CPC Code of Ethics for Therapeutic Work with Children
1) Background:
The welfare of the client is of great importance to members of the Child Psychotherapy Council (CPC) and so shall maintain the highest professional and ethical standards.
2) Purpose:
This policy sets out CPC’s structure for ethical engagement between Child Psychotherapists and children or young people.
CPC is committed to upholding the ethical therapeutic principles and values that are outlined in this policy.
CPC members recognise that membership or registration may be at risk if they fail to fulfil this above commitment. Any major infringement of these ethical principles may result in the practitioner being referred to CPC`s professional ethics committee.
3) Exceptions: Clearly this policy cannot cover every potential ethical, conduct or competence related concern. This document is intended to set out the main expectations CPC has of its members.
4) Guidelines
A. Role of the child psychotherapist
The Child Psychotherapist must:
I) structure the work to always have the best benefit for their client in mind and treat their clients with upmost respect.
II) value each client as a unique person.
III) not wittingly cause harm or injury to their client.
IV) not exploit or abuse the relationship with current or past clients for any purpose including emotional, sexual or financial gain.
V) be fully compliant with current child protection legislation and safeguarding procedures.
VI) promote autonomy for the client and not strive towards dependence of the client towards the psychotherapist.
VII) insure fair treatment and opportunity towards their clients.
VIII) strive to understand his or her own limitations through frequent self-reflection with the help of supervision or personal therapy.
IX) not misrepresent their qualifications and skills of competency and only practice within the limits of his or her professional abilities.
X) [When working online with clients] …… implement and respect the ICO children’s code https://ico.org.uk/media/4019820/5-background-for-teachers-childrens-code-summary.pdf to ensure the safeguarding of practice for online services.
B. Consent to the treatment
I) Before the psychotherapy begins, the Child Psychotherapist needs to seek consent to the psychotherapy offered and how the information of the therapy is shared. It is the Child Psychotherapist’s duty to assess if a young person can make decisions and give consent for their own psychotherapy treatment. The child’s autonomy and rights to be involved in decision-making should be respected as far as their individual circumstances allow.
II) Children and young people are often referred to psychotherapy through third parties, such as parents and institutions. The Child Psychotherapist needs to ensure that the child or young person understands the reason for the meeting and the implication for engagement in the therapeutic encounter.
III) The Child Psychotherapist needs to be able to communicate with the child or young person in an age-appropriate way and explain treatment pathways in ways that the child can understand.
IV) The law presumes that a young person over 16 years of age is able to consent to treatment. However, some 16 years old with disability may not be able to give consent because of inability to make meaningful choices, even with appropriate support.
V) If a child is under 16 years old and would like to access psychotherapy (non-intrusive, non-pharmaceutical) without the knowledge or consent of their parents or legal representative, the Child Psychotherapist must explore with the potential client the reasons behind this desire and, if appropriate, discuss ways the Child Psychotherapist can help the young person to inform their parents or legal representative. If the young person still wants to access psychotherapeutic support without parent or legal representative consent or knowledge, the Child Psychotherapist needs to consider the Gillick competency and Fraser guidelines, which includes:
a) the child’s age, maturity and mental capacity
b) the child’s understanding of the issue, including advantages, disadvantages and possible long-term impact of the psychotherapy process
c) the child’s understanding of any alternative options
d) the child’s ability to explain their rationale around their reasoning and decision making
e) the Child Psychotherapist’s understanding that the young person cannot be persuaded to inform their parents or legal representative but it is in the young person’s best interest to receive the support offered
f) the mental and physical health of the young person are likely to suffer without the support offered
VI) If a child is not mature enough to make decisions about things that affects them, the consent from the parent or legal representative needs to be obtained before starting psychotherapy.
VII) The Child Psychotherapist must regularly review the treatment plan to make sure that it is still in the client's best interest to pursue the agreed course of action.
VIII) Any client or, if the client is not mature enough to make decisions, a parent or legal representative, is entitled to bring the psychotherapeutic relationship to an end. It is the Child Psychotherapist’s task to help the decision maker to understand and reflect on the wish to end the relationship so that this step is made in the best interest of the child and not prematurely or for the benefit of third parties.
C. Confidentiality and disclosure
I) Article 8 of the human rights act protects the right of the client to a right for privacy and a right to family life. This also includes a child’s right for privacy and confidentiality.
II) Trust, maintaining confidentiality, and respect for the client are critical elements of all psychotherapeutic relationships.
III) The Child Psychotherapist needs to inform and gain consent from the client, or their legal representative, about any foreseeable limitations of privacy or confidentiality in advance of the work together, for example, communications to ensure or enhance the quality of work in supervision, to protect a client or others from serious harm including safeguarding commitments, and when legally required or authorised to disclose.
IV) In exceptional circumstances, the disclosure of information of a confidential matter is justified when:
a. The disclosure is in the best interest of the child.
b. The disclosure is to protect the client or others from serious harm such as sexual, physical, or emotional abuse that may result if there is no disclosure.
c. When the disclosure is required by law.
V) The Child Psychotherapist must always be prepared to justify their disclosure.
VI) The Child Psychotherapist must have an open policy about what information, if any, will be shared with other professionals and/or the parents or carers of the child, why sharing information with others is necessary, and that they will also be obliged to keep the communication confidential.
VII) Safeguarding the anonymity and welfare of clients and their family is paramount when any form of publication of clinical material is being considered. If the welfare or anonymity is compromised, such as a former client may still recognise themselves in case material despite the changing of name and circumstances, verifiable consent from the parent or legal representative needs to be obtained.
D. Equality and diversity
I) The Child Psychotherapist needs to ensure high awareness of equality, diversity and inclusion in all aspects of psychotherapy practise. This involves understanding about how discrimination, prejudice and bias operate and continuously reflecting on their own actions and assumptions. This is with the help of other professionals if required.
II) The Child Psychotherapist needs to actively avoid discrimination based on the legally protected characteristics of age, disability, reassignment, pregnancy and maternity, race (including ethnic origin), religion or other protected belief, sex and sexual orientation.
III) If unlawful discrimination based on the above-mentioned legal characteristics are addressed in sessions, the therapist needs to support the client to explore the origin of the discrimination and if necessary, challenge the discrimination and/or take action to address unfair discrimination, prejudice and bias.
D. Data storage
I) Any records and other information from which clients can be identified needs to be securely stored for 7 years after the client reaches 18 years of age. The storage of the records needs to comply with the data protection requirements – see www.ico.org.uk
II) The client, or when relevant the parent or legal representative, need to be informed about what records will be kept, and for how long, before they are disposed securely.
5) Key relevant documents/Appendices:
ICO children’s code https://ico.org.uk/media/4019820/5-background-for-teachers-childrens-code-summary.pdf
