The trial at the center of Malicka’s novel raises important questions about the state of mental healthcare in the United Kingdom. Though the trial is a libel case, Anna Finbow’s defense rests on the assertion that her daughter’s therapist, Jean Guest, uses unconventional practices to recruit clients into a cult under the guise of therapy. One of the defense’s central arguments draws on the fact that in the United Kingdom, the private therapy sector is largely unregulated. In Part 3, Chapter 24 of the novel, Anna’s lawyer argues before the court: “The qualifications that Ms. Guest uses as evidence of her training can be purchased on the internet this evening for under five hundred pounds […]. Truly, in twenty-four hours, your lordship could claim to be a healer, life coach, and even a therapist, giving you direct access to extremely vulnerable people” (206). As of this writing, this remains the case, as counsellors and clinical psychologists may register for accreditation with professional organizations such as the British Association for Counselling and Psychotherapy (BACP), except for certain categories of practitioners, such as art therapists, psychotherapists, dramatherapists, and music therapists, which are regulated and protected professions. However, complaint processes filed through bodies like the BACP are not legally binding, which leaves room for exploitation and abuse.

According to The Guardian, the BACP has logged a 24% increase in complaints against registered therapists since 2020, many of which revolve around the breach of professional boundaries (Hall, Rachel. “All Psychotherapists in England Must Be Regulated, Experts Say, After Abuse Claims Rise.” The Guardian, 19 Oct. 2024.) This report was substantiated by studies of legal cases like Ella Janneh’s, the first person to sue her therapist, television personality Michael Lousada, in the high court for sexual assault in 2024. The trial found that Lousada directly utilized Janneh’s traumatic childhood memories to make her experience dissociation, which he would then exploit to abuse her. Janneh testified to the severe negative impact Lousada’s crimes had on her mental health, which she then spent over eight years seeking justice for.

Members of the BACP have acknowledged that, from the perspective of practitioners, robust complaint systems, while important for minimizing harm across the industry, can spell the end of a therapist’s career (Broughton, Ellie. “The Big Issue: The Truth About Harm in Therapy.” Therapy Today, Apr. 2025.) In one 2021 case, a registered therapist named Susie Jamieson received a complaint that severely impacted her practice and livelihood. In Malicka’s novel, Jean Guest makes a similar argument during the trial, indicating that Anna’s defamatory statements have scared away many of Jean’s clients. Jamieson indicated that a major issue relating to the complaints process is the lack of clarity over what constitutes harmful practices or behavior in the therapy space. Practitioners are prone to make mistakes over the course of their services, but not all of these mistakes are harmful enough to merit disbarment. Jamieson has since worked with many other therapists in the organization, who rely on her insight and experience to guide them through the process of contesting complaints.