ISSUES RELATED TO TRAINING PROFESSIONAL THERAPISTS

Various authors have studied problems faced by trainee counsellors. Becoming therapists
have challenges like being self-critical in practice and having troubling reaction to clients
(Hill, Sullivan, Knox, & Schlosser 2007). Novice therapists experience stress (Kumary &
Baker, 2008; Skovholt & Ronnestad, 2003).Trainee counsellors experience anxiety and
counter-transference management (Nutt-Williams et.al cited in Anastasiou, 2006).Trainees
experience impasse and that they react with negative emotions because they did not know
what to do in session (De Stefano, D’iuso, Blake, Fitzpatrick, Drapeau, & Chamodraka
2007).
Some authors have spoken of problems faced by therapists initially. Nystul (2003) has
identified the following as common problems of novice therapists: focusing on the first issue
in a session, overlooking physical or medical issues, wanting to rescue clients from their
unhappiness, having perfectionist tendencies, having unrealistic expectations, getting carried
away with the latest technique, getting lost in the counseling process, using inappropriate
phrases, having an excessive desire to help, having an excessive need to be liked, getting too
emotionally involved, taking things too personally, having difficulty differentiating between
normal and abnormal, being uncertain about self-disclosure, and being uncertain about
confidentiality.
Others like Theriault, Gazzola and Richardson (2009) have noted that novice therapists
experience feelings of incompetence and that the beginning counsellors have career concerns
(Busacca & Wester, 2006). Much of this has been substantiated by Pereira (2012), who
studied the professional problems faced by therapists. He found that thry face various
professional problems like incompetency in skills, theories, techniques, ethical dilemmas,
anxiety due to client's problems, lack of supervision, low salary and inadequacy in applying
classroom learning to practice and so on.
Professional Problems
1. Training and Application Practical training was not sufficient during the post-graduate
studies. Exposure to actual counselling settings was not adequate during post-graduate
studies.
2. Stigma, Awareness and understanding of Counselling
3. Awareness of counselling is low among people. People are not aware of the difference
between a counsellor, a clinical psychologist, and a psychiatrist. The term counselling is
not clearly defined in India. It is understood differently by different people.
4. Stress and Burnout
Overload of work causes stress in the counsellor. Clients’ issues lead to emotional
exhaustion in the counsellor.
5. Pay/Salary
Counsellors are not paid sufficient salary. Clients are not ready to pay for sessions as
they think that counselling involves only listening and talking.
6. Counselling Process (sessions) and the Client
Clients think counselling is a short-term process. Convincing the family members of the
client about the treatment is a challenge. Clients are reluctant to meet young counsellors
because they think that young counsellors are not good counsellors. Counselling in the
vernacular is difficult as what was learned in English cannot be translated adequately.
7. Ethical Issues
8. In critical cases like suicide, deciding on how much information to disclose to family
members is a challenge.
9. Setting Issues
As in some places, there is no separate room for counselling, privacy and confidentiality
cannot be maintained. As the job is contractual in nature, there is no job-security for
counsellors. There is no proper coordination between various levels of authority and this
causes problems to the counsellor. Because of heavy clerical work, counsellors do not
find enough time for counselling. Workload (case load) is very heavy for counsellors.

RCI NORMS FOR STARTING A REHABILITATION PROFESSIONAL COURSE

1. No Institute of rehabilitation professional course shall be started without the prior approval
of Council / the Central Government.
2. To obtain approval of Council, the institution desirous to start the Degree / Diploma /
Certificate courses shall approach the Council, through the respective State Govt. / Union
Territory Administration. The State Govt. / U.T. Administration shall be requested to assess
the requirements of various professionals.
3. The State Government/ Union Territory Administration must indicate in clear terms
whether they are or not in favour of starting a college / or institutions managed by a non
governmental organisation.
4. The management of the Institute shall adopt the standards of staff, space and equipment as
recommended by the Council and given an undertaking for their phased implementation
within the stipulated period.
5. The management of the Institute must submit in writing, the willingness of University
which can grant affiliation if the Council permits the Degree/Master Course to be started.
6. The management of the Institute must satisfy the Council about possessing enough training
facilities to undertake the Degree/ Diploma courses.
7. The management must provide adequate facilities of administrative and teaching staff
required for the Degree/Diploma course as per the recommendations of the Council.
8. The management of the Institute must submit a plan for the construction of full-fledged
division and appoint competent personnel to manage the same.
9. RCI may issue notice to all State Governments under Section 24(9) of RCI Notification
dated 27/03/1997 which states that “ On receipt of the an application from an organization for
permission to start new rehabilitation professional course, the Council shall call for if not
done by the organization, the recommendations/views of the State Government. In case the
recommendations/views of the State Government are not received within a period of ninety
days, the Council shall be entitled to process the application on its own with the support of
his committees and thereafter take such decision as it deem necessary” and subsequently the
Council may initiate necessary action as provided U/s 24(9) of notification referred above.

ETHICAL AND LEGAL ISSUES IN PSYCHOTHERAPY

In order to have best ethical practice, Barnett has discussed three important strategies for best
ethical practice, which include a combination of positive ethics, risk management, and
defensive practice. Positive ethics focuses the psychotherapist on constantly striving to
achieve the highest ethical standards in the profession. It is guided by a series of aspirational
virtues which include doing good and providing maximum benefit to the client (beneficence),
avoiding exploitation and harm of clients and those associated with them (nonmaleficence),
being faithful to the explicit and implicit obligations that a therapist has to his/her client
(fidelity), promoting client’s independence over time and not creating increased dependence
on the therapist through the therapists actions (autonomy), providing fair and equal treatment,
and access to treatment, to all individuals (justice) and providing adequate attention to our
own physical and psychological wellness so that we are effectively able to implement the
above virtues (self-care) . Risk management although has the same goal as positive ethics for
the clients, but it more specifically focuses on minimizing risks for the psychotherapist that
may result in ethics complaints or malpractice claims and it addresses the issues of informed
consent, effective documentation, and consultation . Defensive practice focuses on the direct
protection of the psychotherapist. It involves making decisions based on reducing the
possibility of adverse outcomes for the psychotherapist . For example, a practitioner may
restrict the range of clients worked with and refuse to work with certain types of clients, such
as those with suicidal ideation or severe personality disorders, out of fear that they materially
increase risk . Based on the above principles, we will cover the ethical and legal issues in
psychotherapy under the headings of competence of therapist, responsibilities of therapists
towards their clients, therapeutic contract, informed consent, confidentiality, privilege and
psychotherapy supervision, documentation, self disclosure, matters of business (advertising,
fees etc), research, countertransference, boundaries, termination and post termination issues.

COMPETENCE OF THERAPIST
Competence is defined as ‘‘the possession of required skill, knowledge, qualification or
capacity’. It is very important that therapists are aware of their competence, with regard to the
level of his/her knowledge, training and supervised experience in a particular kind of therapy.
In addition to the above, some of the authors also include ‘emotional competence’ to
knowledge and technical skills. This actually means, whether the therapist is aware of his
emotional state while dealing with their clients. It is important that the therapists refrain from
initiating or continuing a therapy when they know or should know that there is a substantial
likelihood that their personal problems will prevent them from performing their work in a
competent manner. Further, when a therapist becomes aware of personal problems that may
interfere with performing their duties adequately, they take appropriate measures, such as
obtaining professional consultation or assistance, and determine whether they 8 should limit,
suspend, or terminate the therapy .

RESPONSIBILITIES OF THERAPIST
From an ethical point of view, it is important that the therapists are aware of their
responsibility towards their clients. These include:
Responsibilities to the client
1. Therapy should be undertaken only with professional intent and not casually and/or in
extra
professional relationships.
2. Contracts involving the client should be realistic and clear.
3. Therapists take all reasonable steps to avoid harm to their clients as a result of the therapy.
4. Therapist should seek supervision or refer the client in situations which are beyond their
competence.
5. Therapist should promote client autonomy and encourage clients to make responsible
decisions on their own behalf.
6. Therapist should maintain the professional boundaries.
7. Therapist should avoid any other relationship with their clients which can be detrimental to
the therapeutic process.
8. Therapist should maintain confidentiality. This applies to all verbal, written, recorded or
computer stored material pertaining to the therapeutic context. All records, whether in written
or any other form, need to be protected with the strictest of confidence.
9. In exceptional circumstances when confidentiality has to be broken, attempts must be
made
to seek client’s permission.
10. Agreements about confidentiality continue after the client’s death unless there are
overriding legal considerations.
11. Therapists should not exploit clients (past or present), in financial, sexual, emotional or
any
other way.
12. Sexual relations between the client and the therapist are never acceptable. This is not
restricted to sexual intercourse and includes any form of physical contact, whether initiated
by the client or the therapist, which has as its purpose some form of sexual gratification, or
which may be reasonably construed as having that purpose.
13. Therapist should not accept or offer payments for referrals, or engage in any financial
transactions, apart from negotiating the ordinary fee charged for the therapy.
14. If a therapist makes an attempt to make a relationship with a former client, he should seek
supervision.
15. When a client is incapable of giving informed consent, therapist should obtain consent
from a legally authorised person.
16. Any publicity material and all written and oral information should reflect accurately the
nature of the service offered and the training, qualifications and relevant experience of the
therapist.

Responsibilities to self as a therapist

1. It is the responsibility of the therapist to maintain their own effectiveness, resilience and
ability to help clients. They monitor their own personal functioning, and seek help or refrain
from therapy when their personal resources are sufficiently depleted to require this.
2. Therapists should not undertake therapy when their functioning is significantly impaired
by
personal or emotional difficulties, illness, alcohol, drugs or any other cause.
3. Therapists should have regular suitable supervision and use such supervision to develop
counselling skills, monitor performance and provide accountability for practice .

INFORMED CONSENT
Informed consent to therapy is invaluable as it ensures that a patient’s decision to take part in
psychotherapy is informed, voluntary, and rational. Although it is presumed that seeking help
of the therapist for their problems by the patient means implied consent, but this does not
amount to “informed consent”.
Informed consent should be seen as the primary means of protecting the self-determination
and self-governing rights of clients as it gives the client an opportunity to make an informed
decision about engaging in psychotherapy and it communicates respect for personhood and
reflects the collaborative nature of psychotherapy. It also emphasizes the patient’s role in
making treatment decisions and increasing a sense of ownership over the process. A proper
informed consent procedure also helps the therapist and the client establish a partnership,
with a common goal, decreases the likelihood that patients will put the therapist on a pedestal
and become overly or dangerously dependent on the therapist. Last but not the least, a proper
informed consent procedures can reduce the client’s anxiety by demystifying the therapeutic
process .

THERAPEUTIC CONTRACT
The therapeutic contract should be a written document, which includes the responsibilities of
the therapist and the client in participating in a particular psychotherapy. It should cover the
following:
1. Time: the time of the day when the therapy is to be conducted and provision of change in
exigencies.
2. Duration: the contract must include the duration of each sessions (say 50 minutes)
3. Frequency of sessions: Frequency of the sessions will be______ per week (usually agreed
upon between the client and therapist depending on the variety of the problems and
symptoms).
4. Late to the session: If the therapist will be ever late, he will try to let the client know in
advance, even if the delay is just a few minutes. If the therapist is responsible for delay in
start of the session and the client can stay longer, then the therapist will see the client you for
the full time. If the client arrives late for an appointment, then the session may still end at the
scheduled time, however if it is possible than the session may go to the full time. If either the
therapist or the client is late by more than 15 minutes and don’t inform the other party than
the session will stand cancelled. However, in such a situation either of the party has to bear
the financial liability.
5. Cancellation: In the event of either the client or therapist are unable to keep the
appointment,
they are required to provide twenty-four (24) hours notice of cancellation or they will be
charged for the session.
6. Fees: the client is supposed to pay Rupees ____ for each 50 minutes session. Client should
make the payment is to be made at the beginning of the session. If the duration of the session
extends beyond one hour than the patient will be required to pay an additional fee.
7. Emergency contact: If the patient needs to contact the therapist between sessions, she/he
should call at _____number and leave the message and also mention that it is an emergency.
If
the therapist doesn’t call back the client in _____ time (say 30 min), patient should attend the
emergency outpatient department of the hospital.
8. Issues of confidentiality: The therapeutic contract should mention that the therapist will
maintain confidentiality of the information revealed during the psychotherapy. However it
should also provide the provisions under which the information would be disclosed to others,
for example the confidentiality clause can be worded as: “Information shared by the client
will be maintained strictly confidential except in the following situations:
a) To ensure the best treatment, therapist will at times discuss the case with his colleagues or
supervisor, keeping the identity of the client confidential.
b) If the client communicates threat of bodily injury to self or to another the information
would be disclosed to the family members and the legal authorities.
c) When there is reasonable suspicion of child abuse or abuse to a dependent adult has
occurred, or is likely to occur.
d) If ordered by a court of law, the details of the treatment will be revealed to that court.
e) In case of the couple and family therapy, the therapist should mention that “if you tell me a
secret, you are asking me to help you disclose it, which I will assist you in doing”. “I
maintain
the right to disclose confidential information to other participants in the family or couple if I
feel it is in the best interest of the family or couple to do so. You have equal rights to release
information to outside parties but I will withhold it unless it is in your best interest”.
f) Therapist will disclose the information to a third person or agency, if patient gives in
written to release the information
g) If the patient files a case in the court against the therapist then the patients his privilege of
confidentiality”.
9. Termination: If the client decides to discontinue the therapy, he will make this known to
the therapist within a session, so that an end date can be decided and the client and therapist
can work towards an appropriate ending. Termination of therapy cannot be done on phone,
nor be the decision solely of the client (This is to safeguard the client as frequently, during
the therapy, client may have to discuss underlying difficult material which has been kept
suppressed for the years. Certain defenses/aspects of client may stop him to discuss the same
and that may convince their ego that either - they can’t afford therapy, they don’t have the
time, therapy is not working, or nothing is happening, when, actually a breakthrough is about
to happen. So it is important that they ask for inner guidance with the help of their therapist
when they have these doubts, rather than leave just when life can begin to have new
meaning).
10. Gifts: No gifts will be accepted by the therapist from the client and neither the therapist
will offer any gifts to the client.
11. Self disclosure: The therapy will focus on the issues of the client and the therapist will not
respond to any questions regarding the personal details, and any such attempt by the client
will
be interpreted.
12. Home work assignments: As part of the therapy client will be given some home work
assignments in between the sessions, and the client is expected to carry out the same. If the
client comes to the session, without completion of the homework assignment, then the
therapist
has the right to cancel the session. However, in such situation, the client has to pay for the
session.
13. Documentation: The therapist may take notes during the therapy session.
14. Recording: The therapist may tape record/video record the therapy session for
documentation and supervision purposes.
15. Provision for revision: If required by either the therapist or the client the contract will be
revised after mutual discussion.
16. No suicide contract: In case, patient is suicidal, the contract can include the clause that
patient is not going to harm her/him, and in case she/he has the urge to indulge in the self
harming behaviour, she/he will contact the therapist.

CONFIDENTIALITY
Maintaining confidentiality is the foundation of the psychotherapy. Without the assurance
about the confidentiality, the clients cannot be expected to reveal embarrassing, sometimes
personally damaging, information in treatment setting . As part of the medical profession, the
therapists are expected to maintain the confidentiality of their clients. However, it is
important to remember that the ethical requirement of confidentiality overlaps with the law,
hence, answers to some of the situations can only be predicted by an understanding of both
ethics and law. Hence in situations where things are not clear the therapist should seek legal
consultation.
However, it is also important to note that there are certain exceptions to maintaining privacy.
Hence, information about the exception should be part of both informed consent procedure
and therapeutic contract, because not doing so can place both the therapy and the therapist at
significant risk .

BOUNDARY ISSUES DURING PSYCHOTHERAPY

Boundary issues in psychiatry and psychotherapy per se, don’t have black and white answers.
Nonsexual boundary crossings can enrich therapy, serve the treatment plan, and strengthen
the therapist–client working relationship. They also can undermine the therapy, severe the
therapist–patient alliance, and cause immediate or long-term harm to the client. Choices
about
whether to cross a boundary confront us daily, are often subtle and complex, and can
sometimes
22 influence whether therapy progresses, stalls, or ends.

POST TERMINATION ETHICAL ISSUES

As with other issues related to boundaries, post-termination relationships between therapist
and the client have always being an issue of debate. Although, there is no law to bar the
physician to have sexual relationship with their ex-patients, but it is more or less accepted
that it is unethical to terminate the psychotherapy for having a sexual relationship with the
client. Regarding the post-termination sexual relationship, there are different views. Some of
the authors take the stand that the client may agree for such a relationship because of
unresolved transference and hence it is unethical. Others consider that if a proper termination
of therapy has been done, transference should be considered as resolved, and hence having
sexual relationship after proper termination is not unethical. However this issue becomes
more complicated when the therapy (therapies other than dynamic) doesn’t encourage
transference. Hence, there is no clear consensus on the issue on sexual relationship with an
ex-client. In view of the same, the sanctity of the same will depend on case to case basis.
When faced with such a situation, therapist should seek supervision.

DOCUMENTATION IN PSYCHOTHERAPY
Documentation in psychotherapy should be regarded as a medical and legal record of
assessment, diagnosis, investigations, decision-making, pharmacological and non-
pharmacological management done in the specific case. From the medicolegal point of view
psychiatrists are expected to maintain factual, legible and accurate records because it serves
as a guide to the clinician to provide and plan care for the patient and also as a guide for the
care of the patient in case of change of psychiatrist. Another important usage of medical
record is in the court of law in cases of litigations due to various reasons involving the patient
or the clinician. A proper documentation of what has transpired between the patient and
clinician can at times come to the rescue of the psychotherapists in the court of law or when
such an evaluation is done in cases of complaints against the clinicians.

INDIAN ASSOCIATION OF CLINICAL PSYCHOLOGISTS

CODE OF CONDUCT -1995
Scientific and Professional organizations generally prescribe a code of conduct for their
members. Its sanctity is undoubtedly of a vital importance to the practitioners of health
profession. Indian Association of Clinical Psychologists (IACP) has adopted the following
code of conduct for its professional members with the objective that it would further
strengthen a sense of professional commitment and responsibility as well as help in
sensitizing them to the ethical issues of health profession in general.
(i) PROFESSIONAL COMPETENCE & SERVICES: ‘Competence’ should always be a
watchword to a professional man and such a clinical psychologist should keep abreast of the
latest in the field to enable him to provide efficient and effective services to the sick and
needy. Members of the association fulfilling the eligibility criteria (see Note 2) as laid down
in the IACP revised constitution (1988) are professionally competent to carry out the
responsibilities of a clinical psychologist. As an independent consultant or private practitioner
of mental health his services are likely to be considerably challenging as is true for
professionals of other disciplines. Further, although the consultation fee would largely
depend upon the nature of services offered interest of the patient and his health should always
remain paramount to a clinical psychologist. It is obligatory that he should try his best to
uphold the image of the profession.
(ii) REFERRALS: Whenever a case is referred to a clinical psychologist for his expert
opinion, it is his responsibility to ascertain the basic prerequisites of psychological
assessment. In cases where proper assessment could not be possible, the same should be
communicated to the referring source. He may however suggest to seek opinion of another
colleague or any other health professional having required expertise. Similarly, while
providing therapeutic care if he observes any such sign or symptom which require
consultation of a physician, psychiatrist or any other health specialist he should do the
needful at the earliest possible and accordingly decide the management.
(iii) METHOD OF EXPERT OPINION: A clinical psychologist should exercise his own
discretion in selection of the tests to be administered unless the referring professional had
made request for a particular test. Further, while communicating his expert opinion inferences
may be based upon his test findings as well as clinical notes and observations. As an expert in
the field of mental health he should assume full responsibility of his opinion under all the
circumstances.
(iv) CONSENT FOR TREATMENT: Before starting any treatment, a clinical psychologist
should explain to the patient and available relative the nature of illness, method of
psychological treatment and factors associated with its efficacy and so-called risk factors of
the illness. In psychological methods of treatment or in the application of 2 behavioural
techniques, involvement on the part of patient is of crucial importance and therefore consent
of the patient in true sense is essential. Needless to say, the consent is valid only when the
person is legally competent in doing so.
(v) PATIENTS WELFARE: A clinical psychologist should not only provide efficient mental
health care but should also maintain a high regard for the patient’s integrity and welfare.
Further, whatever treatment procedure he employs should be based upon scientific
knowledge and its reasonably proved efficacy. Professional ethics implies that a therapist
should not take up a case that is not fairly within his competence.
(vi) COURT TESTMONY: While appearing in a courtroom for testimony, he should follow
the required etiquette and maintain the image of a trustworthy and reliable expert. He should
fully refrain from any bias or prejudice and his comments should be based upon the test
findings and his observation as a clinical psychologist.
(vii) CONFIDENTILITY: The information elicited from the patient or his relatives should
not be disclosed to anyone other than concerned co-professional or appropriate authorities.
Clinical record of each patient should be kept carefully under his custody. Further, to
maintain professional sanctity of the test material and prevent its abuse he should not allow
test material to be taken out of his clinical or laboratory except for purposes of teaching or
training students of the discipline or related subject.
 Rehabilitation Council of India (Standards of Professional Conduct,
Etiquette and Code of Ethics for Rehabilitation Professionals) Regulations,
1998.
PROHIBITION OF ADVERTISEMENT AND PUBLICITY
A professional shall not solicit any person with disabilities, directly or indirectly, either
personally, or through any kinds of publicity or advertisement in any newspaper, magazine or
pamphlet, or through any documentary film or placard, or by distribution of any circular,
card, hand-bill, photograph or chart.
Provided that a professional may issue a formal announcement through any press media or by
any other mode about starting or resumption of his practice, change of kinds of practice,
change of address of the place of practice or residence, temporary absence from the place of
practice, winding up the profession or switching over to another professions.
Provided further that a professional may write or publish a purely research, medical or
science literature written or published for the advancement of the professional skill or
science.

DECLARATION BY PROFESSIONAL
At the time registration under section 19, every professional shall make and subscribe an
affirmation or a declaration in the From appended to these regulations and shall agree to
abide by the same.

AMENDMENT IN REGISTRATION CERTIFICATE

(1) No professional shall either himself or through some other person make any amendment,
change or disfigurement of particulars of the registration certificate issued by the Council. If
any change in the address, qualifications or any other particulars of the professional, as
declared at the time of registration is required, a notice of such change shall be given by the
professional to the Council within a period of thirty days from the date of such change and
the registration certificate got amended from the Member- secretary accordingly. The
amendments or change of address or any other particulars in the registration certificate shall
be duly authenticated by the Member- Secretary.
(2) With a view to get the registration certificate amended the professional shall either
produce the original registration certificate personally or through his authorised agent or send
the same to the Member-Secretary under registered post.
(3) The Member-Secretary shall make necessary and required amendments in the Register
and the registration certificate. The amendments made in the registration certificate shall be
duly authenticated by the Member-Secretary.

CHANGE THE NAME OR SURNAME OF PROFESSIONAL.

(1) If any change of the name or surname, as declared at the time of registration is required, a
notice of such change shall be given by the professional to the Council. Such notice sahil be
accompanied by,—
(a) a copy of the notification published in the Official Gazette or in any national daily
newspaper relating to such alteration, omission or addition of name or surname; or
(b) an affidavit regarding such alteration, omission or addition of name or surname
affirmed and authenticated before a Judicial Magistrate or Metropolitan Magistrate;
and
(c) the registration certificate in original.
(2) The Member-Secretary shall make necessary and required amendments or changes in the
Register and the registration certificate. The amendments or changes made in the registration
certificate shall be duly authenticated by the Member-Secretary.

CHANGE OF PLACE OF PRACTICE AND RESIDENCE

If any change takes place in the place of practice or of residence as declared at the time of
registration, the professional shall give a notice of such change to the Council within a period
of thirty days from the date of change and get his registration certificate amended in
accordance with the procedure provided under sub-regulation (2) of regulation 5.

DISPLAY OF QUALIFICATIONS AND REGISTRATION CERTIFICATE

(1) Every professional shall display his correct Degree or Diploma on the sign board, letter
head pad, prescription slip, visiting card, certificate, report and on other kind of documents to
be issued under his signature.
(2) A copy of the registration certificate shall be affixed on a conspicuous place in the
premises where the professional is practising.

PAYMENT FOR PROFESSIONAL SERVICE

No professional shall enter into a contract of "No cure, No payment”. The consultation fee,
the charges in respect of medicaments or other aids and appliances or any other kind of
service, shall not be exorbitant.

PROHIBITION OF PROGNOSIS
No professional shall indulge himself in exaggeration of forecasting of the course of disease
or gravity of the condition of any person with disability.

INFAMOUS CONDUCT.
If a professional, —
(a) indulge in exaggeration of forecasting of course of disease;
(b) involve in any indecent act;
(c) maintain improper or elicit relations with any person with disability;
(d) make use of harsh and rough language with any person with disability:
(e) charge exorbitant consultation fee or service charges;
(f) take any undue advantage from the mental or physical affliction of a person with
disability;
(g) insert, affix or adjust knowingly any non-standard aids or appliance to a person with
disability;
(h) does not undertake the rehabilitation or treatment of persons with disabilities on regular
and required intervals or proper time;
(i) neglects knowingly and intentionally any person with disability;
(j) avails or attempt to avail any benefit meant for persons with disabilities; or
(k) undertake practice in any field other than his specialisation, shall be declared as
professional of infamous conduct.

SUBMISSION OF INFORMATION
Whenever any information in respect of the qualifications, practice, place of practice or
residence of professional or any other kind of information is required by the Council or the
Central Government, of professional shall submit the same without any delay.

MAINTENANCE OF REGISTER, ETC

Every professional shall maintain the proper daily records of persons examined, the
certificates, reports or prescriptions issued and the accounts of consultation fee, service
charges and other charges received by him.

PRODUCTION OF DOCUMENTS, ETC

Whenever the documents including any register, certificate, account books, or other papers in
possession of or under the control of any professional are required to be examined or
inspected with a view to ascertain the recognised qualifications, vailidity of the registration
certificate or in connection with any other matter by the Member-Secretary or by any other
officer duly authorised in this behalf by the Central Government or by the Member-
Secertary, the professional shall produce the same for examination or inspection before the
Member-Secretary or such authorised officer.

CONSEQUENCES FOR CONTRAVENTION OF REGULATIONS

If, after such inquiry as the Council may deem just and proper, any professional is found
guilty of contravention of all or any of the provisions of these regulations, shall be liable to be
declared as professional having infamous conduct or his name may be ordered to be removed
from the Register in accordance with the provisions of sub-section (3) of section 21.