Health Care Complaints Commission v Tsolis

1. It is against that background that the Stage 2 inquiry was held on 13 May 2025.
2. The Commission now seeks orders that:

(1) the practitioner's registration be cancelled (National Law, s 149C(1)(b); and

(2) the practitioner be prevented for applying for a review of the cancellation order for a period of two years, alternatively one year (National Law, s 149C(7); and

(3) the practitioner pay 80% of its costs as agreed or as assessed.

1. The practitioner submits that the orders sought by the Commission are excessive. The practitioner proposes the following protective orders:

(1) a reprimand;

(2) a continuation of the existing conditions on the practitioner's registration;

(3) a "formal condition" that the practitioner engage in supervised practice;

(4) a review of the practitioner's conditions in 12 months with a view to imposing suitable conditions for the practitioner to treat female patients on supervision terms suitable to the Tribunal or Council; and

(5) if necessary for deterrence, a fine, which could be reflected in the costs orders.

1. The practitioner submits that suspension or cancellation of his registration would adversely impact upon many patients in critical areas of western Sydney and would be excess to jurisdictional requirements. He further submits that in circumstances where he is objectively fit for practice, there are suitable conditions that ensure the overriding purpose of the National Law are achieved, and that alternative mechanisms of deterrence must be considered by the Tribunal.
2. The practitioner asks that the issue of costs be reserved until the publication of these reasons.
3. For the following reasons, we have decided to cancel the practitioner's registration as a psychologist and order that he not be permitted to seek registration for a period of 12 months.
4. We will hear the parties on the appropriate costs order.

1. For the convenience of the reader, we set out the complaints the subject of the Primary Decision.

1. Complaint One was that the practitioner was 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 practice of psychology is significantly below standard reasonably expected of a practitioner on equivalent level of training or experience.
2. 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.

1. For the reasons given in the Primary Decision, the Tribunal found Particulars 1(a) to (d) and Particulars 2(a) to (d) established, and that therefore Complaint One was established.

1. 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.
2. 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. [Withdrawn]

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) [Withdrawn]

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.

1. For the reasons given in the Primary Decision, the Tribunal found Particulars 1(c), and 5(a), (b) and (d), 8 and 9 established, and therefore that Complaint Two established.

1. 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.

(1) Particulars 1, 2, 3, 5, and 8 of Complaint Two individually;

(2) Complaints One and Two and the particulars thereof cumulatively.

1. Having found Particulars 1 and 2 of Complaint One established, and Particulars 1(c) , 5(a), (b) and (c), 8 and 9 of Complaint Two established, the Tribunal found Complaint Three established.

1. The Commission relied on the following materials:

(1) Exhibit A, being a 435 page bundle of materials including but not limited to the practitioner's Compliance History Report dated 20 March 2024; the Primary Decision; the Appeal Decision; and a transcript of the Stage 1 enquiry;[1]

(2) Exhibit B, being a four page bundle of materials being the practitioner's Compliance History Report dated 16 December 2024;

(3) Exhibit C, being 120 pages of the practitioner's supervisor, Ms Nesli Karadeniz's, notes of supervision of the practitioner for the period 6 March 2018 to 26 May 2025;

(4) Exhibit D, being emails which were relevant to the tender of the report of Dr Marcelo Rodriguez, an expert retained by the practitioner.

1. We had the benefit of submissions prepared by the Commission's counsel, Mr I Chatterjee. These were originally dated 19 December 2022, but revised on 22 April 2025. We note that the 22 April 2025 submissions were prepared before the Stage 2 inquiry was held.
2. Mr Chatterjee also made oral submissions at the Stage 2 inquiry hearing.

1. The practitioner relied on the following materials which were collectively marked as Exhibit 1:

(1) the practitioner's statement dated 21 March 2025 (practitioner's statement);

(2) references provided by:

(a) Mr Scott Henretty dated 17 March 2025. Mr Henretty is the Deputy Principal at Baulkham Hills High School;

(b) Mr Jonathan Lagrance dated 5 March 2025. Mr Lagrance is a Physiotherapist and Exercise Physiologist;

(c) Ms Nicola Borg dated 18 March 2025. Ms Borg is a solicitor and former patient of the practitioner;

(d) Ms Sabrina Villar dated 230 March 2025. Ms Villar is a Capacity Planner;

(3) a report of Ms Nesli Karadeniz dated 15 March 2025. Ms Karadeniz is a psychologist and the practitioner's supervisor;

(4) the report of Dr Marcelo Rodriguez, psychologist, dated 24 January 2023.

1. The practitioner was required for cross-examination. Where relevant we will refer to his oral evidence below.
2. Ms Kardeniz was also required for cross-examination. Where relevant we will refer to her oral evidence below.

1. This is an extremely detailed statement of some 14 pages. It is divided into the following sections which we will briefly summarise.
2. The first section is titled "An Overview of Reflection". In summary, the practitioner states:
   • he has reflected deeply on his conduct the subject of the complaints;
   • his thoughts "are immersed in remorseful contrition";
   • he is sorry for the harm done to the profession;
   • it is clear to him now that he was not able to identify "micro boundary violations" that resulted in a "slope progression to larger and more significant violations" that compromised the "therapeutic alliance".
3. The second section is titled "Contextual Matters Leading to the Impugned Conduct". Here the practitioner points out he and his wife had their first child three months before Patient A's initial assessment, he had recently established a new practice at Five Dock, and that his wife was on maternity leave it was his responsibility to be the provider for his family. In doing so, he neglected his self-care. When he began working exclusively in private practice, he did not factor in external supervision, nor had he hired a receptionist or an administration assistant, and thus took on too many roles in his practice. In short, he says that his professional and personal obligations were unrelenting. Upon "deep self-reflection", the practitioner says it is clear to him that his conduct emotionally injured and caused pain to Patient A.
4. The third section is titled "Informal Names, Compliments and Communications". Here the practitioner states that he is "extremely remorseful" that he used informal names in the therapeutic context, and that his compliments to Patient A were never intended to harm her.
5. As to his compliments on Patient A's speech, intelligence and appearance, his intention was to enhance Patient A's self esteem, and viewed the compliments as "a part of the thought challenging strategies used in cognitive behavioural therapy as a means of helping a client restructure their thoughts to something more helpful and realistic".
6. The practitioner now understands through almost seven years of external supervision with a psychodynamic-trained supervisor that there are more helpful ways to achieve this "according to the psychodynamic model". He says that at the time of these "sessions"[2] he had only been practising for six years and had not been exposed to the psychodynamic model.
7. As to the volume of calls and text communications between the practitioner and Patient A, the practitioner says that he was unaware that taking too many calls from a "client" constituted a boundary violation.
8. Then over some five pages, the practitioner then discusses his formulation of Patient A's treatment plan, conceding that given Patient A's psychosocial history, his treatment plan may not have been appropriate, and that his boundaries were not clear enough. He says that he was not aware of the concepts of transference and countertransference referred to by the Commission's expert Dr Kenny.
9. The practitioner then states that private practice can be extremely isolating for a therapist, and that he recognises now that he was isolated, highly stressed and lacking crucial peer support. He states that Patient A's reinforcement of him as "a great therapist" triggered vulnerability within him and, as such, took on too much responsibility for Patient A and engaged with strategies he was unfamiliar with. The practitioner says:

42. Finally, I failed to realise that my own paternal/caregiving impulses had been activated due to how vulnerable I believed Patient A to be. Through supervision, I have realised that with the birth of my first child only a few months prior, I had taken the role of fatherhood seriously and that this produced a certain amount of countertransference to Patient A, as I viewed her as vulnerable and childlike and my paternal/caregiving impulses were put on Patient A all of which were sincerely motivated but misguided.

43. Unfortunately, I had not been trained in a psychodynamic approach at any stage in my honours or master's degrees and had never been supervised by a psychologist who practiced a psychodynamic approach. ...

1. The practitioner goes on to say that he was "unprepared for Patient A's presentation in its entirety" and failed to realise that some of the strategies he was putting into place with her may not have been appropriate. He greatly regrets hugging Patient A, and is now "ashamed, embarrassed and remorseful" about allowing that physical contact to occur.
2. Since his treatment of Patient A, he has implemented systems to ensure that boundaries are enforced and that his clients are aware of the benefits of those boundaries.
3. The practitioner concludes this section of his statement by saying at [53]:

I have been able to reflect on my own actions and have taken full ownership of my mistakes. Through clinical supervision, I have acknowledged that I took an over-involved role in my therapy with Patient A. I did not realise that this had become an issue at that time. A material contributing factor to this was a lack of clinical supervision. Upon further reflection, I was able to see that ! saw myself as a protector of this vulnerable client and took responsibility for meeting her emotional needs.

1. The fourth section is titled "9 July 2016". This is the day that the practitioner took Patient A to dinner. He says that he now recognises the flaws in taking Patient A to a licensed venue, and that it was an inappropriate venue for any attempt at therapeutic advance. He now recognises that the duration of any "exposure or flooding session" ought to be "time-capped". The practitioner accepts that these were critical failures in his judgment. He says that his own hubris convinced him that it would be a therapeutically beneficial event, and he mistakenly believed that he could advance Patient A's treatment. He accepts that he was mistaken and clearly wrong about that.
2. The practitioner then states at [57]:

As my therapy with Patient A continued, there was a failure on my part to recognise that, given her issues with attachment, poor relationships with men and low self-esteem, it was highly possible that Patient A could have developed an unhealthy relationship towards me during her therapy sessions. However, I continued with the treatment plan at the time, including what I believed to be an exposure therapy exercise because of my failure to recognise this.

58. I also understand that I should not have undertaken this session to boost Patient A's self-concept. I understand that in attempting to do something "nice" for her, I compromised the boundaries of our therapeutic alliance and this caused confusion for Patient A. It was not until immediately after the exposure session occurred that I was able to see just how far I had strayed from my appropriate clinical boundaries and how flawed my thinking was.

59. I am exceedingly disappointed and ashamed of my decision to embark on this course of action and will never do so again. Through clinical supervision and my own reading, I have developed both insight and compassion into the power dynamics that were present in the therapeutic relationship I held with Patient A. I am aware of the transference and countertransference issues that were involved in my decision to undertake this exposure session in regards to its location and intention. In hindsight, I realise, as a result of the external supervisory process, that I should have sought immediate peer consultation in relation to the matter and how to proceed with consideration given to ceasing our therapeutic relationship at that point.

1. The fourth section is titled "Alcohol Consumption & S 150". Here the practitioner states that, having seen the Tribunal's findings in the Primary Decision "regarding the consumption of alcohol at the exposure session and the inappropriate kissing and touching of Patient A in the Uber", he understands and has insight into how seriously below the requisite standard of conduct those actions are. He states that he finds the conduct in those findings abhorrent and reprehensible, believes that this conduct had an exceedingly detrimental impact on the profession of psychology as well as on Patient A, and condemns this behaviour "in no uncertain terms".
2. The practitioner says that he respects and accepts the findings of the Tribunal. Nevertheless, his recollection that he did not drink at the restaurant has not changed, and apologies for "enlivening the circumstances for which that finding became available to the [T]ribunal".
3. The fifth section is titled "Uber Ride findings". Here the practitioner states at [65]:

... During and throughout the hearing I had denied kissing Patient A. My recollection has not changed. I wholly respect the Tribunal's position in relation to their findings in relation to the [U]ber ride to Patient A's home. I understand that the Tribunal felt it was available to make such a finding. I know and understand a boundary violation of that type is a fundamental failing of any legitimate therapeutic alliance. I am deeply embarrassed and ashamed at my own presentation of the circumstances that led to the Tribunal's finding.

1. The sixth section is titled "Supervision". Here the practitioner describes the positive impact of his regular (fortnightly to monthly) consultations with Ms Karadeniz, whom he sees at his own expense. Through those consultations, he has been able to "reflect upon my therapy with Patient A and the interactions of personal and professional stressors arising during that time". As a result he has taken a number of steps to assist in managing those stressors including restructuring his private practice; utilising the supervision/peer consultations to better "formulate" clients; employing an assistant on a part-time basis to alleviate the administrative load; resuming exercising on a daily basis and ongoing activities of self-care to mind his mental and physical health and limiting hisclient load and working less.
2. In addition, the practitioner has also undertaken an online course on ethical practice in psychology and his kept up to date with my professional development requirements, as well as engaging in regular peer consultation with two fellow clinicians. He has taken a number of steps to ensure that his therapeutic boundaries remain clear, and focused on learning about the concepts of transference and countertransference as well as other treatment modalities not taught in the Clinical Masters Program at University to fill the gaps in his clinical knowledge and practice.
3. The practitioner says that:

I accept that my boundaries were eroded, that I was overly familiar with Patient A and that I took an over-valued sense of my responsibility for her emotional health. I see how all of this had a detrimental impact on her and that when I declined her request to help her pay off her drug debts, that she would see that action as a betrayal as opposed to clear boundaries. Patient A's behaviour reflects my own poor choices in not maintaining appropriate boundaries with her throughout our therapeutic alliance.

1. The seventh and final section of the practitioner's statement is titled "Conditions". Here the practitioner says that he has strictly followed the conditions placed on his registration.[3]
2. The practitioner concludes his statement by stating at [76]:

My fervent wish is that I be permitted to continue in the practice of psychology, a profession that I love and that continues to interest me and excite me. I believe that I have made a positive impact on many of my clients lives and thoroughly enjoy assisting people with strategies to empower them and assist them to live in a more value-oriented manner.

1. The practitioner was cross-examined at length by Mr Chatterjee.
2. The first matter explored by Mr Chatterjee concerned [63] of the practitioner's statement where he stated:

Prior to and throughout the hearing I had denied drinking alcohol at the restaurant as alleged. I unreservedly respect that the Tribunal was of the view that it was open to find that I drank alcohol. My recollection has not changed.

1. Mr Chatterjee asked him whether his recollection had changed. The practitioner stated that it had not.
2. Mr Chatterjee then took the practitioner to [64] of his statement, which dealt with the Tribunal's findings in the Primary Decision that he had misled the Council at the s 150 hearing. At [64], the practitioner had stated

I also understand that the Tribunal have made findings in relation to the 5150 hearing and my response to the alcohol consumption. As above, my recollection has not changed from the time of the hearing. I understand how the Tribunal have come to their decision, and I respect that. It is not my intention at all to have misled the Psychology Council at those proceedings.

1. Again, Mr Chatterjee put to the practitioner that his position remained as it was at the time of the Stage 1 hearing. The practitioner agreed.
2. Mr Chatterjee then turned to [65] of the practitioner's statement, which dealt with the ride home from Bathers Pavilion after the dinner, where the Tribunal found that practitioner had kissed and touched Patient A. Mr Chatterjee asked the practitioner whether it was still his position that he did not engage in that conduct. The practitioner agreed.
3. Mr Chatterjee noted that in [65] the practitioner stated "I wholly respect the Tribunal's position", and what did that statement mean. As a matter of fairness to the practitioner, we will set out [65] in full:

Further, kissing and sexually touching a client is never acceptable within a therapeutic alliance. I have read and reread the APS Code of Ethics on this topic numerous times and am keenly aware why these behaviours cause harm and why they bring the profession of psychology into disrepute. During and throughout the hearing I had denied kissing Patient A. My recollection has not changed. I wholly respect the Tribunal's position in relation to their findings in relation to the uber ride to Patient A's home. I understand that the Tribunal felt it was available to make such a finding. I know and understand a boundary violation of that type is a fundamental failing of any legitimate therapeutic alliance. I am deeply embarrassed and ashamed at my own presentation of the circumstances that led to the Tribunal's finding.

It means that I respect that they made that decision based on the evidence before them.

1. Mr Chatterjee then said that it was a matter of fact that the Tribunal made findings, and apart from observing that the Tribunal made those findings, asked the practitioner what he meant by respecting those findings, the practitioner responding:

I respect the fact that what happened at that - well let me start again - I respect the fact like what I said that on the evidence they had before them they made those findings. And that's, I don't know how else to elaborate on that.

1. After a further iteration of the same question and response, Mr Chatterjee then asked whether the practitioner accepted that up until the end of 2024 the practitioner was seeking to have the findings made by the Tribunal set aside.
2. Simultaneously, the practitioner said that he accepted that proposition, and his counsel Mr Jones objected to the question, on the basis that that was not an accurate depiction of what transpired.
3. After discussion, the Presiding Member allowed the question. After establishing that the practitioner did seek to have the Tribunal's findings set aside, Mr Chatterjee asked the practitioner when he came to the view that he accepted and respected the findings of the Tribunal. The practitioner said he respected the findings when they were made, but he had still his own recollections of what had occurred, and that those recollections had not changed.
4. The cross-examination then turned to the topic of what the practitioner described in his statement at [6] as "micro boundary violations". Mr Chatterjee asked the practitioner what he meant by this. The practitioner said that the boundary violations started off with "smaller things" and progressed to "bigger things".
5. The practitioner agreed that the use of nicknames, and the "cheer leading" strategies focusing as a way of boosting her self-esteem were the micro-boundary violations, whereas the hugs, and accepting too many phone calls, and the dinner on 9 July 2016 were not.
6. Mr Chatterjee reminded the practitioner that his evidence at the Stage 1 hearing was that that dinner was "exposure therapy". The practitioner said that even then he thought his thinking was flawed.
7. The cross-examination than turned to the issue of how the practitioner's thinking of what the practitioner now understood his conduct to be professional misconduct had changed between the events in question and the time of the Stage 2 hearing. After stating that he did not particularly understand the term professional misconduct, Mr Chatterjee then asked the practitioner how his thinking had changed in terms of boundary violations, without using that term "professional misconduct".
8. The practitioner said that back in 2022 he had admitted that his conduct was not correct and wrong. He said that he had reasoning behind the decisions that he made, which were flawed and he accepted that the reasoning was flawed and that the conduct was wrong.
9. The cross-examination then turned to the factors which the practitioner claimed caused or precipitated the misconduct, being those matters referred to in second section of the practitioner's statement titled "Contextual Matters Leading to the Impugned Conduct".

1. The practitioner was re-examined by Mr Jones.
2. Mr Jones asked the practitioner whether, in addition to his statement, there was anything else he wanted to say about the development of insight. The practitioner said that what was the most confronting was that the Tribunal made its findings. He said he understood that his actions made it open to the Tribunal top make its findings, which were "a real heavy blow". He said that the impact it had him, and his family and his career "really made [him] understand the gravity of everything that happened. He said that in 2016 and 2018 he knew he had made mistakes, but seeing the findings was "very very distressing".
3. The practitioner said that this has made him much more aware of maintaining his own mental and physical health. He has become a more cautious psychologist, does not give patients compliments or use nicknames, and does not take phone calls outside of sessions.
4. The practitioner says the more he thinks about the dinner the more embarrassed and ashamed he is, and recognises that Patient A, a vulnerable client, should never have been taken to a licensed venue. He said that he took full responsibility for the alcohol consumption and the Uber ride findings on the night. The practitioner said it was "completely wrong" and that he takes full responsibility for his actions. The practitioner said that the Tribunal's findings made him feel "sick to [his] stomach". He realises the dinner should never have happened. He said he always believed it was the wrong thing to do, even in the middle of the dinner. He says that he does not think he ever tried to defend that fact, that it was wrong for the dinner to take place. Having read the Primary Decision, he realises how far he had strayed away from professional standards.
5. The practitioner told Mr Jones he recognised that he had committed boundary violations, and was remorseful for any distress caused to Patient A.

1. Senior Member Allan asked the practitioner about his understanding of the concepts of transference and counter transference.
2. Member Kusuma asked the practitioner about his supervision sessions with Ms Karadeniz, in particular enquiring what other support the practitioner was receiving. The practitioner mentioned the peer supervision he received from his other colleague in his practice, Ms Kristy Delmas. He confirmed that he was not seeing any psychologist for counselling.
3. The Presiding Member asked the practitioner about his expectations for his future practice. In summary, the practitioner indicated that he did not really expect that he would be able to treat female patients in the future, although he would like to do so, because of the length of time he had practised subject to supervision and the publicity surrounding the (now withdrawn) allegations of sexual assault.

1. All five references are positive and supportive of the practitioner and variously state that:
   • the practitioner accepts responsibility for his actions, and regrets his decisions in this matter (Mr Henretty);
   • the Tribunal's findings about the practitioner are "extremely out of character", and that the practitioner has made a concerted effort to learn from his mistakes (Mr Lagrange);
   • the practitioner displays the necessary attributes of a professional including integrity, empathy and respect (Ms Borg);
   • the practitioner's behaviour will never be repeated (Ms Villar).
2. One of the references was provided by Ms Kristy Delmas, clinical psychologist, whom we understand is in practice with the practitioner. In summary, Ms Delmas relevantly states:
   • since the original complaint in 2018, she has spoken to the practitioner at length about his position on what occurred;
   • the practitioner has readily acknowledged where his decision making should have been different;
   • he has also acknowledged kept Patient A's vulnerability
   • this case presented the practitioner with a first hand experience of his own vulnerability as a clinician;
   • since this case, the practitioner has continued to reflect on his practises with that and increased sensitivity to therapist-client boundaries as well as being aware of himself as it as an individual and how that presents in his therapy;
   • the practitioner has endeavoured to improve his insight into his clinical practise through deep ongoing analysis, taking on the advice of supervisors and peers, engaging in continuous professional learning and reading up to date clinical literature;
   • the practitioner strives to provide a high quality of clinical service;
   • clinicians as passionate, driven and humble as the practitioner are not easy to come by.

1. Dr Rodriguez interviewed the practitioner on 12 January 2023 following which he prepared his report.
2. The tender of Dr Rodriguez's report was opposed by the Commission on the basis that Dr Rodriguez was not available for cross examination. The Tribunal had issued directions on 20 December 2024 requiring any objections to evidence to be notified 14 days prior to hearing, being 29 April 2025. However, the Commission was not advised of Dr Rodriguez's unavailability until 6 May 2025, and therefore was not in a position to raise the objection by the appointed date. The practitioner was notified of the objection 7 May 2025, which the Commission said was the earliest opportunity it could do so.
3. This issue was considered by the Supreme Court in Votraint No. 1019

Pty Ltd v Zauner Construction Pty Ltd [2023] NSWSC 1055. That was a building case, and the report of the expert, one Mr Jones, was the only independent expert report from either party prepared with the benefit of inspection of the actual alleged defects further some of those defects had now been rectified by the time the homeowner sought to tender the report. 4. Be that as it may, the Court (Stevenson J) allowed the tender of the report notwithstanding the expert's unavailability for cross examination. The Court noted at [53] that:

Obviously, the fact that Mr Jones is not available to be tested in relation to his Report is a matter that the judge conducting the final hearing of these proceedings will take into account when assessing the weight to be given to such conclusions in the Report as have survived objection.

1. Further objection was taken by the Commission to a sentence appearing in a paragraph of the report headed "Risk of professional breaches" where the expert gave evidence as to the practitioner's risk of preaching professional boundaries as a psychologist in the future.
2. After hearing oral submissions, the Tribunal allowed the tender of the report, including the sentence referred to above.
3. Dr Rodriguez sets out an extensive history of the practitioner, including his family, employment, romantic, medical and mental health, drug and alcohol and criminal histories. Dr Rodriguez then sets out:

Having his registration cancelled, would bring about his worst fears professionally and personally. Mr. Tsolis began to cry at the prospect of having to sell the family home as he would not be able to afford mortgage repayments if unable to work as a psychologist. He held strong beliefs about caring and providing for his family and being unable to do so would impact on his core beliefs. He saw his role as a "provider and protector" of his family. He apparently had a solid marriage, although he felt like he would let his wife and son down. He felt that he would "fail" his family if they had to sell the family home. He realised some of his core beliefs could be regarded as extreme, conceding that they were long-held beliefs stemming from his upbringing as the son of migrants.

1. Relevantly, Dr Rodriguez concluded that there was "little doubt" that the practitioner demonstrated professional misconduct which would have breached the Australian Psychological Society Code of Ethics, as well as professional standards of a health professional according to AHPRA.
2. Dr Rodriguez then states:

[The practitioner] does not dispute that he engaged in unprofessional conduct by taking [Patient A] to a restaurant; however, he denies:

a) Consuming alcohol with the patient

b) Inappropriately touching the patient

c) Kissing the patient

d) Engaging in a sexual relationship at the time of the incident or at any other time.

Exposure therapy to a restaurant was clearly both unusual and inappropriate. It would not meet any standard of care in Australia. His reasoning that he felt sorry for the patient is also difficult to follow. In that respect, supervision about his counter-transference issues before this event should have been sought by [the practitioner].

[The practitioner] clearly lost any control, if indeed he had any, when the patient began consuming alcohol at the Bathers' Pavilion. By then, [the practitioner] was in a precarious professional situation by taking a patient to a restaurant.

...

[The practitioner] understands that "the perception" created by taking [Patient A] to a restaurant has been negative and widely condemned. He admits that he made a 'judgement error" and for that he shows remorse. He demonstrates insight into his actions and has demonstrated this by engaging in fortnightly supervision for the last 5 years.

(emphasis added)

1. The practitioner initially sought Ms Karadeniz's clinical supervision in March 2018, and he has attended fortnightly to monthly sessions since that time (each lasting approximately 50 minutes). Ms Karadeniz states that the practitioner has reacted exceptionally well to both positive and negative feedback.

Despite feelings of doubt, fear, inadequacy, shame and other negative beliefs about himself in relation to his therapy with Patient A, he has been able to be vulnerable and humble in supervision, owning his mistakes and openly discussing problems. These have been crucial in fostering clinical learning and professional growth. By continuously taking risks in supervision (e.g., presenting the cases he has found most challenging), he has maximised his professional growth and contributed to a positive supervisory relationship.

1. Ms Karadeniz says that the practitioner has been able to reflect on his own actions and has taken full ownership of his mistakes. He has acknowledged that he took an over-involved role in his therapy with Patient A and did not realise that this was an issue at that time due to a lack of clinical supervision.
2. Ms Karadeniz says that the practitioner has developed both insight and compassion into the power dynamics that were present in the therapeutic relationship he held with Patient A. Ms Karadeniz says that the practitioner is "compassionately aware" that Patient A's silence at the time may have been due to her feeling intimidated and uncertain on how to confront him, as the imbalance of power was too great. In addition, her past experiences of sexual assault and violence would have been present and would have contributed to her silence.
3. Ms Karadeniz says that the practitioner has also been cognisant of the need to pay attention to his own personal life and how it may be impacting on his clinical judgment.
4. Ms Karadeniz says that the practitioner described himself as coming from a patriarchal cultural background in which a male's role was to be a provider and protector for his family as well as being strong and not showing weakness - in effect being the rock upon which the family was built. He was working very long hours between practices and had recently become a father for the first time (January 2016) and his role as a provider for his wife and newborn child was of paramount importance to him. Consequently, when Patient A presented as vulnerable and isolated, his paternal/caregiver impulses were activated and resulted in countertransference taking place, in which the practitioner irrationally viewed Patient A as a child in need of help. He therefore took an overinvolved approach to his treatment formulation with Patient A and utilised tools and strategies that he had not previously utilised in order to assist Patient A.
5. Ms Karadeniz says that the practitioner has expressed a great deal of contrition about the blurring of boundaries that resulted in him calling Patient A "kid", "beautiful", "intelligent" as well as the misguided exposure session. He is aware that he emotionally impacted Patient A with these actions. He has recognised that his boundaries should have been stricter and that his concerns about Patient A feeling invisible and impotent during a couple of emotionally charged sessions were unfounded, and that accepting a hug from a patient in these circumstances was inappropriate.
6. Ms Karadeniz says:

In his discussions with me, [the practitioner] has always respected and accepted the findings of the Tribunal and has understood that the conduct in those findings is unacceptable. He has stated that he is appalled at the findings of drinking at the exposure session, lying to the Psychology Council and kissing and touching Patient A. He has repeatedly stressed that he will never again place himself in the position where a finding like this can be made again.

1. Ms Karadeniz's opinion is that the practitioner:

was not experienced enough to adequately treat a patient with this presentation. He did seek out support in the form of a psychiatric referral in order to confirm his diagnosis as well as to treat Patient A's sexual abuse history which he rightly realised was outside the scope of his training. However, he crucially did not take adequate consideration into the personality variables that made Patient A's presentation so complex. In my discussions with [the practitioner] it became evident that he placed too much importance on the diagnosis made by Dr. Gordon Hyde, which did not focus on any personality variables, and he allowed this diagnosis to guide his treatment plan. I believe that with appropriate supervision, this could have been rectified. He had no clinical supervision whilst building up his several practices.

1. Ms Karadeniz says that the practitioner has taken a number of steps to ensure that his therapeutic boundaries remain clear. He has participated, and endeavours to continue to participate in, fortnightly to monthly clinical supervision as required. He has employed an administrative assistant in order to provide a buffer between himself and clients, and is taking more time to prepare for his clients, formulating them more effectively within the clinical supervision setting and focusing on ethics in his own study. In addition, he has spent a great deal of time reading empirical literature and discussing the treatment of personality disorders as well as other psychotherapeutic approaches besides those that he was trained in whilst at university such as narrative, schema and psychodynamic approaches.
2. Ms Karadeniz notes that the practitioner has diligently abided by all the conditions placed on his registration, and has sought supervision of his own volition and at his cost over the last seven years, and is determined to continue this process into the future.

1. Ms Karadeniz was cross-examined by Mr Chatterjee. In our view, she was a co-operative witness, but she had had little independent recollection of her conversations and sessions with the practitioner.
2. Ms Karadeniz agreed that she had copied and pasted sections of earlier reports into her report of 15 March 2025.
3. Mr Chatterjee asked her about her statement in her 15 March 2025 report, that the practitioner has "always respected and accepted the findings of the Tribunal". Given that the practitioner had denied some of the Tribunal's findings, Mr Chatterjee asked whether she understood that the practitioner denied some of the findings of the Tribunal. Ms Karadeniz said she did. Given that matter, Mr Chatterjee asked Ms Karadeniz what she meant by her comment that the practitioner had "always accepted the findings of the Tribunal". Ms Karadeniz gave a lengthy but rather non-responsive answer, concluding with the statement that the practitioner had always accepted how the Tribunal saw the case and at no point did he say "I am not responsible for this".
4. The Presiding Member noted that there was nothing in Ms Karadeniz's notes (being Exhibit C) which revealed any discussion about his conduct the subject of the Primary Decision. Ms Karadeniz said that over seven years, the practitioner has understood the seriousness of his conduct; that they had discussed "blurred boundaries; and that the practitioner had even gone back to his Church, trying to get guidance and accountability", Ms Karadeniz said that, as far as she knew, the practitioner regularly applied the Code of Ethics had "matured through this period".
5. Member Kusuma discussed with Ms Karadeniz when she first became aware of the findings in the Primary Decision, noting that there was no reference to the Primary Decision or its findings in her notes. Ms Karadeniz said she would have gone through any "report", discussed it with the client, and recorded it in her notes. Member Kusuma asked, if not recorded, how likely if was it then that the issue was discussed. Ms Karadeniz said that she was sure it was discussed.
6. Ms Karadeniz was briefly re-examined by Mr Jones.

1. The practitioner relied on an outline of submissions, undated, prepared by his counsel, Mr Jones.
2. Mr Jones also made oral submissions at the Stage 2 inquiry hearing.

1. The relevant provisions of the National Law are as follow:

3A Guiding principles [NSW]

(1) The main guiding principle of the national registration and accreditation scheme is that the protection of the health and safety of the public must be the paramount consideration.

(2) The other 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;

(a1) the scheme is to ensure the development of a culturally safe and respectful health workforce that -

(i) is responsive to Aboriginal and Torres Strait Islander Peoples and their health; and

(ii) contributes to the elimination of racism in the provision of health services;

Example -

Codes and guidelines developed and approved by National Boards under section 39 may provide guidance to health practitioners about the provision of culturally safe and respectful health care.

(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.

Note -

This section is a substituted New South Wales provision.

3B 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.

Note -

This section is an additional New South Wales provision.

149C Tribunal may suspend or cancel registration in certain cases [NSW]

(1) The Tribunal may suspend a registered health practitioner's registration for a specified period or cancel the registered health practitioner's registration if the Tribunal is satisfied -

(a) the practitioner is not competent to practise the practitioner's profession; or

(b) the practitioner is guilty of professional misconduct; or

(c) the practitioner has been convicted of or made the subject of a criminal finding for an offence, either in or outside this jurisdiction, and the circumstances of the offence render the practitioner unfit in the public interest to practise the practitioner's profession; or

(d) the practitioner is not a suitable person for registration in the practitioner's profession.

(2) The Tribunal may suspend a student's registration for a specified period or cancel the student's registration if the Tribunal is satisfied -

(a) the student has been convicted of or made the subject of a criminal finding for an offence, either in or outside this jurisdiction, and the circumstances of the offence render the student unfit in the public interest to undertake clinical training in the health profession; or

(b) the student is otherwise not a suitable person to undertake clinical training in the health profession.

(3) The Tribunal must cancel a registered health practitioner's or student's registration if the Tribunal is satisfied the practitioner or student has contravened a critical compliance order or condition.

(4) If the person is no longer registered, the Tribunal may -

(a) decide that if the person were still registered the Tribunal would have suspended or cancelled the person's registration; and

(b) if the Tribunal would have cancelled the person's registration, decide that the person is disqualified from being registered in the health profession for a specified period or until specified conditions have been complied with; and

(c) require the National Board with which the person was registered to record the fact that the Tribunal would have suspended or cancelled the person's registration in the National Register kept by the Board.

(4A) If the Tribunal decides under subsection (4)(a) that if the person were still registered the Tribunal would have suspended the person's registration, the person may not apply for registration in the health profession during the period for which the person would have been suspended if registered.

(5) If the Tribunal suspends or cancels a registered health practitioner's or student's registration and it is satisfied the person poses a substantial risk to the health of members of the public, it may by order (a prohibition order) do any one or more of the following -

(a) prohibit the person from providing health services or specified health services for the period specified in the order or permanently;

(b) place specified conditions on the provision of health services or specified health services by the person for the period specified in the order or permanently.

Note -

Section 102(3) of the Public Health Act 2010 provides that it is an offence for a person to provide a health service in contravention of a prohibition order.

(5A) The power of the Tribunal to make a prohibition order under subsection (5) extends to a person who is no longer registered if the Tribunal decides under subsection (4) that it would have suspended or cancelled the person's registration if the person were still registered.

(6) If the Tribunal is aware a registered health practitioner or student in respect of whom it is proposing to make a prohibition order is registered in a health profession other than the health profession in respect of which the Tribunal is making the order, the Tribunal must, before making the prohibition order -

(a) notify the Council and the National Board for that health profession, and the Commission, of the proposed order; and

(b) give the Council, National Board and Commission an opportunity to make a submission.

(7) An order may also provide that an application for review of the order under Division 8 may not be made until after a specified time.

1. The Commission submits that the "task" undertaken by a Tribunal in making protective orders (albeit in the context of the Medical Practice Act 1992 (NSW) but adopted numerous times in the context of the National Law) has been described as "[centering] not on punishment as such but on the protection of the public and the maintenance of proper professional standards": Lee v Health Care Complaints Commission [2012] NSWCA 80 per Barrett JA at [21]).
2. The Commission submits that, broadly speaking, five matters can be identified of general relevance:

(1) the need to protect the public, and in particular the future patients of the practitioner, against further misconduct by the practitioner;

(2) the need to protect the public through general deterrence (of other practitioners);

(3) the need to protect the public by reinforcing high professional standard and denouncing transgressions;

(4) the maintenance of public confidence in the profession; and

(5) the desirability of making available to the public any special skills possessed by the practitioner.[4]

1. The Commission notes that in Lee Barrett JA adopted the comments of Basten JA in Director-General, Department of Ageing, Disability and Homecare v Lambert (2009) 74 NSWLR 523; [2009] NSWCA 102 (with whom Hodgson and Tobias JJA agreed on this point) at [83] that:

83 The challenge in the present case is better understood, as discussed in the course of oral submissions, as one in which the Tribunal was required to exercise its discretionary judgment in a disciplinary jurisdiction, the purpose of which was to allow for orders protective of the interests of vulnerable individuals in the care or control of the Department. As is well-established in the disciplinary jurisdiction generally, including with respect to legal and medical practitioners, the specific purpose for which orders are made is protective in the public interest and is not punitive with respect to the individual: see, eg, Ziems v The Prothonotary of the Supreme Court (NSW) [1957] HCA 46; 97 CLR 279 at 286 (Dixon CJ), 289 (Fullagar J, quoting Jordan CJ); Clyne v NSW Bar Association [1960] HCA 40; 104 CLR 186 at 201-202; Pillai v Messiter [No. 2] (1989) 16 NSWLR 197 at 201 (Kirby P). That is not to deny that such orders may be punitive in effect, a matter which may have particular significance in respect of the privilege against self-incrimination: see, eg, Rich v Australian Securities and Investments Commission [2004] HCA 42; 220 CLR 129 at [28]- [32], referred to in the context of a medical practitioner in Health Care Complaints Commission v Wingate [2007] NSWCA 326; 70 NSWLR 323 at [48]. Nor does it necessarily follow that punitive effects may not be relevant in formulating a protective order. For example, the fact that there are such punitive effects may remind the Court that a protective order should be limited to that which is reasonably necessary to provide the required level of public protection: Prakash v Health Care Complaints Commission [2006] NSWCA 153 at [101] (reference to weighing the punitive effects in the balance should be understood in context as limited to the purpose identified here). Further, the punitive effects may be directly relevant to the need for protection. Thus, in a particular case, there may be a factual finding that the harrowing experience of disciplinary proceedings, together with the real threat of loss of a livelihood may have opened the eyes of the individual concerned to the seriousness of his or her conduct, so as to diminish significantly the likelihood of its repetition. Often such a finding will be accompanied by a finding that the person concerned has achieved a level of insight into his or her own character or misconduct, which did not previously exist.

(emphasis added)

1. The Commission submits that where doubt exists as to the practitioner's insight, suspension may not be appropriate as that results in the practitioner's registration being automatically renewed on completion of the suspension period, whereas cancellation of registration will require the practitioner to justify re-registration in a Tribunal hearing. The Commission notes that in Chen v Health Care Complaints Commission [2017] NSWCA 186 Basten JA stated at [21] that "[uncertainty as to the future may lead the Tribunal to cancel a registration rather than suspend it".
2. As to the setting of a non-review period, the Commission notes that the Tribunal stated in Health Care Complaints Commission v Luque [2019] NSWCATOD 129 at [94] that:

The setting of a non-review period is not to punish the practitioner but to protect the public. NSW Court of Appeal jurisprudence has indicated that the fixing of a period of non-review has a 'twofold operation' in that it firstly indicates a minimum period within which the Tribunal considers the person should not be able to practise their profession, thus serving both an individual and general deterrence purpose by sending a message to the practitioner, the public and the profession about professional standards and the seriousness of the breach; and secondly it holds open to the practitioner the possibility of return to the profession at a later time: Chen v HCCC [2017] NSWCA 186; HCCC v Do [2014] NSWCA 307.

1. Finally, the Commission notes that in Health Care Complaints Commission v Schmaman [2019] NSWCATOD 82 the Tribunal stated at [88] that no protective order should be made which has more serious consequences for the practitioner than is reasonably necessary in execution of the protective purpose of the legislation, citing NSW Bar Association v Meakes [2006] NSWCA 340 at [114].

1. The practitioner says little in his submissions about the relevant principles to be applied. That may be because the principles are well-settled and have been stated in many decisions of the Tribunal and the Supreme Court of NSW. The bulk of the practitioner's submissions relate to the application of the relevant principles to the facts of this particular matter.
2. Relevantly, the practitioner submits that:

(1) a protective order should be limited to that which is reasonably necessary to provide the required level of public protection: Lambert at [83];

(2) every case must proceed on its own unique facts: Health Care Complaints Commission v Catt [2024] NSWCATOD 11 at [259];

(3) protective orders are not to be punitive: Lee.

1. The Commission seeks an order cancelling the practitioner's registration pursuant to s 149C(1)(b) of the National Law, together with an order preventing the practitioner from applying for a review of the cancellation order for a period of two years (alternatively one year), pursuant to s 149C(7).
2. In summary, the Commission submits that the practitioner's conduct is of such seriousness that cancellation of his registration is the only appropriate order. It is submitted that this is because:

(1) the established conduct was objectively very serious;

(2) Patient A was highly vulnerable;

(3) the practitioner plainly intended to go out with Patient A for an informal dinner outside the context of therapeutic relationship and, premeditated or not, the dinner resulted in intimate contact between the two, "a gross breach of sexual boundaries";

(4) the practitioner's conduct in then misleading the Council and the combative approach taken to Patient A exacerbate the objective seriousness of that conduct;

(5) while the practitioner was entitled to deny the complaint and test the Commission's evidence, his conduct in these proceedings went further than a mere denial, give n that his approach during the Stage 1 inquiry was to "demonise Patient A.

1. For these reasons, and by reason of objective seriousness alone, the Commission submits that cancellation is warranted to maintain public confidence in the profession, for general deterrence, and to reinforce the minimum professional standards appropriate to practice.

1. The practitioner's position is that the Commissioner's application is excessive and ought to be refused.
2. The practitioner submits that cancellation would amount to belated punitive action rather than a protective order effecting the protection of the health and safety of the public. He submits that the Tribunal has at its disposal, a myriad of alternative protective orders which would:

(1) effect the protection of the health and safety of the public;

(2) ensure necessary deterrence to the profession;

(3) fortify the community's faith in the probity of the profession, and;

(4) avoid depriving the public, in critical areas of Western Sydney, of a skilled clinical psychologist.

(1) he has demonstrated insight to the conduct;

(2) he has demonstrated remorse for the consequences of his failings;

(3) he is of no threat to the community. Rather he assists the community in a time of mental health crises;

(4) some nine years have passed since the impugned conduct;

(5) he was a relatively inexperienced (6 years) clinical psychologist at the time of the conduct and has since developed professionally and personally;

(6) he has demonstrated a respect for the profession, the disciplinary process and the public in his utmost compliance with the conditions imposed on him;

(7) he has managed to ensure he is a critical pillar of the mental health structure in critical areas of Western Sydney.

1. The practitioner further submits that suspension or cancellation at this time would adversely impact upon many patients in critical areas of western Sydney and would be excess to jurisdictional requirements.
2. The practitioner proposes the following protective orders:

(1) a reprimand;

(2) the continuation of existing conditions on his registration;

(3) a "formal condition" that he engage in supervised practice;

(4) a review of the conditions on his registration in 12 months with a view to imposing suitable conditions for the practitioner to treat female patients on supervision terms suitable to the Tribunal or Council as the order may be;

(5) if necessary for deterrence, a fine perhaps reflected in the Tribunal's costs orders.

1. As the Commission submits, the practitioner's initial assessment of Patient A's mental state was that she suffered from (probable) bipolar II disorder, substance and alcohol use disorders and social anxiety.
2. Patient A had disclosed to the practitioner a significant history of sexual, emotional and physical abuse, commencing when she was a child and continuing through her teen years and as an adult. The abuse was from her older siblings and then various partners.
3. Those provisional diagnoses were consistent with later assessment (in around November 2017) by a consultant psychiatrist at the Black Dog Institute, Dr Arten Jebejian, who also considered other diagnoses applicable including inter alia post-traumatic stress disorder. That report summarised Patient A's background and issues as follows:

[Patient A] has grown up 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, which ended in rehab in early 2017. She worked in hospitality over the years. She is keen for therapy.

1. The practitioner was Patient A's treating psychologist over the period May 2016 to July 2017.
2. The Tribunal found that:

(1) the practitioner had, in the course of consultations with Patient A, called her "kid" and "my love"; allowed her to call him "boss";

(2) the practitioner had commented on Patient A's physical and mental attributes by calling her "beautiful" and "intelligent";

(3) the practitioner had failed to maintain appropriate professional boundaries in that he engaged in an excessive amount of contact by telephone and text message, and some of which communication was personal in nature;

(4) by reason of that conduct, demonstrated the judgment possessed, or care exercised, by him in the practice of psychology was significantly below the standard reasonably expected of a practitioner on equivalent level of training or experience (Primary Decision at [4], [5], [12], [13], [214] - [218], and [244] - [256]);

(5) at the end of a number of consultations between 22 April 2016 and 18 July 2017, the practitioner had failed to maintain appropriate professional boundaries in that:

(a) he hugged Patient A;

(b) he inappropriately took Patient A to dinner at Bathers Pavilion in Mosman in circumstances where he was then her treating psychologist;

(c) alcohol was consumed at the dinner by Patient A and the practitioner,

(d) he inappropriately kissed and touched Patient A in the Uber car ride back to her residence in Russell Lea;

(e) he engaged in conduct of a sexual nature towards Patient A; and provided false and/or misleading information to the Psychology Council of New South Wales, namely that he had not consumed any alcohol in the course of the dinner at Bathers Pavilion.

1. It was submitted confidently on behalf of the practitioner that:

(1) he has expressed unequivocal remorse for his failings;

(2) he has confronted and taken ownership of his failings in any harm that flowed from his mistakes;

(3) he has achieved high levels of insight into the constellation of circumstances precipitating his impugned conduct;

(4) over the better part of a decade, he has demonstrated remorse for the harm he is caused an insight into the matrix of precipitating factors leading to the complaints in these proceedings;

(5) he accepts the seriousness of the findings against him, and has a deep understanding of the harm caused and a willingness to take responsibility for the Tribunal's findings.

1. We do not share that confidence. This is for the following reasons.
2. First, in the Primary Decision, the Tribunal stated:

157 ... 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:

[1] 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;

[2] the expression "exposure session" not mentioned in the practitioner's statement of 17 January 2018;

[3] the dinner was not described as such in the practitioner's evidence to the Council on 22 January 2022;

[4] 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")[.]

158 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.

1. Thus, we were surprised to see that the practitioner continued to refer to exposure session on at least five occasions in his written submissions. This appears to us to be a real failure to recognise the Tribunal's findings and it must follow that there is a lack of insight about this issue.
2. Secondly, while the practitioner says he "unequivocally accepts" the findings of the Tribunal "in the events that the Tribunal found on the evening of the dinner", his recollection that he did not drink "has not changed". Here we note that the practitioner stated in his written submissions that it was disingenuous of the Commission to say that his evidence was unchanged, but that that is exactly what the practitioner says, at least on this issue, in his statement.
3. A similar conclusion may be reached in regard to the practitioner's recollection of lying to the Council and kissing and touching Patient A, given the findings of the Tribunal.
4. Thus while we may accept that the practitioner's contrition and remorse is genuine, although we note that at no point in his statement does he apologise for the effect his conduct may have had on Patient A, given his maintenance of his position that he did not drink on the night in question, given the Tribunal's findings, this again appears to us to be a real failure to recognise the Tribunal's findings and it must follow that there is a lack of insight about this issue.
5. Thirdly, the practitioner submits that he has "endured a harrowing experience". That may well be true. However, nowhere does he indicate in his statement any understanding of the effect of his conduct had on Patient A.
6. Fourthly, the practitioner also complains of allegations that "[although struck out, remain in the [Stage 1 decision which was publicised in multiple publications domestically and internationally". That may be correct, but the Tribunal offered the practitioner the opportunity to make an application for redactions of its reasons prior to publication. The practitioner did not take advantage of that opportunity. Had he availed himself of that opportunity, the publication outcome may have been different.
7. Fifthly, we do not consider that it is acceptable to excuse the practitioner's conduct on the basis that Patient A was a unique and challenging case. Nor do we accept that his conduct should be excused because he had been practising for (only) six years. In our view, that it is not an inconsiderable period of practice.
8. Sixthly, we reject the submission that "for the better part of a decade [the practitioner] has demonstrated remorse for the harm he has caused ...". That submission is inconsistent his submissions at the Tribunal hearing that in giving her evidence Patient A "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": Primary Decision at [156].
9. Seventhly, while not being critical of Ms Karadeniz in any way, it is a matter of some regret that the practitioner did not work with a psychologist or other counsellor who did not accept his denials of his conduct and thus could address his personal failings in addition to concentrating on his clinical development
10. Weighing all these matters, we cannot conclude that the practitioners' remorse and insight are as complete as is submitted.
11. We have already referred above to the statement of Basten JA in Chen uncertainty as to the future may lead the Tribunal to cancel a registration rather than suspend it.
12. In Health Care Complaints Commission v Robinson (No 3) [2023] NSWCATOD 34, similar to this matter, the Commission sought cancellation of the practitioner's registration, while the practitioner submitted that the public would not be at risk were he reprimanded and conditions placed on his registration.
13. In determining the appropriate protective order, being an order that the respondent's registration as a medical practitioner (General and Specialist - Ophthalmology) was suspended, the Tribunal stated:

Is it necessary to cancel the Respondent's registration to protect the public, provide a deterrent to other practitioners and retain the public confidence in the medical profession? Will an order such as suspension of registration or a reprimand be sufficient in the particular circumstances of this case?

80 We conclude that the protective order which is required in this case is a suspension of the Respondent's registration for a period of three months. That is to be accompanied by conditions attached to his registration upon his return to practice at the conclusion of that period. We have so concluded because, although we accept the Respondent can practise safely now, with the imposition of conditions, we do accept that the Respondent's conduct demonstrated such significant failing, in a practitioner of his seniority, experience, and learning, that a reprimand will be insufficient to fulfil the obligation cast upon this Tribunal by the National Law and the decisions which are binding upon us. We conclude that maintaining public confidence in the medical profession itself, and in its proper and appropriate regulation, requires that practitioners who are found guilty of professional misconduct at the level illustrated in this case need to have imposed on them protective orders which clearly show the profession and the public that such misconduct will have serious consequences, and that safeguards in the form of supervised conditions will be put in place and operate until the practitioner is determined to be able to practise safely. ...

81 We reach that conclusion in the face of the HCCC requiring the Tribunal to cancel the registration of the Respondent. We conclude that cancellation, in this case, goes beyond the requirement of the National Law to ensure that, in the application of the provisions of the National Law, restrictions on the practice of health professionals are applied only if it is necessary to ensure health services are provided safely. We have also concluded that the protective orders we propose to make do place the health and safety of the public as the paramount consideration. We conclude that the protective orders we will make will promote the maintenance of proper ethical and professional standards of medical practitioners, for the protection of the public and the profession. The orders will also act as a deterrent to medical practitioners.

82 We conclude the provisions of the National Law will be satisfied by the protective orders we will make.

(emphasis added)

1. We adopt that reasoning. The established conduct of the practitioner in Complaint Three alone, and certainly all the established conduct when considered together, demonstrates such significant failing, in a practitioner of his seniority, experience, and learning, that a reprimand will be insufficient to fulfil the obligation cast upon this Tribunal by the National Law.
2. To adopt the language of the Tribunal in Health Care Complaints Commission v Sathiyapal (No 2) [2025] NSWCATOD 96 at [98]:

having regard to the nature and gravity of the Practitioner's admitted or proven misconduct, reputable members of the [psychology] profession, and fair minded members of the community would be concerned if, not having given evidence with respect to his insight into and present attitudes to his offending conduct, and its impact on [Patient A], he was nevertheless permitted to continue to practise. So doing would not only potentially undermine public confidence in the [practitioner] but, unfairly to reputable [practitioners], cause disquiet in the profession and the community as to the vigilance of the Tribunal in relation to grave misconduct of the kind admitted by or proved against the present practitioner.

1. As the Tribunal stated in Health Care Complaints Commission v Azzam [2021] NSWCATOD 106:

92. The public interest is served by protective orders which maintain the standing of the profession and the maintenance of public confidence in the high standards of practitioners: [Prakash v Health Care Complaints Commission [2006] NSWCA 153] at [91].

93. Protective orders also involve an element of encouragement to other practitioners to recognise the importance of complying with professional standards and the risks of failing to do so: Prakash at [91].

94. Nevertheless, although the specific purpose for which the Tribunal makes orders is protective of the public interest and not punitive with respect to the practitioner, such orders may be punitive in effect and that punitive effect may be relevant in formulating a protective order: Lee v Health Care Complaints [2012] NSWCA 80 at [20] citing Director-General, Department of Ageing, Disability and Home Care v Lambert (2009) 74 NSWLR 523; [2009] NSWCA 102 at [83].

95. As noted in Health Care Complaints Commission v Livermore [2021] NSWCATOD 48 at [69], there are important but indirect effects of a disciplinary order in respect of a professional which must be considered when determining the appropriate protective order. These include:

the reminder to other members of the profession of the public interest in maintaining high professional standards, the deterrent aspect to the protective nature of the jurisdiction;

the unacceptability of certain kinds of conduct; and

the maintenance of confidence in the high standards of the profession.

96. Whether the seriousness of the conduct is sufficient to warrant suspension or deregistration is a matter of degree and judgment: Sabag v Health Care Complaints Commission [2001] NSWCA 411 at [82].

(emphasis added)

1. In our view, there must be an order cancelling the practitioner's registration.
2. We have come to that conclusion given the objective seriousness of the totality of the practitioner's conduct, because of the necessity to emphasise to other practitioners that such serious professional misconduct is unacceptable and will not be tolerated, and to maintain public confidence in the profession.
3. Any order short of deregistration would be an inadequate response to the seriousness of the practitioner's misconduct.
4. The appropriate period before the practitioner is permitted to apply for a review of that order is one year.

1. The Commission has already sought an order that it be paid 80% of its costs of the proceedings.
2. The practitioner appears to oppose that order, submitting that given the complexity of the proceedings, the fact that a number of very serious allegations were withdrawn or not established, some of which ought never to have been pressed.
3. The practitioner's counsel submits that the nature and extent of "the event" is unknown until such time that the Tribunal has published its reasons for decision and, without those reasons, the practitioner cannot be properly advised as to a position "available on costs".
4. The practitioner further submits that the Commission's position on costs is presently untenable, seeking in substance a "broad brush" rate of 80% of its costs without providing the Tribunal or the practitioner any basis on which the Tribunal could assess the reasonableness or proportionality of the costs sought: Romanos v Punjabi Fusion Group Pty ltd (No 2) [2023] NSWSC 1395 at [9].
5. As the Tribunal noted in Health Care Complaints Commission v Gahan (No 2) [2021] NSWCATOD 66 at [13(7], a court or tribunal may deprive the successful party of the costs relating to an issue on which the successful party lost when that issue was clearly dominant or separable: Monie v Commonwealth of Australia (No.2) [2008] NSWCA 15 at [64].
6. The Tribunal further noted (at [14]), that that principle:

... was the subject of discussion by the Tribunal in Health Care Complaints Commission v Emery (No. 2) [2017] NSWCATOD 23 at [11]-[19]. In summary:

(1) unless a particular issue or group of issues is clearly dominant or separable it will ordinarily be appropriate to award the costs of the proceedings to the successful party without attempting to differentiate between those particular issues on which it was successful and those on which it failed;

(2) exercising the discretion as to costs on an issue by issue basis can produce complexity and disputation; in determining the proper costs, the appropriate approach is a broad-brush approach: Harrington Estates (NSW) Pty Ltd t/as Harrington Grove Country Club v Turner [2016] NSWCA 369 at [72]; Doppstadt Australia Pty Ltd v Lovick & Son Developments Pty Ltd (No 2) [2014] NSWCA 219 at [18]-[19]).

1. All that said, we will set a timetable for submissions on costs.
2. We propose to consider costs on the papers and without a hearing (Civil and Administrative Tribunal Act 2013 (NSW), s 50(2). Either party opposing that course should address that issue in their submissions. In that respect, we note that in Health Care Complaints Commission v Vorillas (No 4) [2025] NSWCATOD 87, the Tribunal stated:

14 In Westerweller v The Owners Strata Plan No 18482 [2023] NSWCATAP 113 the Appeal Panel stated at [85] that:

[i]t is the experience of the Appeal Panel that costs decisions in the Consumer and Commercial Division and on appeal (unless dealt with at the time of the hearing) are routinely considered "on the papers", and without a hearing. The parties were given an opportunity to provide written submissions and did so. They can be presumed to have included all relevant issues in their written submissions.

15 That principle equally applies to decisions in the Occupational Division: Bolton v Health Care Complaints Commission (No 2) [2024] NSWCATOD 38 at [4].

(1) The registration of the respondent as a psychologist be cancelled pursuant to s 149C(1)(b) of the Health Practitioner Regulation National Law 2009 (NSW).

(2) Any application for review of order (1) may not be made until twelve months after the date of these orders.

(3) The applicant is to file and serve its submissions and if necessary, evidence as to costs on or before 2 September 2025.

(4) The respondent is to respond on or before 16 September 2025.

(5) The applicant may reply on or before 23 September 2025.

I hereby certify that this is a true and accurate record of the reasons for decision of the New South Wales Civil and Administrative Tribunal.

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.

[1] The Commission did not read or otherwise rely on pp 416 to 428 of Exhibit A.

[2] Presumably a reference to the practitioner's conduct the subject of the complaints.

[3] Currently being not accepting any new female clients (from the date of the s 150 hearing); once every three months, providing the Council with a statutory declaration that he is not treating female clients. The first statutory declaration is due three months from the date of these conditions.

[4] The Commission relies on Health Care Complaints Commission v Chahoud [2022] NSWCATOD 36 citing Health Care Complaints Commission v Do [2014] NSWCA 307 as to the first four factors and Health Care Complaints Commission v Duggan [2015] NSWCATOD 142 for all five factors.