Informed Consent:
General Information The coaching/counselling relationship is unique in that it is highly personal and at the same time, a contractual agreement. Given this, it is important for us to reach a clear understanding of how our relationship will work, and what each of us can expect. This consent will provide a clear framework for our work together. Feel free to discuss any of this with me. Please read and indicate that you have reviewed this information and agree to it by filling in the checkbox at the end of this document.
The Counselling/Coaching Process You have taken a very positive step by deciding to seek change. The outcome of our interactions depends largely on your willingness to engage in this process, which may, at times, result in considerable discomfort. Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings of anger, depression, anxiety, etc. There are no miracle cures. I cannot promise that your behavior or circumstance will change. I can promise to support you and do my very best to understand you and any repeating patterns, as well as to help you clarify what it is that you want for yourself.
Confidentiality: The session content and all relevant materials related to your treatment will be held confidential unless you request in writing to have all or portions of such content released to a specifically named person/persons. Limitations of such client held privilege of confidentiality exist and are itemized below:
1. If a client threatens or attempts to commit suicide or otherwise conducts him/herself in a manner in which there is a substantial risk of incurring serious bodily harm.
2. If a client threatens grave bodily harm or death to another person.
3. If the counsellor/coach has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional, or sexual abuse of children under the age of 18 years.
4. Suspicions as stated above in the case of an elderly person who may be subjected to these abuses.
5. Suspected neglect of the parties named in items #3 and # 4.
6. If a court of law issues a legitimate subpoena for information stated on the subpoena.
7. If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an attorney.
Termination:
Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate counselling/coaching after appropriate discussion with you and a termination process if I determine that the counselling is not being effectively used or if you are in default on payment. I will not terminate our professional relationship without first discussing and exploring the reasons and purpose of terminating. You have the right to terminate our relationship at any time. If counselling is terminated for any reason or you request another therapist, I will provide you with a list of qualified professionals that will be able to assist you. You may also choose someone on your own or from another referral source.
If we see each other accidentally outside of the therapy office, I will not acknowledge you first. Your right to privacy and confidentiality is of the utmost importance to me, and I do not wish to jeopardize your privacy. However, if you acknowledge me first, I will be more than happy to speak briefly with you, but feel it appropriate not to engage in any lengthy discussions in public or outside of the counselling office.
PRACTICE POLICIES:
FEES
The current base fee for one 50 minute session is $130.00 including HST. These professional fees are for general individual counseling and all related professional services. Fees for specialized or multiple session services may differ and will be stated at the outset of that service together. Payment is required prior to each session by cash, cheque, email money transfer, paypal or credit card. A $25.00 fee will be charged for any checks returned for any reason. Increase in Fees: Existing clients will be given three months notice of any increase in fees. You are encouraged to discuss any financial matters with your therapist at any time. The payment of fees for counseling is part of the client/therapist relationship. As such it is as open for discussion as is any other concern
APPOINTMENTS AND CANCELLATIONS
Appointments are 50 minutes in length with 5 minutes being used for payment and rescheduling.
Please remember to cancel or reschedule 24 hours in advance. Cancellations and re-scheduled sessions will be subject to a FULL CHARGE IF NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you do not show up for a scheduled session you will be charged the full fee. If you arrive late for a session, you may lose some of that session time.
TELEPHONE ACCESSIBILITY
If you need to contact me between sessions, please leave a message on my voice mail. I am often not immediately available but I will attempt to return your call within 24 hours. I am not available for unscheduled phone calls or texts. Please note that online and face time sessions are highly preferable to phone sessions. However, in the event that you are out of town, sick or need additional support, phone sessions are available. Payment is required via email money transfer or credit card at the start of a phone session. If a true emergency situation arises, please call 911, crisis line or any local emergency room.
SOCIAL MEDIA AND TELECOMMUNICATION
Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any PERSONAL social networking sites (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.
ELECTRONIC COMMUNICATION
I cannot ensure the confidentiality of any form of communication through electronic media, including text messages and email messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.
