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Informed Consent for Psychotherapy

 

General Information

The therapeutic relationship is unique in that it is a highly personal and at the same time, a contractual agreement. Given this, it is important for us to reach a clear understanding about how our relationship will work, and what each of us can expect. This consent will provide a clear framework for our work together. Feel free to discuss any of this with me. Please read and indicate that you have reviewed this information and agree to it by filling in the checkbox at the end of this document.

The Therapeutic Process

You have taken a very positive step by deciding to seek therapy. The outcome of your treatment depends largely on your willingness to engage in this process, which may, at times, result in considerable discomfort. Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings of anger, depression, anxiety, etc. There are no miracle cures. I cannot promise that your behavior or circumstance will change. I can promise to support you and do my very best to understand you and repeating patterns, as well as to help you clarify what it is that you want for yourself.

My passion is to help people gain a better understanding of themselves, by focusing on innate strengths coupled with a desire to change. As a team, we will work together in a safe, trusting, non-judgmental environment. You will be treated with empathy and understanding. My approach is tailored to the needs of each individual client. I integrate various aspects of your life including behavior, thoughts, feelings, and perception, in addition to uncovering experiences in the past that have a bearing on your life today.

My belief is that anyone can be helped to make better and healthier choices in life, leading to feelings of greater happiness and fulfillment. In addition, I believe that each person has the skills to live a more authentic life with the help of a guide who is empathetic and caring and in a safe place where you can freely share your hopes, dreams, and doubts and build on your personal strengths. Our work together is a collaborative team endeavor.

Trust is everything. Your ability to engage with me as your counselor will be the number one factor that determines how well we work together and help you to achieve your goals.

Confidentiality

The session content and all relevant materials to the client’s treatment will be held confidential unless the client requests in writing to have all or portions of such content released to a specifically named person/persons. Limitations of such client held privilege of confidentiality exist and are itemized below:

  • If a client threatens or attempts to commit suicide or otherwise conducts him/her self in a manner in which there is a substantial risk of incurring serious bodily harm.
  • If a client threatens grave bodily harm or death to another
  • If the therapist has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.
  • Suspicions as stated above in the case of an elderly person who may be subjected to these abuses.
  • Suspected neglect of the parties named in items #3 and #
  • If a court of law issues a legitimate subpoena for information stated on the
  • If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an

Occasionally I may need to consult with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your name.

If we see each other accidentally outside of the therapy office, I will not acknowledge you first. Your right to privacy and confidentiality is of the utmost importance to me, and I do not wish to jeopardize your privacy. However, if you acknowledge me first, I will be more than happy to speak briefly with you, but feel it appropriate not to engage in any lengthy discussions in public or outside of the therapy office.

About the therapist

I earned a BA in psychology from Rutgers University, NJ in 1989. I earned my Master of Arts degree in Clinical Mental Health Counseling through Argosy University’s Department of Psychology and Behavioral Sciences in 2013. I am a certified trauma specialist and have received Level 3 training in relationship therapy from the Gottman Institute.

I have had the privilege of living and working in three countries. Whilst resident in the UK and Canada I enjoyed sharing my knowledge whilst teaching high school students. Later, in the US, I assisted newcomers with their relocation, helping them to address all the issues that moving brings with it. Running my own art galleries over a number of years gave me a wonderful insight into the creative process and to the amazing people who through their paint and craft produce artworks to delight us.

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Informed Consent Agreement

BY CLICKING ON THE CHECKBOX BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD, AND AGREE TO THE ITEMS CONTAINED IN THIS INFORMED CONSENT DOCUMENT.