Research in progress at the University of Leicester aims to investigate the interesting question:
Why don’t people complain about poor or harmful experiences of [therapy]?
The researcher is a counsellor, and like many counsellors seems to be comfortable using the word ‘counselling’ to include psychotherapy. (I suppose one day I should write about what I think the difference is.)
The research study is based on a short postal or online questionnaire that asks you about a particular time when you experienced poor or harmful counselling or psychotherapy. It does not ask for any details of what happened — only about your reasons for not making a complaint.
The questionnaire can optionally be followed up by a face-to-face interview, again only to understand why you did not make a complaint.
Complaining about a counsellor or therapist does nothing for you in most cases, unless there was specific harm done that you can be compensated for. Also, at the time you have counselling or therapy that is unsuccessful for any reason, you have other things on your mind. Getting involved in a complaints process is probably the last thing you want.
On the other hand, complaining when a professional does not behave professionally is something you can do to help other people. Even if your complaint is unsuccessful, its existence could add force to other complaints in the future.
Counsellors and therapists do not normally work in isolation. They have managers and supervisors who will encourage them to change their ways if there are complaints. So your complaint might have positive effects that you do not yourself see.
When you make a complaint you do not usually have to gather evidence by yourself. An investigator will usually be appointed to gather evidence for you. So you do not need to have proof of what happened before you complain. On the other hand, the investigator and the complaints process are run by the employers and colleagues of the person you are complaining about, so you might find that there is some bias, or at least bureaucratic resistance, that favours the professional.
For therapists providing CBT, the main professional organisation is the BABCP. Unfortunately, the BABCP’s Guidelines for Good Practice are not written very clearly, and the very first line is a get-out clause (my italics):
1. All members of the BABCP are required to endeavour to adhere to these guidelines.
On the other hand, some other clauses create a bias against therapists, making it seem that the document is just badly drafted (my italics):
1 (ii) Assessments/interventions will always be justified by the available public evidence taking into account all possible alternatives…
Also, the number 1 there is not the same as the number 1 above — the numbering in the document has not been done properly.
Here’s an interesting regulation:
9 (i) Membership of BABCP does not confer any professional status or qualification. [Therapists] will not refer to their membership of BABCP in advertising or elsewhere to imply any such professional status or qualification.
This means that only accredited members can use the BABCP as evidence of their competence to practice. If you come across other people — nurses, counsellors, psychologists, etc. — who use the BABCP name in advertising, but who are not listed by surname in the CBT Register, then that is cause for complaint in itself.
Probably the most common thing that goes wrong in failed CBT is that there is no ‘therapeutic alliance’ — no close, trusting relationship between you and your therapist from the very first session. There is no specific guideline that makes that in itself a cause for complaint, but that should not stop anyone from complaining about it.
It is also common in failed CBT that the therapist is not a member of the BABCP at all. Again, that should not stop anyone from complaining to the BABCP about these therapists. By presenting themselves as the lead organisation for CBT in the UK, the BABCP has taken on a degree of responsibility for all the CBT that is practised in the UK, not only the CBT prectised by its members.
So this research project in Leicester could be important. It might lead to improvements in complaints procedures that allow more people to complain when it is appropriate for them.
To take part, visit the online questionnaire to fill it in on your computer or to request a copy by post. If you know someone else who could take part, let them know about it.