Psychotherapy Agreement

This agreement (“Agreement”) is between John Dray (“Therapist”) and
[insert name of client] (“Client”).

  1. Purpose and Scope of Therapy We agree to work together to help you achieve your goals and objectives for therapy. We’ll decide together what we’ll work on and how we’ll do it, and we can change it if needed.
  2. Confidentiality What you share with me is confidential, and I’ll keep it that way unless I’m required by law to share it or if it’s necessary to protect you or someone else. The way that I handle your data is outlined in the GDPR Statement. (The relevant UK act is the Data Protection Act 2018 implementing EU Regulation 2016/679.) There may be circumstances, e.g. to save a life or prevent harm, where I have to reveal confidential information. If this is necessary, I will endeavour to get your permission first unless is it not reasonably practical, or I am required by law not to get your permission (e.g. Terrorism Act 2000)
  3. Supervision As a trainee therapist, I am required to record sessions. This is to help me offer the best therapy to you. Anonymous transcripts of these recordings will be used both in my supervision and to allow me to complete case studies as part of my training. To maintain confidentiality, your details will be obscured.
  4. Fees The fee for each session is £35, and you’ll pay at the time of service. If we need to adjust the fee, I’ll let you know ahead of time. If you need to cancel a session, please let me know at least 7 days in advance, or you’ll be charged the full fee. The fee is for a session of 50 minutes. Other services may be charged at different rates. This will be made clear at the time.
  5. Limits of My Expertise I will not know everything about every problem. If you’re not happy with how therapy is going or if you need help with something I can’t help with, please let me know so we can figure out what to do next. If you have concerns about treatment, I abide by the Welsh Psychotherapy Institute (WPI) Code of Ethics and you can raise concerns with them: Raising Concerns. In turn, the WPI are governed by the UKCP.
  6. Agreement to Participate in Therapy To make the most of our time together, please come to sessions at the time agreed. If you are more than ten minutes late then the session is cancelled, but the full fee is still payable.
  7. Limitations of Liability Therapy is not without risk, but I’m not responsible for any damages that might happen, except in cases of gross negligence or intentional harm. I do hold professional indemnity insurance.
  8. Governing Law This Agreement is governed by the laws of England and Wales.
  9. Specific Laws Other laws that may affect this agreement include but are not limited to: Drug Trafficking Act (1986), Road Traffic Act (2000), Terrorism Act 2000 section 38B, as amended by the Terrorism, Crime and Security Act 2001, the Children’s Act 1989 and 2002, Safeguarding Vulnerable Groups Act 2006, Care Act 2014.
  10. Ending Therapy You or I can end therapy at any time for any reason by giving notice of three weeks. This will allow us to bring the therapy to satisfactory conclusion. If you decide that you want to work with a different therapist, I can help you find someone else to continue treatment.
  11. Entire Agreement This Agreement is our complete understanding of our work together and replaces any earlier agreements we might have made.

Please let me know if you have any questions or concerns.

 

If we agree to online therapy then the following also applies:

 

Psychotherapy Agreement Addendum: Online Therapy

1. Requirements and Responsibilities

Internet Connection and Technology Setup
You are responsible for ensuring a stable internet connection and having the necessary devices and software installed and updated for video or audio calls. This may include ensuring your camera and microphone are functional prior to the session.
You need to take time to prepare for the session and have a pen and paper handy to note things down

2. Technical Issues and Interrupted Sessions

If the session is interrupted due to technical issues (e.g., poor internet connection, power cuts), I will make up to two attempts to reconnect during the scheduled time. If reconnection is not possible:

If the session is interrupted in the first 20 minutes, I will reschedule a replacement session at no additional cost.
If the session is interrupted after 20 minutes, it will be considered a full session, and no refund or rescheduling will be offered. Exceptions may be made at my discretion based on the circumstances.

3. Missed Sessions or Late Arrivals

It is your responsibility to join the online session at the agreed time. If you are more than 10 minutes late without prior notification, the session will be considered a ‘no-show’, and the full fee will still apply. For missed sessions due to technical issues on your side, the same policy applies unless it is deemed a one-off, unexpected event.

4. Alternative Communication

If reconnection is not possible due to ongoing technical difficulties, please be prepared to continue the session via a different medium, such as a phone call, if suitable for both parties. Please ensure I have an up-to-date emergency contact number to facilitate this.

5. Confidentiality in an Online Setting

I take all reasonable measures to maintain confidentiality in online therapy sessions. However, I cannot guarantee complete security due to the nature of internet-based communication. It is recommended that you use a secure, private internet connection (not a public Wi-Fi) and ensure that your device has appropriate security measures (e.g., updated antivirus software).

6. Secure Environment

Please ensure you have a private space where you will not be overheard or interrupted. Please make sure your counsellor knows of any risks within the home and whether it is not a good time for counselling.

7. Consent to Record Online Sessions

With your permission, I may record online sessions for training and supervision purposes. You will be asked to provide specific consent before any recording is made, and all recordings will be stored securely, in line with GDPR requirements.

8. Crisis and Emergency Situations

Due to the limitations of online therapy, if you experience a crisis during or outside of sessions, please seek immediate help from local emergency services. If a crisis occurs during our session, I will support you as best as I can until we agree on an appropriate plan, which may include contacting a local emergency contact or your GP.

9. Termination of Online Therapy

If connectivity issues or consistent disruptions occur, I may suggest switching to another format (e.g., in-person) or recommend terminating our work if online therapy is not conducive to your therapeutic progress.