Section 7.8 Grievance and Due Process Guidelines

Policy No. 8.01 Due Process:

The basic meaning of due process is to inform and provide a framework to respond, act, or dispute. Due process ensures that the decisions about clinicians-in-training are not arbitrarily or personally based. It requires that the Training Program identify specific evaluative procedures which are applied to all clinicians-in-training, and provide appropriate appeal procedures to the clinician-in-training. All steps need to be appropriately documented and implemented.

Procedures:

• Clinicians-in-training will be presented with the program expectations related to professional functioning, in writing, during orientation. These expectations will be discussed in both group and individual settings.
• Procedures for evaluation, including when and how evaluations will be conducted, will be clearly communicated during orientation and in the training materials.
• The training program will articulate the various procedures and actions involved in making decisions regarding problematic behaviors or concerns.
• In compliance with Training Policy 5.07, CPS communicates with Academic Departments twice a year regarding evaluation and at other times to coordinate training. In the case of problematic behaviors or concerns with clinicians-in-training, CPS will seek input from academic programs about how to address such difficulties, in a timely manner.
• CPS will institute, when appropriate, a remediation plan for identified inadequacies, including the time frame for expected remediation and consequences of not rectifying the inadequacies.
• Clinicians-in-training will be provided with written procedures for how they may appeal the program’s actions. Such procedures are included in the Training Binder and/or Intern Handbook, which the clinician-in-training receives during orientation. These procedures will also be available on the CPS training website.
• Clinicians-in-training will be allotted sufficient time to respond to any action taken by CPS.
• Decisions and recommendations regarding the professional performance of clinicians-in-training will be made using input from multiple sources
• Written documentation of the actions taken by CPS and the rationale for these actions will be provided to all relevant parties.

Policy No. 8.02 Grievances:

In the event that a training issue cannot be resolved between the Training Director and the Assistant Director for Training and the clinician-in-training, the clinician-in-training may choose to file a grievance. A "grievance" is a dispute concerning terms and conditions of training arising from any administrative decision which the clinician-in-training claims is in violation of their rights under established University and/or counseling center personnel regulations, policies, or practices.

Procedures:

• There are two situations in which grievance procedures can be initiated:
  1. In the event a clinician-in-training encounters any difficulties or problems (e.g. poor supervision, unavailability of supervisor, evaluations perceived as unfair, workload issues, personality clashes, and other staff conflict) during their training experiences, a clinician-in-training can:
     1. Discuss the issue with the staff members involved
     2. If the issue cannot be resolved informally, the clinician-in-training should discuss the concern with the TD, ADT, or other member of the senior staff
     3. If the TD, ADT, or member of the senior staff cannot resolve the issue, the clinicianin-training can formally challenge any action or decision taken by the TD, ADT, the supervisor, or any member of the training staff by following this procedure:
        1. The clinician-in-training should file a formal complaint, in writing and all supporting documents, with the TD or the Center Director if the complaint is with the TD. If the clinician-in-training is challenging a formal evaluation, the clinician-in-training must do so within 5 days of receipt of the evaluation.
        2. Within 3 days of a formal complaint, the TD must consult with the Director and implement Review Panel procedures as described in Policy 8.03
  2. If a training staff member has a specific concern about a clinician-in-training, the staff member should:
     1. Discuss the issue with the clinician(s)-in-training involved
     2. Consult with the TD and ADT
     3. If the issue is not resolved informally, the staff member may seek resolution of the concern by written request, with all supporting documents, to the TD for a review of the situation. When this occurs the TD will:
        1. Within 3 days of a formal complaint, the TD must consult with the Director and implement Review Panel Procedures described below.

Policy No. 8.03 Review Panel and Process:

When needed, the Director of the counseling center will convene a Review Panel. The panel will consist of 3 staff members selected by the Director with recommendations from the TD and the clinician-in-training involved in the dispute. The clinician-in-training has the right to hear all facts with the opportunity to dispute or explain the behavior of concern.

Procedures:

• Within 5 work days, a hearing will be conducted in which the challenge is heard and relevant material presented.
• Within 3 work days of the completion of the review, the Review Panel submits a written report to the Director, including any recommendations for further action.
• Recommendations made by the Review Panel will be made by a majority vote.
• Within 3 work days of receipt of the recommendation, the Director will either accept or reject the Review Panel’s recommendations. If the Director rejects the panel’s recommendations, due to an incomplete or inadequate evaluation of the dispute, the Director may refer the matter back to the Review Panel for further deliberation and revised recommendations, or may make a final decision.
• If referred back to the panel, they will report back to the Director within 5 work days of the receipt of the Director’s request of further deliberation. The Director then makes a final decision regarding what action is to be taken.
• The TD informs the clinician-in-training, staff members involved, the academic department of the clinician-in-training, and if necessary, members of the training staff of the decision and any actions resulting from the decision.
• If the clinician-in-training disputes the Director’s final decision, the clinician-in-training has the right to contact the Department of Human Resources to discuss the situation.

Policy No. 8.04 Definition of Problematic Behavior:

Problematic behavior is defined broadly as an interference in professional functioning, which is reflected in one of more of the following ways:

1. An inability or unwillingness to acquire and integrate professional standards into one’s repertoire of professional behavior
2. An inability to acquire professional skills in order to reach an acceptable level of competency
3. An inability to control personal stress, strong emotional reactions, and/or psychological distress which interfere with professional functioning.

Procedures:

• It is the professional judgment of a supervisor/staff member as to when a clinician-in-training’s behavior becomes problematic rather than of concern, and, therefore, consultation with other staff members is encouraged. Clinicians-in-training might exhibit behaviors, attitudes, or characteristics which, while of concern and requiring remediation, are not unexpected or excessive for professionals in training. Problems typically become identified when they include one or more of the following characteristics:
  1. The clinician-in-training does not acknowledge, understand, or address the problem when it is identified by the supervisor or another staff member.
  2. The problem is not merely a reflection of a skill deficit which can be rectified by academic or didactic training.
  3. The quality of services delivered by the clinician-in-training is sufficiently negatively affected.
  4. The problem is not restricted to one area of professional functioning.
  5. A disproportionate amount of attention by training personnel is required.
  6. The clinician-in-training’s behavior does not change as a function of feedback, remediation efforts, and/or time.

Policy No. 8.05 Procedures for Responding to Inadequate Performance by a Clinician-in-Training:

If a clinician-in-training receives an ‘unacceptable rating’ from any of the evaluation sources in any of the major categories of evaluation, or if a staff member has concerns about a clinician-in-training’s behavior (e.g., ethical or legal violations, professional incompetence) the following procedures will be initiated:

Procedures:

• The staff member will consult with the TD to determine if there is reason to proceed and/or if the behavior in question is being rectified.
• If the staff member who brings the concern to the TD is not the clinician-in-training’s primary supervisor, the TD will consult with the primary supervisor.
• If the TD and primary supervisor determine that the alleged behavior in the complaint, if proven, would constitute a serious violation, the TD will inform the staff member who brought the complaint.
• The TD will meet with the Director to discuss the concerns and possible courses of action to be taken to address the issue.
• The TD, primary supervisor, and the Director may meet together to discuss possible courses of action.
• Whenever a decision has been made by the Director or the TD about a clinician-in-training’s training or status within the agency, the TD will inform the clinician-in-training in writing and will meet with the clinician-in-training to review the decision. This meeting may include the clinician-in-training’s primary supervisor. If the clinician-in-training accepts the decision, any formal action taken by the Training Program may be communicated in writing to the clinician-in-training’s academic department. This notification indicates the nature of the concern and the specific alternatives implemented to address the concern.
• The clinician-in-training may choose to accept the conditions or may choose to challenge the action. See the Policy 8.07 for procedures for challenging an action.

Policy No. 8.06 Remediation and Sanction Alternatives:

It is important to have meaningful ways to address problematic behavior once it has been identified. In implementing remediation or sanction interventions, the training staff must be mindful and balance the needs of the clinician-in-training, the clients involved, members of the training cohort, the training staff, and other agency personnel. Remediation/sanction should begin at the lowest level deemed appropriate.

Procedures:

The remediation plan should be constructed with sensitivity to the developmental level of the clinician-in-training and the seriousness of presenting concern. The plan may include any of the interventions listed below, singly or in combination.

• Verbal Warning: The clinician-in-training is given verbal feedback that emphasizes the need to discontinue the inappropriate behavior that is being addressed.
• Written Acknowledgement: Written feedback to the clinician-in-training that formally acknowledges the following:
  • The Training Director (TD) is aware of and concerned with the performance rating
  • The concern has been brought to the attention of the clinician-in-training
  • The TD will work with the clinician-in-training to rectify the problem or skill deficits, AND
  • The behavior associated with the rating is not significant enough to warrant more serious action
• Written Warning: This is a letter that indicates the need for the clinician-in-training to discontinue an inappropriate action or behavior. This letter will contain the following:
  • A description of the clinician-in-training’s unsatisfactory performance
  • Actions needed by the clinician-in-training to correct the unsatisfactory behavior
  • The time line for correcting the problem
  • What action will be taken if the problem is not corrected
  • Notification that the clinician-in-training has the right to request a review of this action
  • A copy of this letter will be kept in the clinician-in-training’s file. Consideration may be given to removing this letter at the end of the training period by the TD in consultation with the clinician-in-training’s supervisor and Director. If the letter is to remain in the file, documentation should contain the position statements of the parties involved in the dispute.
• Schedule Modification: This is a time-limited, remediation-oriented, closely supervised period of training designed to return the clinician-in-training to a more fully functioning state. Modifying a clinician-in-training’s schedule is an accommodation made to assist the clinician-in-training in responding to personal reactions to environmental stress, with the full expectation that the clinician-in-training will complete the traineeship/internship. This period will include more closely scrutinized supervision conducted by the regular supervisor in consultation with the TD. Several possible and perhaps concurrent courses of action may be included in modifying a schedule. These include but are not limited to:
  • Increasing the amount of supervision, either with the same or other supervisors
  • Change in the format, emphasis, and/or, focus of supervision
  • Recommending personal therapy aimed at addressing the behaviors of concern (a list of community practitioners and other options will be made available)
  • Reducing the clinician-in-training’s clinical or other workload
  • Requiring specific academic coursework
  • The length of the modification will be determined by the TD in consultation with the primary supervisor and the Director. The termination of the schedule modification period will be determined, after discussions with the clinician-in-training, by the TD in consultation with the primary supervisor and the Director.
• Probation: This is a time-limited, remediation-oriented, more closely supervised training period. The purpose of probation is to assess the ability of the clinician-in-training to complete their training and to return the clinician-in-training to a more fully functioning state. Probation defines a relationship that the TD systematically monitors the degree to 41 which the clinician-in-training addresses, changes and/or otherwise improves the behavior associated with the inadequate rating for a specific length of time. The clinician-in-training is informed of the probation in writing. The statement will include but is not limited to:
  • The specific behaviors associated with the unacceptable rating
  • The recommendations for rectifying the problem
  • The time frame for the probation during which the problem is expected to be ameliorated
  • The procedures to ascertain whether the problem has been appropriately rectified
  • If the TD determines that there has not been sufficient improvement in the clinician-intraining’s behavior to remove the Probation or Modified Schedule, then the TD will discuss with the primary supervisor and the Director possible courses of action to be taken. The TD will communicate in writing to the clinician-in-training that the conditions for revoking probation or modified schedule have not been met. This notice will include the course of action the TD has decided to implement. These may include continuation of the remediation efforts for a specified time period or implementation of another alternative. Additionally, the TD will communicate to the Director that if the clinician-in-training’s behavior does not change, the clinician-in-training will not successfully complete the traineeship/internship.
• Suspension of Direct Service Activities: This action requires a determination that the welfare of the clinician-in-training’s clients or consultees has been jeopardized. Therefore, direct service activities will be suspended for a specified period as determined by the TD in consultation with the Director. At the end of the suspension period, the clinician-in-training’s supervisor in consultation with the TD will assess the clinician-in-training’s capacity for effective functioning and determine when or if direct service can resume.
• Administrative Leave: This involves the temporary withdrawal of all responsibilities and privileges in the agency. If the Probation Period, Suspension of Direct Service Activities, or Administrative Leave interferes with the successful completion of the training hours needed for completion of their training, this will be noted in the clinician-in-training’s file and the clinician-in-training’s academic program will be informed. The TD will inform the clinicianin-training of the effects the administrative leave will have on the clinician-in-training’s stipend and accrual of benefits.
• Dismissal from the Training Program: This involves the permanent withdrawal of all agency responsibilities and privileges. When specific interventions do not, after a reasonable time period, rectify the problem behavior or concerns OR the clinician-in-training is unable or unwilling to alter their behavior, the TD and ADT will discuss the possibility of termination from the training program or dismissal from the agency with the Director. Either administrative leave or dismissal would be invoked in cases of severe or repeated violations of applicable professional ethical codes (APA/ACA/NASW Codes of Ethics) or laws, when 42 imminent physical or psychological harm to a client is a factor, or the clinician-in-training is unable to complete their training due to physical, mental, or emotional illness. When a clinician-in-training has been dismissed, the TD will communicate to the clinician-in-training’s academic department that the clinician-in-training has not successfully completed the training program.

Policy No. 8.07 How to Appeal or Challenge a Decision to Remediate a Clinician-in-Training’s Behavior:

In the event that a clinician-in-training does not agree with any of the aforementioned notifications, remediation or sanctions, or with the handling of a grievance – the following appeal procedures should be followed:

Procedures:

• The clinician-in-training should file a formal appeal in writing with all supporting documents, with the Director. The clinician-in-training must submit this appeal within 5 workdays from their notification of any of the above (notification, remediation or sanctions, or handling of a grievance).
• Within three workdays of receipt of a formal written appeal from a clinician-in-training, the Director will consult with the Training Director and the Director of Clinical Services and then decide whether to implement a Review Panel or respond to the appeal without a Panel being convened.
• In the event that a clinician-in-training is filing a formal appeal in writing to disagree with a decision that has already been made by the Review Panel and supported by the Director, then that appeal is reviewed by the Director in consultation with the Training Director and the Director of Clinical Services. The Director will determine if a new Review Panel should be formed to reexamine the case, or if the decision of the original Review Panel is upheld.