to any person or entity of the names, addresses or any other identifying information of Patient A.
[2]
Introduction
These proceedings concern a complaint brought by the Director of Proceedings of the Health Care Complaints Commission (Commission) against Mr Sava Tsolis (practitioner).
By Application for Disciplinary Findings and Orders filed 4 June 2021, the Commission seeks cancellation of the registration of the practitioner as a psychologist and prohibition orders under ss 149A and 149C of the Health Practitioner Regulation National Law (NSW) (National Law).
A "Stage 1" hearing was held on 14, 15, 16 and 17 March 2022. Written submissions were later filed and oral submissions heard on 27 May 2022.
In summary, for the following reasons, in relation to Complaint One, we find:
1. each of Particulars 1(a) to (d) is established;
2. Particulars 1(e) and (f) are not established;
3. each of Particulars 2(a) to (d) is established.
In the circumstances, we find Complaint One established, that is that the practitioner is guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that he engaged in conduct that demonstrates the judgement possessed, or care exercised, by the practitioner in the practise of psychology is significantly below the standard reasonably expected of a practitioner on equivalent level of training or experience.
For the following reasons, in relation to Complaint Two, we find:
1. each of Particulars (1)(a) to (c) are established;
2. Particulars 1(e) and (f) are not established;
3. each of Particulars (2), (3), (4) and (7) is not established;
4. Particulars (5)(a), (b) and (d) are established;
5. Particular 5(c) is not established,
6. Particulars (8) and (9) are established.
In the circumstances, we find Complaint Two established, that is that the practitioner is guilty of unsatisfactory professional conduct under s 139B(1)(l) of the National Law in that he engaged in improper or unethical conduct relating to the practice or purported practice of psychology.
In the circumstances, we also find Complaint Three established, that is the practitioner is guilty of professional misconduct under s 139E of the National Law.
[3]
Background
There were three complaints made by the Commission in its Complaint dated 4 June 2021.
The background to all complaints was:
The practitioner was first registered as a psychologist in NSW on 12 January 2010.
The practitioner is employed as the Principal Clinical Psychologist at Insight Psychology Group, Five Dock ("the practice") and has held this position since January 2010.
Patient A is a 40 year old female.
Patient A was referred to the practitioner by her General Practitioner on 20 April 2016 for opinion and psychological management under a Mental Health Plan.
Patient A first consulted with the practitioner on 22 April 2016.
[4]
Complaint One
Complaint One is that the practitioner is guilty of unsatisfactory professional conduct under s 139B(1)(a) of the Health Practitioner Regulation National Law (NSW) (National Law) in that he engaged in conduct that demonstrates the judgement possessed, or care exercised, by the practitioner in the practice of psychology is significantly below standard reasonably expected of a practitioner on equivalent level of training or experience.
[5]
Particulars
The particulars of Complaint One were as follows:
1. On more than one occasion, during consultations at the practice between 22 April 2016 and 18 July 2017 the practitioner failed to maintain appropriate professional boundaries with Patient A in that he:
(a) referred to Patient A as "kid"/and "my love",
(b) allowed Patient A to refer to him as "boss;
(c) commented on Patient A's physical appearance by calling her "beautiful";
(d) commented on Patient A's personal attributes by calling her "intelligent";
(e) asked Patient A to comment on his physical appearance, including his:
(i) haircut;
(ii) beard;
(iii) clothing;
(f) inappropriately disclosed personal information about:
(i) his pregnant wife;
(ii) his new child;
(iii) how many sexual partners he had.
2. Between 28 April 2016 and 23 May 2017, the practitioner failed to maintain appropriate professional boundaries in that he exchanged the following number of 'out-of-session' telephone calls and text messages with Patient A in circumstances where the amount of contact was excessive in the context of the therapeutic relationship and some of the communication was personal in nature:
(a) 122 telephone calls initiated by Patient A;
(b) 137 telephone calls initiated by the practitioner:
(c) 82 text messages sent by Patient A;
(d) 53 text messages sent by the practitioner.
In his Reply, the practitioner:
1. admitted Particular 1(a) in so far as he referred to Patient A as "kid". However, during the course of the hearing the practitioner said that he did call Patient A "my love", but on no more than one occasion;
2. admitted Particulars 1(b), (c), (d);
3. denied Particulars 1(e) and (f);
4. admitted each of Particulars 2(a) to (d).
[6]
Complaint Two
Complaint Two was that the practitioner was guilty of unsatisfactory professional conduct under s 139B(1)(l) of the National Law in that he engaged in improper or unethical conduct relating to the practice or purported practice of psychology.
[7]
Particulars
The particulars of Complaint Two are set out below. Particulars (6) and 7(d) were withdrawn during the hearing:
1. At the end of a number of consultations at the practice between 22 April 2016 and 18 July 2017 the practitioner failed to maintain appropriate professional boundaries in that he:
(a) touched Patent A's thighs;
(b) kissed Patient A's forehead;
(c) hugged Patient A.
2. On more than one occasion, during consultations at the practice between 22 April 2016 and 18 July 2017, the practitioner failed to maintain appropriate professional boundaries in that while hugging Patient A he would ask her about his erection.
3. On more than one occasion, during consultations at the practice between 22 April 2016 and 18 July 2017, the practitioner failed to maintain appropriate professional boundaries in that he:
(a) advised Patient A that he was sexually aroused;
(b) said words to the effect that he often had to shift in his seat due to his arousal.
4. On a date between 22 April 2016 and 18 July 2017 the practitioner failed to maintain appropriate professional boundaries with Patient A in that he:
(a) inappropriately requested that Patient A send, by text message, a photo of her lower back tattoo to him;
(b) inappropriately viewed a photo of patient eyes lower back tattoo that was sent my text message to the practitioner by Patient A.
5. On 9 July 2016, the practitioner failed to maintain appropriate professional boundaries in that he inappropriately took Patient A need to dinner at Bathers Pavilion in Mosman in circumstances where:
(a) the practitioner was Patient A's treating psychologist;
(b) alcohol was consumed by the practitioner and Patient A;
(c) the practitioner inappropriately kissed and touched Patient A during dinner;
(d) the practitioner inappropriately kissed and touched patient a in the Uber car ride back to her residence in Russell Lea.
6. On 9 July 2016, following dinner at Bathers Pavilion in Mosman, the practitioner failed to maintain appropriate professional boundaries in that he engaged in sexual intercourse with Patient A at her home in circumstances where:
(a) the practitioner gained entry into Patient 4% home by requesting to use the toilet;
(b) upon exiting the toilet in Patient A% home, the practitioner entered Patient A's bedroom and started to kiss and touch her;
(c) Patient A said to the practitioner words to the effect of "what is happening", (d) the practitioner responded with words to the effect of "what am I supposed to tell my wife. I have the night off and told my wife I won't be home";
(e) Patient A did not want to have sexual intercourse with the practitioner;
(f) the practitioner asked Patient A if he could ejaculate inside of her;
(g) after/engaging in sexual intercourse, Patient A asked the practitioner to leave her house.
7. On a date after 9 July 2016, during a telephone conversation with Patent A, the practitioner inappropriately:
(a) asked Patient A how her finances were going;
(b) spoke about a previous offer to pay for Patient A's $850 drug debt and retracted the offer;
(c) accused Patient A of being in more debt than she was;
(d) called Patient A a "sex worker" with reference to the evening of 9 July 2016, namely the dinner at Bathers Pavilion and the sexual intercourse that occurred.
8. By reason of Particulars (1) to (5), individually or in any combination, the practitioner engaged in inappropriate conduct of a sexual nature towards Patient A.
9. On 22 January 2018, the practitioner provided false and/or misleading information to the Psychology Council of New South Wales, namely he denied consuming alcohol at dinner with Patient A at Bathers Pavilion in Mosman on 9 July 2016 when he had consumed alcohol at dinner on that occasion.
In his Reply, the practitioner denied Particulars (1), (2), (3), (4) and (7).
In his Reply, as to Particular (5), the practitioner:
1. admitted Particular 5(a);
2. did not admit Particular 5(b);
3. denied Particulars 5(c) and (d).
[8]
Complaint Three
Complaint Three was that the practitioner was guilty of professional misconduct under s 139E of the National Law in that he had:
1. engaged in unsatisfactory professional conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration, or
2. engaged in more than one instance of unsatisfactory professional conduct that, when the instances are considered together, amount to conduct of a sufficiently serious nature to justify the suspension or cancellation of the practitioner's registration.
The Particulars of Complaint Three were:
1. Particulars 1, 2, 3, 5, and 8 of Complaint Two individually;
2. Complaints One and Two and the particulars thereof cumulatively.
In his Reply, the practitioner denied Complaint Three.
[9]
Procedural Matters
At or shortly after the commencement of the first day of the hearing the respondent made an application that Particular (6) of Complaint Two be summarily dismissed, struck out or withdrawn.
In summary, the respondent contended that Particular (6) should be dismissed because:
the Particular had significant evidentiary deficiencies;
the Particular had no reasonable prospects of being proved;
the Particular was vexatious;
maintenance of the Particular sought to inflame bias of the Tribunal; and
maintenance of the Particular sought to bolster the balance of the complaint rather than seeking a determination on the complaint itself.
After oral submissions from both parties, the Tribunal declined to hear and determine that application on a summary basis. However, during the course of the hearing, and after the evidence of Mr Rehaan had been given, the Commission withdrew Particular (6) of Complaint Two.
[10]
The Commission's evidence
The Commission filed one large bundle of material consisting of some 49 documents. These documents included but were not limited to evidentiary certificates provided by the Australian Health Practitioner Regulation Agency (AHPRA) and the Council; correspondence between the Commission and the practitioner; the reasons for decision of the s 150 proceedings of the Council dated 29 January 2022 in relation to a hearing held on 22 January 2022 and the transcript of that hearing; materials provided by the practitioner to the Council; the complaint of Patient A; witness statements of Patient A, Ms Alice Jaroszewicz, Dr Agatino Reullo and an expert report of Prof Diana Kenny dated 12 June 2020 (together with supplementary reports); the practitioner's treatment notes of Patient A and documents produced by Uber and Bathers Pavilion Restaurant in relation to the dinner attended by Patient A and the practitioner on 9 July 2016.
Patient A and Prof Kenny were required for cross-examination.
[11]
Notification to Commission
On 21 December 2017 Patient A sent a notification to the Commission concerning the practitioner. That document relevantly states:
Inappropriate conduct including:
Called/referred to me as "KID" & "MY LOVE" - verbal & written
Said I was beautiful & intelligent & that I spoke well.
Asked me download "Map My Run" App in order to track my whereabouts, in addition to personal time
Asked if I had noticed anything about him eg: haircut, bet [sic -belt) (ARMANI), clothing beard, if I felt , saw noticed his erections when he saw me & and if I felt it when he hugged me.
Hugged & kissed me on the forehead in sessions.
Asked me how many sexual partners I'd had & told me how many he had.
Asked me to send a photo of my lower back tattoos
…
On Saturday 9 July 2016, Sava came to my home & picked me up after briefly coming inside. He took me out to dinner (at his suggestion & request) via UBER. We went to Bathers Pavilion. He wanted me to have a "REAL DATE" experience. He kissed and fondled me at the restaurant, and more openly in the Uber on the way to my house. He took me home & we had sexual intercourse.
In the notification, Patient A stated that the main issues she was concerned about were:
Inappropriate behaviour - all counts - sexual assault.
He did not treat me.
Belittled me & controlled me - Emotionally damaged me
In the notification, Patient A stated that she had also approached her psychologist Ms Jaroszewicz and her psychiatrist Dr Reullo about her complaint.
Attached to the notification was a text exchange between Patient A and practitioner on 9 July 2016 indicating that the practitioner had come to Patient A's house to collect her that day.
[12]
Statement of Patient A to the Commission dated 13 April 2018
In this statement Patient A relevantly stated:
1. each session with the practitioner was held in a doctor's surgery at Five Dock Medical Centre. The sessions were weekly and usually lasted 1 hour. The early sessions were longer in duration, as the therapy sessions continued the sessions became shorter. The sessions would last longer if he was enjoying the topics of conversations;
2. the topics they discussed during sessions included Patient A's childhood, her childhood abuse, her drug and alcohol addictions and the debt associated with her addiction;
3. the practitioner asked her irrelevant questions about her personal relationships and sexuality, including if I had extramarital affairs and how many sexual partners I had since moving to the area. The practitioner told her that this information was important in managing a person with bipolar disorder;
4. the practitioner started to call me "Kid" in our first and second session, when I had started crying. He told her she looked "really pretty" when she cried;
5. during the sessions, the practitioner spoke about his personal life including about his pregnant wife, his new child and the number of sexual partners he had (being 88 in total);
6. Patient A did not pay for any of her sessions with the practitioner, who never asked for payment;
7. exercise was recommended by the practitioner as part of her treatment plan. She was not aware if the practitioner was able to track her movements on Map MyRun;
8. the questions the practitioner asked during sessions often made her feel sad. When Patient A became upset, he would touch her thighs, kiss her forehead and hug her;
9. the practitioner would also hug her at the end of each session;
10. the practitioner would ask Patient A about his haircuts, his erections when he was hugging her, his beard and his clothing. He said "he would often have to shift in his seat" due to his arousal;
In relation to the events of 9 July 2016 Patient A stated:
30. On 9 July 2016 Mr Tsolis caught an Uber to my house. I texted him to wait outside, I didn't want the evening to happen. He texted me that he would go for a walk and come back.
31. On his return we caught an Uber to the restaurant, Bathers Pavilion at Balmoral. On our evening out, we talked about personal issues, he was saying how lucky I was to be there, and how fancy the place was. Mr Tsolis ordered a bottle of wine and scotches, which we drank together. He moved to sit next to me within the booth.
32. Mr Tsolis touched me and kissed me. We returned to my place by Uber. During the Uber ride he continued to touch and kiss me. On arrival at my home, Mr Tsolis asked to use the toilet. After he used my bathroom, he entered my bedroom. I asked him what was happening, and then he started touching and kissing me. I told Mr Tsolis I do not want to do this and asked him to leave. I don't know if I said this out loud. He became angry with me and told me that he had the night off and had told his wife that he wouldn't be home. He asked me what he would tell his wife
33. We had sexual intercourse and he asked me if he could ejaculate in me. After engaging in sexual intercourse I asked him to leave.
34. When he left, I knew he had the shits with me. I sent him a text saying "kisses". I knew that there was no one else I could talk to and I didn't want him to be upset.
35. After the 9 July, I was feeling very scared, I asked him to call me as I felt abandoned and used. I also called Mr Tsolis as I was upset about the amount of money my dad had to pay for medication. Mr Tsolis did not return my calls. I was in debt with dealers and other people. Mr Tsolis had previously offered to give me money to pay these debts. I had always declined this offer.
37. After 9 July 2016, he asked me how my finances were going. Mr Tsolis told me that he had retracted his offer to pay for my debts. My debt was $850. He accused me of the debt being more, after he calculated an approximate costings. He accused me of being a sex worker after we had engaged in sex.
[13]
Text messages
Patient A included 26 pages of text messages between her and the practitioner in her materials. Where relevant we will refer to these messages below.
[14]
Cross examination of Patient A
As noted, Patient A was required for cross-examination.
Patient A was exhaustively cross-examined by Mr Jones about her statement of 13 April 2018.
Patient A denied the suggestion that she had "just slapped this statement together". She said that Patient A said that at the time she wrote the statement it was "100% true to the best of my knowledge".
Patient A agreed she had a short temper but said that she no longer had anger issues.
Patient A agreed that was fair to say that she had "trust issues".
Patient A agreed that it was fair to say that at the time she prepared her statement she had separated from her husband, she was angry, had a stressful history and abused substances including alcohol.
Patient A agreed that it was fair to say she trusted and idolised the practitioner.
Patient A was asked a number of questions about her statement "I think that my last session with him was around 5 September 2016":
Q. I'll just put this. I'll just ask you once again. It's fair to say that any recollection then of events that happened in a therapy session happened on or before 5 September 2016, because that is your last recollection of therapy?
A. Of my last recollection, yes, but according to Medicare I had seen him in 2017.
Q. But that's your last recollection, isn't it?
A. It, it was. I blocked things out. I'm sorry to say, but yeah, I, I blocked things out. There are some things you don't want to go back and see somebody after you're feeling better. Once I've been - either I was - I'd gone self-admission into South Pacific Private and I was good. I didn't - I'd seen multiple doctors in a sense, just Dr Jesse to try and get any other psychologist I could possibly get other than .. (not transcribable).
Q. It's fair to say that any allegation you made in therapy happened before that date?
A. That he - what he did to me, yes, it happened before.
Q. Before September of 2016?
A. Yes, it did.
Q. Do you now accept that there were therapy sessions after that date?
A. As per what I've seen from Medicare, it, it states that, but I'm telling you, sometimes people forget what they had for breakfast, like, the day before I'm saying to the best of my recollection, as per Medicare statements, but the Medicare statements said that I paid money when I didn't and it also says that I was at Concord Hospital when I never, I never saw him there.
Q. You're just saying that you can't remember therapy sessions after September 2016?
A. I can remember the therapy sessions but I didn't like being in the same room as him.
Q. That's not the same as what you've said in your statement, though, is it?
(No verbal reply)
Q. You can't recall therapy sessions after September 2016 with Mr Tsolis?
A. I can recall seeing him in the following year, yes.
Q. You can recall seeing him, but that's not what your statement says?
A. So that's speaking with him, speaking with him.
Q. Speaking with him. Okay.
A. Cause we definitely exchanged phone calls and text messages.
Patient A agreed that the practitioner was professional, warm and welcoming. As to his referring to her as "kid", when asked if she objected to it, she stated that she did not think it was normal, that she did not enjoy it, but she just accepted it.
Patient A denied that she invented the reference "boss" for the practitioner. She denied that she wanted to be friends with him. She said that she only wanted access to him for therapy.
Patient A denied the suggestion that the practitioner had not said "you look pretty when you cry", and to "come here" when she did cry:
Q. He never said to you, "You look pretty when you cry" did he?
A. Yes, he did.
Q. He never asked you to, "Come here" did he?
A. He did. His, his exact words were, "You look really pretty when you're crying. Other people look really ugly, they get all red-faced.
Patient A denied the suggestion that she made up the statement that the practitioner would speak to her about his pregnant wife and child. When it was put to her that these answers were a complete fabrication, she responded that there were some things she chose to block out. She rejected the suggestion that her recollection was not reliable.
In relation to her statement that the practitioner would ask about his haircuts and his beard, she conceded that she could not recall how he looked, but stated he was annoyed when she did not notice anything about his appearance. When it was put to her that this evidence was fabricated, she denied it.
Mr Jones asked Patient A about her understanding of the "two-person feedback rule". She said that she had never heard that term before, including from the practitioner. She denied that the practitioner instituted that treatment in her therapy, and that he was one of the two people constituting the two person feedback rule:
Q. … And what I say to you is that Mr Tsolis was one of the people in the two people feedback rule, wasn't paid?
A. If I wasn't aware of it and I didn't know about it, then no... Because I don't dash I come up I don't know what the two person feedback rule is so I don't understand how I can answer a question that I don't know dash that I wasn't aware of that was in play.
Q. That's okay, we can move on. I just say that that's what it was and he was one of your two people. Because he was one of your feedback people, you were able to call him a lot, weren't you?
A. I cannot answer the question as to this two - if you would take out this two-person feedback rule which I don't understand and was never put forward to me and I don't understand how that then makes you allowed to call someone more frequently, so I don't understand how that would be a permission when I don't - I was never advised of the two-person feedback rule.
Patient A said that she thought sending the practitioner a cocaine "meme" was a way of seeing if he would do something different in his treatment;
Q. Because you were able to call him and reach him via text, you felt as though you got some special treatment, didn't you?
A. I don't - no, I don't. I-
Q. And you would text him jokes?
A. Yes.
Q. And you felt like you were a special client to him, didn't you?
A. I felt like I was a client. I felt like I was, I was under his therapy.
…
Q. Was it also beneficial when you were sending him cocaine memes?
A. Well, in a way I was looking to - I needed more help and I, I - a part of me knew he wasn't helping me and he shouldn't have been responding in that way and I was trying - it was my way of - of trying to get additional help, of just trying to see if he would just do something else. I didn't think he was helping me and I couldn't - I didn't know what else to do.
…
A. Do you think it was appropriate for him to, to not do anything about those messages?
Q. I will just focus on the question. I'm just going to - can you -
A. I was not in my right state of mind, sir.
Patient A agreed that she called and texted the practitioner whenever she wanted to.
After the dinner on 9 July 2016, the next session with the practitioner was 14 July 2016. Mr Jones asked Patient A "Do you agree that there was a review of the exposure session?". She denied that they discussed the two person feedback rule and stated that his case note was fabricated:
Q. … after the Bathers' Pavilion exposure session, the next session you had with Mr Tsolis was on 14 July 2016.
A. Okay.
Q. In that session, do you agree that there was a review of that exposure session?
A. I'll have to refer to his notes because what he says and what I remember are two completely different things. If that's okay with you.
Q. That's okay.
A. Is that okay?
Q. Now, there was a review of that date, wasn't there?
A. I beg your pardon?
Q. There was a review of the date, the exposure session?
A. Well, we clearly - we discussed it, but what he wrote is fabricated. Apart from what - him, him stating that he did breach boundaries and all of those things, but I can say that there is - I saw him on the 14th, yes.
Q. You discussed the two-person feedback rule, didn't you?
A. No. I didn't know what it was. I still - I only found out today when you tried to explain it to me what it is. He has made reference to it there.
Q. As part of that discussion, he had said that you should only call about important things, didn't he?
A. I can't read that writing, but - okay, so may I ask whether that's - okay, well, if that's what he stated here, I can't say anything other than you're, you're reading what he said.
Q. Yes, I'm saying to you what he's said, but you don't have to refer to the notes if you don't wish. If you have a different recollection-- A. He, he didn't want to discuss the night of the - he didn't want to discuss the night of the Bathers' Pavilion with me.
Q. My apologies. This goes to the question that I put to you before about the boundaries, so I'm just clarifying what those boundaries are, okay? So I'll be as quick as I can. So he had said that you should call less; is that correct?
A. No. He said for us not to discuss - he said that we shouldn't talk about - he said, "Let's not talk about the night of the ninth", of, of, of that date. That's what he had said to me. And I was feeling - I, I really - please, sir, I really don't--
Q. It's okay. Take a moment. Now, Mr Tsolis had said to you that the exposure therapy was a one-off event, that session, didn't he?
A. He said, he said, "I don't think we should do this again, kid"
Q. So you would agree that he said that that was a one off?
A. I-
Q. Then in that session he also - actually, sorry, I'll just go back to that. He didn't tell you not to discuss the therapy session, did he, the exposure session?
A. I beg your pardon?
Q. He didn't tell you not to discuss it, did he?
A. Well, I don't understand what you're meaning. He said for us not to discuss what he did. He said, "You didn't tell anybody, did you?"
Q. And I'm saying to you that that's a fabrication.
A. Well, I'm saying to you that that's not. …
Patient A said that the practitioner told her now only to ring for important things, and he did not want to discuss Bathers Pavilion. She said that he said that the dinner was a one off event and that "we should not do this again kid".
There was extensive cross-examination about the dinner at Bathers Pavilion. Patient A was asked about their text communications at the time. She said that she did not want the dinner to go ahead. She denied that she "falsified visitors as a deterrence".
Q. You just gave evidence to the Tribunal that you said you told Mr Tsolis that there were people over because you didn't want the night to occur.
A. That's correct.
Q. Right. Now, do--
A. I thought it would deter him. I thought it would deter him if I wrote down that there were people there; that he would not - he would then leave. He wouldn't - he - it wouldn't have to happen.
…
Q. …, you gave evidence to the Tribunal to say that you falsified visitors to your house, your unit, because you thought it would be a deterrent to Mr Tsolis; is that correct?
A. Yes it is.
Q. Then why did you tell him that your visitors were leaving shortly?
A. Because it was after the time - he didn't - the time was supposed to be earlier and I said 5pm and he arrived, obviously, earlier. And that's why he had said, "Shit". Excuse my French, but I'm just reading what he wrote. "Shit". I had my phone on silent. I just got here", , which was at 4.30. So I thought that by, by me sending that message, he would then go.
Q. Okay. And then at - sorry, …. I say to you that that is a fabrication, isn't it?
A. No, it is not. Well, the, the fact that they weren't there, that's, that's, that's true. They weren't there. But what I said and what - the means behind that- what my - the point of what I said was to try and deter him.
Q. Okay. Don't be too upset. I understand this portion is going to be stressful, so just take your time. We'll move to the next message-
A. Yep.
Q. -because you say, "After they leave I'll have to get ready…so.…5pm".
A. Yeah, so they'll leave around 5 and then I'll be able to be - start to get ready around 5.
Q. Okay. So you agree that that's actually just confirming your plans again with Mr Tsolis, isn't it?
A. Well, basically saying, "After they leave l'll have to get ready, so it'll be about 5 until I start to get ready". Still trying to put him off. But yes, it was - it can be seen as that as well.
Q. Okay. Then he says, "I'll go for a walk".
A. Yep.
Q. And then you say - and then - okay. So, "l'Il go for a walk". There is RS nothing in this text chain that indicates that you wanted to cancel, is there?
A. Nothing specific, no.
Q. The fact that you wanted to cancel the date is a fabrication, isn't it?
A. No. I didn't want it to go ahead. I didn't want it to go ahead. …
Patient A denied that the practitioner never drank at the dinner. She could not recall if she had ordered the drinks. When it was put to her that the practitioner did not order the alcohol, Patient A said that the practitioner asked her what he wanted to drink. The question was put again and Patient A said "I don't understand. I don't recall. To the best of my recollection he placed the orders":
Q. The only thing I want to put to you here is that Mr Tsolis never drank alcohol on that night, did he?
A. He did drink alcohol on that night.
Q. You ordered drinks at the bar, didn't you?
A. No, I did not.
Q. You were seated at the bar before you were -
A. Not to my recollection. I don't recall these things. All I know is that he bought the alcohol, he provided me with the alcohol. I didn't do any of that. I don't recall.
…
Q. … Mr Tsolis didn't order the alcohol, did he?
A. He asked me what I liked - what I wanted to drink.
Q. That doesn't answer the question. He didn't order alcohol did he?
A. I don't understand the question. If he's asked me what I wanted to drink and it was ordered, then it was ordered. I don't recall who, who - I don't, I don't, I don't see myself as being - as doing that. I don't recall. To the best of my recollection, I - he was the person who placed all of the orders. He was the person who asked me what I wanted and all of this and that it was a fancy place and I should feel. (not transcribable)..
Q. So, just to clarify, you don't recall, or he ordered?
A. I can't answer that question as I do not recall to the best of my ability to be able to give you a yes or no answer.
Q. Okay. I'll just say this: I say to you that you ordered drinks at the bar and-- A. I don't recall that happening. I was on medication and I - go on, sir.
Q. Thank you. And then when you were seated at the table, you proceeded to order the drinks when possibly Mr Tsolis was in the bathroom?
…
Q. While you were at Bathers' Pavilion, you ordered drinks while Mr Tsolis was in the bathroom, didn't you?
A. Not to my knowledge, no, I did not, and I wouldn't have done that.
Q. And you didn't see Mr Tsolis drink any alcohol that night, did you?
A. I did see him drink alcohol that night.
Q. So when you gave evidence just now when you say that you were on medication and that you don't recall the specifics of the night -
A. No. Sorry, you may have misconstrued what I said, sir. I said I was on -
…
Q. You never saw Mr Tsolis consume alcohol that night, did you?
A. I did see Mr Tsolis consume alcohol that night.
As to the medication Patient A had taken that night:
Q. … Those prescription medications weren't the only substances you were using that night come up were you?
A. No they were not.
Q. You were you using other substances that night?
A. Yes I was.
Q. What substances were they?
A. I had cocaine.
Patient A denied that the practitioner never kissed her. She denied that her claims of him kissing her and entering her house were a fabrication.
Patient A denied that the practitioner had not kissed her, fondled her or gave her sexual attention in the Uber.
Q. … The Tribunal has heard from the Uber driver already in these proceedings, and what I say to you is that what occurred from the time that you got into the Uber from Bathers' Pavilion to the time that you got home is that you sat in the middle seat and Mr Tsolis sat to the side of you.
A.. We were both sitting in the back seat of the Uber.
Q. Yes, and what I say to you is that you sat in the middle seat.
A. Listen, I had been given alcohol and I was on medication. We were both sitting in the back seat and he was fondling me and I looked at - I can't, I can't, I can't say that I - I can't confirm or deny whatever the Uber driver said.
Q. Okay, but what's your recollection?
…
Q. I'll just ask you the - the question I want to ask is that do you deny that you were sitting in the middle seat?
A. I can't confirm or deny. I don't recall what seat I was sitting in. I was sitting next to him.
Q. That's sufficient. At no time in that Uber ride did Mr Tsolis kiss you, did he?
A. He did
Q. At no time in that Uber ride did he fondle you?
A. He did.
Q. At no time in that Uber ride did he give you any sexual attention?
A. He did. He did.
Mr Jones asked her if she agreed that on her own evidence in an affidavit she swore in civil proceedings she said that, when they returned to her home, they had sex for about 10 minutes. Patient A said she did not know, but agreed that "All of this ha[d] concluded by 10.30":
A …. He came upstairs. He went to go and use the bathroom. And then when he had finished, he'd come across me, pushed into me, walked me into my bedroom and then he said - he started doing it. Please
Q. Just take your time, … because we're coming to the end, okay? Now--
A. He, he used the bathroom.
Q. Mr Tsolis uses the bathroom.
A. Yes.
Q. Given that you were drunk and you had medications and that you'd taken cocaine that night, do you know how long, your estimate of that bathroom use was?
A. Not long at all. It was - I don't think - I think it was a ruse. I think - I know it was a ruse. I didn't - I don't believe he actually used the bathroom. I think he just walked in there and came out.
Q. Your evidence to this Tribunal in relation to who ordered the alcohol was that you can't recall because you were on medication.
A. No, you said that I ordered it. I didn't order it from the bar. I can't recall who - that I ordered it from the bar.
Q. Yes, and you can't recall because you were on medication and-
A. No, it has -
Q. Is that right?
A. No, it is not correct. The medication has got nothing to impair what - I have blocked a lot of this out. Please. All I'm trying to let you know is that your client supplied me with alcohol. He ordered the alcohol and he also consumed the alcohol.
Q. Well, that's not what your evidence is. Your evidence was that you couldn't recall.
A. No, that's not--
A. Supplying somebody with alcohol and purchasing it for somebody is the same thing.
Q. Well, that's why I had to clarify the difference between who paid for the alcohol and who ordered the alcohol.
A. Well, he ordered the alcohol.
…
Q. I really am trying to be as delicate as I possibly can with it, so I do apologise. I understand that it's stressful. I understand that you're upset. But at this stage, it appears to me that you're evading the question. Ultimately, you say that, on your own evidence that you have given in an affidavit, that you had sex for about ten minutes
…
A. It would've taken about that long. I don't know. I don't, I don't know how long it took. All I know is that he, he, he, he came straight, straight onto me and then I said - I don't know if I said "No" or "Don't". I did say, "What are you doing?" And then I, I don't know if I said it out loud or anything like that, but didn't want him to do it and he said, "It is what it is". And then he started to - doing what he was doing to me, and then, and then he-
Q. Okay. Then you have an argument as to whether he can stay over?
A. I asked him to leave.
Q. Yes, but he had argued with you, on your evidence. You allege that.
A. He said, "What am I supposed to tell my wife?" He got angry with me. He said, "Where am I supposed to go? I have the" - he's - "I, I don't have to go home. I've got the night off. I told my wife I wasn't coming home". That was, that was not part of the confirmed plan for a date, was it?
Q. And all of this has concluded before or by 10.30, would you say?
A. Correct.
Q. Right. So that is a 15-minute window.
A. Yep.
Q. And then by 10.34, you are sending him a text message saying, "Kisses"?
A. Correct.
Q. That's not consistent with two people arguing, though, is it?
A. I, I sent that in fear because l'd asked him to leave and I didn't want him to be angry with me, because he already was.
Q. You sent it in fear?
A. Correct.
Q. Did you also attend a therapy session just five days later out of fear?
A. Yes.
Q. That's a fabrication, isn't it?
A. No, it is not.
Q. … Mr Tsolis never went up to your apartment.
A. He did - yes, he did.
Q. Would it change your mind to know that the Commission have withdrawn their complaint in relation to the sex?
A. I beg your pardon?
Q. My question is, would it change your evidence if you knew that the Commission have withdrawn their complaint in relation to the sex?
A. Would it change my - it happened. What would - nothing would change. How can, how can somebody's decision to do something change the course of events?
Patient A denied that the practitioner never offered to her pay drug debt.
[15]
Evidence of Ms Jaroszewicz
Ms Jaroszewicz was Patient A's treating psychologist.
On 16 January 2018, Ms Jaroszewicz sent a notification to the Commission. The notification stated:
My client, [Patient A], has reported that her previous psychologist, Sava Tsolis, had sexual intercourse with her on the 9/7/2016, at her home, after he took her out for a meal in Sydney. [Patient A] reports that Mr Toslis [sic - Tsolis] was treating her from 2/5/2016 to early 2017. [Patient A] also reported that Mr Tsolis paid her compliments, called her pet names, hugged and kissed her at appointments, asked her to send him photographs of herself, asked her about her previous sexual partners and told her about his sexual history. [Patient A] first reported to me that she had had sexual intercourse with Mr Tsolis during an appointment with myself on 14/9/2017. I have been supporting [Patient A] to make a report to the HCCC. During this process (session on 5/12/17 and 21/12/17), [Patient A] showed me text message correspondence between herself and Mr Tsolis which supports many of her allegations, including texts which indicates that Mr Tsolis arrived at her home to pick her up on the 9/7/16 ([Patient A] brought a copy of this to her session on 21/12/17, attached). There is every indication that the correspondence was with Mr Tsolis: his name is saved in her phone and the number matches that listed on his website. My concern is the alleged sexual misconduct of Mr Tsolis and the impact this has had on [Patient A]. Even if sexual misconduct did not occur it seems Mr Tsolis was practicing in a way which constitutes a significant departure from accepted professional standards.
Ms Jaroszewicz prepared a statement dated 3 August 2020. Where relevant we will refer to that statement in our Findings and Consideration sections of these Reasons.
Included in the Commission's materials were counselling case notes of Ms Jaroszewicz prepared on 15 September, 26 October, 31 October, 5 December, 11 December and 21 December 2017.
[16]
Case note of 15 September 2017
This case note relevantly states;
Regarding [Patient A]'s report that her previous psychologist had sexual intercourse with her.
Consulted with senior colleague …
Received email response (saved on file)
Advice given was that the event in itself is a notifiable event and I have mandatory reporting obligation. However, my mandatory reporting obligations are triggered when I have reasonable belief that misconduct has occurred.
A practitioner would typically have reasonable belief that an event (of misconduct) occurred when the event is witnessed directly by the practitioner themselves. Furthermore, the guidelines state that the when a practitioner is told about notifiable conduct that another practitioner or patient has directly experienced or observed, the person with most direct knowledge about the notifiable conduct should generally be encouraged to make a notification themselves.
I did not witness the notifiable (I was informed verbally by [Patient A]), and [Patient A] has the most direct knowledge of the notifiable conduct. Therefore, as per the guidelines, I do not believe that I have reasonable belief of the event. It follows that I therefore am not mandated to report the event at this stage.
…
Produced medical cert (on file)
Said she went to Dr "Tino" for the med cert yesterday
Med cert says "sexual advances from counsellor"
Previously [Patient A] had said her prev psych Sava has tried to come onto her and hence she did not want to see him anymore
Today she said that he had taken her out and that they had had sexual intercourse. She said she let him have sex with her.
She said it was her fault and that she did not want to ruin things for him.
When I asked when this was she said before she went to south pacific private.
When I asked how things had been for her since she said that she had been feeling worse, but that SPP was good because assisted her sobriety.
[Patient A] said that Dr Tino and I are the only people that know that psychologist Sava had intercourse with [Patient A].
[Patient A] said she knew what she was doing in telling me, but that she didn't know what to do, didn't know if she wanted to report it,
She said she knows the difference between right and wrong, she said if this happened to anyone else she would say it is wrong, but as it has happened to her she is not sure. When I asked her why she is unsure when it has happened to her, she explained its because she does not matter (became very emotional)
I explained that this it is not acceptable for a psychological to have intercourse with their client, even if it is consensual, because of the power imbalance and the unequal relationship between therapist and client.
I explained that she had disclosed some critical information to me. I advised I would likely have to act, but that I wouldn't do this right away, as I needed to speak to a supervisor about it first for advice, as this is not something I had dealt with before [Patient A] became tearful at times throughout session, saying she did not matter, and why didn't she matter. I repeatedly explained that she matters, that everyone does, she agreed that she matters a lot to her kids and that she is a good mother to them.
[Patient A] said that her Dr had recommended she go to St George Hop and check herself into mental health for diagnosis and medication review. Said reason for this is psychiatrist wont review diagnosis or meds until she had been to the Black Dog and this appt is not until Nov. …
[17]
Case note of 26 October 2017
This case note relevantly states;
Has started going to church
Finds this comforting
Went to confession and told the priest about Sava having sex with her
Priest re-iterated that not her fault and Sava should not have done this, said God would provide guidance
Few days later Harvey Weinstein issue hit the media. Took it as a sign and knows she can't not report what Sava did now. "If I do then I will know I matter and I need that"
…
[Patient A] said twice "we need to work out what to do about Sava"
I asked her if she would like me to find out what the reporting process is. [Patient A] said "yes please" and then thanked me for asking her because it reiterated that this is something she has to do herself.
[18]
Case note of 31 October 2017
This case note relevantly states:
… thinks reporting this event is going to fix/needs to be the think [sic - thing] that fixes her.
[19]
Case note of 5 December 2017
This case note relevantly states:
[Patient A] brought note pad where she had written down (haphazardly) the things she said Sava Tsolis (psychologist) has done which she has taken issue to [Patient A] said he has used "inappropriate phrases and labels" and had asked "inappropriate questions".
I asked [Patient A] to list the things he had done that were behaviours (rather than her responses to his actions). She listed:
Called me "kid" "my love"
Said I was beautiful and intelligent and spoke well
Said she was beautiful when she cried when other people were not
Asked if he noticed things about him - his Armani belt, that he had had a hair cut, had a shave, shifted in his seat to hide his erection
Hugged her and kissed her forehead in appts at appts
Asked her how many sexual partners she had had and told her how many he had had
Said his marriage was one of friendship/convenience
Asked her to send her a photo of her lower back tattoo (knowing this was where it was)
Took her out for a "date" on 9th July 2016. Explained she deserved to have the date experience. Came to her house. Took her to dinner. Came back to her house. Has sexual intercourse with her. "fondled me at dinner" "fondled and kissed me in the uber"
[Patient A] showed me text messages on her old phone to and from Sava Tsolis, including texts which showed he had arrived at her house to pick her up on 9/7/2016. There was every indication it was this psychologist, saved under his name and texts included ones confirming appointment times). She showed me two documents which she said he had asked her to write "after the event" (intercourse) stating that she had wanted him and what he did to her and what her response to this was.
[Patient A] said she has taken photos of all these messages.
[Patient A] confirmed she has seen Sava from 2/5/2016. Said appts stopped around Sept 5ih. No appts in Dec and Feb. Said her father forced her to return to him for an appt in early 2017 after she had finished rehab at SPP [Patient A] confirmed she would like to finalise report before Christmas.
[20]
Case note of 11 December 2017
This case note relevantly states:
Discussed this case in supervision with colleague …
Agreed that the incident now goes beyond heresay [sic - hearsay], as have since viewed text messages to/from [Patient A] and the psychologist Sava which indicate that he called her pet names, that he had arrived at her home to pick her up on 9/7/2016. Also saw written documents, a screen-shot of which [Patient A] sent to Sava. These were graphic and sexual in nature. [Patient A] said that Sava had asked her to write these and send them to her after they had had sex.
Though I only have [Patient A]'s report that they had intercourse, it is still clear that, even if they did not have intercourse, he is practicing in breach of standards.
There is every indication that the correspondence (text messages) are from Sava, since they are saved under his name.
Confirmed that I too would make a mandatory report to AHPRA regarding the psychologists practice based on the texts I had seen
Discussed with supervisor the course of action from here
Confirmed that my planned way of supporting [Patient A] with the HCCC complaint was adequate
Was advised that after the complaint is sent, the HCCC will be in contact with [Patient A] to take a statement
Was advised that I should tell [Patient A] that I too would be making a report
[21]
Case note of 21 December 2017
This case note relevantly states:
Brought along "evidence" which she had printed out form her phone to accompany the complaint. This was a printed screen-shot of text conversation between Sava and [Patient A] showing that he arrived to pick her up on Sat 9/7/2016 (had viewed this briefly among other texts last session; this screen shot shows the phone number under which he is saved is the same as on the website for Insight Psychology Group
[22]
Evidence of Dr Agatino Ruello
Dr Agatino Ruello. Dr Ruello was Patient A's treating general practitioner between 2009 and 2017. Relevantly he states:
9. On her final appointment with me on 13 September 2017, [Patient A] told me she had fallen onto her left shoulder two days prior and had shoulder pain and a swollen thumb. She also required a medical certificate to provide to Centrelink, which I provided her.
10. During this consultation, I asked [Patient A] how she was going generally. I was aware she had a history of depression. [Patient A] told me that she was seeing a psychiatrist named Dr G Hinde because of some sexual advances made towards her by her psychologist, who I refer to in my notes at Annexure A as "Mr Tsilios".
11. [Patient A] mentioned the sexual advances to me in what I saw was a throwaway manner, in the context of telling me she was seeing a psychiatrist and that was the reason why. She was not specific about what the sexual advances involved, nor did I ask her further questions about this, as it seemed to me she did not want to go into it in any detail.
12. This was the last time I saw [Patient A].
[23]
Evidence of Mr Vinod Rehaan
Included in the practitioner's materials were file notes of telephone conversations between a Council officer and Mr Rehaan. Mr Rehaan was the Uber driver on 9 July 2016 who picked up the practitioner and Patient A after the dinner at Bathers Pavilion.
[24]
File note of 19 May 2020
This file note relevantly states:
Do you currently live in Sydney? Yes
Have you worked as a driver for Uber? Yes
Do you still work for Uber? No
Do you recall a journey in July 2016 picking up passenger/s from Mosman to Russell Lea? Yes. I picked up a man and woman from restaurant Mosman and dropped the woman off in Russell Lea and the man off after that.
Do you recall the names of the passengers? No
Do you recall any description of the passengers? Male may have been Polish or something. Female was wearing red or orange dress
Can you tell me anything else about the passengers? One of them asked me to drive to Russell Lea to drop off the woman and then drop off the man somewhere else
Where did they sit when they got in your car? Beside each other in the back seats
What was your impression of them? They were getting on well, looked like a couple
Why did you think that? Hugging and kissing, leaning into each other, chatting
Were you able to see them well when they were in the car? Wasn't watching them closely as I was focusing on driving but saw them and heard them
Do you recall anything else about the journey? I wasn't familiar with the areas for the journey so was using my GPS. Missed a turn off, woman was not happy about it. I stopped the meter in the Uber app Russell Lea so they wouldn't be charged to continue trip as goodwill gesture as I missed the turn. They were happy with that
What happened when you arrived at Russell Lea? Stopped the meter, they got out of the car together Man said goodbye to woman and got back into the car
What made you think they were saying goodbye Saw them hug and kiss each other before man got back in the car without her
Did you see them kiss on the cheek or lips? Don't recall
How long were they outside the car? Couple of minutes Did you see the man go inside house/unit when they got out of the car at Russell Lea? No, 100% certain he didn't go inside
What happened next? Man got back in the car and said he wanted to continue on to I think Five Dock, If he offered to pay me but I didn't charge him as I'd turned the meter off. Dropped the man off
Thanked Vinod for his help ? said I would like to put what he has told me in statement for our investigation. He said this was fine. I said I would email him a draft which may have some further questions and clarification. He said he was very busy but was happy to do this.
[25]
File note of 10 July 2020
This file note relevantly states:
Phone out call to Vinod Rehaan to discuss statement.
…
Return to topic of journey on 9 July 2016. Do you recall what time you received the job request? No but arrived to collect them about 10pm from Mosman
Can you tell me anything about the two passengers when you picked them up from the restaurant? Didn't initially think they were my passengers as they didn't get in the car straight away. I was looking around for my passengers.
How did you know they were the booking passengers when they got in the car? Would have asked them the booking name and destination to make sure
Did you ask them this? I'm sure I would have but don't remember names
Did you know them or recognise them from anywhere before? No.
Do you remember any other distinguishing features about the passengers? They were white, Caucasian. Man was wearing a suit jacket pants and shirt. Dark brown hair. I think woman had blonde hair. Thought (they were a couple or relationship but was odd when she got out and he kept going.
When you arrived at Russell Lea what do you remember about the area you dropped them off? Residential, houses. One of them asked me to wait. Told them I'd stop the meter as I missed the turn earlier.
You told me last time you saw them both get out of the car and hugging and kissing outside the car- how far away from the car were they during this? About a metre or 2.
Whereabouts were they standing re the car? Near the road area, near the back right side of my car
Did you see the woman go inside a house when you dropped her off at Russell Lea? No.
Anything else you can tell me? Dropped the man off and continued my shift
[26]
Evidence at the hearing
Mr Rehaan agreed to attend the hearing to give evidence. He was shown a two page unsigned statement dated 10 July 2020 by Mr Chatterjee. After some questions by Mr Chatterjee the signed statement was admitted over objections from the practitioner and marked as Exhibit 2.
Relevantly Mr Raheen stated in his statement:
7. When I arrived at the Bathers Pavilion restaurant at Mosman to collect the passenger for this ride at around 10pm. I recall I had to wait approximately 15 minutes in my car. When I first arrived I saw a male and a female outside the restaurant near the front of my car. They were hugging and kissing each other. I initially didn't think they were my passengers as they didn't get into my car straight away and so I was looking around for my passengers.
8. The male and the female then entered my vehicle together and sat side-by-side in the back seat. When customers get into my car I usually confirm their name and destination with them to make sure they are the people who booked. I am sure I would have done so on this occasion.
…
10. During the journey, I recall thinking that the male and the female appeared to be getting on well. While I was not watching them closely during the journey as I was focusing on driving, I did see and hear them hugging and kissing each other and leaning into each other and I could hear them chatting during the journey. I thought they were a couple or in a relationship. I remember thinking at the time that it was a bit odd when she got out at Russell Lea and he continued the journey separately.
…
13. Upon arrival at Russell Lea, the male and female passengers both exited my car together. When they got out of the car, I saw what I thought was the male passenger saying goodbye to the female passenger. I assumed they were saying goodbye because I saw the male and female passenger hug and kiss each other before the male got back into my car without the female.
14. When I saw the male and female hugging and kissing each other, they were standing approximately a metre or two away from me. I think they were standing on the road area. I could see them at the back right-hand corner of my car.
15. I recall the male and female were outside my vehicle for only a couple of minutes. I am 100% certain that the male passenger did not go inside a house when we stopped at Russell Lea after he got out of my vehicle. As soon as the male got back in my car, we left to continue the journey. The male got back into the car. I did not see the woman go into any house.
In evidence in chief, Mr Chatterjee asked Mr Rehaan whether he needed to make any corrections to his statement. He told Mr Chatterjee that his statement was "pretty accurate" and was then gave the following answers to Mr Chatterjee's questions.
As to working as an Uber driver on 9 July 2016, Mr Rehaan said he could not recall the dates but "you" meaning presumably the Commission, "did the research".
As to his statement in par [7] that he saw "a male and a female outside the restaurant … hugging and kissing", he clarified the statement by saying:
I saw them hugging, I did not see lips lock. I don't look at people when kissing. It seemed like they were. I didn't see lips touch.
As to his statement in par [10] that "well I was not watching them closely during the journey as I was focusing on driving, I did see and hear them hugging and kissing each other" he clarified the statement by saying:
I assumed they were kissing - I did not see them kissing. I could hear them hugging sort of, acting like a couple. I assumed that they were.
When asked "What did you see?" Mr Raheen respondent "I couldn't see much".
Mr Raheen was then cross-examined by Mr Jones.
Mr Raheen confirmed that he did not see Patient A and the practitioner kissing in the car, but said they were sitting beside each other. He said that:
"I sort of heard from the sounds that they were hugging and kissing as a couple yes".
He said that when he dropped off Patient A at her home, he was there for no longer than two minutes. He observed the practitioner hugging Patient A but did not see them kissing, although he assumed they did. He said the hug lasted for about five seconds.
[27]
The practitioner's evidence
The practitioner's documents relevant to the Stage One hearing included:
a statement dated 17 January 2018;
a statement dated 25 May 2018;
a statement dated 19 February 2020;
his affidavit sworn 2 February 2022.
The practitioner also relied on an expert of Mr Rolf Reed dated 31 January 2022.
Both the practitioner and Mr Reed were required for cross-examination.
[28]
The practitioner's statement dated 17 January 2018
This statement was prepared in response to the Commission during its investigation. Relevantly the practitioner states:
Dealing specifically with the complaint made in Section 4 of the complaint form I state the following in response to the allegation of inappropriate conduct. I did refer to [Patient A] as "Kid" as this was banter between us and used as method of making her feel at ease.
She in turn referred to me as "Boss" which was a term she coined, not one I directed her to use. do acknowledge that l have told her that she was beautiful and intelligent, but this was to the context of her telling me she had low self esteem, and regarded herself as being neither of those things I was merely seeking to instil some self- confidence at a time when she had a very negative view of herself I agree that I did ask her to download a "Map My Run" application on her phone. This was done for the purpose of allowing her to track her level of physical exercise throughout the day, as l had urged her, as part of her treatment; to increase her physical activity. I might add that this application was to be on her phone alone, and it was not something that could be remotely monitored by me in any way.
I deny that asked [Patient A] to comment on my appearance, clothes, or if she was able to feel my erections when she lugged me. I acknowledge that I did ask her about how many sexual partners she had. This was in the course of her treatment and in the context other telling me other about the failure of her marriage, and inability to maintain long-term relationships, and also about her previous Intimate relationship histories. These were questions posed in the clinical setting.
In relation to sending me a photo of a back tattoo, I acknowledge that this did happen. [Patient A] had the tattoo done on the basis that it was a reward to herself in the context that she regarded she was progressing well with her treatment. She had told me that she had rewarded herself, and had asked me if would like to see a picture of It. I did not solicit the picture from her; Finally, I do not deny that I had dinner with [Patient A], I do however deny sexual contact with her during, or after the dinner as alleged in her complaint. She was returned to her home in an Uber hire vehicle and I remained in this vehicle after she was dropped at her home, and I proceeded to return to my own home.
I acknowledge that in the context of [Patient A] being my patient, it was inappropriate for me to have had a social engagement with her, and it is a matter that will not be repeated.
[29]
The practitioner's statement dated 25 May 2018
Most of this statement will be relevant to the Stage Two hearing. Relevant to the Stage One hearing are his statements that:
As my therapy with [Patient A] continued, I took on an over-valued sense of responsibility for [Patient A]'s welfare. As a result of this, and given that [Patient A]'s self-esteem and confidence was quite low, I mistakenly thought that taking [Patient A] out to dinner would be therapeutically beneficial as it would give her a vote of confidence and enable her to view herself as worthy of another person's time.
However, I understand now that this line of thinking was distorted and not consistent with professional boundaries. I am also extremely apologetic and remorseful for what occurred on 9th July 2016.
Regarding the dinner, I confirm that I paid for it with cash and that I have not retained a tax invoice.
I further confirm that at 9:44pm, [Patient A] and I were collected by an Uber driver who drove us to [Patient A]'s residence. We arrived at [Patient A]'s residence at approximately 10:15 pm and [Patient A] departed the Uber.
I confirm that I entered into a second agreement with the Uber driver whereby he agreed to drive me home for a payment of $25 cash. Accordingly, there is no record of my trip home from [Patient A]'s home. However, attached to this my statement and marked "A" my telephone record detailing that:
a) following [Patient A]'s departure from the Uber at approximately 10:15pm, I sent a text message to [Patient A] at 10:34pm thanking her for her company; and
b) I called my wife at 10:43 pm requesting that she let me into our house at Mortlake as I had left my keys inside my house. In hindsight, I know that I should have sought immediate peer consultation in relation to the matter and how to proceed.
Unfortunately, following the dinner, I was very embarrassed that my judgement had been clouded and that I had strayed away from the normally high ethical standards to which I practice my profession. As a result of that, I did not consult any peers or authorities regarding my actions.
[30]
The practitioner's statement dated 19 February 2020
The statement is principally relevant to the Stage Two hearing. However, on p 2 of the statement the practitioner says:
Anxiety was one of the reasons [Patient A] was in my care, and in particular, her social anxiety. It is often in a treatment plan for social anxiety to use exposure therapy to aid the client in developing skills to cope in social situations. This is implemented if I feel the patient will benefit from this course of treatment.
With reference to the exposure session that took place on 9 July 2016, professionally, I make the concession that the exposure should have occurred during the day. However, there was a clash between my schedule and [Patient A]'s schedule, and, for this to occur, it subsequently turned into a night-time social exposure session. This should have been avoided by choosing a more mutually convenient exposure activity.
[31]
The practitioner's affidavit sworn 2 February 2022
This affidavit too is principally relevant to the Stage Two hearing. Its various sections are titled Background, Termination of Therapy, Further Education, Reflection on My Own Responsibilities and Conclusion
However, relevantly, in the Background Section at [14], the practitioner states:
I wish to clarify the series of events that occurred during the exposure therapy on 9th July 2016 as follows:
a. I caught an Uber from my house to The Patient's residence as I felt uncomfortable with her being in my car (please note my Uber receipts tendered in this submission);
b. I arrived at The Patient's residence and went inside her house briefly;
c. An Uber was then taken from The Patient's residence to the restaurant for the exposure session in Mosman;
d. Following the exposure session, an Uber was taken from the restaurant in Mosman to The Patient's residence at 9:44pm arriving at The Patient's residence at 10:15pm and then The Patient departed the Uber;
e. I confirm that after a short negotiation, I entered into a second agreement with the Uber driver whereby he agreed to drive me home for a payment of $25.00 cash. Accordingly, there was no record of my trip home from The Patient's home.
f. At 10:34pm, The Patient sent a text to me. I responded with a text as can be seen on my Telstra phone record tendered in this submission.
In addition to the other Sections described above, the final section of the practitioner's affidavit was titled "Response to the Patient's Statement 13 April 2018". In summary, he states that:
1. in response to Patient A's assertion that he had asked her questions about her personal relationships and her sexuality, the practitioner states that obtaining a client's relationship history is an important part of a clinical psychology assessment process and was particularly relevant in the first session, as Patient A recently broken up with a partner only one month prior to the initial session;
2. in relation to using the word "kid" in reference to Patient A, that:
The term "kid" was first used in the course of the therapeutic alliance after [Patient A] asked about my clinical experience and through that guess at my approximate age. I corrected her and she expressed surprise that I was in fact 3 years younger than she was, as I look older than my age. At that time, [Patient A] appeared embarrassed at potentially insulting me. As a way of defusing the situation I made the ironic joke of calling her "kid" highlighting our age difference in a humorous way. This joke appeared to have the desired effect and put [Patient A] at ease and she ceased to be embarrassed. Over the course of therapy, I fell in the habit of calling her "kid" as a way of building upon the rapport established by the aforementioned humorous interchange. In no way did I do this as a means of infantilising [Patient A] or exaggerating the power imbalance between us. [Patient A] responded on a later occasion by calling me "boss". I deny instructing her to do this and nor did I insist upon this term. I accept that using the word kid" could be inappropriate in a therapeutic setting. It is a term that can be taken to suggest an overly familiar relationship. I only ever intended to employ the name "kid" as a means of building rapport.
1. in response to Patient A's assertion that he had discussed his personal life with her, the practitioner 'emphatically den[ies]" discussing his sexual or personal history with her;
2. in response to Patient A's suggestion that he was tracking her movements on Map MyRun, he accepts that he did recommend that she download that application, but states that it does not allow for remote tracking of a person's movements;
3. in response to Patient A's statement that he would ask her about his personal appearance and erections, denies that he did so and suggests that patient A was "blending timelines" and that her "recall was not completely accurate";
4. in relation to the dinner on 9 July 2016 he:
1. denies that he had any sexual or romantic contact with Patient A;
2. states that he never departed from the Uber;
3. never attended Patient A's apartment;
1. denies that he ever offered to pay for Patient A's drug debts.
The practitioner concludes his affidavit by stating:
38. I accept that the way that I conducted therapy with Patient Ahad some significant failings. I was unable to manage boundaries and that has resulted in the unfortunate circumstances of this ongoing litigation.
39. I accept that my boundaries became blurred, that I was overly familiar with Patient A and that I took an over-valued sense of my responsibility for her emotional health. I understand how all of this had a detrimental impact on her and that when I declined to help her pay off her drug debts, she could see that action as a betrayal as opposed to the maintaining of clear boundaries. Patient A's behaviour is a reflection of my own poor choices in not maintaining appropriate boundaries with her throughout our therapeutic relationship.
40. I have tried to learn and understand these mistakes in an effort to ensure that they are to never be repeated. I have put a number of measures into place such as engaging in fortnightly clinical supervision with a female psychologist, and employing my wife in an administrative role in order to allow me to better prepare and reflect on my clients. I am also continuing my own personal and professional development through my own reading and attendance of courses.
[32]
The practitioner's oral evidence
Our observations of the practitioner's evidence oral evidence in chief and cross-examination will concentrate on his evidence in relation to the Particulars of Complaints One and Two, and matters relevant to his demeanour and credibility.
[33]
Evidence in chief
In relation to Particular (1)(a) to Complaint One, that is that the practitioner referred to Patient A as "kid" and "my love", the respondent through his counsel said that he denied referring to Patient A as "my love" "on more than one occasion" but if so, "it certainly wasn't a common practice".
In relation to the "elevated" (as described by his counsel) number of phone calls between himself and Patient A, the practitioner explained that his introduction of "two person feedback", given Patient A's mental health, contributed to the high volume of calls. He also said that the calls were over a 13 month period.
In relation to the allegation that he inappropriately viewed a tattoo on Patient A's lower back, he said that there was no way he could not have viewed the image once he opened the text message.
As to the dinner at Bathers Pavilion on 9 July 2016, described by his counsel as "an exposure session", the practitioner said:
Okay. I'm going to, I'm going to be completely frank here in that, you know, I've had over, over pretty much six years to consider everything that happened in my therapy with, with [Patient A]. Now, I just want to put up front that I understand that the dinner should not have happened. I understand that my reasoning for that dinner was flawed and I take full responsibility for that, but I guess the question is why at the time did I think that it was appropriate? There were a few reasons. The first is that, you know, she was presenting with high levels of anxiety, specifically in a social context. She was getting quite aggressive in the social context as a way of, of managing her anxiety in that, you know, anxiety is the fight or flight response. So, so she was using anger as a - in a way to make herself feel more powerful and therefore feel, in some respects, less anxious. I didn't think that was a good strategy for her, considering, you know, she had young children, considering, you know, for other obvious reasons and I wanted to put her in a situation that was outside of her comfort zone in that, her comfort zone was Five Dock, Russell Lea area, which is, Russell Lea is almost a pocket of Five Dock. So, she was well in her comfort zone in that area and I - my rationale at the time was to get her out of that comfort zone and take her to a place that she wasn't familiar with in an effort to try and peak her anxiety and get her to utilise the strategies that we had discussed and see how she, see how she managed. That was one part.
The second part was that she - as you, as you probably noticed yesterday, [Patient A] presents or can present in a way that's highly emotional when she's distressed. She did present to me in that way on numerous occasions and you know, feelings of worthlessness and hopelessness and I mistakenly also thought that doing something, I guess, you know, nice for her would, would be a vote of confidence. Would, in some respects - and I know, you know, strength in that therapeutic alliance and also give her a vote of confidence that, you know, that she was - I think the words I used at the time was, worth sharing a meal with." I didn't see it in a sexual connotation and, you know, I, I, I understand that, you know, that thinking was flawed. I also understand that I should've definitely put some boundaries in place, which I can, I can go into if you want me to.
The practitioner was also asked about the allegation that he provided false or misleading information to the Council during the s 150 hearing. At the Council hearing he was asked by one delegate "Did you have alcohol at the restaurant" and responded "No, no". Mr Jones asked the practitioner if he had anything further to say about that allegation and he responded:
I was asked a, a question - well, in my mind, a direct question whether I consumed alcohol and I answered it. I did not consume alcohol on that night. I think the, you know, if you read the next page of the transcript, I think the, the conversation went to a different topic pretty quickly when I mentioned when the Uber and my wife was mentioned and I, I would imagine, you know, re-reading it, it looks like the, the panel members might've got waylaid by that. But they asked me a question and I answered it. If they had asked me if [Patient A] had consumed alcohol, I would've answered that also, but they didn't.
[34]
Cross-examination
There was an extended discussion about the "two person feedback rule" and whether it contributed to the large volume of phone calls and other communications between Patient A and the practitioner. The following exchange took place:
Q. In hindsight then, you recognise that you were taking too many phone calls from her -
A. Yeah, and I've admitted that. Yeah. Yeah, I was and, and I admitted that. I've always admitted that. I've never, never shied away from that and when I recognised that that was the case, it was later than what I would've liked, for sure, but I pulled it back. I pulled it back after the ninth, I pulled back the "kid" names, the, you know, calling her "kid" after I think the, that week of the ninth. I stopped calling her that. I put my boundaries a lot higher. So, yeah, so, yeah, I wish I had called it earlier. I wish I had, you know, done that, but that's, you know, I'm owning that. I was responsible.
Q. The telephone calls took place over the entire duration of the therapeutic relationship, correct?
A. Yes.
Q. That's from April 2016 to-
A. July 2017.
Q. Mr Reed's evidence yesterday was that you had described that the majority of the calls were in relation to the two person feedback rule and you being one of the trusted persons?
A. Yes, and also like I said earlier, when she was no longer seeing me for a period of time after her Medicare sessions run out, I was also checking up on 10 her and she would also text me, like she texted me and called me about SSP to get my thoughts on it, to get advice. So, yeah, this two person feedback rule was continuing in an altered sense with better boundaries in place, but it was continuing and she was utilising it and I think it was working reasonably well and that's why she came back to me in 2017 because, because it was working well.
Q. You accept that that's what you told Mr Reid, that the two person feedback rule and you being one of the trusted persons was a significant contributor to the volume of the telephone calls?
A. Yes, of course and I'm telling you the same, yeah.
The practitioner agreed that in late June/early July 2016 his relationship with Patient A had progressed or had altered in its character so that it had become less formal and more personal.
However, when this discussion continued after a short interruption to discuss when the luncheon adjournment would take placed, the practitioner denied that the relationship had become more personal, only more informal. He denied that he discussed personal matters such as his appearance, haircut, beard or clothing or spoken to Patient A about his wife and her experiences of being pregnant.
The following exchange then occurred:
Q. I would suggest to you that the therapeutic relationship that you'd had with [Patient A] at this point had changed and so you were sharing personal information and you were talking about your life with her?
A. I, I don't recall doing that. I mean, sharing personal information, "How's the little one going?" "Good. Tiring.' " Etcetera. If that's what you call personal information, then maybe. But I, yeah, I don't think of that as overly personal information, not when you're talking to a new father. I think that's what you would do. If I knew you were a new father, I would ask about your - "How are you holding up? How are you coping?" Yeah, I don't think that that's crazy to see that as a boundary violation.
Q. So you are in no doubt as to what the Commission's case is, Mr Tsolis, I'm putting to you that conversations about your personal life with [Patient A] went beyond introductory chitchat or simply ancillary mentions of your partner or your child and it had gotten to the stage where you were confiding in [Patient A] or speaking to her about your life and you were sharing information with her. Do you agree or deny that?
A. I, I don't, I don't, I don't recall that. I don't agree with that, no.
Q. Which one is it, you don't recall or you don't agree?
A. Well, I - like I said. I think that there would've been broad conversations about my young child. I imagine she probably would've asked, I don't remember, but you know it seems to me logical she may have asked, "How's your wife coping?" considering she's a new mother as well and this was our first child. So, yeah, I, I don't now again where to draw the line of what you think is me confiding and what I would believe is just a normal conversation to have with a fellow human being.
Q. You say that you were in effect, at least at parts of these therapy sessions, having conversations with [Patient A] as a normal human being?
A. I think, I think every therapy session has an element where you discuss things as normal human beings. I don't think - you know, there needs to be some sort of human element to therapy otherwise it doesn't work. You know, it's a, it's a, it's a therapeutic alliance but it's also a rapport. But yeah, I think things are discussed, especially someone that you're seeing for a 16 month period.
The practitioner denied that he raised with Patient A the number of sexual partners she had had.
As to whether or not there was any physical contact with Patient A during therapy sessions he gave the following answer and the following discussion ensued:
A. On a couple of occasions there may well have been a platonic hug at the end of the session. Yes, I admitted to that and you know, I, I own it. It should've never happened but as you saw yesterday, you know, when [Patient A] gets upset, you know, it's quite, it's quite a, quite a, quite a experience and at the end of the session if she'd been distressed to that extent as you saw her distressed yesterday and she would ask for a hug, I would say, I, I gave her, you know, a hug. Maybe a couple of times at best. I saw that as a human thing to do. I acknowledge now I shouldn't have never done it. I was, I was inexperienced. I was stupid, for want of a better term but it wasn't the fact that I was trying to seduce her. Anything but.
Q. You were giving her a hug to comfort her?
A. I was giving a hug to say goodbye at the end of the session. Not to comfort Bye. her, no, not, not during, at the end, at termination of session. Goodbye hug.
Q. Am I correct in assuming that you don't hug any of your other patients?
A. You are correct in assuming that, that's right but you would also be correct in assuming that none of my other clients have a presentation like that. That hyper and that emotionality that you saw yesterday, in my experience, I have never had a client like that before or, or since and, yeah, I'll be honest, I wasn't prepared, I, I wasn't experienced enough to deal with it. I, you know, I made a mistake, I erred and I've always owned it from the get go. That wasn't-
…
Q. I would suggest that you did hug her during sessions to comfort her because you were overwhelmed by the emotion that she was displaying?
A. No. I, I, I can be honest. I was scared of the emotions she would display. … it would be all, it would be a goodbye hug. Just, just that though, nothing more and yeah, so, not during session because I'll be honest, I was, I was in some respects terrified of that, of that - not terrified, maybe that's too strong a word but really - I don't know what the word I can use. Really disconcerted, really panicked. That's the word. Really panicked by her emotions.
Q. Did that become routine, the goodbye hug?
A. No. Like I said, it only happened after, you know, certain blow ups, like what you saw yesterday and that's when my concerns in relating to what you were asking about before, about suicidality, you know, after a session like that, my concerns would go up and stay up for a little while and then, and then, and then we'd have a few good session, it'd come down and it'd go up again. It was, you know, it was a presentation that I never experienced prior and I was, I was unprepared for. Frankly. I was - yeah, I'll own that.
The cross-examination then turned to the topic of the practitioner's romantic feelings for Patient A:
Q. Mr Tsolis, you said that that emotion affected you and I would say that your feelings to - you accepted that it created feelings of protective feelings in you?
A. Right. I'd say that they also -
Q. Your feelings to her also shifted and you developed romantic feelings for her or you found her attractive, there were feelings of attraction towards her?
A. No, I deny that flatly and I'll tell you why. I used the - it took me a while to figure it out, just now, but panic is the right word. When her, you know, when she would express emotion like that, that panicked me but I also knew that there was a real edge to [Patient A] in that as you saw yesterday, you know, she could be quite aggressive, she could be quite standoffish, so this is not someone that, that I would feel comfortable, you know, with in a romantic way. … I can definitely tell you that I was also quite, quite intimidated by her in, in some respects.
Q. I'll be clearer. I'll say that you developed an attraction for her, perhaps because of all of these conflicting emotions that she was making you feel?
A. Well, I, I would say no. I don't see how feeling intimidated by someone or panicked someone could possibly make you attracted to them. I, you know, I don't think those emotions go hand in hand at all.
Q. I suggest to you that you confessed those feelings of sexual attraction to her in a session?
A. No.
Q. I suggest to you that you did - you were aroused by her and you had erections and you told her that you had to shift in your seat because of those erections?
A. Okay, what, what part of yesterday did you feel would've aroused someone, that hyper emotionality? …
Q. Mr Tsolis, I'm not suggesting that you groomed [Patient A], just that you developed an attraction to her or you felt an attraction to her which was sexual in nature? A. I felt, I felt protective towards her, which I've already admitted to. I don't, I don't - you know, I did not, I'm not, it was not a sexual attraction no. It was a protective, a protective - it was of a protective nature.
Q. You agree that you told her that she was beautiful and intelligent and in fairness, I understand that your position is that that was in response to her making self-demeaning statements?
A. I do. I agree with that. …
Q. This is my last question on this topic and we can take the lunchbreak now. I'd suggest that you meant that and you found her beautiful and intelligent?
A. Well, I, I definitely found her intelligent. I definitely, you know, from the way even yesterday how she would respond, how she was well spoken, how she was articulate, definitely I would find her intelligent. I still do find her intelligent and I said that she was beautiful. I would say - I could also say that you're a handsome individual, it doesn't mean that I'm sexually attracted to you. As an objective measure, I would say [Patient A] is an attractive woman and I can say that like I can say that my - I wouldn't say my solicitor, but definitely you are an attractive individual without any sexual content.
The next relevant topic discussed in cross-examination was the "date" (on the Commission's view of matters) or the "exposure session" (according to the practitioner) of 9 July 2016.
Mr Chatterjee first took the practitioner to his Progress Notes of 7 July 2016 which referred to arranging the "dinner." For convenience and to assist in understanding the evidence it is appropriate to set out the relevant contents of the note immediately:
Therapy session with [Patient A] focused on establishing a wellness plan.
Patient A stated that she continued in her use of cognitive defusion and behavioural activation strategies. Her anxiety in public remains high.
She stated that she has made contact with her psychiatrist and he has commenced her on Escitalepram and Quetiapine. Also be offering her support with her distress around her past sexual assaults. Patient I stated that keeping our therapy and that therapy separate was comforting to her.
Wellness plan focused on recognising depressive symptoms, hypomanic symptoms, her strengths, triggers, goals and emergency contact framework based on wellness plan from BDT website.
Upon completion of plan, patient I became distressed and stated that she was doing this alone and was not worth anyone's time. She stated that she felt she had made progress but that it hadn't been acknowledged.
Accordingly dinner was agreed upon in an effort to give Patient A some confidence that she was worthy and also to use this as an opportunity to expose herself to anxiety situations in a public setting.
Dinner scheduled for 9/7/16.
The Progress Note stated in the left-hand column "7/7/16 19:30". The practitioner explained that what that reference meant was that he wrote the progress note at 7:30 pm.
It was put to the practitioner that the first time he suggested to Patient A that "the two of you should go somewhere" was on 7 July 2016. The following response and discussion ensured:
A. I'm not sure. I can't, I can't answer that. I'm not sure. It could've been, it could not have been. Like I said, this - I knew about her social anxiety for a while, it had been discussed, so it was an idea floating around in my mind. Now, it might've been discussed earlier, it might've been discussed on the seventh, I honestly, you know, I think I've been trying to be transparent all the way through here and I honestly don't know the answer to that question. It was a long time ago.
Q. I'm also going to suggest to you that when you suggested it on 7 July, I propose that you say it can't be certain if it was on 7 July but I say that when you suggested it, your intention was from the beginning that it was to be a night time session?
A. No. I, I would say, no. I, I would say that I was probably thinking out aloud and again, this is, you asked me before not to make assumptions or not to try to - you know, so, i can't be certain but the actuality is it turned into a night time session. Now, I can't be certain whether when I discussed it with her, I can't - I don't remember those details to be fair.
Q. On Thursday 7 July, you would've known that you were working all day the following day?
A. Yes, I would've known and that would've been the Friday.
After taking the practitioner to various text messages between himself and Patient A the following exchange took place:
Q. She messages you at 7.40 at night saying, "How are your appointments looking for Friday night?"
A. Yeah. You have clearly by that time not settled on the date and time for what you say is a session?
A. All right, yeah.
Q. And you say, "Well, I was thinking Saturday," yes?
A. Yeah.
Q. She then asks you, "Saturday day?"
A. Right.
Q. And I suggest to you that that means that when you raised the session with her, when you raised the prospect of the session with her, when you spoke with her earlier in the day on 7 July -
A. Which was the Thursday, yeah?
Q. Which was the Thursday, you had not told her that it was going to be a night time session?
A. No, I had not.
Q. She says, "Saturday day?" and you say, "I work Saturday day, I was thinking night"? A. Well, like I, like I told you earlier that I do work Saturday day, so I wasn't, you know, that's a fact. I told you that there is a chance - a good chance sometimes, that I get quite a few cancellations on Saturday for the reasons I outlined earlier. So, there's a good chance I would be working on Saturday and to make it, I guess, clear to sure it up, I then said, "Saturday night. I was thinking night," ' to make sure. I can assure you that if I had finished up earlier, I would have suggested earlier, but I didn't.
Q. Having read all of these, I'm going to suggest to you again that when you first suggested to [Patient A] having what you call a session with her, you had in mind Saturday night, you wanted to take her out on Saturday night. That was your intention on the Thursday when you spoke to her during the day when she was in therapy with you?
A. No, because - okay, what you're saying doesn't really make sense because if you read my, my text message, I said, "I was more thinking Saturday. I work till 6pm in Smithfield on Friday." Now, if I wanted to take her out at night, why don't I take her out at 7pm or 8pm on Friday night? Why did I deliberately try to leave Saturday open? Because I was hopeful that there was a chance that I could take her out during the day. Now, if I wanted to take her out on Saturday, | mean, in the evening, l'd just do it on Friday night, she's free. I finish work at Smithfield at 6, I can be back at Five Dock by 6.30. I can go to dinner with her at 7, at 8, at 8.30 even, this is before COVID. So, I refute that and your own evidence shows that that's not the case.
Q. When did you make the booking at Bathers' Pavilion?
A. I can't remember. I don't - I can't remember that.
Q. You would've had to have made it beforehand?
A. I could've made it during the day, I don't remember at all, to be honest, when I made that booking. …
…
Q. [Patient A] responds to you at 8.23 saying, "Saturday night it is."
A. Right, okay. So, because in response to, "I work Saturday, I was thinking, thinking night." Now, like I said, that-
Q. Sorry to interrupt you because my question -
A. Yeah, I was just answering your question.
Q. My question was, the agreement that it was going to be Saturday night was reached at 8.23 when [Patient A] texted you, do you accept that?
A. No, because I clearly say, "I was thinking night," but like I'm telling you, I didn't express to [Patient A] that I was hoping that clients were going to cancel and that, you know, we can finish up early. That's - you know, I wasn't providing all my reasoning to her. So, I said, "I was thinking night," because that was more likely and that's what happened …
Q. You're saying that even by the time [Patient A] had messaged you at 8.23, you were not in fact certain it was going to be -
A. No, because there's a lot, there's a lot of no shows in psychology, especially in the populations I work for, work with. Especially, especially out west. We're not dealing with the worried well. I can assure you that.
Mr Chatterjee then took the practitioner back to his Progress Note of 7 July 2016 and the following questions and answers ensued:
Q. Your file note there that says, "Accordingly dinner was agreed upon", that's actually wrong because on your evidence today at 7.30 on 7 July you hadn't committed to anything?
A. Well, that's right. I, I would say that is wrong in that dinner, I've written there dinner was agreed upon, I guess what I should've said is, "An early dinner is agreed upon, or something along the lines or what I should've also written is, If I had cancellations I would try to make it earlier." Like I said, I wasn't writing these notes for posterity, they were just a working summary of what I was trying to do and yeah, so, I probably should've put a bit more detail of, you know, "If this happens, then this happens," but there's no point in me doing that, cause these notes are just for me to remember what's happened
Q. Bathers' Pavilion was your idea, correct?
A. Correct.
Q. Why Bather's Pavilion?
A. Because one, it was outside of her area, and two, it's, it's a nice place and 1, and I've been there before and like I said, part of my motivation was to, I guess, give [Patient A] I guess the idea that she is worth someone else's time and I mistakenly - and I'm putting my hand up to this - see that that logic was, that thinking was flawed, but that was where my mind was at, at the time.
Q. You wanted to give her a special night?
A. I wanted to, I wanted to show her that she was worth someone having a nice meal with. That's what I wanted to show her at that time and also to put her out of her, out of her, I guess, safe zone in Five Dock and hopefully get her anxiety up.
Q. I suggest what you wanted to give her was a real date experience, which is what you told her?
A . Well, I never said that and you know, with respect, you're also sort of you're not making much sense. In earlier, prior to lunch, you said I wasn't grooming her, now you're telling me that I'm saying that I'm trying to date her. I would put that as grooming behaviour and I didn't do that, so I didn't refer it as a real date experience and I would say that I referred to it as an exposure session and I would say if the HCCC were honest, they could find those messages prior to the messages that she's got and they would see that it says "exposure session" in those messages. They've got to exist somewhere.
Q. You're saying that you have messages to -
A. I don't have them. I, I would - I'm saying that I would think that if she's got all these other messages, why doesn't she have those that specifically says "exposure session" because I'm positive that I referred to it as an exposure session because it was an exposure session.
Q. You're saying that you texted her at some point saying "exposure session"?
A. I'm pretty sure I have, yes.
Q. But you don't for some reason have access to the messages that you sent?
A. No. No, I don't. They've been deleted. I deleted them, like delete most of my client message[s] that I don't think are important.
The cross examination then turned to the subject of whether or not the practitioner had done exposure therapy sessions for other patients. He said that he had, and then on occasion he had paid for them. When asked whether it would be fair to say he had spent no more than $10 on such occasions he said "not even that. Not even that". The practitioner said he never raised the issue of payment with Patient A, and did not know whether or not she had assumed that he was going to pay for the dinner.
Turning to the dinner itself, he agreed that alcohol was consumed at the restaurant, but said that all the alcohol was consumed by Patient A. The following questions and answers ensued:
Q. … Given [Patient A] consumed alcohol at it, do you say it was an exposure therapy session today?
A. I do say it was an exposure session today that went pear-shaped. Hundred percent. The fact is - and this is why I pulled up on the boundaries very, very quickly after that because one, she consumed alcohol and even though I brought up the fact that this is not beneficial, alcohol is a depressant so she shouldn't be drinking wine because she's got a substance abuse disorder, even if she didn't drinking alcohol when you're meant to elicit anxiety isn't helping because alcohol will often relax people. Dutch courage type thing.
So, I knew it was an exposure therapy session that went pear shaped. It went really badly and that's why I had such a huge wake up call, you know, literally in the middle - you know, when I saw the alcohol, because I thought, this is not, this is not what I had intended. Admittedly, I made a lot of errors and if you want to ask me about those errors. I'm more than happy to run you through them about that exposure session but -
Q. You had a wake up call as soon as you saw the alcohol?
A. Yep. I did.
Mr Chatterjee then took the practitioner to the restaurant bill which showed that one bottle of red wine, three shots of Johnny Walker Black and one glass of Penfolds port had been consumed. The practitioner agreed that "all of that alcohol" had been consumed.
Mr Chatterjee then took the practitioner to the transcript of the s 150 proceedings. For convenience and to assist in understanding the evidence it is appropriate to set out the relevant contents of the transcript immediately:
THE CHAIRMAN: If you identified her as someone who was vulnerable, what was the rationale for then taking her out for a date?
MR TSOLIS: Well, no, I just want to say it was - it wasn't a date because I you know, the way I consider a date is that there's a romantic intention or, you know, an intimate intention there and that was not the case. As foolish as this is going to sound, you know, I just - I felt responsible for her and I felt that I guess just sharing a meal with her would show her that, you know, there was some - you know, that she was worth sharing a meal with and that the idea that she had that she was completely alone and that no-one cared for her and her father had - everyone else had abandoned her and everything else was inaccurate and, you know, looking - you know, just saying those words now, you know, I just feel - I just feel silly, but that's where I was at that time.
THE CHAIRMAN: She makes allegations that you referred to this as a real date experience.
MR TSOLIS: No, no. I deny that.
MS GILL: Did you have alcohol at the restaurant?
MR TSOLIS: No, no.
MS GILL: So why would you have gone in an Uber rather than driving?
MR TSOLIS: I guess the real - I guess the real reason was because I wasn't honest with my wife about where I was going because I get - and it was just easier to just catch an Uber and just say I was going out with a few friends for a few drinks,
THE CHAIRMAN: Why would that be the case, Sava, if the purpose of it was for a therapeutic purpose? Wouldn't you inform your wife that you were engaged in some therapeutic process with a client? Why hide it from her?
MR TSOLIS: My wife is not - I think telling my wife that I was going to dinner with a client, even for a therapeutic process, no, I don't think she would have been - yeah, I don't think she would have been happy about that.
THE CHAIRMAN: But presumably if she found out after the fact, it would have been a worse situation.
MR TSOLIS: Yeah, it would have been the situation - and it is the worst situation.
[ASSOC PROF W WARREN]: the benefit of hindsight.
MS GILL: Can I just ask who chose the restaurant?
MR TSOLIS: I did on -
THE CHAIRMAN: The other allegations are made in terms of your physical contact with her during sessions and asking whether she had noticed you had an erection.
MR TSOLIS: I deny all of that and if you can imagine, the medical centre where - you know, where I'm at, I mean, we've got - we've got walls that are very thin. I've got - I've got two GPs sitting next to me. There is no way I would, you know, risk anything like that, you know, in a professional setting like that. There's a female receptionist sitting outside. It would, you know there's no way that I'd do that.
MS GILL: The hugging and the kissing at sessions as well? Nobody would see or hear that even through very thin walls.
MR TSOLIS: I deny that I kissed her. In terms of a hug, potentially, you know, I think I probably did hug her at the end of the session, but there was no way that I had an erection or anything like that. I deny that and it was purely a platonic hug at that time.
THE CHAIRMAN: What do you mean "a platonic hug"?
MR TSOLIS: So after a session she asked for a hug and I hugged her and that as it. There was no - there was no fondling. There was no - there was no anything like that.
THE CHAIRMAN: Well, why would you respond to a client who asked you to hug them?
MR TSOLIS: Why would I respond?
THE CHAIRMAN: Mm. I mean, I'm presuming you're aware of issues of boundary violations, physical contact and codes of ethics and so forth.
MR TSOLIS: Yeah, I am - I am aware. I just - with someone that is - you know, was so down and so, I guess, down on herself, I - you know, I think it would have made her feel even more rejected if I, you know, wouldn't even just give her a hug and send her on her way.
THE CHAIRMAN: So if any other client asked you for a hug who was needy and unhappy -
MR TSOLIS: Oh, no, no, not at all.
THE CHAIRMAN: ---previously?
MR TSOLIS: No, I don't think so. No.
THE CHAIRMAN: But you're not sure.
MR TSOLIS: No. No, I can - I can tell you I am sure. I'm just thinking back. No, no.
MR.... In your training, you would have been aware of the code of ethics and crossing the boundary - crossing boundary violations and so on, but that's obviously not in your mind when you're contemplating - took this young woman or (indistinct) to her. You were aware of what's required of you.
MR TSOLIS: I guess I am - I am aware and I think I was aware. I just think that, yeah, I had a lapse - a lapse in judgment with this particular client.
The following questions and answers between Mr Chatterjee and the practitioner followed:
Q. … I'm asking Mr Tsolis if in the course of the s 150 hearing , he thought the fact that [Patient A] had consumed alcohol was a relevant factor to raise.
A. The fact is that I was in a state, I would say, pretty much akin to terror on that section 150 proceeding. I, I think I was waffling, I think I was not thinking straight. I had very limited time to prepare for that and I don't think I was in state of mind to judge whether - you know, whether that was about it to bring up. I don't think at that time I, you know what colour do you know, so I, I answer the questions, that's what I was asked to do. I answered the questions. They started asking about the Uber, they started - they mention my wife. I answered - I didn't spare myself, on page 10 I even told them about the fact that I was dishonest with my wife, which is to my shame today. So, I never spared myself here in anything. So, the fact that I didn't bring it up at the time, I would say I was simply trying to hang on in the most probably - bar today - the most stressful moment of my life.
Q. I'm just asking if you consider it to be a matter that was relevant at the time?
A. Relevant to the, the, the panel, the Psychology Board?
Q. Yes.
A. I would say, well, I do say that I think it was relevant but I would say that I was in no position to think of that relevance at that time. That I was in a state of panic and that I wasn't thinking about whether things were relevant or not relevant. I was simply trying to answer their questions to the best of my ability without sparing myself one iota. Without trying to sugar coat things or make myself look better in any way, shape or form. I was just as transparent as I could possibly be.
Q. Being as transparent as you could possibly be and not sugar coating anything was to not refer to [Patient A] having consumed alcohol at what you said was an exposure therapy session?
[OBJECTION - Question allowed]
Q. You said that you were trying to be as transparent as possible and not sugar coating the situation or sparing yourself one iota -
A. Yep, that's right.
Q. And you say that not mentioning the fact that [Patient A] consumed a bottle of red wine, three shots of whiskey and a glass of port was not sugar coating the position?
A. I wasn't sugar coating--
[OBJECTION] - - Question rejected]
Q. Mr Tsolis, to your knowledge, do you say that [Patient A] consumed all of the alcohol that you purchased? A. No, I don't think she - well, I know she didn't consume all the alcohol. So, she didn't consume all the scotch because I left my touch untouched and she didn't drink that. I know she didn't drink all of the wine and I don't know how much of anything else - so, I know she didn't drink all of the wine and I don't think even the, the, the other, the, the port that she had
Q. When you say you left your scotch untouched, what does that mean?
A. I left it at the bar untouched, undranken [as said] untouched and she didn't drink it.
Q. Why did you have a scotch?
A. Cause she ordered me one. So, I went to the bathroom when we got there. She ordered two drinks. I wasn't aware that one of them was a double, so that was hers, I presume and she ordered me the other one, I didn't touch mine.
…
Q. Do you say that not informing the section 150 panel that [Patient A] had consumed alcohol at Bathers' Pavilion, do you say that that's consistent with that, with being transparent and not sugar coating the situation?
A. I would say it's definitely consistent with it because I was, like I said, I was following the conversation and when they started asking different questions, I went to that. By the end of it, I had, I, you know, I hadn't considered the, you know, the alcohol was the last thing on my mind because by the and of it, what they were talking about was potentially suspending my practice. So, no. I. you know, I can honestly say that the alcohol went to the back of my mind because I was confronted with the fact that I might not be able to practice and that was where my mind was at and also trying to, to answer all, all these questions, I had three people firing questions off at me and minimal time to prepare about something that happened years before.
Mr Chatterjee then took the practitioner to par [27] of the Council decision. For convenience and to assist in understanding the evidence it is appropriate to set out the pars [27] and [28] of the Council decision immediately:
27. The delegates noted that they travelled to the restaurant by "Uber". When asked if alcohol had been consumed by either of them at the restaurant, Mr Tsolis denied this. When asked why they would have travelled by "Uber" if no alcohol was consumed. given the restaurant is some distance from [Patient A's] home address, Mr Tsolis said it was because he had not been honest with his wife and had told her he was going out for some drinks with friends. Mr Tsolis admitted that he did not think his wife would have been "happy" even if he had told her he was going out with a client for "therapeutic"
purposes.
28. The delegates have no further information to confirm or refute Mr Tsolis' claims that no alcohol was consumed at the restaurant. If it were later proven that alcohol was provided by Mr Tsolis, and consumed by [Patient A] at the dinner, this would represent a serious breach of the therapeutic process, given [Patient A's] alcohol use history.
The following questions and answers then ensued:
Q. The panel notes on the second sentence, "When asked if alcohol had been consumed by either of them at the restaurant, Mr Tsolis denied this." You did say that's in fact wrong because you say you were never asked about whether [Patient A] had consumed alcohol?
A. That's correct.
Q. You have since this decision filed, by my count, three statements … I suggest that you make no mention of you not drinking and only [Patient A] drinking in that statement?
A. I don't think I made any reference to alcohol whatsoever.
Q. Yes, exactly. In the affidavit that you filed in these proceedings, you've made no mention of the consumption of alcohol, correct?
A. Correct.
Q. You know that one of the allegations that was made against you is that you had consumed alcohol at the restaurant?
A. That's correct.
Q. I'd suggest to you that you did consume alcohol at the restaurant?
A. I don't agree with that. The reason I didn't make any submissions, you know, anything like that, is because I assumed that I'd be asked these questions and to be honest, I also assumed after I read the initial document which happened in 2018, the panel's decision, that I would be interviewed about this again and there would be a transparent process. None of that happened and I was, you know, I wasn't aware of what the process is. I certainly didn't think that it was going to take four years for this to come to where we're at and I assumed that this was going to be an open, transparent process where the HCCC ask me questions, I answer them because they wanted to get to the truth of the matter. None of that happened, so, the reason I - so, that's I guess the reason why I didn't write to the HCCC to say, "By the way, this happened," because I assumed that they would be - we would be participating in some sort of investigation, but none of that occurred, which, to be honest, was quite distressing for four years having this sword hanging over your head without having any transparency about what the process is.
Q. Disciplinary proceedings are commenced against you in this Tribunal, there was a complaint made against you, one of which was particulars was that you consumed alcohol at the restaurant.
A. Right.
Q. You put on an affidavit in these proceedings but you didn't consider it necessary in that statement, in your affidavit, to set out what you say in fact happened at the restaurant?
[OBJECTION - Question allowed]
I'm just going to have to think about this because to be honest, I haven't really thought about it till now. I - the reason why I didn't think it was relevant for me to put it in the statement is that I answered the question truthfully that I didn't drink - one - at the 150 proceedings. Two, I didn't have control over what [Patient A] was going to do at that dinner, so I couldn't not, you know, I couldn't force her not to order drinks or whatever and I'll be honest that I had assumed that I'd be asked all these questions today, which I have been. So, I in the same way I didn't make reference to the "my love" accusation in my affidavit because I figured, one, that I'd be asked about it and I wasn't sure what the exact, you know, how many times I'd said it or hadn't said it and that's why I hadn't included it in my affidavit. So, that's my answer.
Q. You accept that the issue in relation to "my love" is qualitatively rather different from the issue of whether [Patient A] consumed alcohol at the dinner and whether you consumed alcohol at the dinner?
A. Well, like I said, I made it abundantly clear at the s 150 proceedings when I was asked, did I consume alcohol, I answered no. Now, whether the person who wrote this document made a mistake, that's not my job to correct them as far as I can see it and I didn't correct them and I wouldn't even know what avenues to take to correct them to be honest. Even now, I wouldn't even know who to contact here. If your expectation is that I'm going to sit there correcting every mistake that was made here, I've got quite a few others we can bring up, but I didn't do that.
After the further cross-examination Mr Chatterjee suggested to the practitioner that he did drink alcohol at Bathers Pavilion. The practitioner's response was "No, I did not. I did not drink alcohol at Bathers Pavilion". The following questions and answered ensued:
Q. I suggest to you that you are now saying for the first time that [Patient A] consumed all of the alcohol because you are trying to avoid any impression that what had happened at Bathers' Pavilion was not an exposure session but rather-
[QUESTION REJECTED BY THE TRIBUNAL]
Q. I suggest to you that you are making it up that [Patient A] was the only person at Bathers' Pavilion who consumed alcohol because you want to avoid the impression that what happened at Bathers' Pavilion was not an exposure therapy session but in fact was something like a dinner date between [Patient A] and yourself?
A. That's not true. The reason I'm bringing it up now is that this is the first time anybody has ever asked me about it and that's the reason I'm bringing it up now because I've been asked a question and I've answered it, like I've answered every other question, like I was asked, "Why did you take an Uber?" I could've said for convenience, I could've said a number of things, I said specifically because my wife would not have been happy with me going to an exposure session with a female client. I didn't have to say that, but I did,
because it's the truth.
The cross-examination and then turn to the practitioner's use of a "Uber Black" to travel from his house to Patient A's house. The following questions and answers followed:
A. To be honest that was the first time I've ever used the Uber app and i wasn't aware that I was using - I wasn't aware that there was a difference between Uber Black and all the others, so, the only time when! found out that Uber Black was different to the others was when I got the bill at the end of the when I reviewed my emails the next day. So, I can assure you that I didn't deliberately order an Uber Black for [Patient A] because otherwise I would've just ordered one, instead of ordering one to get to her house. So, that was a complete mistake and a costly one at that, to be honest.
Q. To confirm, you had used the Uber app before?
A. Never, that was the first day and my records with Uber can show that. That was the first ever day that I used Uber.
Q. When you say on your email the next day you realised it was more expensive -
A. Yeah, the receipts.
Q. If you'd never used Uber before, how did you know it was more expensive?
A. Because I looked then - I wanted to see why on earth a trip to Russel Lea would cost whatever, it was like $70, $80 and then I did some research and I discovered that there are settings on Uber that I wasn't aware of. So, because I know that a taxi cab to, say, Five Dock or Russel Lea would cost X amount and I realised, well, why am I being charged all of this money and that's when I did the research.
Q. Why didn't you simply use a taxi?
A. Because it was the way of the future. I, I figured, you know, I figured I might as well start using this app, why not. Everyone else seemed to be using it, I was getting - I'd heard good things about it, so I tried it. I've used Uber since, to be honest, but just not ordering Uber Black, that's for sure.
Q. I suggest that you did use the Uber Black because you wanted to impress [Patient A] as part of … (not transcribable) … to Bathers' Pavilion?
A. Why would I use the Uber app - Uber Black to go there? I could've just ordered an Uber normal, gone to her house and then ordered the Uber Black to come home - I mean, to go the, the restaurant. I didn't do that. Why wouldn't I do that? Why would I waste my money? I'm telling you, it was a simple mistake and one that's never been repeated, I might add because I wasn't, I wasn't familiar with the app. I, I didn't really pay much attention when I ordered the, the thing and that's why. I mean, you know, if what you're purporting is true, I would've ordered one from her house to the restaurant and from the restaurant back to her house, but I didn't do that. I also ordered one from my house to her house which she would've never seen, so why waste my money on that?
Q. You were expecting to pick her up at 4.30 weren't you?
A. No, I was expecting to meet with her at 4.30, all right? I knew, I was anticipating to having to go out but - having to go in, so I let the Uber app - I let the Uber go, then texted her and, and there's confirmation, if you check my text messages, you'll see that I - the Uber had already left by the time I text.
…
Q. you were expecting to spend some time at home before you went out for dinner, is it?
A. I was expecting to pick her up from her home. That's what I was expecting to do, because normally when you go to dinner with someone in my, you know, you knock on the door, the person comes out when you go in and you go out afterwards. That was it. It wasn't anything untoward or sinister that I was trying to impress her with a car. If I wanted - the fact that I was taking her to a nice restaurant was, I admitted already that I was trying to be nice and show some care there, which was again mistaken, but I wasn't trying to show off with a car, I can assure you of that.
After discussion about the restaurant booking, the practitioner agreed that he arrived at Patient A's house at around 4:30 pm and subsequently went inside at about 5pm.
The practitioner accepted that Patient A had a problem with alcohol at the time, although she was improving. Mr Chatterjee took the practitioner to his referral to the depression clinic at Prince of Wales Hospital and 14 June 2016, that is approximately three weeks before the dinner. The practitioner accepted that the risk assessment based on her self-report was that she was abusing cocaine, cannabis and alcohol on a daily basis.
Mr Chatterjee put to the practitioner that Patient A's history included 24 standard drinks vodka per day. His response was that he did not exactly believe that but wrote down because that's what she said. In any event the practitioner accepted the Patient A was abusing alcohol on a daily basis he agreed that when he arrived at her home on 9 July 2016, he held the view that she likely had a drug disorder and alcohol use disorder.
The practitioner agreed that until he arrived at Patient A's house, she had no idea where she was going that night. He said that she knew she was going to dinner but didn't know the location. He agreed that she had anxiety in social settings and stated that:
She didn't like being outside of her area, which is the Five Dock, Russel Lea area, which is partly, to be honest, why I also didn't tell her where the exposure session was going to be, because I didn't want her to freak out about it too early sorry, to panic about it too early before I got there because that's why I went there a little bit early to prep her for the session saying, "This is where we're going to go, these are the strategies we're going to use," and that's why I wouldn't have picked her up just in the car, because I had to do some prep work beforehand and that's why I then had the time in her home. So, before any exposure session, you, you prep the client. So, "This is what we're doing. These are the strategies we're going to use." We talk about SUDS, subjective units of discomfort, you run all through that and I wanted to be there in person while I was saying that because if I'd said that over the phone, she, she might of panicked.
Mr Chatterjee asked whether or not the practitioner had done all those things with Patient A on the day. His response was "Definitely. Yep. I sure did."
Mr Chatterjee then put to the practitioner that in his affidavit he made no mention about "all this preparation" that the practitioner said he would do for am exposure session. The practitioner's response was, and further questions and answers were:
A. Why would I put that in, in my affidavit? I don't see why that would be necessary to put in. There was no, there was no allegation that anything untoward happened prior to the dinner. There was false allegations that I went in there after the dinner, but prior, there was no, there was no allegation that l'd done anything improper. So, I just put it in that I went into her house briefly, because that's what I did. Now, I didn't think that it was necessary for me to write, "We discussed relaxation strategies, PMR, grounding exercises," I don't see how that would be of any relevance to you or would be any relevance in this sort of setting. So that's why I didn't write it.
Q. You understand that there is a contest between the case put by the Commission and your case as to what the nature of the dinner was on 9 July?
A. I understand but what you have to understand also, with respect, is that until Monday, there was an allegation that I had committed sexual assault. That was false and that, to be honest, was the main thing that my legal team and I were really concerned about. That was number 1 priority. That ended up being a lie and to be honest, everything else, when you've got an elephant in the room like that, everything else sort of pales in comparison. So, my legal team and myself, you know, for the last four, more than four years, the one thing that I've been terrified of is one day my son Googling my name and reading "sexual assault." So, that, you know, that was, that's been pretty hard and my apologies if I haven't put in why I went into her house previously, because I was pretty focused on not being called a rapist and, and the fact is that you, with respect, also knew that those allegations were untrue and you still brought them forward. For an extra year prolonged that torture for me.
Q. I ask again that you confine your answers to my questions It is important to your case, no, to demonstrate that the session on 9 July was an exposure therapy session?
A. Mm-hmm.
Q. You say that you did specific work at [Patient A's] home in preparation for an exposure therapy session?
A. That's right. I ran through the strategies we were going to use. I explained to her the concept of SUDS, subjective units of discomfort. I explained to her where we're going to go and why. That was it.
Q. You say that you didn't think that was a matter that you needed to put in your affidavit?
A. That's right and I still don't think that's a matter I should've put in my affidavit.
Q. I suggest to you that you didn't do any of that preparation work in [Patient A's] house?
A. Well, any psychologist that has ever done an exposure session would do that preparation. It's part of the deal. So, the fact is that I did do that preparation and that's why I didn't pick her up from the car. That's why I made the effort to go into her home to discuss these issues, I mean, to set this exposure session up.
Q. I suggest to you that you're making this up as you go along?
A. Well, I, I don't, you know, I don't agree with that whatsoever. I think a lot of
stuff has been made up here but not by me.
The topic of cross-examination then turned to Patient A' use of drugs and alcohol. The practitioner's accepted that Patient A used drugs and alcohol to deal with her anxiety. He accepted there was a real possibility that issues under stress that she would consume either cocaine or alcohol.
The cross-examination then returned to the dinner at Bathers Pavilion:
Q. The two of you went and sat at the bar, correct?
A. We were seated at the bar. We, we didn't - you know, we went in to be seated, the table wasn't ready and they seated us at the bar.
Q. You go there knowing you're going to pay for everything?
A. Yes.
Q. You say you went to the toilet?
A. Yes.
Q. You came back and you say she's ordered two drinks?
A. That's right.
Q. Your evidence is that you were flummoxed as to what to do?
A. No, I told her that she shouldn't be drinking. I knew, you know, immediately that I wasn't going to be drinking. I told her that she shouldn't drink. She pretty much said that she's got a right to drink, that, you know, she's allowed to drink, she's legally allowed to drink. I told her it's not idea [sic - ideal?]. I explained why it's not a good idea in regard to the exposure in terms of anxiety and also for her sobriety. She got a bit - what should I say? A bit tense, a bit agitated at that and, and that's when I was flummoxed. I thought I didn't know how to deal with that after that because I didn't want to create a scene in a public setting with someone that I knew that was potentially volatile.
Q. You were concerned that [Patient A] would become volatile?
A. Well, I was concerned if she's challenged, she often reacts in an aggressive sort of away. I think that's been established and I think she's admitted that.
Q. When you say "aggressive" do you mean physically aggressive, what do you mean?
A. No. No, no. Not, well not - no, that didn't cross my mind, I didn't think she was going to attack me, but I did think that she would potentially raise her voice or, you know, something to that effect.
Q. But therapy had been going well up until 9 July, hadn't it?
A. It had. It had and that's part of the problem is that I had been going reasonably well and this was a situation that I wasn't prepared for and I didn't know how to - well, in that moment, I didn't know how to respond to it besides voicing my concerns. I also didn't feel that I - I'm not the police, so I didn't have, I didn't feel that I had the authority to command someone to not drink. I made my concerns known very clearly and then when she started getting a agitated and a bit - I wouldn't say aggressive, but very, agitated, that's the word. That's sort of pushback and that was it.
Q. Describe to me this agitation that she was expressing?
A. She became - she said something to the effect that, "I think I'm doing well. I don't need you to tell me what I can and cannot do. People have been telling me what I can and cannot do my whole life." Something to that effect and, you know, you could see that she was, she was in a - escalating. She was starting to get upset and-
Q. There were clear signs of escalation that you could see?
A. I could see, because I was speaking to her, yes. I could see that she was upset. Now, I didn't say she was waving her arms around or screaming or carrying on or anything like that, but I could see she was getting upset. I could see she was getting agitated and like I said, I've seen her in the state where she's upset and agitated and I was flummoxed what to do about it. I didn't know what to do about it in that setting.
Q. You decided to continue with the dinner?
A. Yes.
Q. You are her therapist?
A. Yes.
Q. You've taken her for what you say is an exposure therapy session?
A. Yes.
Q. You knew you were going to be paying for the alcohol that she was consuming?
A. Yeah, well, I did know that, yeah.
Q. You knew that she had an alcohol use disorder?
A. Yeah.
Q. You say you that had a real concern as to her suicidality at the time?
A. I would - yeah, I - we've already been through this. I've always had a concern for her suicidality, yes.
Q. Your evidence was that your concern went from a ten to a seven?
A. Yeah, yeah, at certain points and other times back to ten, other times back to three or two, depending on how I saw her on a particular day. Like I said, the reason for my concern for her suicidality was the extent of her emotions; how quick she would respond to things, how angry she could potentially get. When she was speaking about her ex-husband, she was ropable in session. She was really visibly angry. When she spoke about the family friend sexually - I don't know if he assaulted her or harassed, I can't remember, when she started working again during our therapy, she was visibly, literally shaking in anger. So, yeah, it's - on those days, I would say my concerns for her suicidality definitely went up when someone is angry or that upset.
Q. Given that context that you've just agreed to, you're her therapist, you're going to be paying for the alcohol, you've got alcohol use disorder, you've got a background concern of suicidality, you decided to continue with the dinner?
A. I didn't know how to pull her out of there. I knew that if I said, "That's it, we're going home, " she would've lost her temper. She would've - it would've been worse. I couldn't just leave her there, because I also knew that she might not have the means to go home. So, I was stuck or I felt that I was stuck. I felt that I didn't have, like I said, the authority to force her home. I didn't know what to do. So, yeah, I was, I was confused and this is, I guess, something else that I should never have put myself in that situation but if I found myself in that situation today, I still wouldn't know what to do because it was, you know, it was a situation I should never have been in. Once I was in there, I didn't know how to get myself out of there.
The cross-examination then turned to the question of the practitioner's arrival at Patient A's home. He agreed that he spent 20 to 30 minutes "to prep her for the exposure session".
It was suggested that no such session took place. The practitioner's response was that:
A. Well, I don't see how you can make that proposal. I don't see on what evidence you've got to make that proposal because I'm telling you, everything my - what I'm telling you is matched with the text messages that your office has provided you, it's consistent with my statement, so I don't really understand how you can make that point. What I want to you know is why do you think that I wasn't in there for 20 minutes?
Q. I'm not saying to you that you weren't in there for 20 minutes, I'm saying that you weren't conducting preparation for an exposure therapy session for 20
or 30 minutes in [Patient A]'s house-.
The topic then changed back to the dinner itself and the ordering of wine at the table. The following questions and answered followed:
Q. [Patient A] ordered the bottle of wine then?
A. Yes.
Q. She ordered in front of you?
A. Yes.
Q. You took no objection to her ordering the bottle of wine?
A. Not in front of the waiter. I didn't feel that that would be appropriate to have that discussion in front of a third party and so I kept my mouth shut. When he left I told her that I don't think that's a good idea. I reinforced the fact that I don't think alcohol is a good idea and she said that she's not going to drink much. Like I said, that's where - that, I'd already, I was already in a state of, well, I'd say, you know, a bit of, a bit of panic at that stage because l'd recognised I'd gotten myself into a situation that was not good. I'd recognised that I did not know how to get out of it and you know, I'll - I'm not embarrassed to say that my anxiety went through the roof and yeah, I wasn't sure how to deal with it. As much as this is going to sound silly, I've had six years to think about this and if I was back in that situation today, I still wouldn't know how to deal with it. The only thing I know is I should have never been in that situation in the first place, but if I was back there, you know, I've replayed that scene countless times in my head, what would I have done differently? The only thing I can say is I should've not been there, but now that I was there, you know, I didn't know how to deal with it. I still don't know if I - how to deal with that situation and I've gone through this with my supervisor, I've gone through this in peer discussions and I'll be honest, I don't know to this day. The only thing I know is I shouldn't have never been there and that's - I put my hand up to that. I always have.
Q. You took no steps to cancel the order for the wine?
A. No, I didn't because I knew that if I'd done that, if I did that, that she would've taken that as - she would've been offended, she would've gotten really upset, I mean, she'd already pretty much demonstrated that that was a touch point for her at the bar and like I said why I definitely didn't want to inflame the situation further.
Q. When you moved from the bar to the table, surely you must've thought that there was a possibility that she was going to order another drink?
A. That's right, I did.
Q. You knew when you were going to the table there was a possibility she might order another drink?
A. Yeah, I was worried about that, that's right.
Q. You didn't, for instance, try to at least change the bottle of wine to a glass of wine, because you weren't planning on having a drink, correct?
A. … Like I said, my anxiety was through the roof. … I've replayed that. If I said, "No, get a glass of wine," she might've said yes, she might've lost her temper, she might've whatever. …
Q. You never said to her before the waiter came, "[Patient A], this is an exposure therapy session … (not transcribable) … should not be drinking at it"?
A. I did say that. Yes, I did say that. I said that at the bar. All right? And that's when she arced up at me. That's when she got all, all, all strained in her voice and quite tense in the jaw, all of those early warning signs of someone getting upset.
Q. You're sitting at the bar, she's arcing up -
A. She's getting tense, yeah, she's, you know, talking in a slightly strained voice, her jaw was clenched, yeah, these are all signs that someone is, you know, getting upset and that's not what I wanted. I'd seen her in a state before and I didn't want that repeated in a public setting.
Q. I want to go over this again because I'm having difficulty following your thinking here. You're at the bar, you have … (not transcribable) … exhibiting defiance, perhaps, with you trying to control the drinking?
A. Well, I, again, I was not, you know, I'm not a police officer. I'm not in a position to control her drinking. I suggested strongly that it was not a good idea, that I didn't think that she should be drinking, that it pretty much negates the exposure and it's not good considering the fact that she's got an alcohol issue. After that, I didn't know what else to do. I didn't know how to stop her. …
Q. What I'm suggesting to you is taking all of those matters into account, which you say were running through your mind at the time, it would be utterly implausible on your version of events that you thought the best thing to do was to just continue on to the table and continue on with the dinner?
A. You're saying that that was implausible?
Q. I am saying that it is implausible that as a therapist attending with a patient for what is meant to be an exposure therapy session, after she'd ordered a drink, your reasoning was, knowing that she might order more drinks and knowing that she might order quite a few more drinks and knowing that you were going to be paying for all of that alcohol, you thought that the most sensible thing to do was to just continue with the dinner?
A. I did. That's exactly what I thought and I'll tell you why because what I was concerned about is if I tell her no, if I say, "We're going," if I say, "You're not allowed," she would've lost it and I didn't want a screaming match in the middle of a restaurant, a public setting, with a client that is highly anxious and I don't know if you know much about anxiety but anxiety is the fight or flight response pretty much. … Like I said, I was in a bad - you know, I had put myself in a bad situation and the way I saw it, there were two bad options. We go along with the dinner and just try to keep it calm and tame or I potentially risk her losing her temper, getting aggressive - not physically, 'cause I'd never seen that to be honest but raising her voice, crying, carrying on, I'd seen plenty of that - in a public setting and yeah, you're right, I chose to continue with the dinner and try to keep her calm, get her home safely without any conflict. So, yeah, that's what I did and again, like I've said, I would challenge any psychologist in that situation to come up with a better idea. I would say all psychologists wouldn't have gotten themselves into that situation in the first place, that's on me, but I've spoken to supervisors about it, I've spoken to peers that a - a peer about it - and the consensus was, well, you were screwed pretty much either way. So, I took the path that I thought was best considering that both options were bad.
Mr Chatterjee then asked the practitioner if he agreed that by paying for the alcohol, it might have been perceived by Patient A that he was enabling her alcohol consumption. The practitioner disagreed, saying:
I can't see how that could be the case when I expressly told her on a number of different occasions that night that she shouldn't be doing this, that we'd worked on alcohol relapse prevention skills, that we had discussed this in countless other sessions that I'd encouraged her to go to rehab, that l'd encouraged her to speak about her alcohol and her drug use to her GP, her psychiatrist that I referred her to, all of this, I can't see how you would say that I'm trying to enable her alcohol or I'm giving a green light to her alcohol abuse.
Mr Chatterjee then turned to the topic of the practitioner's Progress Note (referred to as a file note by Mr Chatterjee) which he prepared the following day 10 July 2016. For ease of understanding the cross-examination, it is convenient to set out the contents of the file note immediately:
Dinner with [Patient A] on the 9th July 2016. I picked up [Patient A] in an Uber afterwards went to Balmoral buy this for dinner. [Patient A] did not appear to exhibit any avert signs of anxiety after we were seated. I dropped patient a off at her home in an Uber at approx 10:30 PM. Upon reflection, clear boundary issues have been brought up. [Patient A] is excessively using the two person feedback rule for unimportant issues. Need for boundary clarification there. Concerned that the dinner may have further relaxed boundaries in the therapeutic allowance. Urgent need for this to be discussed.
Mr Chatterjee suggested to the practitioner that there was no reference in the progress note to the anxiety he had said that Patient A was displaying. The practitioner said "that wasn't anxiety, that was, like I said, frustration. That was not anxiety, that I could tell".
Mr Chatterjee then suggested to the practitioner that the only boundary issue identified in the progress note was an excessive use of the two person feedback rule. The practitioner responded:
I'm thinking in plurals. All right? If you read the writing, "Clear boundary issues," plural. I didn't say "issue" "issues" there's a clear S at the end. Like I was trying to explain to you, what progress notes are there for is to job someone's memory. So, what I put down, the boundary issues, I can assure you there was no way I was going to forget about the alcohol and the two person feedback rule I also wanted to bring up, so I put that down. That and the fact of the dinner. They're the three major issues. I didn't write the alcohol. Looking at that, I should have. I think the reason I didn't write the alcohol is because I knew bloody well that it was a huge issue and that was not something I was liable to forget.
Mr Chatterjee then put a series of propositions to the practitioner as follows:
Q. I will suggest to you that you were drinking with [Patient A] at Bathers Pavilion.
A. I don't, I don't agree with that whatsoever.
Q. I'll suggest to you that it was in fact an intimate evening and you hugged and kissed [Patient A] at Bathers' Pavilion?
A. Did I also sexually assault her afterwards, do you think?
Q. Mr Tsolis, I've already told you on multiple occasions, the way this works is I put a question to you and you answer the question.
A. Mm.
Q. I am suggesting to you that at that dinner you kissed and hugged [Patient A]?
A. No. At the, at the conclusion of the Uber ride, I may have hugged [Patient A] at the end of the, of the, of the Uber ride as a goodbye gesture, that's it. Nothing more.
Q. We'll get to that. I suggest to you that this file note that you've done on 10 July 2016, I'll put it as a sanitised file note that you've done to try and minimise what's happened at the dinner?
A. No. It's simply, like I, like I explained to you, the file notes are there for my memory. I've written that there were boundary violations, I've written the fact that what I wanted to cover and that's what I did cover in our next session. That's what it is. Now, I should have written about the alcohol, …
Q. You say that your anxiety was through the roof during the dinner?
A. Yeah, that's why I couldn't sleep and I woke up at like, 5.30, I'd say, that night, that morning or even earlier because it was running through my mind, that's for sure.
Q. One of the reasons for your anxiety was you knew that that dinner could've gotten you into trouble in a professional context?
A. 100%. That's, that's true. I, I realised at that point just how distorted my thinking was and I also realised how much I had to bring my boundaries back, so I agree with you wholeheartedly and that's where the - that's a good part of the, the anxiety that I experienced, for sure.
Q. I suggest to you that you had written this 10 July file note in a context where you knew there might be some sort of complaint or issue and you're writing that file note to make your conduct in the course of the dinner look as good as it could?
A. If I, if I had wanted to do that, I would've just written the whole story, 'cause that would've made my conduct look better. As in, it would've been bad but I would've written point by point, this is what happened. Because to be honest, if I'd written the fact that [Patient A] - I explained to [Patient A] that she shouldn't be drinking that night, that would probably stand me in better stead today, but I failed to write that. So, if I was going to write a sanitized version of my notes, I can assure you this wouldn't be it. I would've done a hell of a lot of a better job if I was going to lie. I've tried to be as transparent as I can.
Q. I'II suggest to you that what happened was not the version that you had provided the Tribunal yesterday and today where you didn't drink at all and you counselled [Patient A] about her drinking but rather that you were sharing alcohol with [Patient A] at that dinner?
A. Okay. So, if what you're saying is that I am making things up, why wouldn't I make up a better story? I mean, if I was going to lie, I would lie about the whole bloody thing. I didn't do that. I wrote down my stream of consciousness as I was writing this file note and that's, that's what it is. As the issues were in my mind, I jotted them down and that was it. If I was going to lie about it, I can assure you, I would've made up an awful, a much better story than the one that, that I've written down here, that's for sure.
The next topic of cross-examination was the cost of the dinner, which was $280 spent on Uber transport and $330 on the dinner itself. Following that, Mr Chatterjee put questions to the practitioner about him not telling his wife the truth about the dinner. The practitioner agreed that he told his wife that he was going out for drinks with some friends.
Mr Chatterjee then put to the practitioner that the took an Uber on 9 July 2016 because he planned to have some drinks that night. The practitioner denied this, agreeing that taking the Uber was "part of the cover for [his] wife". The following exchange occurred:
Q. Taking the Uber was part of the cover for your wife, the story you gave your wife?
A. Yes and the other thing is, I know it's going to sound a little bit odd, but I also didn't feel a hundred per cent comfortable with [Patient A] being in my car.
Q. Explain that to me, why would you feel uncomfortable with [Patient A] being in your car?
A. I don't know, it just felt, it felt a bit personal because it's - you know, your car is your own personal space and it just felt, I don't know, if just didn't feel - it just didn't sit right with me, I can't, I can't explain it. I thought it was just, yeah, I just felt uncomfortable with that. I just felt that my car, you know, your car is your own personal space, as is your home. like I also wouldn't feel comfortable with inviting a client to my home either. I would obviously not do that. So, that sort of was a bit of an extension of that idea.
Q. Part of the reason you were taking [Patient A] out is because you wanted to give her a vote of confidence that she was worthy?
A. Yes.
…
Q. You spent almost $550 on an exercise?
A. By accident. Like I said, a lot that wasn't - you know, it was not my intention for her to purchase a hundred and however much in alcohol, it certainly was not my intention to order three Uber Blacks, I can assure you that. If you take all of that out, my intention would've been to may spent, I don't know, $200 on that evening.
Q. I'd suggest to you it would have to be at least $300 because you're paying for dinner for two people at an expensive dinner and you're paying for cabs one way or the other?
A. Yeah, $300, I'll give you that.
Q. You were willing to spend $300 for her?
A. Yeah.
Q. You were willing to take her out to a nice restaurant?
A. I was.
Q. You were willing to lie to your wife about it, because you thought it was important enough?
A. Yes.
Q. But you weren't willing to have her sit in your car?
A. No, because like I said, it's, it's not, it's not, it's never been a sexual relationship. It's never been an intimate relationship. It's never been anything of that sort and I viewed her as a vulnerable client. I viewed her as a client that was in distress. I tried my best to help her. I put quite a lot of beneficial things in place which I think have helped her. I took an overinvolved sense of responsibility for her emotional state and I made a decision, one decision well, I made a major decision, one major decision here that I should not have made in taking her out to dinner and then once we're there, the events were quickly went out of my control and I didn't know how to pull it back and here I am today, falsely accused of rape, falsely - all of that. In answer to your question, yeah, I did feel uncomfortable with her coming into my car because I still view her as a client, not as a friend, but as a friend that I wanted to give a thumbs up to, like a, you know, give a boost to. Having dinner with someone, in my view was external. I wasn't inviting her to my home, I wasn't inviting her into my car, I wasn't inviting her into my life, it was simply a dinner, that's how I- it was simply a meal, that's how I viewed it and also an exposure session at the same time.
The final principal topic of the cross-examination was whether or not the practitioner hugged or kissed Patient A outside the restaurant while waiting for the Uber to arrive or in the Uber itself. The practitioner denied both suggestions, but said that he hugged Patient A when the Uber driver stopped at Patient A's house:
Q. What happened when - tell me how the goodbye happened when you got to [Patient A]'s place?
A. Well, the Uber driver stopped, she got out, I followed her, I said goodbye, we hugged, I got back in the car and I went home.
Q. You have a clear memory of getting out of the Uber, do you?
A. Yeah - well, I'm not - to be honest, my memory was jogged when I heard the Uber driver describing the scene. So, yes, my initial thought was I hugged her in the car but since he confirmed that he saw me get out, then I take his word for it but my original memory of the night was I hugged her in the car, I can't see why I would get out of the car, but maybe I did just to check that she - that's, so, I've got to say that my memory has potentially been jogged or altered by hearing the Uber driver's account.
Mr Chatterjee then put to the practitioner that this was inconsistent with his affidavit evidence in which he denied any "sexual or romantic contact" with Patient A. The practitioner responded:
A. Yeah, I don't, I don't see that as sexual or romantic. I hug a lot of people. I hug my mother, I hug my friends on occasion. I wouldn't say that I've got any sexual or romantic feeling for any of those - like I've said many times in my original statements to the s 150 panel, it was purely a platonic hug. So, as you would just a normal human being and I think that's the way the Uber driver also described it, as a hug between two humans, just a normal human hug.
Mr Chatterjee also put to the practitioner that in his affidavit he also stated that he had never departed from the Uber. The practitioner explained:
Q. You state there, "Categorically, I never departed from the Uber"?
A. Yeah, I did state that and as I told you, that's the way I remember it. I remember hugging her in the car. When the Uber driver said his statement, that did job [sic - jog] something, but I'm not if that's the case or not. Like it old you, this happened six years ago and I don't - my recollection is that I didn't leave the Uber. If his recollection is that I may have, I don't remember that but I'm not also ruling it out. I'm not going to - but I don't think I did. From my memory, let's put it that way, from my memory, I didn't exit the Uber.
The practitioner did not recall hugging any other patients.
The practitioner was then taken to parts of the s 150 transcript where the issue of hugging was discussed:
Q. I suggest to you that you had given evidence at the 150 hearing as to platonic hugs in the therapy session?
A. Mm-hmm.
Q. And you understood that the chairman was specifically asking you whether that sort of conduct repeated in the course or at the end of the dinner?
A Right.
Q. And you knew that was the context in which you denied it?
A No, I deny that As I told you before, I didn't - I must have - I think i misunderstood the question because what I was focusing on was the hugging and in some way a sexual connotation - sorry, let me rephrase that. What I was focusing on was the kissing and my idea was that he was implying the hugging was some kind of sexual connotation but what I was really focusing on was the rape allegations and the kissing and the hugging that was probably going to be part of that so I denied it because I didn't kiss her, I certainly didn't rape her and if I didn't pay attention to the hugging part of that three sentence question, then my apologies but in my subsequent submissions, I've consistently admitted that there was a hug but there was never any sexual or romantic contact between [Patient A] and myself and I stick by that.
…
Q. 'Given your familiarity with her within the clinical settings, hugging her when she asks and so forth," and you accept that in reference to your earlier evidence about platonic hugs in therapy sessions?
A I do and I also, I guess, want to point out that he has also understood that it was more than once, which I also understood it and I also answered my questions implying that it was more than once and I think the chairman here clearly understood what I was trying to say. So, what you were saying earlier when you said, You mentioned the word 'session' as opposed to 'sessions'' I think that's inaccurate because I think the chairman understood what I meant that I'd hugged her on a couple of sessions and I think the fact that he mentions that is pretty clear that he understood what I meant, even if now reading back on it, it's not as clear.
Q. The chairman continues, "Could you comment on any inappropriate behaviour that she might have interpreted in terms of that evening?'
A. Right.
Q. You say, "From my perspective, I don't think there was, you know, in terms of any sexual or anything else like that," so you're clearly denying that there was any sexual connection between the two of you?
A. Definitely I'm denying that.
Q. And then the chairman says, "Okay, could I put it to you that - and given her familiarity in the therapy session, that would've transferred to the social setting and that there would've been either some degree of hugging or kissing.
A. Right.
Q. You clearly understand that what's being put to you is not some kind of sexual connection, but the behaviour that you might have engaged in could be misinterpreted?
A. There's no way on God's green earth I would've understood that at that time. I barely understand it now. So, no, not - I refute that. …
Q. I suggest that you are giving evidence now for the first time that you hugged her at the end of the Uber ride -
A. All right.
Q. I'll withdraw that and put the earlier proposition. I suggest to you that you have never in any of your materials said that you hugged her at the end of the Uber ride?
A. I've never been asked. The HCCC has never interviewed me until now. There's been no discussion. If there was, if you guys had approached this in good faith, you would've given me a chance to discuss this … [if you had asked] me questions, you would've tried to get to the bottom of it. All you guys have done is try to pin false rape allegations on me. …
Q. I suggest to you that none of those four statements have you mentioned hugging [Patient A] at the end of the Uber ride?
A. no, because what I was focusing on and what my legal team was focusing on was refuting the sexual assault claim …
Q. I suggest to you that it's not in those statements and I'm asking you if you agree with that proposition.?
A. Yes, I agree.
Q. In none of those statements do you identify that you got out of the Uber that and I've said that earlier.
A. No, because I don't remember getting out of the Uber cab. I don't recall.
Q. I suggest that you are giving evidence for the first time in your evidence to the Tribunal now that you (a) hugged [Patient A] at the end of the Uber ride and (b) that you got out of the Uber because that was the evidence given by the Uber driver -
A. No, no, you're putting words in my mouth. I have never said that I have changed my evidence. I said that with the Uber driver's testimony, that jogged something in my memory, but as I was very clear to state that I don't remember and I think that I hugged her in the car and I didn't get out. I was very clear on that point. Now, I'm not - in my memory, I was in the car. In his memory, I was out of the car. I'm not saying he's lying, but my memory is that I stayed in the car. Now, I may have gotten out of the car but the way I remember it - which is what I told you - I stayed in the car, but it was six years ago and I, I'm not going to say that my memory is foolproof in that particular detail, but I can tell you it was, yeah, it was six years ago.
[35]
Credit of Patient A and the practitioner
Before setting out our factual findings, it is necessary to make some comments about the credibility of each of Patient A and the practitioner.
[36]
The Commission's submissions
The Commission submitted:
16. The resolution of that central controversy is complicated by the fact that there are no independent witnesses to the majority of the impugned conduct, and the weight that can be afforded to both [Patient A] and Mr Tsolis' testimony is limited. This is because with respect to:
16.1. [Patient A], her evidence as to what occurred after the dinner (and in particular after she was dropped back to her residence by Mr Tsolis) is directly inconsistent with that of the only independent lay witness, the uber driver Mr Rehaan, and the Tribunal will likely disbelieve her account of those matters; and
16.2. Mr Tsolis, his evidence as to his interactions with [Patient A] after the dinner are also directly inconsistent with Mr Rehaan's evidence, and in addition (for the reasons set out below), his oral evidence on a number of a significant matters was either simply implausible or in conflict with contemporaneous records, or his prior statements, with the result that the Tribunal will likely be unable to place significant weight on Mr Tsolis' evidence except where it is otherwise corroborated by other material or is against interest.
The Commission submitted that the practitioner was not a satisfactory witness because of recent invention; that is that the practitioner raised for first time in his oral testimony matters that on no plausible view would not have been considered relevant at the time he prepared his evidence, and which one would expect would, if true, to have been included in the written material filed on his behalf through the "long procedural history of this matter". This recent invention is submitted to include the following matters:
alcohol being consumed at Bathers Pavilion, when the practitioner's prior statements make no mention of the consumption of alcohol;
that when he arrived at Patient A's home at about 5 pm or 9 July 2016, he took her through relaxation breathing strategies and measured her "subjective units of discomfort";
his evidence in admitting to hugging Patient A the end of the Uber ride when he dropped her off at her home after the dinner.
The Commission also submits that the practitioner's evidence on important issues was inconsistent with contemporaneous records and his own prior evidence. This includes:
he tried to stop Patient A consuming alcohol at Bathers Pavilion, when his progress notes of the following day made no reference to any consumption of alcohol but is the party, "let alone" Patient A in contravention of his directions;
hugging Patient A at the end of the Uber ride, being directly inconsistent with evidence he gave at the s 150 hearing;
his affidavit evidence that he "never departed from the Uber";
The Commission submits that "[w]hat is most telling however was Mr Tsolis' evidence as to the dinner at Bathers Pavilion being an exposure therapy session". The Commission submits that:
the practitioner was unable to offer any cogent explanation for why he had chosen a licensed venue;
it was not until questioning from the Tribunal that it became apparent that the dinner could not have been an exposure therapy session (which would ordinarily be gradated) but was more akin to "flooding";
there is no suggestion he obtained any advice or assistance on whether flooding would have been appropriate for a patient as complex or vulnerable as Patient A;
the whole concept of the dinner being a session to treat Patient A for anxiety is perverse in light of his evidence that he never told Patient A where they were going until he arrived at her doorstep which - if it was to treat her anxiety - could only have resulted in heightening her anxiety given that she no information or control over the plans for the evening;
the practitioner lied to his wife as to what he was doing on the
night, but the lie he offered (that he was going to have a "few drinks" with friends) would have offered poor cover unless he actually intended to have a drink.
The Commission also submits that the practitioner's Progress Note of 10 July 2016 was "at the very least 'sanitised'".
[37]
The practitioner's submissions
The practitioner submitted that Patient A:
was unreliable;
had an "evasive and inconsistent nature";
made false allegations;
has significant mental health issues;
"embarked on a vengeful crusade to damage the reputation and profession of Mr Tsolis on the basis of an imagined betrayal. It is a symptom of her psychiatric presentation";
embarked on "a vicious and unmitigated pursuit of vengeance", which was behaviour "inherent in the character of a person who demonstrates narcissistic and borderline personality traits",
The practitioner also submitted that Patient A's evidence was "replete with fabrication, inconsistency, evasion and invention".
[38]
Consideration
We consider that both Patient A and the practitioner were unsatisfactory witnesses, and that the evidence of each must be approached with considerable caution.
That said, we accept the Commission's submission that while a witness may not be believed on a particular issue, that does automatically result in a finding that the remainder of that witness' testimony must be disregarded.
The Tribunal accepts that it should not accept [Patient A]'s evidence without corroborative material or unless, in all the circumstances, it is more the plausible and logical account. We reject the more overstated of the practitioner's submissions as to Patient A's motivation. We accept however that some of Patient A's evidence was unpersuasive, such as:
1. saying that sending an email at 10:34PM following the dinner saying "Kisses" was sent "in fear";
2. saying that she also attended a session with the practitioner on 14 July 2022 "out of fear";
Patient A was pressed quite strongly by Mr Jones as to whether she had no recollection of therapy sessions after September 2016 or later in 2017. She gave unclear and unpersuasive responses.
Nor did she give persuasive responses to questions about why she returned to the practitioner for a further referral to South Pacific Private Hospital. She said that she had difficulties finding another psychologist and that she returned "under duress".
And the entirety of her evidence about the practitioner entering her house after the 9 July dinner must be rejected, given the evidence of independent witness Mr Raheen. However, we decline to find that the reason she gave that evidence was because she was "embarked on a vengeful crusade to damage the reputation and profession of Mr Tsolis" or had embarked on "a vicious and unmitigated pursuit of vengeance". Clearly, Patient A has had a troubled and disturbing personal and mental health history, but whether or not that affected her evidence is a matter for independent expert assessment.
As to the practitioner, we see considerable substance in the Commission's submissions about his evasiveness, and the recent invention of some of his evidence. In particular, we do not accept that the dinner at Bathers Pavilion was ever intended to be an exposure session. That is because:
the expression "exposure session" was never mentioned in the practitioner's Progress Notes before the dinner, although the practitioner's Progress Note for 7 June 2016 does state that the dinner would be used to "expose" Patient A to anxiety situations in a public setting;
the expression "exposure session" not mentioned in the practitioner's statement of 17 January 2018;
the dinner was not described as such in the practitioner's evidence to the Council on 22 January 2022;
the expression "exposure session" was not mentioned as such in the practitioner's statement of 25 May 2018 (although the practitioner did refer to the dinner as being "therapeutically beneficial");
The first occasion the dinner appears to have been referred to as an "exposure session" was in the practitioner's statement dated 19 February 2020, that is some three and a half years after the event.
Nor do we accept that the practitioner discussed subjective units of discomfort (or "SUDS") with Patient A before going out to dinner on 9 July 2022. That had never been mentioned at all on any previous occasion.
In addition, we found that:
1. the practitioner did not always give responsive answers. For instance, when asked if he was Patient A's treating therapist in May 2016, his response and the following questions and answers were as follows:
A. I'm part of a multi-disciplinary team at this time. So, her GP is part of this team. I don't know if Dr Hyde was part of the team yet, but he soon joined the team and there's no boss, it's a team effort with clients like [Patient A].
Q. I appreciate that but a number of the questions I understand that you want put context, but a number of these questions are relatively straightforward questions that -
A. I don't think they are frankly. Maybe from your perspective without mental health training, but from my perspective, they're not clear at all. I mean, I what you've got to understand and this is why - maybe I can give some context. Any new client I get, all right, whether they're depressed, they're anxious, they're bipolar -
Q. I'm going to stop you there, Mr Tsolis, and I'm going to repeat my question to you and then you tell me if it is that complicated. My question was, you were her therapist at this time?
A. I was, yes.
Q. Now, that is a simple question, is it not?
A. Yes, and I'm answering. Yes, I was her therapist.
1. the practitioner gave inconsistent evidence. For instance:
1. he agreed that in late June/early July 2016 his relationship with Patient A had progressed or had altered in its character so that it had become less formal and more personal. However, when this discussion continued after a short interruption to discuss when the luncheon adjournment would take placed, the practitioner denied that the relationship had become more personal, only more informal;
2. prior to his admission during the course of the Tribunal hearing, the practitioner denied entering Patient A's home before the dinner;
3. prior to his admission during the course of the Tribunal hearing, the practitioner denied getting out of the Uber when he dropped Patient A home;
4. prior to his admission during the course of the Tribunal hearing, the practitioner had denied hugging Patient A on the night of the dinner;
1. the practitioner gave some unpersuasive evidence, including his explanation as to why he had not informed the Council of various matters ("I had three people firing questions off at me and minimal time to prepare about something that happened years before");
2. we found particularly unpersuasive his explanation as to why he never mentioned "all this preparation" that the practitioner said he undertook for the exposure session (particularly as he was represented at all times):
Why would I put that in, in my affidavit? I don't see why that would be necessary to put in. There was no, there was no allegation that anything untoward happened prior to the dinner. There was false allegations that I went in there after the dinner, but prior, there was no, there was no allegation that l'd done anything improper. So, I just put it in that I went into her house briefly, because that's what I did. Now, I didn't think that it was necessary for me to write, "We discussed relaxation strategies, PMR, grounding exercises," I don't see how that would be of any relevance to you or would be any relevance in this sort of setting. So that's why I didn't write it.
1. we also found his evidence set out above at [137] that while he was prepared to spend $300 on the dinner, take Patient A out to a nice restaurant and willing to lie to his wife about it, but was not willing to have Patient A sit in his car, "in his 'personal space'", wholly unconvincing, unpersuasive and simply not credible.
[39]
Introduction
The practitioner was born in 1984 and is currently 38 years of age.
He was awarded a Bachelor of Psychology from Macquarie University in 2006 and a Masters of Psychology (Clinical) from the University of New South Wales in 2010. The practitioner was first registered as a general psychologist on 12 January 2010.
The practitioner is endorsed in the area of clinical psychology.
Patient A was under the practitioner's therapeutic care from May 2016 to July 2017.
[40]
Relevant medical matters
On 20 April 2016, Dr Peta Jane McInnes referred Patient A to the practitioner for opinion and psychological management under a Mental Health Plan.
The practitioner first saw Patient A on 22 April 2016. His Progress Notes relevantly state:
Initial assessment of Patient A …
[she] arrived in an agitated/irritable mood. She was verbose and often [??] in her speech.
Extremely difficult to take a coherent history …
a suicide risk assessment was undertaken
she denied drug and alcohol use
The practitioner saw Patient A again on 2 May 2016. His Progress Notes relevantly state:
2nd assessment session with [Patient A]. She was able to recognise that she had probably experienced a depressive episode in early November 2015. Depressive symptoms include:
low mood
loss due to minimal appetite[??]
irritability
agitation
fatigue lots of energy
diminished ability to think/concentrate make decisions anxiety
This depressive episode triggered by relationship breakdown …
The practitioner saw Patient A again on 9 May 2016. His Progress Notes relevantly state:
[Patient A] Presented the holy district stateful stop she stated that she felt she had been withholding key information in regards to her past and present.
[Patient A] Reported that she is currently abusing cocaine. She stated she is using approx one gramme per two days and use it to give herself a "lift" when fatigued. In addition she admitted to using THC to "mellow out" And stated she drinks up to 24 standard drinks of vodka per day ... she currently has a $3,500 drug debt.
…
A thorough risk assessment conducted re quality of care provided to children … suicide assessment conducted
The practitioner responded to Dr McInnes on 25 May 2016 relevantly stating:
Presenting Problems:
According to [Patient A], she presented for psychological assistance following some comments made to her at her daughter's birthday party in early April 2016. She stated that other parents commented that she did not seem herself, that she was *over-the- top" and "flighty". Upon further assessment, [Patient A] reported currently experiencing a number of symptoms common in a hypomanic episode including: irritable mood, an inflated self-esteem/grandiosity, decreased need for sleep
(approximately 2-3 hours per night), racing thoughts and a lack of patience for other people. Throughout the assessment, her speech was verbose and tangential.
[Patient A] demonstrated limited insight into these symptoms occurring as a cluster, but when questioned, she reported that she has had a number of these episodes in the past, and they are usually followed by a depressive episode. These changes are unequivocally uncharacteristic of her as reported by her long-term friend, Emmanuel, and the disturbance in her mood is observable by friends and family.
At present, these impairments are not severe enough to require hospitalisation. She has never experienced psychosis whilst in a hypomanic state. These disturbances in her mood and the changes in her functioning appear to correspond chronologically to an increase in her stress levels and feelings of isolation in the context of her relationship difficulties. [Patient A] was a poor historian in this respect and was unable to give a clearer indication than what I have provided.
…
Upon further assessment, [Patient A] reported that she is also abusing cocaine, cannabis and alcohol on a daily basis. She stated that she uses cocaine sparingly throughout the day to give her "an edge" and cannabis to "mellow her out" as well as up to 24 standard drinks of vodka per day. Her drug use has resulted in significant financial distress and she is currently over $3500 in debt to various drug dealers.
Risk Assessment:
No current thoughts of self-harm or suicide reported. At the time of her depressive episode in early November 2015, she reported having suicidal ideation with a vague plan of using sleeping tablets to kill herself. She made no attempt to end her life however.
Mental State Examination:
Pleasant 35-year-old woman who was casually dressed. Engaged well throughout the interview with good rapport established. Mood was agitated/irritable. Affect was appropriate and reactive. No evidence of thought disorder or perceptual disturbance. Thought content relatively appropriate and reflective of questions asked during the interview. Was verbose and tangential at times however. Nil suicidal ideation. Nil homicidal ideation. No evidence of cognitive impairment. Poor insight and judgement noted.
Impression and Diagnosis:
Given her history, it appears that [Patient A] may have bipolar Il disorder, currently in a hypomanic episode. She is also abusing a number of drugs and alcohol.
Suggested Management:
I recommend that [Patient A] undergo a thorough psychiatric assessment at the Black Dog Institute with the aim of obtaining a definitive diagnosis of bipolar II disorder as well as pharmacological intervention as necessary. In addition, I will devise a psychotherapeutic program aimed at better managing her hypomanic/depressive symptoms through cognitive behavioural and other evidenced-based treatment paradigms. Finally, treatment will also involve drug and alcohol management strategies.
The practitioner then saw Patient A on 16 May, 23 May 2016 and 2 Jun 2016.
The practitioner next saw Patient A on 9 June 2016. His Progress Notes record that he strongly recommended Patient A be seen by psychiatrist as soon as possible given her current state. The practitioner recorded that Patient A was agreeable to this and that he would attempt to get her an appointment with the Black Dog Institute or failing that a private psychiatrist. Significantly, the Progress Note also states:
In addition, after basic strategies to reduce impulsive were given including:
1. The 2 person feedback rule [Patient A] encourage to check with two trusted people before making major life decisions - in this case her father and myself.
2. the 48 hour hours before acting rule - taking 48 hours before acting out on impulses or major plans
On 14 June 2016, the practitioner referred Patient A to the Depression Clinic of Prince of Wales Hospital. Relevantly the referral letter states:
Impression and Diagnosis:
Given her history, it appears that [Patient A] may have bipolar II disorder, currently in a hypomanic episode. She is also abusing a number of drugs and alcohol.
Suggested Management:
I recommend that [Patient A] undergo a thorough psychiatric assessment at the Black Dog Institute with the aim of obtaining a definitive diagnosis of bipolar I disorder as well as pharmacological intervention as necessary. In addition, I will devise a psychotherapeutic program aimed at better managing her hypomanic/depressive symptoms through cognitive behavioural and other evidenced-based treatment paradigms. Finally, treatment will also involve drug and alcohol management strategies. [Patient A] has agreed to the treatment plan and we agreed to weekly appointments initially, which will eventually take place at fortnightly intervals.
On 17 June 2016, the practitioner again wrote to Dr McInnes. The practitioner noted that Patient A had been booked in for clinical assessment with a psychiatrist at the Black Dog Institute; and that her progress had been inconsistent, in that she was currently using cocaine and was in a hypomaninc state with a difficulties in synthesising information. He recommended that Patient A receive a further four sessions of psychological intervention. And sought an extension of patient A's Mental Health Care Plan.
The practitioner next saw Patient A on 23 June 2016 and 30 June 2016. On 30 June 2016 his Progress Notes record that he strongly encouraged Patient A to attend meetings of Alcoholics Anonymous and Narcotics Anonymous. The practitioner also noted that Patient A's anxiety about being out in public had increased.
The practitioner next saw Patient A on 7 July 2016. His Progress Notes are set out above at [106].
[41]
Events of 9 July 2016
The practitioner arrived at Patient A's home at about 4:32pm by Uber. Patient A told him by text that she had visitors who would be leaving shortly, and asked the practitioner to return at 5pm. The practitioner sent a text stating that he would go for a walk.
At around 5pm the practitioner entered Patient A's home. They arrived at Bathers Pavilion at approximately 6:02pm for the 6:15 reservation. Allowing for 30 minutes of travel time, we find that the practitioner was in Patient A's home for approximately 30 minutes, a period we find greater than the practitioner's affidavit evidence that he entered the house "briefly".
For the reasons expressed above, we do not accept that the practitioner discussed subjective units of discomfort (or "SUDS") with Patient A before going out to dinner, or conducted any other form of preparation with her.
As to the dinner itself, we do not accept that that Patient A ordered the alcohol and consumed it all. We note the alcohol ordered was a bottle of wine, three shorts of whiskey and a glass of port. We consider on the balance of probabilities that the practitioner, as host or organiser of the dinner, and the person who paid for the dinner, would have ordered the alcohol, and we reject his evidence that he did not. We also consider it not reasonable to believe as true that the practitioner did not consume any alcohol that night in circumstances where he had travelled to and from the restaurant by Uber which allowed him to consume alcohol if he wished.
We are not satisfied that Patient A and the practitioner kissed or hugged in the restaurant. There is no corroborative evidence at all to support Patient A's assertion that they did. However, based on Mr Rehaan's evidence, we are satisfied that:
1. they hugged outside the restaurant after the dinner while waiting for the Uber;
2. they sat beside each other in the Uber on the way to Patient A's home;
3. they hugged again when they reached Patient A's home and when the practitioner got out of the Uber to do so, and that
4. they hugged and kissed in the Uber. Given the clear intimacy between the two we are satisfied and we find that, in addition to the hugging outside the restaurant and outside patient A's home, we are satisfied that the two also hugged and kissed in the Uber. We reject the evidence of the practitioner that they did not. We accept that Mr Rehaan did not actually see any "lips locking" but we accept his evidence, which was in effect not challenged by the practitioner that "he "heard from the sounds they were making that they were hugging and kissing as a couple". We find that that conduct was consistent with the hugging that took place before and after the dinner and the consumption of alcohol during the dinner.
The practitioner did not enter Patient A's home after the dinner. At approximately 22:34 Patient A sent the practitioner a text message saying "Kisses". The practitioner in turn responded at approximately 22:35 with "Thank you and straight back at you kid".
[42]
Events after 9 July 2016
On 10 July 2016, the practitioner prepared Progress Notes concerning the dinner on 9 July 2016. His Progress Notes are set out above at [132].
The practitioner next saw Patient A on 14 July 2016. His Progress Notes relevantly state:
Discussion about dinner and the two person feedback rule leading to relaxed boundaries. Reiterated that two person feedback rules should be focused on important decisions as opposed to trivialities, and that the dinner was a one off that should not be repeated due to blurred boundaries. Patient A appeared a little taken aback but was agreeable.
The practitioner next saw Patient A on 21 July 2016.
On 28 July 2016 the practitioner again wrote to Dr McInnes. Relevantly he stated that Dr Hyde of the Black Dog Institute had confirmed a diagnosis of bipolar II disorder and commenced Patient A on escitalopram and quetiapine and that the practitioner had developed a "wellbeing management plan" for Patient A.
The practitioner next saw Patient A on 28 July and 26 August 2019, and then on 2 and 16 March 2017. Patient A then failed to attend sessions on 30 March, 20 April and 8 May 2017, attending on 15 May and 22 May 2017. She missed her therapy session on 26 June 2017, attended on 13 July 2017 and appears to have had her last session with the practitioner on 17 July 2017.
The practitioner's progress notes for 17 July 2017 state:
Therapy session with Patient A who again presented in an extremely distressed stateful stop she repeated that the individual that she owes the money too has been increasingly insistent that she pay him the money owed. I suggested that she either contact the police if she felt that she was in danger or else ask her father or partner?? Matthew to pay the loan. She stated that neither of these options were possible. She then cut the session short and left. Approximately 2 hours later, patient a contacted me and asked for a loan of $3500 to pay her debt. I informed her that this was impossible for me to do. Patient A ended the call.
[43]
Notifications
On 21 December 2017, Patient A sent a notification to the Commission concerning the practitioner, the contents of which is set out above at [26].
On 16 January 2018, Ms Jaroszewicz sent a notification to the Commission, the contents of which is set out above at [59].
[44]
Section 150 hearing
On 22 January 2018, a s 150 hearing was held by the Council. At the conclusion of the hearing, the delegates imposed the following conditions on the practitioner's registration:
1 The practitioner is not permitted to accept any new female clients from the date of these conditions.
2. Once every three months, the practitioner is to provide the Psychology Council of New South Wales with a statutory declaration as written evidence that he is not treating female clients. The first statutory declaration is due three months from the date of these conditions.
3. The practitioner is only to consult with current female clients for the purpose of termination of the therapeutic relationship, where clinically appropriate, or for referral to another practitioner.
a) The practitioner is to provide written evidence of having finalised the therapeutic relationship with all female clients within one month of these conditions.
In reasons published on 29 January 2018, the Council stated at [14] that the central issue to be determined was whether the practitioner posed a risk to the safety or health of the public that warranted action to be taken by the Council and whether it was generally in the public interest for the Council to take action. To determine these issues, the delegates note that the following subsidiary questions must be answered:
1. are there previous complaint matters relevant to the decision?
2. does the practitioner's practice and/or conduct pose a risk to the health or safety of the public?
3. are there any mitigating circumstances to be considered?
4. does the practitioner's conduct accord with the public interest?
[45]
Are there previous complaint matters relevant to the decision?
The Council noted that [16] that there were three prior complaints on record relating to the practitioner.
The first occurred in August 2013, when the Council received a complaint relating to delays by the practitioner in providing a client with her psychological file. This matter was resolved during the assessment process.
The second complaint occurred March 2015. This related to the practitioner's clinical care of a client.
The third occurred in July 2016 and led to substantiated findings by his then employer, that the practitioner had engaged in corrupt behaviour by misusing hospital resources (relating to his employment at Concord Repatriation and General Hospital).
The second and third matters were closed following a counselling interview.
The Council noted that:
Mr Tsolis denied that the previous complaints history may be indicative of poor judgement or a pattern of non-adherence to appropriate standards of behaviour, and work policies and procedures. Mr Tsolis said he worked with a "difficult population" which resulted in two of the complaints. He described the workplace issue at Concord Hospital as being a case of his manager being "upset that he didn't inform her of his setting up his own practice and that he did not do anything "unethical". Mr Tsolis denied he is a "cowboy" who disregards the rules.
In relation to this issue the Council concluded:
19. The delegates acknowledge that the previous complaints are of a different nature to the current complaint. They have been dealt with previously by the Council and subsequently closed. The previous complaints do not appear to be directly relevant to the current complaint other than possibly demonstrating a degree of poor judgement, at times, by Mr Tsolis. The delegates do not believe the previous complaints should be considered further in relation to the current matter.
[46]
Does the practitioner's practice and/or conduct pose a risk to the health or safety of the public
The Council set out various aspects of the practitioner's evidence at the hearing including but not limited to the following:
1. the practitioner referred Patient A to a psychiatrist at the Black Dog Institute as he had thought she may have bipolar disorder. He also assessed her as having substance use disorders. In a letter written on 25 May 2016 to the referring GP, the practitioner reported that [Patient A] was daily basis", including consuming "abusing cocaine, cannabis and alcohol on a "up to 24 standard drinks of vodka per day".
2. Patient A did not attend the appointment arranged at the Black Dog Institute, so the practitioner referred her to another psychiatrist, Dr Hyde, who confirmed a diagnosis of bipolar II disorder and commenced her on medications in June 2016.
3. following the psychiatric diagnosis for Patient A, Mr Tsolis said that he saw his role as being one of support in helping Patient A establish routines such as for sleep, exercise and eating patterns.
4. the practitioner described Patient A as being an "extremely needy" client who would send text messages or call him multiple times during the day; she became distressed if he did not respond to her calls/texts. The practitioner said he "felt responsible for her" as he believed she had minimum support from others and that he was "the only person really helping her";
5. when asked directly if he thought his judgement was clouded at this time, the practitioner replied that he was not suggesting that and it had never happened with any other patient. When asked to explain the rationale for taking a vulnerable client with a known bipolar disorder, a substance use disorder and a background of childhood sexual abuse, on a "date" to Bathers Pavilion, Balmoral on Saturday 9 July 2016), the practitioner said he did not see it as a "date" as that term suggested romantic intent. He said his intention was to share a meal with her to help her "feel worthwhile". In his view, the events were meant to be "therapeutic";
6. the Council delegates noted that the practitioner and Patient A travelled to the restaurant by "Uber". When asked if alcohol had been consumed by either of them at the restaurant, the practitioner denied this; [1]
7. when asked why they would have travelled by "Uber" if no alcohol was consumed, given the restaurant is some distance from Patient A's home address, the practitioner said it was because he had not been honest with his wife and had told her he was going out for some drinks with friends. The practitioner admitted that he did not think his wife would have been "happy" even if he had told her he was going out with a client for "therapeutic" purposes;
8. the Council noted at [28] that it had no further information to confirm or refute the practitioner's claims that no alcohol was consumed at the restaurant. If it were later proven that alcohol was provided by the practitioner, and consumed by Patient A at the dinner, this would represent a serious breach of the therapeutic process, given Patient A's documented alcohol use history;
9. the practitioner strenuously denied that any sexual activity occurred during the ride in the "Uber" or at Patient A's home on return. The practitioner insisted he did not get out of the Uber and went straight home after dropping Patient A off at her home;
10. in relation to the allegations that the practitioner hugged and kissed Patient A during sessions, the practitioner admitted he "may" have hugged her at times, but that it was "purely platonic" and denied there was any fondling or sexual intent. When asked to explain why he thought it appropriate to hug a client, especially one with the background history of childhood abuse, the practitioner said he thought Patient A was so "down on herself" she would likely feel "more rejected" if he didn't hug her;
11. the practitioner agreed that such behaviour was not in keeping with the code of ethics and expressed that he had had a "lapse in judgement" with this client. He denied having engaged in similar behaviour with other clients.
The delegates noted at [37] that they were concerned that the practitioner did not appreciate, recognise or act on his obligations as a registered health professional to consider if the children may have been exposed to significant risk of harm. At the very least, it appears that the practitioner may have been naive in assuming the children were not at risk, given his own concerns about the veracity of Patient A's information.
The delegates stated at [38] and [39]:
38. Mr Tsolis was asked to explain how the therapeutic relationship with [Patient A] ended. Mr Tsolis reported that [Patient A] told him, in a session sometime in early 2017, that she was in debt to drug dealers. He said he empathised with her and suggested she speak to her father and estranged husband to seek their help. About a month later [Patient A] called and asked him for a loan to pay her debts. Mr Tsolis reported that he told her he could not help her and she should speak to her husband, with whom she was apparently reconciled, at this time. Mr Tsolis said that [Patient A] seemed disappointed but did not express anger at him. Apparently, he has had no contact with [Patient A] since then.
39. Mr Tsolis said that the phone call asking him for money was a "huge wake-up call' and he realised that he had moved to a "dangerous phase" and he thought it best not to pursue any further therapeutic interactions with her. …
On this issue, namely whether the practitioner's practice and/or conduct pose a risk to the health or safety of the public, the delegates concluded:
41. The delegates hold serious concerns about Mr Tsolis' judgement and decision-making capacity, not only in relation to professional boundaries, but also in his continued treatment of a vulnerable client with serious psychiatric and psychological issues, including a background of childhood abuse and substance misuse. His decision to terminate therapy appears to have been guided primarily by self-interest concerns over his crossing of therapeutic boundaries rather than concerns for assessing and managing the impact on his client.
42. Mr Tsolis appears to have been ill -equipped to manage such a complex case and his reluctance to seek and engage in appropriate professional supervision or other help, even once he realised the seriousness of his behaviour, is of serious concern.
43. Similarly, the delegates are concerned at Mr Tsolis' apparent lack of awareness in considering if [Patient A]'s children may have been at risk of harm and if he had any obligations to report any concerns or discuss them with other treating practitioners.
[47]
Are there any mitigating circumstances to be considered?
The practitioner told the delegates that it was a "crazy time" for him and his family with the birth of his son some 3 to 4 months prior to his seeing Patient A initially and that it had been a "difficult time for me". The delegates were of the view that, as an experienced clinical psychologist, the practitioner should have adequate skills and self-awareness to ensure his own well-being and to seek help when required. The delegates do not believe that the practitioner's feelings in relation to his family's "difficult period" mitigates his behaviour in relation to Patient A.
The delegates did not believe that the circumstances of the practitioner's work arrangements and his work hours excuse or mitigate the serious breaches of professional boundaries and poor judgement apparent in his relationship with Patient A.
[48]
Does the practitioner's conduct accord with the public interest?
The delegates concluded at [51] and [52]:
51. The delegates are of the view that the public's confidence in the profession and the ability of the health professional regulatory scheme to protect their safety would likely be seriously undermined if a practitioner alleged to have displayed poor judgement and engaged in serious boundary transgressions of a potentially sexual nature, with a very vulnerable client, was permitted to continue to see female clients. The delegates believe if other clients were to become aware of the allegations relating to Mr Tsolis' conduct, their trust in Mr Tsolis and the profession, and their psychological well-being could be negatively impacted.
52. The delegates are also mindful that the matter is subject to ongoing investigation by the Health Care Complaints Commission (Commission). The delegates are of the view that it is important to maintain public trust in the regulatory system until the further investigations and considerations have reached a conclusion. The delegates therefore believe it to be both in the public interest and necessary for the protection of the public, to restrict Mr Tsolis' practice at this time.
On 25 February 2017, Patient A's general practitioner Dr Jessie Huang referred Patient A to Dr Jane Cass-Verco, psychiatrist noting:
Thank you for seeing [Patient A], age 35 yrs, for continuing management of her anxiety/depression, ? Bipolar Disorder and ?ADHD. She is on a combination of Lexapro 10mg daily and quetiapine 50mg mane 100mg note but she feels she is still not at her best. She states she has a long history of symptoms (eg. school reports) which is consistent with ADHD and would like to trial medication eg. Ritalin.
On 24 August 2017, Dr Alice Jaroszewicz sent a letter to Dr Ruello. The letter stated that Patient A had been referred to her from MYC Australia Employment Services for psychological counselling "to address her non vocational barriers to returning to work". The letter also stated that:
[Patient A] came in for an appointment with me this morning and was obviously very unwell and struggling to cope emotionally. I think she would benefit from a Centrelink Medical exemption whilst she is waiting for Psychiatrists appointments and to allow her to focus on recovering.
On 14 November 2017, Dr Artin Jebejian, consultant psychiatrist, prepared a report in relation to Patient A. Dr Jebejian is a consultant at the Black Dog Institute. Patient A had been referred to him Dr Gordon Hyde, another consultant psychiatrist. Relevantly Dr Jebejian stated:
MSE [Mental State Examination]
[Patient A] was rather slim, engaged in the review, long hair, wearing A T shirt and jeans, good eye contact, animated, spontaneous speech, with normal volume and rate, mood: good, rather reactive affect, no formal thought disorder, no delusion, preoccupied with need to get help with mental health, oriented, aware of her mood changes; low risk issues currently.
IMPRESSION:
Bipolar I disorder, with rather Melancholic Depressive episodes; Dysthymia, Persistent Depressive Disorder; Generalised Anxiety Disorder; Panic disorder with Agoraphobia; Post- Traumatic Stress Disorder; adult Attention Deficit Disorder; previous nicotine use; previous alcohol abuse; cannabis use; previous amphetamine abuse; cluster A, Paranoid, B, Narcissistic and Borderline traits, C, Obsessional traits; liver dysfunction; vit D and B12 deficiency.
[Patient A] has grown up as the only child of her parents, with biological diathesis for mood disorder; she had early divorce of her parents at 7 years; had attachment difficulty with her parents; was traumatised by early exposure to sexual abuse by her older maternal half- siblings, family friend, gang rape late in life; she has used substance to soothe her feelings. She had relationships from teenage years, was traumatised by abuse physically by her partner in her early twenties, then was in a long relation with her ex-husband, and father of her son and daughter. She had alcohol binges in 2016, which ended in rehab in early 2017. She worked in hospitality over the years. She is keen for therapy.
PLAN:
[Patient A] will require mood stabilising medication to manage her condition.
On 23 March 2018, Dr Huang prepared a "GP Mental Health Care Plan" for Patient A. This Plan relevantly stated:
Presenting Issues (what are the patient's current mental health issues?
Mixed anxiety and depressive symptoms, Stress. Past victim of child abuse at hands of half siblings. Also domestic violence in past. Currently separated from spouse and looks after 2 children. Financially stressed. Suffered harassment from past psychologist also. Diagnosed with bipolar 2 disorder and started lamotrigine in Nov 2017 with improvement. Under the care of Dr Artin at Black Dog Institute. Needs to re-engage in psychotherapy.
Mental State Examination:
Anxious, teary
Diagnosis:
Mixed anxiety and depression, Stress, PTSD, Bipolar
Medical History:
Anxiety/Depression; PTSD; Bipolar 2 disorder
On 12 April 2018, Dr Huang referred Patient A to Ms Sue Gynther for psychotherapy "for Bipolar disorder and severe anxiety related to PSTD - sexual harassment from a previous psychologist in Five Dock".
[49]
Are the Particulars of Complaint One established?
The Particulars to Complaint One are set out at [12].
In his Reply, the practitioner:
1. admitted Particular 1(a) in so far as he referred to Patient A as "kid", and otherwise denied the allegations. However, during the course of the hearing the practitioner said that he did call Patient A "my love", but on no more than one occasion;
2. admitted Particulars 1(b), (c), (d);
3. admitted each of Particulars 2(a) to (d).
Accordingly, we only need to determine whether or not Particulars 1(e) and (f) are established.
We do not find these Particulars established, as we do not accept the uncorroborated evidence of Patient A on these matters as being sufficiently persuasive.
In summary, in relation to Complaint One, we find the following Particulars established:
1. Particulars 1(a) to (d).
2. Particulars 2(a) to (d).
[50]
Are the Particulars of Complaint Two established?
The Particulars to Complaint Two are set out at [15]. As noted, Particulars 6 and 7(d) were withdrawn during the hearing.
In his Reply, the practitioner denied Particulars 1, 2, 3, 4 and 7, and did not admit Particulars 8 and 9.
In his Reply, as to Particular (5), the practitioner:
1. admitted Particular 5(a);
2. did not admit Particular 5(b);
3. denied Particulars 5(c) and (d).
Accordingly, we need to determine whether or not Particulars 1, 2, 3, 4, 5(b) to (d), 7, 8 and 9 are established.
We do not find these Particulars 1(a) and (b) established, as we do not accept the uncorroborated evidence of Patient A on these matters as being sufficiently persuasive.
We find Particular 1(c) established, as the practitioner told the Council that "he probably did hug" Patient A at the end of a session, told us that that "on a couple of occasions there may have been a platonic hug at the end of the session", and we have found that he had hugged her twice on the night of the dinner.
We do not find these Particulars 2, 3, 4 and 7 established, as we do not accept the uncorroborated evidence of Patient A on these matters as being sufficiently persuasive.
As to Particular 5(a), this is admitted. As to Particular 5(b), given our findings above, we find that Particular 5(b) established, that is that alcohol was consumed by both the practitioner and Patient A during the dinner on 9 July 2016.
We reject the practitioner's lengthy submission that, as Particular 5 was "presented to the Tribunal in concert with Particular 6":
the Tribunal must reject the position of the Commission;
the Tribunal must not accept any evidence of Patient A;
the Commission's submission of recent invention must be rejected; and
the Tribunal can only rely on the evidence of the practitioner and or independently verified evidence to make any findings of unsatisfactory professional misconduct.
We have explained out approach to the practitioner's evidence above.
That said, we do not find Particular 5(c) established, as we do not accept the uncorroborated evidence of Patient A on these matters as being sufficiently persuasive.
However, given our findings above at [183(4)], we do find Particular 5(d) established,
As we have found Particulars 1(c) and 5(d) established, we therefore find that Particular 8 is established.
Given our findings above at [182], in so far as we have found that the practitioner consumed alcohol at the dinner, we therefore find Particular 9 established.
In summary, in relation to Complaint Two, we find the following Particulars established:
1. Particular 1(c);
2. Particulars 5(a), (b) and (d);
3. Particulars 8 and 9.
[51]
Relevant law and authorities
We will next consider whether the established conduct the subject of Complaints One and Two amount to unsatisfactory professional conduct, and whether Complaint Three, namely that the practitioner is guilty of professional misconduct is established.
Before doing so, it is appropriate to set out the relevant provisions of the National Law. These are as follows.
Section 3, which provides:
3 Objectives and guiding principles
(1) The object of this Law is to establish a national registration and accreditation scheme for--
(a) the regulation of health practitioners; and
(b) the registration of students undertaking--
(i) programs of study that provide a qualification for registration in a health profession;
(ii) clinical training in a health profession.
(2) The objectives of the national registration and accreditation scheme are-
(a) to provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered; and
(b) to facilitate workforce mobility across Australia by reducing the administrative burden for health practitioners wishing to move between participating jurisdictions or to practise in more than one participating jurisdiction; and
(c) to facilitate the provision of high quality education and training of health practitioners; and
(d) to facilitate the rigorous and responsive assessment of overseas-trained health practitioners; and
(e) to facilitate access to services provided by health practitioners in accordance with the public interest; and
(f) to enable the continuous development of a flexible, responsive and sustainable Australian health workforce and to enable innovation in the education of, and service delivery by, health practitioners.
(3) The guiding principles of the national registration and accreditation scheme are as follows--
(a) the scheme is to operate in a transparent, accountable, efficient, effective and fair way;
(b) fees required to be paid under the scheme are to be reasonable having regard to the efficient and effective operation of the scheme;
(c) restrictions on the practice of a health profession are to be imposed under the scheme only if it is necessary to ensure health services are provided safely and are of an appropriate quality.
Section 3A of the National Law, which is an additional provision for NSW, provides, in terms:
3A Objective and guiding principle [NSW]
In the exercise of functions under a NSW provision, the protection of the health and safety of the public must be the paramount consideration.
A "NSW provision" is defined in s 5 of the National Law as:
(a) a provision that forms part of this Law because of a modification made by the Health Practitioner Regulation (Adoption of National Law) Act 2009; or
(b) a NSW regulation.
Note: This definition is an additional New South Wales provision.
Section 139B of the National Law (which is also an additional provision for NSW), which relevantly provides:
139B Meaning of "unsatisfactory professional conduct" of registered health practitioner generally [NSW]
(1) Unsatisfactory professional conduct of a registered health practitioner includes each of the following -
(a) Conduct that demonstrates the knowledge, skill or judgment possessed, or care exercised, by the practitioner in the practice of the practitioner's profession is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience.
…
(l) Any other improper or unethical conduct relating to the practice or purported practice of the practitioner's profession.
Section 139E of the National Law (again, an additional provision for NSW), provides:
139E Meaning of "professional misconduct" [NSW]
For the purposes of this Law, professional misconduct of a registered health practitioner means -
(a) unsatisfactory professional conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration; or
(b) more than one instance of unsatisfactory professional conduct that, when the instances are considered together, amount to conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration.
[52]
meaning of the expression "improper or unethical conduct"
As for s 139B(1)(l), the meaning of the expression "improper or unethical conduct" in s 139B(1)(l) of the National Law was considered by the Tribunal in various cases including Health Care Complaints Commission v Nguyen [2018] NSWCATOD 168 at [47]; Health Care Complaints Commission v Shrimpton [2019] NSWCATOD 25 at [67]-[69] Health Care Complaints Commission v Kesserwani [2020] NSWCATOD 65 at [21] and following, and further considered in Health Care Complaints Commission v Konigson [2021] NSWCATOD 186.
In Konigson the Tribunal stated at [93]-[95]:
93. The meaning of the expression "improper or unethical conduct" in s 139B(1)(l) of the National Law was considered by the Tribunal in Health Care Complaints Commission v Kesserwani [2020] NSWCATOD 65. At [21] and following the Tribunal stated:
21. The words "improper" and "unethical" are not defined by the National Law. There is nothing in the language, the statutory context, or the scheme of the National Law which suggests that either word has any technical meaning, nor is a term of art. Both are ordinary English words. Giving a word its ordinary meaning does not, however, preclude the word deriving shades of meaning from its context and the syntax of the sentence in ways which are significant for the case in hand: Duffy v Da Rin [2014] NSWCA 270 at [30].
22. The Macquarie Dictionary offers several definitions of both words which include:
Improper
2. not in accordance with propriety of behaviour, manners, etc: improper conduct.
Unethical
1. contrary to moral precept; immoral.
2. in contravention of some code of professional conduct.
23. The meaning of the words "improper" and "unethical" were considered in a different statutory context in Office of Local Government v Toma [2015] NSWCATOD 21. After quoting from the discussion of the term "impropriety" by the High Court in R v Byrnes and Hopwood (1995) 183 CLR 501; [1995] HCA 1, the Tribunal wrote:
Applying these authorities, I do not need to state an exhaustive definition of improper or unethical conduct. Rather it is enough to here note that the expression encompasses conduct which, viewed objectively, would be regarded by reasonable persons as falling below the standards of conduct to be expected of Councillors, in that it has a tendency to bring into disrepute the civic office held by Councillors, or the Council, or both.
24. That interpretation was adopted by the Tribunal in relation to the meaning of those words in s 139B(1)(l) of the National Law in Health Care Complaints Commission v Liu [2016] NSWCATOD 133 at [53].
25. The use of the word "or" in s 139(1)(l) suggests that the words unethical and improper should be read disjunctively and do not carry the same meaning. However, their meanings may overlap. While not necessary to reach a concluded view arguably a broader class of conduct is caught by the term improper conduct, than unethical conduct.
26. In our view, the test of "unethical conduct" has both objective and subjective elements. The word "unethical" connotes moral opprobrium. The term "unethical conduct" implies that the conduct concerned not only objectively falls short of a certain professional standard but that the person involved has performed subjectively in a way that is morally dubious or unprincipled and is therefore reprehensible on that ground. It is unnecessary here to provide exhaustive categories of conduct that may be unethical. Conduct may be unethical if it is constituted by a deliberate flouting of significant professional standards. Reckless disregard of, or wilful blindness to, significant ethical standards or principles may also constitute unethical conduct. All will depend on the relevant circumstances.
94. It may be that the phrase "improper or unethical" is a hendiadys in the sense that it is a phrase which invokes the application of values, the content of which derives no elucidation from reference to synonyms, nor from a supposed differentiation from other similar words: see Cooper v The Owners - Strata Plan No 58068 [2020] NSWCA 250 per Basten JA at [24] to [27], in particular at [25]. His Honour was considering the meaning of the expression "harsh, unconscionable or oppressive" which appears in s 139(1) of the Strata Schemes Management Act 2015 (NSW). His Honour stated:
Thirdly, the phrase is better understood as a triune, three words conveying a single criterion. It is towards the other end of a scale from the hendiadys "just and equitable". It invokes the application of values, the content of which derives no elucidation from reference to synonyms, nor from a supposed differentiation from other similar words such as "unjust".
95. It is not necessary to decide this matter, as are satisfied that the admitted conduct of Ms Konigson was clearly improper conduct. We are additionally satisfied that the conduct was unethical, in the sense that it was a clear breach of Ms Konigson's ethical obligations to care for her patients.
Whether conduct is improper or unethical is an objective test: Health Care Complaints Commission v Liu [2016] NSWCATOD 133 at [51]-[60].
[53]
Consideration of Complaint One
Complaint One is that the practitioner is guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that his Conduct that demonstrates the knowledge, skill or judgment possessed, or care exercised, by the practitioner in the practice of the practitioner's profession is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience.
The conduct we have found established is as follows.
First, on more than one occasion, during consultations at the practice between 22 April 2016 and 18 July 2017 the practitioner failed to maintain appropriate professional boundaries with Patient A in that he;
1. referred to Patient A as "kid"/and "my love",
2. allowed Patient A to refer to him as "boss;
3. commented on Patient A's physical appearance by calling her "beautiful";
4. commented on Patient A's personal attributes by calling her "intelligent".
Secondly, Between 28 April 2016 and 23 May 2017, the practitioner failed to maintain appropriate professional boundaries in that he exchanged the following number of 'out-of-session' telephone calls and text messages with Patient A in circumstances where the amount of contact was excessive in the context of the therapeutic relationship and some of the communication was personal in nature:
1. 122 telephone calls initiated by Patient A;
2. 137 telephone calls initiated by the practitioner:
3. 82 text messages sent by Patient A;
4. 53 text messages sent by the practitioner.
The Commission relies on the expert opinion of Prof Kenny. In relation to these matters her opinion is that:
1. Patient A as "kid" or "my love" infantilised Patient A and exaggerated the power imbalance between therapist and patient and that the conduct of the practitioner in this regard fell significantly below the standard reasonably expected of a practitioner with equivalent training or experience;
2. commenting on and complementing Patient A's appearance and personal attributes including calling her beautiful and intelligent fell below the standard recently expected of a practitioner with equivalent training or experience;
3. the following matters were significant boundary violations and constituted behaviours that fell significantly below that reasonably expected of a practitioner with equivalent training or experience, that's attracting Prof Kenny's strong criticism:
1. calling Patient A "kid and allowing her to call him "boss";
2. accepting a large number of out of session texts and phone calls;
3. taking Patient A to dinner;
4. in the course of the dinner, consuming a significant amount of alcohol;
1. telling Patient A that she was beautiful and intelligent as a way of boosting self-esteem was ill advised and constituted a minor boundary violation;
2. in relation to the telephone conversations between Patent A and the practitioner, the calls and texts were too frequent and should not have been permitted to continue in the way that they did and that for a substantial part of the therapeutic contact, Patient A clearly viewed the practitioner as a secure attachment figure to whom she could turn to for emotional regulation. Her reliance on contact and the practitioner's inability to properly curtail this expectation fell significantly below the standard reasonably expected a practitioner of equivalent training experience;
3. "clearly" the dinner was a serious boundary violation, and was conduct that fell significantly below the standard expected of a practitioner of equivalent training and experience. Prof Kenny said that she was "strongly critical" of this conduct.
Prof Kenny's opinions were supported by logical and persuasive reasons.
The practitioner relied on an expert report of Mr Rolf Reed. Mr Reed was asked to comment on the practitioner's use of nicknames for Patient A, and the volume of text messages and phone calls between Patient A and the practitioner.
We found his report of 31 January 2022, to be unhelpful to our task and unpersuasive.
We reject entirely Mr Reed's criticism that Prof Kenny's views were biased and skewed or failed to provide relevant commentary. We found her views informative, well-reasoned and persuasive.
We reject Mr Reed's opinion that it would not be common for Prof Kenny to utilise an informal name (and do not understand how he could make that statement) and that it would be more common for the practitioner "and other behavioural psychologists" to utilise informal names. While it may culturally common place for Australians to use nicknames, we reject that this is appropriate within a therapeutic relationship.
We also reject as unpersuasive his opinion that it was acceptable for the practitioner as a psychologist to engage in the recorded volume of calls and texts given Patient A's circumstances, the limitations inherent within the mental health system and the practitioner's theoretical orientation and training.
We prefer the views of Prof Kenny. And we heard nothing in Mr Jones' cross-examination of her which caused us any doubt about the appropriateness of her opinions.
In the circumstances, we find Complaint One established, that is that under s 139B(1)(a) of the National Law the practitioner engaged in conduct that demonstrates the judgement possessed, or care exercised, by the practitioner in the practise of psychology was significantly below standard reasonably expected of a practitioner on equivalent level of training or experience.
[54]
Consideration of Complaint Two
The conduct we have found established is as follows:
1. at the end of a number of consultations at the practice between 22 April 2016 and 48 July 2017 the practitioner failed to maintain appropriate professional boundaries in that the practitioner hugged Patient A;
2. on 9 July 2016, the practitioner failed to maintain appropriate professional boundaries in that he inappropriately took Patent A to dinner at Bathers Pavilion in Mosman in circumstances where:
1. he was Patient A's treating psychologist;
2. alcohol was consumed by the practitioner and Patient A;
3. the practitioner inappropriately kissed and touched Patient A in the Uber car ride back to her residence in Russell Lea.
1. by reason of Particulars 1(c) and 5(d) in combination, the practitioner engaged in inappropriate conduct of a sexual nature towards Patient A;
2. on 22 January 2018, the practitioner provided false and/or misleading information to the Psychology Council of New South Wales, namely he denied consuming alcohol at dinner with Patient A at Bathers Pavilion in Mosman on 9 July 2016 when he had consumed alcohol at dinner on that occasion.
We have set out above Prof Kenny's views that taking Patient A out to dinner and consuming alcohol at that dinner was a serious boundary violation, and was conduct that fell significantly below the standard expected of a practitioner of equivalent training and experience. Prof Kenny said that she was "strongly critical" of this conduct.
We consider that her reasons justify her conclusion.
In the circumstances, we find Complaint Two established, that is that under s 139B(1)(l) of the National Law the practitioner engaged in conduct that was improper or unethical relating to the practice or purported practice of psychology.
[55]
Consideration of Complaint Three
The Commission submitted that if the Tribunal was satisfied that if any of Particulars 1, 2, 3, 5 or 8 of Complaint Two are proved, this amounts to professional misconduct. The Commission submitted that, objectively viewed, boundary breaches of a sexual nature by a treating therapist are a gross abuse of power. The Commission submits that abuse of that power is particularly severe given Patient A's heightened vulnerability, and her significant history of emotional, physical and sexual abuse.
The Commission submits that, even on the practitioner's version of events, the Tribunal should find Particular 5 of Complaint Two partially proven, specifically Particular 5(a) and part of Particular 5(b). The Commission notes that Prof Kenny's opinion on this was effectively uncontested, the practitioner having chosen not to lead any expert evidence on this issue and Prof Kenny not being seriously challenged in cross-examination.
In addition, the Commission submits that the totality of other admitted conduct (being relevantly calling Patient A "kid" and allowing her to call him "boss"), the volume of out of session contact between the two, and the practitioner hugging Patient A in a number of sessions are, in the particular context of this case, objectively serious enough to warrant suspension or cancellation.
We agree.
We find Complaint Three established.
[56]
Other
In the first instance these reasons are being published only to the parties. This is because of the sensitivity of the withdrawn Particular 6. The Tribunal will consider any application for redaction of these reasons the practitioner may seek. In the first instance, his legal advisers should discuss this issue with the Commission's legal advisers to see if an agreed position can be reached. If not, the Tribunal will receive submissions on the issue, and otherwise can be raised at the next directions hearing.
As it transpired, no application for redaction of the reasons was made.
However, the Commission notified the Tribunal of typographical and other errors which it sought to be amended pursuant to s 63 of the Civil and Administrative Tribunal Act 2010 (NSW). This version of the reasons incorporates those amendments, to which the practitioner did not object.
[57]
Orders
The Tribunal orders that:
1. In relation to Complaint One:
1. each of Particulars (1)(a) to (c) is established;
2. Particulars 1(e) and (f) are not established;
3. each of Particulars 2(a) to (d) is established.
1. Complaint One is established, that is that the practitioner is guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that engaged in conduct that demonstrates the judgement possessed, or care exercised, by the practitioner in the practise of psychology is significantly below standard reasonably expected of a practitioner on equivalent level of training or experience.
2. In relation to Complaint Two:
1. each of Particulars (1)(a) to (d) is established;
2. each of Particulars (2), (3), (4) and 7 is not established;
3. Particulars (5)(a), (b) and (d) are established;
4. Particular 5(c) is not established,
5. Particulars (8) and (9) are established.
1. Complaint Two is established, that is that the practitioner is guilty of unsatisfactory professional conduct under s 139B(1)(l) of the National Law in that he engaged in improper or unethical conduct relating to the practice or purported practice of psychology;
2. Complaint Three is established, that is the practitioner is guilty of professional misconduct under s 139E of the Health Practitioner Regulation National Law (NSW).
3. Costs are reserved.
4. The matter be listed for directions in relation to the Stage 2 hearing and, if necessary, the redaction of these reasons.
[58]
Endnote
We note that the transcript actually records "MS GILL: Did you have alcohol at the restaurant? MR TSOLIS: No, no". The Commission's case was the practitioner was denying that neither he nor Patient A consumed alcohol at the restaurant, whereas the practitioner's case was that he was indicating that he did not consume alcohol that night.
I hereby certify that this is a true and accurate record of the reasons for decision of the Civil and Administrative Tribunal of New South Wales.
Registrar
DISCLAIMER - Every effort has been made to comply with suppression orders or statutory provisions prohibiting publication that may apply to this judgment or decision. The onus remains on any person using material in the judgment or decision to ensure that the intended use of that material does not breach any such order or provision. Further enquiries may be directed to the Registry of the Court or Tribunal in which it was generated.
Decision last updated: 18 November 2022
Accordingly, we will approach the evidence of both Patient A and the practitioner with caution.
In making our findings, we have been assisted by the observations of the Tribunal in In Health Care Complaints Commission v Ng [2015] NSWCATOD 85 where the Tribunal stated (citations omitted):
128. We found the recent discussion by Sackar J in Campbell v Campbell [2015] NSWSC 784 at [73] to [79] to be of considerable assistance. To paraphrase his Honour:
(1) Where a trial judge is faced with a stark choice between irreconcilable accounts, the credibility of the parties' testimony, the trial judge's assessment of the character of witnesses and the manner in which the witnesses give evidence is of primary importance;
(2) The rational resolution of an issue involving the credibility of witnesses will require reference to, and analysis of, any evidence independent of the parties which is apt to cast light on the probabilities of the situation;
(3) A court, in cases involving events which occurred long before the litigation, usually prefers to rely upon contemporaneous, or near contemporaneous, documents, which will often provide valuable and, usually, more revealing, information than what may be flawed attempts at recollection of those facts by persons with an interest in the outcome of the litigation. Greater weight is usually accorded to such documents, as often they provide a safer repository of reliable fact, particularly when it is clear that they have been prepared by a person with no reason to misstate those facts in the documents and where there is no suggestion that the documents are other than genuine.
…
(4) The credibility of a witness and his, or her, veracity may also be tested by reference to the objective facts proved independently of the evidence given, in particular by reference to the documents in the case, by paying particular regard to his, or her, motives, and to the overall probabilities.
…
In relation to the standard of proof, in Ng the Tribunal observed:
131. The onus of proof is the civil standard, as explained in Briginshaw v Briginshaw (1983) 6 CLR 336 and other authorities including Forster v Hunter New England Area Health Service [2010] NSWCA 106).
132. In Forster the Court of Appeal stated:
22 In the decision of the High Court in Neat Holdings Pty Ltd v Karajan Holdings Pty Ltd [1992] HCA 66; (1992) 67 ALJR 170; (1992) 110 ALR 449 the plurality indicated that in the context there under consideration epithets designed to assist in identifying the strength of the evidence necessary to establish a matter on the balance of probabilities test were "at best unhelpful and at worst misleading" (110 ALR at 451). They said that "[t]he most that can validly be said [in the type of case under consideration] is that the trial judge should be conscious of the gravity of the allegations made on both sides when reaching his or her conclusion. Ultimately, however, it remains incumbent upon the trial judge to determine the issue by reference to the balance of probabilities" (ibid).
23 Likewise, in the present context, it is not in my view of assistance to attempt to refine the description of the standard of proof beyond saying that the word "satisfied" in s 82(3)(c) requires the court to reach its conclusion on the balance of probabilities and in doing so to have regard to the gravity of any allegations made and to the seriousness of the consequences that may flow from the making of a particular finding or order. The need to have regard to such matters was authoritatively stated by Dixon J in the seminal decision in Briginshaw v Briginshaw [1938] HCA 34; (1938) 60 CLR 336, especially at 362 (see also Rejfek v McElroy [1965] HCA 46; (1965) 112 CLR 517 at 521-2).
…
134. In Campbell, Sackar J at [72] also referred to Evans and Braddock [2015] NSWSC 249 at [70] - [77], a decision of Hallen J. Hallen J had noted that Emmett J (as his Honour then was) stated in Warner v Hung, in the matter of Bellpac Pty Ltd (Receivers and Managers Appointed) (In Liquidation) (No 2) [2011] FCA 1123 at [48]:
When proof of any fact is required, the Court must feel an actual persuasion of the occurrence or existence of that fact before it can be found. Mere mechanical comparison of probabilities, independent of any belief in reality, cannot justify the finding of a fact. Actual persuasion is achieved where the affirmative of an allegation is made out to the reasonable satisfaction of the Court. However, reasonable satisfaction is not a state of mind that is attained or established independently of the nature and consequences of the fact to be proved. The seriousness of an allegation made, the inherent unlikelihood of an occurrence of a given description, and the gravity of the consequences flowing from a particular finding are considerations that must affect whether the fact has been proved to the reasonable satisfaction of the Court. Reasonable satisfaction should not be produced by inexact proofs, indefinite testimony or indirect inferences (see Briginshaw v Briginshaw (1938) 60 CLR 336 at 361-2).