| Guidance
on good practice in counselling and psychotherapy The British Association
for Counselling and Psychotherapy is committed to sustaining and advancing good
practice. This guidance on the essential elements of good practice has been
written to take into account the changing circumstances in which counselling and
psychotherapy are now being delivered, in particular:
- changes in the range of
issues and levels of need presented by clients
- the growth in levels of
expertise available from practitioners with the expansion in the
availability of training and consultative support/supervision
- the accumulated
experience of this Association over nearly three decades.
The diversity of settings
within which counselling and psychotherapy services are delivered has also been
carefully considered. These services may be provided by the independent
practitioner working alone, one or more practitioners working to provide a
service within an agency or large organisation, specialists working in
multidisciplinary teams, and by specialist teams of counsellors and
psychotherapists. Most work is undertaken face to face but there are also a
growing number of telephone and online services. Some practitioners are moving
between these different settings and modes of delivery during the course of
their work and are therefore required to consider what constitutes good practice
in different settings. All practitioners encounter the challenge of responding
to the diversity of their clients and finding ways of working effectively with
them. This statement therefore responds to the complexity of delivering
counselling and psychotherapy services in contemporary society by directing
attention to essential issues that practitioners ought to consider and resolve
in the specific circumstances of their work.
The term
‘practitioner’ is used generically to refer to anyone with responsibility
for the provision of counselling- or psychotherapy-related services.
‘Practitioner’ includes anyone undertaking the role(s) of counsellor,
psychotherapist, trainer, educator, supervisor, researcher, provider of
counselling skills or manager of any of these services. The term ‘client’ is
used as a generic term to refer to the recipient of any of these services. The
client may be an individual, couple, family, group, organisation or other
specifiable social unit. Alternative names may be substituted for
‘practitioner’ and ‘client’ in the practice setting as the terminology
varies according to custom and context.
Providing
a good standard of practice and care
All clients are entitled to good standards of practice and care from their
practitioners in counselling and psychotherapy. Good standards of practice and
care require professional competence; good relationships with clients and
colleagues; and commitment to and observance of professional ethics.
Good
quality of care
- Good quality of care requires competently delivered services that meet the
client’s needs by practitioners who are appropriately supported and
accountable.
- Practitioners should give careful consideration to the limitations of
their training and experience and work within these limits, taking advantage
of available professional support. If work with clients requires the
provision of additional services operating in parallel with counselling or
psychotherapy, the availability of such services ought to be taken into
account, as their absence may constitute a significant limitation.
- Good practice involves clarifying and agreeing the rights and
responsibilities of both the practitioner and client at appropriate points
in their working relationship.
- Dual relationships arise when the practitioner has two or more kinds of
relationship concurrently with a client, for example client and trainee,
acquaintance and client, colleague and supervisee. The existence of a dual
relationship with a client is seldom neutral and can have a powerful
beneficial or detrimental impact that may not always be easily foreseeable.
For these reasons practitioners are required to consider the implications of
entering into dual relationships with clients, to avoid entering into
relationships that are likely to be detrimental to clients, and to be
readily accountable to clients and colleagues for any dual relationships
that occur.
- Practitioners are encouraged to keep appropriate records of their work
with clients unless there are adequate reasons for not keeping any records.
All records should be accurate, respectful of clients and colleagues and
protected from unauthorised disclosure. Practitioners should take into
account their responsibilities and their clients’ rights under data
protection legislation and any other legal requirements.
- Clients are entitled to competently delivered services that are
periodically reviewed by the practitioner. These reviews may be conducted,
when appropriate, in consultation with clients, supervisors, managers or
other practitioners with relevant expertise.
Maintaining
competent practice
- All counsellors, psychotherapists, trainers and supervisors are required
to have regular and on-going formal supervision/consultative support for
their work in accordance with professional requirements. Managers,
researchers and providers of counselling skills are strongly encouraged to
review their need for professional and personal support and to obtain
appropriate services for themselves.
- Regularly monitoring and reviewing one’s work is essential to
maintaining good practice. It is important to be open to, and conscientious
in considering, feedback from colleagues, appraisals and assessments.
Responding constructively to feedback helps to advance practice.
- A commitment to good practice requires practitioners to keep up to date
with the latest knowledge and respond to changing circumstances. They should
consider carefully their own need for continuing professional development
and engage in appropriate educational activities.
- Practitioners should be aware of and understand any legal requirements
concerning their work, consider these conscientiously and be legally
accountable for their practice.
Keeping trust
- The practice of counselling and psychotherapy depends on gaining and
honouring the trust of clients. Keeping trust requires:
n attentiveness to the quality of listening
and respect offered to clients
n culturally appropriate ways of communicating
that are courteous and clear
n respect for privacy and dignity
n careful attention to client consent and
confidentiality
- Clients should be adequately informed about the nature of the services
being offered. Practitioners should obtain adequately informed consent from
their clients and respect a client’s right to choose whether to continue
or withdraw.
- Practitioners should ensure that services are normally delivered on the
basis of the client’s explicit consent. Reliance on implicit consent is
more vulnerable to misunderstandings and is best avoided unless there are
sound reasons for doing so. Overriding a client’s known wishes or consent
is a serious matter that requires commensurate justification. Practitioners
should be prepared to be readily accountable to clients, colleagues and
professional body if they override a client’s known wishes.
- Situations in which clients pose a risk of causing serious harm to
themselves or others are particularly challenging for the practitioner.
These are situations in which the practitioner should be alert to the
possibility of conflicting responsibilities between those concerning their
client, other people who may be significantly affected, and society
generally. Resolving conflicting responsibilities may require due
consideration of the context in which the service is being provided.
Consultation with a supervisor or experienced practitioner is strongly
recommended, whenever this would not cause undue delay. In all cases, the
aim should be to ensure for the client a good quality of care that is as
respectful of the client’s capacity for self-determination and their trust
as circumstances permit.
- Working with young people requires specific ethical awareness and
competence. The practitioner is required to consider and assess the balance
between young people’s dependence on adults and carers and their
progressive development towards acting independently. Working with children
and young people requires careful consideration of issues concerning their
capacity to give consent to receiving any service independently of someone
with parental responsibilities and the management of confidences disclosed
by clients.
- Respecting client confidentiality is a fundamental requirement for keeping
trust. The professional management of confidentiality concerns the
protection of personally identifiable and sensitive information from
unauthorised disclosure. Disclosure may be authorised by client consent or
the law. Any disclosures should be undertaken in ways that best protect the
client’s trust. Practitioners should be willing to be accountable to their
clients and to their profession for their management of confidentiality in
general and particularly for any disclosures made without their client’s
consent.
- Practitioners should normally be willing to respond to their client’s
requests for information about the way that they are working and any
assessment that they may have made. This professional requirement does not
apply if it is considered that imparting this information would be
detrimental to the client or inconsistent with the counselling or
psychotherapeutic approach previously agreed with the client. Clients may
have legal rights to this information and these need to be taken into
account.
- Practitioners must not abuse their client’s trust in order to gain
sexual, emotional, financial or any other kind of personal advantage. Sexual
relations with clients are prohibited. ‘Sexual relations’ include
intercourse, any other type of sexual activity or sexualised behaviour.
Practitioners should think carefully about, and exercise considerable
caution before, entering into personal or business relationships with former
clients and should expect to be professionally accountable if the
relationship becomes detrimental to the client or the standing of the
profession.
- Practitioners should not allow their professional relationships with
clients to be prejudiced by any personal views they may hold about
lifestyle, gender, age, disability, race, sexual orientation, beliefs or
culture.
- Practitioners should be clear about any commitment to be available to
clients and colleagues and honour these commitments.
Teaching
and training
- All practitioners are encouraged to share their professional knowledge and
practice in order to benefit their clients and the public.
- Practitioners who provide education and training should acquire the
skills, attitudes and knowledge required to be competent teachers and
facilitators of learning.
- Practitioners are required to be fair, accurate and honest in their
assessments of their students.
- Prior consent is required from clients if they are to be observed,
recorded or if their personally identifiable disclosures are to be used for
training purposes.
Supervising
and managing
- Practitioners are responsible for clarifying who holds responsibility for
the work with the client.
- There is a general obligation for all counsellors, psychotherapists,
supervisors and trainers to receive supervision/consultative support
independently of any managerial relationships.
- Supervisors and managers have a responsibility to maintain and enhance
good practice by practitioners, to protect clients from poor practice and to
acquire the attitudes, skills and knowledge required by their role.
Researching
- The Association is committed to fostering research that will inform and
develop practice. All practitioners are encouraged to support research
undertaken on behalf of the profession and to participate actively in
research work.
- All research should be undertaken with rigorous attentiveness to the
quality and integrity both of the research itself and of the dissemination
of the results of the research.
- The rights of all research participants should be carefully considered and
protected. The minimum rights include the right to freely given and informed
consent, and the right to withdraw at any point.
- The research methods used should comply with the standards of good
practice in counselling and psychotherapy and must not adversely affect
clients.
Fitness to practise
- Practitioners have a responsibility to monitor and maintain their fitness
to practise at a level that enables them to provide an effective service. If
their effectiveness becomes impaired for any reason, including health or
personal circumstances, they should seek the advice of their supervisor,
experienced colleagues or line manager and, if necessary, withdraw from
practice until their fitness to practise returns. Suitable arrangements
should be made for clients who are adversely affected.
If things go wrong with own clients
- Practitioners should respond promptly and appropriately to any complaint
received from their clients. An appropriate response in agency-based
services would take account of any agency policy and procedures.
- Practitioners should endeavour to remedy any harm they may have caused to
their clients and to prevent any further harm. An apology may be the
appropriate response.
- Practitioners should discuss, with their supervisor, manager or other
experienced practitioner(s), the circumstances in which they may have
harmed a client in order to ensure that the appropriate steps have been
taken to mitigate any harm and to prevent any repetition.
- Practitioners are strongly encouraged to ensure that their work is
adequately covered by insurance for professional indemnity and liability.
- If practitioners consider that they have acted in accordance with good
practice but their client is not satisfied that this is the case, they may
wish to use independent dispute resolution, for example: seeking a second
professional opinion, mediation, or conciliation where this is both
appropriate and practical.
- Clients should be informed about the existence of the Professional Conduct
Procedure of this Association and any other applicable complaints or
disciplinary procedures. If requested to do so, practitioners should inform
their clients about how they may obtain further information concerning these
procedures.
Responsibilities to all clients
- Practitioners have a responsibility to protect clients when they have good
reason for believing that other practitioners are placing them at risk of
harm.
- They should raise their concerns with the practitioner concerned in the
first instance, unless it is inappropriate to do so. If the matter cannot be
resolved, they should review the grounds for their concern and the evidence
available to them and, when appropriate, raise their concerns with the
practitioner’s manager, agency or professional body.
- If they are uncertain what to do, their concerns should be discussed with
an experienced colleague, a supervisor or raised with this Association.
- All members of this Association share a responsibility to take part in its
professional conduct procedures whether as the person complained against or
as the provider of relevant information.
Working
with colleagues
The increasing availability of counselling and psychotherapy means that most
practitioners have other practitioners working in their locality, or may be
working closely with colleagues within specialised or multidisciplinary
teams. The quality of the interactions between practitioners can enhance or
undermine the claim that counselling and psychotherapy enable clients to
increase their insight and expertise in personal relationships. This is
particularly true for practitioners who work in agencies or teams.
Working
in teams
- Professional relationships should be conducted in a spirit of mutual
respect. Practitioners should endeavour to attain good working relationships
and systems of communication that enhance services to clients at all times.
- Practitioners should treat all colleagues fairly and foster equality
opportunity.
- They should not allow their professional relationships with colleagues to
be prejudiced by their own personal views about a colleague’s lifestyle,
gender, age, disability, race, sexual orientation, beliefs or culture. It is
unacceptable and unethical to discriminate against colleagues on any of
these grounds.
- Practitioners must not undermine a colleague’s relationships with
clients by making unjustified or unsustainable comments.
- All communications between colleagues about clients should be on a
professional basis and thus purposeful, respectful and consistent with the
management of confidences as declared to clients.
Awareness of context
- The practitioner is responsible for learning about and taking account of
the different protocols, conventions and customs that can pertain to
different working contexts and cultures.
Making
and receiving referrals
- All routine referrals to colleagues and other services should be discussed
with the client in advance and the client’s consent obtained both to
making the referral and also to disclosing information to accompany the
referral. Reasonable care should be taken to ensure that:
n the recipient of the referral is able to
provide the required service;
n any confidential information disclosed
during the referral process will be adequately protected;
n the referral will be likely to benefit the
client.
- Prior to accepting a referral the practitioner should give careful
consideration to:
n the appropriateness of the referral;
n the likelihood that the referral will be
beneficial to the client;
n the adequacy of the client’s consent for
the referral.
If the referrer is professionally required to retain overall responsibility
for the work with the client, it is considered to be professionally
appropriate to provide the referrer with brief progress reports. Such
reports should be made in consultation with clients and not normally against
their explicit wishes.
Probity in professional practice
Ensuring the probity of practice is important both to those who are directly
affected but also to the standing of the profession as a whole.
Providing clients with adequate
information
- Practitioners are responsible for clarifying the terms on which their
services are being offered in advance of the client incurring any financial
obligation or other reasonably foreseeable costs or liabilities.
- All information about services should be honest, accurate, avoid
unjustifiable claims, and be consistent with maintaining the good standing
of the profession.
- Particular care should be taken over the integrity of presenting
qualifications, accreditation and professional standing.
Financial
arrangements
- Practitioners are required to be honest, straightforward and accountable
in all financial matters concerning their clients and other professional
relationships.
Conflicts of interest
- Conflicts of interest are best avoided, provided they can be reasonably
foreseen in the first instance and prevented from arising. In deciding how
to respond to conflicts of interest, the protection of the client’s
interests and maintaining trust in the practitioner should be paramount.
Care of self as a practitioner
Attending to the practitioner’s well-being is essential to sustaining good
practice.
- Practitioners have a responsibility to themselves to ensure that their
work does not become detrimental to their health or well-being by ensuring
that the way that they undertake their work is as safe as possible and that
they seek appropriate professional support and services as the need arises.
- Practitioners are entitled to be treated with proper consideration and
respect that is consistent with this Guidance.
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