A few days ago I commented on this recent decision by the UK Council for Psychotherapy to give a Jungian therapist, Rob Waygood, a 6 month suspension rather than a striking-off. Waygood admitted to starting a sexual relationship with a client shortly after the therapy ended. There is no statutory regulator for counselling or psychotherapy, but the UKCP recently became an “accredited voluntary register” with the Professional Standards Authority.
Before exploring this case further, I’m going to put something out there. When I’ve discussed similar cases in the past on this blog, I’ve subsequently wound up getting e-mails from people who know more about those particular cases. I’ve no idea if there’s anyone out there in a similar situation who happens to be reading, but if they are, my e-mail address is thus_spake_z at hushmail dot com.
For my own regulator, the Nursing and Midwifery Council, the indicative sanctions guidance is very clear.
In all cases of serious sexual misconduct, it will be highly likely that the only proportionate sanction will be a striking-off order. If panels decide to impose a sanction other than a striking-off order, then they will need to be particularly careful in explaining clearly and fully the reasons why they made such a determination, so that it can be understood by those who have not heard all of the evidence in the case.
Not only did the UKCP not strike Waygood off, but the original sanction was ridiculously lenient. A warning letter, plus an order to spend two years attending supervision. Such slaps on the wrist used to be absolutely typical of some psychotherapy organisations, particularly those of a psychoanalytic persuasion. There’s numerous past cases where serious boundary breaches were written off as transference gone wrong rather than abuse, and the therapist got sent on his way with nothing worse than a ticking-off.
In this day and age, and particularly now that the UKCP is an assured voluntary register, such token sanctions simply won’t do. The UKCP appealed the decision as unduly lenient, arguing that his behaviour “was fundamentally incompatible with the Registrant remaining on UKCP’s Register.” On appeal the sanction was increased to a 6 month suspension.
Given that the UKCP haven’t struck Waygood off, have they been particularly careful in explaining their reasons for such a determination?
I e-mailed the Professional Standards Authority to ask what they thought of the case. It’s the PSA’s policy not to comment on individual cases, but they did state that, “We expect all AVRs to take sexual misconduct seriously.” They also kindly provided me with a link to the relevant guidance.
I’ve been browsing the PSA’s, Clear sexual boundaries between healthcare professionals and patients: guidance for fitness to practise panels to see how it compares with the UKCP’s decision for Rob Waygood.
The PSA guidance doesn’t state anything along the lines of “for x misconduct, issue y sanction”. However, it does give some suggestions of what might be considered aggravating and mitigating factors.
Some of the aggravating factors they list include:
the vulnerability of the patient. Research shows that abusers often target vulnerable groups of patients, including those seeking help for mental health or emotional problems
The UKCP decision doesn’t give any indication of whether the client had any mental health issues or other vulnerabilities. That said, one could argue that anyone undergoing therapy is in a vulnerable position, particularly in a piece of psychodynamic therapy where you’re opening up your deepest thoughts to a stranger. We do know from the decision that the client suffered harm as a result of the relationship.
whether the healthcare professional took deliberate steps to facilitate abuse, for example scheduling the appointment as the last of the day, working without a chaperone being present, making inappropriate house calls, dissuading the patient from seeking a second opinion
In the Waygood decision, “Visiting the client’s house sometime between 18 and 21 April 2011 and acting in an affectionate manner” certainly reads like an inappropriate house call to me.
whether there was any grooming of the patient, ie did the healthcare professional deliberately cultivate an empathetic relationship with the patient over a period of time?
“Making a number of personal disclosures to the client regarding his sexuality and sexual history”? “Commenting on the client’s femininity during a therapy session”? “Hugging and kissing his client on the hair or neck on either 14 or 28 March 2011″? That sounds suspiciously like grooming.
whether the healthcare professional used confidential information obtained in the course of treatment to their advantage, for example by encouraging the patient to discuss marital problems whilst providing ‘a shoulder to cry on’
Yep. The decision accuses Waygood of, “Using material discussed in therapy to attempt to convince the client to pursue a relationship.”
Waygood was represented at his hearing by a Mr Glyn Oldfield of Brookfields Professional Conduct Services. This is a company that provides what looks to me like Tesco Value representation at misconduct hearings by non-lawyers, presumably for people who can’t afford a lawyer – though they don’t view it that way. They say, “You do not need a lawyer! Most disciplinary processes are not legalistic and what counts is detailed knowledge of your profession, the relevant procedures and how best to respond, not a general knowledge of the law!” I’d be interested to hear what an actual law firm would say about that – particularly a firm that specialises in representing professionals at fitness-for-practice hearings.
Waygood and Mr Oldfield presented a number of mitigating factors – he made an early admission, and demonstrated some insight into what he had done wrong.
The Panel was satisfied that that the Registrant had made early admissions in respect of these allegations and had not sought to deny the allegations, nor indeed to put the aggrieved party to the task of giving evidence at the earlier hearing, or at the Appeal.
Fair enough, he confessed his wrongdoing, and spared his client the ordeal of having to testify. But this results in something that rings an alarm bell for me.
Both Mr Oldfield and the Registrant submitted that the harm to the complainant had not fallen into the category of serious harm, and further that the complainant had not been present at the previous hearing and both her account and some matters of fact that were in dispute had not been tested (by cross-examination).
Was the complainant asked whether she thought the harm she incurred was serious or not? And besides, where does one draw the line between what is “harm” and what is “serious harm”? And even if she didn’t suffer serious harm, was consideration also given to the potential harm that could have been incurred by Waygood’s behaviour? As the PSA makes clear, the trauma from these kinds of boundary breaches has the potential to be absolutely huge and life-changing.
So, going back to that quote I found in the NMC Indicative Sanctions Guidance,
If panels decide to impose a sanction other than a striking-off order, then they will need to be particularly careful in explaining clearly and fully the reasons why they made such a determination, so that it can be understood by those who have not heard all of the evidence in the case.
Has the UKCP been particularly careful in that regard? As a personal opinion, I’d say not.