Terms

AGREEMENT and TERMS – please read carefully and sign below

LAST UPDATED October 14, 2019

The following Agreement and Terms are written with the intention of providing you with the best quality of support possible whilst maintaining clear professional boundaries, which serve the following purposes:

  • mutual respect and courtesy
  • clarity of purpose
  • agreement on fairness, privacy and dignity
  • ensuring that we can rely upon one another
  • avoidance of misunderstandings
  • help in building trust and security
  • help in making the best use of our time

This agreement may be updated at regular intervals and it is your responsibility to be familiar with the terms both before and throughout any work we undertake.  They can be accessed via my email signature or direct link at the above http address.  You are free to discuss them at any time.  I also welcome ideas and feedback on ways to improve the service I offer and will accommodate any improvements where I can.

 

Appointments

  • Please either email or leave a voice message rather than texting as I turn my phone off whilst working and in any case don’t often have time to text back and forth.
  • Assessment appointments are only confirmed after:
    • you have returned your assessment form
    • you have signed this Agreement
  • Please avoid cancelling or rescheduling sessions you have booked unless absolutely necessary.  Cancelling, and particularly, missing sessions is disruptive to both the therapy process and the preparation involved prior to each of your sessions.
  • Sessions are charged at the anticipated fee when*:
    • cancelled with less than 36hrs notice
    • missed without notice 
  • Missed and short-notice cancelled sessions are payable before your next session by bank transfer or deductable from pre-payments. Follow-up appointments are confirmed only when payment for the cancelled session is received.
  • If you do cancel a session please don’t assume that any subsequent session is booked until you actively arrange it with me.  When cancelling please indicate specific times/ dates you’re available for the alternative or subsequent appointment to avoid confusion and unnecessary emailing.
  • If I have to cancel your session with less than 36 hours notice you will be offered your session free of charge.

*Up to a maximum of the flat fee for individuals and £100 for groups, couples and families plus any home-visit fee

 

Fees, Payment and Refunds

  • Cash: payment for face-to-face sessions should be made in cash at each session or pre-paid in cash before sessions if part of an offer, discount or agreement.  I don’t accept cheques or cards. 
  • Bank Transfer: Those living inside the UK can pre-pay sessions by bank transfer only if they live too far away from my location to pay by cash.  Home visits must always be pre-paid by cash. 
  • Late fees not paid cash in full at the session are invoiced and carry an administration charge of 10% of the late fee.  No further sessions are offered until the late fee is paid in full.
  • Paypal is only acceptable for persons living outside the UK.  Online sessions and support minutes are pre-paid for use with Skype, telephone, chat or email support. 
  • My Reducing Fee Scale is designed to reduce costs for individuals and couples who attend regular weekly appointments and who have the greatest need, motivation and commitment to therapy.  As such session fees reduce the more help you need. 
    • If you have a break in therapy of four weeks or more, session fees reset to the starting fee. 
    • The standard flat fee applies to all other ad hoc or non-weekly sessions.
  • Refunds can be given on unused 60 or 90 minute time periods from prepaid 12+2 offers minus any free support time that is part of the offer
  • Supplementary email support is calculated on the amount of time taken to read and reply to your email.  This time is subtracted from your support minutes and a balance remaining included in each email reply.

 

Time Boundaries

Beginning and ending each session on time is important for a variety of reasons:

  • I have no waiting facilities, so arriving no more than a couple of minutes early is sensible in order to avoid waiting outside the front door.  I may not be able to answer the door earlier if I am with another patient or on the phone.
  • Both of us need to rely upon a set amount of time in order to pace the work and to prevent unnecessary stress or distraction.  Giving yourself plenty of time to get to your appointment prevents rushing and a stressful start to the session. If you are late for a session unfortunately extra time cannot usually be given as it impacts upon my other work.
  • Please raise any important issues or information at the start of a session where there is time for issues to be discussed, not at the end e.g.  significant events or facts, changes to your regular session time, session numbers or frequency, proposed ending of therapy etc.  This allows time to talk and plan without a rush.
  • Repeated issues with time keeping, cancellations or rescheduling can sometimes indicate that a patient is acting out unexpressed feelings, particularly if this is disrupting the therapy and causing tension.  It’s important that issues like this and any obstacles to the therapy process are addressed openly and resolved quickly.  However, if we are unable to resolve them in open discussion it is responsible professional practice to bring our work together to an end in order to avoid wasting time, energy and effort on both sides.

 

Ending Therapy

  • Naturally, the therapeutic relationship will come to an end. It’s important to prepare for this in advance so that we can bring the work to a planned, summarised close rather than an abrupt or unspoken end.
  • Please avoid abandoning therapy.  Abandoning without discussion any relationship that is founded on helping, caring and trust sends an ambiguous message of disrespect to the other person.  It tends to be driven by ideas or feelings that can be usefully discussed during a session with a view to bringing about a healthy, mutually respectful close to our relationship.  If you are tempted to ‘just stop going’ to therapy, please make an effort to speak about it, even if this is in your final session.  Your decision to end therapy will always be honoured and accepted with goodwill and no attempt made to convince you otherwise.
  • A planned ending allows me to read through all of my notes so that we can review and summarise the therapy in a way that can be useful in retaining and reinforcing what has been gained.  Please raise the issue of ending openly, in keeping with the spirit and intention of the therapy itself.  

 

Confidentiality Boundaries

Confidentiality is an important aspect of therapy. Anything discussed in therapy will remain confidential and I will ask your permission where I need to share details of your therapy (in very exceptional circumstances noted below) with anyone other than my clinical supervisor (a person I may consult if I need feedback on my work).  If I discuss work I am doing with you in supervision it will be done in a way that avoids revealing any information that could be used to identify you.

Matters that might not be kept fully confidential may exist where:

  • There is any imminent risk of someone being abused or put at risk of harm or serious neglect, including yourself or a child, for example.
  • If you have a history of self-harm or suicidal behaviour I would normally organise a support plan with you in order to allow me to contact a named person if I am concerned for your safety or the safety of others. However, whilst this is a responsible and advisable step to prepare, you yourself are ultimately responsibility for your own safety and therefore it is entirely your decision whether you wish to have support provision in place in such circumstances.
  • Confidentiality with couples and groups – see below.

Should you need further clarification on confidentiality please ask.

 

Other Boundaries

It is a natural part of any relationship to experience feelings towards the other person. Psychotherapy is no different.  You are encouraged to voice your feelings towards me – good or bad – within the psychotherapy relationship as a way of keeping the relationship honest and truthful.  However, there is no place for disrespectful or destructive behaviour in a therapeutic relationship as it relies on mutual respect, goodwill and honesty in order to be effective.  Expressing your genuine feelings responsibly (including anger, resentment and other difficult emotions) allows us to work through your experiences and helps you meet your needs in a mature manner.

In the interests of protecting both parties, psychotherapists adhere to ethical principles that strictly prohibit any form of personal relationship developing with their clients or patients beyond the professional relationship even where there is mutual caring and affection.  There are no exceptions.

If you live in the same area or neighbourhood then our paths may cross from time to time.  In order to protect our mutual privacy, usually I would politely acknowledge you e.g. a nod or smile, without engaging in conversation.  This is merely to preserve any anonymity you may wish to have regarding the work we do, as well as preserving professional boundaries.  Some patients would rather not be acknowledged at all in such circumstances, so please make me aware of any preference when we start working together.

Please ensure that any contact you make is via email or telephone (not text message unless in an emergency), or another agreed means, and not made by coming to my home unexpectedly.  This is no reflection on you, but is in order for me to maintain a healthy, sensible boundary between my work time and my private life.  Thank you for your understanding.

Please limit your contact outside of our sessions to appointment-related matters, unless we have arranged between-session email, telephone or skype support or if you need an urgent appointment.  Any other matters should be discussed at your next session.  The logic of this is, again, to allow me to maintain a clear boundary between my work time and personal time and allows us to maintain focus.

Home visit sessions may be subject to mutual audio recording where explicitly agreed, in order to ensure mutual security.  There should be adequate privacy and no interruptions during the session e.g. phones, doorbells, pets, children, unnecessary noise, people interrupting etc.  Seating should be comfortable, with back support e.g. armchairs, and surroundings clean and as free from clutter and distractions as possible.  Any audio recordings made are strictly private and confidential and should not be shared or published online or elsewhere by either party under any circumstances.

 

Electronic Communications & Privacy

Communicating electronically by telephone, email, skype or chat is never entirely secure.  It is important that you educate yourself on the degree of security you can expect from whatever electronic communication methods you elect to use whilst communicating with me.  Because I have no control over the security of electronic methods of communication, I cannot be held responsible for any information that is hacked or stolen during electronic communications, beyond any reasonable steps I already take to prevent this as an ordinary user.  Taking as many precautions as possible to protect your privacy is sensible when using electronic communications.

Your sessions will never be recorded in any way (e.g. audio*, stills or video on Skype etc) without your permission.  By signing these terms and conditions you are also agreeing not to record your sessions with me without my permission.  The only record I keep is in the form of my session notes, emails and assessment form, all of which are available for you to read during a planned session.  In this way mutual trust, privacy and respect are protected.

* with the exception of face-to-face sessions arranged at your own home, in which case we agree two-way audio recording for our mutual security

 

Groups, Couples, Families

Contact between group members outside of group meetings is often a natural development of group dynamics.  It is helpful to all participants if you observe the following:

  • My duty to each group member is the same and I avoid taking sides with any individual, other than to assist the individual in expressing his or her needs, communicating effectively, and reminding members of agreed boundaries.  Beyond this, responsibility for outcomes from any individual or group work lies entirely with the group members or individual.
  • It is imperative that no individual in the couple or the group is coerced or induced into taking part in therapy as this is counter-productive to a good outcome and runs counter to professional ethics
  • Group, individual and couples boundaries include: agreeing not to speak over another person in the session, including the therapist; agreeing to express anger or other difficult feelings responsibly; avoiding verbal abuse, coercion, dishonesty, threats or physical violence.
  • Individual sessions are possible as an adjunct when also engaging in group or family therapy. They offer an opportunity to work on individual difficulties, and time to formulate what one might wish to express in the group setting.
  • Alliances between some group members to the exclusion of others can often  adversely affect group dynamics in sessions whether consciously intended or not.  Care should be taken to avoid this.
  • Generally it is of greatest value to all if you can resist any form of collusion or negative discussion outside of the group and, instead, bring your honest feelings and thoughts to each session as a genuine contribution to the process.  This principle applies to couples and family members and is in the interests of avoiding a destructive secondary process developing outside the group that can undermine the purpose of therapy.
  • Being as honest as possible with each other and your therapist honours the goodwill in our work together and maintains trust and respect.  It also gives you the best opportunity to benefit from the therapy itself.
  • Confidentiality in groups is limited for practical reasons, as key individual issues will often emerge in the group at some point. Anything discussed in the group or individually is confidential between me and the individual and group concerned.  Normally I would ask individuals in individual sessions to tell me if they do not wish me to divulge specific details within the group.  For practical reasons it is best to keep your disclosure of such information to a minimum in individual sessions.  If in doubt please ask.

 

Other

  • The therapy space is a wifi-free zone for health reasons
  • Please ensure that any mobile devices are always powered off during your session
  • Toilet facilities are available to use at any time
  • Unfortunately there are no waiting facilities or disabled access
  • Please read my Brief Guide to Making the Most of Your Sessions

Should you need to clarify any of the above terms and conditions please don’t hesistate to discuss them with me.

Please sign below to say that you have carefully read and agree to abide by the above Agreement and Terms as part of our work together: