United States Association of Body Psychotherapy Code of Ethics
Guidelines and Introduction
Approved October 2001
The United States Association for Body Psychotherapy (USABP) is an association of body-oriented psychotherapists, allied somatic practitioners, and interns trained in related modalities. The purpose of the USABP is to support the practice and further evolution of the field of body psychotherapy.
Body psychotherapists recognize the intrinsic unity of the human being in our somatic nature. Body psychotherapists, therefore, work in ways that foster the integration of bodily sensation, thought, affect, and movement to promote more integral human functioning and the resolution of psychotherapeutic concerns. Body psychotherapeutic methods, including language, gesture and touch, when used in responsible, ethical and competent ways, make an essential contribution to the psychotherapeutic process by including the missing and often alienated aspects of our being which are rooted in our bodily nature and experience.
These ethical guidelines set forth the principles and standards which guide the practice of this profession. These principles and standards represent a cumulative lived wisdom in the field of body psychotherapy. They are not meant to be all-inclusive. The principles in this code are intended to be aspirational, while the standards are directive. Members of the USABP seek consultation with health care and other professionals, and consider cultural and contextual factors, other certification and licensure regulations for their professions, state and
Body psychotherapists recognize their ethical responsibility to maintain the standards of conduct and care, and of personal and professional development. Thus, body psychotherapists commit themselves to the continual examination of their actions, motives and attitudes in their professional relationships to support the safety and welfare of their clients and to nurture the effective practice of their profession. Body psychotherapists likewise expect, encourage and support ethical behavior and self-examination from their students, supervisees, employees, and colleagues.
GENERAL PRINCIPLES OF BODY PSYCHOTHERAPISTS
Principle A: Competence
Principle B: Integrity
Body psychotherapists seek to promote integrity in the science, art, teaching, and practice of body psychotherapy. In these activities, body psychotherapists strive to be honest, fair and respectful of others and to be aware of their own belief systems, values, needs, and limitations and the effect of these on their work.
Principle C: Professional and Scientific Responsibility
Body psychotherapists are committed to upholding professional standards of conduct; clarifying their professional roles and obligations; accepting appropriate responsibility for their behavior; and adapting their methods to the needs of different clients. When undertaking research, Body psychotherapists strive to advance human welfare and the science and art of Body psychotherapy. They try to avoid misuse of their work. They recognize the need to consult with, refer to, and cooperate with other professionals and institutions to the extent necessary to serve the best interests of their patients, clients or other recipients of their services.
Principle D: Respect For People’s Rights And Dignity
Body psychotherapists strive to be respectful of the fundamental rights, dignity and worth of people. Body psychotherapists are aware of cultural, individual, and role differences and strive to be non-discriminatory regarding age, gender, race, ethnicity, national origin, religion, sexual orientation, disability, and socio-economic factors. They respect the rights of individuals to privacy, confidentiality, self-determination, and autonomy.
Principle E: Concern for Others’ Welfare
Body psychotherapists seek to contribute to the welfare of those with whom they interact professionally. In their professional actions, they weigh the welfare and rights of their patients or clients, students, supervisees, human research participants, and other affected persons and the welfare of animal subjects of research. Body psychotherapists are sensitive to real and ascribed differences in power between others and themselves and they strive not to exploit or mislead people before, during or after professional relationships.
Principle F: Social Responsibility
Body psychotherapists are aware of their professional and scientific responsibilities to the community and the society in which they work and live. They apply and make public their professional knowledge in order to contribute to human welfare. They are concerned about and work to mitigate the causes and effects of human suffering. They encourage the development of law and social policy that serves the interests of their patients, clients and the public. They consider the realities of social injustice, and strive to have a positive impact on these concerns, as professionals and as individuals.
Principle G: Adherence to Professional Codes, and to Local, State, Federal Law
Members of USABP follow the principles and guidelines outlined in this code. They also comply with local, state and federal law and regulations regarding professional practice, as well as codes of ethics of their professional associations, organizations, and accrediting boards. Where there are variations in codes or guidelines, * licensed practitioners, who are bound by other ethical codes, strive to balance the requirements of the various codes in a way that best embodies ethical behavior and resolves the conflict in a responsible manner. If the conflict is unresolvable, the body psychotherapist adheres to the requirements of the law, regulations, or other governing legal authority.
Practitioners seek to perform their responsibilities at the highest level of competence. In areas of practice where professional standards are in evolution, they obtain adequate training and utilize appropriate consultation in order to protect the welfare of those with whom they work. They refer clients to appropriate professionals in their own as well as other fields of expertise as needed.
1. Body psychotherapists do not diagnose, treat or advise on concerns outside the recognized boundaries of their competence. Recognizing the limitations of their expertise, they only provide those services and use those techniques for which they are qualified by education, training and experience.
2. Body psychotherapists provide services, teach or conduct research in new areas or involving new techniques only after first undertaking appropriate study, training, supervision, and/or consultation from persons who are competent in those areas or techniques. If they are forging new paradigms, they proceed with caution and seek appropriate advice and support as needed and obtain appropriate informed consent.
3. Body psychotherapists strive to remain reasonably current regarding new developments in body psychotherapeutic knowledge and practice through educational activities, supervision and/or consultation. They obtain professional or peer supervision/consultation as a standard part of professional practice.
4. Body psychotherapists seek appropriate professional assistance for personal problems or conflicts that may impair work performance or clinical judgment.
5. As teachers/supervisors/researchers dedicated to high standards of scholarship and the presentation of accurate information, body psychotherapists make every effort to present accurate and cogent information to students, supervisees, colleagues, and the public and to prevent the distortion or misuse of their clinical and research findings. They rely on scientifically and professionally derived knowledge in their teaching practice. They present themselves and the field accurately and professionally to the public.
6. When presenting information that lies outside the boundaries of the generally recognized professional and/or scientific knowledge base, body psychotherapists so identify it, specify the data base on which the information rests, and provide access to that data base should it not be generally available.
Body psychotherapists seek to promote integrity in the science, art, teaching, and practice of body psychotherapy. In these activities, body psychotherapists strive to be honest, fair and respectful of others and to be aware of their own belief systems, values, needs, and limitations and the effect of these on their work.
1. Body psychotherapists seek to communicate honestly and truthfully in all their public statements regarding their work and work-related activities. This includes their research, practice, or other work related activities or those of persons or organizations with which they are affiliated. Public statements include but are not limited to paid or unpaid advertising, product endorsements, grant and credentialing applications, personal resumes or curriculum vitae, or comments for use in the media such as print or electronic transmission, statements in legal proceedings, lectures and public oral presentations and published materials. Body psychotherapists do not knowingly make public statements that are false, deceptive, or fraudulent.
2. Body psychotherapists communicate honestly and truthfully concerning their training, experience, and competence. Likewise they make truthful and accurate statements regarding their credentials, their academic degrees, their institutional or association affiliations, their services, the scientific or clinical basis for, or results or degrees of success of, their services, their fees, or their publications or research findings.
3. Body psychotherapists, in their reports to payors, accurately state the nature of the service provided or research conducted, the fees, charges, or payments, their academic degrees, and when applicable, the identity of the provider, the findings, and the diagnosis.
III. INFORMED CONSENT
Body psychotherapists provide services to clients only in the context of a professional relationship based on valid, on-going informed consent. Initial informed consent to use body psychotherapy is expected and should be updated and documented as appropriate during the relationship. Informed consent requires that the person haves the capacity to consent, has been informed of and understands necessary information concerning the course of their treatment, and that this consent has been given without undue influence.
1. Body psychotherapists use clear, understandable language to inform clients of the purpose of treatment, the risks related to treatment, reasonable alternatives to the proposed treatment, limits to the provision of treatment, and the right to seek a second opinion. Recommended additional topics for consent and/or discussion include but are not limited to: confidentiality and its limits, client’s right to refuse or withdraw consent, nature of the business contract, health care benefits, fees, record keeping, termination, supervision, use of touch, complaint or disagreement process and contact information. Ample opportunity for the client to ask questions is provided.
2. In the event that a client is legally incapable of giving informed consent, body psychotherapists obtain informed permission from a legally authorized person, if applicable laws permit such substitute consent. When proceeding with substitute consent, they inform those legally unable to give informed consent about the proposed interventions in a manner commensurate with the person’s mental and cognitive capacities, seek their agreement to those interventions, and take into account their preferences and best interests.
Body psychotherapists avoid engaging in any activities which are harmful or exploitative or which could reasonably be expected to be harmful or exploitative. Body psychotherapists are sensitive to issues of possible harm, solicit discussion of such situations, as appropriate, even when they are not directly raised by the client, and take appropriate action to prevent and minimize harm that might occur.
1. Body psychotherapists are professional in attitude and conduct, reliable about agreements and appointments. They are clear about their policies regarding cancellations and work within the frame of that agreement in good faith with their clients.
2. Sexual relationships between body psychotherapists and their clients are prohibited during the therapeutic relationship and for a minimum of 2 years following the termination of that professional relationship. A body psychotherapist who considers engaging in sexual intimacy with a former client after the 2 years following cessation or termination of treatment bears the burden of demonstrating that there has been no exploitation, in light of all relevant factors that would influence the client’s ability to freely enter such a relationship.
3. Body psychotherapists do not engage in sexual intimacies with individuals they know to be the parents, guardians, spouses, partners, offspring, or siblings of current clients. Body psychotherapists do not terminate therapy to circumvent this rule.
4. Body psychotherapists do not accept as therapy clients persons with whom they have engaged in sexual intimacies.
5. Body psychotherapists refrain from engaging in any behavior which could reasonably be interpreted as harassment, sexual or non-sexual. They monitor their therapeutic relationships to ascertain if clients perceive any harassment and address that concern promptly.
6. Body psychotherapists make reasonable efforts to ensure continuity of treatment. When services must be terminated for a legitimate reason, the therapist makes every reasonable effort to insure that appropriate referrals are made for the ongoing needs of the client prior to termination and makes reasonable efforts to terminate the relationship satisfactorily.
7. Should a client desire to terminate the therapeutic relationship, body psychotherapists provide professional insights into the benefits and consequences of this course of action without explicit or implicit coercion to maintain the relationship against the client’s wishes. At all times they make clear the client’s right to terminate when he/she chooses.
8. Body psychotherapists seek appropriate consultation and/or supervision for any circumstance in which the ethics of their behavior comes into question.
V. MULTIPLE RELATIONSHIPS
Body Psychotherapists avoid exploitive multiple relationships. A multiple relationship occurs when a Body Psychotherapist is in a psychotherapeutic relationship with a person and is at the same time, or sequentially, in another relationship with the same person. Body Psychotherapists make a distinction between normally occurring community interactions and multiple relationships. Body Psychotherapists do not accept as a client anyone with whom they have had a sexual, close personal. or financial relationship or family or relatives of such persons. The boundaries of the therapeutic relationship should be clearly defined otherwise they have the potential to impair judgment, cause damage and undermine the purpose of the therapy.
1. Considerations about potential exploitation include the: nature and intensity of the professional relationship and of the secondary relationship, stage of therapy, amount of transference, degree of the role conflict, level of communication skills, and existence of an evaluative role.
2. Body Psychotherapists are aware of the differences in power that may exist in their relationships with clients, students and supervisees. Body Psychotherapists will be sensitive to the real and ascribed differences in power, be responsible for bringing potential issues into the awareness of those involved, and be available for reasonable processing with those involved.
3. In some situations, for example in small geographical or modality communities, a multiple relationship that is non- exploitive may be undertaken. In these cases, the Body Psychotherapist takes precautions to protect the client from exploitation and damage. Such precautions may include, but are not limited to, acknowledgment of the multiple relationship and its inherent risk to the client, ongoing dialogue, informed consent, documentation, and case consultation and/or supervision.
4. In the event that a Body Psychotherapist is providing services to several persons who have a relationship (partners, parents and children, siblings, families) the therapist attempts to clarify at the onset of the therapy, the relationship they will have with each individual. At any time, if it becomes apparent that the Body Psychotherapist is in multiple relationships which compromise the treatment situation or threaten to impair the objectivity or judgment of the therapist in any way, they clarify, adjust or withdraw from conflicting roles.
5. Barter is the acceptance of goods or services from clients in return for psychological services. Body Psychotherapists do not barter (including work exchange) unless the bartering arrangements are appropriate in the context of the therapeutic relationship, indicated by the needs of the client, and for the welfare of the client. Where bartering is used, the therapist and client make agreements in writing related to the exchange of goods or services to ensure that both understand the scope and limitations of the agreement. Body Psychotherapists consult or obtain supervision to ensure that the bartering arrangement is not harmful to the client, that the client is being given fair value in the exchange, and that no exploitation of and/or damage to the client is involved.
6. As teachers, Body Psychotherapists acknowledge that their relationships with students and/or supervises include factors which often make avoiding multiple relationships difficult. They monitor their teaching and supervision relationships to ensure that they do not become exploitive and/or damaging. Body Psychotherapists do not have sexual relations with students or supervisees and do not subject them to sexual harassment.
VI. COLLEGIAL RELATIONSHIPS
Body psychotherapists maintain respect for colleagues. They refrain from the exploitation of professional relationships for personal gain, whether financial, personal, professional or for research purposes.
1. Body psychotherapists try to avoid entering into a therapeutic relationship with someone who is currently seeing another therapist without the knowledge of that therapist. However, they acknowledge that it is the clients’ right to seek out treatment which they feel best meets their needs. Body psychotherapists inform the client of the potential problems in precipitous terminations and urge them to complete the termination process with their former therapist if it will not be detrimental to the client to do so.
2. If it appears that a client has been abused in a former or concurrent professional relationship, body psychotherapists inform the client how to seek appropriate recourse.
3. The Ethical Guidelines of the USABP makes no attempt to limit the free speech of its members. In exercising their right to free speech, body psychotherapists ensure that their statements are professional and non- combative in tone, balanced. and factually accurate.
4. If a body psychotherapist believes that there has been an ethical violation by a colleague, he/she may bring it to the attention of the individual and seek resolution provided such action does not violate any confidentiality rights. Colleagues should seek counsel, guidance, supervision, and consultations as needed in relation to the process and/or issues.
5. If disputes of a serious nature arise between body psychotherapists regarding professional matters, they utilize outside consultation if unable to settle the matter between themselves.
6. When involved in professional writing for publicity, for inclusion in training programs, or for publication in journals and books, body psychotherapists do not take credit for the intellectual work of others but accurately credit their sources and influences.
VII. PRIVACY AND CONFIDENTIALITY
Body psychotherapists have a primary obligation and responsibility to take precautions to respect the confidentiality of those with whom they work or consult.
1. Confidential information includes all information obtained in the context of the professional relationship. They
maintain the confidentiality of clients and former clients. Body psychotherapists take appropriate steps to protect their confidential information and to limit access by others to confidential information.
2. Body psychotherapists disclose confidential information without the consent of the client only as mandated by law, or where permitted by law. Such situations include, but may not be limited to: providing essential professional services to the client, obtaining appropriate professional consultation, or protecting the client or others from harm.
3. Unless unfeasible or contraindicated, the discussion of confidentiality and its limits occurs at the beginning of the professional relationship and thereafter as circumstances may warrant. When appropriate, body psychotherapists clarify at the beginning of treatment issues related to the involvement of third parties
4. Body psychotherapists may disclose confidential information with the appropriate consent of the patient or the individual or organizational client (or of another legally authorized person on behalf of the patient or client), unless prohibited by law.
5. When agreeing to provide services to several persons who have a relationship (such as partners or parents and children), body psychotherapists attempt to clarify at the outset 1) which of the individuals are clients and 2) the relationship body psychotherapy will have with each person. This clarification includes the role of the body psychotherapist and the probable uses of the services provided or the information obtained.
6. If and when it becomes apparent that the body psychotherapist may be called on to perform potentially conflicting roles (such as marital counselor to husband and wife, and then witness for one party in a divorce proceeding), body psychotherapists attempt to clarify and adjust, or withdraw from, roles appropriately.
7. In cases where there is more than one person involved in treatment by the same therapist (such as with groups, families and couples), the therapist obtains an initial agreement with those involved concerning how confidential information will be handled both within treatment and with regard to third parties.
8. Body psychotherapists maintain and retain appropriate records as necessary to render competent care and as required by law or regulation.
9. Body psychotherapists are aware of the possible adverse effects of technological changes with respect to the confidential dissemination of patient information and take reasonable care to ensure secure and confidential transmission of such information.
10. Body psychotherapists take steps to protect the confidentiality of client records in their storage, transfer, and disposal. They conform to applicable state laws governing the length of storage and procedures for disposal.
11. Body psychotherapists take appropriate steps to ensure, as far as possible, that employees, supervisees, assistants, and volunteers maintain the confidentiality of clients. They take appropriate steps to protect the client’s identity or to obtain prior, written authorization for the use of any identifying clinical materials in teaching, writing and public presentations.
12. When working with groups, body psychotherapists explain to participants the importance of maintaining confidentiality and obtain agreement from group participants to respect the confidentiality and privacy of other group members but they also inform group members that privacy and confidentiality cannot be guaranteed.
13. Body psychotherapists obtain written consent from clients/students before taping or filming any session, such consent to include the intended use of the material and the limits of confidentiality.
VIII. ETHICS OF TOUCH
The use of touch has a legitimate and valuable role as a body-oriented mode of intervention when used skillfully and with clear boundaries, sensitive application and good clinical judgment. Because use of touch may make clients especially vulnerable, body-oriented therapists pay particular attention to the potential for dependent, infantile or erotic transference and seek healthy containment rather than therapeutically inappropriate
1. Body psychotherapists evaluate the appropriateness of the use of touch for each client. They consider a number of factors such as the capacity of the client for genuine informed consent; the client’s developmental capacity and diagnosis; the transferential potential of the client’s personal history in relation to touch; the client’s ability to usefully integrate touch experiences; and the interaction of the practitioner’s particular style of touch work with the client’s. They record their evaluations and consultation in the client’s record.
2. Body psychotherapists obtain informed consent prior to using touch-related techniques in the therapeutic relationship. They make every attempt to ensure that consent for the use of touch is genuine and that the client adequately understands the nature and purposes of its use. As in all informed consent, written documentation of the consent is strongly recommended.
3. Body psychotherapists recognize that the client’s conscious verbal and even written consent for touch, while apparently genuine, may not accurately reflect objections or problems with touch of which the client is currently unaware. Knowing this, body psychotherapists strive to be sensitive to the client’s spoken and unspoken cues regarding touch, taking into account the particular client’s capacity for authentic and full consent.
4. Body psychotherapists continue to monitor for ongoing informed consent to ensure the continued appropriateness of touch-based interventions. They maintain periodic written records of ongoing consent and consultation regarding any questions they or a client may have.
5. Body psychotherapists recognize and respect the right of the client to refuse or terminate any touch on the part of the therapist at any point, and they inform the client of this right.
6. Body psychotherapists recognize that, as with all aspects of the therapy, touch is only used when it can reasonably be predicted and/or determined to benefit the client. Touch may never be utilized to gratify the personal needs of the therapist, nor because it is seen as required by the therapist’s theoretical viewpoint in disregard of the client’s needs or wishes.
7. The application of touch techniques requires a high degree of internal clarity and integration on the part of the therapist. body psychotherapists prepare themselves for the use of therapeutic touch through thorough training and supervision in the use of touch, receiving therapy that includes touch, and appropriate supervision or consultation should any issues arise in the course of treatment.
8. Body psychotherapists do not engage in genital or other sexual touching nor do they knowingly use touch to sexually stimulate a client. Therapists are responsible to maintain clear sexual boundaries in terms of their own behavior and to set limits on the client’s behavior towards them which prohibits any sexual touching. Information about the therapeutic value of clear sexual boundaries in the use of touch is conveyed to the client prior to and during the use of touch in a manner that is not shaming or derogatory.
IX. EDUCATION AND TRAINING
Body psychotherapists who are responsible for education and training programs seek to ensure that the programs are competently designed and provide appropriate experiences and training to fulfill the stated objectives. They recognize the power they hold over students and supervisees and therefore make reasonable efforts to engage in conduct that is personally affirming and respectful toward students and supervisees.
1. Body psychotherapists attempt to ensure that any education and training programs for which they are responsible have accurate descriptions of the program content, training goals, objectives, and requirements that must be met for satisfactory admission to and completion of the program. This information is made readily available to all interested parties.
2. When engaged in teaching or training, educators present pertinent information accurately and objectively with respectful critiques when appropriate. The educational content in their programs is based on information that has some form of valid, publicly available evidence and/or investigation behind it. Educational programs provide exposure to varied theoretical positions as well as scientifically and professionally derived knowledge.
3. Body psychotherapists establish appropriate processes for providing feedback to students and supervisees. They evaluate students and supervisees on the basis of their actual performance on relevant and established program requirements. Additionally, they seek, encourage and utilize feedback from students and supervisees. This feedback may be written, verbal, formal, or informal.
4. When performing the role of teacher or trainer, body psychotherapists maintain a level of confidentiality appropriate for the teaching environment. Teachers and trainers discuss trainees and supervisees only in accord with publicly stated policy or mutual agreement and for the purpose of enriching the educational opportunities of the individual.
5. Body psychotherapists inform trainees and supervisees of the legal/ethical prohibition against representing themselves as competent to perform professional services beyond their level of training, experience or competence.
6. Educators must be able to present adequate credentials that demonstrate that their teaching is within their scope of learning and expertise.
Body psychotherapists design, conduct and report research in accordance with recognized standards of scientific competence and ethics, minimizing the possibility that the results might be misleading. If an ethical issue is unclear, body psychotherapists resolve the issue through consultation with institutional review boards, peer consultations, or other proper mechanisms. They take reasonable steps to implement appropriate protections for the rights and welfare of human participants, other persons affected by the research, and animal subjects.
1. Body psychotherapists conduct research competently and with due concern for the dignity and welfare of the participants.
2. Body psychotherapists are responsible for the ethical conduct of research implemented by them or by others under their supervision.
3. Researchers and assistants are permitted to perform only those tasks for which they are appropriately trained and prepared.
4. As part of the process of development and implementation of research projects, body psychotherapists consult those with expertise concerning any special population under investigation or likely to be affected.
5. Body psychotherapists plan and conduct research in a manner consistent with federal and state law and regulations.
6. Prior to conducting any research (excluding anonymous surveys, naturalistic observations, or similar research) body psychotherapists enter into an agreement with participants that clarifies the nature of the research and the responsibilities of each party. They take special care to protect the prospective participants from adverse consequences of declining or withdrawing from participation. Whether research participation is an academic course requirement or a voluntary activity, the prospective participant is given the choice of equitable alternative activities.
7. Body psychotherapists use language that is understandable to research participants in obtaining their appropriate informed consent. Such informed consent is appropriately documented.
8. For persons who are certified legally incapable of giving informed consent, body psychotherapists provide an appropriate explanation, obtain the participant’s assent, and obtain appropriate permission from a legally authorized person, if such substitute consent is permitted by law.
9. When offering professional services as an inducement to research participants, body psychotherapists make clear the nature of the services, as well as the risks, obligations and limitations. They do not offer excessive or inappropriate financial or other inducements to obtain research participants, particularly when it might tend to coerce participation or distort the results.
10. Body psychotherapists never deceive research participants about aspects that would affect their willingness to participate, such as physical risks, discomfort or unpleasant emotional experiences. Any other deception that is an integral and necessary feature of the design and conduct of an experiment must be explained to participants as early as is feasible, preferably at the conclusion of their participation, but no later than at the conclusion of the research.
11. Body psychotherapists inform research participants of the anticipated sharing or further use of personally identifiable research data and of the possibility of unanticipated future uses.
12. Body psychotherapists provide a prompt, clear opportunity for participants to obtain appropriate information about the nature, results and conclusions of the research and make a good faith attempt to correct any misconceptions that participants may have. If scientific or humane values justify delaying or withholding this information, they take reasonable measures to reduce the risk of harm.
13. When conducting research involving animals, body psychotherapists treat them humanely. They ensure that all individuals using animals under their supervision have received instruction in research methods and in the care, maintenance and handling of the species being used, to the extent appropriate to their role.
14. Body psychotherapists do not fabricate data or falsify results in publications. If they discover significant errors in their published data, they take reasonable steps to correct such errors in every situation where the errors have material effect.
15. Body psychotherapists do not present substantial portions or elements of another’s work or data as their own. When they do present aspects of another’s work, they provide clear and obvious attribution.
16. Body psychotherapists take responsibility and credit, including authorship credit, only for work they have actually performed or to which they have contributed. (A student is usually listed as principal author on any multiple-authored article that is substantially based on the student’s dissertation or thesis.)
17. When reviewing material that has been submitted for publication, grant or research proposal review, body psychotherapists respect the confidentiality and proprietary rights of the authors.