GUIDELINES AND CODE OF CONDUCT

The unconditional acceptance of the Code of Conduct is the basic requirement for the candidates’ registration on the National Register of TMA Caputo-Ippolito (C.I.) Method Operators.

The guidelines and the code of conduct described below must be respected by supervisors, coordinators, team managers and operators. For ease of reference, from now on, all the notions described below and addressed towards the TMA (C.I) Operator should be generalized to all co-workers, supervisors, coordinators, TMA (C.I.) team managers.

The TMA (C.I.) operator enlisted in the register must be aware of the rules contained in the code of conduct, and ignoring such rules does not exempt him or her from personal responsibilities, only in those cases where a specific sanction and/or consequence is provided for the violation of said rules. The same rules also apply in cases where the services, or parts of them, are carried out remotely, via the Internet or any other electronic and/or telematic means.

All TMA (C.I.) operators offer services and perform teaching activities related to TMA (C.I.) only if authorized by the method creators and only within the scope of their own expertise, which is based on their academic career, on their experiences under the direct supervision of TMA (C.I.) staff and on appropriate professional practice. The TMA (C.I.) operator employs methodologies that allow him/her to indicate scientific references, and does not raise, in the expectations of parents or guardians, unfounded expectations. All evaluations are entrusted only to TMA (C.I.) supervisors who will set an intervention plan according to the principles of the Caputo-Ippolito method. The operator will follow the instructions assigned by the supervisor, who was chosen and trained by the creators themselves. These instructions are available on the website www.terapiamultisistemica.it.

The TMA (C.I.) operator is required to maintain an adequate level of preparation and attend theoretical and practical refresher courses every two years, with particular regard to the sectors in which he/she operates. The violation of the continuous training obligation will provide for the removal of the subject from the TMA (C.I.) operators list; as a result, he/she will no longer be able to use the TMA trademark and name. The operator who does not appear in the list will not be allowed to use the Caputo-Ippolito methodology, be followed by a supervisor (C.I.) and be entrusted with cases. The TMA (C.I.) operator updates his/her skills by attending refresher courses that are organized by the method developers. If the TMA (C.I.) operator is unable to attend the required course every two years, he/she must, in place of the update, complete a 24-hour internship working in facilities and projects accredited by the TMA (C.I.) organization. Furthermore, in order to keep his/her name on this list, and therefore be able to use the name TMA (C.I), the TMA operator is required to pay 90 euros per year as the renewal fee for the certification.

The TMA (C.I.) operator is encouraged to work together with experts from other disciplines and all the professional and educational figures that revolve around the subject entrusted to him, in respect of the other people’s skills. The TMA operator (C.I.) must recognize the limits of his/her own specific skills and the boundaries of the areas of intervention, and accept, as customers, only individuals or organizations whose needs are in line with their personal training, experience and resources at disposal; he/she must work under the supervision of a TMA staff member, as indicated by the method developers on the website www.terapiamultisistemica.it.

During the application of the methodology and within the framework of the structured interventions following the principles of the same, the TMA (C.I.) operator only performs the evaluations referred by his/her own reference supervisor, and presents the interpretative hypotheses, the expected objectives and the limits of the results reported by the same supervisor. In some specific cases, the TMA (C.I.) operator only carries out evaluations and judgments in agreement with the (C.I.) supervisor of reference, according to the methodology.

The TMA (C.I.) operator will report to the TMA (C.I.) organization the presence of any figure that acts deceptively as a TMA operator.

The TMA (C.I.) operator must never disclose confidential information without the consent of the interested party, except in cases where it is required by law or allowed for a valid reason. The TMA operator who decides not to apply the criteria foreseen by the methodology and who is therefore excluded from the national register of TMA (C.I.) operators, will no longer have access to the IT, operational and technical supports required by the methodology, as well as the TMA supervision cards, the TMA visual communication cards, the projects E…state sereni, E…state insieme a Noi, Melansana, and will no longer be able to use the logos and denominations Multisystem Aquatic Therapy, multisystem treatment for autism, “Autismile” and “Collective Stroke” on which, among other projects, the method creators have the exclusive copyright.

The TMA (C.I.) operator might be excluded from the list at the creators’ and/or the TMA (C.I.) Organization complete discretion, if errors and/or violations compromise the correct application of the methodology and/or not allow, even provisionally, the use of the TMA name without damaging its image.

If authorized, the TMA (C.I.) operator will discuss the confidential information obtained from TMA reports that have been prepared by the supervisor only for scientific or professional purposes, and only with people directly involved in these issues.

The TMA (C.I.) operator refrains from giving notice of facts of which he/she became aware due to their own professional relationship, and is therefore bound to complete confidentiality.

In the case of a mandatory medical report or the obligation to report, the TMA (C.I.) operator will limit the reference of what has been learned to the bare minimum, due to his/her professional relationship, for the purpose of protecting the subject. In other cases, the operator will carefully assess the need to totally or partially derogate from one’s duty to keep the matters confidential, if serious risks to the life or the mental and physical health of the subject and/or third parties are expected. In all cases, however, he/she should consult their (C.I.) supervisor.

The TMA (C.I.)  operator, in the event of intervention or through groups, must inform, at the initial stage, the members of the group while respecting each person’s right to privacy. In the case of collaboration with other subjects that are equally bound by professional secrecy, the TMA (C.I.)  operator must share only the information that is strictly necessary according to the type of collaboration, and only if it was previously authorized by the entitled party.

The TMA (C.I.) operator must respect the rules of confidentiality in drawing up, storing, consulting, transferring and deleting documents that are under his/her own control, whether written, electronic or otherwise. The TMA (C.I.) operator will keep and delete the documents according to what is established by law and in compliance with the requirements set out in this Code. This documentation must be kept for at least five years following the termination of the business relationship, unless when provided for by specific rules. The TMA (C.I.) operator must ensure that, in the event of his/her own death or impediment, the protection is entrusted to a colleague, i.e. the TMA (C.I.) cooperative.

The coordinator, the supervisor and the operator, in his/her potential task of guiding or tutoring the University apprentices and training the newly trained operators, will make the guidelines and the code of conduct known to all students, encouraging to adhere to them.

In any professional context, the TMA (C.I.) operator must make every effort to ensure that the user has the complete freedom to choose the professional to address.

The TMA (C.I.) operator will adopt a conduct that is not harmful to the persons he/she deals with, and will not use his/her own position and professional tools to ensure themselves or other individuals some undeserved advantages. The TMA (C.I.) operator must not favour any situation that could lead others to fraudulent, illegal or unethical behaviour, and respects the obligations and duties of agreement with the user by working as best as possible, and by avoiding impractical commitments.

The TMA (C.I.) operator, in the initial phase of the professional relationship, will provide the individual, the group, the institution or the community – whether they are users or clients – with adequate and understandable information about the intervention, through informed consent and the registration and membership form provided by the supervisor. He/she will report to the user the aims and procedures of the methodology, as well as the rules of confidentiality. If the professional service has continuity over time, the foreseeable duration of it should be indicated, where possible.

The TMA operator (C.I.) is required to fill in the acceptance form and must ensure that the Personal Profile of the Functions – which will be an integral part of the digital supervision card – is also properly completed and signed by both parents. In any case, he/she must comply with any request relating to the collection of user data, in the manner that the TMA (C.I.) Organization deems appropriate to carry out.

The TMA (C.I.) operator must ensure that the parent or guardian is informed and signs the registration form, by also specifying the terms of payment and billing.

The TMA (C.I.) operator will negotiate the remuneration terms in the initial phase of the business relationship, in accordance with the maximum and the minimum limits indicated after consulting the table of the recommended minimum/maximum compensation, which will be provided by the supervisor and which was illustrated during the course. In any case, the amount of compensation must be appropriate to the relevance of the work. In the field of behaviour, such compensation cannot be conditioned by the outcome or the results of the professional intervention.

The user must be provided, if requested, with information regarding his/her qualification as a TMA (C.I.) Operator. Parents and caregivers must be informed of their rights and of the procedures to be followed in the event of complaints relating to the professional conduct of the TMA (C.I.) Operator; said complaints can be addressed to the supervisor, the TMA (C.I.) organization, and the authorities and bodies in charge. Information concerning the operator and the contacts to use in case of complaints will be available at www.terapiamultisistemica.it. The TMA (C.I.) operator will fulfil all the measures required for the verification of his/her own legal position. For whatever reason he/she is being investigated for criminal offenses, the subject is obliged to promptly inform the supervisor and the TMA Organization. The organization will unquestionably evaluate the opportunity to continue any collaboration.

The electronic recording of the interventions of the Caputo-Ippolito methodology must be expressly authorized by the parent or guardian, and possibly by all the personnel involved. Consent for different uses must be obtained in a specific way, as well as indications provided by the (C.I.) supervisors.

The TMA (C.I.) operator is always responsible for informing the parent or guardian of the intervention procedures that the supervisor may eventually indicate, and which may vary from time to time in relation to the supervisions that have already been carried out.

The interventions are set with short and long-term objectives for users. The choice of the intervention as defined by the supervisor may be based on factors such as efficiency or the cost/benefit ratio, risks, side effects, the user’s preferences, or the experience and preparation of the operator concerned. The TMA (C.I.) operator, as being guided by the supervisor, will, as far as possible, examine and assess the potential effects of all the interventions that could influence the program as envisaged by the methodology, and their possible impact on the achievement of the objectives of said program.

The TMA (C.I.) operator will adequately report, through video recordings, interviews and papers, the work performed by providing the supervisor with all the data necessary for the planned evaluations.

The TMA (C.I.) must operate in a context of intervention that cannot disregard the figure of the supervisor, who takes care of the drafting of the individualized program built on the evaluation of the different functional areas of the child/young person, following the TMA (C.I.) supervision board. Therefore, to ensure the correct application of the Caputo-Ippolito method, and to ensure the quality of the service offered, it is necessary that the operator is periodically supervised by our qualified staff, indicated on the website www.terapiamultisistemica.it in the creators and staff list, under the voice “supervisors”.

The Supervision in fact guarantees the maximum efficacy of the methodology, and is an essential component for the success of the intervention; it allows to monitor the operator’s intervention in all its phases, by offering the opportunity to immediately identify any necessary change in the individualized program. The supervisor defines the objectives for each area and guarantees that the procedures have been followed as best as possible; he/she intervenes on any problematic and critical situation, by adopting new strategies and indicating them to the operator. They also encourage relationships with other professionals that revolve around the child in order to reach common and shared goals, and draw up progress reports if the parent requests them.

What the TMA (C.I.) operator assigns to other professionals must be agreed with the respective supervisors. In this case, the TMA (C.I.) operator will not receive or offer money, gifts, or other incentives when sending them to other professionals.

The TMA (C.I.) operator acts in the best interests of the user to avoid the interruption or termination of the Services. He will make reasonable and timely efforts to facilitate the continuation of the services provided in the event of unforeseen interruptions, in agreement with the supervisor or coordinator of reference; every useful strategy will be implemented in order to find a suitable substitute who is capable of giving continuity in the care, and only for the sole user’s interest. In starting a business relationship, the TMA (C.I.) operator foresees the termination of the relationship with the user in an orderly and appropriate manner. If the employment or contractual relationship is interrupted, the user’s needs should remain of primary interest. The TMA (C.I.) operator will interrupt a professional relationship in a timely manner, when the user: no longer needs the Service, does not benefit from the Service, is damaged by the continuation of the Service, or asks for the Service to be interrupted. Before the interruption of the Service, for whatever reason, the TMA (C.I.) operator will discuss the user’s needs and provide the appropriate Services before the interruption; he/she also will suggest, if appropriate, alternative suppliers, and will take all the reasonable measures to encourage a timely transfer of responsibility to another Operator with the consent of the user and the supervisor and, if present, the coordinator as well.

The TMA (C.I.) operator refrains from undertaking or continuing any work activity where personal problems or conflicts may interfere with the effectiveness of his/her services, and may even make it harmful to the persons to whom they are addressed. The TMA (C.I.) operator also avoids taking on professional roles and carrying out interventions towards users that could compromise their credibility and effectiveness. The TMA (C.I.) operator will not be able to carry out similar activities such as personalized interventions in water with children with disabilities, which may cause confusion regarding the type of service that is actually offered. Furthermore, the operator will have to apply the methodology, as already established, to all children with disabilities who refer to his/her service.

The TMA (C.I.) operator must avoid mixing work and private life that may interfere with the professional activity or otherwise harm the social image of the activity, by committing to maintaining a morally correct behaviour even in private life. It is a deontological violation to carry out interventions aimed at people with whom he/she has had or still maintains serious relationships of a personal nature, especially of emotional-sentimental and/or sexual nature. Likewise, establishing the aforementioned relations during the professional relationship represents a deontological violation. The TMA (C.I.) operator is prohibited from carrying out any task that, due to the professional relationship, might cause unfair direct or indirect patrimonial or non-patrimonial advantages, with the exclusion of the agreed remuneration. The TMA (C.I.) operator does not take advantage of the assumed professional position with colleagues or apprentices, for purposes that are unrelated to the professional relationship. The TMA (C.I.) operator is also required, in absolute autonomy, to take out a professional insurance policy and register with the tax office in accordance with current regulations.

Professional services to minor or interdicted persons are subject to the consent of those who exercise parental authority or guardianship over them. The TMA (C.I.) operator who, in the absence of the aforementioned consent, deems necessary the professional intervention and the absolute confidentiality of the same, is obliged to inform the Tutorial Authority about the establishment of the professional relationship.

When the TMA (C.I.) operator agrees to provide a professional service on the request of a client who is not the recipient of the service, he/she must clarify the nature and purpose of the intervention with the parties involved. This clarification includes the position of the TMA (C.I.) Operator, the possible use of the Services provided or the information obtained, as well as the fact that there may be certain limits to confidentiality. If there is the foreseeable risk that the TMA (C.I.) operator may be called upon to carry out conflicting tasks arising from a third party involvement, he/she must clarify the nature and scope of their responsibilities, keep all parties informed of all developments, and solve the problem as provided for by this Code. When providing Services to a minor or an individual who is part of a protected category on the request of a third party, the TMA (C.I.) operator must ensure that the end user’s parents or guardians are informed of the nature and scope of the Services to be provided, as well as their right to access all documentation and data. The TMA (C.I.) operator must put the user’s well-being above everything else and, in the event that the third party would make requests for services that are detrimental according to the TMA (C.I.) operator, resolve these conflicts in the user’s best interest. If said conflicts cannot be resolved, the Services of the TMA (C.I.) Operator may be interrupted, subject to an adequate transition plan.

The TMA (C.I.) operator will employ programs based on TMA (C.I.) methodology that are conceptually consistent with the principles of the same, by always agreeing upon the planning of the program with the supervisor. The TMA (C.I.) operator will implement the individualized intervention – as defined by the supervisor – according to the behaviours, the environmental variables, the results emerged from the assessments and the objectives of each user, by following the program provided through the supervision card. He/she will inform the parent or guardian – if the supervisor is unable to perform – of any change and implementation of these programs before employing them or making substantial changes to them (in terms of objectives and of using new procedures).

The TMA (C.I.) operator will communicate to the parent or guardian, in a understandable way, the criteria for verifying the objectives reached by the supervisor and those required for the completion of the program, and will describe them to the same supervisor by putting an end to the relationship with the user when such objectives, planned by mutual agreement, have been reached.

The eventual participation of the TMA (C.I.) operator in research projects with its users must be previously authorized by the creators and agreed with the reference supervisor. Then, he/she will be required to promptly and adequately inform the subjects involved with respect to the name, the scientific and professional status of the researcher and the potential institution of belonging in order to obtain prior informed consent. He/she must also guarantee said subjects the full freedom to grant, refuse or withdraw the consent. Under the hypothesis that the nature of the research does not allow the subjects to be informed in advance and correctly about certain aspects of the research, the TMA (C.I.) operator is obliged to provide, at the end of the test or data collection, the due information, and obtain the authorization to use the data collected.

With regard to subjects who, due to age or other reasons, are not able to validly express their consent, the latter must be given by those who have parental authority or guardianship, as well as by the subjects themselves if they are able to understand the nature of the requested collaboration. In any case, the subjects’ right to privacy, non-recognition and anonymity must be protected.

The TMA (C.I.) operator’s researches are designed, conducted and reported in accordance with recognized standards of scientific competence and ethical research. The TMA (C.I.) operator will plan and conduct research in accordance with all current laws and regulations, and with the professional standards that usually guide the steps in conducting research.

The TMA (C.I.) operator that works in the research must follow the indications required for both the TMA (C.I.) intervention and the research. In the case of conflict between clinical and research needs, the TMA (C.I.) operator must put the user’s well-being first. The TMA (C.I.) operator must take part in the research in a professional way, by paying specific attention to the participants’ dignity and well-being. The research in which the TMA (C.I.) operator participates is programmed in such a way that the risk that the results may be misleading are reduced as much as possible.

The TMA (C.I.) operator that participates in the research must always make sure that it is conducted following the current ethical and legal principles. In the case of unclear situations from an ethical point of view, the TMA (C.I.) operator will try to resolve the issue by consulting the supervisor: he will be confronted with independent research committees through consultations between colleagues and other suitable tools.

The TMA (C.I.) operator that participates in the research will do everything possible to maximize the benefits and minimize the risks for its customers or research participants, students and all those he/she works with. The TMA (C.I.) operator will minimize the personal, financial, social and organizational effects that could lead to a misuse of their research. If he/she is aware of a misuse or misleading interpretation of his individual work, the TMA (C.I.) operator will do everything possible to correct its misuse or bad representation.

The TMA (C.I.) operator must avoid any conflict of interest in conducting research, and must minimize interference with participants or with the environment in which the research is conducted. The TMA (C.I.) operator will provide participants or their guardians with understandable information on the nature of the research and the possibility of participating or withdrawing, at any time and without any penalty.

The TMA (C.I.) operator must not spread any identifiable personal information concerning the users, the research participants, or those who request his/her services and have collected such data for work reasons, unless the person or entity concerned has agreed to by written consent, or unless there is not a different legal authorization to do so and, in any case, always with an authorization of both the developers and all the persons concerned.

The TMA (C.I.) operator will hide any confidential information concerning the participants whenever possible, so as not to make them individually identifiable to others and so that discussions cannot harm identifiable participants.

The TMA (C.I.) operator will inform the participants that, at the conclusion of the involvement in the research, adequate communication will be made.

TMA (C.I.) operators must not falsify the research publication data. If a TMA (C.I.) Operator finds an error in a publication in which he/she participated, they will take all actions to correct, withdraw or modify it, or by using other appropriate publishing tools. The TMA (C.I.) operator will neither omit any result that could alter the interpretation of the work, nor publish data that have already been published as original. This does not prevent re-publication of data with appropriate references. The TMA (C.I.) operator will not subtract the data on which the conclusions of the research are based – even after they have been published – to other expert professionals who only try to verify and submit the conclusions to a second analysis, provided that the participants’ confidentiality can be protected, and if there are no legal impediments to their sharing.

The relationship between TMA (C.I.) operators must be based on the principles of mutual respect, loyalty and connection. The TMA (C.I.) operator will support and encourage those Colleagues who, in the field of their own activity, whatever the nature of their business relationship and their hierarchical position, they see the respect of deontological norms compromised.

TMA (C.I.) operators will promote an ethical culture in their work environment, and inform others of the existence of this Code. If the TMA (C.I.) operator witnesses a potential legal or ethical violation, he/she will take the necessary measures aimed at protecting the user. The operator will inform his/her contacts (coordinator, supervisors, TMA creators) of the violation, who will have to report it to the competent authority.

The TMA (C.I.) operator is committed to contributing to the development of TMA (C.I.), in order to favour its spread for human and social welfare purposes.

The TMA (C.I.) operator will refrain from publicly giving negative judgments about colleagues regarding their training, their expertise and the results achieved as a consequence of their professional interventions and, in any case, harmful judgments towards their decorum and their professional reputation. The fact that such negative judgments are aimed at subtracting users from colleagues in any way possible – especially through unfair competition – is an aggravating factor. If there are cases of improper professional conduct that could result in offence for the user or the decorum of the profession, the TMA (C.I.) operator must promptly notify the supervisors and the creators of the TMA (C.I.).

In performing the tasks, and in the circumstances in which he/she publicly represents the TMA for any reason, the TMA (C.I.) operator is required to conform his/her own conduct to the principles of decorum and professional dignity.

The TMA (C.I.) operator will present his/her training, experience and expertise in a correct and accurate way. Regardless of the limits set by current legislation on advertising, the TMA (C.I.) operator must not publicly adopt an incorrect behaviour aimed at acquiring new users. In any case, informative advertising can be carried out in terms of professional titles, the characteristics of the service offered, as well as the price and the total costs of the services according to criteria of transparency and truthfulness, whose compliance can be verified by the (C.I.) supervisors. The message must be formulated in the respect of the professional decorum, in accordance with the criteria of scientific seriousness and the protection of professional image. The lack of transparency and truthfulness of the advertised message represents a violation of the code of conduct.

TMA (C.I.) Operators may employ testimonies from current users on the web pages subject to their written authorization. With regard to these testimonies, the TMA operator and the agent of the testimony are required to comply with all relevant laws regarding the statements of those who bear the testimony. In compliance with the relevant laws, TMA (C.I.) operators are allowed to promote the project by highlighting the type of Services based on the evidence they provide, and the objective results they have obtained and published.

Those TMA operators who do not observe the code of conduct and the TMA guidelines in any part of it, will be deleted from the TMA operators lists, and will no longer be authorized to apply the method. They will also not be able to perform their work at any TMA (C.I.) Centre, and will no longer be able to use neither the expression “Multisystem Aquatic Therapy” nor every logo and name associated with it.

The TMA (C.I.) operator may eventually ask their coordinator or supervisor permission to create a TMA-related page on Facebook or any other social network. The creation of the page is subject to the consent and authorization of the requested person (coordinator or supervisor), in compliance with TMA (C.I.) internal regulations. The Facebook page must have the same format as the official page: Multisystem Aquatic Therapy, the Ippolito-Caputo Method. They must be created as pages (initial screen option: create a page), and not as individual profiles. They may be either regional or relative to individual cities and must all carry the same suffix: Autism, TMA, name, region or city, Caputo-Ippolito method. Should there be a regional or local coordinator, the administrator of the Facebook page will be in charge of creating it according to the conditions described above, and will manage it in full compliance with the Rules of Conduct; the operators can be added as editors and are allowed to publish events, information and anything else in the children’s picture section, as previously authorized by the parents who will complete and deliver the consent form, which TMA Operator has received from the Supervisor.

The TMA (C.I.) operator is obliged to inform the supervisor if he/she detects open pages or profiles on any social network that have been created by unsupervised or, in any case, unauthorized personnel, to use the TMA name.

The TMA (C.I.) operator cannot, in any way, use the registered trademark TMA Caputo-Ippolito method, on any occasion and on any support unless previously authorized.

Supervisors and coordinators are in charge of monitoring compliance with the code of conduct and TMA (C.I.) guidelines, and of communicating any violation so that the TMA (C.I.) Cooperative and its creators can undertake any appropriate initiative.