Does BPS have guidance on boundaries in relationships with clients?
Our Practice Guidelines state:
"Multiple relationships occur when a psychologist is in a professional role with a client or colleague and at the same time is in another role with the same person or group e.g. as a supervisor, sports club member or co-author in a publication or where a psychologist is asked to work at a school where their child is a pupil."
Psychologists should:
- Ensure that the relationship reflects the appropriate context within which the practice is taking place
- Be aware of the issues of multiple relationships and professional boundaries which may lead to (real or perceived) conflicts of interest or ethical considerations
- Clarify for clients and other relevant stakeholders when these issues might arise
When acting as leaders in practitioner or managerial roles, psychologists should maintain an awareness of the importance of respect for boundary and power issues within leadership relationships. In particular, an awareness of the possible abuse of these relationships should be maintained at all times. It is important that psychologists explicitly define the boundary of the relationship and negotiate and respect the responsibility that each holds in relation to it.
Where psychologists are in a position of power/leadership with individuals, it is particularly important that they exercise caution and consider the possible issues which may arise from developing a personal relationship with these individuals. It may be necessary to seek further supervision where appropriate, with additional peers as necessary.
Psychologists have a duty of care towards their clients, who may be vulnerable, and should maintain a professional emotional distance from clients, services users or relatives and should not enter into an intimate or sexual relationship with any clients, service users or relatives they come into contact with as part of practice. Psychologists should also be aware that their duty of care can continue after a client practitioner relationship has ended.
As far as is reasonably practical, psychologists should not enter into a professional relationship with someone with whom they already have, or have had, a close personal relationship. This includes family members and friends. Where there is no reasonable alternative, such as a lack of availability of other professionals, and it is acceptable in the particular context of practice, the psychologist should make every effort to remain professional and objective while working with the individual they know or have known. In such circumstances, at the earliest possible opportunity, this should be disclosed and discussed with a manager, where there is one, and supervisor and a note should be made in client records.
A range of psychologists work with people who initially have accessed the services in a dependent position, and have then transitioned to becoming partners and colleagues in service and policy development and design. The nature of the work becomes more collegiate and the psychologist holds multiple roles including facilitating participation, adapting communication and advocacy.
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If you have any queries, please contact [email protected].
I have received a HCPC Fitness to Practise letter, can you help?
We are aware this can be upsetting and challenging.
You can further information on the Fitness to Practice (FtP) process and details of the professional indemnity insurers we work with.
If you have not already done so, please contact your professional indemnity insurer for legal advice. Some professional indemnity insurers also assist their clients in drafting responses to the HCPC. It is always best to contact your insurer for advice before responding to the HCPC.
If you are a member of a trades union, please speak to your local representative or official for advice and guidance.
We can sometimes raise individual cases with our HCPC dedicated liaison manager. This mostly relates to long delayed FtP cases, the misapplication of administrative processes and issues related to registration.
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If you have any queries, please contact [email protected].
I live outside the UK and would like to work with someone in the UK using tele therapy – what do I need to do?
We are aware that working across international boundaries is becoming more common.
Psychologists in the UK are regulated by the Health and Care Professions Council (HCPC). If you are not based in the UK, your practice would not be governed by UK law (which requires practitioners to register with the health and care professions council) but we would expect that you would make it clear to prospective patients of where you are based and, as such, your practice would be regulated there. We also expect that psychologists have indemnity insurance cover for all their work.
With regards tele therapy specifically, the UK has no legislation or guidance governing the use of tele therapy other than an expectation that psychologists consider the security and confidentiality of individual software being used.
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If you have any queries, please contact [email protected].
I live in the UK and would like to work with someone abroad – is that ok?
From a UK perspective, you are allowed to practice with clients outside the UK.
If you will be using one of the titles protected by UK law (Clinical Psychologist, Counselling Psychologist, Educational Psychologist, Forensic Psychologist, Health Psychologist, Occupational Psychologist or Sport and Exercise Psychologist) you will need to be registered with the Health and Care Professions Council (HCPC).
You would need to check with the body for psychologists in the country where your client resides to see what obligations they may have for psychologists. We don't keep a list of these however a google search can often be useful to help you find the relevant body which could be a regulator or a professional body. You should make it clear to your client that you are based in the UK.
We also expect that all aspects of a psychologist's work are covered by indemnity insurance so please check with your insurer to ensure your work is covered.
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If you have any queries, please contact [email protected].
What professional title can I use?
The Health and Care Professions Council regulated several protected Practitioner Psychologist titles. There are other titles which psychologists may consider using in their work.
Our Practice Guidelines state:
"Psychologists are encouraged to state their registration with the HCPC and protected title(s). This will provide assurance that the psychologist meets national standards of training and professional skills.
The term 'consultant' generally does not have a formal definition. Within the medical field it is used by doctors who have considerable experience and proven expertise demonstrated through examination within their respective Royal Colleges.
While there is no clear comparable grading structure for psychologists outside the NHS (within the NHS, the consultant title is used by psychologists who are employed in Band 8C, 8D and 9 positions), the use of this title would be seen to reflect both seniority and specialist expertise.There is a difference between a 'consultant' psychologist and a psychologist who provides consultations in their context of practice. The Society expects that psychologists should be honest and accurate in representing their professional affiliations and qualifications, including such matters as knowledge, skill, training, education and experience.
The society's position is that this would be applicable in any situation where expert knowledge or skills is being marketed or promoted, whether or not this is for financial gain. Further information is available in Society Document: Guidance on the use of the title 'Consultant Psychologist'."
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If you have any queries, please contact [email protected].
My client has disclosed a crime, do I have to tell the police?
Clients may disclose a crime in their past either as a victim or an offender.
Our Practice Guidelines state:
"Clients are entitled to expect that the information they give to psychologists about themselves and others will remain confidential. Psychologists have a duty not to disclose such information except as discussed below and to bring their confidentiality practice to the attention of their clients, employers, managers and any other professionals involved.
Psychologists have a duty to inform involved parties of their confidentiality standards and practice at the point of first contact. Clients should be informed of the limits of confidentiality where information about them may be shared and confidentiality breached, for example for reasons of safeguarding, requirements of the law, and public protection."
If disclosure of information is deemed necessary, psychologists should obtain specific informed consent from their clients, making the consequences of disclosure as clear and unbiased as possible. There are a number of circumstances where this might not be possible or may not apply: for example where the health, safety, security or welfare of the client or someone else may otherwise be put at risk; and if there are legal or safeguarding responsibilities, such as the need to avoid 'tipping off'. If confidentiality is broken without consent, the client should be told what has been said and to whom, unless such disclosure may expose the client or others to serious harm or is contrary to legal or safeguarding obligations.
Psychologists who are faced with the difficult decision as to whether to disclose information without a client's consent must weigh carefully the arguments for and against disclosure. The responsibility for this decision lies with the individual psychologist.
Disclosure without consent, or against the client's expressed wish may be necessary in situations in which failure to disclose appropriate information would expose the client, or someone else, to a risk of serious harm (including physical or sexual abuse) or death.
The psychologist must weigh up the needs and interests of their own client against the wider welfare, protection and safeguarding of the public.
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If you have any queries, please contact [email protected].