Psychologist sent inappropriate texts to patient she knew before therapy began

A psychologist used WhatsApp to message a patient, a woman she knew before beginning therapy, at all hours of the day and on weekends, mixing personal and professional content. Photo / 123rf

A psychologist who told her patient she loved her during an exchange of 1000 WhatsApp messages over five months has been found guilty of malpractice by blurring professional and personal boundaries.

The continuous inappropriate messages to the woman she knew before the therapy began included “You are loved” and “You have a very special place in my heart and life”, as well as kissing and rose emojis.

The messages were found to be unethical and a breach of her obligations as a psychologist, the Health Practitioners Disciplinary Tribunal (HPDT) heard today.

According to the Professional Conduct Committee (PCC), which brought the charge of professional misconduct against the psychologist, she fostered dependency in a vulnerable client dealing with trauma.

At one point the patient, who had a pre-existing mental health condition, self-harmed. When she messaged the psychologist and told her she felt better after doing it, the doctor messaged back: “That’s good.”

Lawyer for the PCC, Belinda Johns, said the psychologist, who has name suppression, engendered feelings of being special in the client, who she knew and socialised with before the therapy sessions began in June 2019.

The PCC also said the psychologist did not create or keep proper clinical records of the patient’s therapy.

The two women and their partners knew each other in their home country and socialised at each other’s houses on several occasions after immigrating to New Zealand before the patient began having therapy sessions with the psychologist.

There were no boundaries put in place by the psychologist, and almost immediately, the pair began exchanging WhatsApp messages that Johns said were highly inappropriate.

The tribunal was taken through a 70-page transcript of the messages from the psychologist which included: “Know that you are very much loved and cared about” and “You are very very special. It is such a privilege for me to witness your journey.”

On one day, she bombarded the patient with 20 messages in a short period of time compared to the patient’s two response messages.

The emojis symbolised affection and the language she used indicated closeness: “I pray soft dreams for you... love you very much... oh little angel...”

During and after some of the 16 therapy sessions, the psychologist hugged the patient, whose name is also suppressed, and encouraged and received gifts from her.

Johns said the psychologist developed a dual relationship with her patient that was intimate, personal and highly unprofessional, which was bound to cause harm to the patient.

The tribunal heard the patient’s partner, who initially sought the counselling, became concerned at the communication.

In November 2018 the patient ended the therapy, but the psychologist kept in touch, and in March 2018, she messaged the woman’s partner about the patient’s mental health issues without her consent or knowledge.

She quickly deleted the message but the partner had already read it. The patient complained to the Psychologists Board that this breached her privacy.

The psychologist apologised and refunded the $3070 in counselling fees, and was now under supervision and subject to conditions on her practice. She was also ordered to undergo a competencey review by the Psychologists Board.

The psychologist sent 600 texts to her patient in five months. The conversation was in another language and had to be translated for the prosecution. Photo / 123RF

However, the patient told the tribunal the conduct had negatively affected her, and that the psychologist undermined her capability, intellect and mental capacity to speak for herself, something she had been subjected to throughout her life.

She had since experienced a “rollercoaster of emotions” including anxiety, anger, grief, feelings of violation, sadness, regret and panic attacks.

The woman suffered emotional burnout and had to undergo four months of therapy. She and her partner eventually sold their house to move on from the situation.

Johns said the psychologist held herself out as a senior, experienced practitioner and the patient was entitled to place significant trust in her, yet her lack of insight into the dual relationship was “troubling”.

Her initial response to the PCC’s investigation was to downplay the text messages and deny she had fostered dependence. She also deleted the patient’s number from her phone, which deleted the message thread.

That her prior friendship with the patient clouded her judgment was not an excuse, Johns said, and that she did not recognise the serious nature of the conflict of interest and blurring of boundaries before, during and after was of significant concern - especially because she was now in private practice.

Her lawyer Duncan McGill said the dual therapeutic and personal relationship was a one-off and the psychologist had never blurred the boundaries with any other clients.

She accepted she failed to identify the conflict of interest and there was a power imbalance in the relationship, but felt pressured to take on the therapy by the patient’s partner.

“She accepts she got it wrong in this case. That occurred in the context of common heritage, and knowledge of her partner through her own partner. This conduct related to a platonic friendship.”

McGill said there was no evidence of pressure or coercion or that the psychologist took advantage, exploited or harmed the patient, though this was disputed by the PCC.

He said the texts, though inappropriate, were of an overriding caring nature and she was acting out of concern.

The fallout had also impacted her significantly; she was emotionally drained, stressed, had lost confidence and there had been financial implications. Her own family was also impacted by the stress.

She was regretful and remorseful this had happened and had reflected on it and put in place measures to make sure it did not happen again.

He said the tribunal could be assured of the public’s safety because she was already under supervision.

A suspension was not appropriate, but a censure and fine were, he said, together with completing the board’s competence programme.

Tribunal chairwoman Alison Douglass said while the tribunal did not consider the hugs or physical contact on their own as professional misconduct, the other parts of the charge were made out.

She said the conduct was a matter of “very serious concern”, reflected poor professional judgment and warranted disciplinary sanction and penalty.

The PCC sought a fine of $10,000, censure, conditions on practice and costs toward the $118,000 prosecution, while the psychologist did not see permanent name suppression.

The penalty would be made public when the tribunal releases its written decision, including whether it would grant permanent non-publication orders.

Natalie Akoorie is the Open Justice deputy editor, based in the Waikato and covering crime and justice nationally. Natalie first joined the Herald in 2011 and has been a journalist in New Zealand and overseas for 27 years, recently covering health, social issues, local government and the regions.