Receiving a complaint from a client is an unfortunate reality that many psychologists may face at some point in their careers, says Dr Janina Szyndler MAPS.
It’s almost inevitable that all psychologists will, at some point in their professional career, receive a client complaint, says Dr Janina Szyndler MAPS, clinical psychologist.
"If you have been following good practice guidelines, it’s not going to be the end of your working life,” says Dr Szyndler.
Complaints can vary from someone leaving a bad Google review to lodging a formal complaint with Ahpra. Dr Szyndler recently ran an APS webinar focused on the latter: understanding and dealing with formal complaints, which can be accessed on demand.
During her career, Dr Szyndler has heard of various reasons that clients complain.
“Where Ahpra tends to get involved is when people make allegations of improper or inappropriate relationships, unethical practice or unprofessional conduct, [for example].
“[Health practitioners] can also be reported if concerns arise about their [own] mental health or alleged substance misuse.”
As another example, in Dr Szyndler’s experience, there can be a disproportionate number of complaints in Family Law proceedings.
“You have two parents who are in conflict. If a psychologist is perceived as taking one parent’s side over another's, that could trigger a complaint to Ahpra."
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What does Ahpra's investigation process look like?
Dr Szyndler walks participants through the investigation process in detail as part of her webinar, but overall, the process looks like this:
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In most cases, Ahpra will contact the psychologist to let them know a concern has been raised. While this can obviously be a distressing experience, particularly if it comes out of the blue, Dr Szyndler emphasises the importance of trying to remain calm in this situation.
"[Psychologists] often jump to the worst-case scenario and assume this means they're at risk of de-registration. But if you're following good practice, it's actually relatively unlikely to proceed to anything more serious," she says.
Psychologists should be guided and supported by their professional indemnity insurance provider in terms of their response to Ahpra. This is commonly a requirement under insurance policy ref: duty of disclosure section AON (Common Insurance Terms and FAQs).
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Ahpra will then collect information from both the client and the psychologist. This usually means asking for the psychologist's response to the notification and can include accessing the psychologist's case notes. They may also seek information related to professional development and/or supervision.
"These are the basic three things that they usually request. Once they've reviewed those things, that's very often the end of things. They might see that, yes, the client is unhappy, but there haven't been any breaches of conduct or anything that requires their further involvement."
If you practice well, and a complaint happens, you're most likely going to be fine. – Dr Janina Szyndler MAPS
Preventative measures to take
Dr Szyndler says it's not always whatever the client has initially complained about that becomes the primary issue for the psychologist, but rather what the first stage of an investigation reveals.
"I’ve [seen instances] where people don’t have adequate notes, where they’ve maybe responded inappropriately to the complaint or maybe they haven’t been doing any CPD."
In the webinar, Dr Szyndler refers to a range of different resources regarding effective notetaking, including APS's record-keeping practice guidelines.
In general terms, "with notes, there should be an account of what you did and what your treatment plan is. The notes should also include some sort of mental state evaluation or an overview of the person's presentation. Whoever looks at them [needs to have] a clear sense of where you're going with that client."
A significant red flag for Ahpra is the perception that notes have been altered after a complaint was filed, she warns.
"Sometimes people do that... it's fairly clear that they've written the notes almost to fit the story, and that’s not a good look."
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The importance of connection accountability
Connection with your professional network is a vital preventative measure.
"Having good supervision is very helpful, whether that’s with your peers or [formal] supervision. It’s a way of keeping abreast of developments and current standards."
Dr Szyndler also emphasises the importance of reflective practice. This involves standing back to consider the event that led to a concern being raised, and any appropriate actions you have taken to reduce the likelihood of negative outcomes.
Often when challenging situations arise, psychologists would have taken that to supervision, consulted with colleagues, or reviewed their CPD plan to hone their skills in a particular area of practice.
Ahpra values this information, and a psychologists’ PII will guide them in developing an appropriate response that captures their actions.
"Ahpra likes to see people being reflective – to be able to say, 'Maybe this person has a point'. They want to see what you’ve done to help skill yourself up and what you’ve learned as a result to prevent making a similar error in the future."
Understanding the bar for disciplinary action
When practitioners do find themselves facing conditions or performance reviews, it can feel like a punishment. However, Dr Szyndler reminds psychologists that the regulatory framework is built on a single foundation: protection of the public.
"Because there is a duty to protect the public, Ahpra has to be quite strict about certain things," she says. "Boundary violations, for example, are dealt with quite strictly because we deal with people who are potentially vulnerable."
Ultimately, the best defense is a proactive, well-documented and connected professional life.
"If you practice well, and a complaint happens, you're most likely going to be fine."
Learn more about understanding and responding to the complaints process by signing up for this on-demand webinar.