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Codes of Ethics & Professional Practice

I abide by 2 Codes of Ethics & Professional Practice - those of GPTI and those of BADth. You can read both here.

11.       GPTI C0DES OF ETHICS AND PROFESSIONAL PRACTICE
11.1      Code of Ethics and Professional Practice
1.         STATUS OF THIS CODE
2.         INTRODUCTION
3.         THE NATURE OF GESTALT PSYCHOTHERAPY
4.         THE STRUCTURE OF THIS CODE
5.         CODE OF ETHICS: FUNDAMENTAL VALUES
6.         CODE OF PROFESSIONAL PRACTICE

Members’ responsibilities towards clients
6.1 Contracting with clients
6.2 Clients’ safety and confidentiality
6.3 The client-psychotherapist relationship
6.4 Members’ self care and competence to work with clients
6.5    Supervision
6.6    Advertising and public statements
6.7    Research
6.8    Responsibilities to GPTI colleagues and other professional groups
6.9    Responsibilities in law
1.         STATUS OF THIS CODE
1.1        This Code of Ethics and Professional Practice is an amended version of the Code published in the 2004 Handbook. In these Codes “Members” refers to Accredited and Trainee Members; they are bound by the conditions of their membership to work to the ethics and standards espoused in the Codes.
1.2        Ethical guidelines of the United Kingdom Council for Psychotherapy (UKCP) are incorporated in this Code.
1.3        Grateful acknowledgement is made to the British Association for Counselling for its responsible and comprehensive Code of Ethics and Practice for Counsellors, which considerably influenced the formulation of the original GPTI Code of Ethics and Professional Practice in 1994.

2.         INTRODUCTION

2.1.       The purposes of this code are as follows: -
·    To provide a common frame of reference to which Accredited and Trainee Members of the Institute adhere in managing their responsibilities to clients, colleagues and the wider community.
·    To state the standards which Accredited and Trainee Members are required to maintain in their professional practice and to encourage optimal levels of practice.
·    To inform and protect clients, the public and professional associations seeking or using the services of members.
·   To provide a frame of reference for addressing ethical issues in relation to clients, colleagues and the wider community.

2.2.       Applying this Code in situations of particular complexity requires Members to exercise careful judgement and to seek advice and support from senior colleagues and supervisors if they are not clear about how to deal with a professional dilemma. Despite conscientious and sensitive attention to resolving ethical dilemmas, it may not be possible to effect a resolution which is entirely satisfactory for all concerned.

2.3.       The Institute has procedures to manage allegations of poor or unethical professional practice. If allegations of unethical practice are proven, sanctions, including suspension or withdrawal of membership, may follow.

2.4.       As a Member Organisation of the United Kingdom Council for Psychotherapy (UKCP), the Institute is required to report to the UKCP Board the names of UKCP Members who have been suspended or expelled from GPTI.

3.         THE NATURE OF GESTALT PSYCHOTHERAPY

3.1.       Gestalt psychotherapy provides an opportunity for clients to increase awareness of themselves, their relationships with others and with the environment, and to develop their range of responses and choices.

3.2.       The basis of Gestalt psychotherapy is to encourage clients’ self support, personal responsibility and autonomy, whilst respecting their dignity and worth.

3.3       Gestalt psychotherapists work in a variety of settings; they work with individuals, couples, families, groups and organisations.
4.                    THE STRUCTURE OF THIS CODE
This Code is in two parts: -
·            The Code of Ethics that sets out the fundamental values and general principles of gestalt psychotherapy.
·            The Code of Practice that applies these values and principles in detail to the practice of gestalt psychotherapy.
        The meaning of words in this Code:-
·  “Should”, “recommend” and “advise” are used when the actions referred to are those considered representative of good practice whilst not being a current legal requirement nor an absolute requirement of membership.
·  “Must” is used to refer to actions that Members of the Institute are obliged to take.

5.               CODE OF ETHICS: FUNDAMENTAL VALUES

5.1            The relationship between client and psychotherapist is fundamental to Gestalt psychotherapy.
           Members need to acknowledge the power and influence inherent in the psychotherapeutic relationship, the likelihood that they may be recipients of numerous projections and that they, themselves, may project onto their clients out of awareness

5.2            GPTI acknowledges that it operates within an increasingly complex social environment and it values diversity and difference. GPTI also recognises the existence of oppression and discrimination, direct and indirect, inherent at every level within our society, which will inevitably be reflected in GPTI itself. Bearing this in mind, GPTI aims to treat all individuals who have links with the Institute with dignity and respect.

5.3            A clearly bounded relationship is seen as essential to the practice of psychotherapy; dual relationships with clients such as therapist/friend, therapist/supervisor, therapist/trainer and therapist/business colleague are considered unacceptable.

5.4            Clients’ welfare is the foremost concern. Manipulation or exploitation of clients emotionally, sexually, financially, politically or in any other way for the benefit of the therapist or the benefit of others is considered unethical. (See 6.3.6 and 6.3.7)

5.5            A high value is placed on enhancing and respecting the choices made by clients. As part of this, importance is put on providing clear information, for discussion, on the terms and conditions in which a psychotherapy service is offered before engaging in ongoing psychotherapy with anyone.

5.6            The practice of awarding client material maximum confidentiality and providing clients with reasonable levels of privacy, within the work-context, is considered good practice. Any limitations on either of these should be clearly communicated to clients from the outset of psychotherapy.

5.7            Whilst clients’ rights to agreed levels of confidentiality and privacy are valued, so are the fundamental rights to safety and life of the members of the wider community. Conflicts of conscience and interest between the welfare of clients and that of others may arise during the process of therapy; the psychotherapist’s judgement, following supervisory and/or legal consultation where feasible, is used to balance the rights of the parties involved as best as is possible in the circumstances.

5.8            Ongoing supervision is seen as essential in maintaining ethical practice. It is also recognised that, at times, psychotherapy support is necessary to maintain competent practice.

5.9            Gestalt psychotherapists are sensitive to the field in which the therapeutic work is taking place. Supervision and, where relevant, dialogue with colleagues, is used to negotiate this contextual field, which includes its structure and boundaries and also the aims that dominate the field, in order to ensure adequate support for competent practice. (Adapted from EAGT Codes)

5.10         The foregoing values and principles apply whether the psychotherapeutic work is undertaken in a voluntary or paid capacity.
6.                CODE OF PROFESSIONAL PRACTICE

             GPTI Accredited and Trainee Members must abide by the GPTI Code of Ethics and Practice and must be available to answer any questions concerning their practice, in the manner stated in the GPTI Regulatory Procedures.

6.1               Contracting with clients
6.1.1.    Members are responsible for informing clients about their fees, cancellation procedures, availability, supervisory arrangements and the degree of confidentiality which they offer. This should be done before a commitment is made to ongoing psychotherapy.   Any subsequent changes in the working contract should be negotiated beforehand.

6.1.2.    All members must provide information about their qualifications, experience and membership of GPTI. They must indicate that they abide by the Institute’s Code of Ethics and Practice and offer clients access to these. Trainee Members must inform all prospective clients of their professional status in the first interview.

6.1.3.    Members are responsible for informing clients if they become aware of any relevant conflict of interest at the first interview or at any stage of psychotherapy.

6.1.4.        Records ( see 6.9.3 and 6.9.4) should include:
client’s name, address and telephone number
client’s general practitioner’s name, address and telephone number
details of client’s current involvement with other professionals, including other therapeutic relationships
information about relevant health problems
a record of the clinical work

6.1.5.        Members must take into consideration the right of clients to see those records particular to them, as described in the Data Protection Act, and should be mindful of this when recording information.

6.1.6.        Where there are contractual arrangements with a third party, over the payment of therapy for example, Members must make a clearly separate contract with the third party. Any future re-negotiations would be conducted with the third party. Members should be aware that conflicts of interest may arise where a person other than the client pays for therapy. Any contract with a third party should therefore make clear that a Member’s primary duty is to the client.
6.2               Clients’ safety and confidentiality
6.2.1.        Psychotherapists should aim to provide a working environment which, within the context in which the work takes place, offers maximum privacy to clients.

6.2.2.    All client records must be kept under secure conditions to ensure privacy. (See 6.9.3 )

6.2.3.    When there is an adjunct medical aspect to the client’s condition, Members should discuss with him/her whether to seek advice from their general practitioner or other appropriately qualified professional person. Members must obtain clients’ permission before conferring with other professionals, unless there are exceptional circumstances. (See 6.1.1)

6.2.4.    Except where permitted by law, Members must maintain confidentiality both during psychotherapy and after its completion. Any disclosure of information may be made only with the client’s written consent, unless there are overriding legal, safety or ethical considerations. Members should be aware that the disclosure of confidential information is permitted by law in limited circumstances. Where necessary, members should seek guidance from the Ethics Committee and/or legal advice

6.2.5.    Should there be convincing evidence of serious risk or danger to a client, or to others, every effort should be made either to negotiate protective action by the client or to obtain the client’s informed consent to protective action by the psychotherapist. Should neither of these outcomes be agreed, then the Member should be prepared to act without the client’s consent, in order to prevent harm. The Member should be prepared to justify his or her conduct by reference to the law and any relevant guidance issued by the GPTI. (See 6.3.4 and notes on disclosures at end of document)

6.2.6.        Information about clients must be regarded as confidential. Where disclosure is deemed to be necessary, this should be restricted to information that is pertinent to the situation. This applies whether the information is obtained directly from clients or by inference.

6.2.7.        When a Member wishes to obtain relevant data about a client from other professionals or institutions, he/she must observe the rights of the client as regulated by the law. This also applies to the handling of written data regarding the client.

6.2.8.        Members should ensure that personally identifying information about clients is not revealed in overlapping networks of professional relationships. Members should refrain from making trivialising comments about their clients in any setting.

6.2.9.        Members must obtain clients’ informed consent, in writing, to the making of audio or video recordings of psychotherapy sessions; any agreement with clients must make clear that the material may be disclosed in limited circumstances – for example, where required by a court order. Members should consider the implications of power differentials and transference dynamics when discussing recording with clients. Reference may be made to the value of recordings for maintaining and enhancing the quality of service. Information given must include the following:

¨       the client’s free choice, and options to revise any agreement made, at any time in the future
¨       the purposes for which the audio or video tape is intended and the circumstances in which it would be used
¨       assurance that the material will be heard only within the context specified and by professional colleagues bound by the same rules of confidentiality
¨       client control over the material; any requests for recordings to be deleted must be respected
6.2.10. Should Members wish to have their work with a client observed, this must first be discussed and written consent obtained, on the understanding that the client has the right to withdraw this at any time.

6.2.11. When Members are unable to keep an appointment because of illness or other unforeseen events, they should whenever possible make appropriate provision for the care of clients.

6.2.12. Members must make provision for clients to be informed in the event of their serious incapacity or death and must inform clients, in advance, of the manner in which the records relating to them will be handled in these circumstances. Other considerations are the ongoing care of clients; appropriate management of confidential files and tape recordings of sessions; the procedures necessary for the closure of one’s practice in a responsible, ethical and sensitive manner and the nomination of an appropriate person to take these matters forward on the Member’s behalf, where necessary.

6.2.13 Members should consider their personal moral stance and legal duty of care in the case of receiving information about children and vulnerable adults at risk of harm. Initial contracts must clearly state these responsibilities and make clear the circumstances in which the Member will disclose information which would otherwise be treated as confidential.

6.3               The client-psychotherapist relationship

6.3.1.        Members are responsible for working in ways that promote their clients’ self-agency and affirm and enhance their capacity to make creative choices and changes in response to their evolving needs, circumstances, values and beliefs.

6.3.2.    Members must ensure that no person is discriminated against or denied access to services on the basis of his/her disability, race, gender, sexual orientation, social class, age, nationality or religious affiliations. [See GPTI Equal Opportunities Policy and relevant Acts such as the Disability Discrimination and Race Relations Acts]

6.3.3.    Members should provide regular opportunities for clients to review the terms of the psychotherapeutic contract and the progress of psychotherapy.
6.3.4.    Members do not usually act on behalf of their clients. They may decide to do so if requested specifically by their client or in other exceptional circumstances. (See 6.2.5)

6.3.5.        Members are responsible for setting and maintaining the boundaries of the therapeutic relationship. The professional relationship with clients must be managed ethically and respectfully in any circumstances where the client and psychotherapist meet outside the context of the professional relationship.

6.3.6.        Members should be aware of the powerful influences of transference and counter-transference and the potential for exploitation in the psychotherapy relationship. They must not exploit their current or past clients financially, politically, emotionally, sexually, physically or in any other way. Members must not manipulate clients in order to benefit other persons, groups or organisations.

6.3.7.        Physical contact in the therapeutic process is exclusively orientated to the welfare of the client and requires special professional reflection and care. In the handling of physical contact in the therapeutic process, the consent of the client is of primary importance, but by no means the only important factor to be considered. Sexual contact of any kind with current or past clients is considered to be unethical.

6.3.8.        Decisions about ending psychotherapy are the responsibility of both client and psychotherapist. Should the Member’s professional assessment of when to end not accord with the client’s assessment, the Member should facilitate closure in ways that allow for an acknowledgement and discussion of that difference and an honouring of the client’s views. If Members recognise that they are not working effectively with a client, they must inform the client and facilitate termination and, if appropriate, an onward referral. These negotiations should be managed responsibly and with due care and attention for the client’s well-being.

6.4               Members’ self-care and competence to work with clients

6.4.1.    Recognition of limitations is an important aspect of competency. Members must actively monitor the limits of their competence through their own psychotherapy, supervision and consultative support. They should work within their limits and if in doubt consult about the advisability of working with a particular client or client group. Where necessary, they should make appropriate referrals.

6.4.2.    Members have a responsibility to themselves and their clients to maintain their own effectiveness,    resilience and ability to practise effectively. They must monitor their own personal functioning, seek help and/or withdraw from psychotherapeutic work temporarily or permanently when their personal resources are so depleted as to warrant this. Members should not work with clients when their capacity is impaired due to emotional difficulties, illness, alcohol, medication or any other reason. They should make appropriate referrals if necessary.

6.4.3.    Trainee Members must obtain the agreement of their training consultant and supervisor to work with clients.

6.4.4.    Members should take all reasonable steps to ensure their own physical safety when they engage in psychotherapy work.

6.4.5.    Practising Members must obtain professional indemnity and public liability insurance for the protection of their clients and themselves. Members are advised to obtain adequate cover for any legal action taken against them or against the owners of premises in which they work.
6.4.6.    Trainee Members must be in regular personal psychotherapy during training unless otherwise agreed with their training consultant. Other Members are required to have access to psychotherapeutic support where necessary to support and challenge their professional effectiveness.
6.5      Supervision

6.5.1.    The purposes of supervision are to provide a supportive and challenging context within which psychotherapists discuss their work, and to maximise effectiveness. Members are responsible for arranging the form and frequency of supervision appropriate to client contact hours and experience. Trainee Members must comply with the ratio of supervision to client contact hours, as specified in their training contract. It is unethical for Members to practise without regular supervision.

6.5.2     When presenting work for the purposes of supervision, members must respect the boundaries of confidentiality agreed with their clients.

6.5.3.    Members and their supervisors are responsible for ensuring that the main focus of their discussions is purposeful and pertinent to the psychotherapist’s work with clients.

6.5.4.    Members should ensure that their supervisor is not also their psychotherapist.

6.5.5.    Members who are employed by an agency or organisation are responsible for maintaining a clear boundary between concerns they take to their line manager and psychotherapeutic issues they take to clinical supervision.

6.6               Advertising and public statements

6.6.1.    Advertising by Members must be confined to their name, address and telephone number, an accurate description of the service offered, fees, training, status, qualifications and membership of professional organisations. All reasonable steps must be taken to honour undertakings given in publicity material.

6.6.2    Pre-contract and Trainee Members must not imply qualified status that they do not possess and must always describe their membership status in full. A Trainee Member must not describe himself or herself as a ‘psychotherapist’ or ‘gestalt psychotherapist’, unless granted that title elsewhere. Members must not describe themselves as affiliated to an organisation in a manner which inaccurately implies sponsorship or authorisation by that organisation.

6.6.3.    Testimonials must not be included in publicity material. Statements which imply services superior to those provided by others must not be made.

6.7               Research

6.7.1          Members must obtain clients’ informed, written consent to the presentation or publication of case material to colleagues, for training, research or educational purposes. Clients must be informed that they have the right to withdraw their consent and to specify the conditions under which they agree to the material being used. When using case material, members must always ensure that their client’s identity is protected by changing biographical and other identifying details.

6.7.2          When engaged in research in relation to their psychotherapeutic work, Members must conduct this in ways which are respectful, legal and ethical throughout. They should use their data accurately and restrict their conclusions to those compatible with their methodology.

6.8               Responsibilities to GPTI colleagues and other professional groups
6.8.1          Members should conduct themselves in ways, which promote public confidence in psychotherapy. Reference made to, or about, other psychotherapists or professionals should not be made with the purpose or likely outcome of demeaning the other.

6.8.2          If a Member has experienced the unethical conduct or below-standard professional practice of another Member, he or she has a professional obligation to raise the matter in the manner described in the Institute’s Regulatory Procedures
6.8.3          If a Member learns through another party of the below-standard professional practice or unethical conduct of another Member, he or she must raise the matter, as a special and allowed form of third-party allegation, in the manner described in the Institute’s Regulatory Procedures. If the information is acquired within a confidential relationship, the Member should seek consent of the client. Where this is not possible, or consent is refused, the Member should seek further advice and should consider whether disclosure is ethically and legally justifiable. P
6.8.4          If a Member perceives that another Member is no longer fit to practice for reasons of deteriorating health, he or she must respectfully alert that Member to the fact and to his/her responsibility to withdraw from practice. Failure of the Member to withdraw from practice would require further action as set out in the Institute’s Regulatory Procedures.

6.8.5          Members should not accept someone as a client who is already the client of another psychotherapist, unless both psychotherapists agree that this is appropriate.

6.8.6          It is normal practice to acknowledge referral of a client from a colleague or other professional.

6.8.7          Members should accept their part in exploring and resolving conflicts of interest between themselves, the Institute and other agencies, especially where this has implications for clients.

6.9        Responsibilities in law

6.9.1.    Members must work within the legal framework of the part of the United Kingdom in which they practice, and within that of the European Court of Human Rights.

6.9.2.    It is the responsibility of Members to be conversant with the legal implications of their psychotherapeutic work.

6.9.3.        Records whether hand-written or stored on a computer are subject to statutory regulations under the Data Protection Act 1998 and subsequent revisions. Anyone holding records as in 6.1.4 has, by law, to register with the Data Commissioner. Members may need to obtain the consent of clients to the transfer of their personal data to another organisation in the event that the practice is closed down

6.9.4.        Members would be advised to adopt an appropriate policy regarding the retention of records having considered such factors as relevant legal limitations (e.g. Data Protection Act), the nature of the risks involved, the purposes for which the records would be retained and the periods, as stipulated in GPTI, or relevant other, Regulatory Procedures, in which allegations may be brought.

6.9.5.        Members must report to the Executive Council of the Institute if they become the subject of any criminal proceedings or any civil proceedings brought against them in relation to their work as psychotherapists

6.9.6.        Members may be obliged to involve the police where they become aware that a crime has or will be committed, and in some circumstances Members will be legally obliged not to inform the client that they are so doing. Members should seek supervisory and legal advice in all of these circumstances.

6.9.7.        A Member should not generally disclose personal information to a third party such as a solicitor, police officer or officer of a court without the client’s express consent, except in limited circumstances. Members should request that any such third party confirms the basis on which the request for information is made and then seek advice from the Ethics Committee and/or legal advice. Members are advised that they can be called before a court to speak to a report that they have provided.

6.9.8.        Members should take care to maintain a balance between the therapeutic contract and any applicable legal and employment obligations in cases of abuse or serious lack of care involving minors and vulnerable adults.

NOTES

            Disclosures:

Disclosure of personal information without consent may be justified in the public interest where failure to do so may expose the client or others to risk of death or serious harm. Where the client or others are exposed to a risk so serious that it outweighs the client’s privacy interest, you should seek consent to disclosure where practicable. If it is not practicable to seek consent, you should disclose information promptly to an appropriate person or authority. You should generally inform the client before disclosing the information. If you seek consent and the client withholds it you should consider the reasons for this, if any are provided by the client. If you remain of the view that disclosure is necessary to protect a third party from death or serious harm, you should disclose information promptly to an appropriate person or authority. Such situations arise, for example, where a disclosure may assist in the prevention, detection or prosecution of a serious crime, especially crimes against the person, such as abuse of children.

In the event of an allegation being lodged against a Member, the contract for confidentiality changes in order to allow all parties to present their cases. Members may consider including this fact in their initial contract.
Where circumstances allow, you should seek advice from the Ethics Committee and/or and appropriately qualified legal adviser as to whether, in such circumstances, disclosure can be justified before the law and the Institute. Ultimately, only the courts may determine whether a disclosure was justified. However, GPTI may also ask you to justify your decision if a complaint is made. If there is clear consent from the client to the proposed disclosure, it is likely to be permitted. However, queries generally arise where the circumstances do not fall neatly within the anticipated circumstances.


These pages will be regularly reviewed. Any suggestions for modification of the Code of Ethics and Professional Practice should be sent to the Chair of the Ethics Committee.

© GPTI January, 2005

BADth CODE OF PRACTICE:

THE CLIENT

Dramatherapists have moral and ethical responsibilities towards clients and must ensure that they practise with integrity. Dramatherapists should monitor their practice to ensure that they are not making discriminatory decisions based upon a client’s race, class, culture, nationaliy, gender,age, marital status, physical or mental ability, physical appearance, religion, political opinions or sexual orientation. Respect for clients should be maintained in verbal and written reports and notes.
Confidentiality Generally, information received from the clients should be treated as privileged and confidential both during and following the completion of therapy.
However, there are circumstances in which information must be shared with other people or organisations outside of the therapy relationship. The client should be informed that communication of confidential information is permissible in the following circumstances:
·        in discussion with the Dramatherapist’s supervisor, co - therapist or supervision group;
·        with other professionals related directly to the case/care of the client;
·        when a group member has reason to believe that a breach of professional conduct has taken place and intends to inform the regulating body;
·        when the therapist considers that the client, another individual or group of people or society at large is deemed to be in danger of serious harm;
·        when the client is deemed by the therapist to be at serious risk from self harm;
·        when the practitioner is aware of child protection issues being raised in the course of the therapy, even though the therapist may not have direct contact with the child;
·        when a court order to reveal information is issued. Failure to provide information may place the practitioner in contempt of court.
Child Protection
Dramatherapists must be conversant with legislation relating to child protection and the rules of the organisation/venue in which the therapy takes place.
Practitioners have a legal obligation to protect children in any situation where the parents or carers are not offering them basic protection. If a practitioner has cause to suspect that, a child is being abused or at risk of abuse, s/he has a duty to refer that concern to her supervisor, to specialist staff/line manager within the organisation and, if necessary, to Social Services, or the police.
In a situation where there appears to be a conflict of interests the needs of the child must take priority.
The main areas where action must be taken are:
Physical Abuse-is defined as actual or likely physical injury to a child, or failure to prevent physical injury (or suffering) to a child. It can include definite knowledge or reasonable suspicion that an injury was inflicted, or not prevented because of failure to exercise reasonable care by a carer; physical abuse, includes deliberate poisoning;
Sexual Abuse The Department of Health Guidelines (1991) define sexual abuse as ‘actual or likely sexual exploitation of a child or adolescent’. It involves the use of children for the sexual stimulation of adults and covers participation in any sexual activity by a dependent, developmentally immature child who is unable to understand the nature of the activity; Emotional Abuse-is the actual or likely severe adverse effect on the emotional and behavioural development of a child caused by coldness, hostility, or rejection’ or severe over protection; Omission of Care- neglect is defined as the persistent or severe negligence of care. For example, exposure to danger, including cold and starvation, which result in serious impairment of the child’s health or development. Consent
Clients should consent to Dramatherapy interventions prior to the start of therapy. Dramatherapists working with children must comply with the current legislation relating to consent to therapy.
In order to provide informed consent the client must understand the nature of dramatherapy interventions and the relevance of the art form to therapy.
Communications systems relevant to the client’s level, scope, and/or method of understanding should be employed.
Dramatherapeutic interventions may involve appropriate touching of other clients and the therapist(s), or touch by the therapist. The nature and purpose of touch must be explained and informed consent sought prior to any physical contact is initiated. A client’s expressed wish not to be touched should be respected.
A dramatherapist using (or witholding) touch in a therapeutic setting should discuss these decisions in clinical supervision.
In the case of children, a child’s parents/guardian/carer and service purchasers should be communicated with before Dramatherapy commences. The issue of touch should be negotiated with the child during the therapeutic process unless specific rules relating touch are set by the employers. However, Dramatherapists working within the education system should make certain that they adhere to the rules concerning touch of the Local Education Authority, as well as those of the education establishment itself.
The client’s specific consent will be sought for:
·        using case material for publication, teaching or broadcasting. Publications must be presented in a way that preserves the client’s anonymity. (if the client is unable to provide informed consent, the practitioner must obtain consent from a designated guardian or other person able to speak on the client’s behalf) In the case of visual recordings material must be pre viewed by clients prior to distribution. Participants must have the right to edit, modify or delete any material in which they appear. Consent may be withdrawn at any point. Legal advice should be sought for instances of public broadcasting of sessions.
·        conveying information to the client’s family, employer or any other organisation, agency or person seeking information.

Where the client is deemed incapable of giving consent, for example, a person with organic brain injury, the therapist must seek clarification on the current laws.
Information
Dramatherapists should provide clients with relevant information about their:
·        qualifications and details of state registration;
·        areas of expertise and experience;
·        code of practice.

Dramatherapists must not misrepresent their professional qualifications, experience and memberships of organisations or institutions.
Remuneration
·        Dramatherapists must not offer a commission, fee or privilege to any person making a referral. Clients must not be offered any privileges for agreeing to participate in research or publication or other presentation of their case material.
·        Dramatherapists must not use information received in their relationships with clients for personal gain.
·        Dramatherapists in private practice must state their fees clearly.
Contracts
Therapy and risk assessments should be completed in order to decide whether it is appropriate to offer therapy to clients.
A clearly written contract that outlines the nature and form of the proposed therapy must be agreed with the client. This contract should be reviewed regularly to ensure that the client’s needs and welfare are prioritised. Dramatherapists in private practice must include details of fees, methods of payment and financial arrangements for cancelled or missed appointments.
When working with children, Dramatherapists must make sure that the child or young person understands and contributes to their joint contract for the work. When appropriate, pictures and other non-verbal ways of sharing contractual meaning may be used. This may also apply to adolescents and adults who are unable to read and write.
Appropriate time and attention must be given to the conclusion of the therapy. Follow up arrangements should be contracted in a clear manner.
Boundaries
Dramatherapists should be aware of professional boundaries with all clients. Role awareness is of paramount importance in the therapy relationship. Under no circumstances should a sexual relationship be formed with a client or ex client. Social contact with clients should be avoided.
Boundaries can be compromised when the dramatherapist has a dual relationship with someone they are working with. A dual relationship exists if, for example, a client is referred who is known socially to the dramatherapist or if a former client asks for supervision, having themselves trained as a therapist. Any such dual relationships should be discussed in supervision and the results of the discussion recorded before the dual relationship is either proceeded with or terminated.
Dramatherapists providing therapy for trainee Dramatherapists should not have contact with the trainee in any other role connected with the training. It is acknowledged that the therapist and trainee client may come into contact with each other during events organised by BADth. This area should be dicussed during the contracting period.
The working environment should comply with health and safety standards. The therapy space should be adequately sound proofed and provide a level of privacy compatible with a confidential therapy relationship.
When working with children, the dramatherapist may be required, by some organisations, to work in a room or space where there is a viewing window at adult height so school staff/managers may see them at work. This is to protect the safety of the work, the child and the dramatherapist.
All artefacts or written material created by the client during the course of therapy should be treated as confidential and stored in a secure container between sessions. Clients may choose to keep or destroy some items at the end of the therapy. These choices must be recorded in the therapist’s notes. Items remaining in the therapist’s care should be stored for the same period as notes.
Dramatherapists ensure that they do not use their professional relationships with clients to satisfy their own emotional needs.
Clients should be informed of any aspects of the therapy that might affect the client’s participation. For example, the use of video-tape or other recording devices, one-way mirrors or trainee observers. Informed consent must be obtained in method compatible with the client’s abilities to read and write. The client should be informed that they may withdraw consent at any time without prejudice.
Positive and negative feelings towards clients should be discussed with a clinical supervisor.
PROFESSIONAL CONDUCT
Dramatherapists respect the training, practice, and the experience of other professionals and, are aware of, and respect the community in which they work.
Dramatherapists shall, at all times, maintain responsibility for deciding on the suitability of referrals for dramatherapeutic interventions, whatever the source of referrals. Freelance dramatherapists and others not working as part of a therapy team should ensure they establish a clear working relationship not only with the client but, preferably, with his/her consent, with any other professionals involved in his/her care.
Dramatherapists comply with the laws of the country in which they work and behave with a high degree of personal integrity as exemplified by fairness, honesty, consistency and truthfulness combined with the use of discretion.
Dramatherapists do not work while under the influence of alcohol or other substances, which may effect their judgement and perceptions.
Clinical supervision is essential to good practice and Dramatherapists maintain regular supervision in addition to monitoring and reviewing their work alone and with peers.
Dramatherapists acknowledge the boundaries of their personal competence and, if in doubt, are prepared to seek the advice of someone with appropriate qualifications and experience.
Dramatherapists recognise the need for ongoing professional development and actively seek ways to increase their knowledge. Dramatherapists must maintain an awareness of developments in research and clinical practice, for example by reading professional journals or attending conferences and workshops.
Dramatherapists should recognise that the personal distress that may arise as part of an agreed treatment process is distinct from physical or mental distress occasioned by malpractice or inhumane or cruel behaviour.
Dramatherapists are aware of and comply with the Human Rights Act 1998, and are conversant with any other legislation relevant to their area of work.
Any concerns about a colleague’s behaviour or conduct should be reported to the relevant personnel. Dramatherapists must be conversant with the Public Interest Disclosure Act/Order (1999).
The Dramatherapist is responsible for making sure that he/she is adequately insured through Professional Indemnity Insurance.
Dramatherapists are encouraged to research their own practice and to facilitate the research of others. Such research must be within appropriate guidelines for research governance and within any code of research ethics adopted by BADth.
RECORD KEEPING
Record keeping is an integral part of Dramatherapy practice. The term ‘records’ includes:
written records;
photographs, slides, and other images;
microform (i.e. fiche / film);
audio and video tapes, cassettes, CD-ROM;
E mails;
digital records;
computerised records.
Telephone communications with or about the client should be recorded in the notes. Records should not include abbreviations, jargon, irrelevant speculation, and offensive statements. A clear record of all therapy sessions, and communications with clients or about the client, must be maintained for:
continuity of treatment;
clarity of thinking;
analysis of process and content;
presentation for supervision;
communication with colleagues;
clarity in the case of litigation.
The Access to Health Records Act 1990 gives clients the right to access manual health records made after the 1st November 1991.
The Data Protection Act 1984 gives clients access to computer held records. It also regulates the storage and protection of client information held on computer.
In some cases, information can be withheld from a client. Further information can be found in Guide to the Access to Health Records Act 1990 published by Government Health Departments.
Dramatherapists working within organisations must establish under which circumstances other professionals will have access to dramatherapy notes. All records may be requested for inspection if any of the exclusions to confidentiality are activated.
Guidelines for the retention of records can depend on current legislation and health services policy statements. As a guide, records should be kept for eight years after the termination of therapy.
In the case of a minor, notes should be retained until the clients 25th birthday or 26th if theyoung person was 17 at conclusion of treatment, or 8 years after last entry in the record, if longer, or 8 years after death if death occurred before 18th birthday.
Notes and artefacts must be destroyed in confidential conditions.
All systems for recording client work must ensure security in order to preserve confidentiality.
Private practitioners must ensure that provision for secure arrangements for storage or destruction of notes are made in case they should become incapacitated unexpectedly or die.
Disclaimer
This code of practice is not a definitive statement of British/ Scottish law.
Dramatherapists need to be aware of any pre existing guidelines, procedures or requirements that are defined in their contract(s) of employment.
Dramatherapists must abide by the laws of the country in which they practise.
BADth acknowledges the cooperation of The Sesame Institute with this revision of this Code of Practice.
Appendix 1
Guidance on the ethical issues of video taping, photographing, audio recording or filming of Dramatherapy sessions and their subsequent viewing.
The reasons for recording material can be classified into main areas: those that have a therapeutic purpose, the viewing would usually be restricted to group members and those with a direct involvement in the client’s care, training , research and public broadcasting or promotional literature.
General considerations
A clear written contract must be in place before any recording takes place. Informed consent must be obtained from clients and, in the case of people unable to provide consent, legal advice should be sought to establish whether the recording should take place. Consent may withdrawn at any point both during and after the recording.
Before recording commences, Dramatherapists should consider;
their motivations for recording therapy interventions;
the purpose of the recording;
the possible changes to the therapist/client relationship as a result of the request to record material;
any confidentiality agreements that will need to be make with any technicians involved in the recording and with potential audiences.
Before the recording is made the following items should be discussed and agreed with the client(s):
who will have access to the material?
how long will the record be kept?
who has ownership of the material?
where the recordings will be stored;
how recordings will be destroyed;
how contact with the client will be made if there is a proposal to use the recording in an area outside the scope of the original agreement;
the extent and nature of any commentary that the therapist may provide during any showing of the recording;
that the usual group conventions remain in place.
Dramatherapists must explain to clients that the nature of confidentiality will be changed when any of the material is broadcasted or shown to others, whether this is for professional or training purposes or public media broadcasting.
Dramatherapists must consider their own and the clients’ internal and unconscious processes when consent is given or refused for the group or individual therapy to be viewed by those not involved in the group process. There may be some powerful processes, which may influence decisions. Therapists should examine these areas during clinical supervision.
At the beginning of the broadcasting of any Dramatherapy interventions it is important to clarify that the material is constructed from the clients’ perspectives.
Previews of recorded work must be viewed/heard by the participants prior to distribution. Participants must have the right to request that material relating to themselves, is edited, modified or deleted.
Therapeutic Purpose
This refers to the use of recorded material, in whatever form, with clients in the therapy setting. May also include recordings or photographic images produced for clinical supervision.
Training
This area refers to material that may be used for the training of other therapists and developing a body of knowledge. This area will also include recordings or photographs taken for displays, presentations or to illustrate papers at conferences.
Dramatherapists should not involve clients who are experiencing dramatherapy for the first time for the above. Clients who have some experience and familiarity with the method are likely to have a realistic understanding of what is involved and disclosed and are therefore able to provide informed consent.
Dramatherapists should consider the possible consequences and ramifications to themselves when third parties edit any material that may be widely viewed. The therapist(s) are advised to be actively involved in editing.
Public Broadcasting
A Dramatherapist who is involved in media or promotional presentations must adhere to the following procedures:
the therapist(s) and the client(s) must be clear about the contents of contracts before agreeing to recordings. In particular it must be established whether a withdrawal of consent could constitute a breach of contract. Legal advice should be sought before contracts are signed;
clients must be recruited specifically for this purpose;
careful assessment must be made of the individual’s emotional and psychological suitability to be involved. The therapist facilitating the therapy must carry out assessments;
the intent of the broadcast must be made clear;
careful attention must be paid to the potential effect on third parties and all participants must understand the possibility of litigation;
Dramatherapists should consider the possible consequences and ramifications to themselves when third parties edit any material that may be widely viewed. The therapist(s) are advised to be actively involved in editing.
It must be clear to all participants that once the process has been completed and final approval has been given that the material becomes the property of the broadcasting or production company.
Promotional Literature
This area may include recordings or photographs of clients or artefacts made during therapy. Areas of display include Websites, information brochures, or other promotional materials. Written consent must be obtained from the client. In the case of clients’ being unable to write, consent must be recorded in an appropriate form. In the case of minors, a guardian’s consent must be obtained.