Client Registration Form
This contract outlines the agreement we have made about our counselling work. I have the required training and insurance to provide counselling in the UK. I am unable to work with clients outside of the UK.
Your identity, attendance and content of sessions are held confidentially within Larissa Hathway Counselling and will not normally be shared with anyone else without your permission.
We will normally only communicate with doctors, or others with your agreement. If you request that a letter be written to someone outside the Service (eg: to support accessing different types of support; where your counselling is being funded by a third party who requires a report to continue funding etc), you will be asked to sign a consent to disclosure, and the contents of the letter will be agreed between you and your counsellor, wherever possible, before it is sent. A copy of the letter, together with the signed consent to disclosure, will be kept with your records held by Larissa Hathway Counselling.
The only other reasons for breaking confidentiality are when: Your counsellor considers you to be at immediate or serious risk of suicide, or to have lost the ability to take care of yourself; Your counsellor considers there to be a clear possibility of serious harm to others; Your counsellor is required by law to give evidence in court or produce case notes.
Even in these situations, attempts would normally be made to inform, or to discuss disclosure with you, and any disclosure would be the minimum required in the circumstances. Please complete emergency contact details at the end of this document.
We do not release notes for use outside the Service, or provide evidence in legal proceedings, even with your consent. But we would confirm the dates and number of counselling sessions attended if requested to do so by you to an outside agency.
It is standard practice for counsellors to have a supervisor with whom they discuss their work with clients. This is done in a way which does not allow you to be identified and supervisors are also bound to similar levels of confidentiality. In the event of the death or serious illness of your counsellor, this counselling supervisor will be granted access (by means of your counsellor’s clinical will) to records to allow them to notify you of the situation and to help you to make arrangements for ongoing support.
Sessions must not be recorded by clients or counsellors.
Brief, confidential notes on the contents of sessions are written by your counsellor. Larissa Hathway Counselling is the data controller, all records are kept securely in accordance with the guidance provided.
Records will be retained in the Service for 6 years after completion of counselling after which they will be confidentially destroyed.
3. Behavioural agreement
Your counsellor agrees to communicate with you respectfully and professionally at all times through your counselling with Larissa Hathway Counselling and any contact you have with us outside of appointments.
It is important that clients are able to express themselves in appointments but if communication becomes abusive towards the counsellor, they will discuss this with you and counselling may be terminated. Physical or verbal abuse towards the counsellor will not be tolerated. If this is the case your counsellor will provide you with information about accessing more appropriate sources of support and will support you in doing this if appropriate.
Although Larissa Hathway Counselling supports clients who have issues with addiction, we are unable to support clients who attend appointments in an intoxicated state. If clients attend appointments and are intoxicated the session will be terminated by the counsellor and rebooked and the cost of the session will still be payable. If necessary, you will be offered information and support to access more appropriate services, where appropriate.
If you are not happy with any aspect of the Counselling Service, try to speak first to your counsellor. If this does not resolve the issue you are able to pursue your concerns via the BACP. More details can be found via this link: https://www.bacp.co.uk/about-us/protecting-the-public/professional-conduct/how-to-complain-about-a-bacp-member/.
Your counsellor is a Senior Accredited registered member of the British Association for Counselling and Psychotherapy and adheres to its Ethical Framework for the Counselling Professions – a copy of which can be accessed via this link: https://www.bacp.co.uk/about-us/protecting-the-public/professional-conduct/how-to-complain-about-a-bacp-member/.
In your initial counselling appointment, your counsellor will ‘contract’ (discuss and agree) with you the number of sessions approximately that you agree it would be helpful to work towards. You may decide that you would prefer to agree to an open-ended agreement. In this case, your counsellor will ensure that you have regular reviews throughout your work together to ensure that the work is meeting your needs.
You have agreed to access sessions in-person or online via the Zoom Platform following discussion and the provision of details about online counselling contained in the ‘Counselling outline and agreement’.
Details of dates where sessions will not take place will be provided as far in advance as possible to minimise disruption to you and your counselling.
5. Session disruption (online)
If your session is disrupted for technical reasons every attempt will be made to complete the session by other means. If this is not possible you will be either refunded part of or the full amount of the cost of the session. If the technical issue is at your end and is a repeated issue we will discuss whether we need to review the feasibility of continuing online counselling.
It is important that you have a private space for your online counselling sessions. If, during a session, it becomes clear this is not the case we will agree whether we need to reschedule for another time. Where this is the case payment for a full session may still be payable.
We have agreed that I will contact you on the contact number you’ve supplied in case of issues.
Appointments will be scheduled at the end of each session. Appointments are confirmed upon receipt of the agreed payment at least 48 hours prior to the agreed appointment.
Payments should be made by card at the end of the preceding appointment using an iZettle machine or by bank transfer to:
Miss Larissa C Hathway
Sort code: 60-04-05
Account number: 77150473
If you are accessing online appointments, your Zoom meeting link will be sent to you first thing on the day of your appointment.
You agree to arrive at our sessions, either in-person or online, in a timely and prompt manner. Any delays in starting the session may result in a reduction in the length of your booking.
You will have been recommended a minimum number of sessions that you agree to attend; if this needs to be extended, it can, be at the discretion of the counsellor.
If payment is not received in the timescale outlined above the session will be cancelled and your counsellor will contact you to follow up and confirm whether you would like to re-book for another time.
If you need to cancel your appointment you should contact your counsellor at firstname.lastname@example.org Cancellations made more than 48 hours in advance can transfer payment to the next booked session. Cancellations made less than 48 hours in advance will be charged in full.
If your counsellor has to unavoidably cancel an appointment, another will be offered as soon as possible.
8. Ending sessions early
If you opt to end your appointment early full payment for the session will still be payable.
9. Termination of contract
Either party may terminate this contract at any time. We would request that clients inform us, if possible of their wish to terminate counselling. If your counsellor has to terminate the contract early for any reason they will give you as much notice of this as possible and will support you to access alternative support, if appropriate.
If you feel the need for further counselling after you have ended counselling you are welcome to contact Larissa Hathway Counselling again.
We will ask for informal feedback on how you are experiencing your counselling at regular intervals, especially where there is an open-ended agreement. We may request more formal feedback from you at the end of your counselling contract. If this is the case, although we appreciate your input, there is no requirement for you to respond to this request. If you would rather not receive this request please make this clear to your counsellor when terminating your contract.
If you have any questions about the details of this contract, Please contact me to discuss before returning.
SIGNED: Larissa Hathway