Annual review of accreditation 2018/19 Play Therapy UK (PTUK) April 2018
Contents 1. Outcome... 3 2. Assessment against the Standards for Accredited Registers... 4 3. Share your experience... 10 4. Impact assessment... 10 5. Equality duty under the Equality Act 2010... 10 About Play Therapy UK (PTUK) Play Therapy UK (PTUK)registers: Certified Play Therapists Accredited Play Therapists Certified Practitioners in Therapeutic Play Skills Certified Play and Creative Arts Counsellors of Children and Young People Filial Play Coaches Certified Supervisors of Play and Creative Arts Therapists Its work includes: Setting and maintaining standards of practise and conduct Maintaining a register of qualified professionals Assuring the quality of education and training Requiring registrants to keep up their skills up to date through continuing professional development Handling complaints and concerns raised against registrants and issuing sanctions where appropriate. Managing a clinical evidence base As of January 2018, there were 2,047 registrants on PTUK s register. PTUK was first accredited on 11 April 2013. This is its fifth annual review and this report covers 11 April 2017 to 11 April 2018.
Background The Professional Standards Authority accredits registers of people working in a variety of health and social care occupations not regulated by law. To be accredited, organisations holding such registers must prove that they meet our demanding Standards for Accredited Registers (the Standards). Accreditation is reviewed every twelve months. Accreditation can be renewed by a Moderator in cases where there are no concerns that a register is not meeting the Standards. A Moderator can issue Recommendations and note Achievements. Where concerns do exist, or information is not clear, a targeted review will be recommended by a Moderator. The outcome of this review is assessed by an Accreditation Panel, who can decide to are renew accreditation, renew accreditation with conditions, suspend accreditation or remove accreditation. Panels may also issue Recommendations and note Achievements. Condition Changes that must be made within a specified timeframe to maintain accreditation Recommendation Actions that would improve practice and benefit the operation of the register, but do not need to be completed for compliance with the Standards to be maintained. Implementation of recommendations will be reviewed at annual renewal Achievement Areas where a register has demonstrated a positive impact on one of the four pillars of the programme; protection, choice, confidence and quality. 3
Outcome Accreditation for PTUK was renewed for the period of 11 April 2018 to 11 April 2019. Accreditation was renewed by a Moderator following a review of evidence gathered by the Accreditation team and supplied by PTUK. No Conditions were issued. The following Recommendation was issued, to be implemented by submission of annual renewal documentation: 1. The BCTIWC s remit should include scrutiny of PTUK s assessment of risk to provide an independent perspective and to ensure specific risks relevant to the occupations PTUK s register includes are considered. (See paragraphs 3.1-3.7). The following Achievements were noted: 1. PTUK s work to develop an evidence base of practice-based outcomes. (See paragraphs 6.1-6.5). 4
Assessment against the Standards for Accredited Registers Standard 1: the organisation holds a voluntary register of people in health and/or social care occupations 1.1 There have been no significant changes reported or noted in the past year. 1.2 The number of registrants on PTUK s register in the past year has risen from 1,790 to 2,074 despite a slight increase in the number or registrants leaving the register. 1.3 The Authority found that this Standard continues to be met. Standard 2: the organisation demonstrates that it is committed to protecting the public and promoting public confidence in the occupation it registers 2.1 There have been no significant changes reported or noted in the past year. 2.2 In 2017 PTUK applied through the Authority s Notification of Change process to add a new occupation to its register. The new occupation would allow play therapists to safely introduce elements of talking therapies into their work, for children who wish to talk about their problems. PTUK developed additional competencies to those held by registered play therapists required for the Certified Play and Creative Arts Counsellor of Children and Young People grade. 2.3 At that time the Panel discussed a risk that the proposed title for this occupation could be shortened to a form that could mislead people regarding practitioners specialised area of practice. The Panel stated that as there was no existing title or specific occupation for counselling for children (not to be confused with child psychotherapists), the impact of registering this occupation was unclear and would need to be measured. The Panel approved the change and issued the following Condition: The title will appear on the register as Certified Play and Creative Arts Counsellor of Children and Young People. PTUK must ensure the title is used in full and provide an update on its monitoring of this at its 2018 Annual Review. 2.4 The title used on the register is Certified Play and Creative Arts Counsellor of Children and Young People. 2.5 At time of assessment there were thirteen PTUK registrants listed as Certified Play and Creative Arts Counsellors of Children and Young People. PTUK has taken steps to ensure this title is used correctly, including checking registrants websites. 2.6 The Authority found that the Condition had been fulfilled and that this Standard continues to be met. Standard 3: risk management 3.1 Through the process of developing the Certified Play and Creative Arts Counsellor of Children and Young People grade, PTUK identified existing risks that would be further mitigated by the introduction of the occupation, but 5
did not perceive further risks posed to the public in talking therapies that were not already covered under its existing risk management practices. An Accreditation Panel had previously recommended that PTUK should consider asking its oversight body, the British Council for Therapeutic Interventions With Children (BCTIWC), to include scrutiny of PTUK s assessment of risk to provide an independent and lay perspective. 3.2 The Panel assessing the Notification of Change issued a Learning Point for PTUK to work with the BCTIWC when reviewing its assessment of risk to ensure these include those relating to talking therapies and any other forms of specialist or advanced practice by registrants. 3.3 The risk matrix submitted for this annual review did not add, remove, or modify any risks relating to registrants practice. The BCTIWC Annual Audit report does not mention PTUK s assessment of practitioner-risks. It was therefore unclear whether the BCTIWC had worked with PTUK when assessing risks relating to the above. PTUK noted that the BCTIWC has received a copy of the most recent risk matrix and that further risks relating to talking therapies had not been identified. 3.4 PTUK s awareness of specific risks for children and young people has been reviewed in earlier assessments, and risks relating to talking therapies reviewed within its Notification of Change application. While PTUK has awareness of risks relating to play and talking therapies, PTUK may still benefit from involving the BCTIWC when reviewing its assessment of risk, especially when reviewing talking therapies and any other forms of specialist or advanced practice by registrants. 3.5 PTUK s risk matrix largely includes broadly defined risks. The BCTIWC could help to identify further specific risks for both play and talking therapies to ensure that PTUK does not lose awareness of such risks. 3.6 PTUK has added two organisational risks within the business practice section of the risk matrix. One noted PTUK s understanding that as it has implemented higher revalidation requirements than other relevant registers, there is a risk that registrants may leave. This is mitigated by PTUK s promotion that this equates with having higher standards, better records management and other benefits of registration. The other risk identified possible lower acceptance of play therapy in favour of less safe and less effective interventions due to government policy, which PTUK is contesting through, for example, its responses to relevant consultations. 3.7 The Moderator noted PTUK s response to the Learning Point and issued a recommendation for BCTIWC s remit to include scrutiny of PTUK s assessment of risk to provide an independent perspective and to ensure specific risks relevant to the occupations PTUK registers are considered. Standard 4: the organisation demonstrates that it has sufficient finance to enable it to fulfil its voluntary register functions effectively including setting standards, education, registration, complaints and removal from the register 4.1 There have been no significant changes reported or noted in the past year. As part of its due diligence, the Accreditation team reviewed records from Companies House and noted PTUK appears to be financially sustainable. 6
4.2 The Authority found that this Standard continues to be met. Standard 5: the organisation demonstrates that it has the capacity to inspire confidence in its ability to manage the register effectively 5.1 PTUK s previous annual review had checked how it was strengthening the effectiveness, independence and impartiality of the BCTIWC. At that time the Panel were encouraged by examples of how it would audit and report on PTUK s activities. 5.2 In October 2017 PTUK presented a draft report from the Chair of the BCTIWC to the Authority, outlining how it had worked to fulfil its duties, including spot and sample checks of procedures and systems in PTUK s office, interviews with PTUK s Directors, registrants, office staff and Course Directors of the accredited training organisation (APAC), inspection of a sample of advertising material and email correspondence, and formal review by the BCTIWC of PTUK s proposed changes to its competency frameworks. 5.3 The BCTIWC had noted a risk that annual revalidation of all registrants takes several months to complete, due to registrants having clerical problems with using PTUK s Caerus revalidation and records management package, and recommended registrants receive face-to-face training. PTUK has taken actions following BCTIWC s report, including integration of training for Caerus into PTUK-accredited training courses and also developing training for already fully qualified registrants and supervisors. 5.4 PTUK has established regular communications with another Accredited Register for play therapists, the British Association of Play Therapists (BAPT). Both organisations will have representatives at each other s annual conferences in 2018. PTUK has also discussed training matters with a senior member of UKCP. 5.5 PTUK s Professional Conduct Panels may be challenged by appealing to the BCTIWC. At the previous annual review, it was noted that the BCTIWC has a role in both hearing appeals and quality assurance of complaints outcomes and that PTUK was undertaking work to manage potential conflicts of interest. 5.6 PTUK has updated its processes to separate the quality assurance and appeals functions for complaints within the BCTIWC. The BCTIWC Chair performs quality assurance of complaints outcomes. A minimum of three BCTIWC members, two lay and one professional (not including the Chair), will hear appeals against complaints decisions. 5.7 Previous annual reviews have checked PTUK s approach to the handling of personal information and how, for example, PTUK ensured that individual clients, their parents, carers and teachers would not be identifiable through its data collection practices. The BCTIWC annual report reviews data protection and found PTUK s practices to be appropriate. 5.8 PTUK has been active in ensuring compliance with upcoming the General Data Protection Regulation (GDPR) and has worked with registrants to do the same. PTUK identified a challenge that some registrants did not appear to take these requirements seriously which has impeded uptake of its updated Caerus software, which should assist registrants with GDPR requirements. 7
5.9 The Authority found that this Standard continues to be met. Standard 6: the organisation demonstrates that there is a defined knowledge base underpinning the health and social care occupations covered by its register or, alternatively, how it is actively developing one. The organisation makes the defined knowledge base or its development explicit to the public 6.1 PTUK has and continues to develop a quantified evidence base containing 44,000 outcome measures, the effectiveness for over 20 different presenting conditions and the therapeutic activities chosen by the children and has published a paper titled Outcomes of Developing a Clinical Evidence Base for Play Therapy in its journal, the International Journal of Play and Creative Arts Therapies Research. 6.2 The paper examines the reasons for developing a clinical evidence base (CEB) for the Integrative Holistic Model of Play Therapy, distinguishing it from a knowledge base. The paper notes that the CEB enables many factors to be analysed however notes caution where low numbers of records could affect statistical reliability. 6.3 In February, PTUK and members of the Authority s policy team met to discuss PTUK s concerns about the lack of an adequate definition of a clinical evidence base for children s mental health in particular, and psychological therapies in general. PTUK noted that whilst this area is not within the remit of the PSA, support for PTUK s work in further developments was given. PTUK also raised this subject at the Accredited Registers Collaborative March meeting. Two other registers expressed an intertest in this work. 6.4 PTUK has responded in detail to the Transforming Children s and Young People s Mental Health green paper expressing support of the aspirations but with serious concerns about the lack of reference to the AR programme, absence of any risk assessment and failing to take account of evidence available from professional organisations. 6.5 The Authority noted PTUK s work to develop an evidence base of practice based outcomes as an Achievement. 6.6 The Authority found that this Standard continues to be met. Standard 7: governance 7.1 Previous annual reviews had raised concerns about PTUK s tone when communicating with registrants, including its conduct within social media. This had been addressed in previous annual reviews where the BCTIWC was instructed to work with PTUK to promote confidence in the register and its leadership by encouraging good communication that is and is seen to be objective, impartial and fair. BCTIWC checks samples of PTUK correspondence as part of this. 7.2 The minutes of the BCTIWC s September 2017 meeting note that it had checked correspondence from PTUK and identified one example that it felt did not use an appropriate tone. PTUK noted that this was the result of a registrant persistently ignoring advice and taking a up disproportionate amount of time. The BCTIWC advised PTUK that it would expect PTUK will 8
not use this as a model of style and language in future correspondence with other registrants. The BCTIWC has subsequently approved template paragraphs that PTUK will use in correspondence for similar matters. 7.3 As part of its patient journey of PTUK s websites, the team noted some small errors which PTUK resolved to correct. 7.4 The Authority found that this Standard continues to be met. Standard 8: setting standards for registrants 8.1 PTUK highlighted a challenge that some registrants are not adapting to its updated Caerus software, and are not using the instructions or help provided. 8.2 PTUK has taken actions to assist those with difficulties, including I) Launching a programme of one-day subsidised workshops; ii) Added a session to APAC s Certificate and Diploma courses; iii) Added a Quick Start guide and FAQ document to the installation package and available on web site; iv) Providing a further method of support whereby our staff, with the registrant s written consent, can gain access to their computer to investigate Caerus issues. 8.3 The Authority found that this Standard continues to be met. Standard 9: education and training 9.1 There have been no significant changes reported or noted in the past year. 9.2 Following PTUK s addition of the Certified Play and Creative Arts Counsellors of Children and Young People grade, PTUK has updated its register website to provide information about the training requirements for this grade. 9.3 The Authority found that this Standard continues to be met. Standard 10: management of the register 10.1 There have been no significant changes reported or noted in the past year. 10.2 PTUK highlighted the use of its updated Caerus software for registrants as a comprehensive play therapy records management system. 10.3 The Authority found that this Standard continues to be met. Standard 11: complaints and concerns handling 11.1 There have been no significant changes reported or noted in the past year. 11.2 PTUK has one complaint against a practitioner underway. No further complaints were reported. The team does not review live cases. 11.3 Last year, the team conducted an audit of Accredited Registers complaints handling processes. As PTUK had not received any complaints against registrants since its initial accreditation, a sample audit could not be conducted. When the current complaint process has concluded, and has been quality assured by the BCTIWC, the team will review this case. 11.4 The Authority found that this Standard continues to be met. 9
Share your experience 12.1 The Accreditation team did not receive any responses to the invitation to share experience and did not receive any concerns about PTUK during the accreditation year. Impact assessment 13.1 There have been no significant changes reported or noted in the past year. 13.2 PTUK highlighted the potential impact of the consequences of the Transforming children and young people s mental health provision green paper which has not yet recognised Accredited Registers or PTUK s developing evidence base. 13.3 PTUK made its first registrant fee increase in five years. The fee increases varied depending on the membership type and title, with an average increase of 18.03%, equivalent to an annual increase of 3.6% for that five year period. Fees listed on PTUK s website range from 60 annually for trainees to 150 for Accredited Play Therapists. Equality duty under the Equality Act 2010 14.1 The Authority had regard to its duty under the Equality Act 2010 when considering the application for renewal of accreditation. 10