As part of our work to protect the public and promote high standards of practice we launched the ‘What complaints tell us about ….’ resources in 2022. These resources are about different themes within therapy where complaints have been upheld. We are now continuing that work by introducing regular reviews from published complaints, and looking at common themes to support members in identifying any common mistakes, and helping clients understand what is and isn’t best practice.

The main allegations upheld against BACP members for the period of January to June 2024 can be summarised as follows: 

Boundaries 

  • misuse of client information
  • sending of unsolicited information
  • sexual relationship with a client/former client
  • dual relationship
  • contact with client outside the sessions that had nothing to do with therapy
  • inappropriate self-disclosure  

Competence/fitness to practise 

  • providing a diagnosis when not qualified to do so
  • working when fitness to practise may be impaired due to own physical or psychological health  

Confidentiality

  • providing letters to a third party without client consent
  • forwarded an email about a joint therapy session to one of the parties without seeking consent
  • delay in notification of a breach of confidentiality and a lack of apology  

Endings  

  • concluding the therapy without notice
  • ending the therapy without explanation  

Some of the complaints were about frequently recurring issues such as the management of endings in therapy. However, in this period there were also complaints upheld where there was a link to the importance of understanding confidentiality. Examples include where letters have been written about a former client to support a third party – without first making any attempt to seek the consent of the former client. Another instance related to therapy where more than one person was present, and then sharing information received outside the session from one of the parties with the others involved in the therapy. Some of the relevant aspects of the Ethical Framework with regard to this are:  

31. We will give careful consideration to how we reach agreement with clients and will contract with them about the terms on which our services will be provided. Attention will be given to: c. stating clearly how a client’s confidentiality and privacy will be protected and any circumstances in which confidential or private information will be communicated to others.  

55: We will protect the confidentiality and privacy of clients by:
a. actively protecting information about clients from unauthorised access or disclosure  

The above complaints might have been avoided had the therapist sought client consent in advance of sharing any information. Additionally, a recognition of when something has happened, and the importance of duty of candour – as the Ethical Framework states: 

52. We will ensure candour by being open and honest about anything going wrong and promptly inform our clients of anything in our work that places clients at risk of harm, or has caused them harm, whether or not the client(s) affected are aware of what has occurred by: a. taking immediate action to prevent or limit any harm b. repairing any harm caused, so far as possible c. offering an apology when this is appropriate  

As can be seen from the summary of complaints, several of those which have been upheld related to the issue of boundaries. This area covers a breadth of topics related to therapeutic work, and the way that boundaries may be breached is wide ranging.  

In this period some of the boundary breaches related to the therapist engaging in a non-professional relationship with a client or former client and/or inappropriate self- disclosure. Some of the relevant aspects of the Ethical Framework in relation to this are: 

21. We will respect our clients’ privacy and dignity. 

33 We will establish and maintain appropriate professional and personal boundaries in our relationships with clients by ensuring that: 

a. these boundaries are consistent with the aims of working together and beneficial to the client. 

34. We will not have sexual relationships with or behave sexually towards our clients, supervisees or trainees. 

35. We will not exploit or abuse our clients in any way: financially, emotionally, physically, sexually or spiritually. 

48. We will avoid any actions that will bring our profession into disrepute. 

Overall, recent complaints have highlighted the importance of the appropriate management of endings, maintenance of boundaries, maintaining own fitness to practise and respect for client confidentiality.  

We have several resources that explore these topic areas in more detail in our 'What complaints tell us about.... ' series.  

Read more...