimate and/or sexual relationship with you

This is not an exhaustive list.

By allowing an erosion of the boundaries, the professional will often take his/her eye off the treatment they should be providing.

In some cases the professional’s conduct replicates sexual or emotional abuse which a person has previously suffered.

Inappropriate treatment

There are many other ways in which counselling and therapy can be negligent. Below is a list of some examples which can occur on their own or together with boundary breaches referred to above.

  • Failing to enter into an appropriate counselling/therapy contract
  • Failing to explain at the outset the style of counselling or therapy
  • Changing days/times of sessions or cancelling sessions with insufficient notice
  • Acting in an aggressive, critical and abusive way
  • Inappropriately increasing the frequency of sessions
  • Suggesting that sessions could be offered as a “special rate”
  • Dabbling in fringe areas of practice
  • Being directive or opinionated
  • Threatening to terminate sessions
  • Threatening to use against you the information you disclosed to the professional during sessions
  • Blaming you for “not wanting to get better”
  • Failing to address your presenting issues prior to termination of treatment
  • Failing to refer you on to someone better suited to treat your needs
  • Abruptly terminating treatment (including terminating treatment early in order to pursue ongoing social or sexual contact)

We have worked with people from all walks of life and dealt with every gender combination of patient and professional. The majority of our clients are adults (over 18 years of age), but we have pursued claims for people who are under 18 years of age and have received mental health treatment.

We do not judge our clients and we are very open minded. You have the right to trust someone again and we strive to work with you in a way which helps you to recognise that not all professionals conduct themselves in an inappropriate manner.

If you have suffered abuse by a counsellor, psychotherapist or other healthcare professional, you can call Switalskis’ Therapy and Professional Abuse team in confidence on 0800 012 9085 or send us a message using the contact form below.

Disclaimer: The contents of this article are for the purposes of general awareness only. They do not purport to constitute legal or professional advice, and the law may have changed since this article was published. Readers should not act on the basis of the information included and should take appropriate professional advice on their own particular circumstances.