Exceptional circumstances may arise which give the trainee or supervisee good grounds for believing that the client will cause serious physical harm to others or themselves, or have harm caused to themselves. In such circumstances the client's consent to a change in the agreement about confidentiality should be sought whenever possible unless there are also good grounds for believing the client is no longer able to take responsibility for his/her own actions. Whenever possible, the decision to break confidentiality agreed between a trainee or supervisee and client should be made only after consultation with a professional supervisor or experienced psychotherapist.
Any breaking of confidentiality should be minimised both by restricting the information conveyed to that which is pertinent to the immediate situation and to those persons who can provide the help required by the client. The ethical considerations involve balancing the best interest of the client and finding ways to enable him/her to resume taking responsibility for his/her actions (a very high priority for psychotherapists) against the psychotherapist's responsibilities to the wider community.
B.4 Professional Relationship
Trainees and supervisees have a responsibility to establish with clients what other therapeutic or helping relationships are current.
Trainees and supervisees should be aware of their own limitations. It is an indication of the competence of psychotherapists when they recognise their inability to counsel a client and in such circumstances make appropriate referrals.
Trainees and supervisees should avoid unnecessary conflicts of interest and are expected to make explicit to the client any relevant conflicts of interest.
Trainees and supervisees are encouraged to increase their colleagues' understanding of the psychotherapist's role. No colleague or significant member of the caring professions should be led to believe that a service is being offered by the psychotherapist which is not, as this may deprive the client of the offer of such a service from elsewhere.
B.5 Relationship with Clients
Trainees should take all reasonable steps to ensure that the client suffers neither physical nor psychological harm during psychotherapy.
Clients should be offered privacy for psychotherapy sessions. The client should not be observed by anyone other than their psychotherapist without having given his/her informed consent. This also applies to audio/video taping of psychotherapy sessions.
Trainees and supervisees are responsible for setting and monitoring boundaries between the psychotherapy relationship and any other kind of relationship and making this explicit to the client.
B.8 Practitioner Competence
Trainees and supervisees must have received adequate basic training before commencing work with clients and must maintain ongoing professional development.
Professional supervision refers to a formal arrangement which enables psychotherapists to discuss their psychotherapy work regularly with one or more people who have an understanding of psychotherapy and professional supervision. Its purpose is to ensure the efficacy of the psychotherapist-client relationship. It is a confidential relationship. Peer supervision is encouraged and is not an alternative to professional supervision.
The volume of supervision should be in proportion to the volume of psychotherapy work undertaken and the experience of the psychotherapist.
Trainees and supervisees should monitor actively the limitations of their own competence through professional supervision and by seeking the views of their clients and other psychotherapists.
Trainees and supervisees have a responsibility to themselves and their clients to maintain their own effectiveness, resilience and ability to help clients. They are expected to monitor their own personal functioning and to seek help and/or withdraw from psychotherapy, whether temporarily or permanently, when their personal resources are sufficiently depleted to require this.
B.9 Psychotherapy and the Law
Trainees and supervisees should take all reasonable steps to be aware of the current law affecting the work of the psychotherapist.
B.10 Indemnity Insurance
Trainees and supervisees who are practising must be adequately covered by appropriate professional indemnity insurance.
B.12 Resolving Conflicts Between Ethical Priorities
Trainees and supervisees will from time to time find themselves caught between conflicting ethical principles. In these circumstances they are urged to consider the particular situation in which they find themselves and to discuss the situation with their psychotherapeutic supervisor and/or other experienced psychotherapists.