As the professional body jointly holding the UK [and Ireland] public register of CBT practitioners (“CBT Register UK & I”), the AREBT, with our partners BABCP have a key role in ensuring that members of the public are protected when they are engaged in therapy with our Registrants. This guidance mirrors the guidance given to BABCP members.
We are committed to safeguarding and the welfare of children and vulnerable adults, and recognise that the welfare and safety of children and vulnerable adults is paramount.
This document is for guidance purposes only. It provides outline information, and is intended to help Registrants to identify children at risk, and vulnerable adults; to understand safeguarding and to take the appropriate action where needed.
We are aware that complex issues and dilemmas can arise, and will vary across different settings and contexts for clinical practice. You can approach these using relevant legal frameworks, the values and principles outlined in our Code of Conduct – Association for Rational Emotive Behaviour Therapy (arebt.one) and by consulting your clinical supervisor. If employed, then you will also need to seek guidance from your designated Safeguarding Lead/Officer.
- Definitions of children and vulnerable adults
In England, a child is defined as anyone who has not yet reached their 18th birthday. Child protection guidance points out that even if a child has reached 16 years of age and is; living independently or in further education or a member of the armed forces, in hospital; or in custody in the secure estate, they are still legally children and so should be given the same protection and entitlements as any other child.
In Northern Ireland, The Children (Northern Ireland) Order 1995 defines a ‘child’ as a person under the age of 18.
In Ireland, The Children Act 2001 of the Irish Statute Book states that an adult is any person over the age of 18.
In Scotland, the definition of a child varies in different legal contexts, but statutory guidance, which supports the Children and Young People (Scotland) Act 2014, includes all children and young people up to the age of 18. Where concerns are raised about a 16- or 17-year-old, agencies will need to consider which legislation or guidance is appropriate to follow, given the age and situation of the young person at risk.
In Wales, the Social Services and Well-being (Wales) Act 2014 states that a child is a person who is aged under 18.
1b. Vulnerable adults
The definition of vulnerable adult can be less clear. It is usually considered to be an adult who is for any reason unable to take care of themselves or is unable to protect themselves against significant harm or exploitation.
An adult who lacks mental capacity to take care of themselves will be vulnerable; there are other adults who do have mental capacity but may be unable to take care of themselves or to protect themselves from significant harm or exploitation. This may be due to infirmity, for example, and may not be permanent.
In England, The Care Act 2014 defines an adult at risk is ‘any person who is aged 18 years or over and at risk of abuse or neglect because of their needs for care and support’. This definition is broadly consistent with definitions across the devolved nations although in Scotland, the definition of an ‘adult at risk’ or ‘vulnerable adult’ applies to those aged 16 years and over.
- Understanding and identifying abuse and neglect
A person or persons may abuse or neglect a child or vulnerable adult, by directly inflicting harm themselves or by failing to act to prevent harm by others. Abuse and neglect can take different forms including:
- Physical abuse: the deliberate act of physically hurting a child or vulnerable adult. It can involve hitting, pinching, shaking, throwing, poisoning, burning or scalding, drowning or suffocating. Female Genital Mutilation (FGM) is a form of physical abuse, and health and care professionals are required to report it.
- Emotional abuse: the emotional maltreatment of a child or vulnerable adult. It can involve conveying to a person that they are worthless, unloved, inadequate, or only valued only insofar as they meet the needs of another person. It also can include bullying and cyber bullying, causing the abused to feel frightened or in danger.
- Sexual abuse: engaging a child or vulnerable adult in sexual activity of any kind against their will. A child under the age of 16 cannot, as a matter of law, consent to sexual activity. Sexual abuse of someone over the age of 16, or a vulnerable adult, involves engaging them in sexual activity of any kind without their genuine consent. Some vulnerable adults may be incapable of giving such consent, because of their mental capacity or mental health.
- Neglect: the failure to meet a person’s basic physical or psychological needs where it is likely to result in the serious impairment of the person’s health or development. It is the most common form of child abuse and reason for taking child protection action.
- Working with children and vulnerable adults
If you are working with children, Registrants are strongly recommended to complete a Children and Young People CBT/REBT training course. Some training courses in CBT can be found within the BABCP’s list of accredited courses available on the BABCP web site.
If this is not possible then Registrants must complete a general REBT/CBT training to at least post-graduate diploma level plus additional training to acquire: the following
- knowledge of child and adolescent development in order to be able to deliver a developmentally appropriate REBT/CBT intervention
- skills to deliver REBT/CBT that is appropriately adapted for people who are neurodiverse or have neurodevelopmental disorders
- ability to use REBT/CBT within a systemic context (to include family, school, and wider network)
- understand and respond to diversity, faith-based and cultural needs in their work, including in relation to safeguarding concerns.
- understanding of the influence of attachment theory, and ability to deliver REBT/CBT within this context
- sound awareness of the legal frameworks that govern working with under 18-year-olds, which includes safeguarding and mental health risk
Your responsibilities include that:
- You must work in accordance with our Code of Conduct – Association for Rational Emotive Behaviour Therapy (arebt.one)
- You may only accept referrals to work with children and/or vulnerable adults if you have the appropriate training, skills and experience.
- You must engage in clinical supervision with a supervisor who has appropriate experience and skills in working with this client group.
- You must take action to prevent harm caused to clients by other practitioners.
- You must maintain CPD that is specifically relevant to working with children and young people
You must be able provide evidence that you meet these responsibilities and adhere to our Code of Conduct. You will be asked to demonstrate this if you are selected for audit when making your annual Reaccreditation Declaration.
- Reporting and confidentiality
Maintaining confidentiality and trust is central to the therapeutic relationship. Your notes, records and any data that you collect that relates to your clients must be kept securely.
Taking action to safeguard children and vulnerable adults can take precedence over confidentiality, or a client’s explicit wishes. This means that essential information-sharing and acting on concerns may involve breaching confidentiality or those wishes. It is good practice to ensure that you have up to date information about how to manage confidentiality and data security, and what to do if a breach of confidentiality may occur. You should continue to respect confidentiality and the client’s wishes as far as possible outside areas that must be overridden for safeguarding reasons.
You should ensure that potential clients are aware of how safeguarding and confidentiality are approached before agreeing to work with them. This information should be included in your therapeutic contract.
If you have a concern about abuse or exploitation it is your responsibility to share that information. If possible, consult your client first, and your supervisor before sharing information about abuse or exploitation. In most organisations that provide mental health services e.g., the NHS, charities, educational settings, there will usually be a contact for a specific person or department responsible for safeguarding. In independent private practice settings, you will be able to contact the Local Authority designated Safeguarding Lead or Duty Care Officer. Once you have given the name of the child or vulnerable adult the person you have contacted is required to take the case forward.
If you believe your client is in imminent danger you must take steps to ensure their safety, and you may need to contact the police.
You must always keep appropriate records of your decisions and actions, and make notes at the time, or as soon as possible.
If you are uncertain that a child or adult is at risk, the Local Authority’s safeguarding team will be able to advise you. You are able to maintain your client’s anonymity at this initial enquiry stage if you wish to discuss a potential concern.
- Further training
Registrants are expected to complete appropriate training and update regularly on safeguarding. AREBT/BABCP do not directly provide safeguarding courses or give recommendations about external providers. Links to relevant resources such as continuing professional development (CPD) and sources of advice are given below:
- CAFSIG – BABCP Children and Families Special Interest Group provides a forum for members, and organises regular CPD events
- https://www.minded.org.uk – a source of online resources about child and adolescent development and mental health
- www.acamh.org -The Association of Child and Adolescent Mental Health holds a variety of resources and events
- https://youngminds.org.uk – provides online resources for young people and parents/carers on mental health problems in young people
- https://www.annafreud.org/ – The Anna Freud Centre runs some relevant CBT courses
- https://www.bacp.co.uk/events-and-resources/ethics-and-standards/good-practice-across-the-counselling-professions/gpacp002-safeguarding-vulnerable-adults-in-scotland BACP’s guide to working with vulnerable adults in Scotland
- Many local authorities run Level 3 safeguarding courses which are at an appropriate level for registrants, and online training can be accessed.
- Further information
This document is provided for general guidance purposes only.
If you require specific or additional information it is important to take advice from experts in safeguarding, such as your local authority safeguarding team.