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Clinical Governance

Clinical Governance is the third element of PTI's Ethical System.

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Advisory Service

Ethical Framework
Professional Conduct Practice


Clinical governance is the process of managing the quality of the therapists' clinical work. PTI 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. PTI 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 (

    PTI 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 each practitioner identifying their own learning needs. Clinical governance provides the means to do this.

    The use of clinical governance in most countries, 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 children:

  • The measuring instruments have to take into account the constraints of childrens' 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 worldwide. Many different psychometric instruments are, for example, used for assessment. Many of these could be used for clinical governance.

    PTI 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 PTI because it:

  • Is widely accepted as a reliable measure
  • It is easy to administer and score
  • It is available free of charge
  • It is available in many languages

  • For more information about the Goodmans SDQ see www.sdqinfo.com.


    The main principles of applying clinical governance are:

    (1) Selecting an appropriate measuring instrument, normally the Goddmans SDQ
    (2) Taking before and after therapy measures (and perhaps at interim stages if more than 12 sessions are planned)
    (3) Recording the data in an appropriate system such as taking care to protect the confidentiality of clients.
    (4) Analysing 'your' data to detect any evidence of unsatisfactory results and using this information to take corrective action.
    (5) 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
    (6) Sharing your anonomised data with others through reporting, research papers, SEPACTO etc.

    Advisory Service

    PTI offers an advisory service for organisations using therapeutic play, play therapy or filial play who wish to set up clinical governance. For details please email contact@ptiworldwide.org.

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