ACAT Code of Ethics and Practice: Training and Supervision

Approved by ACAT Membership and Council and all Committees April 2009

Introduction

The purpose of the Code is to establish and maintain standards for trainers and supervisors who are members of ACAT and to inform and protect therapists seeking CAT supervision and training.

All members of this Association are required to abide by the main Code of Ethics governing the relationship between therapist and client. This Code of Ethics and Practice for Supervision and training should be read as an extension (covering the conduct of supervisors and trainers) of the underlying principles already set out there. Whilst this Code is not definitive, it aims to provide guidelines for good practice and has application in particular to supervisors and trainers recognised by ACAT.

1.0  Purpose of CAT Training and Supervision

Training is a means of establishing and maintaining the understanding of and competence in the principles and practice of Cognitive Analytic Therapy. Any particular element of training exists within a range of educational purposes and qualifications and the trainer should ensure a clear account is given to trainees of the level, application of and limitations to the training provided. A clear written account of the aims and objectives, methods and where appropriate, means of assessment and examination, should be made available to and discussed with both prospective and actual participants to any training.

Supervision is a formal and mutually agreed arrangement for CAT practitioners and therapists to discuss their work regularly with someone who is an experienced and competent CAT therapist and familiar with the principles and practice of supervision and training. The task is to ensure and develop the efficacy of the supervisee’s CAT practice. Supervision provides supervisees with the opportunity on a regular basis to discuss and monitor their work with clients. It should take account of the setting in which the supervisee practices.

The supervisory relationship has areas in common with, as well as differences from, the therapeutic relationship. The supervisor shares in common with the supervisee a central concern for the well being of her client. Supervision is intended to ensure that the needs of clients are being addressed and to monitor the effectiveness of therapeutic interventions. However, the focus of the supervisor’s attention is on the professional competence and development of the supervisee, for it is through the work with the supervisee that the client’s well-being is protected.

Supervision is a formal collaborative process intended to help supervisees maintain ethical and professional standards of practice and to enhance their effectiveness and creativity as therapists and practitioners. It is essential that the supervisor and supervisee are able to work together constructively as supervision includes both supportive and challenging elements.

2.0  Breaches of the Code

The trainer/supervisor has an obligation to be acquainted with and to act in accordance with these principles. Where a breach of this Code is perceived by a supervisee, trainee or a fellow member of ACAT, the Association has a Complaints Procedure in order to investigate such a breach and to take appropriate action should it be found that a breach has occurred.

3.0  Terminology and Definitions

Training is the term that will be used throughout this Code and refers to all aspects and levels of training and education in Cognitive Analytic Therapy including introductory courses, skills courses, practitioner and psychotherapy training and continuing professional development. Trainer refers to both established and trainee trainers. The word “trainee” stands for all kinds of participants in training whether taking part in a formally assessed course, an introductory course or post qualifying training.

Supervision is the term that will be used throughout this Code and refers to supervision in Cognitive Analytic Therapy. It is also known as consultative support, clinical supervision or non managerial supervision. It is an essential part of good practice for CAT therapy. It is different from training, personal development and line management accountability though it may contain elements of each. Appropriate management of these issues should be observed. Where the feminine pronoun is used it is intended to cover both male and female. The word “client” stands for both patient and client. The supervisor should normally be a practising and experienced CAT practitioner or therapist.

4.0  Non-exploitative and anti-discriminatory practice

Trainers/supervisors are expected to treat trainees/supervisees with integrity, impartiality and respect. They must recognise, and work in ways that respect the values and dignity of supervisees and their clients with due regard to issues such as status, race, gender, age, beliefs, sexual orientation and disability.
a.  The trainer/supervisor has a responsibility to be aware of her own issues of prejudice and stereotyping and particularly to consider ways in which these may be affecting the training/supervisory relationship. The trainer/supervisor has a responsibility to make such issues explicit where appropriate.
b.  The trainer/supervisor needs to be alert to any prejudices and assumptions that supervisees reveal in their work and to raise awareness of these so that the needs of clients may be met with sensitive recognition and appreciation of difference.
c.  The supervisor must not exploit her supervisee sexually, financially or emotionally or in any way.

5.0  Boundaries

It is essential to be aware of the boundaries of supervision.

a.  The supervisor and supervisees should take all reasonable steps to ensure that any personal or social contact between them does not adversely influence the effectiveness of CAT supervision.
a(i)    The supervisor must not have a supervision and a personal CAT therapy contract with the same supervisee over the same period of time.
a(ii)   Former clients should not be taken on as supervisees and former supervisees should not be taken on as clients. If a deviation form this is being considered then a supervisor must be consulted first.
a(iii)  It is unethical for the supervisor to enter into a sexual relationship with her supervisee during a supervisory contract.
b.  The supervisor has a responsibility to enquire about relationships outside the therapeutic contract between supervisees and their clients to ensure that these do not impair the objectivity and professional judgement of supervisees.
c.   The supervisor working with trainee CAT practitioners or therapists must clarify the boundaries of their responsibility and their accountability to their supervisee and to the training course and any agency or placement involved. This should include any formal assessment required.
d.  The supervisor is responsible for setting and maintaining the boundaries between the supervision relationship and other professional relationships, e.g. training and management.
d(i)   Where a supervisee works in an organisation or agency, the supervisor must clarify with the supervisee that the lines of accountability and responsibility are clearly defined in respect of: supervisee/client; supervisor/supervisee; supervisor/client; organisation/supervisor; organisation /supervisee; organisation/client.
d(ii)   The supervisor who becomes aware of a conflict between an obligation to a supervisee and an obligation to an employing agency must make explicit to the supervisee the nature of the loyalties and responsibilities involved.
d(iii)   A supervisor must make a clear distinction between line management supervision and CAT supervision. The best practice is that the same person should not act as both line manager and supervisor to the same supervisee.

6.0  Conduct of Training

6.1  The trainer must be a practising and experienced CAT practitioner.
6.2  Training should take place in an appropriately confidential and conducive setting and any client or personal details discussed should be done with respect for confidentiality and in accordance with the main Code of Ethics.
6.3  Whilst training may not have the same level of involvement as supervision and personal therapy, it is essential that both trainers and trainees are able to work together constructively in an atmosphere of personal learning and exploration. Trainers should have some familiarity with and responsibility for both educational and group processes in the pursuit of training.
6.4  The trainer is responsible for setting and maintaining the boundaries between the training role and other professional relationships such as supervision and management.
6.5  A trainer and or trainee should take all reasonable steps to ensure that any personal or social contact between them does not adversely influence the effectiveness of training for all parties involved. It is unethical for a trainer to enter into a sexual relationship with someone whilst they are a trainee.

7.0  Contractual Arrangements
The trainer should ensure as far as is possible that trainees are aware of the contractual boundaries of the training activity.

a(i)   The training status of trainees continues until graduation (or completion of training where no qualification is offered) and/or formal withdrawal from training.
a(ii)  The trainer should make known to trainees, and act in accordance with, clear procedures for the presentation, submission, assessment and examination of work associated with training and qualification in the principles and practice of CAT. This includes general arrangements such as timing, length, spacing and location of training, the nature and level of the qualification and its professional standing and limitations in relevant settings. Training should take place within surroundings that provide privacy and comfort.
a(iii) Where the training is linked to qualification or accreditation, clear consideration should be given to the recruitment of trainees with appropriate experience, qualifications, standards and aptitudes to be able to make professional use of the training.
a(iv)  The trainer is responsible for making clear and keeping to any contractual arrangements regarding appropriate setting and environment, fees, relating to employers, professional bodies and writing references. The trainer must satisfy herself that she is covered by indemnity arrangements against claims for damages from alleged negligence or accidental injury in respect of any training work or materials she offers or provides.

The supervisor should ensure as far as is possible that the supervisee is aware of the contractual boundaries of the relationship.
a(v)   This includes, day and times of meetings, arrangements for holidays, method of termination of supervision. Financial arrangements need to be clearly established.
a(vi)  The supervisor is responsible, together with her supervisees, for ensuring that the best use is made of supervision time, in order to address the needs of clients.
a(vii) The supervisor and supervisees must make explicit the expectations and requirements they have of each other. This should include the manner in which any formal assessment of the supervisee's work will be conducted. Each party should assess the value of working with the other, and review this regularly.
a(viii) The supervisor is responsible for helping supervisees to reflect critically upon their work but clinical responsibility remains with the therapist.

b.  Before formalising a supervision contract the supervisor must ascertain what personal therapy the supervisee is having or has had.
c.   The supervisor must ensure that together with her supervisee they consider their respective contractual obligation to each other, to the employing or training organisation, if any, and to clients.
d.   Where the supervisor and supervisees work for the same agency or organisation the supervisor is responsible for clarifying all contractual obligations.
e.   The supervisor must inform her supervisee about her policy regarding giving references and any fees that may be charged for this or for any other work done outside supervision time.

8.0  Confidentiality
The supervisory relationship is one in which the supervisee should feel confident that the content of the meeting is private and confidential.

a.  As a general principle, the supervisor must not reveal confidential material concerning the supervisee or their clients to any other person without the express consent of all parties concerned. Exceptions to this general principal are contained within this Code.
b.  When initial contracts are being made, agreements about the people to whom the supervisor may speak about her supervisee’s work must include those on whom the supervisor relies for support, supervision or consultancy. This is particularly relevant when providing supervision to a trainee.
c.  The supervisor should take all reasonable steps to encourage supervisees to present their work in ways which protect the personal identity of clients, or to get their client's informed consent to present information which could lead to personal identification.
d.  The disclosure of confidential information relating to supervisees is permissible when relevant to the following situations:
d(i)   Recommendations concerning supervisees for professional purposes, e.g. references and assessments.
d(ii)  Pursuit of disciplinary action involving supervisees in matters pertaining to standards of ethics and practice.
d(iii) When the supervisor considers it necessary to prevent serious emotional or physical damage to the client, the supervisee or a third party. In such circumstances the supervisee's consent to a change in the agreement about confidentiality should be sought, unless there are good grounds for believing that the supervisee is no longer able to take responsibility for her own actions or there is serious concern about the safety or interests of others who may be threatened by the client’s behaviour. Whenever possible, the decision to break confidentiality in any circumstance should be made after consultation with another experienced supervisor.
d(iv)  In the case of the latter two situations, any breaking of confidentiality should be minimised by conveying only information pertinent to the immediate situation on a need-to-know basis. The ethical considerations needing to be taken into account are:
i.   the supervisor's responsibility to the client and to the wider community.
ii.  enabling the supervisee to take responsibility for her actions.
iii. maintaining the best interests of the supervisee
e.  Information about work with a supervisee may be used for publication or in meetings only with the supervisee's permission and with anonymity preserved unless the supervisee wishes her identity to be known.

9.0  Limitations on Effectiveness

The supervisor should be aware of the limitations of the supervisee and her own ability to offer an effective service.

a.  The supervisor is responsible for helping her supervisee recognise when her functioning as a CAT practitioner or therapist is impaired due to personal or emotional difficulties, any condition that affects judgement, such as illness, the influence of alcohol or drugs, or for any other reason, and for ensuring that appropriate action is taken.
a(i)   If, in the course of CAT supervision, it appears that personal therapy may be necessary for the supervisee to be able to continue working effectively, the supervisor should raise this issue with the supervisee.
b.  The supervisor must monitor regularly how her supervisee engages in self-assessment and the self-evaluation of her work.
b(i)   The supervisor must ensure that her supervisee acknowledges her individual responsibility for ongoing professional development and for participating in further training programmes.
c.  Where the supervisor has concerns about or disagreements with the supervisee’s work which cannot be resolved by discussion between supervisor and supervisee, the supervisor should consult with a fellow professional and, if appropriate, recommend that the supervisee be referred to another supervisor.
c(i)   The supervisor is responsible for seeking ways to further her own professional development and for making arrangements for her own supervision in order to support her supervision work and to help her evaluate her competence. She is responsible for monitoring and working within the limits of her competence.
c(ii)  The supervisor is responsible for withdrawing from supervision work either temporarily or permanently when her functioning is impaired due to personal or emotional difficulties, illness, the influence of alcohol or drugs, or for any other reason

10.  Appropriate Environment

The supervisor has a responsibility to ensure that she is working within an appropriate environment. Supervisees should be seen in appropriate surroundings providing privacy, security and comfort. The supervisor must satisfy herself that she is covered by indemnity arrangements against claims for damages from alleged negligence or accidental injury whether in her private practice or in the work which she undertakes for an employer.

11.  Obligations to the Association and the Profession

The supervisor has an obligation to act in accordance with an awareness of the standing of her profession. The supervisor is responsible for taking action if she is aware that her supervisee’s practice is not in accordance with the main ACAT Code of Ethics.

11.1  Whilst the trainer does not have the same formal responsibility as a supervisor for the professional practice of trainees she should work with reference to the best interests of clients, of the professional and ethical aims of ACAT in particular and the professional standing and effectiveness of psychotherapy in general.
11.2  The trainer is responsible for withdrawing from training either temporarily or permanently when her functioning is impaired due to personal or emotional difficulties, ill health or for any other reason.
11.3  The trainer must regularly monitor the effectiveness of her work, take into account routine evaluation and seek to maintain a high personal standard of continuing professional development. The trainer should put in place procedures for peer review of the effectiveness of their training and seek appropriate consultation in respect of any difficulties she may encounter whilst doing training. The trainer is responsible for working within the limits of her competence and should not make inappropriate claims regarding CAT or other models of psychotherapy.

Approved by ACAT Membership and Council and all Committees April 2009

2014 ACAT AGM

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