You are here: Home > About ACAT > Policies and official documents > Code of Ethics and Practice

ACAT Code of Ethics and Practice

Revised and Amended.  Approved at ACAT’s AGM on: 11 July 2014

Revised October 2018; October 2019; October 2023

INTRODUCTION

The following is intended to guide the ethical and professional conduct of members and trainees of the Association for Cognitive Analytic Therapy (ACAT), described here as ‘therapists’, to promote safe and effective practice. It is also intended to inform members of the public seeking and using services, described here as ‘clients’, of the standards of conduct they can expect.

The nature of the therapy environment is rapidly evolving with more use being made of technology in therapy and a lot of therapy taking place online. This raises particular ethical concerns requiring special consideration for therapists and members of the public alike, we have indicated the main considerations throughout this Code.

The Principles and Practice set out in this Code should be read in conjunction with relevant ACAT documents providing further guidance. These are listed below and are available online via the ACAT website.

ACAT Policies and Official Documents

Supervision Requirements across the Organisation

Safeguarding Vulnerable Adults and Children

Equality and Diversity Policy

Continuing Professional Development Policy

Guidance on Use of Social Media for ACAT Members

Supervision Contract – available to Members under CAT Tools

Lone Working Policy – available under Policies and Official Documents (link as above)

GDPR Privacy Policy – Template for Members – available to Members under CAT Tools

Appointment and Duties of a Professional Executor – available to Members under CAT Tools

Online Therapy Guidance – available to Members under CAT Tools

PURPOSE OF COGNITIVE ANALYTIC THERAPY

Cognitive Analytic Therapy (CAT) aims to relieve psychological distress by enabling clients to develop a shared understanding of the patterns of thought, feeling, and activity which maintain that distress. Where self-limiting patterns are identified the possibility of alternative new patterns opens up. When working in person or virtually, the therapeutic relationship established between therapist and client is fundamental to the building of a shared understanding.

GUIDING PRINCIPLES

• The therapist's central professional concern is the client's wellbeing.
• The Code is developed to avoid the risk of harm to the client and harm to the therapist.
• The therapist should be guided in their work by ACAT's Equality and Diversity Policy.
• This Code is not primarily intended as a restrictive rule book but rather guidance for establishing a safe and effective place for creative psychotherapy to take place.

ADDITIONAL OBLIGATIONS

Therapists with a core mental health profession will also be guided by the codes and regulations of their professional or regulatory body or their employer where relevant.

STRUCTURE, PURPOSE AND LIMITS OF THE CODE

Based on experience, the code identifies situations where harm to a client is possible. It also identifies situations where there might be conflict between different needs, expectations or understandings. To help in these situations a number of key principles have been identified. Each principle is then described in more detail to explain what this means in practice. The therapist has an obligation to know about, and to act according to these principles.

BREACHES OF THE CODE

Where a breach of this Code is perceived by either a client or a fellow member of ACAT, the association has a Concerns and Complaints Procedure to investigate the breach and take appropriate action if it is found that a breach has occurred. Therapists need to be aware of potential breaches when working across different countries which may have different legal jurisdictions.

WHO THE CODE APPLIES TO

This Code of Ethics places the same obligations on psychotherapist members, practitioner members and trainee members of ACAT. This Code also applies to the members of the Ethics Committee in the course of their duties within the committee.

PRINCIPLES AND PRACTICE

1. The Well-Being of the Client

a. The first and most basic principle of this Code is that the well-being of the client is the central concern of the therapist. The therapist should not exploit their client in any way including sexually, financially, emotionally or cause harm of any kind.

b. The therapist should familiarise themselves with the differences between ‘online’ and ‘face to face’ psychological therapy and the impact that either can have on the relationship between therapist and client and the therapeutic process.

2. Boundaries

It is essential to be aware of the boundaries of therapy and to limit relationships with clients to the therapeutic setting.

a. Social contact with clients should be avoided wherever possible. The therapist should not take on members of their family, friends, or colleagues as clients.

b. The therapist should not enter into a sexual relationship with any current or past clients.

c. The therapist should carefully consider possible implications of entering into dual or multiple relationships. This includes via social media. The therapist should make every effort to avoid entering into relationships that risk confusing an existing relationship. For example, dual or multiple relationships could be social or commercial between the therapist and client, or a supervisory relationship which runs alongside the therapeutic one. When dual or multiple relationships are unavoidable, for example in small communities, the therapist takes responsibility for clarifying and managing the boundaries and confidentiality of the therapeutic relationship.

d. Boundary issues may become amplified or increasingly complex in the digital world, with increased availability of and accessibility to personal information. The therapist should ensure that they are aware of the implications of any digital aspect to their work and of their online presence in order to protect themselves and their clients.

3. Contractual Arrangements

The process of informed consent takes place through a shared written contract. This broadly includes the parameters of the work you will do together including times and dates, what will happen if the therapist is suddenly unavailable, financial arrangements and parameters of confidentiality. There are specific contractual considerations which must be included when offering online therapy.

a. When working in private practice you must have a named professional colleague who will contact your clients in the event of your sudden unavailability. This must be included in your contract with the client in accordance with ACAT guidance describing duties of a professional executor.

b. For those practitioners working independently, normal practice is to keep paper and electronic records of clients for 6 years. This arrangement should be discussed with clients in advance and recorded in the client contract. Other arrangements for retention of records should similarly be discussed and recorded in advance with clients.

c. A therapist working via technology needs to confirm arrangements with their insurer for suitability to offer therapy.

4. Confidentiality

The therapist-client relationship is one in which the client should feel confident that the fact that the client is having therapy and the content of the therapy is private and confidential.

a. In general, and subject to the requirements of law, the therapist must take care to prevent the identity of individuals being revealed deliberately or inadvertently, without their expressed permission. The client should be informed at the outset of therapy of the limits of and exceptions to confidentiality, especially in the light of the multiple methods of digital communication. As a therapist you should be aware of the privacy statements of the technologies and platforms you are using.

b. The therapist should take all reasonable steps to ensure that colleagues, staff and trainees with whom they work understand and respect the need for confidentiality regarding any information obtained and act in line with their Trust’s or organisation’s policies relating to this.

c. In exceptional circumstances, where there is sufficient evidence to raise serious concerns about the safety or interests of clients, or about others who may be threatened by the client’s behaviour, the therapist may take such steps as are judged necessary to inform appropriate third parties without prior consent. Wherever possible prior consent should be sought. The therapist must first consult a manager from their employing organisation where relevant, an experienced colleague or supervisor, unless the delay caused by seeking this advice would involve a significant risk to life or health. The client should be informed of this action where possible.

d. The therapist should be having supervision and will discuss their work with their supervisor. On occasions there may also be a need to share information with other health professionals. Discussion of the client in these contexts will be subject to the same rules of confidentiality as well as local trust, employer or organisational guidance.

e. With regard to research and publication, the therapist is required to safeguard the welfare and anonymity of clients when any form of publication of clinical material is being considered. Consent must be obtained where possible. Any written or verbal presentation of clinical material must preserve the anonymity of the client.

f. Similarly, the therapist must not publish any information on social media which could identify or expose a client, including information from which only the client would recognise themselves, without the client's consent.

g. All client information must be stored and safe guarded in keeping with General Data Protection Regulation (GDPR).

h. All of the above should be made clear in any contractual arrangements between therapist and client.

5. Supervision

The therapist must arrange for supervision of their clinical work in keeping with ACAT guidelines.

a. The purpose of supervision - amongst others - is to ensure the efficacy of the work with the client and that the standards of the ACAT Code of Ethics are maintained.

b. Information shared through supervision or professional support is subject to the same rules of confidentiality described above.

6. Limitations on Effectiveness

The therapist should be aware of the limitations on their ability to offer an effective service. This includes:

a. The scope of psychotherapy as a method of relieving distress:  where there are clear grounds that other interventions would be of benefit to the client this should be discussed with the client as a preferred way of relieving psychological distress.

b. The extent of their professional competence:  a therapist should be involved in regular practice, and be engaged in Continuing Professional Development (CPD) as described in the ACAT CPD Policy.

c. Therapists must ensure that they have the necessary skills and technological competence to provide online therapy, and undertake additional training where necessary before offering the service.

d. The therapist must not make false claims as to their competence or training. The therapist should not claim qualifications they do not have.

e. The therapist must actively monitor their personal physical and mental wellbeing. They should seek help where appropriate to assess whether they can continue to provide therapy.

7. Appropriate Environment

Therapists have a responsibility to ensure they are working within an appropriate environment.

a. Clients should be seen in appropriate surroundings providing privacy, security, and comfort.

b. Therapists must satisfy themselves that they are covered by indemnity arrangements against claims for damages from alleged negligence or accidental injury whether in their private practice or in the work which they undertake for an employer. The therapist should be aware of their own personal safety needs in relation to lone working.

8. Professional Relationships

Therapists work within a network of services and need to work with these when appropriate.

a. Therapists should discuss with clients what contact the clients have had with other helping professions.

b. Therapists need to consider where the service they offer may conflict with the help offered by other professionals.

c. Therapists need to consider when communication with other professionals involved in the client’s care may benefit the client.

d. Where there is an appropriate need to contact other professionals, permission should be sought before the therapist makes contact. (Subject to paragraph 4c above).

9. Research

Any research involving clients will be carried out under the relevant research governance and ethical frameworks of the body that is overseeing the research (e.g.: University or NHS Trust) so that fully informed client consent is obtained.

10. Obligations and Accountability to the Profession

a. The therapist should not have been refused membership of, or have been struck off the register of, the appropriate body of their core profession.

b. The therapist should behave in a professional manner and refrain from any behaviour which may undermine public confidence in either their role as a therapist, or the profession as a whole. This includes on public forums such as social media.

c. Where a therapist perceives a colleague is acting in breach of this Code of Ethics, they have an obligation to raise the matter with the person and/or their supervisor or manager or notify the appropriate professional body.

11. Publicity

In advertising their services, the therapist should not make unwarranted claims.

a. Advertising should be confined to a statement of name, relevant qualifications, address, hours available, fees etc. Descriptions of the service offered should be brief and should not be evaluative as to their quality or uniqueness. The therapist should not advertise services in a way likely to encourage unrealistic expectations about the effectiveness of the services offered.

b. The therapist must not use testimonials from clients in any advertising material.

12. Risk

Therapists need to work within the risk management and safeguarding frameworks of the law, ACAT, their employers, local authorities and other regulatory and professional bodies that define the context in which they are practising.

ACAT offers additional and separate guidance around risk in certain areas for example: Safeguarding Vulnerable Adults and Children and Working Online. The therapist should familiarise themselves with these as appropriate.

13. Equality and Diversity

a. The therapist must familiarise themselves with the ACAT Equality and Diversity Policy.

b. The therapist undertakes to actively consider issues of difference and associated power dynamics as these affect all aspects of their work. The therapist accepts that power and privilege are part of all relationships. They should engage in a continuing process of self-inquiry and professional development to ensure that power or privilege is not used in any way to the detriment of the client or themselves. They should ensure that they work in anti-discriminatory ways.

c. Therapists should ensure that they undertake any relevant CPD in relation to issues of equality and diversity in a timely manner.

 

Approved at ACAT’s AGM 11 July 2014.  This revision October 2023.

To be reviewed 2024 and thereafter annually.

News from ACAT

Gemma Harris ACAT has received the sad news that one of our members, Gemma Harris, has recently passed away....

Click to read all news