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Clinical Governance

Our third research report is based upon the total dataset held in SEPACTO, the UK’s database of play therapy clinical outcomes, developed and managed by PTUK. It includes cases covered in previous reports.


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?
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 children:

  • 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.

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.

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 etc.