The Irish Forum for Psychoanalytic Psychotherapy

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IRISH FORUM FOR PSYCHOANALYTIC PSYCHOTHERAPY

Code of Conduct (2016)

Introduction

The nature of the psychoanalytic psychotherapist’s / psychoanalyst’s relationship with his or her client is a uniquely intimate one, and requires a clear awareness on the part of the psychotherapist of the need to conduct himself or herself in a manner which is appropriate, professional and sensitive to the potential vulnerabilities of the patient. It is important that in his or her professional conduct, the psychotherapist should behave in a responsible and considerate manner, not only with clients, but also with trainees and supervisees, colleagues, other professionals and the public at large. Each psychoanalytic psychotherapist will naturally develop his or her own clinical technique, while remaining within the parameters of the established format of psychoanalytic method. A temporary lapse into poor technique is distinct from conscious, wilful neglect or the flouting of the standards of conduct with which the psychotherapist has a duty to be familiar. Such temporary lapses, in and of themselves, rarely constitute a breach of ethics. There are, however, certain fundamental standards of conduct which must be adhered to by all psychoanalytic psychotherapists.

The Ethical Attitude in Psychoanalytic Practice

While the Code of Conduct sets out appropriate professional behaviour, the ethical attitude refers to the attitude we bring to the consulting room, and influences how we work. It leads the psychotherapist to reflect on a difficult session, and guards against ‘going through the motions’, desiring only that the client attends and pays the fee. While the latter attitude may not involve a breach of the Code of Conduct, it may be considered unethical where it exists prior to and independent of transference influences. In order to maintain an ethical attitude, reflection, not only on the work itself but on how satisfied we currently feel by it, is advisable, in conjunction with regular supervision and good self-care practices as described in Item 3, (i) and (ii).

Aim

The aim of this document is to provide as clear a set of guidelines as possible for appropriate professional conduct for members of the IFPP, and in so doing to afford protection to the client, to the psychoanalytic psychotherapist and to the profession.

To whom is this Code of Conduct applicable?

This Code of Conduct is applicable to Full, Associate and Student members of the IFPP. Retired and Affiliate members are not required to abide by this Code, but are asked to acquaint themselves with it, and in particular to respect those items related to the profession of psychoanalytic psychotherapy. Full, Associate and Student members must acquaint themselves with the Code of Conduct and behave at all times in their professional conduct in accordance with this Code. Full members are also bound by the Code of Conduct of the Psychoanalytic Section of the Irish Council for Psychoanalytic Psychotherapy.

Breaches of this Code of Conduct

Should a possible breach of the Code of Conduct be brought to the attention of the Executive Committee of the IFPP, such a potential breach will be investigated in accordance with the Complaints Procedure 2016 of the IFPP and may, if appropriate, be referred to the Psychoanalytic Section of the Irish Council for Psychotherapy for investigation according to the Psychoanalytic Section’s Complaints Procedure and Code of Conduct (2008). The Code of Conduct of the IFPP is compatible with the Code of Conduct of the Psychoanalytic Section of the Irish Council for Psychotherapy, while at the same time incorporating any matters specifically relevant to and considered important by the IFPP.

Should an IFPP member, after appropriate investigation, be deemed to be in breach of this Code of Conduct, he or she will, commensurate with the breach, be admonished, suspended or have membership withdrawn. Any such sanctions, whether arising from an investigation by the IFPP or by the Psychoanalytic Section of the ICP, shall be implemented by the IFPP.

While any established breach of this Code of Conduct is potentially a very serious matter, in the case of admonishment or suspension, the aim of the IFPP is to support that member in preventing any future breach.

The role of the Ethics Committee of the IFPP

The role of the Ethics Committee of the IFPP is to advise the IFPP's Executive Committee and Complaints Committee, as well as advising IFPP members on ethical issues.

 

 

CODE OF CONDUCT OF THE IRISH FORUM FOR PSYCHOANALYTIC PSYCHOTHERAPY

1. Responsibilities to clients

(i) Setting

The psychoanalytic psychotherapist must provide a suitable and safe environment and appropriate conditions for psychotherapeutic work.

(ii) Non-discrimination

The psychoanalytic psychotherapist must follow a policy of non-discrimination on the basis of race, religion, ethnic origin, gender, disability and sexual orientation. It is recognized that a psychotherapist may be unable to provide premises with wheelchair access, or may feel that to work with, for example, someone who is deaf, would not be in that person’s best interests.

(iii) Inappropriate clients

The psychoanalytic psychotherapist must not undertake a therapeutic relationship with any of his or her own relatives or friends, nor generally with anyone closely connected with an existing client.

(iv) Appropriateness of psychoanalytic psychotherapy

The psychoanalytic psychotherapist must consider whether psychoanalytic work is appropriate for a particular individual, and for that person’s presenting symptoms and profile. If it appears to be in that person’s best interests to do so, the psychoanalytic psychotherapist should refer on appropriately.

(v) Terms and conditions

From the outset, it is incumbent upon the psychoanalytic psychotherapist to state clearly to the client the particular terms and conditions of the psychoanalytic work which may be undertaken. This includes details of fees, and of the psychotherapist’s policy with regard to fees for cancelled or missed sessions, and for any breaks taken by the client.

(vi) Qualifications disclosure

The psychoanalytic psychotherapist is required to disclose his or her qualifications when so requested, and must not claim or imply qualifications which he or she does not hold.

(vii) Changes and planned breaks

The psychoanalytic psychotherapist must give adequate notice of any changes in the scheduling of treatment and of planned breaks. The possibility is recognized of unforeseen circumstances arising which could necessitate a cancellation or rescheduling at short notice; for example, an accident or a bereavement. All reasonable efforts should be made to inform affected clients of any changes.

2. Confidentiality and protecting the client

(i) Confidentiality

The psychoanalytic psychotherapist must treat the client’s communications with confidentiality and seek to preserve the client’s anonymity. Confidentiality should be kept as complete as possible. The psychotherapist must disclose, if requested, any limits to confidentiality and any circumstances under which it might be broken to specific third parties.

All exceptions must be considered very carefully and, whenever possible, be made in consultation with a supervisor or appropriate colleague or colleagues. The psychoanalytic psychotherapist must be prepared to demonstrate that the exception is
justifiable.

Exceptions to confidentiality may need to be made in the following circumstances:

a. Where the psychoanalytic psychotherapist believes there to be the possibility of
violent behaviour towards the client him/herself, towards the psychotherapist or
towards a third party.

b. In the management of a client whom the psychotherapist deems to have become
psychotic or who may need medical or other support.

c. It is responsibility of the therapist to inform themselves of current relevant
legislation.

The psychoanalytic psychotherapist should seek the client’s consent before making appropriate contact with other professionals involved in his or her care, such as a general practitioner or psychiatrist. It is recognized that there may be circumstances such as those outlined above where contact can proceed without the client’s consent. The psychoanalytic psychotherapist must consider the client’s best interests when contemplating contact with any other professionals in relation to that client.

(ii) Boundaries with current and former clients

The psychoanalytic psychotherapist is required to maintain appropriate boundaries with his or her clients, taking care not to exploit any current or former client financially, sexually or emotionally.

The psychotherapist / client relationship occasionally has the potential to develop into a different kind of relationship in the future, such as that of colleagues or friends. In such cases, an appropriate time interval should elapse before entering into any joint activities, in order to respect the possibility of persisting transference and countertransference influences. The psychotherapist should be mindful of the earlier therapeutic relationship and of any possible vulnerabilities on the part of the former client in this regard.

(iii) Social contact

During the period of therapeutic treatment, the psychoanalytic psychotherapist must exercise restraint in regard to social contact with the client. Social contact with any person known to be a relative of a client should be approached only after careful consideration, and should occur only with the client’s knowledge and consent.

Following the conclusion of psychotherapy, the psychoanalytic psychotherapist should bear in mind the inevitable continuation of transference and countertransference influences, and should use his or her discretion in any social contact.

(iv) Research and publication

The psychoanalytic psychotherapist must safeguard the welfare and anonymity of clients when any form of research is being considered. Before beginning any research in which a client may be involved, the psychotherapist must clarify with that client the nature, purpose and conditions of the research, and must ensure that informed and verifiable consent is obtained before commencement.

When publication of client material is being considered, the client’s consent should be obtained whenever possible. In every case, all reasonable efforts should be made to protect the client’s anonymity, and particularly in any case where specific features of that case might identify the client.

The psychoanalytic psychotherapist must not, for research or any other purpose, make audio or video recordings of a client, nor use, or permit observation through, a one-way screen mirror, without that client’s consent. Supervisors should also keep this in mind.

3. Maintenance of professional competence

(i) Ongoing learning

The psychoanalytic psychotherapist is required to maintain his or her ability to work competently, and to take the necessary steps in order to do so. This includes ongoing professional learning and training, which in turn includes ongoing clinical supervision. Participation in workshops, seminars, conferences, reading groups and similar events is decided by the individual psychoanalytic psychotherapist, while bearing in mind both the current requirements for Continuing Professional Development and also any individual areas of inexperience as well as interest.

Reasonably frequent participation in discussions with other psychoanalytic psychotherapists in particular, and also with other mental health professionals enriches understanding, and can assist the psychotherapist in his or her work with current clients.

(ii) Physical and mental health

The psychoanalytic psychotherapist is required to maintain his or her own physical and mental health. If physical and / or psychological condition is seriously impaired, the psychotherapist must refrain from practising. In situations such as physical illness, personal stress or alcohol or drug-related problems, the psychotherapist must ensure that his or her clients are referred on appropriately, and should seek appropriate professional help if he or she wishes to resume practising.

The possibility is recognized of unforeseen effects from prescribed medication temporarily affecting the psychotherapist’s work, in which case the psychotherapist should consider whether he or she is currently fit to practice while these effects persist, seeking medical advice if he or she thinks it to be necessary. A distinction is also made between a state of temporary tiredness and one of ongoing physical and / or psychological impairment. In situations such as these, the psychotherapist must exercise his or her own judgement, while bearing in mind the best interests of his or her clients. Consultation with a supervisor and / or colleagues is recommended.

(iii) Legal issues

If a psychoanalytic psychotherapist is convicted of any serious criminal offence or becomes the subject of any legal action pertaining to his or her work as a member of the IFPP, the psychotherapist must inform the Executive Committee of the IFPP and also ensure that the Committee of the Psychoanalytic Section of the ICP is likewise informed.

(iv) Insurance

All members of the IFPP are required to maintain both litigation and accident insurance to levels complying with current ICP and EAP requirements.

4. Responsibilities to colleagues, trainees, the general public and the profession of
psychoanalytic psychotherapy

While this Code of Conduct is concerned primarily with the protection of clients, others must also be protected by the Code, namely colleagues, trainees and the profession of psychoanalytic psychotherapy itself.

(i) Relationships with colleagues

Communications with and about colleagues and other professionals should be conducted with consideration and respect, and while it may at times be necessary to make a criticism of a colleague or other professional, this should be done with care and truthfulness, with a clear distinction made between opinion and fact.

(ii) Psychoanalytic psychotherapy trainees

In the fulfillment of educational or training responsibilities such as lecturing, tutoring, leading seminars or supervision, it is recognized that ethical requirements may differ somewhat from those concerning the protection of clients. For example, social contact may be more likely to occur. The psychoanalytic psychotherapist should nevertheless remain aware that he or she is in a professional relationship with the trainee, and generally behave with appropriate restraint.

Reports and other personal communications about a trainee must be treated as confidential and for the sole use of the relevant staff of the training organization concerned.

(iii) Supervision

The psychoanalytic psychotherapist who provides academic and / or clinical supervision for trainees, or clinical supervision for associate or fully accredited members of the IFPP, or of any other psychotherapy or counselling body, must ensure that those working under his or her direct supervision are familiar with this Code of Conduct. The supervisor must make all reasonable efforts to ensure that the supervisee complies with the Code

The clinical supervisor should ensure that those working under his or her direct supervision do not exceed the limits of their competence.

(iv) Other professionals and the general public

The psychoanalytic psychotherapist should maintain an awareness of the fact that he or she is a representative of the profession of psychoanalytic psychotherapy, and that the profession may be judged by his or her conduct. The psychotherapist should refrain from any action, speech or writing which is defamatory towards other professionals, members of the public, other groups or institutions. An IFPP member is expected to uphold a proper ethical stance in all their professional roles, psychoanalytic and otherwise.

(v) Committees of the IFPP

The Executive Committee of the IFPP must ensure that all members shall have an understanding of this Code of Conduct.

Within an IFPP committee (i.e. the Executive Committee, the Ethics Committee, or a committee convened for the purpose of investigating an allegation against an IFPP member or for any other reason), the committee concerned has the right and obligation to maintain confidentiality about its deliberations. The business of an IFPP committee may be of particular sensitivity, particularly where confidentiality is concerned. However, while IFPP committee members are naturally bound by this Code of Conduct, procedures to be followed within a committee constitute administrative business, the rules of which are laid down by the committee concerned.