Code of Conduct and Ethics

Introduction

The UK Hypnotherapy Council (UKHC) is a leading professional independent association and registration body for hypnotherapists. The UKHC places emphasis on continuing education and evidence based practice, with strong professional support for its registered members.

We continue to raise the bar for ethical standards for hypnotherapy practitioners in the UK. Once registered with the UKHC, all our members at whatever membership level must:

Conduct themselves within both the spirit and wording of the UKHC Code of Conduct and Ethics at all times, in all circumstances.
Maintain and update their education, skills, training, and knowledge through UKHC approved Continued Professional Development (CPD), amounting to minimum of 25 hours of CPD each year, 15 hours must be Hypnotherapy skills related, 10 hours may be other skills such as marketing, business, etc. and for practicing professionals, 6 hours of accredited professional supervision for each year.
Comply with reasonable requests for information to allow the UKHC to carry out its duties to provide and record up to date information about its members, and to swiftly investigate any query into conduct or compliance.

The Purpose of the Code of Conduct and Ethics

The UKHC Code of Conduct and Ethics (the Code) exists to equip clients and users with a clear standard of ethical practice and quality of care they can expect to receive from registered members. The Code provides members with clear guidance as to the standards expected of them in practice. In the event that the UKHC receives a complaint about a member, the Code is the standard of care by which their conduct will be assessed.

All members are personally accountable for their conduct, and must be able to explain and justify their decisions if asked to do so. The primary duty of all members is to ensure that their client’s best interests are their paramount consideration. Members are under a duty to protect and promote the interests, health, and wellbeing of their clients, which requires they engage in evidence based practice. There are three elements to this:

Awareness and use of the best available evidence from research;
Clinical expertise;
Patient values.

Sackett D et al ‘Evidence Based Medicine: How to Practise and Teach EBM’, (2000)

All members must also adhere to the following principles, which are explained more fully in the Code:

Respect the client’s dignity, individuality, and privacy;
Respect the client’s right to be involved and collaborate in decisions about their care;
Justify public trust and confidence by being honest and trustworthy;
Provide a good standard of practice and care;
Protect clients, colleagues, and the public from risk of harm;
Cooperate with colleagues and other professionals in a respectful manner.

The Code aims to provide a useful reference for members and practitioners regardless of the context of their practice, however the Code is not an exhaustive reflection of the law pertaining to hypnotherapists. The UKHC aims to provide unparalleled support for its members, and should any member have a query or require support in interpretation or implementation of the Code, they are invited to contact the Ethics Department.

Code of Conduct and Ethics

You must always act in the client’s best interests
1. The best interests of your client must always be your paramount consideration, and you must actively seek to protect and promote their wellbeing.
2. You must ensure you provide the best possible quality of care for your client, and where necessary, to facilitate this you must collaborate with or refer to other health and social care professionals.
3. You must ensure you adhere to evidence based practice.
4. When working in a team you remain personally accountable for the professional care and advice you provide.
5. You must actively protect the client if you believe they are actually or potentially at risk from a colleague’s conduct, competence, or health. You must place the client’s best interests above any personal or professional loyalty. If you become aware of a situation that actively or potentially puts a client at risk, you must discuss this with your professional supervisor or directly with the UKHC.
You must always act with honesty and integrity
1. You must maintain high standards of personal conduct as well as professional conduct.
2. You must not undermine your professional standing by doing anything that may affect someone’s confidence in you.
3. You must never knowingly be dishonest or misleading, and should always use your best endeavours to ensure the information you provide is up to date and accurate.
4. You must not rouse fear in others, or impose your views upon them.
5. You must always act within the law. If you are convicted of a criminal offence or accept a police caution, the UKHC must be informed. Your membership may be at risk if you are convicted of a serious offence, however each case will be considered according to its own individual circumstances.
You must work within the scope of your professional competence and expertise
1. You must recognise and act within the limits of your professional knowledge, skills, competence, training and expertise.
2. Your duty of care to your client requires that you refer your client to another healthcare practitioner if their needs are beyond the scope of your own knowledge, skills, competence, training, and expertise.
  (1)
You must always act in a professional and ethical way
1. You must maintain high standards of professional and ethical conduct.
2. You must avoid acting in any way that might prejudice or undermine public confidence in the profession of hypnotherapy, or bring the profession into disrepute. (2)
You must justify refusing to continue client care
1. You are free to choose who you accept as your client.
2. If you refuse to continue a client’s care, you must have clear justification for doing so, and must explain to the client how they might locate another healthcare practitioner who may be able to care for them. (3)
You must not abuse your position of trust and confidence
1. You must not cross the professional boundaries appropriate to the relationship between therapist and client, or exploit the client financially, emotionally, sexually, or in any way whatsoever.
2. You must be clear in establishing and maintaining sexual boundaries with your client and their carers. (4a), (i)
3. You must not accept any inappropriate gifts, tips, gratuities, favours, or benefits in kind from a client. (4b)
You must maintain fitness to practice
1. You must maintain and improve your professional knowledge, skills, competence, and professional performance are of high quality, up to date, and in keeping with the requirements of membership as set out by the UKHC, including participating in Continual Professional Development (CPD) and, if in practice, professional supervision. (5), (ii)
You must effectively supervise any tasks you delegate
1. If you delegate any tasks relevant to your client’s care, you must ensure the person to whom those tasks are delegated has sufficient knowledge, time, and skill to carry out those tasks effectively, and you must not ask them to perform any task which is outside their sphere of competence.
2. You must ensure that delegating a task relevant to the client’s care does not prejudice the client’s best interests, safety, or wellbeing.
3. If you delegate any tasks relevant to your client’s care, you continue to be professionally accountable for the satisfactory completion of those tasks.
4. You must continue to provide adequate guidance and supervision to any person to whom you have delegated tasks relevant to your client’s care.
Conflicts of interest
1. You have a duty to avoid conflicts of interest. You must act in your client’s best interests throughout the therapy process, and must not request or accept any inducement, gift, or hospitality from any person, whether client, colleague, or third party, that may affect, or be seen to affect, the way you care for your clients. (6)
Use of titles and qualifications
1. You must not use any title or qualification that may mislead clients or the public about its meaning, application, or significance. In particular, if you use the title “Dr.” or “Doctor”, you must make it clear in all places that the title appears or is referred to, that you are not a registered medical practitioner, unless you are also registered with the General Medical Council. You must not use the title “Consultant Hypnotherapist”.
2. You must not make any claim that you or your services are better than other hypnotherapists.
You must respect the client’s dignity, individuality, and privacy
1. You must respect the client’s dignity, individuality, and privacy, and be sensitive to differences in culture, religion, and beliefs.
2. You must ensure the client is content with the environment in which you are working with them.
3. If the therapy process requires or is optimised by touching the client in any way, you must explain the reasons for the touch fully to the client, and confirm the client consents to being touched.
4. You must not touch a client in a way that may be open to misinterpretation either by the client or by anyone else.
5. You must ensure the client is aware that they may choose to have a third person (‘chaperone’) to be present throughout the therapy process. If the client is under the age of 16, a chaperone should always be present. If the client is a vulnerable adult, it may also be appropriate to have a chaperone present.
6. If you assess that there is a need for a chaperone to be present, you are responsible for making arrangements to facilitate this. You may decide a chaperone is needed to protect your own interests or those of your client, even if the client has not requested one.
You must promote equality and avoid unfair discrimination
1. You must promote equality in accordance with human rights and anti-discrimination laws, and take positive action to tackle discrimination within your practice. (7), (iii)
2. You must ensure your personal beliefs, values, and opinions do not prejudice or influence the care you provide or your treatment of your client.
3. You must act in an unbiased and non-prejudicial way, and provide an identical quality and level of service irrespective of the client’s age, being or becoming a transsexual person, being married or in a civil partnership, being pregnant or having a child, disability, race including colour, nationality, national or ethnic origin, religion, belief or lack of belief, sex, or sexual orientation.
You must communicate effectively with clients
1. You must maintain appropriate communication with your client, their carer(s) and family.
2. You must be respectful to clients by listening, acknowledging their communications, and taking account of their views and opinions. You must encourage clients to play a full part in their care, to ask any questions and express any concerns.
3. You must be polite and considerate to clients at all times.
4. You must share with your client any information they require to make decisions about their own health, wellbeing, and care options. (8)
Consent and capacity
1. You must obtain consent from your client, or if the client lacks capacity, another person with permission or legal capacity, before you assess or care for them.
2. Your client’s consent must be voluntarily given, free from any pressure or undue influence from you, other healthcare practitioners, family, friends, or anyone else.
3. Consent is a process, and may therefore be withdrawn by the client at any time. You must continue to seek the client’s consent at appropriate times throughout their assessment and care.
4. You must respect your client’s decisions. (9)
Confidentiality and disclosure
1. You must keep all information about clients confidential.
2. If you work with others you must ensure proper procedures are in place to protect your client’s confidentiality, and that every person who has access to personal data understands and observes the need for confidentiality
3. You must only use information about clients for the purposes for which it was given.
4. You must protect your client’s personal information against improper disclosure, including taking measures to guard against accidental disclosure.
5. You must not disclose information about your client, including their identity, either during or after the lifetime of the client, without their consent or the consent of their legal representative.
6. You must obtain your client’s express consent before disclosing information about them to any third party.
7. You must ensure that anyone you disclose the client’s personal information to understands that it is given to them in confidence, and they must also respect and observe your client’s confidentiality.
8. In some circumstances it may be necessary to disclose your client’s personal information in the public interest. You may make an exception to the general rule of confidentiality if:
  1. You believe it is in the client’s best interest to disclose information to another health professional or relevant agency;
  2. You believe that disclosure is necessary to safeguard the client’s health and wellbeing;
  3. You believe that disclosure is necessary in the public interest, for example if the client poses a serious risk of harm to others;
  4. You believe that disclosure is necessary to protect yourself, for example if the client poses a serious risk of harm to you;
  5. The law requires you to disclose the information;
  6. You are directed to disclose the information by an official with legal power to order disclosure. (10)
Data protection
1. You must observe and comply with data protection law. The Data Protection Act 1998 sets out the requirements to handling and processing personal data. (iv), (v)
2. Processing data includes holding, obtaining, recording, using, and disclosing information.
3. You must notify the Information Commissioner’s Office that you process personal data, and have a registered data controller.
Managing client records
1. You must give clients access to their personal records in accordance with their legal rights.
2. You must maintain client records that are legible and that accurately represent your interaction with your client. (11)
3. You must retain client records for eight years from the date of the client’s last visit to you or, if the client is a child, until their 25th birthday, or 26th birthday if the client was 17 at the time your care ended. You must make arrangements for client records to be securely stored in the event you cease to practice or die before this.
Financial records
1. You must keep accurate financial records in accordance with the law.
Professional indemnity insurance
1. You must take out and maintain professional indemnity insurance, and any other insurance legally necessary for your practice.
Advertising
1. You must only use factual and verifiable information when advertising your services.
2. Your advertising must not:
  1. Break the law, including section 4 of the Cancer Act 1939;
  2. Be misleading or make unsubstantiated claims;
  3. Abuse the trust of members of the public or exploit their lack of knowledge;
  4. Instil fear of future ill-health;
  5. Put pressure on people to use your services;
  6. Bring the profession of hypnotherapy into disrepute.
Co-operation with colleagues
1. You must respect the skills and contributions of other healthcare professionals involved in the client’s care, and you must not unjustly criticise or undermine them personally or professionally.
2. When working jointly with others, you must agree and record who holds responsibilities for your client.
Managing complaints
1. You must keep a written complaints procedure in your practice that is easily accessible to clients.
2. You must inform your client of their right to make a complaint against you, and their right to refer any unresolved complaint to the UKHC, and give them the UKHC’s contact details.
3. You must deal promptly, fairly, and professionally with any complaint made against you by your client.
Raising concerns
1. You must take action to protect clients when you believe the conduct, competence, or health of another healthcare practitioner is putting clients at risk.
2. You must exercise due diligence before raising a concern about another healthcare practitioner to ensure as far as possible that your information is reliable and your concerns are justified.
3. In the first instance, you should attempt to address your concerns directly with the practitioner themselves, unless you have very good reasons not to. In the event that the practitioner is unwilling to address your concerns, you should report your concerns to the relevant statutory regulatory body, or if healthcare practitioner is another member, the UKHC.
Your own health and wellbeing
1. You must monitor your own health and wellbeing to identify when your mental or physical health may put clients at risk.
2. If you identify a possibility that your mental or physical health may pose a risk to clients, you must obtain and follow advice about whether or how to modify your own practice to minimise that risk. This may mean limiting your work or stopping practicing if your judgment, performance, or fitness to practice is affected by your mental or physical health.
Sharing relevant information with the UKHC
1. You must keep the UKHC informed of all details relevant to your membership status, including any change of address and contact details, any circumstance which may affect your ability or competence to practice including relevant details about your mental and physical health, and any complaint or disciplinary action against you.
2. You must tell the UKHC if you are convicted of any criminal offence or if you accept a police caution.
3. You must make available on request by the UKHC any information relevant to any investigation, and take all reasonable steps to co-operate with any investigation.
Health and safety
1. You must comply with health and safety laws, and must manage any risks to health and safety in your work environment. (vi)
Controlling infection
1. You must assess and manage infection risk, and take appropriate precautions to protect clients, their carers, their family, and yourself from the risk of infection. You must also take precautions against any risk that you may infect someone else. (viii)
Safeguarding children and vulnerable adults
1. You must safeguard and promote the welfare of any children or vulnerable adults you come into contact with in your practice.
2. If you have concerns about the welfare of a child or vulnerable adult or believe they are at risk of abuse or neglect, you must find out about local procedures in your area, and follow them. This may mean contacting your local social services department, or in emergency situations contacting the police. (viii)

Notes for Guidance

(1) Section 3: Working within the scope of your professional competence and expertise.

You should use your professional judgement to assess whether a client’s needs fall within the scope of your practice.
In some cases it may be appropriate to seek advice and support from a senior colleague or other appropriate source when the needs of the client or the complexity of the case may be beyond the scope of your knowledge, skills, competence, and expertise.
You should have regard to whether it may be appropriate and desirable to co-manage the client with another healthcare practitioner.
In circumstances where support or co-management do not bring the client’s case within your sphere of competence, the client must be referred to another healthcare practitioner.

(2) Section 4: Acting in a professional and ethical way.

It is possible to prejudice or undermine public confidence in the profession through your conduct in your professional practice as well as by your conduct in your personal life.
Areas of your professional practice that might prejudice or undermine public confidence may include, but are not limited to:
1. Soliciting or courting clients of other healthcare professionals;
2. Involving clients in, or disclosing to them, arguments between you and other members or healthcare professionals (not to be confused with discussing with clients differences in professional approach or opinion).
Areas of your personal conduct that might prejudice or undermine public confidence may include, but are not limited to:
1. Misuse of drugs or alcohol;
2. Convictions for fraud or dishonesty;
3. Convictions for violence, sexual abuse, or the use of pornography.
Complaints against members about fraud, dishonesty, violence, sexual abuse, or the misuse of drugs or alcohol may result in a charge of unacceptable professional conduct, regardless of whether there are related criminal charges or proceedings, or whether the conduct directly affects your hypnotherapy practice.

(3) Section 5: Justifying refusal to continue client care.

Acceptable reasons to refuse to continue to care for a client include, but are not limited to:
1. If the client has conducted themselves in a violent, aggressive, or threatening manner;
2. If the client’s conduct becomes inappropriate or obsessive, for example by stalking or asking excessive or inappropriate questions about your personal life or family;
3. If the client has an ulterior motive for seeing you;
4. If the client is putting you or anyone else at risk;
5. If the client repeatedly questions or disregards your professional judgment or advice;
6. If the demands of caring for the client are affecting your overall client base or other clients;
7. If the client has become reliant of specific forms of care that are not promoting their health and wellbeing.
8. If an insufficient therapeutic alliance has been developed inhibiting the client’s ability to benefit from the therapy.

(4) Section 6: Upholding your position of trust and confidence.

The Professional Standards Authority has produced the following guidance for practitioners that find themselves sexually attracted to clients:
When sexual feelings towards a patient become a cause for concern

If a healthcare professional is sexually attracted to a patient and is concerned that it may affect their professional relationship with them, they should ask for help and advice from a colleague or appropriate professional body in order to decide on the most professional course of action to take. If, having sought advice, the healthcare professional does not believe they can remain objective and professional, they must:
- find alternative care for the patient
- ensure a proper handover to another healthcare professional takes place
- hand over care in a way that does not make the patient feel that they have done anything wrong.
Small gifts and tokens of appreciation under the value of £100 are usually disregarded for the purpose of this section.

(5) Section 7: Fitness to practice.

The UKHC requires all members to undertake a minimum of 20 hours of CPD relevant to hypnotherapy each year.
The UKHC requires all full members in professional practice to partake in professional supervision for a minimum of 6 hours every year, with at least one supervision session each quarter. The supervisor must be accredited with the UKHC or other professional body.

(6) Section 9: Conflicts of interest.

When considering whether a potential conflict of interest may arise, you should have regard to:
1. The amount and timing of any care you recommend your clients should have;
2. The products or services you recommend clients should use;
3. The payment options you offer to your clients.
You must disclose to your clients any involvement or interest you have in:
1. Any person or organisation you plan to refer your client to;
2. Any person or organisation that sells products or services you are recommending;
3. Recommending a particular product or service;
Research that might affect them as a client.

(7) Section 12: Promoting equality and tackling discrimination.

You are under legal as well as professional duty to promote equality and tackle discrimination.
It is against the law to discriminate against anyone on the basis of age, being or becoming a transsexual person, being married or in a civil partnership, being pregnant or having a child, disability, race including colour, nationality, national or ethnic origin, religion, belief or lack of belief, sex, or sexual orientation. These are known as ‘protected characteristics’.
Discrimination can take the following forms:
1. Direct discrimination – treating someone with a protected characteristic less favourably than others.
2. Indirect discrimination – putting arrangements in place that apply equally to everyone, but the nature of the arrangement puts someone with a protected characteristic at a disadvantage.
3. Harassment – unwanted behaviour linked to a protected characteristic that violates someone’s dignity or generates an uncomfortable or offensive environment for them.
4. Victimisation – treating someone unfairly because they have made a complaint about discrimination or harassment.
You must not discriminate against a person with a protected characteristic when providing your services by:
1. Refusing to provide, or ceasing to provide, a service for discriminatory reasons;
2. Providing a service of a lower standard, on worse terms, or of worse quality;
3. Causing any other detriment or disadvantage.
You have a duty to make reasonable adjustments in the provision of your service so your service is available to everyone who may want to use it.

(8) Section 13: Effective communication.

Information must be presented to your client in a way that is easy for them to understand and use. You must check the client understands the information sufficiently so they can make informed decisions regarding their care.
You should encourage the client to ask any questions or express any concerns they may have, and you must answer questions and address concerns honestly and fully.
The information that should be shared with clients where appropriate includes:
1. The purpose of any proposed technique or approach to their care, accompanied by supporting material if appropriate;
2. The likely outcomes with or without care;
3. Any risks and likely benefits of the proposed technique or approach;
4. The reasons for any referral or co-working with another healthcare professional to provide their care.
5. Any financial implications of choosing one method of care over another;
6. The client’s right to refuse care or seek a second opinion;
7. The client’s right to change their mind at any time.

(9) Section 14: Consent and capacity.

Nobody else can make a decision on behalf of an adult who has capacity to do so.
Capacity means the ability to understand, remember, utilise, and weigh up the information required to make an informed decision, and can communicate their wishes.
There is a presumption that adults have the capacity to make decisions for themselves unless proven otherwise.
Unexpected or irrational decisions do not prove your client lacks capacity, but may indicate the need for further information or explanation.
In the event a client decides to act contra to your professional advice, it is good practice to record the client’s decision in writing, and have the client sign the entry in your records.
Capacity is ‘decision specific’. It may be possible that the client has capacity to make simple decisions regarding their care, but lacks capacity to make decisions that are more complex.
Someone with parental responsibility must give written consent on behalf of a child under the age of 16.
In the UK, at age 16 a child is presumed to have capacity to give consent for themselves. Under Section 8 of the Family Law Reform Act 1969, people aged 16 or 17 are entitled to consent to their own treatment and any related procedures involved in that treatment.
Clients may give consent orally, in writing, or by implication, however it is good practice to record a client’s consent in writing.
Clients have the right to make their own decisions, even if you consider those decisions to be irrational or wrong.
If your client makes a decision you consider to be irrational or wrong, you can explain your concerns and the likely consequences of their decision, however you must not pressure the client in any way to accept your advice.
Your client has the right to refuse care, even when care would be beneficial for their health and wellbeing.

(10) Section 15: Confidentiality and disclosure.

In protecting clients’ information against improper disclosure, it is good practice to ensure that:
1. Your client’s records are handled in a way that they cannot be seen by other people;
2. Electronic recording systems are password protected and are safe from access by anyone without the client’s express consent to view them.
3. Electronic recording systems are regularly updated, saved, and backed up.
4. Paper based recording systems are secure and cannot be accessed by anyone else, regardless of where you are.
5. Any records are disposed of securely.
If you employ a bookkeeper or accountant, they must only be able to view financial information, not the client’s health records;
If you wish to pursue overdue payments, any outside bodies must only be given the minimum information required for that specific situation;
If you wish to sell your business, you must obtain your client’s consent to transferring their records;
When it is necessary to disclose your client’s data, it is good practice to ensure that:
1. You only disclose the information you need to;
2. Anonymise data if this will serve the purpose of the disclosure;
3. The client knows about any necessary disclosures and the reasons for them so your client has the opportunity to object to the disclosure should they wish to.
In some circumstances in which disclosure is necessary in the public interest, it will not be possible to inform your client in advance of the disclosure, for example if giving the client advance notice of the disclosure risks eliciting a violent response, puts another person at serious risk of harm, or if the disclosure might prejudice a criminal investigation or proceedings.

(11) Section 17: Managing client records.

Your client records should include:
1. The client’s personal data;
2. The client’s full case history;
3. The client’s consent to their assessment and care;
4. Your assessment and reassessment of the client’s care needs
5. Your rationale for your approach to the client’s care
6. Care plans which are kept under review;
7. The care provided to the client, and a record of your advice;
8. Copies of relevant correspondence.

Useful Resources

(i) The Professional Standards Authority has produced this document for guidance: Clear sexual boundaries between healthcare professionals and clients: responsibilities of healthcare professionals, January 2008

(ii) You can find the details of UKHC policies and procedures for registering your CPD hours and information to assist in selecting an accredited supervisor on the UKHC website.

(iii) The relevant law in Great Britain relating to equality and discrimination can be found in the Equality Act 2010

(iv) The Data Protection Act 1998

(v) The Information Commissioner’s Office Guide to Data Protection

(vi) The Health and Safety at Work etc Act 1974 (applies to Great Britain)

(vii) National Institute for Health and Clinical Excellence (NICE) guidance on infection control

(viii) Guidance for safeguarding children and vulnerable adults: