Many complaints are made against members for a lack of competence. This can arise in several ways, but often it's because therapists act beyond their remit, offering clients advice which they are not qualified to give.
It is important to be aware of our own limitations and to stay within our role. BACP members commit to ‘providing an appropriate standard of service to our clients’ and ‘working within our competence’ (Ethical Framework, Our commitment to clients, 1b and 2a).
Complaints about competence and fitness to practise
Clients have complained about their therapists for:
- giving a medical diagnosis or opinion
- offering legal or financial advice
- not referring on where appropriate or necessary
- claiming a specialism or ability to work in a particular field without adequate training or preparation
- breaking confidentiality inappropriately or not taking action when necessary
Complaints have also related to the therapist’s fitness to practise, including:
- falling asleep in front of a client
- being intoxicated
- not taking sufficient care of their own health needs
Key considerations for practice
Giving your opinions
Unless you hold specific professional qualifications, counsellors and psychotherapists are not usually in a position to make medical or psychiatric diagnoses, such as autism or narcissism, or give medical opinions.
- Don't get drawn into providing expertise in an area in which you're not qualified, even if clients specifically ask for information or an opinion
- Explain to clients if a matter is beyond your competence and refer them on to an expert for a medical diagnosis or opinion
- If you need to write a report, for example in support of court proceedings, restrict comments to ‘what I have been told by my client’
Promoting your expertise
Be careful how you advertise or describe yourself so potential clients are not misled. You should provide clients with adequate and accurate information from the outset, so they can make an informed decision about whether you or a particular therapy are likely to be appropriate for their needs.
- Check that your personal profile accurately reflects your competence and qualifications
- Only offer specialisms if you have had relevant training and CPD
- Ensure that your supervisor is competent to support any specialisms you offer
Power dynamics
Clients are often vulnerable and may hold therapists in a position of power. Complaints can arise if they feel you have misused or abused this power.
- Be alert to the power dynamics in the therapeutic relationship
- Make sure that your comments, questions or suggestions are not interpreted as expert opinions or directions
Confidentiality
Problems can arise if you disclose information to authorities inappropriately or unnecessarily without the client's consent, or if you fail to take action when clients or others are at serious risk of harm.
- Make sure that you understand when you're legally required to break confidentiality and when it is in the public interest to do so
- Ensure that your clients understand the limits of confidentiality and when you might be required to make a disclosure
- Discuss any concerns with your supervisor
See Confidentiality - what complaints tell us
Self-care
As stated in the Ethical Framework, our primary commitment is to put clients first. You should discuss anything that gets in the way of this in supervision, whether it concerns your own health, personal circumstances, financial pressures, feelings and emotions, or anything else that affects your resilience, stamina or attentiveness. We need to find appropriate ways to offload and replenish our resources, so we don't burden our clients with our own issues or use them to satisfy unmet personal needs.
- Be open and honest in supervision about anything affecting your practice
- Consider the need for personal therapy
- Maintain a healthy work-life balance - ensure that your workload is manageable and take time off when necessary
- Attend to your own self-care
- Prioritise your personal wellbeing over financial need and organisational targets