Terms

AGREEMENT and TERMS – please read carefully and sign below

LAST UPDATED October 31, 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 and personal boundaries.  Boundaries serve the following purposes in a therapeutic relationship:

  • being clear and transparent about what is acceptable and unacceptable
  • mutual respect, fairness, privacy, dignity and courtesy
  • clarity of purpose
  • maintaining low stress, avoidance of misunderstandings and wasted time
  • building trust, reliability and security

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.  Where an individual has difficulty respecting these boundaries, therapy can become stressful, problematic or untenable.

 

Appointments

  • Please either email or leave a voice message rather than texting as I turn my phone off whilst working and 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 
  • If I have to cancel your session with less than 36 hours notice you will be offered your session free of charge*
  • Missed and short-notice cancelled sessions are payable on the day of the missed appointment by bank transfer or deductable from pre-payments. Follow-up appointments are confirmed only when payment for the cancelled or previous 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 make best use of time.

*Up to a maximum of the flat fee for individuals and £100 for groups, couples and families

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 appointments.
  • 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 at the end.

 

Fees, Payment and Refunds

  • Cash: for simplicity 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.
  • Late fees not paid by cash in full at the session carry an administration charge of 10% of the late fee.  They should be paid on the day of the appointment to which the fee refers.  No further sessions are offered or confirmed until the late fee is paid in full.
  • Skype and other Online Support is prepaid before an appointment is offered.  This is purely to keep administration time to a minimum and full refunds can be given with more than 36 hours notice prior to the appointment time.
  • Prepayments and Online Payments: should be made as early as possible and can be made using this linkAs a courtesy please inform me via the web form on the online payment page as soon as an online payment is sent.
    • Bank Transfer: Those who have a UK bank account can pre-pay sessions by bank transfer only when they live too far away from my location to pay by cash.  Home visits and Skype sessions are always pre-paid.
    • Paypal is only acceptable for persons living outside the UK who don’t have a UK bank account.  Online sessions and support minutes are pre-paid for use with Skype, telephone, chat or email support.
    • Appointments are not confirmed until prepayment is received
  • My Reducing Fee Scale is designed to reduce costs for individuals, families 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 three weeks or more, session fees reset to the starting fee on the reducing fee scale or the standard flat fee.
    • The standard flat fee applies to all ad hoc or non-weekly sessions.
    • An additional reducing fee scale applies when more than one session is attended per week
  • 12+2 Offers:
    • Apply only to regular 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, and
      • 10% administration fee on the refunded amount
  • Supplementary email support is calculated on the amount of time taken to read and reply to your emails.  This time is subtracted from your support minutes and a balance remaining included in each email reply.

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 unexpected oneA 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 for you in retaining and reinforcing what has been gained.  An unplanned ending means that you lose the opportunity to review, summarise and consolidate the work in this way.
  • Abandoning e.g. ending the therapeutic relationship by text, email, cancelling or missing the last session, or terminating any relationship that is founded on helping, caring and trust is unneccessarily destructive.  As abandonment sends a message of disrespect to me as a person, I don’t re-engage with a patient when they elect to abandon the therapeutic relationship.  [On this and other crucial issues, please take time to read my Guide to Making the Most of Your Sessions]
  • Persistent undermining behaviours that we are unable to resolve in discussion can make therapy untenable.  These can take the form of passive-aggression, repeated problems with fee payments and cancellations, poor time-keeping, repeated lies or deception, and other persistent behaviours, however subtle, that make the work or relationship unnecessarily stressful or difficult. If we are unable to resolve such matters in honest, open discussion then the therapeutic value of the relationship is compromised.  In this case it is responsible practice to bring our work together to an end in order to avoid wasting time and effort on both sides.
  • Conflicts of interest.  Where patients are working as a couple, group or family I may need to end the work if I become aware of deception, lies or other behaviours that put another patient in my care at risk of harm, or where my silence about a matter could force me to collude to the detriment of a third party.

 

Confidentiality Boundaries

Confidentiality is an important aspect of therapy. Anything discussed in therapy remains confidential and I will ask your permission where I need to share details of your therapy 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. 
  • All records pertaining to our work together are kept securely for a minimum of 7 years following our last contact, and sometimes indefinitely.

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.
  • 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 all of 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 destructive behaviour in therapy as the relationship relies on mutual respect, goodwill and honesty in order to be effective.  Expressing your genuine feelings responsibly (including anger, resentment, envy and other difficult emotions you may feel towards the therapist) 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 may be mutual caring, attraction or 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), 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 (Supplementary Support).  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 within the sessions.

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 in any way 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, couples or group work lies entirely with the individual.
  • It is imperative that no individual in the couple or the group is coerced, pressured or induced into taking part in therapy as this is counter-productive to a good outcome and is in breach of my ethics.  Evidence of coercion or inducement of a group member will result in the therapy being terminated.
  • 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 to avoid unintentional disclosures.  (See Conflicts of Interest above).  If in doubt please ask.

 

Other

  • The therapy space is a wifi-free and mobile-free zone for health reasons

  • Toilet facilities are available to use at any time
  • I ask visitors to remove shoes.  As I have hard floors that can be cold for some people, you’re welcome to bring socks or slippers for your own comfort
  • Unfortunately there are no waiting facilities or disabled access
  • Please take time to read my Guide to Keeping a Therapy Journal and Guide to Making the Most of Your Sessions
  • Supportive materials are available to patients engaged in weekly therapy.  Guided affirmation recordings are also available free to patients who have completed assessment.  See the Affirmation page to request a copy.

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: