I Consent to Counselling...
Welcome to Counselling! Congratulations! Making it through our door is not an easy step for many persons. Engaging in counselling takes a lot of courage and provides you with the opportunity to discover much about yourself. For many individuals, this will be your first experience with counselling, and we believe it is important to be clear and transparent about what counselling is, and what Guidance and Counselling looks like at The Mico University College.
Please read through all the content below carefully and I will discuss any questions that you have. Once we do that – and the counsellor has it on record that you read and had the opportunity to discuss the information, you may sign and submit the form.
Counselling is different than talking to a friend or family member. Our conversations have specific goals, and although your counsellor will be supportive, they also will challenge you. Sometimes you might feel annoyed, tired, or upset following a session. This can happen as you are processing new ways of thinking or because you have spoken about something that has been upsetting to you. As a result of counselling, you may experience changes in your relationships or beliefs that have unexpected results. Usually, these changes are positive in the long – term, but it may be difficult to experience as they are occurring. Your counsellor may suggest trying specific techniques in counselling (i.e., relaxation exercises). If you have any questions about these techniques, it is important you ask. It is also important to know you have the right to stop any exercise at any time during the session. Counselling is one form of treatment for client problems- other forms include medications for psychological symptoms, church groups, and physical activity (e.g., exercises). Feel free to ask your counsellor for referral information.
- Cannot have any other kind of business relationship with you besides the therapy itself.
- Cannot be your therapist if they are related to you or if they are your friend.
- Cannot give legal, medical, financial, or any other type of professional advice.
- You are in imminent danger of harming yourself or know of another person in harms way
- You will harm another person
- A child (age 0-18) is being abused, neglected or is a witness of abuse
- A dependent adult is being harmed or abused
- If your record is subpoenaed. The counsellor may advocate limiting the information admissible, but the court can access your file.
Should you wish to discuss your situation with another individual or agency, you will need to complete a release of information form stating who your counsellor is allowed to speak with and the type of information I can release.
- A copy of your transcripts (in selected cases)
- Your intake form
- Consent to release information form
- Consent to participate in counselling form
- Copies of any letters written on your behalf
- Case notes
The information below focuses on providing healthcare services using the phone or the Internet. Please read this section carefully and let the counsellor know if you have any questions.
- Risks to confidentiality. As telehealth sessions take place outside of your counsellor’s office, there is potential for other people to overhear sessions if you are not in a private place during the session. On my end, I will take reasonable steps to ensure your privacy. It is important; however, for you to make sure you find a private place for our session where you will not be interrupted. It is also important for you to protect the privacy of our session on your cell phone or other device. You should participate in therapy only while in a room or area where other people are not present and cannot overhear the conversation.
- Issues related to technology. There are many ways that technology issues might impact telehealth. For example, technology may stop working during a session, other people might be able to get access to our private conversation, or stored data could be accessed by unauthorized people or companies.
- Crisis management and intervention. Usually, I will not engage in telehealth with clients who are currently in a crisis requiring elevated levels of support and intervention. There may not be an option of in-person services presently, but in a crisis, you may require higher level of services. Before engaging in telehealth, I will develop an emergency response plan to address potential crisis situations that may arise during the course of telehealth work.
You may have to have certain computer or cell phone systems to use telepsychology services. You are solely responsible for any cost to you to obtain any necessary equipment, accessories, or software to take part in telehealth.
For communication between sessions, I only use email communication and text messaging with your permission and only for administrative purposes unless we have made another agreement. This means that email exchanges and text messages with my office should be limited to administrative matters. This includes things like setting and changing appointments, and other related issues. You should be aware that I cannot guarantee the confidentiality of any information communicated by email or text. Therefore, I will not discuss any clinical information by email or text and prefer that you do not either.
Treatment is most effective when clinical discussions occur at your regularly scheduled sessions. But if an urgent issue arises, you should feel free to attempt to reach me by phone. I will try to return your call within 24 hours except on weekends and holidays. If you are unable to reach me and feel that you cannot wait for me to return your call, and if you need immediate attention, contact your family physician or the nearest emergency room.
I (the counsellor) have a legal and ethical responsibility to make my best efforts to protect all communications that are a part of telehealth services. The nature of electronic communications technologies, however, is such that I cannot guarantee that our communications will be kept confidential or that other people may not gain access to our communications. You should also take reasonable steps to ensure the security of our communications (for example, only using secure networks for telehealth sessions and having passwords to protect the device you use for telehealth).
The extent of confidentiality and the exceptions to confidentiality that I outlined in my Informed Consent still apply in telehealth. Please let me know if you have any questions about exceptions to confidentiality.
During this time, it may not be possible to engage in in-person sessions to “check-in” with one another. I will let you know if I decide that telehealth is no longer the most appropriate form of treatment for you. If you decide telehealth is not optimal for you, it is important to let me know.
Assessing and evaluating threats and other emergencies can be more difficult when conducting telehealth than in traditional in-person treatment. To address some of these difficulties, we will create an emergency plan before engaging in telehealth services. If the session is interrupted and you are not having an emergency, disconnect from the session and I will wait two (2) minutes and then re-connect you via the telehealth platform on which we agreed to conduct treatment. If I do not connect via the telehealth platform within two (2) minutes, then call me on the phone number I provided you (876-564-8915).
The telehealth sessions shall not be recorded in any way unless agreed to in writing by mutual consent. I will maintain a record of our session in the same way I maintain records of in-person sessions in accordance with my policies.
If you have a concern about your counselling, I hope you will talk to your counsellor. I take criticisms and suggestions seriously and will try to respond with care and respect.
Having carefully read through the material above, and discussed any questions that you may have with the counsellor, please check off each item below accurately. You will be asked to enter your signature at the end. When you sign this document, it will represent an agreement between us.