Code of Conduct for practitioners
A.1 The lawful needs of clients are the foundation of ethical practice. Clients need to define the changes needed in their experience and capacities that will enable them to meet their needs more effectively. The efforts of practitioners are guided by this founding consideration.
A.2 A fundamental principle underlying good practice is that practitioners do not confuse their own needs with those of clients. The human givens approach therefore emphasises the relationship of trust between practitioner and client, in which the focus should be on the client’s needs and resources, not on the desires, any selfish personal aims, or ideological beliefs of the practitioner. Practitioners should at all times be willing to explain the basis for their ethical decision-making and general approach.
A.3 In addition to this, practitioners need to take account of the fact that human beings are social creatures, and that our lives take much of their meaning from interaction with other people. It follows that practitioners will take account of the social networks within which they and the client are operating and within which their needs must be met in a balanced way.
A.4 Starting from the human givens inclines us to avoid rules for good practice based on clients’ ‘rights’. We arrive in the world with needs to be met and the resources to meet them, but not rights. Rights are not ‘givens’ but are arrived at by negotiation between people and enshrined in laws. However, practitioners should work within the laws of the nation in which they practice.
A.5 Clients require therapeutic services based on best available psychological, physiological and neuro-physiological scientific knowledge relating to healthy human functioning and the rapid relief of distress. Specifically, practitioners should understand the basic emotional and physical needs common to every human being and implications of these for emotionally healthy, well adjusted living.
A.6 For them to recover from whatever is troubling them, clients suffering from emotional distress need practitioners from whom they seek help to have a sound psychological and physiological understanding of all the common mental health conditions – namely stress and depression, fear and anxiety, anger, trauma and addictions. Practitioners should be able wherever possible to offer immediate help to relieve the symptoms associated with these disorders and discuss ways of maintaining change. Such understanding and skills should be based on up to date scientific knowledge relating to these conditions.
A.7 Clients need practitioners to be clear and straightforward in their verbal and, where necessary, written communication. They should therefore avoid vague, ambiguous or vacuous concepts and assertions: communications should be free of “psychobabble”.
A.8 In the event of any dispute between practitioner and client, or if a client wishes to complain about any aspect of their experience with the practitioner, it should be made clear to them that they may contact the Registration and Professional Standards Committee (R&PSC) of the HGI. The R&PSC is committed to resolve the problem, secure an appropriate remedy for the client and the practitioner, and ensure that the public is protected from practitioners whose behaviour, competence or business practice is below the standards set out in this Code. See Section C for a full explanation of the complaints procedure.
A.9 A necessary condition for being a good practitioner is the need for ‘spare capacity’, that is, sufficient time, good mental and physical health and extra energy to devote to clients. Practitioners need this in order to see clearly what is going on with their clients, to understand them and influence events in a positive direction, wherever possible.
A.10 If the practitioner is too self-satisfied, too anxious or too depressed themselves, they have no possibility of developing the capacity to do therapy well. Excessive emotion of any kind is exhausting and uses up the energy needed to be held in reserve in order to observe objectively. If a practitioner’s emotional life is too strong, or is characterised by excessive emotionality, they are not in control and therefore unable to work effectively with clients. So doing therapy should not use up everything the practitioner has got, nor should there be so many draining demands that they have insufficient resources for doing good therapy.
A.11 Beyond practising therapy, practitioners should aim to enjoy meaningful activities with ease and confidence as a way of ensuring that their own emotional needs are met, and in so doing, develop sufficient reserves of energy and attention to work effectively. As practitioners develop competence and confidence in a sport, craft, skill or hobby they take for granted that they can do it well, but do not become vain about achievements. This sense of inner confidence nurtures the spare capacity necessary for doing therapy.
A.12 Practitioners should continually examine their motives and update their skills. This means using supervision in order to discuss challenging cases and/or where the management of risk requires consultation with an experienced supervisor/HG practitioner.
Attendance at meetings of local HG peer supervision groups and conferences is also strongly recommended, as is further training or revision of skills. Evidence of continuing professional development is required for renewal of registration each year, as is a declaration of conformity to the institute’s supervision policy.
A.13 Practitioners should be conscious of their own beliefs and the effects these may have in the context of their work with clients. This will include taking into account any differences between their own cultural background, gender, race, sexual orientation, beliefs, etc and those of the client. It should also take into account the dynamics of perceived authority or influence over clients, and with particular regard to people’s rights including those of privacy and self-determination.
A.14 Standard of responsibility in business practice
- Practitioners are required to be honest, straightforward and accountable in all financial matters concerning their clients and other professional relationships.
- If they advertise themselves as Human Givens practitioners, practitioners must provide therapy (or any other supportive service) on the basis of the Human Givens framework of ideas, and not on the basis of any other framework or training. This does not preclude the use of notions and examples from practitioners’ previous training in other approaches, as long as they are compatible with, and employed within, the Human Givens framework.
- Any advertising should never be unfair, false or exaggerated in ways that will mislead the public. Particular care should be taken over presenting qualifications, accreditation and professional standing honestly to the public. Practitioners should not claim that their personal skills, equipment or facilities are better than anyone else’s, unless they can prove this to be true. All information about services should be honest, accurate, avoid unjustifiable claims, and be consistent with maintaining the good standing of the Human Givens Institute and of the profession as a whole.
- Practitioners are free to decide whom they accept as clients, although they must provide clear justification for refusing to provide or continue treatment. Additionally, they must inform the client as to how they might find out about other practitioners who may be able to provide appropriate treatment. Examples of acceptable reasons for refusing to continue treatment include:
- Evident risk to the practitioner or others, for example if the client is aggressive or violent;
- Persistent questioning of the practitioner’s professional judgement or acting against advice, by the client;
- The client having an ulterior motive for seeking therapy;
- The client receiving another form of treatment that is not conducive to their wellbeing;
- The practitioner lacking the ‘spare capacity’ necessary to provide effective therapy, for instance if they have become ill or overwhelmed.
- Practitioners should never advertise or offer financial rewards or incentives to clients, such as discounts for a series of sessions. They should avoid any possible confusion or false expectations about therapy being a “course of treatment” by not accepting payment in advance. Nor should they barter treatment in return for services of any kind from the client or their representatives, because it creates a confusion of roles. They should also take as few sessions as possible to treat clients (see Section B1.23), and not prolong treatment in order to increase financial gain.
- 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 reasonable foreseeable costs or liabilities. Clients should receive a copy of the therapist’s terms of business, including costs, cancellation arrangements etc. An adaptable pro forma for this purpose is available to members in the Professional Members Area.
- At the point of contractual agreement, clients should be given information about the therapist’s professional body, including information on providing feedback and making a complaint.
- Practitioners should comply with relevant health and safety, building regulations and environmental health standards where they work, and ensure that their premises are accessible to those with a disability, or arrange an alternative venue if this is difficult.
- They must maintain comprehensive professional liability insurance.
- Although it is not a legal requirement, the HGI strongly recommends that therapists operating solely as self-employed practitioners obtain a Disclosure and Barring Service (DBS) disclosure (formerly called a Criminal Records Bureau disclosure). For further information on DBS disclosure, see the Professional Members Area.
- Clients should be made aware that they can withdraw from receiving professional services at any time they so choose.
A.15 Standard of client privacy and confidentiality
Practitioners should respect the privacy and confidentiality of clients as is ethically and legally appropriate:
- They must keep appropriate records. Records should contain sufficient detail, including a description of the client’s presenting situation, their expectations of therapy, the treatment provided and the outcome, if known.
- They should respect and maintain client confidentiality at all times. Case notes and records for each client must be kept in a secure place. (Note: Detailed guidance on maintaining the security of sensitive data is provided in the ‘Essential Information’ section of the Members Area of the HGI website: http://www.hgi.org.uk/private-practice/essential-information/data-protection) They should be kept for seven years. Practitioners need to be aware of their responsibilities under the Data Protection Act and any other legal requirements. Further information is available via the website of the Information Commissioner’s Office at www.ico.gov.uk and in the Professional Members Area. Practitioners should make provision for secure disposal of records in the event of their incapacity. The following are allowed access to the client’s records:
- the client or their duly authorised legal representative;
- those with parental responsibility where the client is a child under 16;
- any practitioner other than yourself when client consent has been given;
- administrative staff, for example, receptionists, practice managers;
- a police officer in possession of a warrant from a circuit judge.
- They should normally obtain the consent of clients who are considered legally competent, or their duly authorised representatives, for disclosure of confidential information.
- They should restrict the scope of disclosure. No more information should be disclosed than is consistent with professional purposes, the specifics of the initiating request or event. It should be disclosed in line with the specifics of the client’s authorisation, as long as this is consistent with acting within the law.
- They should record, process, and store confidential information in a way that is designed to avoid accidental disclosure.
- They should ensure from the first contact that clients are aware of the limitations of maintaining confidentiality. This means telling them about:
- potentially conflicting (or over-riding) legal and ethical obligations;
- the likelihood that consultation with supervisors and colleagues may occur in order to support the client’s best interests; and
- the possibility that third parties (such as translators or family members) may assist in ensuring that the activity concerned is not compromised by lack of communication.
Note: A Client Confidentiality Agreement document is available to support the above process.
- They must advise the client that if they should reveal any illegal or potentially harmful act, the practitioner is obliged to inform the appropriate authority. This would be the case if the practitioner had serious concerns about:
- the safety of clients;
- the safety of other persons who may be endangered by the client’s behaviour; or
- the health, welfare or safety of children or vulnerable adults.
- All practitioners should be aware of their specific legal obligations under The Children’s Act 1989 and ‘No Secrets’ guidelines regarding the treatment of underage clients. They also have a duty to notify the relevant authorities when vulnerable adults need protection.
- Before breaching a client’s confidence, they should consult a professional supervisor or colleague, unless the need for disclosure is so urgent that any delay is undesirable.
- They should keep a record of any breach of confidentiality and the reasons compelling disclosure without consent. This should be written either before the disclosure or as soon as possible afterwards, with a note of the date.
- When disclosing confidential information directly to clients, practitioners need to consider not only their client’s confidentiality; they should also safeguard the confidentiality of information relating to others. They should provide adequate assistance in understanding the nature and contents of the information being disclosed.
- They should only make audio, video or photographic recordings of clients with the explicit permission of clients who are considered legally competent, or their duly authorised representatives.
- They should endeavour to ensure that colleagues, staff, trainees, and supervisees with whom practitioners work understand and respect the provisions of this code concerning the handling of confidential information.
A.16 Standard of informed consent.
Note: A customisable Client Information sheet and Client Confidentiality Agreement document are available to support the following. HGI Registrants can download these documents here.
- Practitioners should negotiate clear and ethical agreements with clients, whether verbal or written as appropriate in different contexts. These should always operate on the basis of informed consent. This should be explicit consent on the part of the client. Clients, particularly children and vulnerable adults, should be given ample opportunity to understand the nature, purpose, and anticipated consequences of any professional services or research participation, so that they may give informed consent to the extent that their capabilities allow.
- They should seek to obtain the informed consent of all clients to whom professional services or research participation are offered.
- They should keep accurate records of when, how and from whom consent was obtained.
- They should remain alert to the possibility that those people for whom professional services or research participation are contemplated may lack legal capacity for informed consent.
- When informed consent cannot be obtained from clients, no duly authorised representative can be identified and a pressing need for the provision of professional services is indicated, they should consult when feasible a person well placed to appreciate the potential reactions of clients for assistance in determining what may be in their best interests. This could be, for example, a family member, or current or recent provider of care or services.
- When the specific nature of contemplated professional services precludes obtaining informed consent from clients or their duly authorised representatives, they should obtain specific approval from appropriate institutional ethics authorities before proceeding. Where no institutional ethics authority exists, peers and colleagues should be consulted.
- If a practitioner is contemplating research that is not covered by a recognised research body with due ethical standards, they must obtain permission from the HGI before proceeding.
- Practitioners must take particular care when seeking the informed consent of detained persons. This is because the circumstances of detention may affect the ability of such clients to consent freely.
- Unless informed consent has been obtained, they must restrict research based upon observations of public behaviour to those situations in which persons being studied would reasonably expect to be observed by strangers. This means taking into account local cultural values and the privacy of persons who, even while in a public space, may believe they are unobserved.
- When professional services or research occur over an extended period of time, or when there is significant change in the nature or focus of such activities, they should obtain supplemental informed consent.
- Practitioners must only withhold information from clients in exceptional circumstances, when necessary to preserve the integrity of research or the efficacy of professional services, or in the public interest. They should specifically consider any additional safeguards required for the preservation of client welfare.
- They should avoid intentional deception of clients unless:
- deception is necessary in exceptional circumstances to preserve the integrity of research that has been approved by an appropriate ethics committee, or the efficacy of professional services;
- any additional safeguards required for the preservation of client welfare are specifically considered; and
- the nature of the deception is disclosed to clients at the earliest feasible opportunity.
- Practitioners should ensure from their first contact with them that clients are fully aware of their right to withdraw at any time from research participation.
A.17 Standard of personal consent.
- Practitioners should avoid personal and professional misconduct that might bring the Human Givens Institute, or the reputation of the profession, into disrepute. Convictions for criminal offences that reflect on suitability for practice may be regarded as misconduct by the Human Givens Institute.
- In view of the inevitable power imbalance that exists within the therapeutic relationship, therapists must never exploit their privileged position to obtain personal advantage of any kind, including sexual, emotional or financial advantage. Sexual relations with clients are forbidden. ‘Sexual relations’ include intercourse, any other type of sexual activity, or sexualised behaviour. Therapists should consider very carefully the potential consequences, and exercise great caution, before entering into any personal or business relationships with former clients, and should expect to be held professionally accountable if any such relationship results in harm to the client and/or the reputation of the HGI.
- Treatment should only continue until a client has sufficiently recovered, or until it becomes apparent that any progress within a particular client/practitioner relationship is unlikely, and no longer.
- They should never impose their own world-view on their client. Thus they should avoid using language that may directly, or indirectly, intentionally or unintentionally, plant suggestions that may encourage false memories (for example, false memories of child sexual abuse) or cause unhealthy thought patterns.
- They should never abuse, manipulate, or otherwise indulge in any kind of cult behaviour or practices which bind a client to the therapist;
- They should never take advantage in any other way of the inevitable power invested in the role of ‘therapist’.
A.18 In the event of any ethical dilemmas or queries arising in the course of practice, practitioners may wish to consult with their supervisor, or to contact the HGI's Registration and Professional Standards Committee (RPSC), for support. Where there is evidence indicating that a client is at risk of immediate harm, practitioners have a duty to make their concerns known to an appropriate authority, for example the client’s GP, the local social services department, and, if deemed necessary in the circumstances, the police.
Note: To support ethical decision-making, practitioners may wish to refer to the resource ‘Resolving ethical dilemmas’, which takes a step-by-step approach to problems based on human givens principles and the RIGAAR method of communication. (See Appendix 3)
Continue to: Section B
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