Informed consent is a principal obligation of psychological practice, ensuring that clients understand the nature, risks, and benefits of any treatment before proceeding. The recent disciplinary case of Psychology Board of Australia v Asher [2025] VCAT 517 (Asher) highlights the serious consequences of failing to obtain proper informed consent—particularly in writing—before commencement therapeutic treatment. .

In Asher, amongst other findings, the Victorian Civil and Administrative Tribunal (VCAT or the Tribunal) specifically found that the psychologist in question, Gregory Asher, had not obtained adequate informed consent for what was essentially experimental floatation tank therapy. In Asher, the Tribunal engaged in a helpful discussion of the principles behind the necessity of clear, documented client consent.

Key Takeaways from Psychology Board of Australia v Asher

1. The Legal and Ethical Obligation of Informed Consent

The Tribunal examined whether Mr. Asher had obtained informed consent before providing floatation tank therapy—an adjunct treatment to psychological counselling. The Board alleged that:

• There was no documented evidence (written or in clinical notes) produced by Mr Asher of informed consent; and,
• The absence of such documentation inferred a failure to meet the professional standards.

While the Tribunal did not conclusively find that consent was never obtained (as verbal consent may have been given but not recorded), the lack of written evidence was of significant concern to the Tribunal.

2. Why Written Consent Matters

The Tribunal noted that under the APS Code of Ethics while informed consent can be oral or written, best practice requires written documentation because:

• Verbal consent is difficult to verify retrospectively.
• Written consent ensures clarity about what, precisely, the client has consented to, including the risks of the treatment and alternatives.
• Professional guidelines (such as those from the APS) emphasise proper record-keeping to protect both client and practitioner in the event, such as the present, that consent is queried.

3. The Risks of Poor Documentation

The expert witness, Dr. Emma Collins, stated:

Providing an adjunct therapy such as floatation therapy without documented consent is unprofessional and unsafe. The lack of informed consent documented for this adjunct floatation therapy is significantly below the standard reasonably expected of someone with an equivalent level of training or experience to Mr Asher.

Even if consent was given verbally, the failure to document it left Mr. Asher vulnerable to allegations of professional misconduct. This risk was significantly exacerbated given that the treatment was irregular and effectively experimental.

Best Practices for Practitioners

To avoid similar pitfalls, practitioners should:

1. Always Obtain Written Consent for Non-Standard Therapies

• Standard psychological interventions (e.g., CBT, talk therapy) may not always require separate written consent, but adjunct or alternative therapies (e.g., hypnotherapy, floatation tanks, EMDR) should be clearly documented.
• Use structured consent forms** that outline
  • The nature of the treatment, including references to the evidentiary basis of the treatment;
  • Potential risks and benefits;
  • Alternative treatment options;
  • The client’s right to withdraw consent and/or discontinue treatment.

2. Document Verbal Discussions in Clinical Notes

If verbal consent is obtained (e.g., in an emergency or informal setting), practitioners must record:

• What was discussed;
• The client’s acknowledgment and agreement; and,
• Any questions or concerns raised.

Additionally, should any conversation be verbally initiated by a client in session, this should be recorded along with the session notes.

3. Adhere to the Professional Guidelines

The APS Code of Ethics and Ethical Guidelines emphasize:

• Principle A.3.1: Psychologists must fully inform clients about services unless an explicit exception applies.
• Principle A.3.3: Consent must cover risks, benefits, and alternatives.

Conclusion

The Asher case serves as a reminder that informed consent is not just a formality, it is a legal and ethical safeguard for both clients and practitioners. While the tribunal did not impose severe sanctions in this instance (due to evidentiary limitations) instead opting for a reprimand, the case reinforces that written consent remains best practice in protecting against allegations of professional misconduct.

Practitioners who fail to implement proper consent processes risk not only disciplinary action but also reputational damage. By adopting clear documentation processes, practitioners can ensure compliance with their ethical standards and avoid the risk of disciplinary action.