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APPENDICES TO THE ETHICS MANUAL OF
PROCEDURES
- Ethics Complaint Form
- Letter to
Complainant
- Waiver of
Confidentiality Privilege and Authority to Release Information
- Letter to
ITAA Member Against Whom the Allegations are Made
- Flow Charts of Complaint
Process
ETHICS COMPLAINT FORM
CONFIDENTIAL
Date_______________
1. Complainant (Person making the complaint)
Name_______________________________
Address______________________________
City, State or Province, Postal Code,
Country___________________
Home Phone ( )__________ Business Phone ( )________________
Email:
2. ITAA member (respondent - person being
complained about)
Name______________________________
Address_______________________________
City, State, Postal code, Country______________
Telephone ( )___________ Email:
3. Your relationship with the respondent at
the time of the alleged violation (e.g., client, colleague, employee, trainee,
etc.)
4. Date/s of the alleged unethical behavior
5. Details of the alleged violations
Write an account of what happened that you believe to be an
ethical violation and how the events affected you. Be as specific as possible.
Please type or use a computer if possible. Include this when you return the
form. You may send additional information at any time up until the Ethics
Committee begins its deliberation.
6. The section/s of the ITAA Code of Ethics that you
believe have been violated
7. Provide details of the outcome of the action that
you took to confront the ITAA member
8. Any actions that you have taken or are
considering taking to deal with the alleged violations (e.g., advising the
respondents employer, initiating a formal grievance process with another
body, seeking legal sanctions, etc.)
9. Have you filed a formal complaint against the ITAA
member with any other organization?
Yes___________ No___________
If yes, what organization? Please include a contact number.
10. Provide the names, addresses and telephone
numbers of witnesses, if any, or others who might provide relevant information
about the events you are filing a complaint about. If possible obtain from them
a signed statement that can be sent along with this form.
Signed
Date
.
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LETTER TO
COMPLAINANT
Date
CONFIDENTIAL
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
xxxxxx
xxxxxxx
Dear
I am responding to your letter regarding your complaint
against___________________________.
Since you believe that this member has violated the ITAA
Code of Ethics, you may file a formal complaint with the ITAA Ethics
Committee by using the enclosed Ethics Complaint form.
Please read the enclosed copy of the ITAA Code of
Ethics.
Please read the enclosed Waiver and Release of Information
Form. In order for the Ethics Committee to proceed with the case, it is
necessary that you give the Committee permission to use your name and the
information you provide when we contact the member with your complaint and when
the Committee considers your case. Please sign the form, which gives the Ethics
Committee permission to use your name in this manner.
Please understand that signing of the waiver to release
information grants the Ethics Committee permission to send a copy of your
complete complaint materials including witness statements and any additional
material provided to the member for a response,
Please return all of the materials in envelopes marked
CONFIDENTIAL to:
The Chairpersons
ITAA Ethics Committee
ITAA 2186 Rheem Drive Pleasanton, CA 94588
When all the material has been received, the
chairpersons first steps will be to decide whether the allegations in
your complaint would, if proven factual, constitute a violation of the ITAA
Code of Ethics and therefore warrant an investigation. If so, the
chairperson will appoint a suitable person to investigate. You will be informed
of this decision.
The investigator will be responsible to:
- Contact both the complainant and the respondent to gather
information
- Notify both parties of the ethics procedures to be used.
- Notify the respondent of their rights to appear, to
testify or present their side of the allegations.
- Determine if a resolution can be agreed to through a
mediation process.
A full copy of the Ethics Manual of procedures to be used
can be obtained from the ITAA office.
Once you have considered making a formal complaint you are
advised not to discuss the matter with anyone not directly involved with it.
All information should be treated as highly confidential. The Ethics manual
outlines the procedures for any disclosure of information.
Please retain copies of all the documents included with this
letter for your own reference. Also, please keep copies of all your
correspondence with the Ethics Committee.
We realize that this may be a very difficult as well as
lengthy process. We appreciate your patience and cooperation. If you need any
further assistance in reaching a decision or in compiling your complaint please
feel free to contact either of the chairpersons of the Ethics Committee.
Thank you for contacting the Ethics Committee with your
concerns. Our organization is committed to maintaining high standards of
ethical practice in Transactional Analysis.
Sincerely,
xxxxxxxxxxxxxxxxxxx
Ethics Committee Co-chair
Enclosures: Ethics Complaint Form
ITAA Statement of Ethics
Waiver Form
Summary of Procedures for Ethical Complaints
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WAIVER OF CONFIDENTIALITY
PRIVILEGE
AND
AUTHORITY TO RELEASE INFORMATION
I, ________________________________________ have filed a
complaint with the International
(name of complainant)
Transactional Analysis Association (ITAA) dated
__________________ against a member of the
(date of the complaint)
ITAA ______________________________________________
(name of the ITAA member (respondent) against
whom the complaint has been filed)
I hereby waive any confidentiality privilege
with respect to the member of the ITAA against whom I have made a complaint
(respondent) so that the member may respond to my complaint and provide
confidential information to the ITAA Ethics Committee regarding the matters
raised in my complaint; and to those people who, in the discretion of the
committee, its staff or legal counsel, it may be necessary to contact in order
to conduct a full and fair investigation of the complaint.
I hereby authorize the release of the information contained
in my complaint to the respondent, the members of the ITAA Ethics Committee,
the investigator or investigation sub-committee who will conduct a thorough and
fair investigation of the complaint, the legal counsel for the ITAA, and those
individuals who in the discretion of the committee or its legal counsel may
need to receive this information. I also authorise the release of this
information to those that might carry out any ensuing therapy or supervision
resulting from discipline to the respondent.
I waive any claims that I may have or could have against the
ITAA, its Board of Trustees, its employees or committee members, relative to
the release of information that is the subject of my complaint.
I authorize the use of my name in the investigation of my
complaint by the ITAA Ethics Committee, and the legal counsel for the ITAA.
__________________________________________
Name of complainant (Please Print)
_____________________
_________________________________________
Date Signature of complainant
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LETTER TO ITAA MEMBER AGAINST WHOM THE
ALLEGATIONS ARE MADE
Date
CONFIDENTIAL
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
xxxxxx
xxxxxx
xxxxxx
xxxxxx
Dear
I am writing to you as Co-chair of the International
Transactional Analysis Ethics Committee. I regret to inform you that the ITAA
Ethics Committee has received a formal complaint against you from
_______________________. A copy of his/her correspondence is enclosed as well
as a waiver and permission to release information.
The Ethics Committee will now begin a process of
investigation to determine if there has been an ethics violation. At this
point, the Ethics Committee makes no assumptions of the validity of the
information provided by the complainant. We know that this is a difficult and
often lengthy process and we would appreciate your cooperation.
CHARGES
Based on the information provided thus far by the
complainant, I have determined that allegations of ______________________, if
found to be factual, would be a violation of the ITAA Code of Ethics, as
follows:
1. Principle ### which states:
This charge is based on ____________ in the
complainants materials.
2. Principle ### which states:
This charge is based on _____________.
These charges are based on information that we have at this
time. It may be necessary to charge you with additional violation, if further
allegations come to our attention.
YOUR RESPONSE
Please respond to each of the allegations made by the
complainant, even if they are not specifically outlined in this letter. If you
fail to respond to any specific allegations within thirty (30) days of the date
of this letter, the Ethics Committee may take your lack of response as your
admission of the facts in this allegation and consideration may be given to the
status of your ITAA membership.
To assist us in the investigation, please also provide the
following information:
A sequence of events leading up to the time of the alleged
violations and following that time.
Any other relevant information such as copies (not
originals) of relevant documents such as billing records, letters, clinical
records, telephone bills, diaries, letters, etc. which might explain or
validate your response
You may also submit information from other people with
relevant information. You may send this with your own response or have these
people submit this directly to the ITAA office at the address on this
stationery. Any information submitted should have a signed authorisation for
its use in the ITAA Ethics complaint process from the person releasing the
material. Please do not ask for or submit general letters of support from
current or former clients.
Send your written response within thirty (30) days of
receipt of this letter. You may consult with legal counsel, but you must
respond to the charges yourself. Failure to respond could result in termination
of your membership in ITAA.
Please understand that your response may, if necessary to
the investigation, be discussed in detail with, or forwarded to the
complainant.
PROCESS
A flow chart is enclosed to help you understand the enclosed
procedures and the process of the investigation as described below.
The first step will be the investigation conducted by an
investigator appointed by the ITAA Ethics Committee chair. This investigation
will be conducted largely through correspondence with you, the complainant,
witnesses suggested by you and/or the complainant, and other persons with
useful information.
During this stage of the process the investigator will
remain open to the complaint being resolved by negotiation through a mediation
process.
It is the Ethics Committees responsibility to see that
investigations are conducted thoroughly and impartially and that its
procedures are followed. It is your responsibility to cooperate with the
investigation, to respond fully and truthfully to inquiries within the
deadlines given, and to provide all the information requested by the Ethics
Committee and staff.
After this investigation, and if no mediated resolution to
the complaint is reached, the next step is for the Ethics Committee to meet and
review all the relevant information gathered in the investigation, arrive at a
decision as to whether or not, in its judgment, violations of the ITAA Code
of Ethics have occurred and, if so, what actions should be recommended. It
is not a meeting where members, complainants, or witnesses are present or are
interviewed.
When the Ethics Committee reaches a decision, you will be
notified. If the investigation is continuing, you may be requested to provide
further information. If the decision is that you did violate the Code of
Ethics and disciplinary actions are recommended, you may accept those
decisions, or you may exercise your right to have those decisions reviewed by a
hearing board.
We make every effort to complete the investigation and
deliberation process in as timely a manner as possible. However, due to the
complexities involved in most ethics cases and the difficulty for the ITAA
Ethics Committee to have face-to-face meetings to deliberate, this process can
unfortunately be time-consuming. Your prompt response to this letter and
subsequent communications will serve to expedite this matter.
CORRESPONDENCE
We are sending this notice to you at the last known address
we received from you with payment of your dues and mailing that to the address
will be deemed sufficient notice.
Please send your response and all other correspondence to
... Please include the date, your current address, home
and office phone numbers and email address on all correspondence. Please advise
which of the addresses will provide confidentiality for any correspondence.
Once you have received notice of a formal complaint you are
advised not to discuss the matter with anyone not directly involved with it.
All information should be treated as highly confidential. The ethics manual
outlines the procedures for any disclosure of information.
We realize that this may be a very difficult as well as
lengthy process for you. We appreciate your patience and cooperation, and will
endeavour to maintain and respect confidentiality.
Sincerely,
xxxxxxxxxxxxxxxxx
Ethics Committee Co-chair
Enclosures: Materials from complainant, with waiver ITAA
Code of Ethics Summary of Procedures for Ethical Complaints Flow Charts
ITAA ETHICS
PROCEDURES FLOW CHART |