Hong Kong Association of Art Therapists - Professional Ethics

This document sets out the guidelines on ethics and conduct for art therapists in Hong Kong. The guidelines aim to provide the public with better understanding of the competency of art therapists and the quality of art therapy services. (As there is no qualified accreditation course for art therapists in Hong Kong, some of the contents here refer to the professional ethics guidelines of foreign art therapists’ associations.)

(1) Professional Qualifications and Registration

"Art Therapist" or "Art Psychotherapist" refers to a psychotherapist who has successfully completed an approved professional training course. Art therapists use visual art as a mode of expression and communication to conduct psychotherapy.

Hong Kong does not currently have an established approved professional training course, the existing professional accreditations are mainly issued by professional registration institutions or art therapists associations in the United Kingdom, the United States, Canada and Australia.For more information about the approved professional training/courses, please refer to the attachment (Updating).

The basic qualifications (requirements) of art therapists include: 1) completion of a master'sdegree or above in art therapy (or a relevant postgraduate course and obtaining a certified qualification from the relevant national association), 2) completion of the required clinical practice hours and clinical supervision, 3) maintenance of professional ethics and 4) continuous education on relevant professional knowledge.

Art therapists shall demonstrate fitness to practice art therapy and that they do not pose arisk to the public. If any art therapists are found to be abusing its power, involved in any complaint, indicted on any offences, or involved in offences related to the practice of arttherapy or the public health, they will be subject to disciplinary sanctions and their eligibilityto practise and registration will be re-assessed.

(2) General Principles

2.1 Protect the Rights and Interests of Clients

Art therapists shall always regard the best therapeutic interests of their clients as paramount.Art therapists must treat clients and their carers as individuals, respect their privacy, dignity and decisions, and work in close-cooperation with clients.

Art therapists must not discriminate against or refuse provision of service to anyone on the basis of race, gender, sexual orientation, nationality, ethnicity, religious background, socioeconomic status, marital status, political beliefs and mental or physical disability. Art therapists should always maintain appropriate boundaries with clients and their carers and keep the therapist-client relationship professional.

2.2 Professional and Safe Services

Art therapists shall treat clients fairly, listen to them carefully, take account of their needs and wishes, and offer equal access to art therapy services.

Art therapists shall provide clear and sufficient information to clients and their carers to enable them to have a better understanding on the art therapy services to be provided. Art therapists shall also keep records of the meetings and services provided.

Art therapists shall strive to reduce any potential risks. Where there are safety risks, the risksshall be evaluated in accordance with the existing regulations in both Hong Kong and the place of practice, and art therapists shall produce appropriate reports promptly.

Consistency and continuity of treatment time and space are important elements of art therapy which can effectively strengthen clients’ confidence in treatment and improve the efficiency of treatments.

Art therapists shall be self-aware of their psychological state and shall maintain a stable psychological state during practice. Art therapists shall keep their skills and knowledge updated and shall continue to receive professional supervision and continuous education on the relevant skills and knowledge.

2.3 Be honest, Credible, and Responsible

Art therapists shall make clear and accurate representations of their education and professional qualifications to avoid misrepresentations.

Art therapists shall avoid engaging in dual relationships with clients and shall only maintain at therapeutic relationship with clients and their carers. Art therapists shall also avoid conflicts of interest and shall not engage in sexual intimacy or sexual relationship with clients to prevent any physical and mental harms to clients.

Art therapists shall strive to ensure that the services will not cause harms to clients, their carers, groups and society. Moreover, art therapists are under duty to report to relevant third parties, where necessary after having obtained the consent of the clients and/or their carers, any misconduct and acts of discrimination on the part of another art therapist.

(3) Morality and Responsibility

Art therapists shall always treat clients equally.

Prior to the provision of art therapy services, art therapists must explain clearly to clients about their rights, roles, expectations and limitations of the treatment. Art therapists must strive to maintain the therapeutic relationship. Art therapists shall not use their professional capacity to make intimidating, false or dishonest statements or conspiring extra benefits beyond the cost of treatments.

Art therapists shall make appropriate referral if it is clinically judged that other forms of therapy are more beneficial than art therapy to clients.

On the other hand, art therapists shall continue to do personal creation and professional trainings to familiarize themselves with and explore different types of artistic media.

(4) Professional Conduct

4.1 Confidentiality

Art therapists shall respect and protect confidential information obtained from clients, including, but not limited to, all verbal and/or artistic expression occurring or created within the client-therapist relationship. Art therapists must not disclose confidential information to any third party. Art therapists shall comply with the same confidentiality standards with regards to electronic documents, such as labelling documents as confidential documents, securing the documents with password, or disposing of them after the required supervision.

Where necessary, art therapists are under duty to disclose relevant information to the client’s family/guardian and/or relevant third parties (e.g. school, police), especially if there are concerns about the safeguarding and wellbeing of clients or any third parties such as suicidal risks or fatal infectious disease.

Clients are entitled to the right of privacy. Where the client, through his legal representation, waives the right, the art therapist will not be bound by the duty of confidentiality.

In the event where the art therapists are requested to provide information by a court order involving criminal offences, art therapists may breach the duty of confidentiality to the extent of revealing necessary information relevant to that course of action.

Where the client is a minor, art therapists shall obtain written consent from the parent or guardian of the minor client prior to the start of therapy. Unless mandated by law, art therapists are refrained from disclosure of information to the parent or guardian that might negatively affect the minor’s treatment. Art therapists must also report suspected or known child abuse related to minor clients to appropriate authorities (e.g. Social Welfare Department or Hong Kong Police Force).

4.2 Client Artwork

Art therapists must obtain prior written consent from the client, or the parent/guardian, for any therapy session or client’s artwork be photographed, video-taped, audio-recorded, duplicated, or otherwise observed by a third party. In cases where the minor client refuses the therapy session to be observed by the parent/guardian but their parent/guardian insists to observe, art therapists shall ensure that they strike a balance between the interests of the client and the parent/guardian.

Art therapists shall obtain prior written consent from a client or the parent/guardian, before disclosing/displaying/exhibiting the client’s information, information obtained in therapy, and/or the client’s artwork to the public, or using the information and artwork in teaching materials or any other publications in written or electronic forms.

Even if prior written consent has been granted, art therapists shall ensure that appropriate steps are taken to protect client identity and disguise any part of the notes, art expression or audio or video recording that reveals client identity unless the client, parent or guardian specifically designates in the signed written consent that the client’s identity may be revealed.After consent has been granted, the client, parent or guardian have the right to withdraw the consent at any time. If they decide to withdraw the consent after the artwork has been used or displayed, they must understand that the information may not be completely erased.

4.3 Professional Relationship

Art therapists shall respect and cooperate with other professionals (e.g. clinical psychologist, social worker, etc) if it is in the best interest of the client. Art therapists shall not take advantage of their professional relationship with clients to further their own interests. Art therapists must avoid exploiting the trust and dependency of relevant clients. Art therapists shall not engage in any relationships with clients, students, trainees that are exploitative by their nature, such as requesting students to take over jobs or to learn knowledge unrelated to art therapy.

Art therapists shall not engage in any intimate or sexual relationship with current or former clients within four years after the conclusion of the therapeutic relationship. In the event thatsuch intimate or sexual relationship arises during the prohibited period, the burden of proof is on the art therapists to show that such intimate or sexual relationship did not develop by reason of the therapeutic relationship.

4.4 Finance Arrangements

Art therapists acting as independent practitioners shall enter into with clients or third-party payers, clear financial arrangements conforming to accepted professional practices. Art therapists shall take reference from local private organizations in Hong Kong in determining therapy charges. Art therapists are encouraged to offer a sliding fee scale to clients who are unable to pay full fees due to financial difficulties.

Art therapists who intend to commence legal action collect outstanding fees from clients must first inform clients of such intended actions and offer clients the opportunity to make payments.

Art therapists shall avoid accepting gifts from clients. Prior to acceptance, art therapists shall consider the value and meaning of the gifts in order to avoid confusion in the therapeutic relationship or the creation of any doubts and misunderstanding.

4.5 Advertising

Art therapists shall accurately represent their professional qualifications, education, training, and experience to enable the public to make informed choices in relation to art therapy services. Art therapists providing art therapy education shall indicate clearly the specific area of art therapy they specialize in.

Art therapists must not use advertisements that include inappropriate, false, fraudulent, misleading or deceptive statements or information and avoid creating false expectations to art therapy.

4.6 Assessment

When assessing clients, art therapists shall apply the relevant knowledge and appropriate assessment methods acquired in their professional training. When determining the appropriate assessment methods, art therapists shall take reference from relevant researches and consider any relevant factors, such as the clients’ background, needs, education, and personal views, to better understand and serve the needs of their clients.

Prior to carrying-out the selected assessment method, art therapists shall inform clients regarding the nature, purpose and the use of results of the assessment method and client’s consent shall be obtained for the carrying-out of the assessment method.

Art therapists shall take reasonable steps to ensure that all assessment artwork and related data are kept confidential to avoid misuse of the assessment results.

4.7 Access to Records

Art therapists must maintain or dispose relevant records in accordance with local regulations in both Hong Kong and the place of practice. Relevant records include assessment plans and results, records of the client’s behavioural, verbal or artistic expression during therapy etc.Records shall be stored or disposed of in means that conform to confidentiality. Art therapists shall retain the case records for a period of seven years, or for a period specified in the regulations of the organization the therapist is employed.

It is suggested that material produced during the art therapy session be named with initials, dated, and safely stored throughout the therapeutic relationship. Unless consent is obtained from the client, or a minor client’s parent/guardian, , art therapists must not disclose any therapy records to third parties including artworks produced during therapy. If the clients request to take back their artworks during therapy, art therapists shall make appropriate clinical decision considering the clients’ needs. Upon termination of therapy, art therapists shall negotiate the handling of artworks with their clients.

Art therapists must not delete or amend the original therapy record. If the clients request to access their therapy records, art therapists must not refuse unless it may bring physical or psychological harm to them. If the minor clients’ parents/guardian requests to access clients’ therapy records, art therapists shall enquire about the purpose, assess whether it is in the best interest of the clients and obtain clients’ consent for the disclosure.

4.8 Referral and Termination

Where the client has attained stated goals or fails to further benefit from the art therapy service, art therapists shall consider termination and terminate art therapy service in agreement with the client and in a planned manner. Art therapists shall discuss referral or future arrangement with the clients to promote a smooth transition for them. Art therapists must not end therapy abruptly without taking appropriate therapeutic interventions to ensure continuity of care.

Art therapists shall respectfully end art therapy service and provide appropriate referral service where they are involved in dual relationship with the clients or where their professional incapability impairs their clinical judgement and/or increasing the harm to clients.

4.9 Delivery of Art Therapy Services via Internet

Before delivering art therapy service via the internet, art therapists shall inform clients of the nature, advantages and limitations of using electronic technology in therapy, such as the nature and approach of online therapy, the regulation and procedure of confidentiality, the limitation of network safety and technology, the limitation of data protection and confidentiality, etc.

Art therapists shall assess the cognitive, emotional, psychological, and physical status of the clients to decide whether it is an appropriate means for them to engage in therapy via internet.Where internet art therapy is adopted, art therapists shall also take steps to ensure the confidentiality and safety of internet network, conversation, online location, and file storage.

In the event that a therapy session is interrupted and cannot be continued due to internet connection failure, art therapists shall offer resources on psychological support and risk management to clients so that they could seek appropriate help where they reside. Art therapists shall also take reasonable steps to ensure that any art therapy services provided through the internet are in conformity with applicable laws, regulations, and ethnical requirements of the location in which their clients reside.

(5) Practice Standards of Art Therapists

5.1 Private practice

Prior to the commencement of the therapeutic relationship, private practiced art therapists shall sign a confidentiality agreement and provide accurate information regarding the service and the relevant professional background. The recommended information includes the art therapist's qualifications (education background, training, expertise, and professional certification), fees, treatment approaches, arrangements on treatment time, data storage, confidentiality principles, limitations of treatment, and the duty of art therapists to give early notice to the family/guardian of the client or relevant third parties under special circumstances.

5.2 Teaching, Training, Supervision and Consulting Services

Art therapists shall provide students or supervisees with accurate information to enhance their professional knowledge and development. In the teacher-student/supervisor-supervisee relationship, art therapists shall always maintain a clear boundary between their professional and ethnical relationship and must not sexually harass students. The therapist shall understand that he/she has an influence on students or supervisees and shall avoid doing any exploitative act.

5.3 Research, Writings and Publishing

In all research and writings, art therapists must cite the references properly, protectresearchees’ identity, and must not conceal the research results or make any falsestatement. Art therapists shall obtain written consent from researchees or their legalguardians in advance of the study. During the study, researchees have the right to withdrawor refuse to participate in the study.

Conclusion

The professionalism of the Hong Kong Association of Art Therapists indeed depends on the upholding of the professional code of ethics and highest practice standards by every practicing art therapists. We believe that every art therapist will conscientiously hold his/her post, equip themselves with the required qualifications, comply with principles and ethics, and provide professional and safe art therapy services to those in need, thereby raising public awareness and understanding of art therapy.