Psychology Board of Australia v The Registrant
[2013] QCAT 627
| CITATION: | Psychology Board of Australia v The Registrant [2013] QCAT 627 |
| PARTIES: | Psychology Board of Australia (Applicant) |
| V | |
| The Registrant (Respondent) |
| APPLICATION NUMBER: | OCR010-13 |
| MATTER TYPE: | Occupational regulation matters |
| HEARING DATE: | On the papers |
| HEARD AT: | Brisbane |
| DECISION OF: | Judicial Member Brabazon QC Assisted by: Ms Denise Britton, Ms Karen Butler, Mr Graeme Lawrence. |
| DELIVERED ON: | 18 November 2013 |
| DELIVERED AT: | Brisbane |
| ORDERS MADE: | 1. The Tribunal finds that the Registrant has behaved in a way that constitutes professional misconduct according to s 5 and s 196(1)(b) of the National Law because of unprofessional conduct that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience. 2. The Registrant is reprimanded. 3. The details of the reprimand must be recorded on the Board’s register for a period of three years from the date of this order. 4. The Registrant’s registration is suspended, for a period of 12 months, from 20 November 2013 to 19 November 2014. 5. That suspension order will be automatically lifted after a period of six months has passed, to 20 May 2014. The lifted suspension will expire three years after the date of this order – on condition that the Registrant complies with the following orders, and is not the subject of disciplinary action. 6. In any event, the suspension order will remain in place until the completion of a course of counselling with a clinical psychologist or psychiatrist who specialises in boundary violation issues (‘the counsellor’). The counsellor shall be nominated in writing by the Registrant and approved in writing by the Board. The Registrant must provide to the counsellor, within 7 days of being notified of the Board’s approval of the counsellor, a written authority and direction to the counsellor to produce a report to the Board as well as a copy of this order and the Tribunal’s reasons. The purpose of the counselling is to facilitate the Registrant’s developing insight into why the reasons for the engaging in the behaviour which is the subject of these proceedings and to develop an awareness of professional boundary management strategies, in particular relating to counter-transference issues. The counselling is to continue until such time as the counsellor is of the opinion that further counselling is unnecessary for that purpose and has provided a report to the Board. 7. The following conditions must be imposed upon any future practice and shall remain in place until the Registrant has completed the equivalent 18 months of full-time active employment as a psychologist: 7.1 The Registrant can only practise in a setting approved in writing by the Board. 7.2 Within 14 days of obtaining employment as a psychologist, the Registrant must nominate in writing a psychologist for the Board to approve as a supervisor. If the Board does not approve the nominee, the Registrant must make a further nomination in writing within 7 days. The Registrant must practise under the supervision of the supervisor. The supervision does not have to be direct supervision provided the supervisor is present at all times at the same location and is available for reasonable access. The Registrant must ensure a written logbook is kept which records each occasion worked and the name of the supervisor for each occasion. Each entry must be signed by the supervisor. The Registrant must produce the logbook to the Board upon request. 7.3 The Registrant must provide a copy of the Tribunal’s reasons, this order and a written authority to the supervisor, within 7 days of the supervision commencing, to report to the Board as to the Registrant’s fitness and competence to practise: 7.3.1 if the supervisor holds a concern about the Registrant’s fitness and competence to practice; 7.3.2 if requested by the Board to provide a report about the Registrant’s fitness and competence to practice; 7.3.3 in any event at intervals of 3 months from the commencement date of the supervised practice. 7.4 Within 14 days of obtaining employment as a psychologist, the Registrant must nominate in writing a psychologist for the Board to approve as a mentor. If the Board does not approve the nominee, the Registrant must make a further nomination in writing within 7 days. As soon as practicable after the mentor is approved by the Board, the Registrant must commence meeting with the mentor at intervals of no more than 14 days. The mentoring must focus on professional boundary management issues and strategies to ameliorate risks arising from the vulnerabilities of patients or the Registrant. 7.5 The Registrant must provide a copy of the Tribunal’s reasons, this order and a written authority to the mentor, within 7 days of commencing the mentor relationship, to report to the Board as to the registrant’s fitness and competence to practice: 7.5.1 if the mentor holds a concern about fitness and competence to practise; 7.5.2 if requested by the Board to provide a report about fitness and competence to practise; 7.5.3 in any event at intervals of 3 months from the commencement date of the mentor relationship. 8. All costs and expenses in relation to the matters set out in paragraphs 2 and 3 are to be borne by the Registrant. 9. The Registrant is to pay the Board’s costs of and incidental to these proceedings on the standard basis in accordance with the District Court scale of fees to be assessed by Hickey & Garrett or QICS (as the Board elects) within 28 days after these orders or such further time as the Board may allow. 10. Pursuant to s 66 of the Queensland Civil and Administrative Tribunal Act 2009 the publication of any information which may identify the Registrant is prohibited. |
| CATCHWORDS: | HEALTH PRACTITIONER – PSYCHOLOGIST – DISCIPLINARY PROCEEDINGS – Psychologist – professional misconduct – non publication order - sanction |
APPEARANCES and REPRESENTATION (if any):
This matter was heard and determined on the papers pursuant to s 32 of the Queensland Civil and Administrative Tribunal Act 2009 (QCAT Act).
REASONS FOR DECISION
Jurisdiction
QCAT has jurisdiction to hear matters referred by a medical board, under the Health Practitioners Regulation National Law (Queensland) (National Law). See section 398C of the Health Practitioners (Disciplinary Proceedings) Act 1999 and section 6 of the Health Practitioner Regulation National Law Act 2009. It is an “enabling Act” – one that confers powers on QCAT.
When QCAT hears a matter about a registered health practitioner, it may decide that:
(i)The practitioner has behaved in a way that constitutes unsatisfactory professional performance;
(ii)The practitioner has behaved in a way that constitutes unprofessional conduct;
(iii)The practitioner has behaved in a way that constitutes professional misconduct.[1]
[1] S 196(1)(b) of the National Law.
If such a finding is made, QCAT can:
§Reprimand the practitioner
§Impose conditions on registration
§Suspend or cancel the registration.[2]
[2] S 196(2) of the National Law.
If the Tribunal decides to impose a condition on the practitioner’s registration, it must also decide a review period for the condition. See s 196(3) of the National Law.
These reasons will be relatively brief, because of the way in which the evidence has been presented to QCAT. That is, much is common ground, agreed by the parties. It is convenient to set out the parties own submissions about the facts, and any appropriate penalty.
The non-publication application
The Registrant asks for a non-publication order, to protect family members. The Board does not oppose the making of such an order.
QCAT can make such an order – see s 66 of the QCAT Act. In this case, s 66(2)(b) is relevant – the order can be made if QCAT considers that it is necessary, “to avoid endangering the physical or mental health or safety of a person.”
The Registrant’s spouse has been affected by this litigation, impacting on already precarious health following cancer surgery in 2008. Both parents fear adverse impacts on their children, if the details of this decision became publicly known. It appears that their children have very fragile temperaments.
The above brief details are explained in detail in two reports, by a psychiatrist, and a psychologist. Both reports support the desirability of protecting the spouse and children from undesirable publicity.
Because of those reports, and the Board’s attitude, it is appropriate to order that there be a non-publication order.
The facts
The Board and the Registrant have agreed about the facts and documents. Their statement is reproduced here, with some changes to protect the identity of the Registrant. In substance, the statement accepts the allegations in the Hearing Notice, which sets out the Board’s grounds for disciplinary action.
The Registrant’s response
The Board sent a “show cause” notice to the Registrant, on 19 January 2011. There was an immediate response, to explain such behaviour in an improper way to a young client. Sorrow was expressed for the misjudgement. There was no effort to excuse the misconduct. There was an insistence, which is not challenged, that similar misconduct had not occurred, before or after these allegations. (That is not contested). There was an acknowledgement of such unprofessional behaviour, in relation to email exchanges. There was an apology, to all affected by such misconduct.
The joint submissions on sanction
An anonamized version of these joint submissions is attached to these reasons. Apart from the ancillary orders, the effect is that the Registrant is now suspended from practice for six months, with a further six months period, itself suspended for three years.
The assessors
The Tribunal was assisted by three assessors. Two were psychologists.
It should be said, that the assessors and myself reached a unanimous view, about the appropriate sanction – in particular, the lifting of the suspension after six months, if the Registrant complies with the other conditions – that lifting, to be in place for three years, on certain conditions.
The reduced sanction is because of the Registrant’s otherwise good behaviour, the impact on the Registrant’s family, the impact on the Registrant personally, and the Registrant’s early and sincere recognition of such unacceptable conduct.
The orders
The orders substantially follow the draft orders proposed by the parties. The proposed orders had some confusion about the different impacts of a suspension or cancellation of registration. In the event that either party feels it necessary to amend the order in the judgment then they may make a further application to QCAT, to be heard by myself – if it cannot be a consent order.
A review period
Section 196(3) of the Health Practitioner National Law (Qld) says:
If the (Tribunal) decides to impose a condition on the practitioner’s registration, the Tribunal must also decide a review period for the condition.
Sections 125, 126 and 127 contain the Board’s powers to change or remove conditions, upon application by a registrant, or upon its own initiative. During a review period, the Board cannot act under these sections, unless it is satisfied that there has been a change in the registrant’s circumstances.
It would seem in this case, that the appropriate review period is three years – to 29 October 2016.
The Formal Orders
The Tribunal finds that the Registrant has behaved in a way that constitutes professional misconduct according to s 5 and s 196(1)(b) of the National Law because of unprofessional conduct that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience.
The Registrant is reprimanded.
The details of the reprimand must be recorded on the Board’s register for a period of three years from the date of this order.
The Registrant’s registration is suspended, for a period of 12 months, from 20 November 2013 to 19 November 2014.
That suspension order will be automatically lifted after a period of six months has passed, to 20 May 2014. The lifted suspension will expire three years after the date of this order – on condition that the Registrant complies with the following orders, and is not the subject of disciplinary action.
In any event, the suspension order will remain in place until the completion of a course of counselling with a clinical psychologist or psychiatrist who specialises in boundary violation issues (‘the counsellor’). The counsellor shall be nominated in writing by the Registrant and approved in writing by the Board. The Registrant must provide to the counsellor, within 7 days of being notified of the Board’s approval of the counsellor, a written authority and direction to the counsellor to produce a report to the Board as well as a copy of this order and the Tribunal’s reasons. The purpose of the counselling is to facilitate the Registrant’s developing insight into why the reasons for the engaging in the behaviour which is the subject of these proceedings and to develop an awareness of professional boundary management strategies, in particular relating to counter-transference issues. The counselling is to continue until such time as the counsellor is of the opinion that further counselling is unnecessary for that purpose and has provided a report to the Board.
The following conditions must be imposed upon any future practice and shall remain in place until the Registrant has completed the equivalent 18 months of full-time active employment as a psychologist:
7.6The Registrant can only practise in a setting approved in writing by the Board.
7.7Within 14 days of obtaining employment as a psychologist, the Registrant must nominate in writing a psychologist for the Board to approve as a supervisor. If the Board does not approve the nominee, the Registrant must make a further nomination in writing within 7 days. The Registrant must practise under the supervision of the supervisor. The supervision does not have to be direct supervision provided the supervisor is present at all times at the same location and is available for reasonable access. The Registrant must ensure a written logbook is kept which records each occasion worked and the name of the supervisor for each occasion. Each entry must be signed by the supervisor. The Registrant must produce the logbook to the Board upon request.
7.8The Registrant must provide a copy of the Tribunal’s reasons, this order and a written authority to the supervisor, within 7 days of the supervision commencing, to report to the Board as to the Registrant’s fitness and competence to practise:
7.3.4 if the supervisor holds a concern about the Registrant’s fitness and competence to practice;
7.3.5 if requested by the Board to provide a report about the Registrant’s fitness and competence to practice;
7.3.6 in any event at intervals of 3 months from the commencement date of the supervised practice.
7.9Within 14 days of obtaining employment as a psychologist, the Registrant must nominate in writing a psychologist for the Board to approve as a mentor. If the Board does not approve the nominee, the Registrant must make a further nomination in writing within 7 days. As soon as practicable after the mentor is approved by the Board, the Registrant must commence meeting with the mentor at intervals of no more than 14 days. The mentoring must focus on professional boundary management issues and strategies to ameliorate risks arising from the vulnerabilities of patients or the Registrant.
7.10The Registrant must provide a copy of the Tribunal’s reasons, this order and a written authority to the mentor, within 7 days of commencing the mentor relationship, to report to the Board as to the registrant’s fitness and competence to practice:
7.5.4 if the mentor holds a concern about fitness and competence to practise;
7.5.5 if requested by the Board to provide a report about fitness and competence to practise;
7.5.6 in any event at intervals of 3 months from the commencement date of the mentor relationship.
All costs and expenses in relation to the matters set out in paragraphs 2 and 3 are to be borne by the Registrant.
The Registrant is to pay the Board’s costs of and incidental to these proceedings on the standard basis in accordance with the District Court scale of fees to be assessed by Hickey & Garrett or QICS (as the Board elects) within 28 days after these orders or such further time as the Board may allow.
Pursuant to s 66 of the Queensland Civil and Administrative Tribunal Act 2009 the publication of any information that may identify the Registrant is prohibited.
QUEENSLAND CIVIL AND ADMINISTRATIVE TRIBUNAL
REGISTRY:BRISBANE
NUMBER:OCR010-13
Applicant:PSYCHOLOGY BOARD OF AUSTRALIA [‘Board’]
AND
Respondent: THE REGISTRANT
STATEMENT OF AGREED FACTS & AGREED DOCUMENTS
Registration
The Registrant is middle aged, and presently registered. The registration is currently subject to conditions which relate to the Registrant’s health.
Background
[2.1] Notification and referral
In January 2011, the Australian Health Practitioner Regulation Agency (‘AHPRA’) received a notification from the mother of one of the Registrant’s patients. The notification alleged, inter alia, that there were sexual discussions that put the patient’s mental health at risk, sought intimacy with the patient, misused power over the patient and failed to terminate the treating relationship.
In February 2011, an Immediate Action Committee of the Board resolved to:
(a) take immediate action in accordance with s.156 of the Health Practitioner Regulation National Law Act (Queensland) (‘National Law’);[3] and
[3] All references to sections in this Statement of agreed facts and documents are to the National Law unless otherwise specified.
(b) investigate the notification in accordance with s.160.
In January 2011, the Registrant provided a response to a Show Cause Notice issued by the Board.
In February 2012, the Board obtained statements from a psychologist and a psychiatrist.
Annexure 3 is a copy.
In July 2012, the Board resolved to refer to the matter to the Tribunal in accordance with s.193(1)(a)(i)
[2.2] The treating relationship
The treating relationship between the Registrant and the patient commenced in March 2008.
The final consultation occurred in December 2009.
[2.3] The patient
10. The patient was aged 17 years during the period the conduct the subject of these proceedings occurred.
11. The Registrant commenced treating the patient in 2008 to address issues of depression related to a disrupted family history. The patient was also under the care of a psychiatrist, who prescribed antidepressants.
12. It was noted that the patient had symptoms of depression and suicidal ideation at one of the initial counselling sessions.
The conduct
13. The conduct alleged in paragraphs 2 to 5 of the Part C relates to an extensive series of emails transmitted by the Registrant to the patient, August 2009 to March 2010.
Guilty plea
14. The Registrant admits the conduct to professional misconduct.
Mitigation
15. At the time of the conduct, the Registrant was under significant stress in family life. The Registrant’s spouse had been diagnosed with an aggressive form of cancer in 2008 and had been undergoing treatment for that illness. Around that time, the Registrant’s spouse was also the victim of workplace bullying and harassment and was supported by the Registrant through that event.
16. The Registrant may have been suffering from an Adjustment Disorder at the time of the conduct.
17. When The Registrant recognised that the patient had developed transference, discussed with the patient about terminating their therapeutic relationship and transferring the patient’s care to another psychologist.
18. The Registrant consulted the patient’s treating psychiatrist, for advice on how to manage transference and counter-transference issues. There is a copy of a chain of emails between the Registrant and the psychologist given in December 2009.
19. The Registrant also sought advice from a psychologist who had given “peer supervision” with from time to time.
20. The Registrant admitted the conduct in the response to the Board’s Show Cause Notice, and expressed shame and remorse for the conduct.
21. The Registrant sought treatment from a psychologist on 29 April 2011. The issues which are the subject of these proceedings were discussed over weekly (then bi-weekly) sessions for almost 6 months.
22. The Registrant also sought treatment from a psychologist commencing in January 2012, initially on a fortnightly basis, then on a monthly basis from July 2012. The Registrant was treated using a combination of psychodynamic and systemic psychotherapy. The conduct the subject of these proceedings was discussed.
23. In 2012, the Registrant commenced a privately funded supervisory relationship with a registered psychologist. The supervision related to academic work as at 2013, the Registrant had met with him on 6 occasions.
24. In about October 2012, the Registrant completed a program of study at a university about ‘Exploratory Psychotherapy Interventions’. The course was completed.
QUEENSLAND CIVIL AND ADMINISTRATIVE TRIBUNAL
REGISTRY:BRISBANE
NUMBER:OCR010-13
Applicant:PSYCHOLOGY BOARD OF AUSTRALIA [‘Board’]
AND
Respondent: THE REGISTRANT
JOINT SUBMISSIONS ON SANCTION
Statutory regime
These proceedings were brought pursuant to s.193(1)(a)(ii) of the Health Practitioner Regulation National Law Act (Queensland) (‘National Law’).
Nature of the proceedings
The relevant object of the National Law is to provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered.
The jurisdiction exercised by the Tribunal is protective, not punitive. This is so even though the outcome of disciplinary action may be that a great deprivation is experienced by the person disciplined.
Professional misconduct
Professional misconduct is defined in s.5 of the National Law as including:
(a) unprofessional conduct by the Respondent that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and
(b) more than one instance of unprofessional conduct (being professional conduct that is of a lesser standard than that which might reasonably be expected of the Respondent by the public or the Respondent’s professional peers) that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and
(c) conduct of the Respondent, whether occurring in connection with the practice of the Respondent’s profession or not, that is inconsistent with the Respondent being a fit and proper person to hold registration in the profession.
The Registrant admits that the conduct amounts to professional misconduct. It is submitted that the conduct falls within limb (a) of the definition of professional misconduct.
Sanction
The parties respectfully submit that the Tribunal make orders per the draft that is Annexure 1 to these submissions. The following submissions are made in support of those orders.
[5.1] Inappropriate relationship
The parties submit the Registrant’s conduct clearly amounts to a professional boundary violation. There are a number of factors which make this violation very serious:
(a) The nature of the emails transmitted by the Registrant was sexual.
(b) The Registrant made a number of serious personal disclosures.
(c) The Registrant sought to establish an intimate personal relationship with the patient.[4]
[4] Admission to charge 5 in the Part C.
(d) The age difference between the Registrant and the patient (17) was great.
(e) The vulnerability of the patient as demonstrated by the Registrant’s clinical records. The patient suffered from depression and demonstrated suicidal ideation.
(f) There was a significant power imbalance between the parties. The email interactions suggest the patient looked up to the Registrant. At one stage the patient said, “wouldn’t mind being a psychologist myself.” The Registrant fostered this notion.
(g) The boundary violation commenced during the course of the therapeutic relationship.
(h) The Registrant initiated the continuation of the inappropriate relationship beyond the cessation of the therapeutic relationship.
(i) The Registrant sought to continue the inappropriate relationship even after the patient expressed feelings of discomfort with the situation.
(j) The Registrant allowed the inappropriate relationship to continue even after identifying a crossing of patient boundaries.
(k) The Registrant had personal interests at heart when indulging in the conduct.
In the parties’ submission, the seriousness of the conduct warrants a lengthy period of suspension. However, this should be tempered by the practitioner’s demonstrated insight and remorse.
[5.2] Insight, remorse and genuine understanding
In the matter of Re Liveri, a matter relating to an application for admission as a legal practitioner, in respect of the importance of insight and remorse going to fitness to practice, the Court said at [21] –
‘(The applicant’s) unwillingness, subsequently, to acknowledge that misconduct, establishes a lack of genuine insight into its gravity and significance: for present purposes, where the Court is concerned with fitness to practise, that aspect is at least as significant as the academic dishonesty itself.’ (emphasis added).
In Dental Board v B[5], Fryberg J said at [37] –
[5] [2003] QCA 294.
‘The absence of remorse and insight are matters relevant to sanction’
Similarly, in Law Society of New South Wales v Walsh[6]Beazley JA said –
[6] [1997] NSWCA 185
‘Another relevant factor will be whether the practitioner truly understands the error of his or her ways.’ (emphasis added)
11.The above demonstrate the importance which attaches, in proceedings such as these, to a respondent gaining a genuine and true understanding of why their conduct was inappropriate.
12.The Registrant pleaded guilty to the charges pursued by the Board at the earliest opportunity.[7]
[7] See Form 36.
13.The Registrant has acknowledged that the emails sent to the patient were “highly inappropriate”[8], that the conduct was “wrong and improper”[9] and has admitted the conduct at a very early stage.[10]
[8] V1 at p.4.
[9] V1 at p.7.
[10] The response to the Board’s Show Cause Notice. (SAFD at p. 1 of annexures) .
14.The Registrant has expressed his shame and remorse for the conduct.[11]
[11] See the response to the Board’s Show Cause Notice on 31 January 2011 (SAFD at p.1 of annexures); V1 at p.4, 5 and 7; PG at p. 3; SS at p.2.
15.As observed by others, the Registrant has taken full responsibility for the conduct and has not attempted to justify or minimise the behaviour.[12]
16.Voluntarily and very early on in the disciplinary process, the Registrant sought treatment. The Registrant also voluntarily sought professional supervision of academic work to assist with professional and work related challenges.[13]
17.In all circumstances, the Registrant has demonstrated insight into the behaviour[14] and has willingly submitted to further education and monitoring of future practice.[15]
[5.3] Deterrence - General and Specific
[12] See V1 at p.7; PG at p.3; SS at p.2.
[13] See SS at p.2.
[14] See PG at p.2.
[15] See letter from University 2013 ( SAFD at p.315 of annexures).
In Law Society New South Wales -v- Foreman[16] Giles A-JA said at 471 in respect of the matter of general deterrence in proceeding such as these –
‘The public is protected by ensuring that those unfit to practise do not continue to hold themselves out as fit to practise. But the object of protection of the public also includes deterring the legal practitioner in question from repeating the misconduct, and deterring others who might be tempted to fall short of the high standards required of them.’ (emphasis added)
[16] (1994) 34 NSWLR 408.
In the matter of Queensland Nursing Council v Dodd [17], McGill SC DCJ said, at [58], in respect of an appeal by the Council against a decision of the Nursing Tribunal (as it then was) at first instance to not impose a preclusion period against a nurse convicted of serious criminal offences –
[17] [2010] QDC 220.
‘There is also the consideration that there is legitimately an aspect of general deterrence associated with the imposition of a disciplinary order under these provisions in the Act. Although the essential purpose of powers of this nature is to protect the public, that deterrence is an appropriate consideration when making such an order was recognised by McMurdo P in Graham v Queensland Nursing Council at [29]. That part of the process of maintaining the reputation of the profession is by making orders which have a general deterrent effect for other members of the profession was recognised by the equivalent New South Wales Tribunal in HCCC v Flynn [2009] NSWNMT 1 at [14]. The proposition seems with respect obviously correct.’ (emphasis added)
20.In the present matter, the consideration of specific deterrence is less significant for the reasons discussed in section 5.2 above.
21.In the opinions of the psychiatrist and the psychologist there is no significant risk of danger to the public or a risk of reoffending.[18]
[18] V1 at p.15; PG at p.3.
22.However, general deterrence is of particular importance. The parties submit the Tribunal must seek to emphasise the impropriety of the behaviour subject of these proceedings by ordering a strong sanction. It is submitted that a 12 month suspension satisfies this aspect of the Tribunal’s role.
[5.4] Other Mitigating Factors
23.The conduct stemmed from an inability to deal with transference and counter-transference issues rather than any inherent psychopathology or predatory intentions.[19]
[19] See V1 at p.13 and 14; see also statement of (removed); SAFD at annexure 2 and statement of (removed); SAFD at annexure 3.
24.There is currently no impairment which would affect the capacity to work as a psychologist.[20]
[20] See V1 at p.14; PG at p.2.
[5.5] Comparatives
25.In Psychology Board of Australia v Duangpatra [2012] QCAT 514 (Annexure 2), the practitioner provided psychological services to a prisoner on about 45 to 50 occasions. A week after the therapeutic relationship ceased the parties began to have intimate telephone conversations. They also exchanged letters. The practitioner expressed some insight into her conduct. She also expressed remorse. The practitioner was suspended for a period of 6 months (suspended after 3 months for 18 months).
It is submitted that the inappropriate relationship in this instance is far more serious. Unlike Duangpatra it commenced during the therapeutic relationship. The power imbalance was also far more acute.
26.In Nursing and Midwifery Board of Australia vClydesdale [2013] QCAT 191 (Annexure 3), a registered nurse working in a psychiatric department of a hospital engaged in an inappropriate relationship with a patient. The patient (a young adult male) was vulnerable in that case by reason of his suicidal state at the time he presented at the hospital. The practitioner and patient exchanged a number of text messages. The practitioner also provided gifts to the patient and accompanied him on holidays out of town on 3 occasions. The Tribunal did not accept the practitioner was grooming the patient for a sexual relationship. The practitioner did not demonstrate insight into his conduct.
It is submitted this case is a more serious boundary violation than Clydesdale because of the matters outlined in section 5.1 above. The relationship in this case had strong sexual overtones.
27.The exchange of sexually explicit text messages and emails between a teacher and student over a period of about 4 months has been subject of a lengthy suspension (30 months).[21] It was accepted in that case that the student was vulnerable.[22] It is submitted that the power imbalance and vulnerability of the patient in the context of a psychologist/patient relationship is not dissimilar to a teacher/student relationship.
[21] Queensland College of Teachers v DRR [2012] QCAT 671.
[22] At [91].
28.It is submitted that, having regard to the authorities, a 12 months suspension is appropriate having regard to the seriousness of the conduct and the Registrant’s demonstrated insight and remorse.
Other orders
29.The parties make the following submissions in respect of the other orders sought:
[6.1] Counselling
30.A psychologist is of the view that the Registrant would benefit from individual psychotherapy,[23] and has already commenced such therapy with (removed).[24] (removed) recommends this therapy continue until the end of 2014.[25] The parties submit the length of the counselling should be at the discretion of the counsellor as provided for in the draft orders.
[23] V1 at p.15.
[24] See PG at p.2. See also SAFD annexure 7 at p.2.
[25] PG at p.2.
[6.2] Supervision
31.A psychologist opined that the Registrant will require ongoing supervision (although he could not comment in relation to clinical work).[26]
[26] SS at p.2.
32.(removed) also considers that the Registrant would benefit from supervision, particularly in relation to the issues of transference and counter-transference.[27] This view is also shared by the psychologist.[28]
[27] PG at p.3.
[28] V1 at p.15. See also SOFD annexure 7 at p.2.
[6.3] Mentoring
33.The parties submit it is also appropriate the Registrant be ordered to establish a mentor relationship. This will provide another avenue to discuss any difficulties in practice which may arise.
34.It is submitted that no further formal education is necessary given the Registrant’s completion of the course about psychotherapy information.
Costs
35.The Registrant has agreed to pay the Board’s costs of the proceedings. It is appropriate that such an order be made.
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