Ethical complaints. Towards a best practice for psychotherapy and counselling organisations

In this research I review the experiences of people who have made complaints against their therapists and of therapists who have received such complaints. These are complaints which have involved ethical contraventions and boundary violations and have been addressed by either the British Association for Counselling & Psychotherapy, the United Kingdom Council for Psychotherapy or the British Psychoanalytic Council. As far as I can ascertain there has been no published research into such experiences. Alongside this I review the experiences of members of Ethics Committees who make decisions about complaints. I briefly review with the complainant and therapist the processes leading up to the complaint; then in more detail the therapist’s response to the complainant; any support received; the experience of the tribunal and the aftermath of this. I have not had the opportunity to interview both therapist and complainant involved in the same complaint. Ethical issues of sensitivity, a non-intrusive approach and confidentiality and anonymity were of paramount importance throughout the research. At all times I endeavour to involve interviewees in the process and to ensure that they gave their informed consent to anything written. The focus throughout is on the participants’ experience. Interviews with both complainants and respondents employed a partially guided storytelling, narrative approach which allowed for rich and evocative storytelling. A number of recurring issues are highlighted. The interviews exposed wide differences between the reality experienced and the expectations which therapists had of the support that organisations were prepared to offer. Therapists and complainants were often unprepared for, and shocked by, the quasi-legalism of the complaints process and the lack of any process of alternative dispute resolution. An analysis of complaints showed differences between the numbers and types of complaints made to male and female therapists. Chairs of Ethics Committees from different modalities in UKCP and BPC whom I interviewed regarding their experiences of handling complaints often expressed anxiety and at times frustration at the confines of the written complaints procedures. Issues around confidentiality often lead to secrecy and feelings of isolation. Provisions for ethics training within the organisations’ are explored alongside any provisions for learning from the experiences of complaints. Research showed there was a very wide range of such provision. To set these experiences within a wider context a review of complaints received by other organisations; the General Medical Council, Health Professions Council and the Office of the Independent Adjudicator [Universities] is presented. By focusing attention on the human aspect of therapy breakdown I hope that this research will influence the way complaints are handled and, where appropriate, initiate changes in procedures.