Patient alleges therapist crossed ethical line by accepting legal power over her health and money

A B.C. woman who gave her psychotherapist power of attorney and the ability to make legally binding decisions about her health says she did so believing Susannah-Joy Schuilenberg was a doctor of psychology.

As CBC reported last week, Schuilenberg is the subject of a complaint alleging the doctorate and two master's degrees she once advertised "are not credible and possibly fraudulent."

The patient, whom CBC has agreed not to name, says she was shocked by that news.

"By that I mean physical shock. I was dazed. I didn't know where I was, really. I was confused. I had trouble processing thoughts. I couldn't eat," she said in an interview last week.

But she now believes it would have been inappropriate for any counsellor or therapist, no matter their qualifications, to agree to these legal powers.

"When I look at this from a detached perspective, a logical, reasonable perspective, I realize if she had been part of a true regulatory body she would have been tied to a real code of ethics and she would not have been able or allowed to assume those roles," said the patient, who is in her 40s

As a therapist, Kelowna's Schuilenberg is not subject to the regulation that professionals like psychologists face. There's no college that sets a code of ethics therapists must follow to practise legally, or that can revoke their licences when they don't meet that defined set of standards.

Documents provided to CBC show that the patient granted Schuilenberg enduring power of attorney on Sept. 5, 2019, and signed a representation agreement for enhanced power for health and personal care on the same day.

At the time the agreements were signed, billing records show the patient was seeing a student counsellor who was working directly under Schuilenberg's supervision.

The patient's former lawyer, who witnessed the signing of those agreements, has confirmed that at one point Schuilenberg was also a beneficiary of the patient's will, although CBC has not seen that document.

'Dual relationships' discouraged

Steven Taylor, a clinical psychologist and professor at the University of B.C. in Vancouver, said this situation sounds like what's known as a "dual relationship" which registered psychologists are told to avoid.

The College of Psychologists of B.C., strictly prohibits any situation in which a psychologist's objectivity and professional judgment could be affected because of their "familial, social, sexual, emotional, financial, supervisory, political, administrative, or legal relationship with the client."

Schuilenberg said she could not comment on a detailed list of questions about the arrangement.

"As is true of all mental health professionals, speaking of clients/former clients requires a current, signed permission to share confidential information," she wrote in an email.

The patient told CBC she was not comfortable with giving Schuilenberg the power to release confidential and personal details.

Billing records show she was a patient of Schuilenberg's beginning in 2016, paying as much as $197 for a one-hour visit. During about four years of treatment, the patient has also seen Schuilenberg's mother, as well as her husband and the student working under Schuilenberg's supervision.

Until recently, Schuilenberg, called herself a "doctor of psychology" and used the honorific "Dr." She advertised earning two master's degrees and one doctorate within the space of just four years.

The patient says those impressive credentials were one reason she started seeing Schuilenberg for treatment of post-traumatic stress disorder related to a life-threatening medical diagnosis and a long and difficult recovery from a medical procedure.

The patient said Schuilenberg was easy to talk to and she felt comfortable and safe in her cosy clinic.

"I didn't know any different. I thought the sessions were helpful," she said. "But the sessions never resolved the trauma."

The patient alleges that as her treatment continued, she became friends with Schuilenberg and her family. She says she proposed making Schuilenberg her medical representative and granting her power of attorney after fleeing an abusive home.

"There's no one else I had," the patient explained.

Dangers of clouded judgment

These legal agreements generally grant a person wide authority over someone else's life.

Enduring power of attorney provides the ability to make decisions about someone's finances and property, a power that continues when that person is mentally incapable of doing so themselves. An enhanced representation agreement allows a medical representative to make decisions about everything from health care to diet and clothing.

Taylor, the UBC psychologist, said there are good reasons people who provide psychological counselling are discouraged from taking on this sort of double role with a client.

Without knowing the details of the Schuilenberg case, Taylor gave the hypothetical example of a therapist in private practice who realizes their sessions aren't helping. The ethical choice would be to discontinue those appointments, he said.

"But if you have power of attorney and control over the patient's finances ... in essence, you're paying yourself because you control the patient's finances, which can cloud your judgment about the patient's need for your therapy," Taylor wrote in an email.

Schuilenberg isn't a registered psychologist, but she does belong to the Canadian Professional Counsellors Association, which has a Code of Ethics that generally recommends against dual relationships.

The Canadian Professional Counsellors Association says it continues to investigate an April complaint filed against Schuilenberg in relation to her credentials. She has acknowledged that her 2008 master of arts in counselling psychology was fraudulent, and says she gave up her doctorate as a result.

The only graduate degree that remains on Schuilenberg's website is a master of religious education, but she has changed the year it was completed and added that it is "non-traditional."

The patient said she had a long, sleepless night after reading about the allegations against Schuilenberg.

"The next day I went outside late at night to pray to the sky, because God is up there. I asked him how, after all of the terrible things that have happened in my life, how this has now happened," she remembered.

Then she says she took action, taking steps to revoke the power of attorney and medical representation agreements, and tearing up her will.

"I still can't make sense of this. My post-traumatic stress disorder has become worse in my opinion, and I think I need to find a therapist [who] can help me to process this," she said.