The Statement of Ethical Principles of the EAP (European Association for Psychotherapy), voted by EAP Board, October 2026
PREAMBLE: Psychotherapists respect the dignity and worth of the individual and strive for the preservation and protection of fundamental human rights. They are committed to increasing knowledge of human behaviour and of people's understanding of themselves and others and the utilisation of such knowledge for the promotion of human welfare. While pursuing these objectives they make every effort to protect the welfare of those who seek their services, of people related to those using their services (where that does not conflict with the needs of their clients) and of any research participants that may be the object of study. Psychotherapists respect other members of their profession and of related professions and make every effort, in so far as they are able and where that does not conflict with these interests of their clients, to provide full information and give mutual respect. They use their skills only for purposes consistent with these values and do not knowingly permit their misuse by others. While demanding for themselves freedom of inquiry and communication, psychotherapists accept the responsibility this freedom requires: competence, objectivity in the application of skills, and concern for the best interests of clients, colleagues, students, research participants, & society members. Artificial machines, or mathematically computable algorithms, commonly referred to as "Artificial Intelligence", must not take precedence in psychotherapy or psychotherapeutic context, decision making, and interventions, but must be comprehensively controlled by a fully qualified psychotherapist at all times.
In the pursuit of these ideals, psychotherapists subscribe to detailed ethical principles in the following areas, which follow:
- Responsibility
- Competence
- Moral & Legal Standards
- Confidentiality
- Welfare of the Consumer
- Professional Relationships
- Public Statements
- Assessment Techniques
- Research
Psychotherapists cooperate fully with their own professional, national, and european organisations & associations and with the European Association for Psychotherapy (EAP) by responding promptly and completely to inquiries from and requirements of any duly constituted ethics or professional committees of such associations or organisations of which they are a member or to which they belong. Acceptance onto the Register of the European Certificate for Psychotherapy (ECP) commits a psychotherapist to adherence to all of these principles.
PRINCIPLE 1: RESPONSIBILITY
General Principle: In providing services, psychotherapists maintain the highest standards of their profession. They accept the responsibility for the consequences of their acts and make every effort to ensure that their services are used appropriately.
Principle 1.a: As practitioners, psychotherapists know that they bear a heavy social responsibility because their recommendations and professional actions may alter the lives of others. They are alert to personal, social, organisational, financial, environmental, or political situations and pressures that might lead to misuse of their influence.
Principle 1.b: Psychotherapists clarify in advance with their clients all matters that might pertain to their working together. They avoid relationships that may limit their objectivity or create a conflict of interest.
Principle 1.c: Psychotherapists have the responsibility to attempt to prevent distortion, misuse, or suppression of their findings by an institution or agency of which they are employees.
Principle 1.d: As members of national or organisational bodies, psychotherapists remain accountable as individuals to the highest standards of their profession.
Principle 1.e: As teachers or trainers, psychotherapists recognise their primary obligation to help others acquire knowledge and skill. They maintain high standards of scholarship by presenting information objectively, fully, and accurately.
Principle 1.f: As researchers, psychotherapists accept responsibility for the selection of their research topics and methods used in investigation, analysis and reporting. They plan their research in ways to minimise the possibility that their findings will be misleading. They provide thorough discussion of the limitations of their data, especially where their work touches on social policy or might be construed to the detriment of persons in specific age, sex, ethnic, socioeconomic, or other social groups. In publishing reports of their work, they never suppress disconfirming data, and they acknowledge the existence of alternative hypotheses and explanations of their findings. Psychotherapists take credit only for the work they have actually done. They clarify in advance with all appropriate persons and agencies the expectations for sharing and utilising research data. Interference with the milieu in which data are collected is kept to a minimum.
Principle 1.g: As supervisors, psychotherapists recognise their primary obligation to help others develop knowledge and skill. They ensure high standards of reflective learning.
PRINCIPLE 2: COMPETENCE
General Principle: The maintenance of high standards of competence is a responsibility shared by all psychotherapists in the interest of the public and the profession as a whole. Psychotherapists recognise the boundaries of their competence and the limitations of their techniques. They only provide services and only use techniques for which they are qualified by training and experience. In those areas in which recognised standards do not yet exist, psychotherapists take whatever precautions are necessary to protect the welfare of their clients. They maintain knowledge of current health, scientific and professional information related to the services they render.
Principle 2.a: Psychotherapists accurately represent their competence, education, training, and experience. They claim as evidence of educational & professional training qualifications only those degrees or qualifications obtained from reputable educational institutions or those recognised by the EAP. They ensure that they adequately meet the minimum professional standards as laid down by the EAP, the relevant National Awarding Organisation's criteria, and the criteria of the relevant European Wide Accrediting Organisation in their modality or method, where these exist. They respect the other sources of education, training and experience that they have received.
Principle 2.b: As practitioners, and as teachers or trainers, psychotherapists perform their duties on the basis of careful preparation and readiness so that their practice is of the highest standard and communication is accurate, current, and relevant.
Principle 2.c: Psychotherapists recognise the need for continuing education and personal development and are open to new procedures and changes in expectations and values over time.
Principle 2.d: Psychotherapists recognise differences among people, such as those that may be associated with age, sex, socio-economic, and ethnic backgrounds or the special needs of those who might have been specifically disadvantaged. They obtain suitable training, experience, or counsel to assure competent and appropriate service when relating to all such persons.
Principle 2.e: Psychotherapists responsible for decisions involving individuals or policies based on test results have an understanding of psychological or educational measurement, validation problems, and test research.
Principle 2.f: Psychotherapists recognise that personal problems and conflicts may interfere with professional effectiveness. Accordingly they refrain from undertaking any activity in which their personal problems are likely to lead to inadequate performance or harm to a client, colleague, student, or research participant. If engaged in such activity when they become aware of their personal problems, they seek competent professional assistance to determine whether they should suspend, terminate, or limit the scope of their professional activities.
Principle 2.g: Psychotherapists entering into new fields of activity ensure that they have completed all the training and professional requirements related to that field of activity, prior to practising, and that their activity in this new field is of the highest possible standard. They ensure that there is no dilution of, confusion or conflict with any current activity.
PRINCIPLE 3: MORAL & LEGAL STANDARDS
General Principle: Psychotherapists' moral and ethical standards of behaviour are a personal matter to the same degree as they are for any other citizen, except where these may compromise the fulfilment of their professional responsibilities or reduce the public trust in psychotherapy & psychotherapists. Regarding their own personal behaviour, psychotherapists are sensitive to prevailing community standards and to the possible impact that conformity to or deviation from these standards may have upon the quality of their performance as psychotherapists. Psychotherapists are also aware of the possible impact of their public behaviour upon the ability of colleagues to perform their professional duties.
Principle 3.a: As professionals, psychotherapists act in accord with the principles of EAP and their National Awarding Organisation's (NAO) and their institute or association's standards and guidelines related to practice. Psychotherapists also adhere to relevant governmental laws and regulations. When European, national, provincial, organisational, or institutional laws, regulations, or practices are in conflict with EAP, the NAO, or their institution or association's standards and guidelines, psychotherapists make known their commitment to EAP, their NAO & their institute or association's standards and guidelines and, wherever possible, work toward a resolution of the conflict. As professionals, they are concerned with the development of such legal and quasi-legal regulations that best serve the public interest, and they work toward changing existing regulations that are not beneficial to the public interest.
Principle 3.b: As employees or employers, psychotherapists do not engage in or condone any practices that are inhumane or that result in illegal or unjustifiable actions. Such practices include, but are not limited to, those based on considerations of race, handicap, age, gender, sexual preference, religion, or national origin in practice, in hiring, promotion, or training.
Principle 3.c: In their professional roles, psychotherapists avoid any action that will violate or diminish the human, legal and civil rights of clients or others who may be affected.
Principle 3.d: As practitioners, teachers, trainers and researchers, psychotherapists are aware of the fact that their personal values may affect their communication, the use of techniques, selection and presentation of views or materials and the nature or implementation of research. When dealing with topics that may give offence, they recognise and respect the diverse attitudes and individual sensitivities that clients, students, trainees or subjects may have towards such matters.
PRINCIPLE 4: CONFIDENTIALITY
General Principle: Psychotherapists have a primary obligation to respect the confidentiality of information obtained from persons in the course of their work as psychotherapists. They reveal such information to others only with the consent of the person (or the person's legal status representative), except in those unusual circumstances in which not to do so would probably result in clear danger to the person or to others. Psychotherapists inform their clients of the legal limits of confidentiality. Consent to reveal information to others would normally be obtained in writing from the person concerned.
Principle 4.a: Information obtained in clinical or consulting relationships, or evaluating data concerning children, students, employees, and others, is discussed only for professional purposes and only with persons clearly concerned with the case. Written and oral reports present only data germane to the purposes of the evaluation or for a referral, and every effort is made to avoid undue invasion of privacy.
Principle 4.b: Psychotherapists who present personal information obtained during the course of professional work in writings, lectures, or other public forums either obtain adequate prior consent to do so or adequately disguise all identifying information.
Principle 4.c: Psychotherapists make provisions for maintaining confidentiality in the storage and disposal of records, and in the event of their own unavailability.
Principle 4.d: When working with minors or other persons who are unable to give voluntary, informed consent, psychotherapists take special care to protect these person's best interests and consult others involved appropriately.
PRINCIPLE 5: WELFARE OF THE CLIENT
General Principle: Psychotherapists respect the integrity and protect the welfare of the people and groups with whom they work. When conflicts of interest arise between clients and psychotherapists' employing institutions, psychotherapists clarify the nature and direction of their loyalties and responsibilities and keep all parties informed of their commitments. Psychotherapists fully inform clients as to the purpose and nature of any evaluative, treatment, educational, or training procedure, and they openly acknowledge that clients, students, trainees, or participants in research have freedom of choice with regard to participation. Coercion of people to participate or to remain in receipt of services is unethical.
Principle 5.a: Psychotherapists are continually cognizant of their own needs and of their potentially influential position vis-à-vis persons such as clients, students, trainees, subjects and subordinates. They avoid exploiting the trust and dependency of such persons. Psychotherapists make every effort to avoid dual relationships that could impair their professional judgment or increase the risk of exploitation. Examples of such dual relationships include, but are not limited to, professional treatment of or research with employees, students, supervisees, close friends, or relatives. Sexual intimacies with any such clients, students, trainees and research participants are unethical.
Principle 5.b: When a psychotherapist agrees to provide services to a client at the request of a third party, the psychotherapist assumes the responsibility of clarifying the nature of the relationships to all parties concerned.
Principle 5.c: Where the demands of an organisation require psychotherapists to violate these or any ethical principles, psychotherapists clarify the nature of the conflict between the demands and the principles. They inform all parties of their ethical responsibilities as psychotherapists and take appropriate action.
Principle 5.d: Psychotherapists make advance financial arrangements that safeguard the best interests of and are clearly understood by their clients, students, trainees or research participants. They neither give nor receive any remuneration for referring clients for professional services. They contribute a portion of their services to work for which they receive little or no financial return.
Principle 5.e: Psychotherapists terminate a clinical or consulting relationship as soon as it is reasonably clear that the client is not benefiting from it, or whenever the client requires. They offer to help the client locate alternative sources of assistance.
PRINCIPLE 6: PROFESSIONAL RELATIONSHIPS
General Principle: Psychotherapists act with due regard for the needs, special competencies, and obligations of their colleagues in psychotherapy, psychology, medicine & other professions. They respect the prerogatives and obligations of the institutions or organisations with which these other colleagues are associated.
Principle 6.a: Psychotherapists understand the areas of competence of related professions. They make full use of all the professional, technical, and administrative resources that serve the best interests of consumers. The absence of formal relationships with other professional workers does not relieve psychotherapists of the responsibility for securing for their clients the best possible professional service, nor does it relieve them of the obligation to exercise foresight, diligence, and tact in obtaining the complementary or alternative assistance needed.
Principle 6.b: Psychotherapists know and take into account the traditions and practices of other professional groups with whom they work and they cooperate fully with such groups. If a person is receiving similar services from another professional, the psychotherapist carefully considers that professional relationship and proceeds with caution and sensitivity to the therapeutic issues as well as the client's welfare. The psychotherapist discusses these issues with the client so as to minimise the risk of confusion and conflict, and seeks, where possible, to maintain clear and agreed relationships with other involved professionals.
Principle 6.c: Psychotherapists who employ or supervise other professionals or professionals in training accept the obligation to facilitate the further professional development of these individuals and take action to ensure their competence. They provide appropriate working conditions, timely evaluations, constructive consultation, and experience opportunities.
Principle 6.d: Psychotherapists do not exploit their professional relationships with clients, supervisees, students, employees or research participants sexually or otherwise. Psychotherapists do not condone or engage in sexual harassment. Sexual harassment is defined as deliberate or repeated comments, gestures, or physical contacts of a sexual nature that are unwanted by the recipient.
Principle 6.e: When psychotherapists know of an ethical violation by another psychotherapist, and it seems appropriate, they informally attempt to resolve the issue by bringing the behaviour to the attention of the psychotherapist. If the misconduct is of a minor nature and/or appears to be due to lack of sensitivity, knowledge, or experience, such an informal solution is usually appropriate. Such informal corrective efforts are made with sensitivity to any rights to confidentiality involved. If the violation does not seem amenable to an informal solution, or is of a more serious nature, psychotherapists bring it to the attention of the appropriate institution, association or committee on professional ethics and conduct.
Principle 6.f: Publication credit is assigned to those who have contributed to a publication in proportion to their professional contributions. Major contributions of a professional character made by several persons to a common project are recognised by joint authorship with the individual who made the principal contribution listed first. Minor contributions of a professional character and extensive clerical or similar nonprofessional assistance may be acknowledged in footnotes or in an introductory statement. Acknowledgement through specific citations is made for unpublished as well as published material that has directly influenced the research or writing. Psychotherapists who compile and edit material of others for publication publish the material in the name of the originating group, if appropriate, with their own name appearing as chairperson or editor. All contributors are acknowledged and named.
Principle 6.g: In conducting research in institutions or organisations, psychotherapists secure appropriate authorisation to conduct such research. They are aware of their obligation to future research workers and ensure that host institutions receive adequate information about the research and proper acknowledgements of their contributions.
PRINCIPLE 7: PUBLIC STATEMENTS
General Principle: Public statements, announcements of services, advertising, and promotional activities of psychotherapists serve the purpose of helping the public make informed judgments and choices. Psychotherapists represent accurately and objectively their professional qualifications, affiliations, and functions, as well as those of the institutions or organisations with which they or the statements may be associated. In public statements providing psychotherapeutical information or professional opinions or providing information about the availability of techniques, products, publications, and services, psychotherapists base their statements on generally acceptable findings and techniques with full recognition of the limits and uncertainties of such evidence.
Principle 7.a: When announcing or advertising professional services, psychotherapists may list the following information to describe the provider and services provided: name, highest relevant academic degree or training certificate earned from an accredited institution, date, type, award of the ECP, membership of psychotherapy organisations and professionally relevant or related bodies, address, telephone number, office hours, a brief listing of the type of psychological services offered, an appropriate presentation of fee information, foreign languages spoken, policy with regards to insurance or third party payments and other brief & pertinent information. Additional relevant or important consumer information may be included if not prohibited by other sections of these Ethical Principles.
Principle 7.b: In announcing or advertising the availability of psychotherapeutic services or publications, psychotherapists do not present their affiliation with any organisation in a manner that falsely implies sponsorship or certification by that organisation. In particular and for example, psychotherapists do not state European, national registration or institutional or associational status in a way to suggest that such status implies specialised professional competence or qualifications. Public statements include, but are not limited to, communication by means of periodical, book, list, directory, internet, television, radio, or motion picture. They do not contain (i) a false, fraudulent, misleading, deceptive, or deceptive, or unfair statement; (ii) a misinterpretation of fact or a statement likely to mislead or deceive because in context it makes only a partial disclose of relevant facts; (iii) a testimonial from a patient regarding the quality of a psychotherapist's services or products; (iv) a statement intended or likely to create false or unjustified expectations of favourable results; (v) a statement implying unusual, unique, or one-of-a-kind abilities; (vi) a statement intended or likely to appeal to a client's fears, anxieties, or emotions concerning the possible results of failure to obtain the offered services; (vii) a statement concerning the comparative desirability of offered services; (viii) a statement of direct solicitation of individual clients.
Principle 7.c: Psychotherapists do not compensate or give anything of value to a representative of the press, radio, television, or other communication medium in anticipation of or in return for professional publicity in a news item. A paid advertisement must be identified as such, unless it is apparent from the context that it is a paid advertisement. If communicated to the public by use of radio or television, an advertisement is prerecorded and approved for broadcast by the psychotherapist. Copies of advertisements and recordings of broadcasts are retained by the psychotherapist.
Principle 7.d: Announcements or advertisements of "personal growth groups," special interest group sessions, courses, clinics, trainings and agencies give a clear statement of purpose and a clear description of the experiences or training to be provided. The education, training, and experience of the staff members are appropriately specified and available prior to the commencement of the group, training course or services. A clear statement of fees and any contractual implications is available before participation.
Principle 7.e: Psychotherapists associated with the development or promotion of psychotherapeutic techniques, products, books, or other such offered for commercial sale make reasonable efforts to ensure that announcements and advertisements are presented in a professional, scientifically acceptable, ethical and factually informative manner.
Principle 7.f: Psychotherapists do not participate for personal gain in commercial announcements or advertisements recommending to the public the purchase or use of proprietary or single-source products or services when that participation is based solely upon their identification as psychotherapists.
Principle 7.g: Psychotherapists present the science and art of psychotherapy and offer their services, products, and publications fairly and accurately, avoiding misrepresentation through sensationalism, exaggeration, or superficiality. Psychotherapists are guided by the primary obligation to aid the public in developing informed judgments, opinions, and choices.
Principle 7.h: As teachers, psychotherapists ensure that statements in catalogues and course outlines are accurate and not misleading, particularly in terms of subject matter to be covered, bases for evaluating progress, and the nature of course experiences. Announcements, brochures or advertisements describing workshops, seminars, or other educational programs accurately describe the audience for which the program is intended as well as eligibility requirements, educational objectives, and nature of the materials to be covered. These announcements also accurately represent the education, training, and experience of the psychotherapists presenting the programs and any fees involved.
Principle 7.i: Public announcements or advertisements soliciting research participants in which clinical services or other professional services are offered as an inducement make clear the nature of the services as well as the costs and other obligations to be accepted by participants in the research.
Principle 7.j: A psychotherapist accepts the obligation to correct others who represent the psychotherapist's professional qualifications, or associations with products or services, in a manner incompatible with these guidelines.
Principle 7.k: Individual diagnostic and therapeutic services are provided only in the context of a professional psychotherapeutic relationship. When personal advice is given by means of public lectures or demonstrations, newspaper or magazine articles, radio or television programs, mail, or similar media, the psychotherapist utilises the most current relevant data and exercises the highest level of professional judgment.
Principle 7.l: Products that are described or presented by means of public lectures or demonstrations, newspaper or magazine articles, radio or television programs, mail, or similar media meet the same recognised standards as exist for products used in the context of a professional relationship.
PRINCIPLE 8: ASSESSMENT TECHNIQUES
General Principle: In the development, publication, and utilisation of psychotherapeutic or psychological assessment techniques, psychotherapists make every effort to promote the welfare and best interests of the client. They guard against the misuse of assessment results. They respect the client's right to know the results, the interpretations made, and the bases for their conclusions and recommendations. Psychotherapists make every effort to maintain the security of tests and other assessment techniques within the limits of legal mandates. They strive to ensure the appropriate use of assessment techniques by others.
Principle 8.a: In using assessment techniques, psychotherapists respect the right of clients to have full explanations of the nature and purpose of the techniques in language the clients can understand, unless an explicit exception to this right has been agreed upon in advance. When the explanations are to be provided by others, psychotherapists establish procedures for ensuring the adequacy of these explanations.
Principle 8.b: Psychotherapists responsible for the development and standardisation of psychological tests and other assessment techniques utilise established scientific procedures and observe the relevant EAP, national, and institutional or organisational standards.
Principle 8.c: In reporting assessment results, psychotherapists indicate any reservations that exist regarding the validity or reliability because of the circumstances of the assessment or the inappropriateness of the norms for the person tested. Psychotherapists strive to ensure that the results of assessments and their interpretations are not misused by others.
Principle 8.d: Psychotherapists recognise that assessment results may become obsolete and do not represent a complete picture of the assessed. They make every effort to avoid and prevent the misuse of obsolete measures or incomplete assessments.
Principle 8.e: Psychotherapists offering scoring and interpretation services are able to produce appropriate evidence for the validity of the programs and procedures used in arriving at interpretations. The public offering of an interpretation service is considered a professional-to-professional consultation. Psychotherapists make every effort to avoid misuse of assessment reports.
Principle 8.f: Psychotherapists do not encourage or promote the use of psychotherapeutic or psychological assessment techniques by inappropriately trained or otherwise unqualified persons through teaching, sponsorship, or supervision.
PRINCIPLE 9: RESEARCH
General Principle: The decision to undertake research rests upon a considered judgment by the individual psychotherapist about how best to contribute to human science and human welfare. Having made the decision to conduct research, the psychotherapist considers alternative directions in which research energies and resources might be invested. On the basis of this consideration, the psychotherapist carries out the investigation with respect and concern for the dignity and welfare of the people who participate and with cognizance of regulations and professional standards governing the conduct of research with human participants.
Principle 9.a: In planning a study, the psychotherapist who carries out the investigation (the investigator) has the responsibility to make a careful evaluation of its ethical acceptability. To the extent that the weighing of scientific and human values suggests a compromise of any principle, the investigator incurs a correspondingly serious obligation to seek ethical advice and observe stringent safeguards to protect the rights of human participants.
Principle 9.b: Considering whether a participant in a planned study will be a "subject at risk" or a "subject at minimal risk", according to recognised standards, is of primary ethical concern to the investigator.
Principle 9.c: The investigator always retains the responsibility for ensuring ethical practice in research. The investigator is also responsible for the ethical treatment of research participants by collaborators, assistants, students, and employees, all of whom, however, incur similar obligations.
Principle 9.d: Except in minimal-risk research, the investigator establishes a clear and fair agreement with research participants, prior to their participation, that clarifies the obligation and responsibilities of each. The investigator has the obligation to honour all promises and commitments in that agreement. The investigator informs the participants of all aspects of the research.
PRINCIPLE 10: TECHNOLOGICAL ASSISTANCE IN PSYCHOTHERAPY
General Principle:
The integration of modern technology, the internet and the development of artificial intelligence (AI) into the practice of psychotherapy over recent years raises several ethical principles, mainly concerning security. privacy, legalities and ethical practice.
Psychotherapists always make every effort to ensure the quality and safety of their relationship with the client, especially when using modern technology. Psychotherapy practice adheres to the "do no harm" principle. The life, welfare and well-being of patients and clients is paramount in any modern psychotherapy practice context and takes priority over any corporate, business, or financial pursuits, and any professional recommendations, particularly when there is no direct contact with the psychotherapist (e.g., the patient / client using AI systems).
Psychotherapists can find themselves less constrained by some of the more traditional boundaries of face-to-face work (for example, of location, setting, office hours, travel, etc.) but can face significant new challenges (relating to matters of security, confidentiality, containment, self-disclosure and much more).
The psychotherapist is aware of possible changes in the power balance between client and practitioner when working remotely. This may in turn affect interventions, techniques, theoretical perspectives and understanding. The psychotherapist takes into account any ‘disinhibitation’ effect.
Psychotherapists as members of professional associations in psychotherapy (in their country or in their modality) conform to more detailed guidelines about working remotely that apply to them. These guidelines usually serve three purposes: (1) To enable practitioners to be more aware of the questions working online or remotely raises; (2) To provide clinical considerations for those wishing to provide services online or remotely in significant areas such as assessment, risk and safeguarding; (3) To highlight the general considerations of working online/remotely or with technological assistance. There are also similar guidelines that specifically apply to work with children, adolescents and vulnerable clients.
Principle 10.a: Keeping and storing information about clients.
Psychotherapists comply with General Data Protection Regulations (GDPR). Key GDPR requirements include obtaining informed consent, having clear privacy notices, securing all data, and understanding a client's rights like access, correction, and erasure. Psychotherapists ensure that they work on a lawful basis with proper methods for processing client data, obtaining freely-given, specific, informed, and unambiguous consent, and implementing strict security measures to protect sensitive information. Psychotherapists are – in effect – "data controllers" (according to GDPR) and, if necessary, register with the Information Commissioner's Office (ICO) (or equivalent).
Principle 10.b: Working with clients online and remotely.
Working online or remotely in this context refers to any therapeutic service other than being together in-person in the same room. Ways to connect are ever expanding and developing so this list is not exhaustive but includes: – contracted therapeutic exchanges of emails; contracted therapeutic exchanges by SMS (text); live video therapy sessions; live audio therapy sessions, online sessions or on the phone; and contracted therapeutic interactivity via chat rooms or forums; etc.
Psychotherapists clearly inform clients of any system requirements and warn them of the possibility of technological failures, limitations, and risks, including what they would do in the case of technological breakdown. It is best if this is in writing so that the client isn’t stuck having ‘forgotten’ what was said or what the therapist would do if the connection was interrupted unexpectedly. In complex situations, the psychotherapist may insist that someone else is present in the home of the client, or may insist that they have their phone on, so that they can be called if they cannot be reconnected via the internet.
The psychotherapist ensures that any internet platform for online therapeutic work is reasonably secure, and the psychotherapist subscribes to a secure platform from reputable company. The psychotherapist ensures the security of their emails and texts with their clients, using encrypted email or password protected services. The psychotherapist keeps such communications to a minimum and distinguishes between administrative and clinical emails. The psychotherapist is aware that there is a risk that digital information could be intercepted by a third party, either remotely or by someone with in- person access to the therapist or client’s computer or phone because appropriate security measures have not been set up. Contact information stored on a computer or phone should always be anonymised to minimise the risk of data ‘mining’.
The psychotherapist makes it clear from the outset as to who will initiate the session. For example, if it is a phone call, who calls whom? If using an online meeting app, who creates the meeting? Providing information in writing to explain all elements of the contract and ways of working is recommended.
The psychotherapist should ensure that any digital payment facilities provided are secure and from a reputable company. They should also consider how references are set up so that their bank and/or accountant cannot identify a client simply by seeing the bank statement.
It is important to note that under Consumer Contracts Regulations, therapy online is a ‘service’ and at the start of a therapy a client has a right to cancel any contract within 14 days of signing and receive back any monies paid upfront (minus any sessions conducted) within 14 days.
If clients are identified as being unlikely to benefit from working online/remotely, are at additional risk from it or are beyond your area of competence, you should have procedures in place to direct the client to more suitable help. It is worth noting that research is showing that for some clients, working online/remotely can be more beneficial than working with them in person.
It can be particularly useful when working online/remotely to take details of a ‘safety contact’ – someone who the client trusts and who knows they are in therapy with you – who you can contact if you become concerned for the client’s safety.
Geographical distance minimises some of the practical issues of offering therapy and opens-up possibilities for many to work with more distant and diverse clients. Cultural differences may be more complex working online or remotely and it can be easier to make presumptions. Online/remote practitioners need to keep an awareness of these factors and be prepared to discuss this in supervision. Supervisors must only offer only services for which they are competent and in which they have adequate training and experience. This applies to all contexts including working online or remotely.
The psychotherapist may also need to verify the client's identity initially (perhaps via a passport or driving licence). There have been cases where potential clients have misrepresented their details or age group (e.g., using online therapy to access an adult psychotherapist.) The psychotherapist needs to be wary of absolutely every approach for therapy or information and make sure that they are communicating with the person they think they are: this sort of check may not feel comfortable, at first.
The psychotherapist is aware that online or remote clients may also find it easier to conceal problems such as psychosis or being actively affected by substances than they would if they were seen in-person.
The psychotherapist may need to check on the client's confidentiality or responsibilities (i.e., it has been known for clients to have sessions when their baby is asleep in another room). Some clients struggle to find a quiet space but may not fully realise the implications. The psychotherapist makes the client aware of any situation where their own confidentiality may be compromised, such as using a work computer, library, cybercafé or if the screen can be viewed by others (for example, from a window). Clients may have problems finding a secure place – and so live chat or email therapy might be safer alternatives.
Permission to use text messaging must be sought before sending any text, even a confirmation of the appointment time. This should be a part of the contract/agreement. Clients and practitioners should be aware that the automated storage of messages, back-up files or visited internet sites leads to a ‘history of use’ being kept on the computer or phone. Suitable software can be used to counteract this. The retention of data should be in accordance with your Privacy Notice so you will need to understand how and where material created online is stored and how it can be deleted.
Printed Internet Relay Chat (IRC) or Instant Messaging (IM) transcripts, emails, client details and other sensitive material must be stored securely in line with the procedure for in-person client notes. The psychotherapist should also consider what they would do if they were requested to submit full transcripts of their communication with clients, as in legal proceedings or an ethics enquiry.
The psychotherapist ensures that they have suitable premises and technology to undertake remote therapy, so that client confidentiality is maintained and not overheard, seen or accessed by others. Consideration also needs to be given to what a client may perceive from the psychotherapist’s environment in respect of self-disclosure and what interruptions might happen?
There may also be ‘modality-specific’ considerations when working online. The psychotherapist follows the recommendations of their professional association for that modality.
A thorough risk assessment is required for all clients when working online or remotely. On rare occasions, a psychotherapist may have to take action to ensure a client’s safety. The options when the client is not in the consulting room are limited. The psychotherapist needs to think through, for every client, what they would do in extreme circumstances and create a plan. This can seem ‘over the top’ to clients, so it will take some skill to set this in place sensitively. The psychotherapist thinks this through properly, and ensures the plan is included in the routine documentation given to the client at the start of the therapy. Any circumstances under which a secondary means of contact (emergency contact information) may be used must be made clear and explicit to the client before the therapy begins.
If working internationally, the psychotherapist is aware that the sessions are subject to the laws of both lands. The psychotherapist ensures that the client has proper information about how and to whom to make a complaint: stating that any complaint or claim would be heard in the psychotherapist’s country.
Psychotherapists working in private practice should be aware that their work counts as a business and therefore any international sanctions (of countries, organisations or individuals – including international payments) may apply. Psychotherapists are required (by law) to follow sound business practices.
When working on-line or remotely, psychotherapists are required to pay extra attention to their self-care and wellbeing. To ensure efficacy, it may be necessary to take more frequent breaks away from devices. It may be beneficial to review scheduling and planning to mitigate against the screen fatigue and eye strain, with regular breaks.
Principle 10.c: Working with Social Media
Social media have facilitated a wider and more open discourse concerning many aspects of mental health, wellbeing, social inclusion and openness, creating and facilitating new spaces where it is possible to challenge historic issues of stigma and prejudice. There are also sometimes occasions where conflict, bullying and angry confrontation can be found and where different groups and individuals run the risk of being marginalised. Psychotherapists are aware of such different challenges, contradictions and disparities, which can affect the client. Some of these issues are particularly pertinent for those working in therapy.
Principle 10.d: Working with artificial intelligence (AI)
The use of artificial intelligence (AI) is evolving rapidly, presenting opportunities and challenges for psychotherapists. AI has the potential to enhance psychological clinical decision-making and outcomes, improve access to care, and enhance provider workflow and efficiency.
Psychotherapists do not give AI any precedence in psychotherapy, nor in psychotherapeutic context, decision-making and interventions. Its use must be comprehensively controlled by a fully qualified psychotherapist at all times.
Psychotherapists should carefully evaluate and validate AI tools before implementing them in their psychotherapeutic practice.
The use of AI in psychotherapy refers to the use of artificial intelligence to provide psychological support through applications like chatbots and virtual assistants, offering immediate support, accessible and cost-effective information about mental health care, and aid in writing documents, etc. The psychotherapist retains professional accountability for any machine (hardware or software) mistakes, errors, confidentiality breaches, malpractice or any unintentional damages incurred by patients, clients, supervisees, or students of the profession. The psychotherapist ensures that, if used, non-human systems are comprehensively insured.
While AI can provide tools like guided exercises, support during waiting times, greater accessibility, and initial triage, it is not a replacement for human therapists due to its limitations in emotional depth, in building rapport, understanding non-verbal cues, limited long-term memory, inadequate safety and a potential for invalidation, etc. AI aims to make mental health care more accessible and cost-effective (though it is currently seen as a supplement rather than a replacement for human therapists due to limitations in replicating human empathy and nuanced understanding).
Psychotherapists note the potential benefits of AI, but also the risks, like dependence, lack of validation for serious conditions, and inadequate safety protocols.