AGREEMENT FOR COUNSELLING

BETWEEN THE COUNSELLOR

AND THE CLIENT

HOW WE CAN WORK TOGETHER ONLINE – Basis for Our Agreement

COUNSELLOR SECTION

I can offer you online counselling either live, using a private chatroom (on MSN or Yahoo Instant Messenger) or by email. Whichever method you choose the following points form the basis for our working agreement.

Emails can be exchanged in two ways in my online counselling.

You may want to write to me as often as you like, knowing I will respond to all your emails on a set day each week (e.g. Thursday.]
Or you may want me to respond to each email as I receive it. I normally reply to emails within 48 hours and will let you know when this is not possible. Please indicate at the end of this note, which option you prefer.

My main email response to you I call a Therapeutic Email and that is the one I number. (I number the emails in a package in the subject line as TE1 of 3 or TE2 of 5 etc.) You may have a query after you have read a TE and you can send me a separate email about it which doesn’t count in the total.

Live Sessions need to be booked with me in advance by email. It normally takes 24 hours to arrange but can sometimes be done more quickly.

Confidentiality I keep our counselling sessions and records confidential as long as we are in a counselling relationship, then they are transferred to CD for a further six months, in case you wish to return for more counselling. After that, they are destroyed. I work to the Guidelines for Good Practice of my professional body, the British Association for Counselling and Psychotherapy where I am a Member.

Your identity and personal details will be protected by me and the only exceptions I will make are when I judge that there is serious risk to yourself or others or when I am compelled to by Law (e.g. if you disclose an act of terrorism). In the rare event that I break confidentiality, this is done with your prior knowledge wherever possible and only to people who absolutely need to know (e.g. doctors).

Referral It is not always possible to know at the beginning, if working online is the most appropriate way for you to get help. If I believed that face to face counselling would be a better way to help you I would suggest that either we hold face to face sessions or, if this were not possible, I would help you to find a counsellor near to you and support you whilst you made the change to face to face.

HOW WE CAN WORK TOGETHER ONLINE – Basis for Our Agreement

CLIENT SECTION

Please ask any questions before completing the blank spaces below and returning the form to me with your next email.

I have read through and agree with the previous page of this Agreement. I confirm that I am over 16 years of age and that the information given by me here is accurate to the best of my knowledge.

Basic Details about me

Name …

Telephone number (in case of technology failure during live sessions)…

Email address …

Communication

I would like us to communicate in the following way (please put X against the option you prefer – you can always change it later)

Receive email responses on a set day each week (indicate which day)

eg Tuesday .. Thursday .. Friday ..

Book a ‘live’ session during the following times

(indicate the days/times which would suit you best)

eg Mondays (6 - 9pm) .. Tuesdays (12- 4 pm) .. Fridays (4 - 6 pm) ..

The following information is optional.

Name of GP ...

(only contacted with your prior knowledge)

Tel. No. of Surgery …

(please include full dialling code)

Date of commencement of this Agreement …