Victoria Thackstone, specialist in dealing with claims for adults who have suffered abuse and negligent treatment by mental health professionals, explores what professional and therapy abuse is.
“Professional abuse” and “therapy abuse” are the terms we have given to claims arising out of negligent treatment by someone in a position of trust in a medical or therapy setting – the “practitioner”.
This is a highly specialised area of clinical negligence law, which not only requires legal knowledge, but a psychological understanding and empathy of what the client has been through.
Types Of Practitioner
The types of practitioner we have successfully pursued civil claims against is wide-ranging, but is most frequently counsellors and psychotherapists.
In addition, we have pursued claims against hypnotherapists, psychiatrists, psychologists, community psychiatric nurses, occupational therapists in mental health services, mental health social workers, gynaecologists, breast surgeons, acupuncturists, osteopaths, homeopaths, GUM (sexual health) health advisors and GPs.
Regulated And Unregulated Professionals
Only practitioners that have a protected title, such as doctor (to include psychiatrist), nurse, social worker, art therapist, occupational therapist or practitioner psychologist have to be registered with a state regulatory body in order to practice.
Currently, counsellors and therapists are not state regulated and do not have to be a member of a voluntary membership organisation to practice. There are voluntary membership organisations which counsellors and therapists can apply to be members of such as the UK Council for Psychotherapy, the British Association for Counselling and Psychotherapy, and the British Psychological Society.
If the professional is a private practitioner and is a member of either a regulatory body or membership organisation a complaint can be made to the regulatory body or membership organisation for the practitioner’s conduct to be investigated.
If the practitioner is employed, for example by the NHS, a private service or charity, a complaint to the employer can often be turned into a disciplinary process between the employer and the practitioner. As with a private practitioner, a complaint can also be made to their regulatory body or membership organisation.
Regulatory bodies and membership organisations have the power to “punish” the practitioner by placing sanctions on them or striking them off their register. Civil claims are different as they are not there to “punish” the practitioner and are designed to enable the client to obtain compensation as a result of the harm that they have suffered.
If a practitioner is not a member of a regulatory body or voluntary membership organisation there is unlikely to be any recourse for a complaint. In view of this we would always suggest checking out the potential practitioner’s accreditations before entering into counselling or therapy with them.
The fact that the practitioner is not a member of a regulatory body or voluntary membership organisation should not deter you from contacting us in respect of a potential civil claim.
Clients have their own unique experience of negligent treatment and boundary violations.
To provide effective treatment, the practitioner should maintain professional boundaries, endeavour to offer a treatment plan which is appropriate to the issues raised by the client and be competent in the treatment they are providing. The client should be able to trust the practitioner and know that the treatment being offered is the right treatment for them.
It is not always possible to neatly categorise the practitioner’s conduct into either a breach of boundaries or negligent treatment as often there may have been a combination of issues, interacting and overlapping.
Thevast majority of cases involve abuse over a period of time, often involving a gradual erosion of acceptable professional/client boundaries leading to emotional and, sometimes, sexual abuse. The period of time over which the acts are perpetrated can range from a single occasion to weeks, months or years.
Breach Of Professional Boundaries
There are many ways in which boundaries can be breached, as every case is individual and every client has their own unique experience. The following are examples of what can occur:
- Entering into a personal relationship, for example a friendship;
- Engaging in sexual activity, or sexual innuendo or inappropriate comment, for example relating to the patient’s appearance or dress;
- Entering into a business relationship with the client (for example by paying the client to carry out administrative business tasks for the practitioner – the payment could take the form of a reduced fee for therapy sessions);
- Encouraging overuse of telephone, e-mail, text or social media contact between sessions;
- Meeting up outside of sessions for a drink or a meal;
- Allowing sessions to go on for too long;
- Moving sessions to the end of the working day;
- Holding sessions at inappropriate venues;
- Hugging, holding hands, kissing;
- Giving and accepting gifts;
- The practitioner disclosing their own problems and difficulties, and discussing these with the client.
- Attending social gatherings/functions/shows together;
- Meeting family members;
- Going on holiday together;
- Asking the client to perform tasks, or offering for others to perform tasks for the client (for example gardening or DIY).
Psychotherapy and counselling can go wrong in a number of ways. Every case is different and every client’s experience is unique. Here are some examples of what can occur:
- Breaching the boundaries set out above;
- Failing to explain at the outset the style of psychotherapy or counselling;
- Failing to establish a sufficiently clear working contract;
- Changing days/times of sessions or cancelling sessions with insufficient notice;
- Inappropriately increasing or decreasing the frequency of sessions;
- Allowing sessions to go on for too long;
- Holding sessions at inappropriate venues or times;
- Acting in an aggressive, critical and abusive way, being directive or opinionated;
- Being over friendly;
- Encouraging over-dependency;
- Blaming the client for ‘not wanting to get better’;
- Failing to address issues adequately;
- Abruptly terminating treatment.
We believe it is not for the client to know what a practitioner should or should not do, and we believe that everyone is entitled to enter into treatment with the expectation that the practitioner’s conduct is appropriate. If you think you may have experienced professional misconduct, please do not hesitate to make contact with us for an initial discussion.. Initial contact is free of charge and without obligation.
Victoria Thackstone is a Litigation Executive in the Therapy and Adult Abuse Department at Switalskis Solicitors and has over 15 years’ experience working in professional and therapy abuse law. Victoria can be contacted on 01302 279745 or by email at firstname.lastname@example.org