Codes of ethics, professional practice and complaints procedure from Handbook Oct 2014

Professional Ethics and Practice

The Professional Ethics Committee (PEC)

The Committee’s role is to act as the guardian of the organisation’s professional standards. The Committee does this through the Codes of Ethics and Professional Practice and by upholding AGIP’s Equal Opportunities Policy.

The Committee’s work covers the following four areas:

(a) Maintaining, and updating as necessary, the Code of Ethics and Professional Practice and the Complaints and Appeals Procedure;

(b) Implementing the Complaints and Appeals procedure when a complaint has been received;

(c) Dealing with requests from people applying for professional membership of AGIP under our accreditation scheme;

(d) Liaison with UKCP over membership matters and the hearing of complaints and appeals.

The Committee meets approximately four times a year or as required according to the business in hand.

All queries and/or correspondence should be addressed to:

The Co-ordinator,
Professional Ethics Committee,
AGIP
1 Fairbridge Road
London
N19 3EW

CODE OF ETHICS AND PROFESSIONAL PRACTICE

Preamble

(a)     This Code contains the standards of ethics, practice and conduct which AGIP expects all members to follow whether they meet patients in person, online or otherwise, for supervision and for all professional activities as a psychoanalytical psychotherapist, analytical psychologist or psychoanalytical psychotherapist in training.

(b)     The term ‘member’ means an individual AGIP member and is any category of membership of AGIP. For Professional, trainees and training members it is expected that they will practice psychoanalytic psychotherapy or analytical psychology. In doing so attention must be paid to any unconscious processes at work between the member and their patient or supervisee when considering ethical practice: the use of supervision or consultation to help identify such processes is required for trainees and Professional members. The Training Committee has regulations concerning supervision for trainees: the frequency of supervision is not specified for Professional members but left to their own judgement.

(c)     The term ‘patient’ includes individuals, couples, families or groups who engage in psychotherapy with the member. In the case of AGIP members who undertake supervision, their work with supervisees is also covered by this Code.

(d)     AGIP is responsible for monitoring and regulating the conduct of its members. Should a concern arise about a member’s practice, it is against these standards that it will be judged through the AGIP Complaints Procedure. Note: for AGIP Professional members who are also UKCP Registrants, complaints must be addressed to the UKCP thus for UKCP Registrants, the UKCP Code of Ethics and Professional Practice must be read in conjunction with this Code.

(e)     The member commits to engage with the challenge of striving for ethical practice and conduct, even when doing so involves making difficult decisions. If difficulties or doubts arise as to whether a course of action is ethical, the practitioner should consult the Professional Ethics Committee of AGIP and others where appropriate, for example their supervisor or the Professional Conduct Officer of the UKCP.

Conduct

In the numbered points below, we set out the things AGIP regards as key to ethical practice and they are grouped under these headings:

• Best interests of patients
• Professionalism
• Communication and consent
• Records and confidentiality
• Professional knowledge, skills and experience
• Social responsibility
• Trust and confidence
• Supervision
• Trainees and Training Members
• Breaks in clinical practice
• The role of AGIP

As an AGIP member you must:

Best interests of patients

1. Act in your patient’s best interests.
2. Treat patients with respect.
3. Respect your patient’s autonomy.
4. Not have sexual contact or sexual relationship with patients and avoid where ever possible social contact with patients.
5. Not exploit or abuse your relationship with patients (current or past) for any purpose including your emotional, sexual or financial gain. Other than in the payment of fees, you should not enter into financial transactions with your patients.
6. Not harm or collude in the harming of your patient or the patients of others.
7. Weighed up your patient’s interests against the interests of others is if there is an imminent and serious threat to the patient, or to others.
8. Decide whether or not to treat the patient, the form of psychotherapy to be practised and the psychotherapeutic handling of the case.
9. Endeavour to restrict your practice within the limits of your own training or competence.
10. Ensure that you maintain a satisfactory level of professional competence.
11. Not make referrals for financial or other gain except as determined by the Clinical Committee.
12. Ensure that you provide a treatment setting conducive to good practice and in which there is as little as possible risk of interruption or intrusion.
13. Ensure as far as reasonably possible If there is a physical aspect to the patient’s condition, that the patient has sought medical advice. Where patients refuse to act on your advice in the matter, you have a right to refuse to continue psychotherapy having given due consideration to the patient’s welfare.
14. Not knowingly take into treatment a patient already in treatment with a colleague without prior consultation.

Professionalism

15. Decline any gifts, favours, money or hospitality that might be interpreted as exploitative.
16. Not either pay or receive payment of referral fees save as otherwise determined by the Clinical Committee activities.
17. Be aware of the power imbalance between you and your patient, and avoid dual or multiple relationships* that risk confusing an existing relationship and may impact adversely on a patient. If a dual or multiple relationship is unavoidable, for example in a small community, take responsibility for clarifying and managing boundaries and protecting confidentiality.

[* Such relationships could be social or commercial relationships between the member and the patient, or a training relationship running alongside a supervisory or tutorial one.]

18. Exercise all reasonable care before entering into a personal or business relationship with former patients, taking in to account the time that has elapsed since therapy ended. Should such a relationship prove to be detrimental to the former patient, you may be called to answer an allegation of misusing your former position.
19. Recognise that your behaviour outside your professional life may have an effect on your relationship with patients and take responsibility for critically examining these potential negative or positive effects to the benefit of the patient.
• Be cognizant of the Codes of Ethics and Professional Practice of other organisations of which you may be a member, such as the UKCP. These guidelines are also intended to regulate the professional conduct of members of AGIP.
• Not behave in a way detrimental to the profession, to AGIP, to colleagues or to trainees. This includes but is not limited to: not knowingly take into treatment a patient already in treatment with a colleague without prior consultation. Unethical conduct in a colleague should be referred to the Professional Ethics Committee and/or the UKCP Professional Conduct Officer.
• Must, in the case of Professional members, commit to take part in any re-accreditation process as stipulated by AGIP.
• Not make written or spoken statements to a third party about a colleague’s work without the colleague’s consent except as part of a formal complaint.

Communication and consent

20. Provide in your advertising, and on request, a clear and honest statement of the qualifications relevant to your field of practice and your AGIP membership, and advertise your services accurately and in a responsible and professional manner, without exaggeration. All trainees and training members must use the phrase “member in training” in any advertising.
21. Ensure that the use of title such as ‘Doctor/Dr’ and post nominal initials after your name in communications are: accurate; indicate whether it is a medical or academic qualification; and reasonably informs the public of their relevance to the practice of psychoanalytic psychotherapy or analytical psychology.
22. Not make any claims which you cannot demonstrate to be true or include testimonials from patients in any advertising. Any statements should be descriptive but not evaluative of other psychotherapists, schools of psychotherapy or organisations. You must exercise caution when joining web sites or advertising in a manner that allow testimonials from patients.
23. Take care when contributing to public discussion in the media that no therapeutic advantage is claimed and that there is no invitation to the general public to consult you.
24. Explain to a patient, or prospective patient, your terms, fees and conditions including payment for missed sessions and holidays, and be ready to provide information to clarify other related questions such as likely length of therapy, methods of practice to be used, the extent of your own involvement, complaints processes and how to make a complaint, as well as arrangements for referral and termination of therapy.
25. Confirm each patient’s consent to the specifics of the service you will offer, through a clear contract at the outset of therapy (this will not normally be a written contract), and help patients to understand the nature of any proposed therapy and its implications, what to expect, the risks involved, what is and is not being offered, and relevant alternative options.
26. Not intentionally mislead a patient about the type or nature of psychotherapy practised.
27. Only participate in research about patients with patients’ verifiable and informed consent before the commencement of therapy and research, clarifying the nature, purpose and conditions of any research in which patients are involved and in accordance with relevant codes and guidance. For publication, permission to release any such information must be obtained in writing. Also, you should pay particular attention to any additional guidance or special considerations which may apply to specific groups, such as children and young people.
28. Disclose to a patient, on request, appropriate details of your training and qualifications.
29. Where you work both in a non-fee-paying setting and in a private fee-paying setting, not normally transfer patients or referrals from non-fee-paying to the fee-paying part of your practice. Where this does arise, it should only be done with reference to the local protocol, in the interests of the patient and after adequate consultation/supervision.

Records and confidentiality

30. Respect, protect and preserve patients’ confidentiality. As required by law, you must protect sensitive and personally identifiable information obtained in the course of your professional work. You must be familiar with the Access to Health Records Act 1991 and the relevant Data Protection legislation including the General Data Protection Regulations, and work within this legislation.
31. When making a written or verbal presentation of patient material in any circumstances, preserve the patient’s anonymity and permission to release any such information be obtained in writing. The exceptions to this apply to members taking their clinical work to supervision and to trainees who are required to include details of their clinical work with patients in their written assignments or in clinical case discussion groups: however, the patient’s anonymity must always be preserved.
32. Safeguard the welfare and anonymity of patients when any form of publication of clinical material is being considered and to always obtain your patient’s verifiable consent in any case where the welfare or anonymity of a patient may be compromised. This includes situations where a patient or former patient might recognise themselves in case material despite the changing of names or actual circumstances.
33. Make such notes and keep records which are accurate, legible and timely as you believe will support you in your work; and keep patients’ information confidential, subject to legal and ethical requirements including safe storage of notes with password protection if held electronically, and discuss them only within appropriate professional settings.
34. Notify patients, when appropriate or on request, that there are legal and ethical limits to confidentiality, and circumstances under which confidential information might be disclosed to a third party. If you deem it necessary to override confidentiality, i.e. for the safety of the patient, or of other persons, especially children, if possible the patient should first be informed. You should consult with a professional colleague about this course of action.
35. Obtain legal and ethical advice in relation to providing information for judicial or administrative proceedings, and as to the potential impact that this could have on the commitment of confidentiality to the patient, even when patient consent is given.

Professional knowledge, skills and experience

36. Offer only the forms of therapy in which you have had adequate training or experience.
37. Understand the limits of your competence and stay within them in all your professional activity, referring patients to another professional when appropriate. This includes recognising that particular patient groups, such as children and families, have needs which not all practitioners are equipped to address.
38. Ensure continuing ability to practise by securing supervision and ongoing professional education and development sufficient to meet the requirements of AGIP and the CPJA College.
39. Ensure that you do not work with patients if you are not able to do so for physical or mental health reasons, or when impaired by the effects of drugs, alcohol or medication. You have a responsibility for maintaining your own mental and physical wellbeing and seeking psychotherapeutic or medical help or undertaking further education or training where necessary.
40. Make considered and timely arrangements for the termination of a therapeutic relationship, or if you are unable to continue to practise, ensuring that patients are informed and alternative practitioners are identified where possible.
41. Have arrangements in place for informing patients and, where appropriate, providing them with support in the event of your illness or death. Members are required to have made and lodged a regularly updated name and contact list of their patients, a Clinical Will, with a named person and that name must be lodged with AGIP.

Social responsibility

42. Actively consider issues of diversity and equalities as these affect all aspects of your work and acknowledge the need for a continuing process of self-enquiry and professional development.
43. Not allow prejudice about a patient’s sex, age, colour, race, disability, communication skills, sexuality, lifestyle, religious, cultural or political beliefs, social economic or immigration status to adversely affect the way you relate to them.
44. Avoid behaviour that can be perceived as abusive or detrimental to any patient or colleague based on the above factors. Unethical conduct must not be condoned in a psychotherapist colleague.

Trust and confidence

45. Act with candour in supervision/consultation. In the case of trainees also to act with candour in the training, supervision, tutorials and in relation to the Training Committee.
46. Act in a way which upholds the profession’s reputation and promotes public confidence in the profession, AGIP and its members, including outside of your professional life as an AGIP member.
47. Maintain an awareness of, and comply with, all legal and professional obligations and AGIP polices which apply to your practice.
48. Ensure that any communication in which you take part, and in particular your participation in social media, is carried out in a manner consistent with this Code.
49. Safeguard children and vulnerable adults, recognising your legal responsibilities concerning their rights and taking appropriate action should you consider any such person is at risk of harm.
50. Challenge questionable practice in yourself or others, reporting to AGIP potential breaches of this Code, and activating formal complaints procedures especially where there may be ongoing harm to patients or you have significant grounds for believing patients to be at risk of harm.
51. Ensure that your professional work is adequately covered by appropriate indemnity insurance or by your employer’s indemnity arrangements.
52. Co-operate with any lawful investigation or inquiry relating to your psychotherapy practice. Inform AGIP if you are:
53. charged with a criminal offence;
54. convicted of a criminal offence, receive a conditional discharge for an offence, or accept a police caution;
55. disciplined by any professional body or membership organisation responsible for regulating or licensing a health or social care profession; or
56. suspended or placed under a practice restriction by an employer or similar organisation including placements because of concerns relating to your competence, health or practice of psychotherapy.

    Any member who has been convicted in a court of law in a civil or criminal action relating to a patient shall notify the AGIP Professional Ethics Committee and in the case of a UKCP Registrant, the UKCP Professional Conduct Officer, of the facts immediately. Conviction of any criminal offence shall automatically be reviewed by the Professional Ethics Committee, who may recommend to Council the termination of membership of AGIP.

57. Not employ, make referrals to, recommend or facilitate the practice of someone who has been removed from AGIP membership, the UKCP’s Register or that of any relevant organisation.

Supervision

58. Supervision is understood to be a reflective and evaluative process conducted within an agreed working relationship between a qualified or trainee psychotherapist and an appropriately knowledgeable supervisor.
59. In respect of supervision, in the above paragraphs of the Code of Ethics and Professional Practice, the reference to patient may be replaced by supervisee as appropriate.
60. AGIP promotes the responsibility for practitioners to determine the nature and extent of supervision that they require at any particular time and at different points in their career.

    It is a requirement for qualified practitioners with less than three years post graduate experience to be in formal supervision. Professional members should include in their CPD record a statement of the nature, extent and regularity of their supervision, including the name(s) of their supervisor, or their rationale for not undertaking supervision at this particular time. When working with patients under the age of 18 it is mandatory to have regular supervision.

61. Members are expected to seek supervision/consultation when clinical or ethical dilemmas arise and to keep a note of that consultation separate from their patient’s notes. Supervisees (professional members and trainees) have a responsibility to be candid in supervision and to draw attention to any significant difficulties or challenges that have arisen in their clinical work.
62. Trainees and Professional Members should be able to provide an account of their supervision at any given time. The supervisee should be able to demonstrate and articulate the ways in which they monitor their own practice and seek appropriate support and guidance in their practice from others.
63. Supervisors are responsible for providing an environment/setting for their supervisee to discuss any/all aspects of their practice without judgement blame or criticism and support the supervisee in addressing/resolving difficulties and challenges.
64. Supervisors need to be aware of both the limits of their own competencies and those of their supervisee and to support the supervisee where referral on or the seeking of expert advice is indicated: eg referring the patient for psychiatric consultation; referring the supervisee for specific consultation.

Trainees and training members

1. Students, trainees and training members are expected to be in good standing on admission to, for the duration of and up to qualification on their course. The Training Committee may suspend or terminate the course of a student, trainee or training member under conditions determined by the Training Committee if they cease to be in good standing.
2. There should be no sexual involvement between tutor and her/his trainee.

Breaks in clinical practice

3. Due to personal circumstances, sometimes a break in practice may be required. This may be because of maternity leave, illness, bereavement or other unforeseen event, or a member may opt to take Sabbatical Leave. The Member must have successfully completed one years’ membership and be in good standing (including but not limited to: being a fully paid-up member, no pending complaints and attend regular CPD) with AGIP before applying for a break.
4. In the case of Professional members, applications for a break should be made to AGIP Council: for trainees, applications should be made to the Training Committee. Approval for the application for sabbatical leave/break in clinical practice will be given to the member/trainee in writing stating the expected date of return to practice.
5. The maximum period of a break in practice or a sabbatical is one year. AGIP Council may determine the level of fees, if any, contact and support during member’s absence. In the case of a trainee, the Training Committee will determine the level of fees, if any, contact and support during trainee’s absence.
6. During a break of more than three months the member’s membership of AGIP will be temporarily suspended and held dormant until the member returns back to work. Members and trainees may not undertake any clinical work with patients or supervisees during their break.
7. For Professional members, if required as a result of the break, a request for an extension for additional time to complete the 5-year re-accreditation must be submitted to the Professional Ethics Committee well in advance of the date that re-accreditation is due.

The role of AGIP

72. AGIP is required to monitor and regulate its members’ practices. At the annual renewal of membership, the Association will ask for signed assurance that the member is abiding by or has in place:

    (i)         the AGIP Code of Ethics and Professional Practice

    (ii)        adequate professional indemnity insurance cover

    (iii)       has made provision in case of emergency and has deposited a patient’s contact list (a Clinical Will) with a named individual and has notified the AGIP office of the name of their Will holder

    (iv)       has maintained professional competence

    (v)        is abiding by AGIP’s CPD requirements

    Professional Members are required to sign declarations covering points (i) – (v); Training Members and Trainees in clinical practice are required to sign declarations covering (i), (ii), (iii) & (iv); Training members and Trainees not in clinical practice are required to sign a declaration covering point (i).

73. The Training Committee is responsible for ensuring that Training Members and Trainees maintain adequate supervision. Trainees and Training members are required to sign declarations (i)–(iii) at their clinical interview before starting their clinical work.

    Members should also refer to the UKCP and CPJA Codes of Ethics and Professional Practice.

Guidelines for the complaints procedure

(a) When setting out a complaint, the complainant is reminded that evidence should be given and clear reference made to the particular paragraph(s) of the AGIP Codes of Ethics and Professional Practice the therapist has allegedly transgressed. It is important to give specific examples and/or incidences of the therapist’s conduct which give rise to the complaint.

(b) Complainants must use the Complaints Form, copies of which may be obtained from the AGIP Office. Any supporting evidence must be submitted with the form.

(c) AGIP is willing to give advice on how to make a complaint without prejudice as to whether a complaint may be substantiated or not. This advice is often helpful in clarifying the issues and explaining the process.

(d) The Investigating Committee will be selected from senior professional members who have no prior knowledge of the work of or relationship with the therapist complained against. The same applies if there should be a hearing or an appeal : panel members will have no prior knowledge of the work or relationship with the therapist complained against.

(e) When responding to a complaint, it may be helpful to the investigating panel for the therapist to give his/her understanding as to what happened in the work with the client which might have led to the complaint.

(f) Once a complaint has been accepted, all communication concerning the complaints process should be made in writing to the Co-ordinatorof the Professional Ethics Committee or the person designated to co-ordinate the complaints procedure in the particular case.

Revised November 2022