The descriptor’ member’ refers to anyone working with the NCHP/NSTT in the capacities of:
- Officer.
- Tutor.
- Therapist.
- Supervisor.
- Employee.
- Student.
- Trainee.
In terms of context and the spirit of the Policy, the UKCP Code of Ethics states:
“Be aware of the power imbalance between the practitioner and client, and avoid dual or multiple relationships which risk confusing an existing relationship and may impact adversely on a client. If a dual or multiple relationship is unavoidable, for example, in a small community, take responsibility for clarifying and managing boundaries and protecting confidentiality…
…Exercise all reasonable care before entering into a personal or business relationship with former clients, taking into account the time that has elapsed since therapy ended. Should such a relationship prove to be detrimental to the former client, you may be called to answer an allegation of misusing your former position.”
Ethical principles underpinning the Policy:
- Non-harm and ‘right’ use of power.
- Ethical and honest practice.
- Optimum conditions for learning, growth, and development.
- Justice, objectivity, and fairness to ensure and maintain high standards of professional practice for the benefit of clients, members, and the public.
- Respect for the integrity and confidentiality of the relationship between client and therapist.
- Respect for the integrity of the training programs and the learning process.
- Respect for the integrity of the assessment procedures.
- Openness, transparency, and accountability.
- Valuing the humanistic principles of individual responsibility, personal autonomy and relationships.
- Recognition of the limitations of all systems.
- Freedom of choice.
- Valuing diversity of life in all its complexity as a source of richness for our work in our various modalities.
- Respect for personal and professional developmental needs.
- Congruence with training models and methods.
- Supporting the health of a system by requiring both firm boundaries and structures to support it, as well as a degree of flexibility.
- Placing a high value on awareness and management of the tension between these needs by all involved.
Values informing the Policy:
The following expressions of values provide a philosophical rationale for the Policy.
- To recognise that the interconnectedness of relationships and tasks within the objective of training therapists is complex, rich and diverse; and that it is essential to bring awareness to this as part of creating integrated training.
- To uphold the principles of openness and transparency in all the different forms of relationships created in training psychotherapists to safeguard any potential abuse of power.
- To value the aliveness and unpredictability within any systems and procedures training organisations may implement to control and regulate experience in psychotherapy training contexts.
- To consciously embody an intention of ‘non-harm’ in all such relationships.
- To uphold the principle of providing external consultancy and internal supervision to support training staff in managing personal and collective roles and responsibilities and organisational dynamics.
Philosophical bases for separating the therapeutic relationship from other relationships primarily oriented towards training, supervision, and assessment (acknowledging that whilst all roles and corresponding relationships overlap and interpenetrate, they also have clear differences, boundaries and limitations; awareness and management of particular roles’ limitations are essential for ‘non-harm’ to all concerned):
- To prevent undermining the client’s power and self-authority through a disproportionate balance of power in the relationship due to the therapist being the client’s tutor/supervisor/examiner. This situation could lead to potential abuse of power on the therapist’s part.
- To provide a clear boundary around the client/therapist relationship to protect the possibility for depth relationship work and to help provide safe conditions for working with transferential and subtle energetic material within the relationship field.
- To protect the therapeutic relationship from unnecessary pressure, demand and influence caused by the tension inherent in holding two or more roles that involve different tasks.
- To protect the integrity of the discreet relationships involved (such as therapist/client, supervisor/supervisee, and assessor/assessed).
- To encourage authenticity and appropriate challenge in training, supervision, assessment, and the psychotherapeutic relationship.
- To provide clarity when working with relationships and tasks that are intrinsically interrelated and capable of becoming confused and enmeshed (for example, supervision processes are implicitly present within the tutor/student or trainee relationship).
- To encourage commitment and integrity in tutors, supervisors, assessors, and therapists by taking responsibility for relationships and power imbalances.
Policy Statement
- This policy defines some instances where dual relationships may occur and some dual relationships that we disallow in any event.
- This policy covers dual relationships relating to NCHP/NSTT members. Therefore, it must be considered in conjunction with other NCHP codes, policies and procedures where contextually appropriate.
- We consider that dual relationships are unique to the individual/s, may come in many forms, and may occur in several circumstances at different times and places.
- It is the responsibility of individuals within NCHP/NSTT to carefully consider the implications and possible consequences of any possible dual relationship as it arises.
- We recognise that in an organisation the size of NCHP/NSTT, some dual relationships will be unavoidable, and all possible connotations cannot be exhaustively listed.
- We recognise that relationships and their contexts/complexity may develop and change.
- NCHP/NSTT members are responsible for setting and monitoring clear boundaries between working relationships and friendships or other relationships.
- An ‘external relationship’ (hereafter ER) refers to a relationship between an NCHP/NSTT therapist (or student/trainee therapist) and their client or another person/body outside the NCHP/NSTT organisation.
- An ‘internal relationship’ (hereafter IR) refers to a relationship between an NCHP/NSTT member and another NCHP/NSTT member.
External Relationships:
In ERs, priority is given to the conditions necessary for creating and maintaining an ongoing in-depth client/therapist relationship as partial fulfilment of professional psychotherapy requirements, without interference from overlapping relationships.
Internal Relationships:
- NCHP/NSTT members are responsible for setting and monitoring clear boundaries between working relationships and friendships or other relationships.
- Tutors and supervisors will not accept students/trainees for therapy individually or in a group.
- If a former client of a tutor enrols for training, the tutor will disclose this to the NCHP, with the permission of the former client. Where possible, a minimum of three months must have elapsed between the completion of therapy and the start of the training.
- The tutor must ensure that the student has the opportunity for both parties to discuss their thoughts and feelings related to this relationship in a collaborative environment.
- The former therapeutic relationship is to be kept confidential from the training environment.
- If either party experiences any concerns regarding the boundaries of this relationship, they are encouraged to discuss this with the NCHP so that alternative training options can be discussed and offered.
- Tutors must be sensitive to transference behaviours and communication within the training environment and will seek support and discussion from the NCHP in the best interests of both parties.
Disallowed internal dual relationships are as follows:
- Therapist and tutor.
- Therapist and supervisor.
- Therapist and assessor.
- Tutor and supervisor (for at least one-year post qualification);
- Tutor and assessor*.
* Dual relationships in the assessment process:
The following points articulate philosophical reasons for separating the training relationship and the assessment process:
- Objectivity, fairness and good practice in training and assessment for the protection of the public and the profession.
- The integrity of the assessment process.
- Preventing misuse of power dynamics.
- Creating independence in the assessment procedure so that although a tutor could input into the assessment process, their role, knowledge, and opinion are balanced by others not involved in training the student or trainee.
The NCHP recognises that:
- The overriding aim within the NCHP is to assess anonymously wherever practicable.
- Training therapists requires formative and summative assessments.
- Assessor refers to anyone assessing work summatively and formatively.
- Cohorts benefit from being trained by several tutors during their pathway. We proactively manage this to ensure that formative assessment processes vary, are as objective as possible and reflect different practice styles.
- Some assessments must occur in a synchronous context, and some in an asynchronous context; therefore, it is not realistic or helpful to have all assessments carried out anonymously.
- Formative feedback, assessment and supervision may occur during the live (face-to-face or online) training sessions.
- The NCHP anonymous summative assessment process (whether single, double or check) ensures that the student/trainee and assessor are mutually unidentifiable at all points by using a dedicated and specific administrator and data-management process.
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- The NCHP recognises that some assessment processes require a dual relationship (the NCHP undertakes to uphold the NCHP/NSTT Code of Ethics and Clinical Practice requirements in managing any dual relationships where they are unavoidable).
- Where exceptional circumstances may require a dual relationship, the NCHP will present a detailed account of its reasons for the exception on a case-by-case basis to COOHP.
Although the overriding aim within the NCHP is to assess anonymously wherever practicable, the following intentional applications of (and exceptions to) anonymity in the process of formative and summative assessment apply:
Formative feedback processes (not anonymised):
- Live face-to-face and remote live (online) training.
- Asynchronous online classroom discussion forums/tutorials.
- Stage 1 SCARF (where the tutor/s provides individualised formative feedback on a student’s progress).
- Triad work (recordings).
- Stage 4 dissertation supervision/proposal.
Formative feedback processes (anonymised):
- Stage 2 treatment planning and case conceptualisation.
Summative assessment process (not anonymised):
- Stage 1 case study (video recording).
- Stage 2 case study (video/audio recording).
- Stage 4 group presentations (presented by the trainee/s).
- Stage 4 self-reflective journal.
- Stage 4 psychological maturity viva (personal reflection process not carried out by current tutor or supervisor and recorded).
- Stage 4 submission checking for UKCP accreditation.
Summative feedback process (anonymised):
- Stage 1, 2 and 3 essay submissions.
- Stage 2 ethics paper.
- Stage 4 written work in core modules.
- Stage 4 safeguarding submission.
- Fitness-to-practice log.
- Stage 3 and 4 literature review submissions.
- Stage 4 dissertation submissions.
Date of the last amendment to this document and ratification by The Academic Board – 16/5/22.