Regulation of Complementary and Alternative Therapists
Guidelines for the Employment of Complementary Therapists
in a Community Setting
Background
The need to develop a set of guidelines for the employment of complementary therapists and the delivery of a complementary therapy service in a community setting arose out of the development of such services in the Canal Communities area of Dublin (Rialto, Inchicore and Bluebell specifically). Several community groups are currently offering complementary therapies to their clients and the general public, and are offering taster sessions in various therapies on a once off basis at celebratory events such as National Women’s Day. In addition, community based education providers are finding the provision of sessions in complementary therapies are a very effective way to engage people in a range of activities they would not otherwise participate in. Although many complementary therapies require training that can be as long and extensive as that of some mainstream healthcare therapies, training in complementary therapies is often used as the first step on the education ladder for adult early school leavers. Funding for the delivery of these therapy sessions is provided through the HSE and other state agencies.
The usefulness of complementary therapies in a community setting is undisputed and wide ranging. But several years of experience in the delivery of such services has led the Canal Communities groups (providing agencies) to recognise the need for clear guidelines and protocols around the employment of therapists and the delivery of the complementary therapy services. The development of these guidelines took place over two facilitated workshops which included representatives from the providing agencies as well as the therapists delivering the services for those agencies. Individual feedback on the document was sought from therapists who could not attend either workshop.
Guidelines
The following guidelines were developed in response to the experiences of community service providers and therapists. They fall under three headings:
1. Employment Issues,
2. Physical Environment
3. Client-Therapist Relationship Boundaries.
Employment Issues
1(a) Terms of Employment (sessional)
The terms under which Complementary and Alternative Medicine (CAM) Therapists are employed need to be regularised in the same way as other staff. CAM Therapists are usually employed on a sessional basis and this needs to be reflected in the ‘contract’ or ‘agreement’ at the start of their employment. This contract should contain the following:
* Agreed time and duration of the sessional work and level of flexibility involved in this (if any)
* Length of the contract
* Fees per session – there should be a standard rate of payment with flexibility depending on the therapy and experience of the therapist
* Method of payment e.g. by invoice from the therapist
* References – to be kept on file
* Make it clear that the therapist, as an independent contractor, is responsible for their own tax liabilities
The grievance procedures of the providing agency which should be agreed to by the therapist
* Make clear that the therapist is responsible for their own professional indemnity insurance and a copy of the therapist’s current insurance certificate should be kept on file by the providing agency and updated annually for as long as the therapist is employed by the agency.
* Copy of current membership of a professional body for the therapy the therapist is employed to deliver (to be submitted annually).
* Responsibility for supply of equipment, barrier protection, etc.
* Name of support/contact person. This could be a Community Health Worker or other person appointed to oversee and support the delivery of the CAM service.
* Review and evaluation procedures and how frequently these will take place
* Probationary period and methods of evaluation of the work at the end of this period
* A brief statement of the ethos of the providing agency and an agreement that the therapist will work within this ethos
* Agreement that best professional practice will be followed at all times
* Agreement that the therapist will work within the scope of practice of the therapy/therapies they are employed to deliver
* Any other issues of importance to both therapist and employer.
Supplementary Documentation
CAM therapists should come under the equality, health and safety and other policies that pertain to the rest of the service provider’s staff. Therefore their copy of the contract should be accompanied by a copy of the following:
* Agency grievance procedures
* Agency health and safety procedures, including the use and disposal of sharps
* Children First Guidelines
* Guidelines for the employment of CAM therapists in a community setting
* Garda Vetted Statement
* Any other relevant agency policies and procedures that exist
Employment
1(b). Terms of Employment (on staff)
Therapists are often members of staff of the providing agency and provide a complementary therapy as one of their many other duties. Such therapists are employees of the agency and their therapeutic work is covered under their staff contract. However, the providing agency needs to ensure that:
* the therapist has continuous insurance cover for the delivery of the therapy
* is fully qualified in that therapy
* is a member of a professional body for that therapy (copy of current membership certificate to be attached to contract).
1(c). Terms of Employment (casual)
This refers to therapists who are employed by a providing agency on a very casual basis to deliver taster sessions at health fairs, celebratory events, etc. A much briefer contract needs to be agreed between the agency and such therapists which would include:
• Date, place and time of delivery of the service
• Rate of pay and method of payment, e.g. by invoice
• Agreement on provision of equipment e.g. plinths, barrier protection, etc.
• Agreement on the use and disposal of sharps
• Membership of a professional body
• Copy of current professional indemnity insurance to be attached to contract
• Garda Vetted Statement to be attached to the contract.
• Ensure that the providing agency’s insurance covers the service to be provided
2. Qualifications of Therapists
Therapists should be fully qualified in the therapy/therapies they will practice. As with other staff, the providing agency should request copies of relevant certificates, transcripts, etc. which should be kept on file.
3. Professional Body Membership
All CAM therapists should be members of the relevant professional bodies for their therapies. To qualify for membership, a therapist must have the required level of training/qualification and insurance cover. A list of such bodies is available on www.ficta.com or in the appendix of the Report on the Regulation of Complementary Therapists available from the Government Publications Office or the website of the Department of Health and Children at www.dohc.ie/publications.
4. Insurance
All CAM therapists should carry professional indemnity insurance. Increasingly insurance companies look for evidence of membership of a professional body and continuing professional development. Without this evidence, a higher premium may be charged.
All service providers need to check with their own insurance company for guidance on what may be covered by the therapist’s professional insurance and what is covered by the providers public liability insurance.
5. Induction
CAM therapists working in a community based agency are part of a larger system of care for clients and the community and will become part of a staff team, albeit in quite a different way to permanent staff. Therefore an induction process, organised and delivered by the providing agency, would be good practice. The induction would cover such issues as:
• The history of the project/community group
• The work that they do
• Why they do this work
• Where the therapy and therapist fit into the overall service
• The ethos of the project/group
• The procedures in place to ensure continuum of care for service users and the community (see no. 6 below)
• Database of health and well being services in the locality for purposes of referral if required.
• Agency protocols, limits to confidentiality, agency policy on working with under age clients, etc.
6. Continuum of Care
CAM therapists, like other provider agency staff, form part of a continuum of care for clients of the agency and have the potential to feed into the development of health and wellbeing services for the community in general. They may play an important role in monitoring and mapping developments in health care needs for the community in which they work. Therefore it is good practice to check in with CAM therapists on a regular/quarterly basis to monitor trends emerging in their work and as part of their conditions of employment, therapists agree to these check in sessions. As payment is on a sessional basis, therapists would be paid to attend such sessions or they could become part of regular supervision.
7. Pre-qualified Therapists
Because CAM is such a useful progression route for adult early school leavers, many providing agencies support former clients, CE workers and others in acquiring qualifications in CAM therapies. As part of that support, the agencies may give such students the opportunity to work with clients as part of their training. Pre-qualified therapists must be supervised in their work by a qualified therapist. This more in-depth level of supervision could be part of the support the group/agency is offering as part of the progression process. The same professional insurance requirements apply to student therapists as to fully qualified therapists. Agencies need to check with their own insurer about cover for student therapists.
8. Database of Therapists
Because community based service providers are often in close geographical proximity to each other and interact in many ways as part of their community involvement brief, it makes sense to share resources such as CAM therapists. Clusters of community service providers could develop and share a database of CAM therapists which would make the sourcing of such therapists easier for all the agencies concerned. All agencies would need to develop protocols around the sharing and recommending of therapists because by putting them on a database the agencies would, in effect, be acting as referees for the individual therapists with all the implications of this. Inclusion on such a database would need to be with the clear consent of the therapist.
9. Offering a Service
When a community group decides to offer a CAM service to its clients, the staff publicising the service or referring clients to it need to be fully aware of the nature and scope of the therapies they are publicising or referring to. Liaising with the therapists prior to publicising or referring is essential.
10. Supervision
Therapists working in the community setting, like those working in hospitals, often find the work difficult and emotionally and physically draining. Therapists who are members of staff should automatically come under the providing agency’s support and supervision systems. In the case of sessional and casual therapists, the agency is not responsible for providing supervision but it should check that the therapist has adequate support systems (e.g. clinical supervision) to enable them to care for themselves while carrying out their therapeutic work. Subject to having adequate resources, the agency could also make time and space available for the therapists to meet and support each other.
Physical Environment
1. Liaison Worker
The providing agency needs to appoint a member of staff to oversee the delivery of the CAM service and be the contact worker for the CAM therapists. This could be a Community Development Health Worker (CDHW) if such a post exists within the agency or another member of staff.
2. Work Place
The health and safety of the client and therapist are paramount. Therefore the physical environment and lay out of the therapy space should be determined by the therapy and the therapist’s needs. This should be agreed in advance, particularly when two or more therapists are sharing a work space. The CDHW takes a role in working with the therapists to determine the work space needs, ensuring that they comply with the agency’s health and safety guidelines, facilitating communication in relation to work space and helping to resolve any difficulties or disagreements that might arise in relation to same.
3. Set-up/Set-Down Procedures
The providing agency in conjunction with the therapists, needs to develop procedures in relation to the use of space, equipment, etc. Ideally the following should occur:
• The Community Development Health Worker would set up the room according to what has been agreed and have it ready for the therapist to begin work.
• Equipment including barrier protection to be purchased either by the therapist, or by the providing agency in agreement with the therapist. The cost of equipment to be borne by the providing agency.
• The therapist is responsible for setting down equipment including sharps, according to the agency’s set-down procedures, e.g. the counting of needles on insertion and removal. The Community Development Health Worker is responsible for setting down the rest of the room.
• The disposal of sharps and other potentially hazardous materials is the responsibility of the providing agency.
Guidelines are available from the Taskforce on Needlestick/Sharps Injuries. These guidelines should be provided by the providing agency and agreed to by therapists.
4. Reporting of Incidents
It is vital that procedures for the reporting of any difficulties relating to the physical environment be in place. For example, should the number of acupuncture needles removed from a client not equal the number inserted, this must be reported immediately and the situation rectified.
An incident book should be provided. At the end of each period of CAM service delivery, both therapist and Community Development Health Worker should sign off in this book that the set down procedures have been followed. All incidents should be reported and written up in the incident book as soon as possible after they occur and appropriate steps taken.
5. Written Records
All therapists need to keep written records of their therapy sessions for insurance purposes and for best practice of the therapy. These records should be kept under lock and key on the premises by the providing agency and the agency must ensure that access to these records is limited in the same way that access to psychotherapy and medical records is limited. Clear guidelines around this need to be in place and communicated to all involved in the delivery of the CAM service. This level of confidentiality is essential in a setting where clients and staff may know each other outside of the agency. Records should also contain consent forms signed by the client. Copies of these records should be available to the therapist if required for personal insurance and professional association purposes. The therapist must ensure that such copy records are subject to the same confidentiality requirements as original records.
Client-Therapist Relationship Boundaries.
1. Roles and Scope of Practice
These should be set out in the terms of employment and the therapists should work within the boundaries of what they have been hired to do. Therapists need to be aware of the scope of practice of their therapy, what it is not suitable for as well as what it does treat. They need also to be aware of the holistic nature of their therapy and that it may give rise to emotional, psychological or other responses that they may not be trained to deal with. Therefore they need to be familiar with referral procedures and information that are available within the providing agency.
2. Referral
Therapists should refer clients to other supports when issues arise that are outside the scope of they provide. This arises most frequently with emotional responses where the therapist may inadvertently slip into the role of counsellor. No one should provide counselling if they are not qualified to do so.
The providing agency needs to draw up a list of locally based support systems either within their own agency or in the wider community. This should be available to all CAM therapists. However, some agencies using CAM therapies are set up in such a way that referral is more appropriately done by the agency in conjunction with the therapist. All agencies need to develop their own referral policy with due regard to confidentiality.
3. Initial Interview and Evaluation
Therapists should conduct an initial interview with clients to assess the suitability of the therapy for their needs. An interview questionnaire should be available in the providing agency if the therapist does not have their own therapy specific template. This interview should include:
• Questions related to the client’s mental as well as physical health
• Information on the scope of practice of the therapy. This should be given to the client before the first session
• Information on what happens in the therapy or is likely to happen e.g. laying of hands, use of oils, use of needles, etc.
• Information on possible side effects/reactions to the therapy and referral possibilities and options.
• Therapist should explain to the client that they are going to use more than one therapy if this is the case.
• Confidentiality and its limits, e.g. that the Children First guidelines will be followed.
All of the above information needs to be given to clients before they undertake a therapy session so that they can make an informed decision about whether they want to proceed with the session or not. This decision needs to be respected. There should also be a short evaluation at the end of each session. This can be informal but information gained becomes part of the session notes. Where the therapy is being offered on a once off basis, this same information can be given in very brief form and some quick questions asked to assess the suitability of the therapy for the client.
If more than one therapist is using the room at the same time, a separate room needs to be provided for this initial interview in order to preserve confidentiality.
4. After Session Care
Some clients may need support immediately following a session even if they have been given referral information, and time needs to be allocated to this. The providing agency should make provision for this by having a worker (Liaison Worker or CDHW) on hand to sit with the client until they feel ready to leave. These workers need training and guidance on their boundaries and how to support clients without falling into the role of counsellor/therapist. They may also need supervisory support from time to time to help them deal with their own reactions to the more difficult issues that may arise for clients.
5. Number of Sessions
Financial constraints may limit the number of sessions any one client may avail of. However, unless there are serious limits to resources, the number of sessions should be decided by the therapist and client in accordance with the therapeutic guidelines and protocols for that therapy. Providing agencies need to bear in mind that they are offering therapy with all that this implies and therefore offering clients the option of ‘dipping in and out’ of various therapeutic practices may not be in the best interests of the client.
6. Once off Sessions
CAM therapies are used quite extensively in community settings in a once off or taster format. Difficult therapeutic responses are less likely to arise at health fairs, etc. due to the public nature of the setting, but they can and do happen. Therefore providing agencies, in consultation with therapists, need to decide what therapies can be appropriately offered in these settings and set up a support system e.g. a worker to be on hand to sit with clients afterwards, should that be required. Clients need to be informed of this option by the therapist at some point during the session.
7. Confidentiality
The boundaries and limits of confidentiality need to be explained to the client on the first session or at the intake session if there is one. Information passed to community health workers or other members of staff managing/supporting the CAM service should be limited to what they need to know in order to support the client. This, of course, is open to interpretation. The FICTA Meta-Code of Ethics may be of assistance here.
8. Working with Children (under 16)
To safeguard children, vulnerable adults, therapists and the providing agency, CAM treatments should only be offered with written parental/guardian consent, and the service should be operated within current legal guidelines.
Definitions of Terms
What is Complementary Therapy?
There is no one therapy that is called complementary therapy. It is an umbrella term used to cover a wide range of different health and wellbeing related practices and systems that are currently outside of mainstream medical practice in Ireland. What these often very different practices have in common is radical holism*, i.e. person centredness and an assumption of a level of equality between client and therapist that is often quite different from the relationships within allopathic (mainstream) healthcare services.
Many mainstream or allopathic medical practitioners would say that their approach is holistic. But for them holism means that they take into account the client/patient’s lifestyle, stress levels, etc. Radical holism takes this approach a step further into the areas of energy and spirituality, aspects of the person that cannot yet be scientifically quantified.
Complementary v Alternative
The use of either term is controversial in the complementary therapy sector and mainstream health services.
Alternative
.
Some medical systems such as Traditional Chinese Medicine have evolved as complete healthcare systems in themselves and therefore could be termed ‘alternative’ to modern allopathic medicine. In the West they are often categorised under the umbrella of ‘complementary’, while in the East they have been the primary system of healthcare for centuries.
The term ‘alternative’ could be seen to imply a rejection of allopathic medical practices. This is not so and would not be in anybodies best interests. Complementary therapists do not reject allopathic (science based) medicine, are more than willing to work with allopathic medical practitioners and do refer clients to GP’s. etc. when appropriate. In practice, most complementary therapies can stand alone. For their own personal reasons however, a client may choose to use a CAM therapy as an alternative to mainstream medical treatment.
Complementary
There is difficulty with this term too because it implies the CAM therapies are only complementary to allopathic medical systems when in fact they are valid and complete healthcare services in themselves. Complementary therapists see their therapies as being equally valid, effective and helpful as allopathic medical provision, and that the two systems can and do complement each other.
Other terms such as ‘whole systems therapies’ have been tried but none have come into popular usage. The European Parliament Environment and Health Committee continues to use the term Complementary and Alternative Medicine (CAM) and that is why the acronym CAM is used throughout this document.
It’s a Therapy
Complementary therapies are often used quite lightly, as relaxation aids, in the beauty industry and quite casually at health fairs, etc. They can and do function at this level but it is vital that all those engaging in CAM therapies at whatever level recognise that they are ‘therapies’. This means that they have therapeutic effects which in turn means that they can cause emotions to surface and other reactions that the client may deem unpleasant. This is often a normal part of the therapeutic process but if the client enters into the practice without recognising the fact that it is a therapy, they may see the effects as negative or even dangerous. This has implications for the therapist, the client and for the agencies/groups providing such therapy services.
Holistic
Definitions of holism vary but for the purposes of this document it is vital that clients, therapists and providing agencies bear in mind that CAM therapies are holistic. This means they can function on many levels simultaneously. CAM therapies work with the physical, emotional, psychological, energetic, and spiritual dimensions of the person as well as looking at lifestyle and life circumstances. The non-physical elements can often contribute to the physical symptoms of illness. The effect of this can be two fold:
Although the visible activity of a therapy may be physical such as the insertion of acupuncture needles, a breathing technique or a particular physical posture, the effect can be holistic in that a physical intervention may result in visible emotional, mental, spiritual or energetic effects. While a client may present for the therapy with a physical ailment such as back pain, there may be psychological, emotional, spiritual, energetic or lifestyle dimension to the problem.
The holistic nature of complementary therapies has important consequences for the client, therapist and providing agency.
The CAM Sector
In recent years the number of CAM therapists in Ireland has expanded rapidly due to demand for their services by the public. The whole sector has expanded to such an extent that the Department of Health and Children is currently supporting the development of a robust self-regulation system for CAM therapists. For many years now the CAM sector has been self-regulating, ie. each therapy has developed its own professional bodies which register and regulate therapists in that field. However, some therapies have more than one regulatory body and regulation systems may vary. In addition, many people practising as 'complementary therapists' are not members of any regulatory body.
The publication of the Report of the National Working Group on the Regulation of Complementary Therapists in 2006 has set in motion a process by which the sector is receiving state support to organise and regulate itself. This is a work in progress and community service providers need to be aware of this when planning to deliver a CAM service. Many CAM professional bodies have come together under the umbrella of the Federation of Irish Complementary Therapy Associations (FICTA) for the purpose of engaging on a national level with State agencies and Departments.
The standards of training in the sector vary widely and this is a difficult area for providing agencies to assess. Therapists working in the beauty or health spa industry may have quite a different training from those working therapeutically, for example. At the moment, the best guide to assessing the therapist’s training are the requirements for membership of the relevant professional body.
The Community Sector
CAM therapists are employed by a wide range of community based groups such as Community Drug Teams, Community Development Projects, Family Resource Centres and Community Youth Projects. In some cases the CAM therapist will be a member of staff of the community group (providing agency) and their complementary therapy work is just one of many duties within the agency. Most frequently, CAM therapists are employed as sessional workers which means they have reasonably regular employment with that agency but on an independent contractor basis. At other times they are employed casually for once off events. In addition, many of the clients of the providing agency are encouraged and supported to train in complementary therapies by the agency itself. They are subsequently employed by the agency sessionally or casually as CAM therapists, often prior to their qualification as therapists. People employed in this manner require a higher level of support from the agency. In all cases the agency needs to consider these guidelines when employing CAM therapists.
Community groups operate under community development principles and have a particular ethos and a duty of care to the communities in which they are located. Many are involved in monitoring health trends in their communities and developing responses to emerging health needs. The CAM therapist, when employed on a sessional basis, becomes a part of a larger team working within a particular ethos and a wider community brief. This needs to be recognised by both the providing agencies and the therapists and procedures put in place to facilitate the incorporation of the therapist and the CAM service into this wider brief.
Some community based agencies have ‘Community Development Health Workers’ (CDHW) on staff to work with the health brief of the agency. In these cases the CDHW is usually the person designated to liaise with the CAM therapist and oversee the CAM service. Where CDHW’s are not on staff, a member of staff needs to be appointed to oversee the CAM service and be the contact person for the CAM therapists and clients.
Appendices
Appendix A
Groups and Individuals That Contributed to the Development of these Guidelines
Groups
Bluebell Community Development Project
Bluebell Drugs Advisory Project
Dolphin House Community Development Association – Dolphin Health Initiative
Fatima Groups United – Fatima Health Initiative
Fatima Regeneration Board
Health Services Executive
Health Promotion Department
Inchicore Community Development Project
Rialto Community Drug Team
St. Michael’s Estate Family Resource Centre
Turas
Therapists
Taru Burstall
Dave Carr
Eileen Hannon
Sandy Lee
Josephine Lynch
Brigid Maher
Lucy Mullee
Tony Walsh
Consultant
Catherine Dowling
Appendix B
Useful Resources
Federation of Irish Complementary Therapy Associations
Website: www.ficta.com
E-mail: fictasecretary@gmail.com
Phone: 087 6187218
Report of the National Working Group on the Regulation of Complementary Therapists
Government Publications Office
Sun Alliance House
Molesworth Street
Dublin 2
Phone: 01 6476879 www.dohc.ie/publications
January 2010
Meta-Code of Ethics for Complementary Therapists
Introduction
The Meta-Code of Ethics presented here is the result of a series of consultations and discussions with FICTA members over a period of 15 months, and a workshop facilitated by Ronny Swain of the Department of Applied Psychology, University College Cork, in May 2007. This process was carried out for the purpose of developing a framework which the member organisations agree to use in formulating their own codes of ethics. The code is closely based on the members contributions, on materials presented at the workshop, and Dr Swain's review in December 2007
"One definition of ethics is rules of conduct or duty, especially with respect to what is considered right and wrong. A Code of Ethics does not provide fail-safe solutions, but rather a systematic procedure for reducing uncertainty" (Swain, 2007)
The fact that a given practice or conduct is not specifically addressed by the Code does not necessarily mean that it is ethical and acceptable. Good practice may require reflection, consultation with colleagues and dialogue with clients.
The Meta-Code sets out the standards of professional conduct that apply to therapists' activities in so far as they are part of their professional, scientific, and educational roles and apply to those activities across a variety of modes of communication, e.g. in person, postal, telephone, media, internet, and other electronic media.
FICTA presents this Code as the minimum that FICTA member associations’ codes of ethics should meet. Members are invited to review their existing Code and to ensure that it is in line with the four named principles put forward, in whatever style or format they wish.
Complementary Therapists provide services to others who are referred to in this document as clients (some member associations may use the word patient).
Preamble
Complementary Therapist are health care professionals who are trained in a coherent healing philosophy, and treatments that are different from allopathic medicine. They assess, diagnose, prescribe and treat within the scope of their therapy, and have a holistic approach to managing and promoting physical, mental, spirit and emotional health and well-being. Complementary Therapists uphold the dignity of clients and practise within the law, and in accordance with standards set by their professional association.
Meta-Code
The Meta-Code is based on commonly held principles, attitudes and values relevant to all aspects of health care delivery. FICTA member associations agree to ensure that their codes of ethics are based upon, and not in conflict with, the ethical principles specified below.
1. 0 Respect for the dignity and rights of others
Complementary Therapists respect and promote the fundamental rights, dignity and worth of all those with whom they work. They respect clients’ rights to privacy, self-determination, autonomy and confidentiality, consistent with their professional obligations and the law.
In particular, Complementary Therapists:
1-1 Respect the knowledge, insights and experience of clients, colleagues, students, and relevant third parties.
1-2 Do not allow their services to clients to be affected by extraneous considerations such as age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socio-economic status.
1-3 Obtain appropriate informed consent from clients prior to the commencement of treatment, and ensure that clients know of the right to withdraw consent after treatment has commenced.
1-4 Use appropriate procedures to obtain consent for treatment of clients (including minors) whose capacity to give consent is limited for any reason.
1-5 Safeguard the confidentiality of information received from clients, except for clearly specified circumstances, including where the safety of clients or others is threatened, or disclosure is required by law.
1-6 Only that information which is relevant to such circumstance should be disclosed.
1-7 Ensure that clients’ records are stored securely and that access is limited to those (including clients) who have a legitimate right of access.
2 - 0 Competence
Complementary Therapists strive to maintain high standards in their work. They provide only those services and use only those techniques for which they are qualified by training, education and experience.
In particular, Complementary Therapists:
2-1 Recognise the limitations of their competence and expertise and of the scope of the therapy which they use, and work within those limitations.
2-2 Limit the elicitation and giving of information to that which is necessary for professional purposes.
2-3 Do not practice when either their functioning or judgement is impaired, for example due to illness or drugs.
2.4 Terminate treatment, with consent, at the earliest time consistent with good care of the client.
2.5 Refer a client to another therapist or healthcare professional as and when appropriate.
2.6 Accept the obligation to engage in continuing professional development.
2.7 Accept the obligation to make themselves familiar with the Code of Ethics of their professional association as a supportive framework for practice.
2.8 Continue to develop their ethical practice and awareness through study, reflection, and dialogue and in the spirit of accountability, peer support and collegial solidarity.
3. 0 Responsibility
Complementary Therapists take seriously their responsibility to safeguard the interests, health and safety of their clients, by avoiding detrimental acts or omissions.
In particular, Complementary Therapists are responsible for:
3.1 Promoting and maintaining high professional standards in services to clients.
3.2 Ensuring that their activities are in keeping with the code of ethics of their professional association.
3.3 Co-operating, consulting with and referring to other professionals as and when the best interests of clients indicate.
3.4 Sharing only that information which is considered necessary and does not conflict with the clients rights.
3.5 Ensuring that clients understand the benefits and limitations of the therapy they are providing.
3.6 Actively co-operating with disciplinary procedures put in place by their professional association.
3.7 Acting in such a way as not to damage public confidence in their professional
association.
4. 0 Integrity
Complementary Therapists are honest, fair, and straightforward in their professional activity.
In particular, Complementary Therapists:
4.1 Ensure that they represent their training, qualifications and experience accurately.
4.2 Ensure that prior to commencing treatment, prospective clients are fully advised of the terms and conditions of professional contracts, including costs and the possible effects, extent and duration of treatment.
4.3 Minimise conflicts of interest and dual relationships that may affect their professional relationships.
4.4 Take action to deal with any harmful effects or mistrust that arise from their professional activity.
4.5 Do not exploit clients for gratification of their personal desires, beliefs and financial gain, either during the professional relationship or after its termination.
4.6 Take action whenever they are concerned that a colleague may be behaving unethically, either by raising the issue with the colleague, or reporting the behaviour to their professional association, as appropriate.
end
22/02/2008
Recommendations of the National Working Group
Having looked at the areas of the complementary therapy sector which need re-mediation and development, the National Working Group has very specific reasons for making the following eight recommendations to the Tanaiste and Minister for Health and Children.
The particular recommendations of the group to the Minister for Health and Children are:
1. Statutory regulation for herbalists/acupuncturists/Traditional Chinese Medicine practitioners. To achieve this, it is recommended that a small, single-focus working group be established without delay to consider the complex issues and various models involved in statutory regulation.
Recommendation 1 arises from the importance of regulation for therapists practicing therapies of a high risk category.
2. For all other groups, the development of a robust system of voluntary self-regulation is recommended.
Recommendation 2 arises from the need to develop robust systems of voluntary self-regulation for therapists practicing complementary therapies not covered by recommendation 1.
3. Facilitated work-days for various therapy organisations to progress areas of development with a view to encouraging federation into one representative organisation for that therapy. This is a necessary first step before harmonisation of advice on education standards in collaboration, as appropriate, with providers and HETAC/FETAC.
4. A report on the state of the sector following these facilitated work days.
5. Publication of a comprehensive, up-to-date information booklet incorporating a client/therapist charter for the public following the publication of the report on the state of the sector.
Recommendations 3, 4 and 5 arise from the need to support and assist therapy organisations to harmonise standards and to provide the public with reliable and current sources of information on properly qualified and registered complementary therapists.
6. Immediate setting up of a forum for dialogue between the complementary and conventional medical sectors.
Recommendation 6 arises both from the increasing expansion of integrated healthcare and from the importance of providing factual and accurate information on complementary therapies and therapists to the conventional medical sector. This needs to be at the initial level of undergraduate education, for GPs, consultants and hospital administrators and on a continuing basis. This report is a stage in the process of development of the sector, not the end of the process.
7. The establishment of a National Annual Forum for the sector to continue the momentum arising from the work of the Working Group.
8. Following the facilitated work days and the report on the sector, the establishment of a working group on the single issue of the development of a Complementary Therapies Council which would oversee issues in the complementary therapies area.
Recommendations 7 and 8 arise from the need to continue that process, to maintain and build on the momentum of the collaboration and interaction of the Department of Health and Children with the complementary therapy sector over the last few years and to progress the work done by the Working Group over the last two years. Some recommendations are concurrent, some consecutive. They are necessary, realistic, focused, phased and achievable in a reasonable time-frame.
The implementation of all these recommendations will advance the development of the complementary sector and the knowledge of the general public. It should lead to a point where the sad cases which make the headlines - of rogue practitioners incorrectly described as complementary therapists - will be a welcome rarity and the consumer will no more go to an unqualified, unregistered and unmonitored practitioner than they would to a barber to get their teeth pulled.
The National Working Group looks forward to the speedy implementation of all these recommendations.