A Fair Process In A Difficult Situation
Marriage and family therapists are professionals who strive to provide the best services for their clients. Therapists are also human beings and on occasion tend to make unfortunate mistakes when rendering these services. The point at which the client perceives that they have been injured by the professional is when they may seek justice from an outside source, such as the courts or a licensing board and/or professional organization. This article will explain how an ethics complaint is processed by the American Association for Marriage and Family Therapy (AAMFT).
The AAMFT Procedures for Handling Ethical Matters is the official document that outlines the association's process for investigating ethics complaints against its members. An examination of these procedures indicates that it is primarily a "paper review" process. Complaints may be submitted by members of the AAMFT, non-members and the AAMFT Ethics Committee. In all but those cases that are filed by the AAMFT Ethics Committee, the complainant must have first-hand knowledge about the issue or be able to provide relevant testimony related to it.
The AAMFT Ethics Committee may initiate a complaint when presented with sufficient information indicating allegations that could constitute a violation of the Code of Ethics. According to the procedures, "When a member has been disciplined by another professional association or a regulatory board, or convicted of a felony, or misdemeanor related to his or her qualifications or functions by a court, it is the policy of the AAMFT Ethics Committee that the Committee will presume that such findings are correct and appropriate." However, the member is offered an opportunity to demonstrate evidence to overcome this presumption, through documentation that: (1) the investigative process was flawed and resulted in an incorrect outcome, and/or (2) that the action taken was too severe for the type of infraction.
Upon receipt of a complaint alleging violations of the AAMFT Code of Ethics ("Code"), ethics staff review for jurisdiction, filing deadlines, merit and precedent. For a case to proceed, complainants must waive therapist-client confidentiality and permit the use of their name and the provision of a copy of the allegations to the respondent member. All applicants and members are held to the Code, as are resigned members for a period of one year after resignation. If the complaint is judged to have merit under the Code, staff draft charges and present the case to the chair of the Ethics Committee for consultation and approval or modification. The Ethics Committee, usually acting through the chair, has the sole authority to make charges against members. Once the member is charged, the full investigative process is engaged and the complainant is notified. The member is required to address the allegations and present a defense within 30 days. If the member resigns in anticipation of, or during, the course of an ethics investigation, the Ethics Committee will complete its investigation. Any publication of action taken by the association will include the fact that the member attempted to resign during the investigation.
At any point in the process, the chair or full Ethics Committee may close the case for lack of merit or hold it in abeyance if the allegations appear to be more appropriately handled by another professional, civil or regulatory body.
When case materials are complete, the staff prepares and presents them to the Ethics Committee for deliberation. Only the full Committee can make a finding that a violation has occurred. "Preponderance of the evidence" is the standard of proof, and no members, complainants or witnesses attend Committee meetings, which are held each spring and fall. The Committee is composed of four Clinical Members and two public members.
If the Committee finds the member in violation of the AAMFT Code of Ethics, the next step is to render an appropriate sanction based on the severity of the infraction. For the most serious violations, the Committee may recommend termination of membership with a permanent bar to readmission. As a sanction for lesser violations, the Committee may seek rehabilitation of the member by offering a "mutual settlement" in which the member agrees to mandated education, supervision, therapy, suspension or other actions. If the complaint has been filed against an applicant for membership, the Committee makes a report to the Standards Committee recommending that the application proceed or be denied. The Committee also issues warnings or reprimands as deemed appropriate. Members found in violation of the Code have the right to a hearing before the AAMFT Judicial Committee. If an appeal hearing is not requested, the Ethics Committee's findings and sanctions become final.
If the member files an appeal with the Judicial Committee, the committee’s chair appoints a Hearing Panel to conduct a hearing. At the hearing, the Ethics Committee chair presents the charges against the member and has the burden of proving these charges by a preponderance of the evidence. During the hearing, the Ethics Committee chair and the member may be assisted by counsel, present witnesses, cross-examine witnesses and make brief opening and closing statements. An audiotape is made of the hearing. The Hearing Panel renders a decision within 30 days, indicating whether or not a violation was found, and if a violation is found, ordering action to be taken. Since 1990, 25 ethics cases have been reviewed by the Judicial Committee. The last hearing was held in 1997.
A member may make a final appeal to the AAMFT Board of Directors if they believe that a procedural violation impaired their defense before the Judicial Committee Hearing Panel. The Board reviews the appeal at its next scheduled meeting and renders a decision based solely on the member's written statement and the response from the Judicial Committee or AAMFT’s legal counsel. The Board renders a written decision within 30 days of the meeting. This decision may affirm the Judicial Committee’s decision or order a new hearing. Since 1990, the AAMFT Board has reviewed three ethics cases. The last appeal to the Board was reviewed in 1994.
All information obtained by the Ethics Committee and all case proceedings are confidential with limited exceptions. At this time, termination of membership is the only sanction that is routinely made public. Sanctions that involve mutual settlements, warnings or reprimands remain confidential and the only notification is made to the complainant. The procedures permit AAMFT to provide a limited report on the case to a regulatory board or another professional association upon their request. At that time, the member is provided a copy of the report.
For information on how to file an ethical complaint with the association, please consult the AAMFT’s Web site at www.aamft.org or call (703) 838-9808 and request to speak with the AAMFT Ethics staff.
This article first appeared in the June/July, 2001 Family Therapy News and may not be reproduced without attribution.
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