UKCP fails to sanction therapist despite admitting destroying notes

A couple of weeks ago I published the apparent mishandling of a Fitness to Practice inquiry by the UK Council for Psychotherapy. The UKCP took over three years to find proven seven allegations against John Smalley, a Jungian analyst from the Independent Group of Analytical Psychologists. These allegations related to smoking during therapy, making derogatory remarks about clients to other clients, blurring the boundaries between his art business and therapy, and introducing two clients to each other in inappropriate circumstances.

Not only did the UKCP take an inordinate amount of time to come to these findings, but once they did, they failed to apply any sanction at all to Mr Smalley. He was just sent merrily on his way. This is even more shocking when I discovered a startling admission from the hearings. Mr Smalley freely admitted that he destroyed his notes.

At a hearing on 9th December 2011, the complainant’s barrister was quizzing Mr Smalley on his witness statement.

As a professional, there’s two things here that are absolutely shocking to me. First, “It’s not my practice to keep notes and there’s no professional requirement to do so.”  Throughout my nurse training, I had it drilled into me, “If you haven’t documented it, you haven’t done it.” I’ve lost count of how many times I was told that.

The Nursing and Midwifery Code is quite clear about this.

42. You must keep clear and accurate records of the discussions you have, the assessments you make, the treatment and medicines you give and how effective these have been
43. You must complete records as soon as possible after an event has occurred
44. You must not tamper with original records in any way

Okay, that’s the obligation for nurses. Is it different for psychotherapists?

Smalley’s UKCP member organisation is the Independent Group of Analytical Psychologists. Their Code of Ethics isn’t on their website. I e-mailed them on May 31st and asked if I could see a copy. They didn’t reply.

What about the UKCP itself? Their Ethical Principles and Code of Professional Conduct is on their website.

8. Records
8.1 The psychotherapist agrees to keep such records as are necessary to properly carry
out the type of psychotherapy offered.
8.2 The psychotherapist commits to store and dispose any personally identifiable records
or data securely in order to protect the client’s confidentiality.

I’m still not so clear.  A psychotherapist has to “keep such records as are necessary”? Frankly, that’s a bit vague and wishy-washy. Compare it to the NMC Code and the difference in wording is stark.

The second thing that shocks me is that he admits destroying notes. This seems to be something that the complainant’s barrister was trying to catch him out on, while discussing a dispute over the provision of receipts.

In my NHS trust, it’s certainly not considered acceptable to destroy notes 6 months after a patient is discharged. There are good reasons for this. A civil tort can be brought up to six years after the event. As for a fitness to practice inquiry, that can be brought at pretty much any time. Oh, and there’s that unambiguous statement in the NMC Code that I have to follow. “You must not tamper with original records in any way.” I don’t even destroy my old work diaries from previous years. Never mind notes.

After such a black-and-white statement in the middle of a hearing, the UKCP still decided his fitness to practice was not impaired, and didn’t sanction him.

Both IGAP and UKCP have indicated that they do not wish to discuss the specifics of this case.

This is an organisation whose own chair recently told its members, “There has been too much crony-ism and amateurism in the conduct of complaints for far too long.” Could this be the sort of thing they were talking about?

More from the Independent Group of Analytical Psychologists

Continuing my exploration into the murky world of psychotherapy regulation, I’ve just had another e-mail from the Independent Group of Analytical Psychologists.

The story so far…I discovered that it had taken three and a half years for a fitness to practice hearing to find seven allegations proven against a Jungian analyst, John Smalley. Despite this no sanctions were issued against him. Mr Smalley is a member of the Independent Group of Analytical Psychologists (IGAP), a member organisation of the United Kingdom Council for Psychotherapy.

I’d been exchanging e-mails with IGAP, who confirmed they found no case to answer against Smalley (the complainant then appealed to the UKCP, which found their decision “perverse and incorrect”).

My last e-mail read.

Thank you for your information.

In such cases where there has been a breach of the Code of Ethics, where are they publicised? How many such cases have there been?

Does IGAP intend to sign up to the Central Complaints Process?

Zarathustra

The UKCP’s new Central Complaints Process (CCP) is intended to replace the current “two-tier” complaints system, where people first complain to the member organisation and then can appeal to the UKCP if unsuccessful.

Dear Zarathustra

Since the UKCP Central Complaints Process is not yet finalised, it is too early to say if IGAP will sign up to it or not, but is likely to do so if it is felt to match our professional standards and has nothing that contradicts our existing Code of Ethics.

As regards breaches of our Code of Ethics, we keep any such cases on file, as required, for a minimum of six years. There has been no such breach for several years now, so there is nothing publicised anywhere.

Being a small organisation we do not have the resources to continue a correspondence. Please direct any further enquiries to UKCP.

Regards

IGAP Ethics Committee

Hang on a minute, the UKCP is saying that the CCP “will be in place for all UKCP registered members by the end of next year.” But here’s at least one member organisation with a view that basically amounts to, “Well, we’ll consider it.”

That begs an interesting question. What will happen if a member organisation simply refuses to sign up to the CCP? Will they be expelled from the UKCP?

Not that the CCP exactly covered itself in glory during the Smalley case either. The process took two years to decide that there was misconduct, but they weren’t going to do anything about it.

Interesting also, that IGAP has admitted that the reason I couldn’t finding any hearing outcomes on their website is because they haven’t found a breach of their Code of Ethics in years. Okay, they’re a small organisation (I counted 56 analysts on their member list), but not one instance of misconduct in years? That doesn’t inspire confidence, especially when we’ve found at least one instance when a “no case to answer” decision by IGAP was ruled “perverse and incorrect”.

 

 

The Smalley Case and the Independent Group of Analytical Psychologists

This weekend I published the findings of a fitness to practice hearing for a Jungian analyst with the UK Council for Psychotherapy. It took three and a half years to find seven allegations proven, but not to apply any sanction. The UKCP is planning to replace its current “two-tier” complaints system, where people complain first to the therapist’s member organisation, and then UKCP hears appeals if the complaint is successful. Under the new system, there will be a single Central Complaints Process (CCP) which all the member organisations will be expected to sign up to.

The analyst, a Mr John Smalley, is registered with a UKCP member organisation, the Independent Group of Analytical Psychologists. A complaint was initially made to them, and they found no case to answer, which prompted an appeal to the UKCP. IGAP’s decision was found to be “perverse and incorrect”, and the complaint was sent to the new CCP.

I decided to ask IGAP their views on the case, and got some terse and unhelpful replies before they stopped replying altogether. Arguably these e-mails show a distinct lack of transparency on the part of some psychotherapy organisations, and possibly a lack of communication between the UKCP and their members organisation.

On 18th May, I sent them the following e-mail:

To the person responsible for handling press queries

My name is Zarathustra. I am a blogger who writes for the Not So Big Society at https://notsobigsociety.wordpress.com. In particular I write about the regulation of psychotherapy.

I understand that an IGAP/UKCP psychotherapist, John Smalley, was recently the subject of a UKCP fitness to practice hearing, and the result was that four allegations were found proven, but no sanctions were applied.

IGAP originally found that there was no case to answer against Mr Smalley., but this decision was found to be “perverse and incorrect” by the UKCP Central Final Appeals Panel. Does IGAP stand by its previous findings?

Are you satisfied with the manner that the UKCP conducted the hearings? I understand that it took two years for them to resolve the issue. Do you consider this to be a timely response?

Do you still have confidence in Mr Smalley’s fitness to practise?

Does IGAP intend to sign up to the UKCP’s Central Complaints Procedure?

The outgoing UKCP chair recently stated, “There has been too much crony-ism and amateurism in the conduct of complaints for far too long.” Do you agree or disagree with this comment?

The deadline for the article I am writing is Friday 25th May.

On the 22nd May, I got the following reply.

In response to your queries we have to state that IGAP’s ethical obligations about confidentiality prevent us from giving information beyond publicising the outcome of a hearing where there has been a breach of our Code of Ethics and Practice.

In the case you mention we confirm that IGAP found no case to answer. We cannot confirm the statements you made referring to UKCP.

IGAP Ethics Committee

Not a very detailed response, I have to say. I decided to press them for more detail.

Thank you for your response.

I couldn’t actually find those hearing outcomes where there has been a breach of the Code of Ethics. Where do you publicise them? How many such outcomes have you published in the past?

Has IGAP yet made a decision as to whether to sign up to the UKCP Central Complaints Process?

regards

Zarathustra


I still haven’t found anywhere that lists hearing outcomes for breaches of the IGAP Code of Ethics. As far as I can take, they’re not listed anywhere on their website. For that matter, the website doesn’t even seem to display their Code of Ethics. It doesn’t even say how to make a complaint. For comparison purposes, here’s the very extensive Professional Conduct pages for the British Association of Counselling and Psychotherapy, with their Ethical Framework here, outcomes published here and an online complaint form here.

Anyway, on the 25th May, I got this reply from IGAP.

Dear Zarathustra

Nothing is publicised where there has been no breach of the Code of Ethics.

IGAP has had no further information from UKCP in the case you refer to.

Regards

IGAP Ethics Committee

Well, that really didn’t answer my question. Though I find it very interesting that UKCP found seven allegations proven against an IGAP-registered therapist, but IGAP appear to be suggesting that UKCP haven’t told them that! Or have I read that wrong?

I sent them another e-mail.

Thank you for your information.

In such cases where there has been a breach of the Code of Ethics, where are they publicised? How many such cases have there been?

Does IGAP intend to sign up to the Central Complaints Process?

Zarathustra

So far, no response to this e-mail. [Edited to add: I’ve since had a further reply from IGAP. The discussion continues here.]

This shows the lack of transparency of some UKCP member organisations. I still don’t know where they publish outcomes of breaches of ethics, or what their Code of Ethics even is, for that matter. I don’t know whether they plan to sign up the Central Complaints Process. But I just can’t get over their claim that they’ve “had no further information from UKCP” regarding the case.

UKCP takes 3 and a half years to not sanction a therapist

Back in February I obtained some court documents relating to a psychotherapist who was on a fitness to practise hearing with the UK Council for Psychotherapy. The case was a failed attempt by John Smalley, a Jungian analyst, to have a judicial review of his hearings on the grounds of delay. Since then a copy of the final ruling has landed in my e-mail inbox. On 16th March 2012, the UKCP complaints panel decided that seven allegations had been proven, but that these did not impair his fitness to practise, and that there would therefore be no sanction.

From the time a complaint was originally received by his UKCP member organisation, it’s taken a grand total of three and a half years to reach this conclusion (over 3 years of which were spent in UKCP’s Central Final Appeals (CFAP) and Central Complaints (CCP) procedures), stringing out both complainant and registrant for an inordinate length of time. The case illustrates some of the problems in complaining against a UKCP-registered psychotherapist.

Mr Smalley is a member of the Independent Group of Analytical Psychologists (IGAP), which is a member organisation of the UKCP. Currently anyone making a complaint must first complain to the member organisation. If the complaint is rejected, they can then appeal to the UKCP. This process has such a poor reputation that even the UKCP’s own former chair recently admitted that, “There has been too much crony-ism and amateurism in the conduct of complaints for far too long.” The UKCP complaints archive is surprisingly small. In fact, it lists only two decisions in the last three years – one of which was Derek Gale, a notorious abuser who was struck off by the Health Professions Council before the UKCP struck him off.

At present the UKCP is moving towards replacing this two-tier system with a single Central Complaints Process (CCP), though this has reportedly been met with resistance from some of the member organisations.

In August 2008 IGAP received a complaint against Smalley from a former client (or analysand, as they’re sometimes called in psychodynamic therapies). IGAP initially ruled in November 2008 that there was no case to answer, and also turned down an appeal in January 2009, but the complainant then appealed this decision to the UKCP’s Central Final Appeals Procedure (CFAP) in February 2009.

The CFAP ruled that IGAP’s decision had been “perverse and incorrect”, and ordered that the case be heard before the new Central Complaints Process. Incredibly, it took them until March 2010 – over a year – to come to this decision.

Cue another year and a half of procedural faffing and delays, resulting in the attempt by Mr Smalley to have a judicial review on grounds of delay, before the final UKCP hearings were scheduled for December 2011. And finally in March 2012 (another four months later!) the UKCP gave its ruling.

A number of other allegations were found to have been not proven.

The panel ruled that Mr Smalley had reflected on his errors, that there was no evidence of financial gain from his misconduct, and that no other complaints had been received. For that reason they decided not to apply any sanction.

It’s taken three and a half years from the time IGAP first received a complaint, and over three years since the complainant first lodged an appeal with the UKCP. All to arrive at this not-very-impressive result. For comparison purposes my own regulator, the Nursing and Midwifery Council, aims to resolve Fitness to Practise hearings within 18 months.

During the process, Mr Smalley’s services continued to be advertised on the IGAP website, with no mention that his fitness to practice was being called into question.

From what I’ve been told, it sounds like both Mr Smalley and the complainant have remonstrated bitterly about this inordinate length of time.

I e-mailed IGAP for comment, and received the following reply.

In response to your queries we have to state that IGAP’s ethical obligations about confidentiality prevent us from giving information beyond publicising the outcome of a hearing where there has been a breach of our Code of Ethics and Practice.

In the case you mention we confirm that IGAP found no case to answer. We cannot confirm the statements you made referring to UKCP.

The UKCP said of the case:

Our fitness to practise and complaints processes aim to be fair, transparent and proportionate, and to work in the public interest. At present we have a two-tier system, with our organisational members dealing with the first stage of a complaint and UKCP acting as the appeal body. This can mean that cases take longer to conclude than we would like. We work hard to reduce delays but sometimes they occur for reasons outside our control – for example, the availability of all parties.

This particular case took longer than normal, partly because it was considered by two separate panels when an appeal panel referred it to UKCP’s Central Complaints Process.

We are confident that we gave sufficient opportunities to the parties and their legal representatives to put forward their views to receive a fair and transparent consideration and this inevitably lengthened the timescale. We had four public hearings, including a two-day hearing, one judicial review application, both in writing and a high court hearing. The parties were able to present their views, and all parties were legally represented. There was further delay when one hearing had to be adjourned because of circumstances beyond our control.

The final hearing of this case was decided by an independent panel, and they documented their decision and reasons.

Complaints against UKCP psychotherapists do not normally take 3 years to resolve. In fact we have never had a case like this one, and hope we never again have a case that takes so long to resolve. We recognise that there is room for improvement and we are committed to review and improve our processes. For example, we are currently introducing a centralised complaints system which will replace the two-tier system. This will be in place for all UKCP registered members by the end of next year.

I e-mailed Mr Smalley for comment, but did not receive a reply.

If I was a client of a UKCP-registered psychotherapist, I’d be worried about this. If I were to make a complaint, I’d like to feel it would be processed without excessive delay.

Likewise, if I was a UCKP registrant, I wouldn’t be very happy either. I wouldn’t want to be strung out for three years wondering whether I might be struck off.

At present there is no statutory regulator for psychotherapists, though organisations such as the UKCP are supposed to provide self-regulation of the profession. The previous Labour government was proposing that psychotherapists become regulated by the Health Professions Council, which currently regulates arts therapists, occupational therapists and clinical psychologists. The Con-Lib coalition shelved that plan in favour of a proposal for “assured voluntary registration” where the likes of the UKCP could apply for an official stamp of approval from the Council for Healthcare Regulatory Excellence (to be renamed the Professional Standards Authority).

This case appears to show that the UKCP’s complaints system has some serious problems. The therapist’s member organisation decided there was no case to answer, even though he was smoking in therapy! It then took over a year just to agree to hear the complainant’s appeal and send it forward into the new Central Complaints Process.

But even then the CCP took two years to find at least some of the allegations proven, but not do anything about it.

Is the UKCP ready yet to receive approval from the CHRE/PSA? I’d say this case raises some question marks about that.

A Dangerous Method Indeed: Therapist Investigated for 3 Years, Still Able to Practise

Today the David Cronenberg film, A Dangerous Method, was released. It depicts the pioneering psychoanalyst Carl Jung (played by Michael Fassbender) engaging in what would now be considered serious professional misconduct.

A Dangerous Method

In a chilling parallel, The Not So Big Society has obtained court documents showing a Jungian psychotherapist has been under investigation for alleged misconduct for over three years, apparently with no conclusion reached. Throughout this period he has been able to continue advertising his services with no warning that his fitness to practice may be impaired.

The case is likely to raise serious questions about the way psychotherapy is regulated in the UK.
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