The Standards of Practice Code is intended for use by all members of the World Wellness Association for Holistic Therapies (WWAHT). Through the development and use of these Standards, the WWAHT continues to display its commitment to serving its members and promoting the highest possible quality of Therapy practice in a safe, competent and ethical manner. It also sets out for the general public the quality of care they should expect to receive from professional therapists who are members of the WWAHT.
Why have standards of practice?
The Standards of Practice have been developed as a tool to determine whether a Wellness / Holistic Therapist can conduct their practice at an acceptable level. These Standards will serve as a reference tool for:
- The therapists to better understand their job requirements
- Educators to address as objectives in curriculum design
- Complaints investigation
- Discipline hearings
- Fitness to Practice
- Quality Assurance
- Client relations
- The public, by providing objective standards by which to assess the quality of treatment.
Confidentiality Statement: Wellness/Holistic Therapists are advised that giving information about a client to any person except as required or allowed by law or except to facilitate diagnosis or treatment of a client is considered to be professional misconduct.
Accountability for Standards: The Wellness/Holistic Therapist is only held accountable to meet a Standard if he/she is the person who has performed the task.
The Standards of Practice are intended to be generic and have been developed to describe the outcomes of the various tasks the Therapist is required to perform within the Scope of Practice. The Standards of Practice describe how well a Therapist is expected to perform. How to do each task is determined by the minimum competencies taught through the educational institutions.
Practitioners should adhere to the following Standards:
- Prepare the Treatment Area
- Ensure that the room and equipment surfaces have been cleaned
- Ensure that you use only sheets and towels that have been freshly laundered.
- Ensure that sheets/towels used for draping will allow for full coverage of the client.
- Ensure that the linens and pillows do not interfere with the client’s ability to get on and off the table.
- Ensure that any obstacle or substance that could make the floor slippery is removed from the treatment room to prevent accidental falls.
- Ensure that equipment is properly maintained, and that manufacturer’s instructions are followed correctly.
- Inform the Client of the Fees and Obtain Agreement to a Fee Schedule
- Ensuring that your price list is posted in a location where clients may see it, or a copy provided to the client.
- Ensuring that you explain the rates for the Therapy appointment to the client including what part of the treatment time will be used for taking a health history and assessment / reassessment.
- Ensuring that you explain to the client your policy with regard to cancellation of appointments.
- Providing the client with an opportunity to ask questions about the rate and fee schedule.
- Ensure that any charges that deviate from the set schedule have been agreed to by the client and documented in the clinical notes with the reasons and agreement indicated.
- Wash Your Hands and Any Skin Surface that Will/Has Come in Contact with the Client
Ensure that soap and water or alcohol-based hand sanitizer is used to clean skin surfaces by washing for a minimum of 10 seconds, immediately before and immediately after each client treatment.
- Interview the Client to establish Treatment Goals
- Ensure that the interview questions include client’s goals for the treatment; limitations to activities of daily life; identification of area(s) client would like to focus on; discovery of contributing factors.
- Ensure that you give the client an opportunity to inform you of any specific area(s) to be treated and to relay any information the client chooses about his/her treatment goals.
- Ensure that you give the client an opportunity to ask questions.
- Obtain, Update and Record the Client’s Health History
Health history information must be requested from the client to identify indications and/or contraindications to treatment. Information requested must include, at the minimum:
- date on which health history was taken or updated
- general health status
- client name, address, date of birth, telephone number, occupation, source of referral, next of kin details
- name and address of primary care physician
- current involvement in treatment with other health care practitioner(s)
- current medication(s) and condition(s) they are treating
- timing and nature of injuries or accidents
- timing and nature of surgical procedures
- history of other forms of Therapy
- primary complaint
- allergies or hypersensitivity reactions
- diabetes, cancer, epilepsy, skin conditions, pregnancy, history of migraines
Obtain the client’s consent to perform the assessment / reassessment or treatment.
- To ensure the treatment is consistent with the WWAHT Scope of Practice.
- To ensure that consent is obtained voluntarily.
- To ensure that consent is not obtained through misrepresentation or fraud.
- To ensure that the client is told the nature and purpose of the proposed assessment /reassessment and/or treatment including the areas of the body involved (if applicable).
- To ensure that the client is informed of any risks, benefits, possible complications and any contraindications of the assessment / reassessment and/or treatment.
- To ensure that the client is informed that assessment / reassessment or treatment will be stopped or modified at any time, at his/her request.
- To ensure that you tell the client that you will be checking periodically to determine the client’s level of comfort.
- When treating a child or vulnerable adult, it is advisable to have a parent or guardian present for the consultation and treatment, and their details recorded on the client’s consultation form. This is to safeguard the member against any allegations of inappropriate behaviour.
- To ensure that the client is given an opportunity to ask any questions.
- Determine the Client’s Needs by Conducting Assessment/Re Assessment
Given information about a client’s treatment goals, health history, the client’s consent and/or that on-going treatment is taking place and a scheduled reassessment is due.
- To ensure that you discontinue the assessment if requested by the client.
- To ensure that the Code of Practice standards are followed if undressing or undraping is required prior to, during or following conducting the assessment/reassessment.
- To ensure that you refer the client to other health care professionals for conditions that you cannot assess or if the need for referral is indicated in the assessment or re-assessment, for example: severe unremitting pain or severe pain with no history of injury.
- Members can refuse, discontinue or defer treatment, providing this is not on grounds of discrimination and their decision not to treat can be justified.
- Determine if Wellness/Holistic Therapy Treatment is Indicated
- To ensure that if there is a contraindication to Massage Therapy, you refer the client to another qualified health care professional or that you modify the treatment so that the client is not put at risk.
- To ensure that any referral that is made is documented in the client’s health record.
- Some therapies/treatments may not be safe or appropriate for certain children or vulnerable adults, such as hot stone therapy, bikini or intimate waxing, or thermal auricular therapy, which requires the client to remain still for some time. Members must determine whether the therapy/treatment is safe and appropriate for the individual and, where necessary, treatment must be declined or an alternative suggested.
- Treatment and Treatment Plans
Explain the initial treatment to the client.
- To ensure that the treatment is consistent with the WWAHT Scope of Practice.
- To ensure that any changes in the client’s wishes regarding consent are obtained before each treatment and are followed.
- To ensure that the client is given an opportunity to ask any questions.
- Where appropriate, members must carry out patch tests and thermal tests on clients prior to treatment in order to minimise the risk of an adverse reaction.
- Pre / Post Treatment Protocol
Instruct client on undressing/dressing procedures.
- To ensure that you explain to the client the reasons for the removal of clothing (where applicable).
- To ensure that you instruct the client to remove the clothing and items which they are comfortable removing.
- To ensure that you provide the client with an opportunity to ask questions.
- To ensure that you provide the client an opportunity to dress/ undress out of the view of the therapist and other people.
- To ensure that you get permission from the client to re-enter the area.
- To ensure that the draping is secured.
- To ensure that if the client requests that the draping is rearranged for his/her comfort, you accommodate the request as long as you are not uncomfortable with any body parts being exposed.
- To ensure that female breasts are not exposed except when being treated in accordance with Technique Standards.
- To ensure that the client’s genitalia or gluteal cleft are not exposed.
If the client requires assistance to dress / undress themselves the following procedures are followed:
o Ensure that you inform the client of those pieces of clothing you will need to remove.
o Ensure that you remove only those pieces of clothing the client wants to remove.
o Ensure that you inform the client of where you might touch him/her and why.
o Ensure that you touch only those areas of the client’s body needed to remove the client’s clothing.
o Ensure that you record the client’s consent and the assistance provided.
o Ensure that all efforts are made to maintain respectful privacy of the client by use of covering, while assisting him/her to dress/undress.
- Recommend Self Care
Given that the treatment has been completed and the client is dressed, and that self-care is indicated.
- Ensure that you explain to the client appropriate self-care including its intended effect and possible negative reactions.
- Ensure that the client is informed that if the self-care causes any severe negative reactions the client is to discontinue its use.
- Ensure that you demonstrate the recommended exercise(s) (where applicable).
- Ensure that you witness that the client understands the self-care and / or exercise correctly
- Ensure that the self-care and / or exercise does not put the client at risk.
- Safe Practice / Risk Identification and Management for an Outbreak of Infectious Diseases
Members have a responsibility to ensure the health and safety of themselves and the people they work with, at all times. Members must abide by current health and safety regulations, by-laws and registration and/or licensing requirements relevant to their practice in their own country.
Members are required to have first aid kits appropriate to their business to ensure their clients can be given immediate attention if they are injured during the treatment.
Given an infectious disease has been identified as a public health risk in the community:
- Ensure that you are aware of the symptoms of the infectious disease.
- Ensure that you use protective barriers if the status of the client is unknown.
- Ensure that you clean the clinic area with approved antiseptic cleansers.
- Ensure that you follow any directive issued by the local public health unit.
- Advertising and Promoting Therapy services
- All promotional material, regardless of format, must be legal, decent, honest and truthful and must not be misleading.
- Members must not claim in their promotional material that they can treat, heal or cure a medical condition, or make a medical diagnosis.
- Members who offer therapies/treatments that are not recognised by the WWAHT must not imply in their marketing materials – directly or indirectly – that these therapies are recognised by the WWAHT.
- Complaints Procedure
- Members must have a written complaints procedure in place that clients can readily access if they are unhappy with the service received.
- Members must deal promptly and fairly with any complaint made by a client.
- Members must advise clients that they have the right to refer any complaints to the WWAHT and provide the client with WWAHT’s contact details.
- Where a complaint leads to legal action, the member must advise the WWAHT and their insurance provider as soon as possible.
- Continuing Professional Development
- WWAHT Full Members must maintain and improve their professional skills, knowledge and performance, in keeping with WWAHT membership and industry standards by completing a minimum of 12 annual CPD hours out of which a minimum of 10 must be Primary CPD.
- The WWAHT defines CPD as a range of classroom-based learning activities (Primary CPD) and online based courses or webinars, reading industry related news or books, watching industry related TV programs (Secondary CPD with reflective practice) through which professional therapists maintain and develop their skills to ensure that they retain their capacity to practise safely, effectively and legally, within their scope of practice.
- Full Members are advised not to enrol on any therapy training courses without checking with their insurance provider and the WWAHT that these qualifications will be accepted for CPD purposes.
- Equality and Diversity
- Clients must be treated fairly and without discrimination and members must not refuse a service to clients on discriminatory grounds.
- Members must never allow their personal views about gender, age, ethnicity, disability, sexuality, social or economic status, lifestyle, cultural or religious beliefs affect how they treat a client.
- Conduct and Professional Behaviour
- Great care must always be taken to maintain an appropriate and professional relationship with clients.
- Members must establish and uphold clear sexual boundaries with clients, to avoid breaking trust, compromising the reputation of the profession, and potentially committing a criminal offence. Where a member is sexually attracted to a client, it is the member’s responsibility not to act on these feelings and to discontinue treatments in a professional manner if the member believes their feelings for the client will impact their professional relationship.
- Members must not criticise other therapists or healthcare professionals to clients or other third parties.
- Members must not solicit the clients of another therapist, healthcare professional or previous employer (soliciting can be defined as directly or indirectly requesting, persuading or encouraging clients to transfer their business).
- Data Protection, Confidentiality and Record Keeping
- Members must collect, store, process and erase personal data in line with the Data Protection Act 2018 and EU General Data Protection Regulation (GDPR).
- Personal data obtained from clients should be relevant, not excessive, accurate, kept up to date, stored securely, treated in confidence, and erased when no longer needed.
- When obtaining any personal data (information), this data must be collected, processed, stored and erased in line with GDPR. Personal data can be defined as any information relating to an identifiable, living person, including (amongst others) names, contact details, IP addresses, dates of birth, gender and health information.
- It is essential to keep full and accurate records for all clients for a minimum of 7 years, including details regarding every treatment they have had, and any products or equipment used as part of those treatments. As well as being good practice, in the event of a dispute or potential court claim, the member may have to rely on these records in court to justify their actions/ decisions.
- Client records must be legible, professional and in the English language, or in the official language of the country where the member practises.
- If working with others who need access to the client’s records for professional purposes, it is important that appropriate data protection procedures are in place and that everyone who has access to personal and sensitive data about a client understands the need for, and importance of, confidentiality. From the outset, the client must be made aware of who will have access to their personal information (data) and for what purposes.