February 2023: Martha Bvunzawabaya, Reference No 00756181, Registrant ID 378491

Allegations

Allegation 1
1.1 The Member suspended her regular supervision with [ . . . ] in/around March Year 1 as she was taking a break from seeing clients.

1.2 The Member arranged to restart it on 1 December Year 1.

1.3 The Member had no supervision arrangement in place between March and 30 November Year 1.

1.4 Between August and November Year 1, the Member saw one or more clients without having appropriate supervision in place.

1.5 The Member thereby failed to meet professional standards, including in particular by acting in a way which was inconsistent with the following paragraph of the Ethical Framework for the Counselling Professions 2018:

53 We will consider carefully in supervision how we work with clients.

60 Supervision is essential to how practitioners sustain good practice throughout their working life. Supervision provides practitioners with regular and ongoing opportunities to reflect in depth about all aspects of their practice in order to work as effectively, safely and ethically as possible. Supervision also sustains the personal resourcefulness required to undertake the work.

Allegation 2

2.1 The Member experienced one or more episodes of auditory hallucinations in October-December Year 1.

2.2 On/around 4 December Year 1 the police attended the member’s home as a result of allegations she made against her [ . . . ] as a result of her hallucinations.

2.3 On 4 December Year 1, the Member was referred to and admitted by the Crisis Resolution and Home Treatment Team (the Crisis Team).

2.4 On 5 December Year 1, the member was assessed by the Crisis Team when she described experiencing auditory hallucinations; the Crisis Team later discharged the Member into her GP’s care.

2.5 While experiencing mental health problems, the Member continued to see clients without having attained appropriate personal support for the mental health issues she was experiencing to ensure her own wellbeing, including an assessment by a suitable professional as to whether in light of her mental health condition she could continue to see clients safely and/or otherwise provide therapeutic services in accordance with professional standards.

2.6 The Member thereby failed to meet professional standards, including in particular by acting in a way which was inconsistent with the following paragraph of the Ethical Framework for the Counselling Professions 2018:

91 We will take responsibility for our own wellbeing as essential to sustaining good practice with our clients by:

c. seeking professional support and services as the need arises.

Allegation 3

3.1 The Member attended supervision with [ . . . ] on 1, 9 and 16 December Year 1 and 13 January Year 2.

3.2 During supervision on 1 December Year 1, the Member did not disclose to [ . . . ] that she had experienced one or more episodes of auditory hallucinations or any other concerns about her mental health and wellbeing.

3.3 During supervision on 9 December Year 1 she told [ . . . ] that the police had attended her home because of allegations she made against her [ . . . ] but did not disclose that the allegations were connected to her hallucinations.

3.4 The Member thereby failed to meet professional standards, including in particular by acting in a way which was inconsistent with the following paragraph of the Ethical Framework for the Counselling Professions 2018:

72. Supervisees have a responsibility to be open and honest in supervision and to draw attention to any significant difficulties or challenges that they may be facing in their work with clients. Supervisors are responsible for providing opportunities for their supervisees to discuss any of their practice-related difficulties without blame or unjustified criticism and, when appropriate, to support their supervisees in taking positive actions to resolve difficulties.

Allegations 1, 2 and 3 are allegations of professional misconduct.

Admissions

The Member accepted that she:

1. suspended her regular supervision with [ . . . ] in/around March Year 1 as she was taking a break from seeing clients due to COVID-19 pandemic restrictions; and

2. arranged to restart supervision on 1 December Year 1;

3. attended supervision with [ . . . ]on 1, 9 and 16 December Year 1 and 13 January Year 2 and:

a. on 1 December Year 1, the Member did not disclose to [ . . . ] that she had experienced one or more episodes of auditory hallucinations (because she had not had any); and

b. on 9 December Year 1 she told [ . . . ] that the police had attended her home because of allegations she made against her [ . . . ] but did not disclose that the allegations were connected to her hallucinations (because she had not had any).

Evidence before Panel

In comings to its decision the Panel carefully considered the following:

• The BACP’s bundle of evidence and exhibits.

• The written self-referral by the Member and evidence gathered by the BACP.

• The written submissions and oral evidence of the Member.

• The BACP Professional Conduct Procedure 2018.

• The Ethical Framework for the Counselling Professions 2018.

Summary of Evidence

The complaint, as summarised by the Investigation and Assessment Committee, stated that the Member referred herself to BACP on 8 December Year 1, to disclose fitness to practise concerns in relation to her health; specifically that she had been experiencing auditory hallucinations.

The Member disclosed that the police would shortly be contacting BACP regarding her mental health. She stated that she had gone through a period of her life where she had made a serious allegation against her [ . . . ], which resulted in him being investigated by the police. She said that during this episode she had raised issues with regard to hearing voices.

On 14 December Year 1, [ . . . ] Police contacted BACP raising concerns regarding the mental health of the Member and advising that she was still seeing vulnerable clients.

On one occasion, the police had been called to her address because of a fear for her welfare; the police were informed by a third party that the member was hearing voices and they were telling her what to do as well as telling her what to say to her clients.

On 31 January Year 2 the Member informed BACP that:

a. she is currently self-employed;

b. she has a private practice based at [ . . . ]

c. she has raised her issues with her co-leads at [ . . . ] one of whom is also her supervisor.

The Member also enclosed a letter from her GP dated 26 January Year 2 confirming that the Member has been seeing her GP regularly regarding her mental health. She has also reportedly been seeing a counsellor regularly and has been taking sertraline, both of which appear to have helped. The GP reported that she has been calm and compliant and has reported to her GP a significant improvement in her mental health.

On 4 February Year 2, the Member emailed BACP to advise that she had been assessed by the mental health crisis team and discharged into the care of her GP. This is confirmed in a letter from the crisis team dated 22 January Year 2. That letter confirmed that the Member had two experiences of auditory hallucinations at the end of Year 1, the second of which had led the Member to make allegations against her [ . . . ]. The assessment identified no evidence of psychotic illness and the Member had reported grieving over her [ . . . ] death and feeling isolated.

The Member's GP wrote a further letter to BACP on 5 February Year 2 confirming that she is not qualified to state whether the Member is fit to practise and is not able to carry out an assessment to determine the same. She stated that the Member would benefit from an occupational health or mental health assessment.

[ . . . ] wrote on 8 February Year 2 confirming that the Member had been suspended pending the outcome of the fitness to practise enquiry.

The Member's supervisor ([ . . . ]) wrote to BACP on 8 February Year 2 confirming that she has been the Member's supervisor for about ten years, meeting fortnightly for about an hour. Between March–December Year 1 there was a break from supervision as the Member told [ . . . ] that she was taking a break from client work due to a bereavement. An arrangement was made to restart supervision on 1 December Year 1 and three supervision sessions took place before [ . . . ] informed the Member on 20 January Year 2 that she should cease work immediately. The Member declined the suggestion that a supervision should take place on 27 January Year 2. A supervision took place on 3 February Year 2 and the following day the Member terminated the supervision arrangement.

[ . . . ] confirmed that the Member had informed her that she had been seeing two clients since August Year 1, one weekly and one fortnightly via Zoom. She reported to [ . . . ] that she had recommenced with the rest of her clients at the end of November Year 1. [ . . . ] had not been aware of this, nor had she been aware of the Member's mental health difficulties.

[ . . . ] expressed concerns about the lack of proactive and open disclosure to her by the Member. She has not been able to establish any awareness with the Member of how her mental health issues were reflected in her work, and of any potential transferential repercussions.

[ . . . ] told BACP on 19 February Year 2 that the Member had emailed her on 18 February Year 2 to say that on 17 February Year 2 she had been advised by BACP that it was up to her whether she continued seeing clients or stopped and she had decided to resume work as soon as possible.

BACP decided to bring this complaint under paragraph 1.5 of the Professional Conduct Procedure 2018 on the basis that the Registrar considers that it is in the public interest for the detail of the self-referral of the Member to form the basis of a complaint that the Member may have breached a number of provisions of BACP’s Ethical Framework for the Counselling Professions 2018.

The Member responded setting out a safety care plan to address her personal, professional and general wellbeing, which included:

1. Personal therapy;

2. Regular supervision (1.5 hours per month);

3. Easing herself back into work by spreading her client work evenly across the week rather than working long periods of time without breaks in between;

4. Exercise (running five times per week for at least 45 minutes) meditation, getting enough sleep, rest and eating nutritionally balanced meals as a way to help with her mood;

5. Expanding her social network professionally and personally. She is currently in contact with other therapists at [ . . . ] and expanding her social network on a personal level by spending more time with family and friends;

6. Having breaks away from work periodically throughout the year;

7. Reflective practice that includes being more open to communication and learning more about areas that need further enhancement as the need arises;

8. Further personal reading and CPD;

9. Drug therapy – she continues to take sertraline as prescribed by her GP;

10. Monthly mental health reviews with her GP;

11. Relapse prevention techniques - that include her being aware of her triggers which include isolation and withdrawal and addressing these triggers before they take root.

Decision and Reasons for Findings

On balance, having fully considered the above, the Panel made the following findings:

Allegation 1 - UPHELD

General

By way of context, the Member explained, and the Panel accepted, that she was a self-employed counsellor. She advertised her services through [ . . . ] , the BACP and the [ . . . ] but all her clients at the time of the events in question were either through [ . . . ] or by word of mouth. She saw her clients in consulting rooms provided by [ . . . ]. Her supervisor, [ . . . ], was a Director/Co-owner of [ . . . ] and she paid [ . . . ] separately for her professional supervision. When she restarted supervision, she saw [ . . . ] on 1, 9 and 16 December Year 1, 13 January and 3 February Year 2.

Allegation 1.1 – PROVED

The Member admitted she suspended her regular supervision with [ . . . ] in/around March Year 1. She explained this was because of COVID-19 pandemic restrictions. The Panel noted the electronic message exchange between the Member and [ . . . ] on 30 March Year 1 in which the Member suggests rescheduling supervision ‘when work picks up again’ and refers to cancelled appointments and work quietening down. [ . . . ] indicated she was having a similar experience and asked the Member to contact her when things picked up.

The Panel found that the Member was taking a break from clients, albeit one imposed on her by COVID-19 restrictions, and that she suspended her regular, formal supervision with [ . . . ] on 30 March Year 1.

Allegation 1.2 – PROVED

The Member accepted that she restarted her formal, regular supervision with [ . . . ] on 1 December Year 1.

Allegation 1.3 - PROVED

The Member denied having no supervision arrangement in place between March and 30 November Year 1. She said that during that period she attended online peer supervision organised by [ . . . ] and informal, ad hoc, meetings with her supervisor.

When questioned, the Member described the peer supervision as video meetings for counsellors who used [ . . . ] facilities where attendees discussed how they were coping with lockdown and provided mutual support with lockdown-related issues. She said she attended two sessions on 18 April and 3 July Year 1. She said she also had a catch-up with [ . . . ] in May Year 1. This was supported by the electronic message from [ . . . ] dated 25 May Year 1 asking the Member to contact [ . . . ] for a ‘catch up’. There was also a message from [ . . . ] on 22 September Year 1 saying ‘am online now’. The Member stated that she was not charged for either the peer supervision sessions or the catch-up meetings with [ . . . ].

[ . . . ] letter to the BACP dated 8 February Year 2 stated ‘There was no supervision undertaken from March Year 1 until December Year 1. The Panel accepted, as far as supervision with [ . . . ] was concerned, this was a fact that [ . . . ] was able to give direct evidence about. It also found that [ . . . ] was aware of the peer support sessions and so this statement indicated that she, as a professional supervisor, did not consider those to be supervision. The Panel accepted that the Member had not been able to challenge [ . . . ] evidence by questioning. However, the Panel could not hypothesize a reason why [ . . . ] would give false evidence about this matter. The Member had described a good relationship with [ . . . ] over several years and had not indicated a breakdown of the relationship. The Panel therefore concluded [ . . . ] evidence was reliable.

The Panel found [ . . . ] evidence that [ . . . ] provided no supervision to the Member between March and 30 November Year 1 was consistent with the Member’s evidence of not paying for supervision in this period and with the Member’s description of the sessions. It noted the BACP definition of ‘supervision’ in the BACP Good Practice in Action 054: Introduction to supervision in the counselling professions:

A specialised form of professional mentoring provided for practitioners responsible for undertaking challenging work with people. Supervision is provided to ensure standards, enhance quality, advance learning, stimulate creativity, and support the sustainability and resilience of the work being undertaken (BACP 2018a).

The Panel found that the peer sessions and meetings with [ . . . ] were welfare support put in place as a result of the isolation of lockdown. They did not amount to ‘supervision’ as defined by the BACP. Accordingly, the Panel found the Member had no supervision arrangement in place between March and 30 November Year 1.

Allegation 1.4 –PROVED

The Member denied seeing clients between August and November Year 1. She said she planned to start seeing clients from 2 December Year 1, which is why she restarted supervision with [ . . . ] on 1 December Year 1. This start date then got delayed and she saw clients for a couple of weeks before Christmas and then for a short period in Year 2 before she stopped on the advice of [ . . . ].

The Member’s self-referral email on 8 December Year 1 stated that she was ‘currently in supervision and my work has carried on as usual with no issues.’ [ . . . ] statement said the Member told [ . . . ] that she had been seeing two clients since August Year 1, one weekly and one fortnightly on Zoom, and that she re-commenced with the rest of her clients towards the end of November Year 1. [ . . . ] recalled expressing concern that the Member had been practising without supervision in place. The Panel recognised that this evidence was hearsay. However, it found it implausible that the Member would have told [ . . . ] that she had seen clients when she had not, especially as this would have been self-incriminating. The Panel was satisfied that [ . . . ] was a reliable witness and therefore that her recollection of what the Member told her was likely to be accurate.

The Panel therefore found that the Member saw one or more clients without having appropriate supervision in place between August and November Year 1.

Allegation 1.5 –PROVED

The Panel applied the facts found proved to paragraphs 53 and 60 of the BACP Ethical Framework for the Counselling Professions 2018. It found that the member had acted in contravention of both paragraphs.

Allegation 2 – UPHELD

Allegation 2.1 – PROVED

The Member denied having experienced auditory hallucinations or of reporting experiencing them to anyone. She highlighted that the police had admitted that their reference to the Member reporting hearing voices came from a Social Worker and had not been directly witnessed by the police officer and the Police had accepted this was hearsay. She also said that the Crisis Resolution Home Treatment Team (Crisis Team) had withdrawn their reference to auditory hallucinations because of this.

The Member accepted that in her self-referral email dated 8 December Year 1 she stated ‘During this episode I raised issues to do with me hearing voices.’ She explained that that this was about her raising issues with the police reporting that she had heard voices and not stating that she had experienced issues with hearing voices.

The police investigator originally reported that they were called to the Member’s address ‘as a fear for welfare, she said that she was hearing voices and they were telling her what to do as well as telling her what to say to her clients’. The police have since confirmed this was information received from the Member’s family social worker, but the officer reporting this conversation is confident she is reporting it accurately.

The Crisis Team discharge letter dated 22 January Year 2 reported that she was admitted to the team’s care on 4 December Year 1. On 5 December Year 1 she was seen and assessed and ‘reported experiencing auditory hallucination’ in October for the first time and again, for a second time, when it ‘led to her to make allegations against her [ . . . ].’ At the time of writing the letter, the Member had declined an offer of therapy as she was seeing a private therapist, and had reported seeing her GP and being prescribed Sertraline. At a professionals meeting on 14 December Year 1, the Crisis Team announced it would be discharging the Member to the care of her GP. The Member provided evidence that this letter had been removed from her records by the Crisis Team on the basis of information she gave to the NHS Trust that the police had ‘retracted’ the statement as hearsay.

[ . . . ] statement reported that on 9 December Year 1, during supervision, the Member reported to her directly that, ‘she had experienced some mental health difficulties in October, namely hearing voices, but reported she was not experiencing them presently.’ [ . . . ] stated that the first time she knew that the Member had said she had heard voices twice was on 22 January Year 2 when the Member sent [ . . . ] a copy of the Crisis Team discharge letter.

The Panel was not persuaded by the Member’s explanation. It found the statement in her self-referral clear and unambiguous and noted her high standard of written and oral communication during the BACP investigation and hearing. It found that the statement from [ . . . ] that the Member had told her she had heard voices in October Year 1 was consistent with the record of assessment in the Crisis Team’s letter. The Panel recognised the Member had managed to have this letter expunged from her medical records as she did not want the reference to psychotic symptoms when she was not diagnosed as showing any psychosis. However, this deletion was based on the NHS Trust understanding the police had ‘retracted’ the statement as hearsay. That was inaccurate; the police had labelled the statement as hearsay but emphasized that it was an accurate reflection of a conversation with the family social worker.

The Panel noted that the Member only started denying hearing voices and challenging the police correspondence after the matter was being investigated by the BACP. In the case of the Crisis Team correspondence (6 July Year 3), this occurred after she had been made subject of an interim suspension by the BACP. The Panel also found the Member downplayed the Crisis Team involvement, denying that she was admitted to their care and stating she was simply told she had ‘mild depression’ and to see her GP. The Crisis Team letter made it clear she was admitted from 4 14 December Year 1 and her GP confirmed she took anti-depressants until May Year 2 and attended six therapy sessions. This was not consistent with ‘mild depression’.

The Panel therefore found that the Member had reported hearing voices to the BACP, [ . . . ] and to one or more of her family social worker, the Crisis Team or the police. It therefore found that she experienced one or more episodes of auditory hallucinations in October-December Year 1.

Allegation 2.2 – PROVED

The Member accepted that the police visited her home on 4 December Year 1. She said this was to discuss her allegations of [ . . . ]. The Member explained she had [ . . . ] in October Year 1 and the police had previously attended the home in November Year 1 [ . . . ].

The Crisis Team letter reported the Member stating that her hallucinations had ‘led to’ her making allegations against her [ . . . ]. The Member’s self-referral stated that she had made serious allegations about her [ . . . ] that resulted in him being investigated by the police and ‘during this episode’ she had raised issues to do with her hearing voices.

The Panel had already found that the member had experienced hearing voices in October-December Year 1.
The Panel concluded that, at the time, the Member believed and informed others that her allegations were as a result of her hallucinations. It recognised the Member no longer believed this was true and considered herself to have been gas-lighted [ . . . ].

Allegation 2.3 – PROVED

The Panel found this was proved by the Member’s admission that she was referred to the Crisis Team on 4 December Year 1 and the Crisis Team’s letter stating she was admitted to their care on 4 December Year 1 and discharged on/after 14 December Year 1 (date of professionals meeting).

Allegation 2.4 – PROVED

The Panel found this proved on the basis of the Crisis Team letter, which was corroborated by the Member’s comments to [ . . . ] on 9 December Year 1. The Panel found the Member’s denial was inconsistent and lacked credibility. She said she was asked questions during the assessment about hearing voices but also denied there being any discussion about auditory hallucinations.

Allegation 2.5 – PROVED

The Panel relied on its previous finding that the Member was seeing clients from August Year 1 onwards and had experienced mental health problems from October Year 1 onwards. However, the Member’s evidence was she started seeing her private therapist after seeing her GP on the advice of the Crisis Team, which would have been after 5 December Year 1 at the earliest. Her GP says she was diagnosed with depression in December Year 1. The Member told the Panel she sought help as advised by the Crisis team and her GP.

The Panel therefore found that the Member had seen clients while suffering from mental health problems without seeking support for the mental health issues she was experiencing to ensure her own wellbeing.

Allegation 2.6 – PROVED

The Panel applied the facts found proved to paragraph 91.c of the BACP Ethical Framework for the Counselling Professions 2018. It found that the member had acted in contravention of that paragraph.

Allegation 3 – UPHELD

Allegation 3.1 – PROVED

The Panel found this proved by admission and independently by [ . . . ] evidence.

Allegation 3.2 – PROVED

The Member told the panel she did not disclose auditory hallucinations to [ . . . ] on 1 December Year 1, which was consistent with [ . . . ] evidence. She explained this was because she had not had any.

The Panel relied on its previous finding that she had experienced auditory hallucinations in October December Year 1. It also found that, as the Member had reached the point of referral to the Crisis Team on 4 December Year 1, on the balance of probabilities she was experiencing mental health problems on 1 December Year 1. It found she had not disclosed either auditory hallucinations or other mental health problems to her Supervisor, [ . . . ] , on 1 December Year 1.

Allegation 3.3 – PROVED

The Member confirmed she did not disclose that her allegations against her [ . . . ] were connected to auditory hallucinations to [ . . . ] on 9 December Year 1, which was consistent with [ . . . ] evidence. The Member explained this was because she had not had any hallucinations. The Member confirmed she told [ . . . ] about the police attending her home, which [ . . . ] corroborated. [ . . . ] evidence was that this as the first time she knew about the hallucinations and police visit.

The Member had previously told the Panel that she self-referred to the BACP on 8 December Year 1 on the advice of [ . . . ] to pre-empt the police report. When asked how this could be when the first contact she had with [ . . . ] after the police visit was 9 December Year 1, after the self-referral, the Member said she had spoken to or messaged the Member on 4, 5 or 6 December Year 1. [ . . . ] statement contained no mention of such contact and the Member had not provided copy messages of such an exchange. The Panel found the Member’s evidence on this matter unreliable.

The Panel found this proved on the basis of its previous findings and [ . . . ] evidence.

Allegation 3.4 – PROVED

The Panel applied the facts found proved to paragraph 72 of the BACP Ethical Framework for the Counselling Professions 2018. It found that the member had acted in contravention of that paragraph.

Professional Misconduct

The Panel considered whether the allegations amounted to Professional Misconduct as defined by the BACP Professional Conduct Procedure 2018. It agreed that the allegations amounted to Professional Misconduct individually and collectively.

Decision

The Panel was unanimous in its decision that there had been a failure to comply with the Professional Standards, specifically that the Member had acted contrary to paragraphs 53, 60, 91 and 72 of the BACP Ethical Framework for the Counselling Professions 2018.
The Panel found the allegations (individually and collectively) amounted to Professional Misconduct (as defined by the BACP Professional Conduct Procedure 2018).

Sanction

Before deciding on sanction, the Case Manager will invite the Member to make any written representations which they wish the Panel to take into consideration when deciding an appropriate sanction. The Member will be given 14 days on receipt of this decision to do so. The Panel may, where it considers it appropriate, list a further hearing for the purpose of sanction.

Sanction Decision

The Panel reconvened [ . . . ] to determine the appropriate sanction (if any) to impose on the Member. It reminded itself of its findings above and the provisions of the Professional Conduct Procedure 2018 and BACP Protocol 14 Guidance on Sanctions.

The Panel considered the Member’s undated sanction submissions. The Panel considered that in her sanction submissions the Member contested the Panel’s findings in relation to Allegations 1,2 and 3. The Panel noted that the Member continues to deny that she has suffered from any mental health illnesses or experienced auditory hallucinations. The Panel considered that the Member had failed to show any respect for the Panel’s decisions. Further, the Panel determined that the Member had wholly failed to demonstrate any insight into her failures and problems and their consequences for clients, colleagues, and the reputation of the profession. The Panel determined that the allegations found proved were serious and there remained a risk of repetition.

Taking into consideration all matters and the absence of any mitigating factors, the Panel concluded that the only appropriate sanction which would adequately protect the public and the reputation of the profession was withdrawal from membership.

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