The Stuart Macfarlane case – the UKCP responds

Today I published the story that Stuart Macfarlane, a psychotherapist registered with the Guild of Analytical Psychologists and UK Council for Psychotherapy, had been suspended for two years due to serious sexual misconduct with a mentally ill patient. The normal sanction for this kind of misconduct is a striking-off, not a suspension.

Earlier in the week I’d e-mailed the UKCP. This is what I asked them.

Thanks for your e-mail. I was just about to contact you as it happens. The story is regarding Stuart Macfarlane, who is currently suspended for two years by the Guild of Analytical Psychologists (formerly the Guild for Analytical Psychology and Spirituality).

Can you confirm that this was for serious sexual misconduct with a patient (a vulnerable adult with mental health issues)? 

Does the UKCP have an opinion on GAP’s decision to suspend rather than strike off Mr Macfarlane?

Is there a reason why Mr Macfarlane’s case is not on the UKCP complaints archive?

Will Mr Macfarlane be allowed to re-register with the GAP/UKCP at the end of his suspension?

I’ll be aiming to publish on this story on Friday, so I’d appreciate any response from the UKCP before then.

The UKCP’s response arrived Friday lunchtime, so wasn’t included in my original post. That said, it’s quite a long response, so it’s probably worth giving it a post of its own.

The complaint against Stuart MacFarlane was handled by a UKCP member organisation. I am sure you will address your questions about the detail of the case to that organisation. We are unable to comment on their complaints process or details of the case because we are an appeals body.

We do not publish decisions made by other organisations because this falls outside our policy on the publication of decisions. This policy is available on our website:

We are unable to make speculative comments on whether a named individual would be allowed to re-register. We have a proper process for cases to be considered. What we can say is that for any member wishing to re-register at the end of a sanction, UKCP’s Registrar would consider the possibility in light of whether the sanctions were complied with, along with other factors.

The UKCP member organisation that has made decisions about Mr Stuart MacFarlane, has issued public statements about the case which you can find here:

We are utterly in favour of strong regulation. We have regulatory systems to protect the public and the privacy of those involved. Those systems include controls on qualifications, entry to our register and fair systems for dealing with those cases where there is reason to question whether someone should be allowed to continue on the register. And within these strict processes we have lay and professional involvement, and access to appeals where someone feels a case has not been handled properly. For that reason we can’t engage in speculation about cases or trial over the internet.

So, if a UKCP-registered therapist is disciplined by a UKCP member organisation, this doesn’t get published by the UKCP? That’s surprising, to say the least. I looked up their publications policy for fitness to practise decisions, and there it indeed is.

Decisions of Member Organisations
22. UKCP will not publish the determination of an organisational member, where complaints had originated from the organisational member complaints process.

The policy is dated 29th November 2012. I presume this must be a change in policy, because they’d previously published the determination for Geoffrey Pick, suspended by the Arbours Association in May 2011, also for serious sexual misconduct (he was subsequently allowed to re-register both with Arbours and UKCP, and then resigned when the media started to take an interest).

Admittedly this is an issue that eventually should become moot for future cases as all the member organisations sign up with the UKCP’s new centralised Complaints and Conduct Process. However, that doesn’t protect the public in this particular case.

I think I’ll address their final comment about “trial over the internet”. I’m not a fan of trial by internet either. I’m a fan of trial by…well, trials. Or at least trial by fitness to practice hearing. And Mr Macfarlane has indeed had a hearing where there was a finding of fact. I’ve e-mailed the GAP, the UKCP and Macfarlane, and so far none of them have disputed the facts that I’ve queried. Admittedly that’s partly because they didn’t tell me much anyway. Even so, none of them have e-mailed me back saying, “No, no, it definitely wasn’t serious sexual misconduct!”

What concerns me here isn’t so much the fact finding as the way it was published (or wasn’t), and the kind of sanction imposed. At the risk of repeating myself from previous posts, here is the indicative sanctions guidance that the Nursing and Midwifery Council uses.

 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.

Given that this is not only a case of serious sexual misconduct, but one in which significant harm was inflicted on a vulnerable adult, it seems inconceivable that this wouldn’t have resulted in a striking-off anywhere else. And even if it was conceivable, there’s that line about how panels should be “particularly careful in explaining clearly and fully the reasons why they made such a determination.” The GAP’s statement is clearly not particularly careful to explain this. If anything, it’s particularly vague. If I hadn’t gone digging, it wouldn’t be clear at all that it was a case of this severity.

For that reason, what I’m engaging in here is not trial by internet, but the use of Google as safeguarding by other means.

A second therapist commits serious sexual misconduct, is not struck off

Back in April I broke the news of Geoffrey Pick, a psychotherapist registered with the Arbours Association and UK Council for Psychotherapy. After conducting an “inappropriate relationship” with one of his patients, he was suspended for a year instead of struck off. He was then allowed to re-register with the Arbours and UKCP. Only when it came to media attention did he resign his registration. Shockingly, I’ve now discovered that this is not the only case of its kind.

A couple of months ago I was researching this blog post, which I wrote after I’d noticed that a high percentage of psychotherapists facing misconduct hearings seemed to be Jungians (Pick was from a Jungian background). It was pointed out to me that there was a case involving a Jungian that didn’t appear in the UKCP complaints archive. Stuart Macfarlane had been suspended for two years by the Guild of Analytical Psychologists (formerly the Guild for Analytical Psychology and Spirituality). The details of what he did were rather vague.

Stuart MacFarlane has been found to be in breach of the GAP Code of Ethics 2008 (1.7) in
two areas:
1. personal relationships – infringing and violating the trust of a client
2. inadequate standards of practice.

He has also been found to have breached the Code of Ethics 2008 (3.6) concerning
Professional Boundaries:

3.6 psychotherapists shall not take advantage of or exploit the dependent nature of the
therapeutic relationship, current or past, for example with regard to fees, sex or in any
other respect.

These breaches constitute Serious Professional Misconduct under section 7.1(b) of the
Code of Ethics.

I’ve since been able to establish that Mr Macfarlane engaged in serious sexual misconduct with a client. The individual in question is a vulnerable adult with mental health difficulties. As a consequence of his actions, she experienced a deterioration in her mental health. She continues to receive psychiatric support.

To give a comparison of what would usually be the sanction, here’s the indicative sanctions guidance for my own regulator, the Nursing and Midwifery Council.

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.

Macfarlane, however, was not struck off. He received a two-year suspension order. Potentially at the end of this he could be allowed to rejoin the Boy’s Club, sorry, Guild of Analytical Psychologists, and resume practice. Oh, and he was also ordered to write a letter of apology to the client and refund her fees – as though she’s a dissatisfied customer at Sainsbury’s rather than somebody subjected to the worst possible breach of boundaries.

I e-mailed the GAP. They declined to elaborate further on his misconduct besides the information posted online. I asked why he was not struck off and whether he would be allowed to re-register. They replied, “The decision reached was in accordance with the complaints process set out under the G.A.P. Complaints Procedure Code, which emphasises the confidentiality of the proceedings. We are unable to comment on an individual’s possibility of being allowed to re-register until the suspension period has ended, and such matters as compliance with the sanctions have been considered.”

And why is his case not in the UKCP’s online complaints archive? The outcomes listed there are, by and large, far less serious than Macfarlane’s. In case there’s any doubt that Macfarlane was a UKCP therapist, here’s his entry on the register, dated 29th October 2011.

Stuart Macfarlane UKCP Page

I e-mailed the UKCP to ask why he’s not in the archive, and if he will be allowed to rejoin the UKCP register. I haven’t so far received a reply. [Edited to add: the UKCP have now responded]

I did, however, get a reply from Macfarlane himself.

Thank you for your email, and for giving me the opportunity to answer your questions in advance of your publishing. I have made a mistake and I am doing all I can to make amends, including attending therapy weekly.
I broadly support your goal to improve and standardise regulation across the psychotherapy profession, but as I do not agree with the way you are going about it, I shall not be engaging any further with you about this .
However, I wish you well.
Another therapist who has completely overstepped the mark with his client, resulting in catastrophic consequences to a vulnerable person. And this time next year he could possibly be practising again.
Utterly unbelievable.

The #Pillshaming Bingo Card

The #Pillshaming Twitter hashtag was created by @Sectioned_ to refer to condescending articles and viewpoints, deriding the use of psychiatric medication. There’s been a fair few of these recently. In the Guardian Giles Fraser and Will Self leapt onto their respective soapboxes to pour forth a series of tired cliches. Today in the Daily Mail, Dr Joanna Moncrief published an article which has some valid points but also a lot of pillshaming tropes – prime among them that bipolar disorder has become “fashionable” because Stephen Fry and Catherine Zeta Jones have it.

Let’s get one thing clear. I have huge respect for Stephen Fry, but the fact that he has bipolar disorder tells us one thing and one thing only; that there are a lot of celebrities out there, and by a simple matter of statistics at least some of them can be expected to have bipolar disorder. I’m sure there are plenty of celebrities with diabetes: does that make diabetes fashionable too? I’m sure Mr Fry didn’t feel that he was making a high-end fashion statement when he attempted suicide earlier this year. (“This is not just an overdose, this is an M&S overdose…”)

I would respond more to Dr Moncrief’s article, but Purple Persuasion has already written an excellent rebuttal in which she concludes, “Sad to say that when it comes to discussing bipolar and to mental health drugs, it’s lazy journalism that seems to be really in fashion.”

And it’s this lazy journalism that prompted @Sectioned_ to ask me to create a #Pillshaming bingo card, to accompany my Twitter Drama bingo card. As well as scanning the articles by Fraser, Self and Moncrief, I also had suggestions of pillshaming tropes tweeted to me by @Sectioned_, @MarkOneinFour, @BettyGudrun, @444BlackCat and @KennerleyWendy. It really didn’t take me long to fill the squares.

So, without further ado, here is the #Pillshaming Bingo Card.




Oxfam speaks out on human cost of austerity

Today Oxfam published their briefing paper, A Cautionary Tale: The true cost of austerity and inequality in Europe. They describe the enormous suffering and waste that austerity measures have caused both in Britain and elsewhere in Europe. As a mental health professional, I’m particularly disheartened that suicide rates are increasing in the UK after years of decline. They’re also on the increase in Spain. I suspect this tragic increase is a reflection of lower standards of living, greater inequality, higher unemployment and the slashing of public services to help vulnerable people.

Oxfam point out that this is a tale they’ve seen elsewhere.

The European experience bears striking similarities to the structural adjustment policies imposed on Latin America, South-East Asia, and Sub-Saharan African in the 1980s and 1990s. Countries in these regions received financial bailouts from the IMF and the World Bank after agreeing to adopt a range of policies including public-spending cuts, the nationalization of private debt, reductions in wages, and a debt management model in which repayments to creditors of commercial banks took precedence over measures to ensure social and economic recovery. These policies were a failure; a medicine that sought to cure the disease by killing the patient.

They also have some unpleasant predictions for the future.

Austerity measures will have impacts beyond their period of implementation. The Institute for Fiscal Studies predicts that poverty rates in the UK will have increased by between 2.5 and 5 percentage points by 2020, equivalent to 2.7 million more people living in poverty.

Europe could have an additional 15 to 25 million people living in poverty by 2025 if austerity measures continue, equivalent to the population of the Netherlands and Austria combined.

At best, the countries most affected by austerity will become the most unequal in the Western world. At worst, they will rank amongst the most unequal anywhere in the world.


Oxfam point out that austerity isn’t even succeeding on its own terms, with most EU countries seeing their debt-to-GDP ratio go up, not down.

Ireland’s return to growth is often held up as an exception to the above. Yet Ireland potentially offers a window into the future for other EU countries, with reports of high levels of regional income inequality, insecure employment and significantly decreased spending power. Moreover, Ireland is highly dependent upon the state redistributing income through taxes and transfers, a feat which is likely to diminish as austerity measures continue to bite.

They call for an end to this failed approach, arguing that the EU should accept that much of the current public debt is simply unpayable, and should negotiate a restructuring or cancellation of the debts. This should be combined with stimulus programmes, investment in public services, strengthening of democracy and fairer taxation.

You can read the full report here.


More on the loophole that unscrupulous psychotherapists could use to keep practising

Last week I discussed possible ways that a psychotherapist might avoid a misconduct investigation under the new system of “assured voluntary registration” (AVR). Since then I’ve been making some enquiries to the relevant professional bodies, and have had some replies.

Quick recap: after the 2010 general election the incoming Coalition government shelved plans to make counselling and psychotherapy state-regulated professions, opting instead for AVR. Under this new system, existing professional bodies such as the British Association for Counselling and Psychotherapy and the UK Council for Psychotherapy could apply to have their self-regulating procedures accredited by the Professional Standards Authority. The BACP has already achieved PSA accreditation. The UKCP is working towards this, and has brought in a new Complaints and Conduct Process in order to comply with the standards required by the PSA. However, not all UKCP member organisations are signed up to the new process yet, and so the UKCP has not yet achieved accreditation.

Somebody recently tried to complain to the UKCP against their former therapist, making extremely serious allegations. However, the therapist had already resigned his registration, so there was nothing the UKCP could do to investigate.

I e-mailed the following scenario to the UKCP, BACP and PSA, and asked them for comment.

Is there provision to safeguard against a psychotherapist resigning from a PSA-accredited body to pre-empt an imminent complaint against them, and then perhaps later re-registering with another body?

To take a hypothetical example, in which one assumes that the UKCP has become PSA-accredited. In this example a BACP-registered psychotherapist learns that a complaint is about to be made against him. He promptly resigns from the BACP register before the complaint is made, thus preventing it from going forward. At a later date he attempts to register with the UKCP.

Under such a scenario, would the UKCP have access to a “paper trail” which would alert them to the fact that an attempt at a complaint had been made? Will there be information-sharing between the various AVR bodies with regard to such potential issues?

I got the following reply from the UKCP:

Your question about whether information sharing or paper trails form part of AVR should be addressed to the PSA. We can’t answer on their behalf. What we can do is tell you about the ways we aim to safeguard our register.

When someone applies for UKCP registration, they are asked to declare if they have been disciplined by any professional body or membership organisation responsible for regulating or licensing a health or social care profession. We investigate all declarations, contacting the body in question and taking appropriate action.

If someone has been struck off a statutory/voluntary register and applies for UKCP registration, they would have to declare this. We would then refer the details to our Professional Conduct Committee for advice. We would then make a decision to grant registration, grant registration with conditions, or refuse to grant registration.

UKCP’s complaints and conduct process prevents a registrant from resigning once we have received notification of a complaint or concern. If someone is in good standing at the point of resigning we cannot prevent them leaving; this is the case for other regulators.

As far as we know, what we do is similar to other registration bodies – statutory or otherwise. [emphasis mine]

The UKCP is correct that if somebody resigned prior to a complaint being made, other regulators wouldn’t open an investigation either. But here’s a difference: if a nurse resigns from the Nursing and Midwifery Council, they’re effectively striking themselves off. “Nurse” is a protected title and you have to be NMC-registered to use it and to apply for jobs. This isn’t the case for “counsellor” or “psychotherapist”. Because they’re not protected titles they can carry on working regardless of whether or not they’re still registered.

I got a particularly interesting reply from the BACP:

Any BACP member complained against is prevented from resigning from membership in order to avoid accountability under our Professional Conduct Procedure. However, this only currently applies if a complaint has already been received by the Registrar. A former member cannot be held to account under the current procedure if the complaint is received after resignation of membership.

We are currently engaged in the process of changing this procedure. This change will be implemented at the earliest possible opportunity and will enable us in future to hold former members to account for their practice whilst they were in membership, subject to the conduct procedure in effect at the time.

We publish the outcomes of all conduct cases where the complaint has been upheld (either in full or in part) on our website, where they are available to the public, as well as other professional bodies.

I would like to add that this response relates specifically to BACP – we can’t speak for or on behalf of the Professional Standards Authority or other accredited registers.

I’m sorry that I’m unable to give you any idea of timings, but if you would like me to I’m happy to get in touch with you with relevant updates as I’m aware of them. [emphasis mine]

So, the BACP are changing the rules? This makes a lot of sense. If the jurisdiction of a complaint is based on whether they were registered at the time of the alleged incident rather than at the time of the complaint, then that makes it easier to generate a paper trail that might alert other bodies.

Also, given that a lot of people who use psychotherapists hire one privately, it’s also worth emphasising the value not just of a paper trail but also a Google trail. If somebody’s fitness-to-practice ruling is up on the relevant body’s website (or if some sneaky blogger has broadcast the details – hi there!) then a member of the public searching for information about that therapist could be forewarned.

Since the BACP appear to have made a very sensible decision, I hope that other AVR bodies will follow suit.

Finally, here’s the response from the PSA:

Information sharing between holders of Accredited Voluntary Registers (AVRs) in the interests of the public is an important part of accreditation and is an explicit requirement of our standards.

If a registrant is removed from an AVR and subsequently applies to join a different AVR, this must be disclosed to the second AVR and must be taken into account in any decision. Withholding such information would be a clear breach of our standards.

In the example provided, the Professional Standards Authority would expect AVRs to work in partnership to protect the public, even if no formal complaint has been investigated.


The loopholes that can enable unscrupulous psychotherapists to keep practising.

There’s no doubt that times are changing for psychotherapists in the UK. Although plans to make psychotherapy a state-regulated profession were shelved when the Coalition took over from Labour, the new system of “assured voluntary registration” (AVR) is increasingly gearing up. However, the loopholes in this system are starting to show, and those loopholes could put the public at risk.

A quick primer on AVR. It’s basically a form of regulation-lite where existing professional bodies can apply for accreditation from the Professional Standards Authority (formerly the Council for Healthcare Regulatory Excellence, which oversees the work of regulators like the General Medical Council, Nursing and Midwifery Council etc). The British Association for Counselling and Psychotherapy has already achieved PSA accreditation. The other main professional body, the UK Council for Psychotherapy, is working towards it.

At least one loophole has now emerged. An individual recently tried to make a complaint to the UKCP about her former psychotherapist. The allegations were extremely serious, and have been the subject of litigation. However, she was told by the UKCP that she couldn’t make a complaint against him as he had already resigned from their register.

To be fair to the UKCP, the exact same thing would happen if somebody tried to complain to the Nursing and Midwifery Council against a nurse who had previously resigned. They probably wouldn’t be allowed to resign after a complaint has been made, but if they’ve already left the register then it would be outside the NMC’s jurisdiction and there’s nothing they can do.

But here’s the difference. “Nurse” is a protected title and you have to belong to the NMC register in order to practice as one. Any nurse who resigns their registration is effectively striking themselves off. “Psychotherapist”, however, is not a protected title, and you can belong to any professional body or none. As AVR becomes more established it’s likely that a psychotherapist wouldn’t get work from the NHS, social services, schools, universities or the voluntary sector without belonging to a PSA-accreditated body. However, for any practitioner who’s outside of that, accepting self-referrals from the public, anything goes.

All this comes at a time when psychotherapy services are being decimated in the NHS under the pressure of cuts. Waiting lists of six months or more for talking therapies are commonplace, if they can be accessed at all. They’re frequently on a time limit, such as six sessions, regardless of whether or not six sessions are actually enough. The result is that people who feel they need therapy and can afford to do so are more likely to turn to the private sector to seek out a therapist.

Because AVR isn’t true statutory regulation in the manner of doctors, nurses, social workers etc, a psychotherapist who suspects a complaint may be imminent can just resign from their professional body and carry on practising.

Possibly they might join another professional body. For example, the College of Psychoanalysis UK which isn’t PSA-accredited, though they do have a complaints procedure. You can read it here. Complaints have to be proven to the criminal standard of “beyond reasonable doubt” (the usual standard of proof for such hearings is the civil standard of “on the balance of probabilities”). If that isn’t enough to put people off complaining, then Part 5, Section 1.2.1, informs us that, “the Panel shall have the power in its discretion…to require the Complainant to pay such costs and expenses in the event of the complaint not being upheld.” In other words, prove the complaint beyond reasonable doubt or face a big bill. It’s almost as if they’re trying to put people off from complaining.

Or, of course, a therapist can just not bother to join any organisation, but carry on seeing their existing clients and advertising their services.

All this shows why psychotherapy needs proper statutory regulation rather than the halfway fudge of AVR. In the meantime, my recommendation to anyone seeking a psychotherapist is to check that they remain registered with a PSA-accredited body such as the BACP.