KB-2023-003302 - [2025] EWHC 1628 (KB)

Between 15 August and 28 November 2018, the Claimant conducted ten sessions of Cognitive Behavioural Therapy (“CBT”)with Client A. Client A gave no evidence to the UKCP or to me. The evidence I have, as to why Client A sought CBT and what the treatment involved, comes principally from the Claimant. Client A was referred to the Claimant by an insurance company to treat a driving phobia that had emerged following a road traffic accident. The Claimant’s notes record that “treatment sessions focused on travel anxieties and mood disturbance exacerbated by underlying general anxiety disorder, life stressors and chronic pain. Discussed formulation of anxiety/panic symptoms and trauma related problems…”.

On 28 November 2018 treatment was paused. I am told that this was because the Claimant needed to take a break for reasons related to his health. Ms Mauladad KC told me that all of the Claimant’s other patients were transferred but Client A chose to wait for the Claimant’s return. The notes of the Claimant’s interview, with the person conducting the investigation on behalf of his employer, record the Claimant as saying that Client A was ‘an attractive woman’ and ‘When she decided to wait for me to come back to work, I did feel that this was a ‘hook’ for me. This was someone that had waited for me… I had in mind meeting up with her for a coffee, perhaps in 6 month’s time – but events overtook me.’

The Claimant returned to work and began seeing Client A again from August 2019.

In or around December 2019, during what was to be the penultimate session, Client A asked the Claimant whether he found her attractive. The Claimant later gave evidence about this: “…that was a very out of the blue question… I was trained to use self-disclosure, not to lie to clients - I wouldn't have said to her that that wasn't the case - but as I was thinking how to respond, obviously, I did blush, and she could see that, and she said to me, 'I can see the answer to that question' .

On 18 December 2019, the Claimant and Client A had their final therapy session. The Claimant later said, in an interview with his employer, that during this final therapy session the Claimant asked him to meet up for a coffee or Christmas drink. The Claimant said that he replied: ‘No, we can’t meet up for a while’. At the end of the session, Client A asked the Claimant for a hug and he agreed. They hugged. The Claimant’s notes, after the conclusion of therapy, recorded that Client A ‘reported significant recovery from travel and driving phobia, including being able to now drive on busy motorways and urban roads, with only residual or no anxiety’.

On 28 December 2019 (i.e. 10 days after the final session), Client A sent a text to the Claimant proposing a meeting. The Claimant accepted that proposal. A sexual relationship commenced on or about 30 or 31 December 2019 and continued until June 2020, during which time the parties exchanged explicit communications and images.

There is evidence that the Claimant sought advice in peer supervision about whether to have a sexual relationship with a client. It is not clear, from the evidence before me, when exactly the Claimant sought that advice. In the letter dated 14 October 2021 from the Claimant’s employer, it is recorded that the disciplinary panel ‘heard that you had explored the ethics of having a relationship with [Client A] with peers in private practice before the last therapy session…’. The record of the interview of the Claimant, during the NHS investigation, had not been clear as to the date when the Claimant spoke to his peers. It may be that the panel received other evidence on this issue, at the hearing before them. In any event, what is clear, from the Claimant’s own evidence, is that his colleagues warned him against having a sexual relationship with Client A and he ignored their advice.

The sexual relationship between the Claimant and Client A lasted approximately 6 months. They met several times, normally at the Claimant’s flat and once in his car. On each occasion they engaged in intimate relations. They exchanged naked and sexual images and had phone and video sex. The sexual relationship ended in June 2020 when Client A informed the Claimant that she was having chemotherapy.

The Claimant did not hear anything further until January 2021 when Client A contacted him to ask about providing therapy to her son, who suffered from anxiety. In the end, the Claimant did not provide therapy to Client A’s son.

On 12 March 2021, Client A’s partner (“DE”) discovered communications between Client A and the Claimant. Client A admitted to DE that she had had a sexual relationship with the Claimant.

On 14 March 2021, DE submitted reports concerning the Claimant to the Defendant and other bodies. The Defendant imposed an Interim Suspension Order. The Claimant’s other regulator, the BABCP, adopted that decision.

In April 2021 the Claimant engaged the services of Dr Wilkinson to engage in mentorship work. Dr Wilkinson is an eminent psychotherapist of 30 years standing. He has been, among other things, chair of the Defendant’s Humanistic and Integrative Psychotherapy College. In the same month, the Claimant also attended an online training course in ‘Maintaining Professional Boundaries’ provided by ‘The Clinic for Boundaries Studies’. This was the first of several such courses the Claimant attended.

The Claimant’s employer conducted an investigation into DE’s complaints. While the investigation was carried out, the Claimant was suspended from client-facing duties. During the investigation, the investigating officer spoke to the Claimant, Client A and others.

On 4 October 2021 the Claimant provided a submission to his employer for the disciplinary hearing due to take place on 7 October 2021. In that submission, he accepted that his judgment in relation to Client A was ‘questionable’.

On 7 October 2021, the Claimant’s employer conducted a disciplinary hearing to consider the allegation that the Claimant had engaged in a sexual relationship with a former private client. In a telephone conversation on 8 October 2021, Ms Hutton, a general manager, informed the Claimant of the outcome – saying the allegation was upheld and they had significant concerns in the Claimant’s ability to ‘safely and effectively’ perform the role of Clinical Lead but that, as an alternative to dismissal, they could offer the Claimant the role of ‘Band 7 CBT Therapist’, which would not require him to supervise others. The Claimant accepted this offer.

In a letter dated 14 October 2021, Ms Hutton wrote to confirm the outcome of the disciplinary hearing and the contents of the telephone conversation of 8 October 2021. She said that the suspension would be lifted, he could return to work, in a lower role, as a ‘Band 7 CBT Therapist’ post. The letter added that ‘Interim arrangements may need to be confirmed while your suspension with [the UKCP and BABCP] is addressed. Should your suspension continue or become permanent then further formal processes may be required and there would be a final written warning in place for 12 months.’ As it happened, although the UKCP terminated their interim suspension, the BABCP did not (see below). The effect of the BABCP interim suspension remaining in place was that the Claimant did not return to a client-facing role. Instead, he worked in what he described, in a witness statement, as a ‘non-clinical role’. However, I think it reasonable to infer from the letter of 14 October 2021 that the intention and expectation of his employer, after having completed their investigation, was that the Claimant would return to a client-facing role as a therapist. The letter does not record any reasoning as to why the Claimant’s employer decided this was appropriate. However, I think it can reasonably be inferred that the Claimant’s employer did not consider that the Claimant posed a significant risk to patients.

In a ‘statement of learning for UKCP’ dated January 2022 the Claimant said that over the last 11 months he had had much time to reflect and process what happened. He said this event ‘seems so out of character with the rest of my 20+ year career as a psychotherapist’. He said he was ashamed and sorry to Client A, DE and their family. He said he was sorry for the impact on clients, supervisors, colleagues and the reputation of the profession. He said that at the time this happened, he thought it would be OK to begin a sexual relationship with this particular client after the sessions ended. He said that he could now see that his judgment at the time was wrong. He said that Client A’s interest and ‘assertive requests to meet’ were ‘red flags of a transferential process’. He said he should have refused to meet and held a ‘firm and clear boundary’ when she asked if he found her attractive. He said ‘in my role as a psychotherapist, I alone was responsible for saying No’. He mentioned that at the time he was going through a period of depression due to chronic pain. He said it was a ‘one off event in a twenty-year career’. He said he was deeply sorry and knew it would never happen again. He said, through reflective and development work, he had a ‘deep understanding of the potential pitfalls and warning signs which would prevent any boundary transgressions in the future’.

The Claimant provided a witness statement, 31 January 2022, for an Interim Orders Panel (“IOP”) hearing before the UKCP. He exhibited certificates from the courses he had attended. He also exhibited a 5-page development plan he had developed with Dr Wilkinson. He said he recognised and accepted his own ‘role and responsibility’ in entering into sexual relations with a former patient, as well as the impact this hand on her, her family and the reputation of the profession.

The 5-page development plan was detailed, identifying situational risk factors and what action he would take in relation to them. One of the areas addressed in this plan was ‘power differential in therapist-client relationship’. In relation to this he said he would ‘monitor and regularly review’ any ‘slippage of recognition and awareness of power differential’. The first of the key learning points he said he had learned was ‘remembering the power differential is always present between the therapist and patient’ and it is ‘the therapist’s responsibility to hold boundaries’.

On 4 February 2022 the IOP reviewed and discharged the interim suspension order. They said they were able to give weight to Dr Wilkinson, the Claimant’s mentor, who had ‘spent a considerable amount of time’ with him and assessed him as not having ‘predatory or recidivist propensities’. They also noted the work he had undertaken attending courses. They expressed the view that the Claimant had ‘developed insight and … demonstrated that he has done so.’ They considered that the risk of repetition between then and the substantive hearing was ‘low’.

However, the BABCP did not amend their suspension, to reflect this change by the UKCP, and so the Claimant remained in a non-clinical role.

On 14 November 2022 the Claimant provided a Reflection Statement (which was, for reasons that are unclear, initially omitted from the bundles before me). He said that public trust in the professional standards of psychotherapy was vital. He said that, at the time, his personal power ‘felt diminished’ and he ‘lost sight of the inherent power differential between professional and client’. He then identified different forms of power, including but not limited to coercive power, and rejected ‘the accusation’ that he had used coercive power with any of his clients. He said that ‘from a virtue ethics perspective’, if he had acted with courage he would have said ‘No’ when Client A asked to meet up again socially after the end of their sessions. He said that “rather than ‘courageously’ holding a firmly closed door I chose to be seduced over the boundary into more intimate relationship.’ He referred to his ‘hubris and isolation’ at the time and how his relationship with his partner at the time had ended due to his illness. He said he had become complacent and not noticed how isolated he had become. He said what happened felt like a ‘perfect storm’. He said he was now far more aware of the pattern of ‘counter dependency’ he had fallen into at the time. He said he had identified and put in place measures to ensure this ‘lapse in judgment’ never happens again, such as talking to others, self-care, self-reflection (medication, morning pages, diet, exercise, sleep), seeking self help and being organised. He said he was aware of the warning signs which ‘led to my transgression’, including emotional avoidance, hubris (‘know it already & blame others attitude’), isolating (shame-hiding), not taking action. He said he could state with certainty that he would ‘never again’ put himself in a position to ‘breach boundaries’.