A helpful reminder of what is usually discussed during your initial sessions. Print the card for reference.
The First Steps
Do you remember your first appointment with your new therapist? I'd imagine that there was a lot happening for you that day. Negotiating car parking, finding the location, keeping yourself on time - all the while you are thinking about why you have come. Wondering what will the therapist be like? How will I know if he heard the bell? Will anyone see me entering the therapy centre? Is there a loo?
It is an important step, that first session. It signifies a moment in your life when you have decided to explore the options for the challenges that you are facing. You have decided to trust another person with your personal thoughts and feelings, you have also decided to trust yourself in that communication too.
So I have wondered how might I help to make these initial steps into your therapy process more accessible, supported and informative. The process itself will depend on the relationship we build as you attend over a period of sessions. I hope that my approach will encourage you to trust me and the psychotherapeutic process so that you can talk about everything that is on your mind, in your heart and in your experience.
During the initial sessions one of the important things we will need to do is talk about a working agreement. It's a framework of how we might work together. For example we will agree a regular day and time for your appointment. We will talk about attendance, timekeeping and keeping to a consistent regular schedule. By agreeing a framework we are actively creating a therapeutic space for you. One which is built on trust, respect, openness, honesty - something that has clear and fair rules of engagement.
For example, the cancellation policy is designed with life and people in mind. Things happen, events and life will at times conspire to challenge your attendance. The cancellation policy is designed to allow for those things that are out of your control and those that aren't. Please take note of this part of our working agreement - read it now - or print and cut it out for reference so that you won't be caught or disappointed when the cancellation policy applies. We will talk more about this should a cancellation occur.
Besides the 'housekeeping' and logistics of committing to a psychotherapeutic process there is one further area of importance that I'd like to draw your attention to. It concerns the concept of confidentiality and what that means in counselling. It is very important that you have a full and assured understanding of what this means, what it implies and what are the ethical and legal requirements under which counselling falls. Please read the paragraphs below to familiarise yourself with these limitations. I will discuss all aspects of confidentiality, including any concerns you may have, in our initial sessions. If you have any questions please do not hesitate to ask me. You can use the online enquiry form by clicking here or we can talk directly when we meet.
Confidentiality ( & the limits ) in Counselling and Psychotherapy
What does ‘Confidentiality’ mean in Psychotherapy and Counselling?
I aim to provide a consistent, safe and private space where I hope you will feel able to talk about whatever is on your mind. To do this all personal information is treated in the strictest confidence.
I believe that confidentiality and understanding the limitations of that confidentiality is an essential prerequisite to effective professional and ethical counselling and psychotherapy.
I am also bound by the IACP Code of Ethics and Practice for Counsellors, Psychotherapists and Supervisors which includes the Limits of Confidentiality.
At the first meeting I will clearly explain about the rare occasions when confidentiality might be broken with or without your consent. If at any stage you are unclear or do not understand these limitations I will be happy to explain them further. Please familiarise yourself with the summary below:
Summary of ethical and practice focus points concerning Confidentiality and the Limitations of Confidentiality in Counselling & Psychotherapy
- When information given by a client indicates that minors (under 18 years of age) maybe currently at risk of physical, sexual, emotional abuse and/or neglect.
- When a client is actively suicidal, and a need for a supportive safety net is identified, confidentiality may be limited to ensure as far as possible a client's safety. This may include contacting elected family members, a G.P. and other named or relevant people on the client's behalf. In as far as possible a safety plan will have already been agreed upon so that the client is participative in electing to put the plan into action.
- On the occasion where files / notes are subpoenaed by the courts.
- When there is an indication that a client may pose a threat to others, that threat includes physical, sexual, emotional abuse and/or neglect of minors and/or adults by a client.
The Code in Detail
(excerpt containing considerations of Confidentiality)
Below is an excerpt from the Code of Ethics and Practice which binds all practising counsellors and psychotherapists who are members of the Irish Association for Counselling & Psychotherapy (I.A.C.P.). Please click here if you would like to read the full code featured on the I.A.C.P. website.
1.0. Respect for the Rights and Dignity of the client
Practitioners honour and promote the fundamental rights, dignity and worth of clients.
They respect clients' rights to privacy, confidentiality, self-determination and autonomy, consistent with the practitioner's other professional obligations and with the law.
More specifically, practitioners shall:
1.1.1.Have sensible regard for clients' beliefs and values.
1.1.2. Not allow their service to clients to be diminished by factors such as gender, sexual orientation, disability, religion, race, ethnicity, age, national origin, party politics, social standing or class.
1.1.3. Convey sensible respect for prevailing community mores, social customs and cultural expectations.
1.1.4. Work in ways which promote clients' personal autonomy.
1.2. Privacy and Confidentiality
1.2.1.Ensure that the setting for sessions is appropriately private.
1.2.2. Treat in confidence personal information about clients, whether obtained directly or indirectly or by inference. Such information includes name, address, biographical details, and any descriptions of the client's life and circumstances which might make the client identifiable by others.
1.2.3. Ensure that information which may lead to the identification of clients is not transmitted through overlapping networks of confidential relationships.
1.2.4. Break confidentiality only where required by law, or where there are grounds for believing that clients will cause physical harm to themselves or others. Where feasible, practitioners shall endeavour to obtain the client's consent, and consult their supervisor or an experienced colleague, in advance of any such disclosure. However, in emergencies, practitioners shall make their own judgment as to what action is best.
1.2.5. Minimize any breach of confidentiality by conveying only that information which is necessary, and only to relevant persons.
1.2.6. In supervision and consultation with colleagues, reveal only that information about clients which is relevant for those purposes.
1.2.7. Discuss the limits of confidentiality with the client at the time of initial contracting, the discussion to include the implications for confidentiality of the supervisory relationship.
1.2.8. Store, handle, transfer and dispose of all records (including written, electronic, audio and video) securely and in a way that safeguards the client's right to privacy.
1.3. Informed Consent and Freedom of Consent
1.3.1. Ensure that the client consents to participate at all stages and respect clients' right to discontinue at any time.
1.3.2. Provide reasonable opportunity during the course of the relationship for review of the terms on which the service is being offered.
1.3.3. Not normally act on behalf of their clients. If they do, they shall ensure that the client consents in advance to any proposed action.
1.3.4. Where the client is concurrently engaged in another professional helping relationship, obtain the client's permission before conferring with the other professional.
1.3.5. Obtain the client's consent before making audio or video recordings of sessions.
1.3.6. Obtain the client's consent to attendance at sessions by third parties.
1.3.7. When publishing research or case studies concerning clients or supervisees, ensure that identities are carefully disguised and obtain appropriate consent.
1.3.8. Written Permission from both parents / legal guardians should be obtained (where possible) by therapists before commencing therapy with a minor.
1.3.9 If it is not possible to obtain written permission from both parents / legal guardians then written permission must be obtained by at least one parent / legal guardian prior to the commencement of therapy.