When you go and see a mental health professional, you may do no paperwork at all. Or, you may be asked to sign screeds of incomprehensible bumpf. With me, it's a bit in the middle.
I'm hot on informed consent, meaning that I want my clients to understand exactly what terms govern our sessions.
However, ethics can be complex, and clients are not up for a three week discussion on the subject.
Also, many of my clients speak English as a second, third or fourth language, so it's important to keep terms simple.
So what I do is offer clients a short chat about the basics before we start, and then I send them a very simple agreement afterwards. My main aim is to make sure we agree and that we have the emergency contact details in place.
If you're curious about terms, Alvin and I talk about the basics, plus basic ethical issues, in Reaching Out: Your Easy Guide to Finding Affordable Quality Online Therapy A Practitioner's Perspective available FREE on Amazon, Google Play, Kobo and other shops.
And this is my agreement; (updated 17th November 2022. Note, this is the local one. The international one has a different payment scheme. Also, I may update this from time to time, so see it as a guide only)
Benefits and Risks of Therapy
Therapy is about helping promote understanding as well as healing and change. Therapy can help you like yourself more, understand and improve relationships, cope with stress and many other issues. However, talking about problems or remembering bad times can also be uncomfortable.
Therapy is not cut and dried. Also, as satisfaction is a personal experience, it’s part of ethics to warn that outcomes are not guaranteed.
Furthermore, as therapy is a personal experience, it typically takes time before we learn to understand each other. So please don’t expect instant change.
Open communication is the bedrock of success.
If you want to change your goals or try another approach, just say so. Being flexible and adapting are part of therapy. In addition, if we talk regularly, I will ask for feedback on our sessions. Just say what you think. It all goes into maximising the process for your benefit.
Age and Consent
I work with adults only, so you must be over 18 years of age.
When we talk, we exchange a lot of information. You will see me take notes. This is because I check our progress before and after we speak.
The notes are secret – but not from you. We are working together and so I share bits of the notes as we speak. Afterwards, I will send you all the notes along with the invoice.
I am invested in your privacy. You should know that:
· I will never talk about you to anyone, unless you explicitly give me permission
· I have an up-to-date firewall and anti-virus system in place
· I keep my notes offline; I do not use cloud services
· My backups are on an external hard drive, not on a server
· I do not use therapy goal tracking software or apps
On your end, I suggest that to maintain your privacy, you avoid company phones and email; use your own private phone and email.
Exceptions to confidentiality
My first duty is to you. I look after your interests first. I also strive to guard your privacy.
However, there are a handful of exceptions.
· If I believe you are actively suicidal, or
· If I believe you will try and hurt someone else,
I must prevent deadly danger and serious harm to you and others. This is why we appoint an emergency contact.
Should you become dangerous to yourself or to others, we ask your emergency contact to help.
Ideally, we see this coming and we work out a plan together that gets you the help and support you need. Where possible, you and I talk to your emergency contact together.
However, should you refuse, and should I deem you an active danger, I will contact your emergency contact without your permission.
Should they not respond, I will take whatever action I deem suitable in order to prevent harm.
When you want me to talk to third parties
· If you ask me to talk to your doctor, lecturer, HR or other person this presents a confidentiality issue.
Ideally, I never want to talk about you. However, I will write a letter and send it to you. Then you share it with whoever you decide.
If the police or a court judge demand information about our sessions, I will consult my legal team. I will only break privacy if they advise me to respond.
How We Talk
We talk over online video Skype, WhatsApp, Messenger, Telegram or Google Meet. You pick what works best for you.
As services change, and countries block services from time to time, I reserve the right to add and drop methods. I will always do my best to ensure there’s a service that works for you. However, should your country block all access, our therapy relationship stops.
Our sessions are intensive, and there should be no interruptions. While we talk, our phones are off.
Be on time! Also, do not talk to me from bed. This is a professional session. Be up and dressed.
During office hours I will answer texts and email as soon as I can. Should you text me after hours, I will respond the next working day.
While I’m okay with a very short note or check-in outside of sessions, I do not offer a text-based therapy service. I also don’t read diaries, documentation and so on outside of sessions. I keep my prices as low as possible, but I don’t work for free.
We schedule sessions in advance, either via text or email. We can also book ahead at the end of a session.
If you have to cancel, do so at least 24 hours before our session. If you do not cancel in time, I will charge for the session.
You can email me at firstname.lastname@example.org and you can send me an SMS or WhatsApp to +60 number.
In the event of a lightning strike or other issue that kills our internet connection, I will use mobile data and communicate over WhatsApp. If you’re in a non-WhatsApp country, I can use Skype or Telegram.
Mid Therapy Termination
If you decide this isn’t working for you, or you’ve changed your mind, that’s perfectly okay. I have no set minimum or maximum sessions; it’s pay as you go.
There are no termination fees. You also keep all the notes so you can work with someone else.
You can tell me you’re not coming back, or that you’re taking a break, or you don’t have to tell me at all. You are an adult and you make your own decisions. It’s entirely up to you.
Although it’s a very rare event, I sometimes call a halt to a therapy relationship. I do this if:
· I think you need to see a different professional.
· I think you're not interested in the sessions.
· You turn up late too often or are on your phone with others.
First 15-to-20-minute consultation: free
Notes service: free
I invoice on the day, immediately after the session. Please pay promptly.
I love what I do but I don't want to be involved in endless hassles over payment. So it's 'pay as you go'. If you decide not to pay after a session, our relationship ends.
Insurance and Court Cases
I am a private practitioner and do not work with insurance companies.
I do not take on court case work. Travel time, prepping, and constant changed court schedules are simply too difficult to deal with for a single private practitioner like me. So if you want sessions to use for your divorce, custody, sexual harassment or other case, I am not the person for you.
I take ethical issues extremely seriously. If you think I am not following the ethics of my profession, talk to me.
You can also contact my professional association the BACP at www.bacp.co.uk. If you lodge a formal complaint, please note that I must immediately stop working with you. Also, you give up your privacy. I will hand over the notes to my legal team with instructions to use them as necessary, and the BACP must also be given copies of your notes. As these parties may store, share or publish your notes, this will have privacy implications.
I have had the opportunity to discuss any questions I have about this information and I agree to the terms.
If you've questions, feel free to ask.