Therapy Agreement 
 

                                                                                CBT Therapy Agreement

This therapy agreement explains the key principles and arrangements under which I can offer you British Association for Behavioural & Cognitive Psychotherapies (BABCP) Accredited, Cognitive Behavioural Therapy (CBT).  Europe Accredited EMDR (Eye Movement Desensitisation Reprocessing).

Please discuss any of its contents or ask any questions that you have regarding the therapy process.  

As this agreement may need to change from time to time, I will contact you if there are significant changes that affect you to ensure that you are aware of them.
 

Aim of CBT

Cognitive Behavioural Therapy is an effective, evidence -based talking therapy.  It is structured, brief and present focused. 

We will explore your current problems together and agree on a treatment plan.  You will learn new therapeutic techniques to improve your psychological health and well-being.   We will establish your specific therapeutic goals and determine what you would like to change as an outcome of engaging in therapy.

We work together on your problems.  I will help and guide you, but for therapy to be effective, you must take an active role.  It is important that you complete between session tasks and practice your skills in your everyday life to address your problems, both now and in the future once therapy has finished.  My aim is to teach you to become your own therapist.

EMDR therapy may be offered to process and desensitise to past events. I use EMDR in combination with CBT techniques for PTSD/trauma, phobias, OCD, health anxiety, low self-esteem and social anxiety. I am an EMDR Europe Accredited practitioner.
 

Sessions and Payment

Each session will last for 50 minutes.  A commitment to prioritise and attend sessions is required.  Arriving to sessions on time is important.  If you arrive late the session cannot run over due to my commitment to other clients. 

Each private 50-minute session, including assessment, costs £95.  Alternate charges apply to company referrals due to the additional administration required.  Payment is required on the day, by cash or card payment, and this confirms the next appointment booking.  I can accept VISA, MasterCard, Maestro, American Express and Apple Pay.  Receipts are issued with each payment. 

If you need to cancel, please give 24 hours’ notice or the full session will be charged.  If you do not attend without cancelling or are late for your session you will be charged for the full session. 

 

Therapy often lasts for 6-12 sessions.  Your progress will be reviewed regularly.  You are under no obligation to continue sessions.  At the 6th session we will review your treatment and progress, and establish if further sessions are required, and if so, how many more we will need.  If at any time I feel another service would be more appropriate, I will refer you on to ensure your needs are met.

In the event that I need to cancel an appointment I will contact you with as much notice as possible and reschedule.

Our relationship must remain a professional one.  If we meet in a public place, I will only acknowledge you if you acknowledge me or if you have advised in advance that you wish me to do so.  I cannot add clients as friends on any social media.
 

Confidentiality

I must collect and hold information of a personal nature about you. I am committed to ensuring that I do this in a way that protects your privacy.
 

The Law

As a private CBT Psychotherapist, and a member of the BABCP (British Association for Cognitive and Behavioural Psychotherapists), in accordance with the GDPR (2018) and the Data Protection Act (1998), information must be collected and used fairly, stored safely and not disclosed unlawfully. Information must be obtained for specific lawful purposes only. It must be adequate, relevant and not excessive. It must be accurate and kept up to date. It should not be held for longer than is necessary. It should be processed according to an individual’s rights under law and be protected in appropriate ways. Information should not be transferred outside the European Economic Area (EEA) unless with an adequate level of protection.
 

How information is used

The information you share during therapy is confidential. Information will not be routinely shared with anyone connected to you, and I will not inform anyone that you are seeing me except for the referring organisation (if applicable).

The information I document will be shared openly with you throughout therapy. You can request to see the information at any time, and I will go through it with you.

Information may be shared with other organisations if I decide that not sharing that information may place you, or anybody else, at risk of harm. For example, if you advise me that you are a risk to yourself or others, you disclose a child or adult safeguarding concern, or a serious crime. Information may also be shared if it is demanded by a court of law.

Anonymised information will be shared routinely when discussing my caseload in Clinical Supervision. No patient-identifiable information will ever be shared as part of this process.

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How information will be obtained

Information will be sought and obtained through you and (if applicable) the organisation that referred you to me. I will not actively attempt to gain information by any other means unless that information is needed to protect you or anybody else from harm.

Information may be obtained through audio recordings, but only with your explicit consent that this may happen. I will always discuss this with you before using a recording device and obtain your consent as part of the recording process. Audio recordings will be held with the same security as detailed for written records and are subject to the same rules and restrictions.
 

How information will be stored

Information will be stored securely at the address of my private practice. Paper records will be kept in a locked filing cabinet in a locked room. These records will be backed up on a double-encrypted memory system in case of fire damage to the property.
 

Why is it necessary to keep information about you?

It is required by law that information obtained in a healthcare setting is kept and stored for a period of time even after you leave that setting, so that evidence exists about what happened while you were under my care.

To be able to contact you throughout therapy to arrange appointments, reschedule appointments and seek updates on progress.
 

How long will information be kept?

I will keep all information and records for 7 years from the date that the last record was made, or if under 18 years, 7 years after your 18th birthday.

You have the right to request to view your records, to request amendments to information you deem inaccurate, and to request that your information be erased.
 

Complaints

If you wish to complain about the way your privacy or data has been handled, then you can do so by emailing me, or by contacting the Information Commissioner’s Office (ICO) directly at http://ico.org.uk or telephoning them on 0303 123 1111

Risk Management

I do not offer emergency assistance.  If you are concerned about an immediate risk of harm - either to yourself or someone else - phone 999. If it is not an emergency but you require urgent advice, call 101. Visit your local Accident & Emergency department if necessary.

I will request details of your GP and next of kin. I will only contact if I am concerned about your wellbeing.

I will seek consent to contact you by phone, email or letter. This will include consent to email information, updates or news.

 

 

Please initial the box below if you are happy for me to contact you in the following ways:

 

 

Yes

No

Phone

 

 

Email relevant updates and information,

 

 

Letter

 

 

 

Acknowledgement and Consent

I have read, understood, and I agree with the above statements, and the terms of the privacy policy.  I consent to the therapy.  I have had the opportunity to ask questions and received satisfactory answers to any questions raised.

Client signature

 

Therapist signature

 

Print name

 

Print name

 

Date

 

Date