Director of the Psychological Protection Society
by Maeve Lewis
M.L. Are most practising therapists insured nowadays?
S.M. I think there are quite a lot who aren’t but it is impossible to estimate. Some people are not insured because they believe the risk is negligible. Other people aren’t insured because they believe they can manage the risk. But the professional societies are trying to persuade people to be insured.
M.L. Do the insurance companies have regulations concerning whom they will insure? Are there therapists whom they would not insure?
S.M. At the moment we re covering psychologists who have psychology degrees and people who describe their business as “counselling and psychotherapy” who have done counselling courses. We have to accept the information a person gives us when they fill up a proposal form – it s a matter of trust basically. We then go on to look at what they’re doing. If they are doing something which might involve additional risk then obviously we’d collect further information, or the insurance company might say “we can’t cover this.’ So there is an element of discretion there which is exercised by the insurers and as they have to cover the risks, it’s right that they should have this discretion.
M.L. Do you require that a therapist be accredited by a professional association?
S.M. The insurance companies want people to be members of professional societies. The important thing is that they want people to have codes of ethics or practice and they would like the professional societies to have disciplinary procedures. If people come along who aren’t members of a society or who don’t have codes of practice then they come under the economy scheme.
M.L. Do you think insurance companies influence the way therapists are practising? Are there approaches to psychotherapy which wouldn’t be insured?
S.M. Clearly psychotherapy is expanding. Methods of treatment are developing and in a sense we don’t know if they work. The insurance companies are concerned that this may give rise to claims and they would tend to be cautious of new types of therapy. Therefore I would write back and ask for clarification about it. Often this doesn’t help very much but at least the insurance companies have the details. With regard to touch therapies, the problem is that touch can be so easily misinterpreted and can be different for men and women. Touch can sometimes have a sexual element which the client perceives and the therapist doesn’t intend. The question is whether touch therapies should be covered by insurance or not. In the past we have tended to exclude touch but we re looking at it now to see if this rule should be changed. We know that touch therapies are very important, particularity in Ireland and it’s a question of how the policy would have to be altered.
M.L. Do you think that the awareness of possible litigation is influencing the ways in which psychotherapists are practising?
S.M. What is litigation? In the last year we spent £12,500 altogether in the UK and Ireland on solicitor fees.
M.L. So in other words, the situation is not like the USA where there is a high level of litigation?
S.M. Not at the moment. However, therapists themselves seem convinced that a higher risk exists and of course it is their right to lake higher cover. Objectively, as far as we can tell, there haven’t been serious claims. It could happen but therapists seem to get worried about it and the reason they get worried is that the people who sell insurance tell them what could happen!
M.L. So really, there haven’t been many claims?
S.M. In Ireland, we’ve just paid out £6,000 on a case. It was dealt with by the solicitors and didn’t go to court, which cut down costs. We were also in the Family Courts some years ago to get a decision about confidentiality. We were able to fund that out of our own funds, not out of the insurance funds. We got a favourable response to that. It saved the therapist from being disciplined.
M.L. I know you can’t go into details of individual cases, but would you have a sense of the type of grievances which tend to come up in the UK or Ireland?
S.M. There are things like breaches of confidentiality, so therapists need to be very, very careful who they inform about a case – you need to get the client’s consent in writing basically or they can and will sue. Which? magazine looks at cases against GPs from time to time and a lot of cases arise from bad manners. If you conduct your practice with respect for the person you’re looking after and keep them informed, I think you would probably reduce considerably the risk of being sued.
M.L. If a therapist is sued, what are the implications regarding future insurance cover?
S.M. If the therapist is sued, the insurance company will look at what has happened and decide if they will continue to give cover or not. I would suspect that they would continue to give cover except in exceptional circumstances. But much more dangerous is if the professional society suspends membership. Then, certainly in the UK, the insurance will lapse. This hasn’t been raised in Ireland as yet but I think there is that danger.
M.L. What is the situation regarding insurance for supervisors? If a supervisor is sued, what is the liability of the supervisor?
S.M. If it is a student, the student could either be working and keeping the supervisor informed or working on their own initiative and not informing the supervisor. If the student was not informing the supervisor, it would be the trainee s policy that would be involved. But provided the supervisor has been kept informed, the supervisor’s policy could also be involved
M.L.Would the same apply to an experienced therapist working under supervision?
S.M. This issue has not been tested, bill I would have thought the same might apply.
M.L. If a therapist is going to be sued what should they do?
S.M. They should contact me immediatey and they should provide full details . What I would do is I would discuss it with the person who is in difficulty to see if we can find some to resolve it and take it from there. But you must inform me immediately if you suspect something is going to happen. Even if it shows you in a bad light, you must inform .
M.L. If somebody informs you that somebody may sue them and then nothing happens – will that influence their future premiums?
SM. No, no. But it has to be recorded by the insurance company.
M.L. From a purely ethical point of view, what do you think about therapists who practice without insurance?
S.M. I think it’s a decision everybody has to take for themselves. For example, I have computers and I don’t insure them but I put aside a sum each year for each of them which would in time cover anything that may happen to them. Equally, a therapist could decide to put aside half a per cent of every fee they receive which they would then use to pay for any damages they require. At the moment I think a therapist could do this but I think they would be far wiser to insure themselves, obviously!
M.L. Do you think it will become a legal obligation to have insurance in order to practice?
S.M. You could make it a legal obligation from your own professional society. I suspect it probably won’t become a legal obligation, at least for some time.