Revised and Amended. Approved at ACAT’s AGM on: 11 July 2014
Revised February 2018
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’. It is also intended to inform members of the public seeking and using services, of the standards of conduct they can expect.
Purpose of Cognitive Analytic Therapy
Cognitive Analytic Therapy (CAT) aims to relieve psychological distress through enabling clients to develop a shared understanding of the patterns of thought, feeling, and activity which maintain that distress. Where self-limiting patterns can be identified the possibility of alternative new patterns opens up. The therapeutic relationship established between therapist and client is fundamental to the building of a shared understanding.
The primary guiding principle of this Code is that the therapist’s central professional concern is the client’s well-being. In his/her work, the therapist acts impartially, putting aside personal considerations and demonstrating a respect for the client’s autonomy. The therapist should be guided in his/her work by an awareness of ACAT’s Equality and Diversity Policy.
The Code offers additional protection to that offered by the legal and regulatory structures in place to safeguard all citizens and assumes that the therapist will be acting in a lawful manner towards his/her client. It aims to provide a framework for addressing the complex issues arising out of the psychotherapeutic relationship. It aims to protect the client from harm and also to provide guidance as to what constitutes harm. The Code also aims to offer protection to the therapist from unjust allegations of harm.
Therapists have obligations not only to their clients but also to their profession. Therapists with a core mental health profession will also be guided by the codes and regulations of their professional or regulatory body (eg: UKCP, GMC, HCPC, NMC, and others). Where employed, they will also be obliged to act within the policies and procedures of their employing organisations (eg: NHS Trusts). This Code addresses the relationship between the therapist and his/her colleagues, his/her profession and the other helping professions. The Code gives consideration to issues to do with advertising of services, research, and publication.
Structure, Purpose and Limits of the Code
The Code embodies the experience of the profession in establishing areas where harm to the client is possible or where conflicts between principles make assessment of the most advantageous course of action complex. This experience is distilled in an interconnected system of distinct principles. Each principle is followed by a more detailed description of some of its practical consequences. The practical consequences outlined cannot be comprehensive and address all situations but are intended as guidance to help therapists to balance out competing demands. It should not be interpreted as a restrictive rule book but rather as a method for establishing a safe and effective place for creative psychotherapy to take place.
Breaches of the Code
Therapists have an obligation to be acquainted with, and to act, in accordance with these principles. 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 in order to investigate such a breach and take appropriate action should it be found that a breach has occurred.
Who the Code Applies to
Membership of ACAT is gained after successful completion of a Practitioner Training. Additional training is required in order to be recognised as a Psychotherapist and registered by the United Kingdom Council for Psychotherapy. This Code of Ethics imposes the same obligations on psychotherapist members, practitioner members and trainee members of ACAT.
Psychotherapist members, practitioner members and trainee members of ACAT are all described here as ‘therapists’.
The word “client” stands for both patient and client.
PRINCIPLES AND PRACTICE
1. The Well-Being of the Client
The first and most basic principle of this Code is that the well-being of the client is the central concern of the therapist.
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 as client’s members of his/her own family, friends, or colleagues.
b) The therapist should not enter into a sexual relationship with his/her current client or past clients.
c) Therapists should carefully consider possible implications of entering into dual or multiple relationships including via social media, and make every effort to avoid entering into relationships that risk confusing an existing relationship and may impact adversely on a client. 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, therapists take responsibility to clarify and manage boundaries and confidentiality of the therapeutic relationship.
3. Contractual Arrangements
Therapists should ensure as far as is possible that the client is aware of the contractual boundaries of the relationship.
a) This includes, day and times of meetings, arrangements for holidays, method of termination of therapy. The right of the client and of the therapist to terminate, subject to contractual arrangements, should be acknowledged.
b) Where the client is paying for the service, financial arrangements need to be clearly established.
c) Therapists should consider how, in the event of their sudden unavailability, this information can be most appropriately communicated to their clients. This will also include careful consideration of how a client might be informed of a psychotherapist’s death or illness and, where appropriate, supported to deal with such a situation.
The therapist-client relationship is one in which the client should feel confident that both the fact of the meeting and the content of that meeting 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.
b) Therapists 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.
c) In exceptional circumstances, where there is sufficient evidence to raise serious concern 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 - although wherever possible prior consent should be sought - after first consulting a manager from the employing organisation or an experienced and disinterested 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) This confidentiality is further limited by the requirements stated elsewhere in this Code for the need for the therapist to have supervision and to liaise appropriately with other helping professionals. Discussion of the client in these contexts is subject to the same rules of confidentiality.
e) 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 and to obtain their consent 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.
The therapist should arrange for supervision or consultation on his/her clinical work as appropriate.
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) Knowledge gained in the course of giving supervision or professional support is subject to the same rules of confidentiality
6. Limitations on Effectiveness
The therapist should be aware of the limitations on his/her 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, the therapist should normally discuss this with the client.
b) The extent of his/her professional competence - a therapist should be involved in regular practice, and be engaged in Continuing Professional Development as described in the ACAT CPD Policy.
c) The therapist must not make false claims as to his/her competence or training. The therapist should not claim qualifications s/he does not possess.
d) The level of his/her personal functioning: the therapist must actively monitor his/her own personal functioning and, if in doubt, seek help in assessing where the balance between the demands/needs of the client for a service conflict with his/her day to day capacity to deliver that service.
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 his/her private practice or in the work which they undertake for an employer.
8. Professional Relationships
Therapists act within a network of services and need to act with respect for these services.
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) Permission should be sought wherever possible when there is a need to contact other professionals where appropriate and the therapist should then proceed to make such contact.
Any research involving clients will be carried out under the relevant research governance and ethical frameworks of the body that is overseeing the research (eg: University or NHS Trust) so that client consent is fully informed.
10. Obligations to the Profession
Therapists have an obligation to act in accordance with an awareness of the standing of his/her profession.
a) The therapist should not have been refused membership of, or have been struck off the register of, the appropriate body of his/her core profession.
b) The therapist should not behave within his/her therapy related activities in ways which undermine public confidence in either his/her role as a therapist or in the work of other therapists, including on public forums such as social media.
c) Where a therapist perceives a colleague acting in breach of this Code of Ethics, s/he has an obligation to raise the matter with the person and/or notify the appropriate professional body.
In making his/her services publicly known, the therapist should not make unwarranted claims.
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 shall refrain from making exaggerated, sensational and unjustifiable claims for the effectiveness of his/her methods, from advertising services in a way likely to encourage unrealistic expectations about the effectiveness of the services offered, or from misleading those to whom services are offered about the nature and likely consequences of any interventions to be undertaken. The therapist is advised not to include testimonials from clients in any advertising material.
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. There is a duty to act to protect clients and to safeguard others.
ACAT offers the following guidance in these areas:
13. Equality and Diversity
a) Therapists undertake to actively consider issues of diversity and equalities as these affect all aspects of their work. The therapist accepts no one is free from experiences of prejudice and acknowledges the need for a continuing process of self-enquiry and professional development.
b) Therapists undertake not to allow prejudice about a client’s gender, age, colour, race, disability, and sexuality, social, economic or immigration status, lifestyle, religious or cultural beliefs to adversely affect the way they relate to the client.
c) Therapists undertake not to engage in any behaviour that is abusive or detrimental to any client or colleague based on the above factors
Approved at ACAT’s AGM 11 July 2014 | Revised February 2018