Contract agreement for online therapy via video

Please take some time to carefully read through the contents of this contract for online therapy. If you agree to the terms and conditions that this contract holds, please sign the contract and submit the contract agreement below.

 

The following outlines the terms of the contract for therapy between:

 

Peter Golder (Psychotherapist) on behalf of Acorn Counselling Therapy and the (Client) that signs and completes details on this document.

 

Confidentiality

Confidentiality is a means of providing you with safety, privacy and autonomy. As part of my (Peter Golder) professional development and ethical working, I attend regular clinical supervision where my work is discussed. When doing this I will not share your identity or any other details which could identify you.

 

In the event that I believe it would be helpful to communicate with other professionals, I will speak to you first, to make you are aware of this and get your consent. The exception of this would be if you told me something that you or another had done or were intending to do, and this action was something I was legally or ethically obliged to disclose. This relates specifically to if someone, and especially a child, is in serious danger of being harmed. In the unlikely event that this happens, I would inform you that I was going to discuss this with other professionals and would do so, with or without your consent, remembering that we are all bound by UK law.

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At times I use aspects of my therapeutic work in my continued professional development. When doing this I ensure that the anonymity of my clients is protected.

 

Therapy Sessions

Sessions last for 50 minutes and will usually be at the same time and day each week. We will agree on there frequency between us on an ongoing basis. In some circumstances, with mutual consent, it may be that we choose to plan one of your sessions on another day of the week and at another time, in order to provide a flexible service when needed. 

 

If you are late for a session for any reason, please let me know as soon as you can. If you are late for your session, the session cannot be extended.

 

If you arrive to a session and your behaviour has been affected in any way due to substances use e.g. alcohol / drugs, I may decide not to proceed with the session, this will be at my discretion and the session will remain chargeable.

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Cancelled and missed sessions

I will give you as much notice as possible if I need to cancel your session for any reason.

I require at least 48 hours’ notice if you have to cancel a session. If you can’t give 48 hours then you will be need to pay for that session, unless we have previously agreed otherwise. To cancel a session you can email, call or text me directly.

 

Payment for sessions

Fees are £50 per session. Payment for sessions will be made before the session or on the same day as the session by bank transfer. Please note that your name may appear on Acorn Counselling Therapy bank statements. The statements will be seen by myself, Peter Golder at Acorn Counselling Therapy.

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The bank details to make the payments are;

Account in the name of - Acorn Counselling Therapy

Sort code. 40-25-03    Account no. 01695428

 

Preparing for your sessions

Please ensure that you are in a quiet and private space for your online/telephone therapy sessions where you will not be overheard or interrupted. I will also do this. If anyone else enters the room then the session will have to stop. You may wish to have a glass of water and tissues available.

 

Online video sessions

Online video sessions will be held on ZOOM which is a free and secure video software platform. You can download it here https://zoom.us. I will send you an ‘invite’ to each of your sessions. You can click this when you are ready to start the session. Please make sure you have a good internet connection before starting online video sessions.

  

Please note that any inappropriate behaviours will result in the termination of the session with immediate effect.

 

Although Zoom has the facility to record sessions, this feature WILL NOT be used by either of us unless we have discussed this in detail previously.

 

Technical issues

If for any reason we cannot connect to the internet in order to make our therapy session then we will let each other know as soon as possible. If the internet connection drop off during the session, we will attempt to reconnect. If no connection can be made, then we will let each other know. I will call you, using the mobile number I have for you. My mobile number is 07565 636852. We can continue the session by telephone or we may decide to end the session and continue the following week. (Please keep a copy of my telephone number safe in case you should need it).

 

After your sessions

After the session try and take some time for yourself before starting to do something else, having a hot drink, writing a few words in a journal or just relaxing for 10 minutes will help give you a gentle transition back into your home life.

 

Computer Privacy

You may want to consider using a firewall and antivirus to protect your software and hardware from third parties and viruses. You could also use an encrypted webmail service that offers a high form of security for emails, file exchanges etc. It is a good idea to password protect your computer so that others cannot gain access to your documents and information you have stored.

 

If you have any questions before our first online video session, please email using this secure email address - info@acorncounsellingtherapy.com

 

Social Media

• I request that no part of our conversations are shared on social media by yourself or someone else of your choosing

• I request that you or anyone else that you know, do not search any personal profile on social media of a member of Acorn Counselling Therapy or send a message by social media to a personal social media account of a member of Acorn Counselling Therapy. You may however search and look at Acorn Counselling Therapy's facebook page or other Acorn Counselling Therapy social media.

• If any of these requests are not met, I reserve the right to withdraw the offer of therapy.

 

Other rights

In the unlikely event that I discover I am not competent to deal with what you bring, I will consult in the first instance with my supervisor who is external to the practice and will work with you to find alternative means of help. 

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I may ask for permission to use our work (anonymised to protect your identity) in training as part of case study or research. I may also ask to record our session to aid my personal professional development. Any stored files or information pertaining to the work/recordings will be anonymised. You have the right to decline these requests. 

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In the event I am unexpectedly incapacitated either short term or indefinitely, I have made secure and confidential arrangements for you to be contacted and advised. Alternative resources and support will be made known and available to you should you wish to utilise these. 

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Certification of therapist

I am a qualified counsellor and psychotherapist and a registered member with the UK Council for Psychotherapy (UKCP) and United Kingdom Association of Transactional Analysis (UKATA) and as such abide to their Code of Ethics and Professional Guidelines (a copy of which are available from their respective websites).

 

Complaints

If you have a complaint about my work or the therapy service, the first stage is to discuss this with me as your counsellor. If you feel unable to discuss the complaint with myself, you can contact one of the organisations that I am a registered member of UKCP and UKATA. 

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The therapy work undertaken by Peter Golder is in accordance with the laws of the United Kindom and as such any disputes will be subject to legal processes within the United Kingdom. 

 

Termination of Therapy

There may be times during therapy that you feel distressed and feel that therapy is not helping you. This is not an uncommon experience part way through therapy. If you feel you would like to stop therapy at any time, please talk this through with me first. This will give us both the opportunity to understand more fully what is distressing you, enabling us to find a way to resolve the distress that you may be feeling. With this in mind I ask that you give two clear sessions notice of ending therapy.