Fortune Favours The Brave

Claims and complaints in the psychological world - part 1

• Howden Insurance Brokers Ltd

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Ever wondered how psychological and related practitioners can protect themselves from the pitfalls of claims and complaints?

In this episode, we are joined by Max Ekstein from Arch Law who unravels the complexities of safeguarding your practice and reputation. Dive into the strategies that can help shield you from issues regards to claims and complaints, and learn about the processes that will help you manage these risks more effectively.

We provide insights into the crucial role of insurance policies in the allied health sector, as well as guide you through the stages of handling informal complaints, and what to expect when issues escalate to formal claims.

Stay tuned for our next episode of this series where we'll dive into the British Association for Counselling and Psychotherapy (BACP) and their complaints process.

Podcast intro/outro:

Welcome to Howden's podcast Fortune Favors the Brave. We all take risks in our everyday life, and business is no different. In this podcast, we're speaking to the experts about a topical challenge or issue and what business leaders can do to overcome it.

Jo Mountain:

Welcome to Howden's Fortune Favors, the Brave podcast. My name is Jo Mountain and I am the divisional director of the Allied Healthcare team looking after the insurance requirements of psychological and educational practitioners. I'm joined today by Max Ekstein of Arch Law, who assists our clients should they find themselves with a complaint made about them to their professional or registering body or with a claim for compensation for some alleged wrongdoing. This will be part one of a three-part podcast series, with this session looking at claims and complaints in the psychological therapy world, with parts two and three focusing specifically on the complaints process of the BACP, the British Association of Counseling and Psychotherapy, and the HCPC, the Healthcare Professionals Council. Max, can you tell us about yourself and your background please?

Max Ekstein:

Sure thanks, jo. So, as Jo said, I'm a solicitor at Arch Law. I qualified as a solicitor in 2006. I didn't actually do law as my first degree. I did politics and philosophy as a first degree, then worked for a few years in different areas before going back to university to do a law conversion course. I think actually, in terms of this kind of work, it's probably proved helpful, because a lot of it is about your experiences getting on with people, and I think having a sort of slightly wider background has probably been helpful. I initially worked at a big law firm for about 15, 16 years before moving to Arch Law as a consultant.

Jo Mountain:

Fantastic Thanks, M max. So let me start by introducing the concept of risk, by asking you to tell us about a risk you've recently taken and whether it paid off.

Max Ekstein:

So I guess I mean probably one of the biggest risks. As I say, I qualified as a solicitor in 2006, worked for a big law firm for many years and then a couple of years ago decided to go and work independently as a consultant at Arch Law, which is effectively a self-employed role. So that obviously was a big change from working with a big law firm to working independently. So, yeah, that was probably a big risk and, yeah, so far it's paying off. So far so good. So far so good.

Jo Mountain:

So just to give you a little bit of background about me, I've worked in the insurance industry for 37 years, falling into it after A-levels and not really knowing what I wanted to do. I specialised in psychological and related professions for 29 of those 37 years and it now feels like a vocation, particularly helping those where they've received claims or complaints. So back to the policy and how it can help. The two main areas of cover are civil liability cover, which is claims for compensation for some alleged wrongdoing, and complaints either to professional associations or registering bodies. There are also various other extensions at play, such as representation at coroner's court and reimbursement of unpaid fees to avoid a claim or complaint. Where these are formal, M max steps in with his expertise to assist. However, prior to that, I can assist with informal complaints made direct to the practitioner, where the right advice can often mitigate that complaint or claim becoming formal and moving forward. Max, can you talk us through your role at the point that Howden appoint you?

Max Ekstein:

Sure, absolutely so. As Jo says, jo will generally deal with matters at an informal stage. As Joe says, joe will generally deal with matters at a formal stage. So if a client of the therapist is expressing dissatisfaction but it's something short of a formal claim or complaint to a regulator, so Joe will deal with that stage of things as and when it reaches the stage that either a civil claim for compensation is made or it's a complaint to a regulator such as the HCPC and BACP are made, then that's the point that I'll be instructed to assist with that formal process. Also, on occasion, sadly, I'm instructed in relation to inquests. That's something that, given the nature of the work that therapists do, it does arise on occasion. So we also assist with inquests.

Jo Mountain:

So we just wanted to cover some of the main areas where claims and complaints arise from. So if I introduce each one and then Max is going to tell you a little bit more about it, and with giving us some specific examples, hopefully. So, starting with boundary issues, if you can tell us what boundary issues are, M max, and perhaps give us some examples.

Max Ekstein:

Sure. So I mean boundary issues are when there's some kind of blurring of the boundary between the therapeutic relationship and either some kind of personal relationship, some kind of friendship. On occasions I've had business relationships where a therapist has entered into a business relationship with a client. These are all things that need very, very careful attention by the therapist. I think it's particularly with technology these days, with mobile phones. Probably 20, 25 years ago there was less of a possibility of blurring of boundaries, but these days, where the general blurring of boundaries between your work life and your personal life with mobile phones, it's something that I think unfortunately, people can sometimes slip into.

Jo Mountain:

So another area that gives rise to claims and complaints on a regular basis is where it's either couples or working with children. So could you tell us a little bit about that area of risk, Max, please?

Max Ekstein:

Yeah, absolutely so. I mean most standard therapy, if I can put it that way, will involve the therapist and one individual client, and there can be complex issues, of course, but when you are dealing with either couples counselling or situations where the client is a young person, then that can give rise to its own complexities. An example of a few cases I've dealt with has been where a therapist has provided counselling to a couple Down the line. One half of the couple has asked for the therapist to write a letter in support of them. Sometimes in connection with court proceedings, the therapist, with all good meaning, has agreed to write the letter without giving sufficient thought to well, actually both parts of the couple were my clients and then the other half of the couple finds out about this letter and is very unhappy about it, and that has resulted in complaints With young people.

Max Ekstein:

Again, confidentiality can be a big issue. So if you're dealing with a young person of, say, 13, 14 years old, who are competent, they will sometimes have their own thoughts about the information that they do and don't want to be shared with their parents. The parent will sometimes want more information to be shared with them than the young person wants. That can result in some complicated situations and I would say the main thing there is just to try and get clarity at the outset of the therapeutic relationship as to what information will or won't be shared.

Jo Mountain:

So contracting is quite important.

Max Ekstein:

Absolutely. Just having, as I say, clarity at the outset is always good, fantastic, and one of the areas that where I've been assisting clients with complaints over the last couple of years has been psychologists acting as expert witnesses in the family courts. So they will be asked to provide an opinion on where they think a child should be. In terms of one of the parents, both of the parents, this is obviously a very, very emotive area. You're almost inevitably going to irritate one of the parties by your is obviously a very, very emotive area. You're almost inevitably going to irritate one of the parties by your findings and by your opinion. Sometimes, at the end of the case, the dissatisfied party will make a complaint to the regulator saying they weren't happy with the work of the experts. That's something that I've dealt with a number of complaints in that area over the last two years.

Jo Mountain:

We've also seen issues arise with psychologists working in the prison service. Tell us a bit more about that, too.

Max Ekstein:

Yeah, absolutely so. I mean, sometimes prisoners will not be happy with the psychological input that's been prepared, sometimes in relation to the expert witness work that psychologists have performed, sometimes to do with parole issues. So yeah, that's another area where complaints are made.

Jo Mountain:

So we'd just like to finish with some advice on what to do if you find yourself in any of the positions that we've described. So, firstly, don't panic and don't go it alone. Tell your insurance broker or company straight away. It is a condition of your policy and, of course, we can help, as we've described, both myself and Max. But before you get to that stage trying to mitigate getting there and relating to general practice make sure that you take complex issues to supervision where help is waiting, and can head off claims and complaints by dealing with those issues before they become a problem. Would you agree with that, M max?

Max Ekstein:

Yeah, absolutely. I mean particularly in terms of taking matters to clinical supervision. Obviously, supervision is an integral part of your practice. It can be helpful to discuss any complex matters with your supervisor, but also, if a complaint is subsequently made, if you can say that you took the matter to supervision, then that is, it can be a very helpful point to make when you're defending these, these kind of complaints.

Jo Mountain:

Thank you for joining us for this podcast. We hope you found it helpful and thank you, M max, for your invaluable input. Join us next time in part two, where Max will join me again to discuss the complaints process of the BACP, the British Association of Counseling and Psychotherapy.

Podcast intro/outro:

Thank you for listening to this episode of Fortune Favors the Brave from Howden. To hear more episodes and subscribe to our channel, search Fortune Favors the Brave on your favorite podcast app.