COUNSELLING AGREEMENT
NATURE OF THE COUNSELLING RELATIONSHIP
Counselling is a process in which the client wishes to achieve personal growth in their life and overcome challenges and obstacles that they may be encountering. The counsellor is there to be an attentive listener, to show empathy and understanding to the client, to show them the utmost respect and offer unconditional positive regard. They will act as guide in enabling the client to overcome their obstacles and challenges for themselves and where appropriate provide structure and method to the process of analysing the challenge and aiding the client in developing strategies and ways of thinking to accomplish this change. It is the client who achieves change, the counsellor can not ever do this for the client.
It is also important to remember that in overcoming issues in your life, it may be that you can feel worse before you feel better and this is a common experience.
CONFIDENTIALITY
It is essential that confidentiality be maintained and trust established between counsellor and client. Our work together will remain completely confidential, and what is discussed in session will not be discussed outside of that session. The only exception to this rule is where a coun- sellor may discuss issues arising from sessions with their own mentor or supervisor, although when this happens anonymity is maintained.
RECORD KEEPING AND DATA PROTECTION
The counsellor may take notes in sessions in order to better understand the client and aid in preparation for subsequent sessions. These notes will never be passed on to a third party. Any notes will be retained for the period of counselling, and then a period of __ years, in case the client wishes to return to counselling at a later date.
Within our strict code of confidentiality, the counsellor will need to keep your name, contact details, and attendance data on record in my office. The counsellor keeps a record of all appointments offered, attended, and cancelled, and of the payments made. I do this so that we can run an efficient appointments system and make sure that the premises are safe for every- one.
Subject to local regulation, you have a right to see all of your notes and records. If you would like to see the information that the counsellor may have about you, please ask at any point throughout the counselling process.
In accepting the offer of counselling you agree to these records been kept.
COUNSELLING FRAMEWORK / PROCEDURE
We will work on a: (delete as appropriate)
Session to session basis
Commit to ___ number of sessions over a period of ___ weeks ‘a block’
Enter the details of the agreed process by which sessions will be arranged (eg by email/ phone call etc) and the location for sessions: ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
Each session will be ___ minutes long.
Agreed fees:
Price per session ___ Price per block ___
The fees are payable in advance for a block, and at the completion of individual sessions, or by other arrangement detailed below:
CHANGES
Session to session arrangements can be cancelled at any time with at least ___ hours notice prior to an arranged session. Where a block has been paid for, cancellation is not possible as it would defeat the purpose of committing to a block. However, changes in session times should be made ___ hours before the agreed time and in accordance with agreed procedure. A break in a block may be arranged by mutual consent.
PROBLEMS
If at any time you experience problems with the counselling process, it is best to bring it up with the counsellor and attempt to overcome any obstacles that have arisen. The counsellor and client undertake in good faith to resolve any problems to the best of their ability and to the satisfaction of both parties. The counselling can be brought to an end if necessary.
There may be some exceptional circumstances in which the counsellor will need to terminate your work together, if any conflict of interest occurs, or any ethical boundaries are breached or it is clear that the relationship can not be productive. (If this were to occur in a block of sessions, a refund for sessions missed would be payable if paid for in advance).
THE UNDERTAKING OF THE COUNSELLOR
I undertake to act to the best of my ability as your counsellor and to work with you to help you overcome your personal challenges and obstacles. I undertake to offer you my full and undivided attention during our sessions together, to offer no judgement, only observation. I will never tell you what to do, as you will always decide for yourself, I will only seek to help you explore the possibilities available to you. I promise to adhere to the values and principles of the Achology manifesto, and to do my very best to ensure you have a productive and transformative experience in alignment with your own values, goals and stated desires. I will be totally committed to your desire for change and healing and celebrate your every success.
Where issues of mental health or physical health run beyond the scope of my ability to help, I will always advise you visit a relevant professional.
I look forward to a healing and fulfilling counselling journey with you.
THE UNDERTAKING OF THE CLIENT
I am motivated and committed to the counselling process. I understand that in order to achieve results, my full participation and commitment will be required.
I accept full responsibility for myself and any actions I take during the counselling process. I know that I must take responsibility for my life in order to empower myself to achieve the change and healing I wish to make and that no one else can do this for me.
I can afford the counselling fee at this time. I agree to honour my scheduled session times, and I can afford the fees for counselling at this time. If my circumstances change I will tell my counsellor as soon as possible.
I have read and agree with the counselling Agreement.
Name:
Signature:
Date: