Introduction
The Association of Reflexologists (AoR) is committed to the highest possible standards of professional conduct and as such has adopted a Code of Practice and Ethics which all members of the AoR, by joining the association, undertake to abide by.
This Code of Practice and Ethics is designed to encourage integrity and responsibility for complementary therapy practitioners, as well as to uphold and further the standing of the profession and the Association of Reflexologists . It also defines the expectations of members to behave professionally and ethically and at all times to:
1. Act in the best interests of clients and treat them with respect
2. Maintain client confidentiality
3. Take responsibility for own actions
4. Practise only within the limits of competence and to maintain and develop knowledge and skills
5. Protect own and the reputation of the profession
6. Respect and maintain good relationships with other practitioners and health professionals
7. Practise within the law, both personally and professionally
1. Act in the best interests of our clients
a) We must always act in the best interests of clients; the safety, comfort, confidentiality and welfare of the client must take priority at all times.
b) Be aware of the client relationship and develop listening skills and a caring attitude.
c) Never allow views about the sex, age, colour, race, disability, sexuality, social or economic status, lifestyle, culture or religious beliefs of clients to affect how we treat, or the advice we give. As far as practical we should ensure that any advice given should match the economic status, lifestyle, culture and religious beliefs of the client.
d) We must not abuse the trust of existing or potential clients, nor exploit their lack of knowledge.
e) All practising AoR members must ensure their professional practice is fully covered by professional indemnity insurance against public liability and malpractice at all times and - on request - provide the AoR with their insurance details.
f) As a practitioner working in our own environment, we should:
i. Ensure a private treatment area with easy access to bathroom facilities is provided
ii. Ensure that we comply with the terms of the disability discrimination legislation and ensure disabled access for your clients, where practicable
iii. Ensure that premises and equipment are clean and hygienic
iv. Ensure that our own health and hygiene are not such as to put the client at risk
v. Ensure that local constraints are adhered to
g) When treating a client, we should not share with them any unnecessary personal information about oneself, and we should not encourage, or allow, them to offer us their support in relation to our own personal circumstances.
h) We must recognise the responsibility we have towards clients at all times.
i. Before an initial consultation with a client, an accurate description of reflexology in laymans terms should be available
ii. A statement of fees should be made before commencement of treatment
iii. We must obtain a signed consent form before commencing the initial treatment. Obligations towards minors and adults at risk). Some clients because of age, illness or mental capacity may not be able to give consent to treatment. In these circumstances we must obtain clear consent from somebody that we are satisfied is authorised to give consent on behalf of the client. This may in some circumstances be a team of health professionals or care providers. This consent must be gained in writing
iv. We must obtain a full medical history before commencing the initial treatment
v. When working with children, young people and adults at risk, we may require either a basic or an enhanced DBS check
vi. Full and accurate contemporaneous (ie at the time of consultation) records of treatments given should be kept
vii. If we practise or offer other therapies it should be made clear to the client that they form no part of the reflexology treatment. Some therapies are inappropriate for use with children and adults at risk. Others may be suitable; however, members who offer such treatments should have knowledge of the relevant requirements of the Children Act 2004, the Protection of Children Act 1999, the Safeguarding Vulnerable Groups Act 2006, The Care Act 2014 and other pertinent legislation, and apply it to their work. For information on these acts, see www.opsi.gov.uk. Clients must give signed consent to having any other therapy alongside their reflexology treatment.
Relationships with Clients
As an AoR member, we must act ethically in all relationships with clients. Specifically:
i) Personal Relationships
We must deal with clients in a professional manner which is not open to misunderstanding or misinterpretation. Non-physical behaviour, gesture, unnecessary physical contact, verbal suggestion or innuendo may be construed as abusive or harassing. When treating a relative or a friend, clear boundaries must be maintained between social and professional relationships.
j) Inappropriate Relationships
An inappropriate personal relationship means either a sexual relationship, or any inappropriate emotional involvement with a client. We should not use our professional position to pursue any inappropriate personal relationship with a client, or with anyone having a close relationship with a client. If we find that we are becoming involved in an inappropriate relationship with a client, we should end the professional relationship and should, if appropriate, recommend an alternative reflexologist for any future treatments. If a client shows signs of becoming involved in such an inappropriate relationship, we should discourage the client, and if necessary end the professional relationship.
k) It is recommended that we retain a contemporaneous note of the situation, the actions taken, the reasoning for choice of actions and any outcomes, in case of any future claim of alleged misconduct.
2. Maintain client confidentiality
The therapist/client relationship is one of trust. We must treat all information about clients as confidential, and only use such information for the purposes for which it was given.
a) We should not disclose, or allow to be disclosed, to third parties any information gained (whether about a client or about any other person), except where such disclosure is authorised by the client and/or other person concerned, or is required by legal or regulatory process, or where such information is already in the public domain. Similarly, confidential information acquired as a result of professional and business relationships should not be used to the personal advantage of you or third parties.
b) The client has responsibility for their own health. However, if we have concerns about their symptoms, we should suggest that the client consults their Medical Practitioner or Practice Nurse. Unless the client specifically requests that confidentiality be broken, we are advised not to contact anyone on his or her behalf in order for help to be obtained.
c) We must also comply with any relevant data protection legislation and follow best practice for handling confidential information relating to individuals at all times. Best practice is likely to change over time and we must stay up to date. We must be particularly careful not to reveal, deliberately or accidentally, confidential information that is stored on computers. All records must be kept secure. Paper records must be kept under lock and key and computer records should be password protected. Where a member is working with or for another business, a legally binding document should be signed by both parties making absolutely clear who has access to client records and to whom they belong in the event of the arrangement ceasing. If we keep client records on an electronic device, we should check if we are required to register with the Office of the Information Commissioner (http://www.ico.org.uk/for_organisations/data_protection/registration/).
d) Confidentiality can be a particular challenge when treating minors. We must have an adult (either a legal parent or guardian, or someone holding signed consent from a legal parent or guardian) present at the consultation if the child is under 16.
e) If case histories are used (for example in connection with research or the furtherance of knowledge), they must be used anonymously to protect client identity and confidentiality.
3. Take responsibility for our own actions
We are personally accountable for our actions and must be able to explain and justify our decisions.
4. Limits of competence & refusal to treat
a) As an AoR member, we should carry out treatments and give advice only within the limits of our professional training and competence - ie having received the proper training and be duly qualified to perform the treatment. No unqualified advice should be given.
b) We should inform our clients and seek their consent before introducing new treatments into their existing treatment programme.
c) A consultation must be undertaken before each treatment to ensure that the most appropriate treatment is being given to the client and that no new contraindications have occurred between treatment sessions.
d) We have the right to refuse to treat a client, providing the refusal is carried out in a professional manner.
e) We should refuse to treat a client if:
i. We do not feel competent to do so, for example if they are suffering from mental health problems, an addiction, or are suicidal, etc. In such circumstances, we should suggest that they contact their GP for further help and referral
ii. We are unable to converse with the client in a manner fully understandable by both parties
iii. We feel our client is becoming reliant on reflexology and neglecting other aspects of their health and wellbeing
f) It is permissible under the Equality Act 2010 for a therapist to choose to treat only clients of the same gender in treatments where physical contact is involved.
g) In the event of us being unable to treat, if we wish to refer the client to another therapist, the client must:
i. Be offered an equivalently qualified and experienced reflexologist or an alternative appointment
ii. Be given enough information about the suggested therapist to make an informed choice
h) We should not:
i. Diagnose a medical condition
ii. Prescribe
iii. Claim to cure or treat specific conditions
Continuing Professional Development (CPD)
The mark of a professional is that they are willing to continually update and expand their knowledge and skills to give the best to their clients.
i) It is compulsory for all Full, Fellow and Honorary members to undertake CPD in accordance with the AoR Continuing Professional Development policy. Each year, the AoR run random checks on members to ensure compliance with the CPD policy, so members should be prepared at all times to present their CPD records and files upon request.
j) First Aid: The AoR strongly recommends that we have a current First Aid certificate. If a medical event does occur you must assess each situation thoroughly and decide if it is suitable to offer care and act accordingly. Depending on the level of the incident the best action may be to dial 999 immediately.
If we have a client with a specific illness that may reoccur during treatment (for example epilepsy), then at the very first treatment we should have a discussion of their requirements and produce a written plan of what to do should that eventuality take place.
Health & Fitness to Practice
k) We must be aware of our own health and fitness to practice and adjust our treatments accordingly.
We must limit our work or stop practising if we or another person has any reason to believe that our performance or judgement is affected by our physical, emotional or mental health. We must also take appropriate precautions to protect our clients, anyone accompanying them, our staff and ourself against infection, and against the risks that we might infect someone else.
5. Protect our own reputation and that of our profession
We should conduct ourself with honesty, integrity and dignity, and act in a way which maintains the reputation of our profession, maintaining high standards of personal and professional conduct. We should avoid any behaviour or activity that is likely to damage the reputation of our profession, or undermine public confidence in our profession. Appropriate professional boundaries must be maintained between us and our clients. Development of a personal relationship must result in the cessation of the therapeutic relationship. We should not speak or write disrespectfully of fellow reflexologists or the Association of Reflexologists, either in a private or a work capacity, at any time. This includes both private and work related communications of any nature. If we are representing the AoR in any capacity, we should abide by the following:
a) Act in a responsible and professional manner.
b) Use our knowledge and experience to contribute to the development of the profession and the specific area we represent. Take care that any information we post on social media on topics for which we are deemed to be knowledgeable is factual and not misleading. If we have a personal opinion which negates currently understood information, either do not post it, or make it clear that this is only our own personal opinion, and not a professional statement of fact.
c) Promote policies and procedures which uphold human rights and which seek to ensure access, equality and participation for all.
d) Ensure that we do not act out of prejudice against any person or group, on any grounds, including origin, ethnicity, class, status, sex, sexual orientation, age, disability, beliefs or contribution to society.
e) It is our responsibility to make the AoR aware, in writing, of any relevant changes in our situation which might impact our professional status, reputation or membership of the AoR.
f) If, during our period of membership, we are convicted of any offence, apart from traffic related offences, it is our duty to inform the AoR immediately in writing. Each case will be assessed individually. Any breach of the above may result in the AoR taking disciplinary action.
6. Relationships with other practitioners and health professionals
a) We should not claim to ‘cure’ or ‘heal’ medical ailments or to diagnose medical conditions.
b) We should endeavour to foster good relations with those working in orthodox medicine.
c) We should not contradict medical treatment instructions given by a doctor or medical professional. It is possible to complete a treatment:
i. Where there is no reason to believe that reflexology would cause harm
AND
ii. Where the client choice overrides medical opinion of the efficacy of a treatment
AND
iii. Where we are confident treating.
d) Always ascertain at the consultation stage whether the client has any medical conditions or is undergoing medical treatment likely to be affected by reflexology. In the event of a current or recent contraindication, we should not carry out any treatment until we have the consent of the doctor or other medical professional treating the client. The client can obtain such consent either verbally or in writing from the doctor.
i. If verbal consent is received, the client must then sign his or her client record that such consent has been given. The written consent from the client must be attached to our client records.
ii. Alternatively, with the signed approval of our client, we can write to the doctor directly giving full information on the treatment to be carried out, our competence to do so, and requesting a response.
e) When working in a multi-disciplinary team, we remain accountable for our professional conduct, any care or professional advice we provide, or any failure to act. We must protect patients and clients if we believe that they are actually or potentially at risk from the conduct, performance or health of a colleague. The safety of patients, clients and users must come before any personal or professional loyalties at all times. As soon as we become aware of any situation that puts a patient, client, user or colleague at risk, we should discuss the matter with an appropriate professional colleague.
f) The AoR Code of Practice and Ethics forms a basis for standards of professional behaviour expected of a practitioner. In a multi-disciplinary environment, additional standards and Codes may also apply. For example:
i. Local clinical governance
ii. Communications with other healthcare professionals
iii. Local licensing
It is our responsibility as a therapist to decide which Code of Conduct we believe takes precedence; however, the AoR expects the AoR Code of Practice and Ethics as a minimum standard for practice.
g) Members must act with respect for fellow reflexologists, practitioners, and all other healthcare professionals. Any activities of a competitive nature must be conducted in a fair and open manner. Activities to be avoided include, but are not exclusive to:
• Inappropriate comments
• Personal slights
• False claims
• Breaching of copyright and any form of plagiarism
7. Practise within the law
We must comply with all relevant laws and regulations and shall avoid any action that may discredit the profession.