Your personal details are needed for
Without knowing your identity I cannot have deemed to have obtained
informed consent (for counselling).
In the normal course of counselling there should be no need to contact
you between sessions. However I may need to cancel a session at short
notice due to unforeseen circumstances such as illness, in this case I
would need to email you or text you (and I would appreciate you doing
If an emergency situation arouse, I may need to inform someone of your
At the moment the possibilities are
Skype or FaceTime (with an embedded counselling room due to be added by
March 2013). So in this section please confirm which you
would like to use and supply the necessary ID or associated Email
address (possibly phone number) so I know who is calling me / adding me
/ sending me a contact request (many people use aliases online and I
would not like to reject you by mistake!)
In all communications with Central
England Counselling, the Client agrees to honestly represent their
identity and Personal Information.
Client must be over 16 years of age.
Counselling sessions will take place on ‘online’
Counselling session will last between 55 and 65 minutes (with an
intended average of 60 minutes), at the discretion of the Counsellor.
Counselling will be open ended (not limited to a specific number of
sessions) and will be periodically reviewed by the Client and
Counsellor, to assess and agree that it is of benefit to the client.
Client will be responsible for initiating the call at the booked time.
session will start at the agreed/booked time. If the Client is late
‘logging on’ the session length can only be extend beyond the original
agreed end time at the discretion, good will and availability of the
Client agrees to give the Counsellor as much notice as possible if the
need to cancel arises. Two cancellations in a row by the
client will deemed to have broken any contract or commitment (legal or
ethical) the Counsellor has to the Client, and the Counsellor will have
the right to refuse any further bookings by the Client.
Counsellor agrees to give the client as much notice as possible of any
illness or event that may prevent them being available for a scheduled
session. The Counsellor will try to offer an alternative arrangement.
Counsellor reserves the right to cancel or curtail a session if the
Cient appears to be unduly under the influence of alcohol or other
Counsellor is a member of the British Association of Counsellors
& Psychotherapists and will work within their ethical framework.
England Counselling agree not communicate your Personal Information to
anyone without your consent, other than the following exceptions:
While receiving regular supervision (by another qualified counsellor)
which is a requirement of the British Association of Counsellors and
Psychotherapists. Supervision may involve the Counsellor
disclosing your personal information to their Supervisor. The
Supervisor is in turn bound by the same rules of confidentiality as the
Counsellors have both a legal and ethical requirement to report any
suspicion of child abuse or risk of child abuse to appropriate child
If there is reason to believe that a person's life (yours or that of
another) may be in danger the situation will be reported to an
appropriate authority (in the case of it being your life the
appropriate action may be agreed between us).
If there is reason to believe that a person (you or another) is at risk
of serious harm, the situation will be reported to an appropriate
authority (in the case of serious harm to yourself the appropriate
action may be agreed between us).
Courts of law may have the power to demand the release of your records
if you are involved in a court case and the court believes your
communications with your Counsellor has a bearing on that case.
Counsellors are responsible by UK law to report acts or potential acts
of terrorism serious crime or money laundering.
England Counselling's ability to fulfil these obligations are limited
by the information that you provide.
are advised to check and keep contact details up to date, failure to do
so releases Central England Counselling from any ethical and/or legal
obligation to warn of life threatening situations. You are
also advised that even if Central England Counselling has your correct
contact details we may in practice only become aware of any life
threatening situations AFTER those situations have arisen and past.
possible confidentiality will not be broken without
first discussing the issue with the client.
Records – Brief written ‘session notes’ may be kept by the
Counsellor. They will be kept in a secure place, and separate
from any names or contact details (notes and names or contact details
will be linked by a code system known only to the Counsellor).
In the event of the Counsellor’s death they will be
destroyed (by the Counsellor’s Supervisor) otherwise they
will routinely be destroyed after two years.
Client’s personal details and notes will NEVER be passed to a
3rd party unless specifically requested by the Client or
demanded by a court of law.
Counsellor and Client agree that without the explicit permission of the
other being obtained beforehand a session may not be recorded under any
Fees: The cost of each session will be 40.00 GBP. The Client
will be required to book (and pay) for each session before the session
is due to take place. The Counsellor is under no obligation
to continue the counselling sessions if the fee is not paid.
Further conditions, may be added to this contract with the
mutual consent of the Client and Counsellor.
The Client agrees to be bound by Internet regulations,
policies and procedures.
Cient agrees to comply with all applicable local, national and
international laws and regulations.
is good practice to ensure that your computer is running anti-virus
England Counselling does not guarantee that its online Counselling
Service will be uninterrupted nor does it guarantees the availability,
reliability, timeliness or appropriateness of the Service.
the event of a session terminating before time due to technical
difficulties judged (by the Counsellor) to be the fault of the
Counsellor’s equipment or connection ...
If the session has run less than 35 minutes, the Client will have the
choice of a refund for that session or their next session (55-65
minutes) free of charge.
If the session has run between 35 and 50 minutes the Counsellor will
agree to adding that time to the next session if the Client wishes, but
no refund will be given.
If the session has run for 50 minute it will deemed to have been a
In the event of a session terminating before time due to
technical difficulties judged (by the Counsellor) to be the fault of
the Clients equipment or connection ...
Client accepts and agrees that the Counsellor is under no obligation to
offer any further time or refund.
Although not forming part of these
conditions in any way: the Counsellor may or may not suggest as a good
A session lasting less than 35 minutes long may be re-arranged
free of charge.
In a session lasting between 35 and 50 minute the missing time may be
added to the next session.
A session lasting over 50 minutes will be deemed to have been
Client agrees that it is the Counsellor’s sole prerogative to decide
those equipment or connection is at fault and that this decision is
final, and no correspondence will be entered into regarding this
decision after it has been made.
England Counselling is not responsible for any damages whatsoever as a
result of the loss of use of computer equipment or data. The
sole remedy is for the Client to discontinue their use of Central
England Counselling’s Online Services.
Client agrees that Central England Counselling cannot be held
responsible for any third party claim, demand, or damage, including
Legal fees, arising out of your use of Central England Counselling’s
Online Counselling Service
rights not expressly granted herein are reserved.
There are some circumstance in which
I cannot offer you Online Counselling.
are also some circumstances in which you may like to reflect on whether
Online Counselling is the best option for you. If any of the
following situations are applicable to you please follow the hyper-link
for further information.
are living outside the UK?
are under the age of 18
are uncomfortable or inexperienced using a computer?
are currently seeing another counsellor?
are feeling suicidal?
are taking medication?
Sometime medication and Counselling
do not mix! In a first session I will usually ask if you are
on any medication. Due to the many types of medication and
their trade names I will often not know what effects or side-effects
that medication may have .. I will usually go and ‘look it up’ after
the first session. It is possibly useful therefore if I have
advance knowledge of any medication that you think may have an effect
on our ‘Counselling Relationship’ or are unsure of. This is
an optional discloser (just as it will be in the first session) but I
cannot be held responsible if you conceal the fact you are on a
medication, that later proves to have a bearing on the ‘Counselling’
(this would usually be a ‘strong’ anti-depressant or an anti-psychotic
drug). So if you would like to: please list the name and
dosage of any medication you are currently taking in the box below.
1 ... Pre-assessment form
2 ... Personal Details
3 ... The counselling contract
6 ... Medication
check you details carefully. I have no way of
knowing/checking if the details you are giving me are correct.
If they are incorrect this obviously limits what I could do
in an emergency situation.
you would like to give me the details of an emergency contact
(relative, friend doctor) please enter them in the box below (this is optional). This contact would only
ever be used in an emergency situation and if possible your permission
would be obtained beforehand. For example: if you were taken
ill while we were online or if I thought that you were in danger of
causing yourself serious physical harm (although I may be prepared to
agree/contract to taking no action in these circumstances).
5 .... How would you like to connect
I have read and understand the pre-assessment
Date of birth
I confirm (as the Client) I have read,
I will be using Skype
I will be using FaceTime
How would you like to be contacted in
a non-emergency situation.
example: I need to cancel at short notice due to ill health.
me an Email:
my Mobile Phone:
my Land-line Phone:
I confirm that: I have read understand
and accept to the above contract