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Last revision accepted at the General Assembly, Belgrade (30.05.2007) PREAMBLE The YUAP Ethical Code is socially constructed with reference to development within psychotherapy and within wider society. Ethical principles are derived from values related to Human Rights included in the Universal Declaration of Human Rights and indicate attitudes to assume in order to translate values into professional practice. Practice of the psychotherapeutic profession, all members of the YUAP (association members and individual members) accept that the practice of psychotherapy requires responsibility and the following ethical principles are binding for all members of the YUAP. National association members, affiliated to YUAP, need to provide their own norms, which have to be consistent with the YUAP Ethical Code and the national legal requirements. PURPOSE There are different purposes for ethical code: Ø the enhance a practitioner's awareness and thinking in terms of ethics (values and principles as well as norms and prohibitions); Ø the regulation of inappropriate behavior (to protect the clients from unethical applications of psychotherapy by all its psychotherapists and training members); Ø the promotion of optimal behavior (to set standards for its members); Ø the foundation for the setting of complaints. THE PSYCHOTHERAPEUTIC DISCIPLINE AND PROFESSION Psychotherapy is both a scientific and an applied discipline. It is a separate profession, too. As psychotherapy developed as a specific scientific discipline, the need for its own ethical code is seen as part of that development of identity. Psychotherapy is the systematic use of a relationship between the therapist and client to produce changes in cognition, feelings and behavior and further development. The psychotherapeutic discipline is characterized by its commitment to the responsible accomplishment of the aforementioned task. Psychotherapists respect dignity and worth of the individual and strive for the preservation and protection of fundamental human rights. Psychotherapists are required to use their expertise while taking into account the individual's dignity and esteem and for the client's best interest. Psychotherapists respect other members of their profession and of related professions and make every effort, in so far as they are able and where that does not conflict with the interest of their clients, to provide full information and give mutual respect. They use their skills only for purposes consistent with these values and do not knowingly permit their misuse by others. Within psychotherapy as the helping profession, ethical principles need to address many areas in order to influence ethical behaviour. The main principal ones are: clients, self as practitioner, trainees, colleagues and human environment/community. In the pursuit their profession, psychotherapists subscribe to detailed ethical principles in the following areas, which follow: - Responsibility
- Professional competence and development
- Confidentiality
- Welfare of the client
- Professional relationships
- Public statements
- The right to clear and true information
- Assessment techniques
- Psychotherapy research
- Specific prohibitions
1. RESPONSIBILITY General Principle: In providing services, psychotherapists maintain the highest standards of their profession. They accept the responsibility for the consequences of their acts and practice and choose behaviours taking into account a wide variety of factors, e.g. client, self, trainees, colleagues and environment/community as a whole. Psychotherapists make effort to ensure that their services are used appropriately. Principle 1.a: As practitioners, psychotherapists know that they have a significant social responsibility because their recommendations and professional actions may alter the lives of others. They are alert to personal, social, organisational, financial, environmental, or political situations and pressures that might lead to misuse of their influence. Principle 1.b: Psychotherapists clarify in advance with their clients all matters that might pertain to their working together. They avoid relationships that may limit their objectivity or create a conflict of interest. Principle 1.c: Psychotherapists have the responsibility to attempt to prevent distortion, misuse, or suppression of their findings by an institution or agency of which they are employees. Principle 1.d: As members of national or organisational bodies, psychotherapists remain accountable as individuals to the highest standards of their profession. Principle 1.e: As teachers or trainers, psychotherapists recognise their primary obligation to help others acquire knowledge and skill. They maintain high standards of scholarship by presenting information objectively, fully, and accurately. Principle 1.f: As researchers, psychotherapists accept responsibility for the selection of their research topics and methods used in investigation, analysis and reporting. They plan their research in ways to minimise the possibility that their findings will be misleading. In publishing reports of their work, they never suppress disconfirming data, and they acknowledge the existence of alternative hypotheses and explanations of their findings. Psychotherapists take credit only for the work they have actually done. They clarify in advance with all appropriate persons and agencies the expectations for sharing and utilising research data. Interference with the milieu in which data are collected is kept to a minimum. 2. PROFESSIONAL COMPETENCE AND DEVELOPMENT General principle: The maintenance of high standards of competence is responsibility shared by all psychotherapists in the interest of the public and the profession as a whole. Psychotherapists recognise the boundaries of their competence and the limitations of their techniques. They only provide services and only use techniques for which they are qualified by training and experience. In those areas in which recognised standards do not yet exist, psychotherapists take whatever precautions are necessary to protect the welfare of their clients. They maintain knowledge of current health, scientific and professional information related to the services they render. Psychotherapists are required to practice their profession in a competent and ethical manner. They are required to pay attention to research and development in the science field of psychotherapy. For psychotherapists are required continuing professional education & professional development and supervision. Psychotherapists should limit their practice to those areas and treatment methods in which it can be proven that they have gained sufficient and certified knowledge and experience. Principle 2.a: Psychotherapists accurately represent their competence, education, training, and experience. They claim as evidence of educational & professional training qualifications only those degrees or qualifications obtained from reputable educational institutions or those recognised by the EAP. They ensure that they adequately meet the minimum professional standards as laid down by the EAP, the relevant National Awarding Organisation's criteria, and the criteria of the relevant European Wide Accrediting Organisation in their modality or method, where these exist. They respect the other sources of education, training and experience that they have received. Principle 2.b: As practitioners, and as teachers or trainers, psychotherapists perform their duties on the basis of careful preparation and readiness so that their practice is of the highest standard and communication is accurate, current, and relevant. Principle 2.c: Psychotherapists recognise the need for continuing education and personal development and are open to new procedures and changes in expectations and values over time. Principle 2.d Psychotherapists recognise differences among people, such as those that may be associated with age, sex, socio-economic, and ethnic backgrounds or the special needs of those who might have been specifically disadvantaged. They obtain suitable training, experience, or counsel to assure competent and appropriate service when relating to all such persons. Principle 2.e: Psychotherapists responsible for decisions involving individuals or policies based on test results have an understanding of psychological or educational measurement, validation problems, and test research. Principle 2.f: Psychotherapists recognise that personal problems and conflicts may interfere with professional effectiveness. Accordingly they refrain from undertaking any activity in which their personal problems are likely to lead to inadequate performance or harm to a client, colleague, student, or research participant. If engaged in such activity when they become aware of their personal problems, they seek competent professional assistance to determine whether they should suspend, terminate, or limit the scope of their professional activities. Principle 2.g: Psychotherapists entering into new fields of activity ensure that they have completed all the training and professional requirements related to that field of activity, prior to practising, and that their activity in this new field is of the highest possible standard. They ensure that there is no dilution of, confusion or conflict with any current activity. 3. CONFIDENTIALITY General statement: Psychotherapists have a primary obligation to respect the confidentiality of information obtained from persaons in the course of their work as psychotherapists. They reveal such information to others only with the consent of the person (or the person's legal representative), except in those unusual circumstances in which not to do so would probably result in clear danger to the person or to others. Psychotherapists inform their clients of the legal limits of confidentiality. Consent to reveal information to others would normally be obtained in writing from the person concerned. Therapeutic relationship is founded on the assumption that what passes between psychotherapist and client is a matter for them alone, and breaches of professional confidentiality are regarded as seriously unethical and against the code of practice of the profession. Successful therapy requires that the therapist should not be bound by any absolute restriction of confidentiality imposed by the client. Psychotherapists should not lose sight of their moral duties of common humanity to fellow citizens who are not their clients. The general principle underlying the limits of confidentiality should be that confidential information given to a therapist by a client in therapy is the property of the client, and should not be divulged to a third party unless this is judged by the therapist to be necessary for the protection of someone's safety. There could be extreme situations where the principle would have to be abandoned. The psychotherapists will not enter into or maintain a professional relation where other activities or relationships between psychotherapist and client might jeopardize the professional contract. The same applies to supervision. Principle 3.a: Information obtained in clinical or consulting relationships, or evaluating data concerning children, students, employees, and others, is discussed only for professional purposes and only with persons clearly concerned with the case. Written and oral reports present only data germane to the purposes of the evaluation or for a referral, and every effort is made to avoid undue invasion of privacy. Principle 3.b: Psychotherapists who present personal information obtained during the course of professional work in writings, lectures, or other public forums either obtain adequate prior consent to do so or adequately disguise all identifying information. Principle 3.c: Psychotherapists make provisions for maintaining confidentiality in the storage and disposal of records, and in the event of their own unavailability. Principle 3.d: When working with minors or other persons who are unable to give voluntary, informed consent, psychotherapists take special care to protect these person's best interests and consult others involved appropriately. 4. WELFARE OF THE CLIENT General Principle: Psychotherapists respect the integrity and protect the welfare of the people and groups with whom they work. Psychotherapists emphasize the importance of enhancing the growth of each person. Psychotherapists take care of both self and others (physically, mentaly. etc.) bearing in mind the uniqueness and the worth of everyone. Psychotherapists take into account the consequences of their own actions as clients, trainees, therapists, supervisors, counsellors, etc. When conflicts of interest arise between clients and psychotherapists' employing institutions, psychotherapists clarify the nature and direction of their loyalties and responsibilities and keep all parties informed of their commitments. Psychotherapists fully inform clients as to the purpose and nature of any evaluative, treatment, educational, or training procedure, and they openly acknowledge that clients, students, trainees, or participants in research have freedom of choice with regard to participation. Coercion of people to participate or to remain in receipt of services is unethical. Principle 4.a: Psychotherapists are continually cognizant of their own needs and of their potentially influential position vis- a -vis persons such as clients, students, trainees, subjects and subordinates. They avoid exploiting the trust and dependency of such persons. Psychotherapists make every effort to avoid dual relationships that could impair their professional judgment or increase the risk of exploitation. Examples of such dual relationships include, but are not limited to, professional treatment of or research with employees, students, supervisees, close friends, or relatives. Sexual intimacies with any such clients, students, trainees and research participants are unethical. Principle 4.b: When a psychotherapist agrees to provide services to a client at the request of a third party, the psychotherapist assumes the responsibility of clarifying the nature of the relationships to all parties concerned. Principle 4.c: Where the demands of an organisation require psychotherapists to violate these or any ethical principles, psychotherapists clarify the nature of the conflict between the demands and the principles. They inform all parties of their ethical responsibilities as psychotherapists and take appropriate action. Principle 4.d: Psychotherapists make advance financial arrangements that safeguard the best interests of and are clearly understood by their clients, students, trainees or research participants. They neither give or receive and remuneration for referring clients for professional services. They contribute a portion of their services to work for which they receive little or no financial return. Principle 4.e: Psychotherapists terminate a clinical or consulting relationship as soon as it is reasonably clear that the client is not benefiting from it, or whenever the client requires. They offer to help the client locate alternative sources of assistance. 5. PROFESSIONAL RELATIONSHIPS General Principle: Psychotherapists act with due regard for the needs, special competencies, and obligations of their colleagues in psychotherapy, psychology, medicine & other professions. They respect the prerogatives and obligations of the institutions or organisations with which these other colleagues are associated. Principle 5.a: Psychotherapists understand the areas of competence of related professions. They make full use of all the professional, technical, and administrative resources that serve the best interests of clients. The absence of formal relationships with other professional workers does not relieve psychotherapists of the responsibility for securing for their clients the best possible professional service, nor does it relieve them of the obligation to exercise foresight, diligence, and tact in obtaining the complementary or alternative assistance needed. Principle 5.b: Psychotherapists know and take into account the traditions and practices of other professional groups with whom they work and they cooperate fully with such groups. If a person is receiving similar services from another professional, the psychotherapist carefully considers that professional relationship and proceeds with caution and sensitivity to the therapeutic issues as well as the client's welfare. The psychotherapist discusses these issues with the client so as to minimise the risk of confusion and conflict, and seeks, where possible, to maintain clear and agreed relationships with other involved professionals. Principle 5.c: Psychotherapists who employ or supervise other professionals or professionals in training accept the obligation to facilitate the further professional development of these individuals and take action to ensure their competence. They provide appropriate working conditions, timely evaluations, constructive consultation, and experience opportunities. Principle 5.d: Psychotherapists do not exploit their professional relationships with clients, supervisees, students, employees or research participants sexually or otherwise. Psychotherapists do not condone or engage in sexual harassment. Sexual harassment is defined as deliberate or repeated comments, gestures, or physical contacts of a sexual nature that are unwanted by the recipient. Principle 5.e: When psychotherapists know of an ethical violation by another psychotherapist, and it seems appropriate, they informally attempt to resolve the issue by bringing the behaviour to the attention of the psychotherapist. If the misconduct is of a minor nature and/or appears to be due to lack of sensitivity, knowledge, or experience, such an informal solution is usually appropriate. Such informal corrective efforts are made with sensitivity to any rights to confidentiality involved. If the violation does not seem amenable to an informal solution, or is of a more serious nature, psychotherapists bring it to the attention of the appropriate institution, association or committee on professional ethics and conduct. 6. PUBLIC STATEMENTS General Principle: When announcing or advertising professional services, psychotherapists may list the following information to describe the provider and services provided: name, highest relevant academic degree or training certificate earned from an accredited institution, date, type, award of the ECP, membership of psychotherapy organisations and professionally relevant or related bodies, address, telephone number, office hours, a brief listing of the type of psychological services offered, an appropriate presentation of fee information, foreign languages spoken, policy with regards to insurance or third party payments and other brief & pertinent information. Additional relevant or important client information may be included if not prohibited by other sections of these ethical principles. Principle 6.a: Public announcements or advertisements soliciting research participants in which clinical services or other professional services are offered as an inducement make clear the nature of the services as well as the costs and other obligations to be accepted by participants in the research. Principle 6.b: A psychotherapist accepts the obligation to correct others who represent the psychotherapist's professional qualifications, or associations with products or services, in a manner incompatible with these guidelines. Principle 6.c: Individual diagnostic and therapeutic services are provided only in the context of a professional psychotherapeutic relationship. When personal advice is given by means of public lectures or demonstrations, newspaper or magazine articles, radio or television programs, mail, or similar media, the psychotherapist utilises the most current relevant data and exercises the highest level of professional judgment. Principle 6.d: Advertisments of "personal growth groups", special-interest group sessions, courses, clinics, trainings and agencies give a clear statement of purpose and a clear description of the experiences or training to be provided. The education, training, and experience of the staff members are appropriately specified and available prior to the commencement of the group, training course or services. A clear statement of fees and any contractual implications is available before participation. Principle 6.e: Psychotherapists associated with the development or promotion of psychotherapeutic techniques, products, books, or other such offered for commercial sale make reasonable efforts to ensure that announcements and advertisments are presented in a professional, scientifically acceptable, ethical and factually informative manner. Principle 6. f: Psychotherapists present the science and art of psychotherapy and offer their services, products and publications fairly and accurately, avoiding misinterpretation through sensationalism, exaggeration, or superficiality. Psychotherapists are guided by the primary obligation to aid the public in developing informed judgements, opinions, and choices. Principle 6. g: As teachers, psychotherapists ensure that statements in catalogues and course outlines are accurate and not misleading, particularly in terms of subject matter to be covered, bases for evaluating progres, and the nature of course experiences. Announcements, brochures or advertisments describing workshops, seminars, or other educational programs accurately describe the audience for which the program is intended as well as eligibility requirements, educational objectives, and nature of the material to be covered. These announcements also accurately represent the education, training, and experience of the psychotherapists presenting the programs and any fees involved. Principle 6. h: Individual diagnostic and therapeutic services are provided only in the context of a professional psychotherapeutic relationship. When personal advice is given by means of public lectures or demonstrations, newspaper or magazine articles, radio or television programs, mail, or similar media, the psychotherapist utilises the most current relevant data and exercises the highest level of professional judgement. 7. THE RIGHT TO CLEAR AND TRUE INFORMATION General principle: At the beginning of the psychotherapeutic treatment, psychotherapists are required to make the client aware of their rights with special emphasis on the following: - the psychotherapeutic method employed - length and extent of therapeutic relation - financial terms of the treatment - confidentiality - complaints procedure the client should be given the opportunity to decide whether she/he wishes to enter psychotherapy and if so with whom. Information given to clients must be factual/objective and true. Any blatant or misleading advertising is impermissible. 8. ASSESSMENT TECHNIQUES General Principle: In the development, publication, and utilisation of psychotherapeutic or psychological assessment techniques, psychotherapists make every effort to promote the welfare and best interests of the client. They guard against the misuse of assessment results. They respect the client's right to know the results, the interpretations made, and the bases for their conclusions and recommendations. Psychotherapists make every effort to maintain the security of tests and other assessment techniques within the limits of legal mandates. They strive to ensure the appropriate use of assessment techniques by others. Principle 8.a: In using assessment techniques, psychotherapists respect the right of clients to have full explanations of the nature and purpose of the techniques in language the clients can understand, unless an explicit exception to this right has been agreed upon in advance. When the explanations are to be provided by others, psychotherapists establish procedures for ensuring the adequacy of these explanations. Principle 8.b: Psychotherapists responsible for the development and standardisation of psychological tests and other assessment techniques utilise established scientific procedures and observe the relevant national, and institutional or organisational standards. Principle 8.c: In reporting assessment results, psychotherapists indicate any reservations that exist regarding the validity or reliability because of the circumstances of the assessment or the inappropriateness of the norms for the person tested. Psychotherapists strive to ensure that the results of assessments and their interpretations are not misused by others. 9. PSYCHOTHERAPY RESEARCH General Principle: The decision to undertake research rests upon a considered judgment by the individual psychotherapist about how best to contribute to human science and human welfare. Having made the decision to conduct research, the psychotherapist considers alternative directions in which research energies and resources might be invested. On the basis of this consideration, the psychotherapist carries out the investigation with respect and concern for the dignity and welfare of the people who participate and with cognizance of regulations and professional standards governing the conduct of research with human participants. Principle 9.a: In planning a study, the the psychotherapist who carries out the investigation (the investigator) has the responsibility to make a careful evaluation of its ethical acceptability. To the extent that the weighing of scientific and human values suggests a compromise of any principle, the investigator incurs a correspondingly serious obligation to seek ethical advice and observe stringent safeguards to protect the rights of human participants. Principle 9.b: The investigator always retains the responsibility for ensuring ethical practice in research. The investigator is also responsible for the ethical treatment of research participants by collaborators, assistants, students, and employees, all of whom,however, incur similar obligations. Principle 9.c: Except in miminal-risk research, the investigator establishes a clear and fair agreement with research participants, prior to their participation, that clarifies the obligation and responsibilities of each. The investigator has the obligation to honour all promises and commitments in that agreement. The investigator informs the participants of all aspects of the research that might reasonably be expected to influence willingness to participate and explains all other aspects of the research about which the participants inquire. Failure to make full disclosure prior to obtaining informed consent requires additional safeguards to protect the welfare and the dignity of the research participants. Research with children or with participants who have impairments that would limit understanding and/or communication requires special safeguarding procedures. Principle 9.d: Methodological requirements of a study may make the use of concealment or deception seem necessary. Before conducting such a study, the investigator has a special responsibility to (i) determine whether the use of such techniques is justified by the study's prospective scientific, educational, or implied value; (ii) determine whether alternative procedures are available that do not use concealment or deception; and (iii) ensure that the participants are provided with sufficient explanation as soon as possible. There exists a presumption not to use such techniques. Principle 9. e: Psychotherapists, where necessary, are required to do research and work interdisciplinary with representatives of other sciences for the well-being of the client. In the interest of the scientific and theoretical development of psychotherapy, psychotherapists should participate in appropriate research projects. Psychotherapeutic research as well as publications are subject to the above ethical guidelines. The interests of the client are paramount. Principle 9. f: Information obtained about research participant during the course of an investigation is confidential unless otherwise agrees upon in advance. When the possiblity exists that others may obtain access to such information, this possibility, together with the plans for protecting confidentiality, is explained to the participant as part of the procedure for obtaining informed consent. 10. SPECIFIC PROHIBITIONS Psychotherapists are required to act responsibly, especially given the special nature of the psychotherapeutic relationship which is built on trust and a certain amount of dependency. Failure of responsibility in dealing with the trust and dependency relationship in psychotherapy is a serious error of treatment. The following prohibitions must be observed: A psychotherapist must not sexually exploit her/his clients. A psychotherapist must not emotionally exploit her/his clients. A psychotherapist must not socially exploit her/his clients. A psychotherapist must not financially exploit her/his clients. A psychotherapist must not deceive her/his clients. A psychotherapist must not reveal confidential information revealed to her/him by a client. A psychotherapist must not engage in any "therapy" which is really just a covert form of policing. A psychotherapist must not permit considerations of religion, nationality, race, party politics or social standing to intervene between her/his professional duty and her/his clients. 11. GUIDELINES FOR TRAINING IN ETHICS The aforementioned ethical guidelines are applied to the relationship between the trainer and trainee as appropriate, between colleagues, students, research participants, and society members. Psychotherapists are fully informed about Ethical Principles of EAP. Psychotherapists are fully informed about Code of Ethics of their national association and committed to respect it. To maintain up to date of ethical awareness is responsibility of each member of association. National association will organize regularly seminars in Ethics. Belgrade (30.05.2007) Union President Prof. dr Snezana Milenkovic
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