Trainees and therapists must practice in accordance with the ethical framework/s of the professional bodies to which they subscribe and that govern their clinical work. It is incumbent on therapists to make themselves very familiar with the ethical framework and its implications for clinical practice. The Irish Association for Play Therapy and Psychotherapy have developed a comprehensive Code of Ethics to cover the practice of its members working with clients, including children and adolescents.
Therapists hold an ethical responsibility to be familiar with, and work in accordance with, the relevant legislation, ethical, and child protection guidelines, e.g. Children First, IAPTP Codes. All practitioners are advised to undergo specific training in this area and to have relevant reference material in their libraries. CTC offer a free training event each year to keep students fully up to date with relevant child protection guidelines. See our brief guide to Child Protection here.
Clinical Practice with Child Clients while Training
Many therapist training courses include a practicum and/or clinical practice component. CTC believes that trainee therapists should be individually assessed by the training organisation prior to undertaking any clinical practice component with vulnerable clients. Trainees can however begin to utilise and integrate newly acquired, and developing, skills in any work for which they were already qualified prior to undertaking the specific therapy training. This may include therapeutic work with children and/or adults, or other work of a clinical intervention nature. It may also include personal development or issue based work.
Our view is that the needs of trainees, and their future clients, are best met by the trainee initially undertaking a series of child observation sessions and play practice sessions with children without clinical issues prior to agreeing a therapy contract with a child with specific therapeutic needs, including significant emotional issues that would best be met by a process based intervention. The trainee therapist can use child observation sessions and play practice sessions to focus on issues of developing observational skills, understanding child development, overcoming personal anxiety, noticing their own process while with the child, developing personal reflective skills, play skills, and confidence in their ability to pay more attention to the child’s play and presentation than to their own pre-occupation with doing the right thing. In essence the trainee uses this time to learn about ‘being’ rather than ‘doing’ while facilitating sessions with children, and becomes more spontaneous and authentic with the child. While not ‘therapy’, these play sessions will facilitate children in reaching their potential, developing resilience, and deriving therapeutic benefits from the play and the relationship with an attentive adult. These sessions will often be based on practicing non-directive play skills but may include creative arts sessions or activity based groupwork sessions.
When CTC trainees begin their clinical practice, referrals are carefully screened to ensure that assigned clients do not have significant needs which may be more appropriately met by a more experienced practitioner. Every child can benefit from play therapy, therefore trainees beginning clinical practice can work with children to help them achieve optimal growth and increased resilience. Trainee play therapists begin their clinical practice with children with minor adjustment or developmental issues. The difference between these sessions and the play practice sessions referred to above is that these sessions rely on the therapeutic powers of the interpersonal relationship in addition to the powers of play. The framework for the sessions is derived from application of the therapeutic model/s in which the practitioner is being trained, and the contract and context for the sessions is clearly defined and structured. Children with complex issues are referred to experienced therapists.
Evidence Based Practice
Therapists must monitor their own effectiveness and ensure that the service they provide is informed by practice based theory. Clinical governance is the process of managing the quality of the therapists’ clinical work and monitoring the efficacy of the therapeutic interventions. The therapist will gather evidence from their practice through a variety of ways including, but not limited to, action research, checklists, questionnaires, feedback from referrers and clients, and qualitative approaches. There is a clear cycle of therapists gathering evidence from their practice and this evidence informing emerging theory at the forefront of the field. This can only be beneficial in increasing our understanding of the process of therapy and the process of change.
The gathering of ‘data’ can never be allowed to interfere with, or in any way compromise, the client’s therapy process, the development / maintenance of the therapeutic relationship, ethical considerations (including confidentiality), or any other aspect of the professional work. Research proposals must be approved by the Ethics Committee who will consider all aspects of the proposal including issues of informed consent and well-being of the client.
The Strengths and Difficulties Questionnaire is one tool used by play therapists in assessing referrals and monitoring the child’s progress.
IAPTP Code of Ethics
Keeping Safe: Child Protection Awareness Workshops
In light of new legislation and recent amendments, plus additional changes due to come into effect in 2013 with regard to Child Protection, you might be interested in attending a HSE training course on Child Protection Guidance. These are information sessions for relevant professionals and are offered in various locations around the country. Details. Application forms are available on the HSE website and from relevant HSE personnel. You can apply directly to the HSE for a place on one of these courses.
You can download the HSE’s Children First: National Guidance for the Protection and Welfare of Children, Child Protection and Welfare Practice Handbook, and a copy of Our Duty to Care: The Principles of Good Practice in Working with Children and Young People. Hard copies of these resources are available for purchase from the Government Publications Sales Office, Molesworth Street, Dublin 2.
Please contact the HSE Information & Advice Person on Children First in your area if you have further queries. Details of all HSE Children First Information and Advice Officers, their role, and training provision, is available HERE.