Contract agreement for
Please take some time to carefully read through the contents of this contract for in-person counselling. 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 counselling between:
Peter Golder (Counsellor) on behalf of Acorn Counselling Therapy and the (Client) that signs and completes details on this document.
Confidentiality is a means of providing you with safety, privacy and autonomy. The contract of your counselling sessions is confidential. 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. 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.
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.
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 or at the session by chip and pin. Please note that your name may appear on Acorn Counselling Therapy bank statements. The statements will be seen by myself, Counsellor and Giancarlo Squillaci, business manager of Acorn Counselling Therapy.
The bank details to make the payments by bank transfer are;
Account in the name of - Acorn Counselling Therapy
Sort code. 40-25-03 Account no. 01695428
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 counselling
Certification of counsellor
I am a qualified counsellor and registered member with the National Counselling Society (NCS) 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).
If you have a complaint about my work or the counselling 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; NCS and UKATA.
Termination of Counselling
There may be times during counselling that you feel distressed and feel that counselling is not helping you. This is not an uncommon experience part way through counselling. If you feel you would like to stop counselling 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.