The Tribunal's Decision
116Having considered all of the evidence before it, the Tribunal is comfortably satisfied that the cancellation order, made in relation to Mr Holbrook, remains appropriate. The Tribunal is not satisfied that Mr Holbrook is a suitable person to hold registration as a psychologist, so as to justify the making of a reinstatement order.
117Mr Holbrook's position remains that his past professional misconduct, his defects in character and his diagnosis of personality disorder can be explained, in the main, by an adverse drug reaction to Zoloft. He continues to maintain that an ADR is the primary reason for his transgressions when this diagnosis has not been formally made for him. Mr Holbrook's assertion that he suffered from an ADR is not supported by any credible medical or psychiatric assessment. It appears to be a self diagnosis only.
118r Holbrook was not honest about his use of Zoloft. He also continued to use it, even after he had experienced 'problems' with it. His use of a number of other psychotropic medications did not attract his interest or concern.
119His assertion that he does not suffer from a personality disorder is not supported by persuasive evidence. The Tribunal could attach very little weight to the report provided by Dr Masih, given that in her oral evidence she retracted many of her opinions and indicated that her professional opinion was provided without full disclosure of all relevant material and without psychometric evaluation. Dr Masih expressed her personal support for Mr Holbrook but also stated that she considered him to be manipulative.
120Comments by Dr Lotz and Dr Masih were made without reference to any previous relevant documentation and are based on Mr Holbrook's own account of his condition.
121The Tribunal accepts the Commission's submission that Mr Holbrook fails to accept or take responsibility for the findings of the Psychology Tribunal in this regard.
"He continues to pursue his discredited 'theory' that his conduct arose as a result of an ADR. There is no credible evidence to support such a theory."
122Mr Holbrook has been diagnosed with a personality disorder and anxiety. He has been found to suffer from an impairment which prevents him from practising safely as a psychologist. However, he has not demonstrated that he has accepted this and addressed the issues raised by the various clinicians who have assessed him.
123He has not sought treatment for aspects of his personality that appear to have underpinned his boundary violations and other inappropriate behaviours. Indeed he does not appear to accept that any treatment could be beneficial or effective.
124He acknowledged that he would have great difficulty in engaging in a therapeutic relationship. He said he would not get enough out of therapy to justify an investment in it. He accepts his personality as it is. "I don't think I need therapy to sort things out."
125Mr Holbrook has not demonstrated that he has overcome the deficiencies in his character identified by the Psychology Tribunal in 2010. Indeed, Mr Holbrook does not accept the Psychology Tribunal's findings in relation to his character.
126The Tribunal could attach very little weight to the character references provided by Mr Holbrook. Many were written several years ago and did not relate to his current circumstances. The more recent references were written without adequate background information being provided to the referees.
127The Tribunal was also troubled by Mr Holbrook's dishonest behaviour in not telling the truth to various agencies in relation to his use of Zoloft and in making a conscious decision to deceive the Department of Education. It is also of concern that Mr Holbrook spoke of having 'negotiated' a diagnosis of dysthymia with a GP, when this was not in fact an accurate diagnosis of his condition and treatment needs.
128There appears to have been a lack of transparency when Mr Holbrook was organising his references and supporting reports, which appeared in part to suggest some manipulation on his part.
129The Tribunal also notes Mr Holbrook's criminal history.
130In terms of addressing the question of his competence to practise, Mr Holbrook has undertaken no relevant educational courses or professional development since the cancellation of his registration. He has not studied ethics (except in the context of a massage course) nor has he engaged with peers in any mentoring or 'supervisory' capacity. The Psychology Tribunal prevented Mr Holbrook from seeking a review within three years of its decision, to allow him opportunities for rehabilitation. He does not appear to have pursued any active rehabilitation and took the view that simply not working for three years was all he had to do.
131The Tribunal considered there was very little weight which could be attributed to the Vocational Profile which Mr Holbrook tendered to establish his competency, as the validity and reliability of the instrument was not established by evidence. The Commission asserted that the Career Profile could be anything to anyone and the Tribunal agreed as the Profile did not appear to measure what Mr Holbrook asserted it measured.
132Mr Holbrook demonstrated a lack of critical evaluation of his behaviour and a lack of insight in relation to his transgression of personal boundaries. Almost all of Mr Holbrook's evidence referred to his needs, his goals and future wishes. He did not discuss the impact of his behaviour on the children in his care or their families. He did not express remorse. There was no evidence of empathy or understanding of the impact of his behaviour on others.
133Mr Holbrook has rejected any diagnosis or suggested treatment that does not accord with his entrenched view that his behaviour was caused by an ADR. The Tribunal also noted with concern a tendency for Mr Holbrook to attribute bad faith to others, if their views differed from his own. He inferred that the processes of the Psychology Tribunal and the Department of Education were designed to achieve a particular end, and that information was manipulated to achieve that end.
134Mr Holbrook has difficulty acknowledging his shortcomings. For example, he did not appear to understand the outcomes in the criminal proceedings and considered that he had been to some extent exonerated or that his level of culpability significantly reduced.
135He did acknowledge some schizoid traits as well as his social anxiety/awkwardness. Concern has been expressed that such traits may be inconsistent with a role as a psychologist, particularly one working with children and adolescents.
136The issue to be determined is whether or not the cancellation order remains appropriate at the time of this review and whether a reinstatement order should be made by the Tribunal. The onus is on Mr Holbrook to demonstrate that the issues raised by the Psychology Tribunal in 2010 have been addressed, so as to render the cancellation order no longer appropriate, and to demonstrate that he is now a suitable person to be registered as a psychologist. (See Re Mansour Haider Zaidi [2006] NSWMT 6)
137Mr Holbrook has failed to discharge this onus. He has not provided persuasive evidence that he has remedied the defects in his character identified by the previous Tribunal. He has neither effectively challenged the diagnosis of personality disorder not indicated that he has actively treated or effectively managed this condition. His assertions about his competence and suitability to practise rest on evidence, such as a Career Profile and character references, which have very limited probative value.
138The Commission submits that,
"The Applicant has failed to demonstrate the heavy onus that he is a fit and proper person to be held out to the rest of the profession, to patients and to the whole of the community as a person worthy of their confidence and that he is to be trusted to exercise the high responsibilities of the profession. He has failed to displace the decision for deregistration which has been made. There is no basis for the Tribunal to find that for the future the Applicant will act in accordance with the high standards and responsibilities of the profession."
139The Tribunal accepts this submission and for the reasons set out above, determines to dismiss Mr Holbrook's application.
140The Tribunal also considers it appropriate that Mr Holbrook not seek a further review until a period of three years has elapsed from the date of this order. Mr Holbrook did not adopt the suggestions of the Psychology Tribunal in relation to ongoing therapy and this remains an outstanding matter for him to address. In addition, undertaking an ethics course and other appropriate educational activities requires time. Mr Holbrook also needs time for reflection and to develop insight and an understanding of the impact of his behaviour on those in his care.
141The Tribunal notes that the prohibition order made by the Psychology Tribunal in 2010 continues.
142In relation to costs, Mr Holbrook's submission rests solely on his financial difficulties, and while the Tribunal accepts Mr Holbrook has these difficulties, they do not provide a persuasive reason for not following the usual course in these matters.