Revised and Amended. Approved at ACAT’s AGM 11 July 2014; revised February 2018; May 2020
The following abbreviations will be used throughout this document:
ACAT: Association for Cognitive Analytic Therapy
CAT: Cognitive Analytic Therapy
UKCP: United Kingdom Council for Psychotherapy
The purpose of the procedure is to provide a process which deals effectively with concerns and complaints about therapists who practise Cognitive Analytic Therapy (CAT). The process will protect clients and the public, and promote the quality of CAT.
The process is designed to:
ACAT’s Concerns and Complaints Procedure will deal with concerns and complaints about full ACAT members who are not full UKCP members. Concerns and complaints about ACAT members who are also full UKCP members will be dealt with by the UKCP Complaints and Conduct Procedure. Concerns and complaints about trainee practitioner members of ACAT will initially be dealt with by the employing NHS Trust or organisation and made known to the Course Director in their consideration of the training progress of the trainee. To comply fully with ACAT’s Code of Ethics, which imposes the same obligations on ACAT trainee members, the Concerns and Complaints Procedure allows for the Chair of the Ethics Committee, in consultation with the Chair of the Exam Board, to investigate any breaches of the Code by trainee practitioners and to determine in their sole discretion, whether membership should be suspended/terminated.
The ACAT Concerns and Complaints Procedure is available to the following as complainants: -
Breaches of ACAT’s Codes of Ethics and Practice which are alleged to have occurred when the person complained about was an ACAT member fall within the scope of the procedure. Note: the complainant may not articulate their concerns in such formal terms.
If a concern or complaint relating to the same conduct is being pursued by a third party organisation, ACAT may await the result of that organisation’s deliberations, and reserves the right to accept its judgement. This would be at the discretion of the Chair of the Ethics Panel, taking into account public protection issues, timescales, and levels of proof involved.
Alleged breaches of contract (except breach of the therapy contract), or claims for damages or compensation do not fall within the scope of this procedure. Nor do those arising from a member’s employment with a third party organisation (eg NHS Trust, private clinic).
Concerns and complaints should be lodged within three years of the occurrence of the conduct being complained of. Concerns and complaints outside this limit will only be considered in exceptional circumstances.
ACAT is unable to proceed with anonymous complaints except in exceptional circumstances and at the discretion of the Chair of Ethics Panel.
4. PRACTICE PRINCIPLES
The following key Practice Principles run throughout the process and inform its design:
5. STAGES IN THE PROCESS
Appendix 2 Procedure Flowchart
5.1 Initial Contact
When a concern or complaint is received by ACAT, it will be immediately referred to the Chair of the Ethics Panel, who will appoint a member of the Ethics Panel to be the Concerns and Complaints Officer for this particular matter.
5.2 Initial Screening
Within five working days of appointment, the Concerns and Complaints Officer will attempt to contact the complainant, listen to his/her concerns, consider whether the issue falls within the scope of the procedure, and discuss with him/her the options available and his/her preferences for taking the matter forward. In listening to the complainant, the Concerns and Complaints Officer will be alert to whether there are any indications for concern about the therapist’s wellbeing, and if so, confer immediately with Chair of the Ethics Panel. The options are:
Following the initial screening, the Concerns and Complaints Officer compiles a brief report, confers with Chair of the Ethics Panel, and takes action accordingly. The therapist is informed of the concern that has been raised and the action taken.
5.3. Formalising the Complaint
If the complainant does wish to proceed formally, s/he will be requested to complete the ACAT Complaints Referral Form (Appendix 4 Complaints Referral Form) and return it to the Concerns and Complaints Officer within fifteen working days of receipt. The Concerns and Complaints Officer will send a copy of the completed form and any additional information to the therapist, who will be requested to respond to the Concerns and Complaints Officer in writing, within fifteen working days of receipt. The Concerns and Complaints Officer will pass the complaint and response to the Chair of the Ethics Panel for screening.
5.4. Screening a Formal Complaint
The Chair of the Ethics Panel considers how serious the complaint is and how provable it is. The Chair of the Ethics Panel may ask the complainant and therapist for more information, in writing, and any such information will be shared with the other party.
If the Chair of the Ethics Panel, in consultation with the Chair of ACAT, decides there is not enough information to support the allegation(s), s/he will write to the complainant and explain why. The complainant can take this information into account, and resubmit the complaint within five working days. If the Chair of the Ethics Panel considers that the submission and further information still do not provide enough information to support the allegations, s/he will designate the complaint as unsubstantiated, whereby no further action is taken, and will write to the complainant accordingly.
If the Chair of the Ethics Panel considers that there is sufficient information to support a prima facie case that the ACAT Codes of Ethics and Practice have been breached, then s/he considers the likely seriousness should the complaint be upheld. If s/he considers that it is unlikely that sanctions imposed would restrict the therapist’s practice, s/he will instruct an Investigation Panel. If s/he considers it likely that sanctions might include restrictions on practice, in consultation with the Chair of ACAT, s/he will instruct an Adjudication Panel.
5.5. Investigation Panel
An Investigation Panel is made up of up to three members of ACAT's Ethics Panel, including at least one lay member. The panel will be chaired by one of the ACAT members. It will investigate and adjudicate the complaint on the basis of all the written information submitted by both parties and it may request further documentary evidence from either party. The parties will not be required to attend the Investigation Panel in person. The Investigation Panel members may consult the Chair of the Ethics Panel during their deliberations.
If at any stage during their deliberations, it appears that opportunities for informal resolution have emerged, the Investigation Panel Chair may refer to the Concerns and Complaints Officer to offer and arrange mediation.
Within twenty working days of appointment, the Investigation Panel will attempt to complete its deliberations and submit a brief report of its findings and any decisions on sanctions to the Chair of the Ethics Panel.
The Investigation Panel can uphold the complaint, dismiss it, or exceptionally and with the agreement of the Chair of the Ethics Panel, refer it to an Adjudication Panel.
If the concern/complaint is upheld, the Investigation Panel can impose sanctions falling short of restricting practice. These may include requesting a letter of apology to the complainant, further training, additional supervision, or a written warning to cease defined behaviours or practices.
Within seven working days of receiving the Investigation Panel Report, the Chair of the Ethics Panel will write to both parties with a summary of the Investigation Panel's findings and decisions, and arrange for implementation and monitoring of any sanctions. The complainant will generally only be informed whether the complaint has been upheld and if so, that appropriate steps have been taken.
Failure to comply with any sanctions will constitute a gross breach of ACAT's Codes of Ethics and Practice which the Chair of the Ethics Panel will refer to the Chair of ACAT. The Chair of ACAT may either issue a warning that the sanctions imposed will automatically convert to suspension if not complied with by a given date; or membership will be suspended with immediate effect.
If the therapist has a core profession or is a member of another psychotherapy organisation, the Chair of the Ethics Panel will have a duty to inform relevant and statutory body or bodies when a complaint is upheld. This will be made clear in the letter to the therapist detailing the Investigation Panel’s findings and sanctions. In these circumstances, details of the Investigation Panel’s findings will be shared with the regulatory or statutory body or bodies.
5.6. Adjudication Panel
An Adjudication Panel is convened under ACAT’s Concerns and Complaints Procedure by the instruction of the Chair of the Ethics Panel, when s/he considers that a formal complaint may be serious enough such that, if it is upheld, any sanctions imposed on the therapist would be likely to include restrictions on their practice.
An Adjudication Panel will comprise up to three members of ACAT’s Ethics Panel.One of these will be a lay member.The Adjudication Panel will be chaired by an ACAT member.A secretary will also be appointed to service the Adjudication Panel.When selecting members for the Adjudication Panel, the Chair of the Ethics Panel will be mindful of issues of diversity and the need for impartiality.
If at any stage during the AP’s deliberations, it appears that opportunities for informal resolution have emerged, then the AP Chair may refer to the CCO, to offer and arrange mediation.
The Adjudication Panel is not a court of law.It is a body drawn from members of a professional organisation and lay people, tasked to determine, by carefully evaluating written and oral information, the probability of whether one of its members has breached its Codes of Ethics and Practice.It is the civil standard of proof, “the balance of probabilities”, which is applied.Any sanctions which might be applied, are restricted to matters relating to the professional practice of CAT.
Having consulted with the parties, the Chair of the Adjudication Panel will set a date for the hearing as soon as possible and ideallynot more than thirty working days after the Adjudication Panel is commissioned.The Adjudication Panel will have all the written material previously submitted with the Complaints Referral Form and the responses from the therapist, and may request further information as they see fit including any reports from previous consideration of the complaintEither party may submit further documentation and give notice of witnesses they intend to call, (including those of the other party who previously made statements in writing) up to twelve working days before the hearing.The Chair of the Adjudication Panel will arrange for all additional written information to be copied to the other party at least sevenworking days before the hearing.The Adjudication Panel will also arrange that notification to call witnesses will also be given sevenworking days before the hearing.
The Adjudication Panel will normally hold a hearing, at which the parties to the proceedings will present their cases orally.The complainant, who will be encouraged to be present unless there are reasons to the contrary, will be a witness, and may be accompanied by another person for support.The therapist may be accompanied by another person, either to support, or to represent them.The therapist is entitled to engage a legal representative, at his/her own expense.The case against the therapist will be presented by the ACAT Concerns and Complaints Officer originally appointed by the Chair of the Ethics Panel to the case. ACAT may engage a legal representative or other appropriate person to advise on procedure and s/he may be present at the Adjudication Panel.
5.6.1 Procedure at the Hearing
The Chair of the Adjudication Panel is responsible for ensuring that the hearing is conducted in an orderly and respectful manner, and is empowered to do so.S/he may call for, or consider requests, for adjournments at any stage.
Witnesses will only be present in the hearing while they are giving their testimony and being examined.For all witnesses, the Adjudication Panel will give consideration as to whether the witness needs some form of assistance, or special arrangements in order to give their evidence effectively.Where a complainant or witness is considered particularly vulnerable every effort will be made to provide appropriate support so that s/he may participate in the hearing safely.
Failure of the person complained against to attend the hearing without good reason or due notice, will result in the complaint being heard in his/her absence.
The hearing will proceed in the following order, subject to the discretion of the Chair:
a) The Concerns and Complaints Officer (Presenting Officer) will read out the allegations and the therapist will indicate whether s/he admits to them or not. If the allegations are admitted at this stage, then the proceedings continue at point f below. If refuted, then:
b) The Concerns and Complaints Officer will present the case against the therapist and call any witnesses to be examined. Witnesses may then be cross-examined by the therapist, re-examined by the Concerns and Complaints Officer and may be asked questions by the Adjudication Panel.
c) When the Concerns and Complaints Officer has finished presenting the case, the Adjudication Panel may withdraw to consider whether enough evidence has been produced to warrant a response to the allegations. If the Adjudication Panel considers there is not enough evidence, it will dismiss the allegations forthwith. Otherwise:
d) The therapist will respond to the case presented against him/her and call any witnesses to be examined. Witnesses may then be cross-examined by the Concerns and Complaints Officer, re-examined by the therapist, and may be asked questions by the Adjudication Panel
e) The Adjudication Panel will withdraw and decide whether they consider the allegations proved on the balance of probabilities. They will then return to the hearing to announce the complaint upheld or not upheld, and the reasons for their decision. If the complaint is not upheld then the hearing is ended. If upheld:
f) The Adjudication Panel will invite oral submissions from both parties about what they consider would be the appropriate ensuing consequences of the complaint being upheld. The therapist may wish to describe particular mitigating circumstances surrounding the case.
g) The Adjudication Panel will withdraw and consider what further measures, or / and sanctions to impose. The decision may be conveyed orally to the therapist following deliberations and in writing to both parties as below. The hearing is then ended.
Within five working days of the hearing, the Chair of the Adjudication Panel will submit to the Chair of the Ethics Committee, a brief report of the Panel’s findings and its reasons, and any consequent measures and sanctions.Within a further three working days, the Chair of the Ethics Panel will write to both the complainant and therapist confirming the Panel’s findings and rights of appeal.The letter to the complainant will not generally allude to any specific consequences or sanctions imposed but rather that appropriate action is being taken.It may be considered appropriate to inform the complainant if the therapist has been suspended.
The Adjudication Panel may impose any sanction it sees fit, including one or more of the following:
The Chair of the Ethics Panel will arrange with the Chair of ACAT for the implementation, monitoring and recording of any sanctions.
If the therapist has a core profession or is a member of another psychotherapy organisation, the Chair of the Ethics Panel will have a duty to inform relevant and statutory body or bodies when a complaint is upheld. This will be made clear in the letter to the therapist detailing the Adjudication Panel’s findings and sanctions.
In these circumstances, details of the Adjudication Panel’s findings will be shared with the regulatory or statutory body of bodies.
Failure to comply with any sanctions will constitute a gross breach of ACAT's Codes of Ethics and Practice, which the Chair of the Ethics Panel will refer to the Chair of ACAT, who may either temporarily suspend the therapist’s membership and issue a warning that suspension will be confirmed if sanctions are not complied with by a given date; or suspend the therapist’s membership forthwith.
Within 15 working days of receiving the findings and recommendations of an Investigation or Adjudication Panel, either party may apply in writing to the Chair of the Ethics Panel, requesting an appeal and giving their grounds. The Chair of the Ethics Panel, in consultation with the Chair of ACAT, will review whether the grounds for appeal are substantial enough to be likely to significantly alter the previous Panel decision and will make a final decision as to whether to allow an appeal and write to the party accordingly.
An appeal will be considered by a new Investigation or Adjudication Panel (an Appeal Panel) made up of members of the Ethics Panel previously uninvolved in the complaint. The new panel will have access to all previous documentation relating to the complaint and will have the discretion to decide on the best way to consider the grounds for appeal and whether it is necessary to call witnesses or request further submissions from any party. The Appeal Panel will be conducted and reported according to the appropriate procedures detailed in 5.5 and 5.6 above.
Any sanctions imposed by the previous Investigation Panel or Adjudication Panel will remain in place until an appeal has been heard.
5.8. Further HIPC Appeal procedure
If the procedures outlined in 5. ‘Stages in the Process’ (including 5.7 Appeal),
• do not satisfactorily resolve the concern or complaint for either ACAT or the complainant or complainee, or both, or
• if either party feels the hearing was not fairly conducted,
ACAT may appeal to the HIPC Ethics and Complaints Committee (ECC). HIPC ECC will then consider whether there is a case to answer only on the grounds of whether ACAT followed due process as laid down in the ACAT Concerns and Complaints Procedure guidelines. HIPC would not re-hear the complaint itself or challenge the outcome of the complaint if due process was followed correctly (see https://ukcphipc.co.uk/wp-content/uploads/2020/02/3.-HIPC-ECC-TERMS-OF-REFERENCE-EXISTING.pdf).
Appendices relating to this Concerns and Complaints Procedure:
Appendix 1: Ethics Panel Terms of Reference and Role of Chair
Appendix 2: Flowchart
Appendix 3: Mediation Guidelines
Appendix 4: Complaints Referral Form
Agreed at ACAT’s AGM 11 July 2014
Revised February 2018; May 2020
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