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British Association for Counselling and Psychotherapy www.bacp.co.uk February 2019 BACP membership number: 0 0 Click or tap here to enter text. Counsellor/ psychotherapist accreditation application form: section 1 ‘A quality standard for the experienced practitioner who can demonstrate high standards of competent and ethical practice’ Page 1 of 38

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British Association for Counselling and Psychotherapywww.bacp.co.ukFebruary 2019

BACP membership number: 0 0 Click or tap here to

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Counsellor/psychotherapist accreditation application form: section 1 ‘A quality standard for the experienced practitioner who can demonstrate high standards of competent and ethical practice’

This pack must be read in conjunction with the Guide to ApplyingPlease retain a complete copy for your own records as applications won’t be returned after assessment

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BACP Fair Processing NoticeThe information you provide in this form is required to processes your accreditation application. Only our accreditation team will have access to this information while your application is being processed after which it will be removed from our systems.

You will have the right to access the information you have provided as well as the other rights afforded to you under data protection laws.

We need this information to process your accreditation application. You may withdraw your application at any point and request for the information to be destroyed. This will result in your withdrawal from the process.

If you do not provide all the information required on this form your application may not be processed

To find out more about the way we look after personal data please see the BACP privacy notice (www.bacp.co.uk/privacy-notice/)

New interactive Accreditation Resources are available to help you understand the requirements and assist you through our accreditation process. These resources are free to access at www.bacp.co.uk/accreditation

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Completing section 1 of your applicationPlease complete this application form with your details, information of your current practice and evidence of your reflective practice (please see further guidance throughout this application form).

Your details

BACP membership number: 0 0 Click or tap here to enter text.

Full name: Click or tap here to enter text.

Email address:Click or tap here to enter text.

Phone number: Click or tap here to enter text.

Did you complete a PCE-CfD IAPT accredited course? Yes ☐ No ☐

Please include a copy of your training letter or completion certificate in support of your application

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Standard for accreditationYou can apply for accreditation if you provide counselling or psychotherapy to individual people, couples, children and young people, groups or families and can provide satisfactory evidence to meet all Criteria 1 to 9.

Eligibility criteriaPlease read the following guidance to ensure you’re eligible to apply for accreditation.

When you apply and throughout the assessment process, you must:

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Be a registered member of BACP

Be practising as a counsellor and/or psychotherapist

Have undertaken training and supervised practice to meet one of the following criteria:

You have been awarded a qualification from a BACP accredited training course and:• Have been in practice at least three years when you apply for accreditation• Have at least 450 hours of supervised practice accumulated within three to

six years (they do not have to be consecutive years)• Of the 450 hours at least 150 of the hours of supervised practice must be

after the successful completion of your BACP accredited course• Have been supervised for at least 1½ hours per month throughout the period

of practice submitted Or

You have successfully completed and received an award for practitioner training that:• Included at least 450 hours of tutor contact hours• Was carried out over at least two years (part-time) or one year (full-time)• Had a supervised placement as an integral part of the training • Covered theory, skills, professional issues and personal development

And• Have been in practice at least three years when you apply for accreditation• Have at least 450 hours of supervised practice accumulated within three to

six years (they do not have to be consecutive years)• Of the 450 hours at least 150 hours of supervised practice must be after you

have successfully completed your practitioner trainingHave been supervised for at least 1½ hours per month throughout the period of practice submitted

BACP membership number: 0 0 Click or tap here to enter

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Supervision:

You have an ongoing current contract for counselling/psychotherapy supervision for a minimum of 1½ hours per month. For all practice submitted you must be able to demonstrate you had supervision arrangements for a minimum of 1½ hours per month.

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Complaints and refusalIf a formal complaint against you is being investigated, we'll be unable to accept your application for accreditation until the outcome of the investigation has been decided. Please provide a response to the following questions:

Is there a formal complaint against you currently being investigated by us or any other relevant professional body? Yes ☐ No ☐

If you've answered 'yes', we're unable to process your application until the outcome of the investigation has been decided.

Has any formal complaint made against you been upheld by us or any other relevant professional body? Yes ☐ No ☐

If you’ve answered ‘yes’, please provide details of the complaint and outcome from the relevant body with your application.

Have you been refused recognition, certification or accreditation by any relevant professional body? Yes ☐ No ☐

If you’ve answered ‘yes’, please upload a copy of the details of the refusal from the body concerned with your application

Please now move on to Part A

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Part A – Current practice Please provide details of your current practice as follows:

How many client hours do you undertake each month on average? Click or tap here to enter text.

Please give details of all your current counselling/psychotherapy practice. (In each case please give your role, the setting and include your employer’s details)Click or tap here to enter text.

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Part B – Diary of current practice

Type: Click or tap here to enter text.Client Details: Click or tap here to enter text.

Date Session No. Client Length

(mins) Main concerns of session

Type: Click or tap here to enter text.Client Details: Click or tap here to enter text.

Date Session No. Client Length

(mins) Main concerns of session

Type: Click or tap here to enter text.Client Details: Click or tap here to enter text.

Date Session No. Client Length

(mins) Main concerns of session

Type: Click or tap here to enter text.Client Details: Click or tap here to enter text.

Date Session No. Client Length

(mins) Main concerns of session

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Your route to accreditationIf you’re applying using a BACP accredited training course, you should now go to part C

If you’re applying using any other training course/s you should now go to part D

See the Guide to Applying section on ‘your training’ if you are not sure which route is right for you.

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Part C: if you’ve completed a BACP accredited course Please send us copies of your award from each course and provide details in the form below.

Full title of course: Click or tap here to enter text.

Main theoretical approach: Click or tap here to enter text.

Other theoretical approaches: Click or tap here to enter text.

Training institution’s name: Click or tap here to enter text.

Institution’s address: Click or tap here to enter text.

Postcode: Click or tap here to enter text.

Institution’s phone number: Click or tap here to enter text.

Start date of course: Click or tap here to enter text.

Date completed: Click or tap here to enter text.

Title of the award you received: Click or tap here to enter text.

Date received: Click or tap here to enter text.

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Part D: if your training wasn’t BACP accreditedThe training you provide details of in this section does not need to have been undertaken all on one course, although there must be clear evidence of practitioner training in counselling / psychotherapy. Please copy this form and complete for each course you want to give details of, starting with the most substantial course(s). You can only use courses that you have successfully completed and for which you have received the award certificate.

Your training must have included a supervised placement as an integral part of your course. You must be able to give details of this placement. You should not count your placement hours in the formal taught contact hours total given for the course.

You must show how the course covered the following elements: theory skills professional issues personal development

If you have an official breakdown of the course hours and elements from your training institution, you can send this providing the breakdown is clearly shown.

Please send us copies of your award from each course

See the Guide to Applying section on ‘your training’ for more information

Full title of course: Click or tap here to enter text.

Main theoretical approach: Click or tap here to enter text.

Other theoretical approaches: Click or tap here to enter text.

Training institution’s name: Click or tap here to enter text.

Institution’s address: Click or tap here to enter text.

Postcode: Click or tap here to enter text.

Institution’s phone number: Click or tap here to enter text.

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Please provide a breakdown of the number of formal taught contact hours (not including hours in placement). For example, three hours a week, two 20-hour residential weekends over two academic years = 202 hours: Click or tap here to enter text.

Total taught hours: Click or tap here to enter text.

Start date of course: Click or tap here to enter text.

Date completed: Click or tap here to enter text.

Title of the award you received: Click or tap here to enter text.

Date received: Click or tap here to enter text.

Dates of your placement: Click or tap here to enter text.

Please give details of your placement: Click or tap here to enter text.

Please briefly describe how theory, skills, professional issues and personal development were covered on the course:

Theory:Click or tap here to enter text.

Skills:Click or tap here to enter text.

Professional Issues:Click or tap here to enter text.

Personal Development:Click or tap here to enter text.

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Part E: Practice submitted Please provide details of your submitted practice by completing the table below

Dates for each 12-month period(from - to)

Your role, the place and setting for this practice

Hours of practice during period

How many are post-training practice hours?

Number of months practiced in this period

From:

To:

From:

To:

From:

To:

From:

To:

From:

To:

Please give totals for these two columns:

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Reflective practice criteria 6-9Please now provide evidence of your reflective practice. All pieces of work submitted in support of Criteria 6, 7, 8 and 9 should be presented as follows:

Criteria 6: Continuing Professional Development - CPDThis part asks about your commitment to CPD in the 12 months up to the date of making your application and relates to an activity undertaken post qualification. Examples are training courses, conferences, workshops, research, discussion groups or reading (this list is not exhaustive).

6.1 Describe one CPD activity, relevant to your area of practice, detailing what the activity is, that you have undertaken in the 12 months before applying for accreditation. Please state clearly the date/date range of the activity you discuss.

6.2 Provide reason(s) for choosing the activity with reference to your practice

6.3 Show how the activity has influenced your practice

Maximum word count = 900 words in total

Criteria 7: Self-awarenessThis part is about your self-awareness gained through, for example, personal therapy, membership of a personal development group, or a major life change (this list is not exhaustive). This activity can have taken place at any time.

7.1 Describe an experience or activity which has contributed to your own self-awareness.

7.2 Provide a reason(s) for the choice of the experience or activity.

7.3 Show how you use this self-awareness in your practice.

Maximum word count = 900 words in total

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Criteria 8: Knowledge and understandingThis part is about the knowledge used that informs your practice with clients. It incorporates your understanding and use of theory/theories and on what basis you integrate different theory/theories with clients in a meaningful way.

8.1 Describe a rationale for all your client work with reference to the theory / theories that informs all your practice

(If the theory/theories used did not form part of your practitioner training / CPD evidence, please explain how you came to practise in this way.)

8.2 Describe the place of your self-awareness within your way of working

(This section should describe how you use your reflective awareness of yourself in relation to your understanding of the therapy process.)

8.3 Describe how issues of difference and equality impact upon the therapeutic relationship

(This awareness should also include how you consider issues of difference and equality in the context of your work.)

Maximum word count = 1400 words in total

Criteria 9: Practice and supervisionThis section is about how you practise. Your case material should demonstrate the application of the theory/theories described previously under 8.1.

You may submit one or two pieces of case material.

In your case material account for:

9.1 How your practice is consistent with your described way of working (as described in 8.1)

9.2 How you use your self-awareness in the therapeutic relationship9.3 How your practice demonstrates your awareness of issues of difference

and equality and the impact they have on your counselling / psychotherapy relationships

9.4 Use of the BACP Ethical Framework for the Counselling Professions

And you should show how you have gained awareness from supervision and demonstrate how this awareness is applied in your work with client(s) in your case material.

9.5 Describing the awareness you have gained through reflection in and on supervision

9.6 Showing how you apply that awareness in your practice

Maximum word count = 3,000 words in total

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Considerations Referencing – please ensure that you indicate where your work meets each

individual sub criterion within the work by using brackets, section headings or margin notes. For example, under 8, indicate where (8.1) is met.

Word count – Please keep within the word count for each criterion and do not exceed the count given. You must show the word count at the end of your piece of work for each of the criterion below.

Further information on these criteria is available in the Guide to Applying

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Please attach or insert your reflective criteria 6 – 9 here. Criterion 6 Maximum 900 wordClick or tap here to enter text.

Criterion 7 Maximum 900 wordClick or tap here to enter text.

Criterion 8 Maximum 1,400 wordClick or tap here to enter text.

Criterion 9 Maximum 3000 wordClick or tap here to enter text.

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Declaration of honestyI declare that as far as I know, my full application (part 1 and part 2) contains only true information. I understand the officers of BACP may make such enquiries as they consider necessary to verify the information given. I understand that if any incorrect, incomplete or plagiarised information is discovered, my application for accreditation may be invalidated and my application withdrawn. Such matters may also be referred for consideration under the Professional Conduct Procedure or the Article 12.6 procedure as appropriate.

Applicant’s signature/e-signature:Click or tap here to enter text.

Date:Click or tap here to enter text.

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Supervisor reportGuidance for the SupervisorA Supervisor Report is required as part of the application for accreditation. As a nominated Supervisor you’ll need to confirm the supervision arrangements. Prior to completing the report, you should read the case material, which should be a typical example of the applicant’s client work.

When you have completed your report, please give it to the applicant to sign and send to us with their application form if sending by post. If the application is being submitted via email, please email the Supervisor report section separately from your own email address.

We may contact you as part of the assessment procedure.

BACP fair processing noticeThe information you provide in this form is required to processes a member’s accreditation application. Only our accreditation team will have access to this information while the application is being processed after which it will be removed from our systems.

You will have the right to access the information you have provided as well as the other rights afforded to you under data protection laws.

You may withdraw your report at any point and request for the information to be destroyed.

To find out more about the way we look after personal data please see the BACP privacy notice (www.bacp.co.uk/privacy-notice/)

If you have any questions about your report, please contact us on 01455 883300Thank you for your time and commitment to the accreditation process

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Part A: Applicant’s detailsApplicant’s membership number: 0 0 Click or tap here to enter text.

Part B: Supervisor’s detailsYour name: Click or tap here to enter text.

Daytime phone number: Click or tap here to enter text.

Email address: Click or tap here to enter text.

Profession or occupation: Click or tap here to enter text.

Professional body: Click or tap here to enter text.

Your membership number: Click or tap here to enter text.

Please give your qualifications and experience as a supervisor and practitioner: Click or tap here to enter text.

Is there any professional (for example, line-management responsibility) or personal relationship between you and the applicant, other than for the purpose of this supervision?

Yes No

If yes, please give details: Click or tap here to enter text.

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Part C: The supervision contractWhat supervision arrangement do you have with the applicant (tick all that apply)individual ☐peer ☐group ☐

Please complete a section for the arrangement / all arrangements that you have indicated above.

Individual supervision Contract start date: Click or tap here to enter text.

End date: (If still current, write ‘on-going’.) Click or tap here to enter text.

Contracted frequency of sessions: weekly ☐fortnightly ☐monthly ☐

Contracted length of sessions: Click or tap here to enter text.

Peer supervision How many peer members are there? Click or tap here to enter text.

Contract start date: Click or tap here to enter text.

End date: (If still current, write ‘on-going’.) Click or tap here to enter text.

Contracted frequency of sessions:

weekly ☐fortnightly ☐monthly ☐

Contracted length of sessions: Click or tap here to enter text.

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Group supervision How many supervisees are contracted to attend this group? Click or tap here to enter text.Contract start date: Click or tap here to enter text.

End date: (If this supervision arrangement is still current, write ‘on-going’ for the end date.) Click or tap here to enter text.

Contracted frequency of sessions:

weekly ☐fortnightly ☐monthly ☐

Contracted length of sessions: Click or tap here to enter text.

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Part D: Supervisor declarationPlease tick the appropriate box and complete as applicable:

I have supervised all the case material (criterion 9) that the applicant has provided for this application ☐

or

I have supervised part of the case material (criterion 9) that the applicant has provided in this application ☐

Please state which part: Click or tap here to enter text.

or

I did not supervise any of the case material (criterion 9) the applicant has provided in this application ☐

: Your supervision of the applicant’s work

As the applicant’s Supervisor, what is your understanding of the applicant’s theoretical orientation as applied to their work?Click or tap here to enter text.

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What is the Applicant’s understanding of the BACP Ethical Framework for the Counselling Professions?Click or tap here to enter text.

How does the applicant’s work reflect his or her awareness of the BACP Ethical Framework for the Counselling Professions? Click or tap here to enter text.

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Please comment on the applicant’s use of supervision in general and to the case material provided (if you have supervised this work).Click or tap here to enter text.

What action – as agreed with the applicant – would you take if either of you were concerned that the work might exceed the limits of his or her competence? Click or tap here to enter text.

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What action would you take to protect the applicant’s clients if the standard of his or her work was poor at any time? Click or tap here to enter text.

Any additional comments from Supervisor or Applicant: Click or tap here to enter text.

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Part F: Signaturese-signatures are accepted if the report is emailed to us by the Supervisor.

Applicant’s signature: Click or tap here to enter text. Date: Click or tap here to enter text.

Supervisor’s signature: Click or tap here to enter text. Date: Click or tap here to enter text.

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Sending us your applicationPlease send us your application form via email or post and as follows:

If sending by emailPlease password protect your application and inform us of the password via a separate email or phone call. The Supervisor report section will need to be emailed separately by your Supervisor. Once we’ve received your application form, we’ll send you a link to complete part 2 of the application online.

If sending by postPlease send your application form including the supervisor report with original signatures from you and your Supervisor. Once we’ve received your application form, we’ll send you a link via email to complete part 2 of the application online.

Please includeCopies of your award certificates need to be included where necessary.

Ensure your membership number is on any additional or separate sheets.

FeesYour fee for accreditation* (£230, or £115 if you pay a reduced-rate membership fee). We accept cheques and card payments (Maestro/Switch, MasterCard or Visa only). Please write cheques to ‘BACP’ and put your surname and membership number on the back. Call 01455 883300 to make a card payment. If we accept your payment, that does not mean you have been accredited.

Please post cheques to the Accreditation Team, using the address below.

Next stepsWe will let you know by email that we have received this part of your application. We’ll then send you a link to complete part 2 of the application process. Please note that we won’t be able to process your application until you’ve completed parts 1 and 2 and we’ve received the Supervisor report and Proposer statement. Please be aware that due to the robustness of the process it can take up to five months to receive a decision.

We will not return your application. It will be destroyed after we have assessed it, so please make a copy of your application for your own records.

Accreditation TeamBritish Association for Counselling and PsychotherapyBACP House15 St John's Business ParkLutterworthLeicestershire, LE17 4HB

Email: [email protected]

*From time to time we review our fees, please check the website or call us to find out the current fee.

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