Counselling is a space for clients (see the definition of a client, below) to express themselves either by talking or writing, to be heard and feel understood with the goal of changing the way they feel, behave, see or think about things or themselves. This involves a willingness from the client to be reflective, share their thoughts, feelings and fears with the Therapist. In order to do this safely both Therapist and Client enter into a psychological contract. This aims to provide a clear understanding of the limits of confidentiality and boundaries for both parties to work safely within.
This agreement is made between your
Counsellor .......................................................... & Client.................................................................
Date.......................................
Who agree to work together under the practice of counselling and understand the limits of confidentiality where there is a risk of harm to self or others. The client has been provided with the Privacy and GPDR statement and understands the data and purposes of data being held. The client was directed to the terms and conditions on the website prior to the initial meeting and has been provided with a summary of the contract at the beginning of the first counselling session. Engaging with the sessions thereafter is implied agreement to the contract.
An assessment is not the same as counselling work and as such is not covered by this agreement in the same way. You only become a client, covered by the ethics once an assessment has been completed and we have agreed a suitable treatment plan and you have been offered counselling and you have paid counselling which has commenced. The privilege of confidentiality is awarded when an assessment has been undertaken and paid for.
Our work is bound by the ethics and principals laid down by my membership and registration of the British Association of Counselling & Psychotherapy (BACP) and the NCS.
Your privacy is really important to me. Your contact details will only ever be used for appointments and sending agreed resources. Arriving no more than a few minutes before your appointment will reduce the likelihood of clients crossing paths on my drive or you meeting anyone other than your Counsellor. To protect your therapeutic journey and privacy, social media connections are appropriately limited.
The work that we do together is private and confidential;
This means that you can not share the content of our therapeutic work in the public domain in any format, not screenshots, not pictures, not emails, not material from sessions, or any other angle of our work in any way without written permission, this is because most of it is covered by copyright laws.
It goes without saying that insights you have as a result of being in therapy are yours to share verbally with family and friends as part of your self development.
With confidentiality there are some limits to the degree of confidentiality that counselling can offer any client. These are explained as follows:
Insights that I have as a result of working with clients are mine to use for the benefit of the wider mental health community, this is how we improve our treatment and develop as practitioners, this may mean that something I say to you to help you understand a situation better (such as an anology), may appear in a pubic domain, it will not be identifiable to your story.
All BACP & NCS registered Counsellors have regular Supervision. What this means to you is that I seek regular consultation with a supervising counselling therapist qualified in this process. The consultation is for my practice (rather than seeking instruction on working with you) This is to ensure your best interests are always at the heart of our work together.
Brief notes are kept about the material shared in session and comply with the new general data protection law. Counselling notes could be requested for submission by a court of law.
Counselling is not above the law. In the UK, specific laws tend to lend themselves to adult counselling. They are: Equality Act 2010 Data Protection Act 2018 Human Rights Act 1998 Terrorism Act 2000 Money Laundering and Terrorist Financing (Amendment) (EU Exit) Regulations 2020.
If you are concerned about any aspect of our work and contact my ethical body I reserve the right to share correspondence, and clinical notes to clarify the situation.
Often by the time clients come to see me the brain has already worked out that by thinking dangerous thoughts there is a release of chemicals which make the client feel better.
Often when clients come to see me they are embarrassed to share they are having thoughts about suicide.
My approach is to explain the chemical reactions which take place when we have dangerous thoughts. Often when clients understand this it makes perfect sense and also removes the shame often associated with thoughts of self-harm and suicide.
However it is important to point out I have a duty if there is a risk of serious harm to you or others to manage and reduce that risk. Often suicide or violence is disclosed in sessions which presents a conflict between keeping our work private and making a disclosure which will reduce the risk of harm. Decisions to work through the risk, are not taken lightly.
The ethical approach is to discuss any conflict in advance or as soon as possible after the conflict becomes apparent. By speaking further it can help to clarify what was said and therefore the risk that was heard. It also may present you with choices as to what support you would prefer. Clients are usually relieved to discover self harm and suicidal thoughts are the bodies way of creating soothing through the cortisol released after dangerous behaviour.
If I receive a message indicating a plausible risk of harm I advise the police and request a well-being check based on the limited information I hold.
Often clients who find it hard to be present with historical, present or future fears, medicate to escape. Sometimes they use legal substances, sometimes prescribed, sometimes other substances, or behaviours.
Your counsellor can't stop you from self medicating but they may advise you if there is a risk so you have informed choice.
Sessions are usually 50 minutes long, (EMDR may require a slightly longer session) and includes 10 minutes grace for housekeeping.
Sessions are scheduled weekly or fortnightly at a regular time.
Once a time is agreed it is your time regardless of whether you choose to attend.
Cancellation of our time requires at least 48 hours notice to be non chargeable. The cancellation policy can be applied to any single missed session up to a maximum of 2 missed sessions.
Cases of planned long term absence& missed sessions should be discussed in session.
Payment prior to forth coming booked sessions secures that session.
When attending an appointment you are required not to be under the influence of illegal drugs or alcohol.
A condition of counselling is that you conduct yourself in an appropriate manner, which does not do not cause your therapists well fare & business or household; direct concern, distress, harm, violence or threat before, during, between or after sessions.
Regular attendance is best and I will make every attempt to ensure this continuity is maintained for you with the exception of circumstances outside of our control which may dictate a review of this promise.
Whilst I always appreciate clients recommending friends I would never acknowledge to either party, contact, attendance or any material disclosed, once the person has become a client.
In the case of an emergency which impacts our arrangements, a trusted colleague
would take my diary & phone contacts (no client notes) and make contact if I was ever unable to.
Gilly works:
8.30am to 3pm,
Monday to Thursday
delivering face to face sessions.
It is highly likely that when you enquire I will be either in session with a client or not in the office.
I will reply when I can give message the time and attention it requires.
This means there may be gaps between messages. I don't take unplanned calls from anyone.
What to expect:
If you would like me to book you an initial assessment session I will need to know the days and times which best suit you.
Once an assessment time has been agreed we will reply to you and I will tell of our intention to set this time aside for you, we will refer to this as a confirmation text. This means your time is written in our diary. You time is secured when you make payment for your assessment.
We set aside an hour for an assessment, during this time it is important for you to stay away from narratives about your past which may be retraumatising, but instead you will be prompted through your current symptoms. This will give us sufficient information to help us allocate the right counsellor for you.
Once a time has been agreed we will reply to you and tell of our intention to set this time aside for you, we will refer to this as a confirmation text. This means your counselling time is written in our diary. You time is secured when you make payment for your session.
This message will also ask you to read the above contact. Proceeding is implied agreement to the terms and conditions of the contract. Depending on the government guidelines it may not be appropriate to sign paper copies, however when it is deemed safe to do so this will be done.
What happens if:
If you choose to call me, it is likely I will be with other people and I will excuse myself before talking to you about anything sensitive.
If you choose to message me, it is likely I will be doing life and I will set aside time to give your message the time and attention it deserves.
I do not carry my work phone around with me because your privacy is important to me and I would not wish to lose my phone.
So if I have not confirmed a time with you before I leave the office at 2.30pm it is likely the message will be picked up the following day. If you need a reply urgently, you are welcome to let me know and that will help me prioritise but is not a guarantee.
On occasion clients may require a virtual session either on the phone or video.
Occasionally life gets in the way of a planned call.
If you call and I can not get to the phone I will call you straight back.
Occasionally someone will call at the exact same time as a planned call and I will give my apologies and excuse myself to prioritise you. Occasionally someone will knock at the door just before you are due to call and I will give my apologise and excuse myself to prioritise you. This is similar to Face to Face work and why I allow 10mins grace when I book our time together.
Sometimes life just gets in the way and there is no avoiding it.
If this happens, just like it does for you in life I will not be available and I will contact you at the earliest opportunity to rearrange.
This rarely happens but therapists are not immune to life's unexpected interruptions and I really appreciate your patience and understanding if this happens to any of our therapists. It will be as upsetting for me as it will be for you, if I ever miss planned time with you.
Sometimes what we plan to happen and what actually happens is slightly different. This can be triggering. This is all part of the work. Life is triggering. Unfortunately I can not protect you from all the triggers therapy can bring. Booking therapy is triggering. Being in therapy can be triggering.
Therapy helps you deal with the triggers differently. Over time these triggers can become less overwhelming.
I can't promise I won't trigger you unfortunately, I am human just like everyone else. I can promise that once you have started therapy and within the safety of contained sessions I am trained to help you understand the triggers better. Unfortunately it can be very difficult to work with each other when trust becomes undermined before sessions commence. I am not equipped to work with your triggers before you become a client. A client is someone who pays for and attends sessions. When you become a client we become bound by the ethics which support the work. If the trust breaks down before this time the intension to work together is automatically void and there is no way to unravel that safely, unfortunately. If this happens you will be advised that I will not be able to take you on as a client and may make recommendations to support you moving forward.
I am unable to offer unplanned out of hours services. Although it is generally possible to arrange additional sessions if needed or
possible to book a half hour telephone session or email exchange at £30.
As with face to face work it is important to understand what is needed and how best to achieve this.
A 24 hour response time can be expected. (technology permitting)
In an emergency, for a listening ear you can contact the Samaritans on:
Text: 07725 90 90 90
Call: 08457 90 90 90
In case of a medical emergency please contact your local doctor's surgery or hospital for medical help or advice as I am not medically trained and your safety is my top priority.
In the case of suicidal tendencies a focus is put on stabilisation to calm the dis-regulated nervous system. I may also encourage the involvement of the crisis team accessed via the GP.
If clients falls into a crisis - counselling will be paused as it is not possible to do the work of counselling at the same time as navigating a mental health crisis. Unfortunately I am not a crisis manager.
Sometimes I recommend you to see other professionals I work alongside to help the work & sometimes I recommend other types of therapy for the work. Staggering the work with new professional is the best way to do this. If you start new work with me and then jump into working with someone new at the same time before we have established a mutual understanding of the risks to your self regulations, our work will be terminated immediately, as I will be unable to gauge who's work is doing what to you. The same applies for if you start work with me just after starting another form of therapy.
Some clients are aware of what is going on and want to make changes. This is not the case for everyone.
Others might just feel the increased pressure building, this can happen with any kind of unrest or trauma (small or large). This can lead to feeling almost helpless, with emotions overflowing; maybe outbursts of frustration or anger, maybe flooding of overwhelm becoming stronger and more frequent so much so that they cause an anxiety.
Whilst at the other end of the spectrum others are forced into therapy when one day things go too far and intervention is the only option left.
There is no right or wrong time to start therapy. But there may become a point when the risk of an outburst or overwhelm might threaten the status quo, our job, our sense of sanity or the relationships we care about and love, so much, that we make the step into therapy.
Where ever you wish to start, your therapist will start where you want to start and travel as far as you wish to go, on this journey, providing what you present is within their scope of their training. This can usually be established by looking through the website or asking the question upon enquiry.
I think of the therapeutic journey as similar to a road trip. Even without travel anxiety, if it is a long trip, you might pack a drink and a few essentials, a coat, spade if it is snowing, a snack.
In counselling the therapist will make sure we have the essentials to keep you safe enough for the journey, especially watching out for any PTSD triggers.
We then set the sat nav - your destination or goal and press go. As you may have found with most electronic routing apps, you can come off at the wrong junction, take a back road or the main road, it won't matter. Google maps will keep you on track for the end goal. Therapy is like that too. Your therapist is trained to pick up the themes of your work regardless of if you choose to bring past, present or future topics.
One thing I would like to reassure you is that I will not ask you to talk about any past trauma in detail, especially in the first session. Healing does not need to involve retraumatising you. In fact any good therapist will know that it is not necessary to go into details about your traumatic events unless you are actually choosing to process that material. It is ok & sometimes helpful to give your therapist bullet point headings about your past. But this does not mean you need to spend lots of time on upsetting subjects.
But when we change the relationship we have with our past we automatically change the present experience.
Clients present with all sorts of symptoms for example PTSD, depression, irritability, loss of interest, numbing, decreased concentration, insomnia, emotional overwhelm, hopelessness, shame and worthlessness, loss of memories, mistrust, stress, anxiety, panic attacks, inability to tolerate uncertainty, low self confidence, substance abuse, disordered eating, self destructive behaviours or indecision. For the client stuck in the midst of symptoms it can often feel difficult to work out where these symptoms have come from.
Firstly, it is the job of your therapist to listen to what is going on for you currently. Your therapist will try to imagine what it is like to wear your shoes just now.
From there you both will work out what the goal of therapy might be.
Everything else is the job of your therapist. So if there is a big 'T' or small 't' trauma lurking in the background which requires a bit of help to settle, your therapist will help you identify it and help you work with it so it doesn't feel so distressing.
If at any point a referral seems more appropriate your counsellor will advise you of the ethical requirement to refer on to a more appropriate service.
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