Clinical governance is the process of managing the quality
of the therapists' clinical work. PTUK regards it as an essential element in
its ethical system. Whereas the Ethical Framework and professional Conduct
elements provide the basis for safe working with children the purpose of
clinical governance is to safeguard the effectiveness of the therapeutic work.
Clinical governance aims to answer the questions:
- How safe is the work of a Play Therapist?
- How effective is the work of a Play Therapist?
- How do we know?
Much is talked about evidence based practice in primary
health care. However practice based evidence is at least as equally important
because it is based upon actual real world therapy with a direct link to an
individual therapist's work. PTUK uses data acquired as a result of clinical
governance to assemble practice based evidence through its System for
Evaluating Play And Creative Arts Therapy Outcomes - SEPACTO.
PTUK also believes that each of its practitioner members has
a duty to continually strive to improve their practice. It is not sufficient to
undertake CPD (Continuing Professional Development), including further play
therapy training, without identifying learning needs. Clinical governance
provides the means to do this.
The use of clinical governance in the UK, for psychology
based therapies is in its infancy although some progress is being made in adult
counselling in primary care. There are significant differences in working with
- The measuring instruments have to take into account the
constraints of children’s ability to complete questionnaires.
- The vast majority of children do not self refer. This means
that the objectives of the parent/carer, referrer, or commissioner of the
service have to be taken into account.
At present there isn't an agreed standardised measure. Many
different psychometric instruments are, for example, used for assessment. Many
of these could be used for clinical governance.
PTUK does not make the use of any particular instrument
mandatory but it does require the therapist to submit details of the
documentation/measure/system that they are using for approval. SEPACTO
is sufficiently flexible to accommodate data from most measures. The use of the
Goodmans SDQ is recommended by PTUK.
The main principles of applying clinical governance are:
- Selecting an appropriate measuring instrument
- Taking before and after therapy measures and perhaps at
interim stages if there are more than 12 sessions planned.
- Recording the data in an appropriate system such as SEPACTO
taking care to protect the confidentiality of clients.
- Analysing your data to detect any evidence of unsatisfactory
results and using this information to take corrective action.
- Comparing your data with other relevant data sets to
identify any significant evidence that indicate that improvements could be made
in your practice. Using this information to identify CPD needs etc.
- Sharing your anonymised data with others through reporting,
research papers, SEPACTO