INFORMED CONSENT

The purpose of this form is to share some important principles with you that will guide the therapeutic practice. Based on this information, you can make your decision as to whether or not to continue our therapeutic relationship with informed expectations. Please read this carefully, and feel free to ask any questions if you would benefit from clarification.


“I” throughout this document refers to Dr Catrin Williams

“you” throughout this document refers to the individual booking the service.


THERAPY INFORMATION

Therapy is a process, which relies heavily on building a trusting relationship between therapist and client. This takes time in order for a person to open up and for the therapist to understand what he or she is struggling with. I utilise practices from Schema therapy, which is a therapy that requires time, and a solid therapeutic relationship. If you are looking for a more short-term solution, then I may not be the right Psychologist for you.

CONFIDENTIALITY

All information disclosed within sessions and the written records pertaining to those sessions are confidential and may not be revealed to anyone without your written permission except where disclosure is required by law or if I consider you to be a risk to yourself or others. In this case, I may contact the police.

EMERGENCY

If there is an emergency during therapy, or in the future after termination, where I become concerned about your personal safety, the possibility of you injuring someone else, or about you receiving proper psychiatric care, I will do whatever I can within the limits of the law, to prevent you from injuring yourself or others and to ensure that you receive the proper medical care. For this purpose, I may also contact the person whose name you have provided, or the police in extreme cases. I am not a crisis service, which means that I will not take any responsibility over your safety if you are experiencing a period of crisis. If this is something that you might struggle with, we will develop a ‘crisis plan’ together. This will outline what emergency/crisis services that will be available to you and this will be your support network between our sessions.

HEALTH INSURANCE & CONFIDENTIALITY OF RECORDS

 Disclosure of confidential information may be required by your health insurance carrier in order to process the claims. If you so instruct, only the minimum necessary information will be communicated to the carrier. I have no control over, or knowledge of, what insurance companies do with the information submitted or who has access to this information.

CONSULTATION

I may consult with other professionals regarding my clients; however, each client’s identity remains completely anonymous and confidentiality is fully maintained.

ONLINE AND PHONE COMMUNICATION

Should you utilise email, text or a phone call to communicate with me, and share no concerns about this, I will take this as your confirmation and consent to utilise this as a mode of communication. I will take no responsibility if this information is somehow viewed or apprehended from your means of communication (E.g., phone or computer).  

LEGAL PROCESSES

Sometimes clients become involved in a legal issue while they are in therapy or after therapy has been completed. I draw your attention to the fact that under the Data Protection Act (1988) I may be obliged to supply copies of our therapy records to a requesting appropriate party providing you consent. If the client discloses that they have committed an offence unknown to the police, then it is my responsibility to inform the police of this. 

RECORDS

Notes may be taken during and after each session, which will be kept in accordance with the Data Protection Act (1998).   These notes will be securely stored. I will discuss the disposal, retention or otherwise of any such notes at the end of our engagement. They are disclosed to no one other than the clinical supervisor, unless required under a court of law or if I feel they need to be shared to ensure your safety or the safety of others around you. You have the right to inspect your records should you so wish, and this request will be fulfilled during a therapy session.

TELEPHONE & EMERGENCY PROCEDURES

If you need to contact me between sessions, please leave a message on my phone or email me and I will get back to you as soon as possible. If an emergency arises please contact The Samaritans or appropriate emergency services. Please note that I run an appointment-based system and do not offer any emergency support.

PAYMENTS & INSURANCE REIMBURSEMENT

Clients are expected to pay the standard fee (see fee list) per session at the booking of each session unless other arrangements have been made.

TERMINATION

You have the right to terminate therapy and communication at any time. If you choose to do so, upon your request and if appropriate and possible, I will provide you with names of other qualified professionals whose services you might prefer.

CANCELLATION

Since the scheduling of an appointment involves the reservation of time specifically for you, a minimum of 48 hours (2 days) notice is required for re-scheduling or cancelling an appointment. Unless we reach a different agreement, the full fee will be charged for sessions missed without such notification. I retain the right to terminate or suspend sessions at any time without having to give a reason. This may be due to perceived risk to myself, or due to conflicts in the therapeutic relationship. Should this occur, it will be openly discussed and reviewed with you.