Understanding complaints: insights from the 2023 PCC annual report

Complaints in 2023

In 2023, UKCP received the highest number of complaints compared to previous years. In total, we received 102 complaints, of which 91 were about UKCP registrants. This means that approximately 0.95% of UKCP registrants were the subject of a complaint.

We’re not sure why the number of complaints has increased over the years. It may simply be because the number of UKCP registrants has increased. Or it could be that society’s increase in awareness of mental health issues has caused a parallel rise in expectations about the quality of care they receive. Perhaps clients are better informed about the standards they rightfully deserve.

Learning from complaints

After the conclusion of each complaints case, the complaints and conduct team undertakes a root cause analysis to identify the behaviours or situations that triggered the complaint.

The root cause analysis of complaints involves:

1. reviewing the information
2. categorising the complaint into one or more broadly defined groups based on the issues
3. identifying recurring issues based on the categorisation
4. analysing the circumstances causing the complaints within each category.

The root cause analysis helps identify the underlying causes of complaints. It provides valuable insights into the behaviours or situations that lead to complaints. Information from the root cause analysis is then shared with members through the learning from complaints section of the UKCP website. Findings also help shape training events and policies. The aim is to help members avoid circumstances in which trigger points may arise.

Top causes of complaints in 2023

The root cause analysis has shown us that the three most recurring causes of complaints in 2023 were unprofessional communication and/or breakdown in communication, failure to maintain professional boundaries and decisions made by another professional body. Let’s explore the root causes for each recurring cause for complaints.

Unprofessional communication and/or breakdown in communication

Effective communication lies at the heart of every therapeutic interaction. Clients seek solace in therapists who not only listen actively but also communicate with clarity, empathy and respect. If a therapist lacks clear communication skills or struggles to explain therapeutic concepts, clients may become frustrated and lodge complaints.

Therapists must also be mindful of the language they use, ensuring it is respectful, non-discriminatory and culturally sensitive. The use of insensitive or offensive language can cause harm and result in complaints from clients.

With the ever-growing prevalence of electronic communication, therapists must maintain professionalism online and on social media. Social media posts can be easily misinterpreted or taken out of context. Something intended innocently may be perceived differently by clients, colleagues or the public.

Addressing complaints and concerns about unprofessional communication is essential for therapists to maintain the trust and confidence of their clients and uphold professional standards in the field of therapy.

Failure to maintain professional boundaries

Boundaries are the bedrock of trust. Therapists must maintain clear boundaries to uphold the integrity of the therapeutic relationship. Breaches in boundaries can erode trust and compromise the efficacy of therapy.

Therapists should avoid engaging in dual relationships with their clients, where they have multiple roles or relationships with the client outside of therapy. This could include being friends, romantic partners or having a business relationship with the client. Breaching this boundary can lead to complaints as it undermines the therapeutic relationship and can cause harm to the client.

While some self-disclosure by therapists can be beneficial in building rapport and demonstrating empathy, excessive or inappropriate personal disclosures can breach professional boundaries. Clients come to therapy to focus on their own concerns, and if the therapist shares personal information that is not relevant to the therapeutic process, it can detract from the client's experience and lead to complaints.

Decisions by another professional body

Decision by another body refers to situations where the complaint was triggered by a decision or action taken by another organisation or regulatory body, such as the NHS or other regulators. These decisions might include findings of professional misconduct or breaches of ethical standards and can stem from a range of situations, for example, failing to maintain professional boundaries, dishonesty or breaching client confidentiality.

It is important for members to hold in mind their ethical obligations under paragraph 39 of the Code of Ethics (below) which states that they must declare such information to UKCP in a timely manner, rather than waiting until membership renewal season to do so.

1. 39. Cooperate with any lawful investigation or inquiry relating to your psychotherapeutic practice. Inform UKCP and any relevant organisational member if you are:
   40. charged with a criminal offence
   41. convicted of a criminal offence, receive a conditional discharge for an offence, or accept a police caution
   42. disciplined by any professional body or membership organisation responsible for regulating or licensing a health or social care profession or
   43. suspended or placed under a practice restriction by an employer or similar organisation because of concerns relating to your competence, health or practice of psychotherapy.

Therapists have a responsibility to be accountable. By actively declaring any complaints, convictions or disciplinary actions to UKCP, members can foster trust, strengthen the therapeutic alliance and ultimately enhance the quality of care they provide.

Conclusion

Anticipating the future is key to staying ahead of the curve. Understanding trends in complaints about therapists is instrumental in elevating the standards of mental health care and promoting client wellbeing. By prioritising boundaries, honing communication skills and upholding ethical standards, therapists can cultivate environments conducive to healing and growth. By analysing and learning from complaints, the UKCP aims to improve professional standards and promote confidence in the psychotherapy profession.

You can read more about complaints in 2023 in our newly published complaints annual report. We will further explore the 2023 report at our next learning from complaints event this summer.