Consent
Thank you for the opportunity to help you reach your goals. Please read the following pages carefully, and ask about anything that is unclear.
Counselling Relationship
I am hoping that we will work together as a team. You have knowledge about your own life and I have knowledge and expertise about the therapeutic process. I expect you to be actively involved in this process as you work toward your goals. I have found that clients benefit most from the therapy process if they engage in some form of self-help between their sessions. For this reason, I may assign homework to maximize the effectiveness of the therapy. I will invite your input to determine what would be the most useful things for you to do between sessions.
Session Format
Sessions are normally 50 minutes long. Sessions are usually face-to-face. During the sessions I will do one or more of the following:
Listen to your concerns and allow you to express your feelings help you to identify your strengths and resources;
Help you to identify the thoughts, feelings, behaviours, or circumstances that are interfering with you meeting your goals;
Help you to set goals and develop concrete action plans for managing or overcoming the obstacles to your well-being;
Use a specific intervention that is appropriate to your goals;
Provide relevant information, verbally, via white-board and/or in handout form;
Conduct formal and informal assessments to measure your progress and enhance motivation;
Suggest some reading or writing assignment to help you gain insight into your concern;
Give a homework assignment to be completed between therapy sessions.
Fees, Cancellations & Curtailment
Fees vary from £15 – £125.00 per session.
Cancellation or amendment is free providing 48 hrs notice is given. Where less than 48 hrs notice is given full payment will apply. Exception to this is where I manage to fill the cancellation slot with a different client and a credit or refund will be offered. Receipts can be provided on request via email.
Curtailment. I reserve the right to refuse Counselling ending or cutting short a session if at any point I believe a client is under the influence of any substance that hampers the clients ability to take part in the session. Prescribed medication is fine providing it is taken at the appropriate dosage.
Your Rights
You have the right to ask questions about my treatment methods so you can make informed decisions about what methods are most suitable for you. You have the right to stop therapy if something about it is not working for you. If this should happen, I would appreciate your feedback about what is not working for you. I may be able to suggest alternate resources. You have the right to ask for a referral if that would be in your best interests.
Risks of Psychotherapy
Psychotherapy involves a degree of risk. You may experience uncomfortable emotions as you talk about the issues that are concerning you. Sometimes therapy involves talking about unpleasant aspects of your history. Psychotherapy is focused on facilitating change according to the goals you set. Any change (even good change) can affect a person’s established system. You may meet with some resistance from other people in your life as a result of the changes you make.
Confidentiality
All interactions which take place in the setting of therapy are considered confidential. This includes requests by telephone, all interactions with this counsellor, any scheduling or appointment notes, all session content records and any progress notes that I take during your sessions. I will not even verify that you are a client. You may choose to give me permission in writing to release any or specific information about you to any person or agency that you designate.
Limits to this agreement
- In some legal proceedings a judge may issue a court order.
This would require this counsellor to testify in court. - If I learn of or believe that there is physical or sexual abuse or neglect of any person under 18 years of age, I must report this information to the relevant authorities.
- If I learn of or believe that an elderly person, or disabled person is being abused or neglected, I must file a report with the appropriate authorities.
- If I learn of or believe that you are threatening serious harm to another person, I am obligated to report this. This can be in the form of telling the person who you have threatened, contacting the police or another professional body.
- If there is evidence that you are a danger to yourself and I believe that you are likely to kill yourself unless protective measure are taken, I may be obligated to contact family members or others who can help provide protection
- There may be times when I consult with outside sources about cases. In these cases, no personally identifiable information will be used to discuss this case. However, discussion topics will be used in order to ensure that I am getting and giving the best assistance possible. The persons with whom I discuss cases are legally bound to keep information confidential.
- Stopping Therapy
- In starting therapy, you begin a goal-focused process that has a beginning, middle, and end. It is recommended that stopping therapy be planned for and discussed with the therapist.
I have read and discussed the above information with my counsellor.
I understand the nature and limits of confidentiality.