Therapist Update Details

PLEASE READ: In order to maintain your status as a member of STOPSO you are required to comply with the following criteria:

Agree to abide by the Good Therapy – STOPSO Code of Ethics and Practice.
Have completed a minimum of 30 hours continuous professional development (CPD) in the last year (see Practice Guidelines - Continuing Professional Development). A minimum of 8 hours CPD must be relevant to sexual offending/sexual abuse therapy.
Be a practitioner working in the field of therapy with at least 100 hours of face-to-face work in the last year. While it is understood that supervision may form part of a Member’s clinical practice, it is recommended that there is a balance between supervision and clinical practice so that it does not constitute your sole mode of practice. Practitioners who have been accredited for over 5 years are exempt from this criterion as long as they are continuing to work in the field
Have had no unauthorised breaks in practice of longer than twelve months.
Have adequate supervision for the caseload you carry, ie not less than one hour per month (see Practice Guidelines – Supervision and the Supervision Contract). To confirm this, your supervisor’s signature is required.
Be adequately insured (£2,000,000 minimum).
Sign the member declaration (page three).
I agree to send pre and post research questionnaires to my clients and to send the completed forms via email to STOP SO. STOP SO will be requesting statistical information with regards referrals on a quarterly basis. This will be collated for the purpose of ongoing research
In completing this application form, you are agreeing to our terms and conditions. Please be aware that STOP SO expects all registered therapists to work ethically within their professional membership guidelines. Any issues of concern that come to the attention of STOP SO will be dealt with expediently. STOP SO reserves the right to cancel the membership of any therapist whose conduct brings the organisation into disrepute.

NOTE: STOPSO reserves the right to change any of the criteria required for annual renewal of accreditation and to audit the applications by requiring documentary evidence to be produced on request.

First Name

Last Name

Email*

Annual Hours of Therapy*

Can you confirm you have completed at least 100 hours of face-to-face or online therapy during the past year? If not please provide information as to why this criterion has not been met.

Senior practitioners, who have been accredited for five years are exempt from the clinical practice criterion, as long as they are continuing to work in the field of sexual and relationship therapy. You must continue to meet all the other criteria to renew your accreditation.

Yes
No

Breaks in Practice*

Have you had, or do you anticipate having a break in practice of more than 12 months.

Yes
No

Breaks in Practice - Details*

Supervision*

Can you confirm you have been in regular, ongoing supervision or consultation at the required levels over the past year? If No please enclose further information

Yes
No

Supervision - Details*

Continuing Professional Development*

Can you confirm you have completed a minimum of 30 hours of Continuous Professional Development in the year prior to this renewal? A minimum of 8 hours must be relevant to sexual offending/sexual abuse.

Yes
No

Client agreement*

Please confirm you are using a written client agreement.

Yes
No

Indemnity Insurance*

Can you confirm you have Professional Indemnity Insurance of not less than £2 million

Yes
No
Not Applicable

NHS Employees*

Can you confirm you have Clinical Negligence Scheme and Risk Pooling Scheme?

Yes
No
Not Applicable

Insured amount

If none of the above please give details below and the amount you are insured for

Professional membership*

Are you registered with UKCP, BACP, NCS or COSRT

Yes
No

Professional membership - Other*

If not registered with UKCP, BACP, NCS or COSRT, please give details of other membership

Over the past year:

A - Have there been any criminal or civil convictions or proceedings, upheld or pending, against you?*

If Yes, please give details

Yes
No

More details*

B - Have there been any complaints or disciplinary proceedings, upheld or pending, brought against you?*

If Yes, please give details

Yes
No

More details*

C - Have you had your membership of any professional body withdrawn?*

If Yes, please give details

Yes
No

More details*

Practice details

Areas of practice*

Please confirm which of the below groups you are able to work with by ticking all the apply

Under 18
Survivors
Couples
Offenders – contact
Offenders – online only or before crossing the line

Practice locations

Please list below the postcode of any locations you have practice rooms

Address	Post Code

Ethnicity

Please advise us of your ethnicity*

Member Declaration

I confirm that I am a current member of STOPSO.
I confirm my commitment to maintain ongoing supervision, personal and professional development for the duration of my membership.
I confirm that all the above statements are true and that I agree to abide by the governing documents of STOPSO.
STOPSO are signatories to The Second

Memorandum of Understanding against Conversion Therapy.

By signing the declaration you are confirming the following:

I will not advocate or use conversion therapy, which assumes that any one sexual orientation or gender identity is superior to or preferable to any other. I will not seek to work in such a way as to impose or attempt to impose change in a client’s self-determination of sexual orientation or gender identity.

Confirmation

By signing this declaration you are confirming the above

I confirm